Health and Social Care Update - January 2014

Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

Clinical Risk/Health and Safety	Mental Health
Commissioning	Patient and public engagement
Employment/HR	Primary Care
Finance	Procurement
Foundation Trusts	Public Health
Governance	General

Clinical Risk/Health and Safety

Publications/Guidance
Learning from Maternity Claims. This note published by the NHS LA together with a press release was published on 10 January 2014.

State of maternity services report 2013. This report looks at a number of indicators of the pressures on maternity care and the resources available to cope in England, Scotland, Wales and Northern Ireland. It focuses on the latest available statistics, revealing what is happening on the frontline of care.

Saying sorry. The NHS Litigation Authority (NHS LA) has issued further guidance which supports and encourages Trusts to apologise to patients.

Patient safety alert on placement devices for nasogastric tube insertion. ​​A patient safety alert was issued on 5 December 2013 by NHS England on the use of placement devices for inserting nasogastric tubes. This alert has been issued via the Central Alerting System (CAS) to ensure all hospitals and community services that use nasogastric tubes continue to follow previous guidance issued by the National Patient Safety Agency (NPSA), even when placement devices are used.

Infectious Respiratory Viruses – the use of facemasks and respirators. NHS England has updated guidance on respiratory protection. This information replaces the previously issued material for dealing with patients who may have been infected with influenza, to support clinicians in their individual risk assessment which indicates they need to use respiratory protection.

News
NHS England announces a further £150m to improve patient safety and care. Announces changes to acute services' tariff, giving hospitals an additional £150m to both improve safety and ensure patients are treated with care and compassion, such as employing extra nurses. The money is to come out of Clinical Commissioning Groups' usual financial settlement.

NHS pays out for mental health failings. A man who saw his father beaten to death by his schizophrenic brother has criticised the NHS mental health system. Following a legal battle, the man secured a payout from the NHS to fund private treatment for the post traumatic stress disorder and depression he suffered after witnessing the killing. In February 2008, the NHS discharged Richard Thorp, Robert Thorp’s brother, after withdrawing him from his psychiatric medication. Following his discharge, Richard killed his father in front of Robert. In 2011, an independent report into the killing was carried out. The report concluded NHS failings had resulted in Richard not being as responsive to his treatment, however no direct connection was made between the killing and NHS failings. As a result, the NHS made an out-of-court settlement with Robert to assist in his treatment for post traumatic stress disorder.

National register for breast implant operations. Breast implant operations will be logged on a national register in a bid to avoid a repeat of the PIP scandal. The registry will be piloted from January 2014. In the New Year, the government is also expected to announce it will adopt the majority of recommendations in a report into the implant scandal by Professor Sir Bruce Keogh.

MPs conclude that secrecy by pharmaceutical companies could put patients at risk. The Public Accounts Committee has criticised pharmaceutical companies and has expressed "extreme concern" that patients are at risk of being prescribed drugs wrongly because doctors are denied access to research on how effective they are. The Committee found that about half of all clinical trials are never published, with results favourable to a drug about twice as likely to be made public as negative ones.

NHS patients on drips at risk of serious errors. Patients' lives are being put at risk because of errors in intravenous (IV) fluid care, warns NICE. Despite being an extremely common treatment, a lack of training for healthcare professionals has resulted in patients receiving too much or too little fluid, or even the wrong type of fluid.

Bevan Brittan Events
Clinical Risk Claims and Complaints Forum 06 February 2014 : Timings TBC. Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. This regular seminar addresses a variety of clinical risk and complaints related issues. Further information about the exact topics that will be discussed in this session will be provided closer to the date of the seminar.

If you wish to discuss any clinical risk or health and safety issues please contact Joanna Lloyd or Stuart Marchant .

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Commissioning

Publications/Guidance
Planning and delivering service changes for patients. NHS England has published a good practice guide to assist CCGs when developing proposals for major service changes and reconfiguration. This guidance builds on earlier best practice guidance developed prior to the new commissioning system, but has been brought up to date, reflecting the roles and responsibilities of commissioners to deliver improvements in services for patients and local communities. The new guidance provides a one stop resource for the principles and processes for building proposals for major service change, including how to develop the business case, assess proposals against the Government’s ‘four tests’, as well as how to assure patient and public engagement is at the heart of the process. The guidance will supplemented by an assurance toolkit which sets out how NHS England will support and assure local commissioning proposals.

Everyone Counts: Planning for Patients 2014/15 - 2018/19. This guidance sets out the need for bold and ambitious five year strategic plans from NHS commissioners. It describes an approach to deliver transformational change with the first critical steps over the next two years, to achieve the continued ambition to secure sustainable high quality care for all, now and for future generations.

Better Care Fund. Letter to local authorities from Local Government Minister Brandon Lewis and Care and Support Minister Norman Lamb about the Better Care Fund.

Improving access to health care for gypsies and travellers, homeless people and sex workers: An evidence-based commissioning guide for Clinical Commissioning Groups and Health & Wellbeing Boards. This commissioning guidance from the RCGP and DH says that radical changes are needed to meet the healthcare needs of vulnerable groups, including sex workers, gypsies and travellers and homeless people. it says that GPs who commission services in England under the Health and Social Care Act 2012 should consider paying for mobile units and clinics, and other outreach facilities. Cultural awareness training for frontline NHS staff dealing with gypsies and travellers is another key recommendation in this new guidance, which aims to improving access to healthcare for vulnerable groups.

Consultations
Change proposals for specialised services NHS England is currently developing a five year vision and strategy for the commissioning of specialised services. As part of this work NHS England is inviting ideas from patients, public and professionals for ideas of how changes could be made to specialised services. The first round of submissions will close on 28th February 2014.

Bevan Brittan Updates
The NHS - challenging times for commissioners and providers. As 2013 drew to an end, the press described it as the NHS’ “annus horribilis” because of bruising reports about quality of care. There was also the controversy around the role independent sector providers play in delivering our care. Many saw the introduction of The NHS (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 as heralding compulsory tendering of all health service contracts, leading inexorably towards “privatisation of the NHS”.

Better Care Fund plans: How does it fit? Work on the Better Care Fund (BCF) plan has already started for most CCGs and local authorities with a timescale that is very short indeed - the 2 year plan needs to be completed by March 2014.

Bevan Brittan Events
Mergers, Acquisitions and Service Change in the NHS: Competition Law Aspects. 27 February 2014 : 10:00-12:30 (registration opens at 09:30) The seminar will be followed by lunch. Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct,London, EC4M 7RF. Bevan Brittan together with Oxera have joined their professional expertise in order to deliver the ' Mergers, Acquisitions and Service Change in the NHS: Competition Law Aspects' seminar. The seminar aims to examine the legal and commercial issues involved in mergers, acquisitions and service change in the NHS, and the lessons that can be learnt from recent successful and unsuccessful mergers, including the case of the Royal Bournemouth and Christchurch Hospitals and Poole Hospitals Trust.

Social impact bonds. 07 May 2014 : Timings TBC. Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. This seminar will provide an overview of the key legal issues associated with social investment projects, including social impact bonds (SIBs), for commissioners and providers including the alternative legal structures, use of corporate vehicles, investor issues and the payment by outcomes contract.

If you wish to discuss the issue of commissioning please contact David Owens.

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Employment/HR

Publications/Guidance
Emergency medicine – background to HEE proposals to address workforce shortages. The board of HEE has agreed joint proposals from HEE and the College of Emergency Medicine to address workforce shortages in emergency medicine. This report contains proposals and recommendations for improvements in the future workforce of emergency departments to ensure that patients receive consistent, high quality, safe and effective care.

NHS services, seven days a week – costing seven day services. This report looks at the financial implications of seven day services for acute emergency and urgent services and supporting diagnostics.

Cases
West London Mental Health NHS Trust v Chhabra [2013] UKSC 80 (Sup Ct). The Supreme Court has allowed an appeal against the CA's decision that the NHS trust had been entitled to convene a conduct panel in disciplinary procedures against a doctor, C. The court held that a case manager handling a complaint against a medical practitioner had discretion in the formulation of the matters to go before a conduct panel, provided that they were based on a case investigator's report and its accompanying materials. However, in this case there had been a number of irregularities in the NHS trust's disciplinary proceedings against C which cumulatively rendered its convening of a conduct panel unlawful as a material breach of her contract of employment.

Consultations
Consultation on revalidation and the revised code. This is the first part of a six-month public consultation and it focuses on how the proposed model of revalidation can be implemented in a variety of employment settings and scopes of practice. The consultation also seeks to gather information to draft a revised code and develop guidance for revalidation. This consultation will close on 31st March 2014.

Bevan Brittan Updates
Collective conscience. The Court of Appeal has looked at whether a Council was justified in asking a Christian care worker to work weekends, despite her belief that Sunday should be a day of rest. In coming to its decision, the Court of Appeal has helped to 'fill in the gaps' in our understanding of the 'group disadvantage' aspect of indirect religious discrimination, following the decision of the European Court of Justice in Eweida v UK, earlier this year. Sarah Maddock looks at where these recent cases leave us.

Employment news round-up, December 2013. Laurie Child brings you the final Employment news round-up of 2013 : the latest details on shared parental leave; whistleblowing news; details of the proposed new Acas Code following the EAT's surprise decision earlier this year, that an employee's choice of companion does not have to be reasonable – plus the commencement date for new TUPE has been announced.

Long-term sickness absence. It's an all too common problem for employers: how to deal with the fair dismissal of an employee who has been absent from work for a prolonged period of time due to ill health. A recent Scottish Court of Session case, called BS v Dundee City Council, has provided welcome clarity on this difficult question. John Moore looks at the details.

If you wish to discuss any employment issues or any of the items raised in this sectin please contact Julian Hoskins or James Gutteridge.  

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Finance

Publications/Guidance
NHS services, seven days a week – costing seven day services. This report looks at the financial implications of seven day services for acute emergency and urgent services and supporting diagnostics.

2014/15 national tariff payment system. These new rules allow local experiments in ways of paying for NHS-funded services in order to develop innovative new models of care for patients.

NHS England publishes CCG funding allocations for next two years following adoption of new formula. NHS England has published the funding allocations that CCGs will receive over 2014/15 and 2015/16. This follows the NHSE Board's decision to adopt a new funding formula for local health commissioners that will more accurately reflect population changes and include a specific deprivation measure. Funding for NHS commissioners will rise from £96bn to £100bn over the next two years. The funding allocations will be aligned with new NHS planning guidance that asks commissioners to prepare both two year operational plans and five year strategic plans. Everyone Counts: Planning for Patients 2014/15 to 2018/19 describes NHS England’s ambition for the years ahead and its ongoing commitment to focus on better outcomes for patients. It describes the vision for transformed, integrated and more convenient services, set within the context of significant financial challenge. The planning guidance is accompanied by a suite of support tools intended to assist commissioners with their planning considerations to maximise the best possible outcomes for their local communities.

Consultations
Risk assessment framework: addendum for assessing risk at independent providers of Commissioner Requested Services. Since October 2013, Monitor has used the risk assessment framework to monitor financial and governance risks at NHS foundation trusts. The financial parts of the risk assessment framework will also apply to all independent sector providers of Commissioner Requested Services from 1 April 2014. This consultation puts forward a proposed approach to monitoring financial risk at those organisations. The consultation closes on 6 February 2014.

If you require further information about any of the items raised in this section please contact David Owens.

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Foundation Trusts

Publications/Guidance
Annual plan review 2014/15 guidance. This guidance on the 2014/15 planning round covers Monitor’s expectations for foundation trusts and sets out details of their forthcoming annual planning review process.

The NHS Foundation Trust Code of Governance. The NHS Foundation Trust Code of Governance (the Code) is Monitor's way of providing guidance to NHS foundation trusts to help them deliver effective corporate governance, contribute to better organisational performance and ultimately discharge their duties in the best interests of patients.

Meeting the needs of patients: improving strategic planning in NHS foundation trusts. This document is aimed at NHS foundation trusts; Monitor looks at what strategic and operational planning can achieve and how the sector can be supported in moving towards these goals. 

Bevan Brittan Updates
Francis Report update - the age of candour Robert Francis QC's report into the Mid-Staffordshire NHS Foundation Trust Public Inquiry was heralded as the 'NHS event of 2013'. However, this description may be wrong on both counts.

If you wish to discuss any issues relating to foundation trusts please contact Vincent Buscemi.

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Governance

Publications/Guidance
Securing sustainability: planning guidance for NHS trust boards 2014/15 – 2018/19. This guidance from the NHS TDA sets out what NHS boards should focus on to be able to continue to deliver high quality care today whilst taking the necessary action to ensure they can continue to do so in the future.

The NHS Foundation Trust Code of Governance. The NHS Foundation Trust Code of Governance (the Code) is Monitor's way of providing guidance to NHS foundation trusts to help them deliver effective corporate governance, contribute to better organisational performance and ultimately discharge their duties in the best interests of patients.

If you wish to discuss any issues relating to governance please contact Vincent Buscemi.

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Mental Health

Bevan Brittan Training - If you would like to know about our free lunch time training sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.

Publications/Guidance
Liaison psychiatry for every acute hospital: integrated mental and physical healthcare. This report summarises existing evidence of need for liaison psychiatry services in all acute hospitals and then provides evidence for the range of problems addressed, and range of interventions required, to meet core mental health demands in acute hospitals. It also contains case examples that demonstrate the benefit of services; provide detailed considerations for service design, including principle organisational standards, access and response standards, hours of operation, remit and staffing; governance is addressed as a range of clinical and organisational risks and how these can be reduced by liaison psychiatry services are described. Lastly, key considerations required to set local standards for common mental health-related problems that occur in acute hospitals are provided.

Mental wellbeing of older people in care homes. This NICE quality standard covers the mental wellbeing of older people (65 years and over) receiving care in all care home settings, including residential and nursing accommodation, day care and respite care.

High security psychiatric services Directions. The Directions apply to providers of high security psychiatric services. They set out the requirements for providers to make sure they have robust arrangements for safety and security, and for children visiting patients in high security hospitals.

Ten questions for your council. These ten questions aim to help local authorities promote the wellbeing of their population and improve the recovery of people with mental health problems by providing information about the size, impact and cost of the unmet need to both treat mental health problems, to prevent them from arising and to promote wellbeing.

Overlooked and forgotten: a review of how well children and young people's mental health is prioritised in the current commissioning landscape. This report reviewed 145 JSNAs and 142 JHWSs from the total of 151 health and wellbeing boards that were in the public domain in early 2013. It offers support and recommendations to health and wellbeing boards on how they can prioritise and address children and young people’s mental health.

News
A £25 million pilot scheme run in ten areas will see mental health nurses posted in police stations and courts. The scheme aims to cut reoffending rates and provide early diagnosis and treatment. If successful, the scheme will be rolled out nationally by 2017.

Senior judge calls for greater transparency at Court of Protection Sir James Munby, president of the Family Division of the High Court, and of the Court of Protection, has asserted that there is a "pressing need" for the Court of Protection to be transparent and operate in an open fashion.

The Care Quality Commission (CQC) is investigating the care of dementia sufferers at 150 care homes and hospitals across the country. The aim of the review is to analyse care offered to people suffering with dementia so it can identify areas of future improvement.

If you wish to discuss any of the items raised in the above section please contact Simon Lindsay or Stuart Marchant.

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Patient and public involvement

Publications/Guidance

Smart Guides to Engagement - two new publications. NHS Networks' Smart Guides to Engagement series is for everyone working in or with CCGs. The guides have been written by experts to provide straightforward advice on all aspects of patient and public engagement in an easily digested format. It has published two new guides covering Unlocking the power of information and Engaging with individual patients.

NHS co-payments: how popular are they among healthcare users?This report discusses the results of a survey of patients and their opinions on the use of co-payments and top-up fees in the NHS.

Options appraisal on the measurement of people's experiences of integrated care. This report recommends that integrated care should be measured in a way that combines information from existing national health and social care data sets with feedback directly from patients, service users and carers. It concludes that a new, bespoke validated survey of users of health and social care which captures experiences of care coordination across services would be hard to justify in terms of cost, burden, and time to develop and implement.

Developing measures of people's self-reported experiences of integrated care. This report includes a set of 18 questions developed and tested with people from a wide range of backgrounds and with experience of using different health and social care services. The team’s recommendation is to introduce a small number of these questions into relevant national surveys to help local providers and commissioners see what is working well and what needs to change.

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected dataThis study aimed to identify variation in patient-reported outcomes (PROMs) across hospitals; assess the relationship between the cost and outcomes among NHS hospitals for these procedure; and determine the extent to which variations in outcomes and costs are due to differences in hospital performance

Consultations
Change proposals for specialised services NHS England is currently developing a five year vision and strategy for the commissioning of specialised services. As part of this work NHS England is inviting ideas from patients, public and professionals for ideas of how changes could be made to specialised services. The first round of submissions will close on 28th February 2014.

Accessible information - Your views (voluntary organisations / patient groups)NHS England has begun a programme of work aimed at ensuring that disabled patients, service users and, where appropriate, carers, receive information in formats that they can understand, and that they receive appropriate support to enable them to communicate. This will particularly affect people who are d/Deaf, blind, deafblind, have some hearing or visual loss, or have a learning disability, as well as carers.

If you wish to discuss any queries you may have around patient and public engagement please contact Claire Bentley. 

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Primary Care

Publications/Guidance
Personal Medical Services (PMS) contracts: locum employer superannuation funding and out of hours opt out deductions. This letter from NHS England sets out arrangements to ensure a consistent and equitable approach, in relation to PMS contracts, to funding of employer superannuation costs for GP locums and deductions for having opted out of providing out of hours services. 

If you wish to discuss any queries you may have around primary care please contact David Owens.

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Procurement

Publications/Guidance
Procurement Policy Note – New threshold levels for 2014. This PPN sets out the finalised threshold values to apply from 1 January 2014 to 31 December 2015. It also provides a summary of all the changes to threshold levels for public contracts, utilities contracts and defence and security contracts from January 2014. The levels are slightly lower than the 2012 figures, because of fluctuations in exchange rates - the threshold for central Government and NHS supplies and services contracts from 1 January 2014 is £111,676, and the works contracts threshold is £4,322,012; the threshold for local authority supplies and services contracts is £172,514.

NHS standards of procurement evidence tool: provides suggested evidence that should be reviewed as part of an assessment of a trust against the NHS procurement standards. It should be used with the NHS standards of procurement: Peer review guidance, which provides NHS organisations with an objective review process.

Bevan Brittan Updates
New procurement thresholds from 1 January 2014 - The Cabinet Office has announced the European Procurement Regime thresholds that apply from 1 January 2014. The thresholds are slightly lower than the previous levels, because of fluctuations in exchange rates.

If you wish to discuss any queries you may have around procurement please contact Matthew Mo.

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Public Health

Publications/Guidance
Children and Young People's Health Outcomes Framework. Public Health England have published a new resource that brings together and builds on health outcomes data from the Public Health Outcomes Framework and the NHS Outcomes Framework. It responds to the Children and Young People’s Health Outcomes Forum’s recommendation that a version of these frameworks be created which highlights areas of particular relevance to improving the health outcomes of children and young people.

Health inequalities in the EU: final report of a consortium. This report, by a consortium led by Sir Michael Marmot, provides an outline of new evidence on health inequalities in the European Union and the policy response at EU and national level to health inequalities since 2009. The former London Health Observatory collaborated on this report.

Public health grants to local authorities 2013 to 2014 and 2014 to 2015. This local authority circular outlines the public health grants to local authorities. The ring fenced grants for 2013 to 2014 and 2014 to 2015 provide local authorities with £2.66 billion and £2.79 billion to spend on public health services for their local populations. The grant conditions and reporting arrangements that will apply to the grant from April 2013 have also been published.

News
New public health research partnerships to get £47.5 million. Announces the 12 priority areas and the successful university applicants for contracts for the new NIHR Health Protection Research Units (HPRUs) that will run for five years from 1 April 2014. Funding for each HPRU will be held by a university in partnership with Public Health England to enable collaboration between world class research in academia and PHE.

If you wish to discuss any queries you may have around public health please contact Olwen Dutton.

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General

Publications/Guidance
The Care Bill: factsheets. These factsheets accompany the Care Bill that was introduced into Parliament on 9 May 2013. There are two new factsheets to reflect the provisions added to the Bill on Chief Inspectors and CQC independence (#17) and Trust Special Administration (#18). The bill has passed through the Lords and is currently at the Committee stage in the Commons.

Protecting and promoting patients’ interests: Licence exemptions – Guidance for providers. All providers of NHS healthcare services in England will need a licence from Monitor from April 2014, unless they are exempt. The licence will set out the conditions that licence holders will have to meet in order to provide NHS services. NHS providers are responsible for determining if they are exempt, and for applying to Monitor for a licence if they are required to hold one. This guidance helps providers of NHS services understand whether they need a licence, or if they are exempt from the requirement to hold a licence.

Using clinical communities to improve quality: Ten lessons for getting the clinical community approach to work in practice. This report introduces an approach – the clinical community – used by the Health Foundation’s Closing the Gap through Clinical Communities programme to support and secure improvements in health systems across multiple sites. The programme supported 11 clinical communities to come together around shared goals, to learn from each other but with the latitude to develop and apply local solutions. The programme has led to a range of improvements in the quality of care which continue to be sustained today. Drawing on the evaluation of the programme, the report outlines ten key lessons for getting the approach to work in practice and avoiding potential pitfalls.

Life after death: six steps to improve support in bereavementThis report outlines benefits for improving support for people who are recently bereaved: reducing the use of acute health and social care services, lessening the number of days lost to the economy, and improving the wellbeing of those facing such a significant change in their lives. It includes a call for clarity about who is responsible locally for commissioning and providing bereavement support, with better coordination and information about services. 

Consultations
Sustaining services, ensuring fairness: Government response to the consultation on migrant access and financial contribution to NHS provision in England. Sets out the Government's response to the July 2013 consultation that sought views on charging migrants and overseas visitors to use NHS services and how better to identify patients who should be charged. It announces changes to be introduced, including:
 extending charging for primary care services, such as prescriptions. GP and nurse consultations will remain free, which will mean that everyone will continue to have initial access to prevent risks to public health such as HIV, TB and sexually transmitted infections. Other types of primary care services that are being considered for charging include minor surgery that is carried out by a GP and physiotherapy that has been referred through a GP ;
 overseas visitors paying higher charges for services that are subsidised for patients entitled to free NHS care. These include optical and dental services which are currently highly subsidised;
 a new system for identifying and recording patients who should be charged for NHS services; and
 the introduction of charging for A&E services for visitors and migrants including emergency care. No one will be turned away in an emergency. 
It states that the changes will allow the NHS to recoup money and will create a consistent charging system across the NHS whilst encouraging only those who need urgent and emergency care to attend. Many changes will start to be introduced over the coming year. Further detail on the timing for implementation will be available in March 2014.

Consultation on potential new indicators for the 2015/16 Quality and Outcomes Framework (QOF). NICE is seeking views on ten potential new indicators for its QOF menu. The consultation closes on 3 February 2014.

Accessible Information – Your Views (survey for staff)NHS England has begun a programme of work to develop and implement an Information Standard – a framework of requirements which health and adult social care organisations should follow – in order that disabled patients, service users and, where appropriate, carers, receive information in formats that they can understand, and that they receive appropriate support to enable them to communicate.

Consultation on QOF indicatorsThe consultation on potential new indicators for the 2015/16 QOF is now open.

Use of restrictive practices in health and adult social care and special schools. The Royal College of Nursing has been commissioned by the DH to lead a review and develop new guidance on the use of positive behaviour support (PBS) and the minimisation of restrictive practices across health and adult social care. This project is part of the programme of actions set out in Transforming care: a national response to Winterbourne View Hospital. This consultation and draft guidance seeks further views to help it strengthen and refine the proposed guidance, including particularly ensuring ways that the rights of individuals and their families can be promoted and examples of best practice in PBS and de-escalation techniques. The consultation closes on 13 February 2014.

Bevan Brittan Events
Health and social care seminar (London). 04 February 2014 : Timings TBC. Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. This high level session will deal with some of the current issues local councils are dealing with given their new responsibilities about health; and will look at their duties and responsibilities; governance issues around health and wellbeing boards; the integration agenda and developing effective partnerships; health commissioning and NHS contracts.

Health and social care seminar (Birmingham). 05 February 2014 : Timings TBC. Location: Bevan Brittan, Interchange Place, Edmund Street, Birmingham, B3 2TA. This high level session will deal with some of the current issues local councils are dealing with given their new responsibilities about health; and will look at their duties and responsibilities; governance issues around health and wellbeing boards; the integration agenda and developing effective partnerships; health commissioning and NHS contracts.

Health and social care (Bristol). 06 February 2014 : Timings TBC. Location: Bevan Brittan, Kings Orchard, 1 Queen Street, Bristol, BS2 0HQ. This high level session will deal with some of the current issues local councils are dealing with given their new responsibilities about health; and will look at their duties and responsibilities; governance issues around health and wellbeing boards; the integration agenda and developing effective partnerships; health commissioning and NHS contracts.

If you wish to discuss any of the items raised in this section please contact Claire Bentley.

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