18/12/2018
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.
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Bevan Brittan Free Training Events
Bevan Brittan Events
Bevan Brittan Digital Health Forum - 12 March 2019 London
Housing and Asset Management Seminar - 9 January 2019. Bristol
Clinical Risk Webinars
Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. You can sign up to watch the training sessions remotely via our webinar facility. If you would like to receive notification of the webinars coming up just ask Claire Bentley.
Knowledge Transfer
Training. In addition to our free training programme for 2019, we also provide bespoke knowledge transfer sessions on a range of healthcare law topics. If you wish to discuss any queries you may have around training or webinars please contact Claire Bentley.
Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.
Acute and emergency care
Publications and guidance
Guidance for NHS trusts and foundation trusts providing emergency departments, urgent treatment centres and inpatient services. Specified public services now have a legal duty to refer service users they consider may be homeless or threatened with homelessness to a local housing authority. For health services the impact will be on NHS trusts and foundation trusts in the provision of any of the following NHS health services:
•accident and emergency services in a hospital
•urgent treatment centres
•in-patient treatment (of any kind)
Investigation into the provision of mental health care to patients presenting at the emergency department This Healthcare Safety Investigation Branch (HSIB) report highlights the variation in mental health care across emergency departments. The investigation followed HSIB being notified of the case of Diane, a 57-year-old woman who died by suicide. The early investigation focused on her last four presentations at her local emergency department, the last one being the day before she died. The investigation also examined her interactions with local healthcare services spanning two years. The report sets out four recommendations aimed at improving patient care.
Ambulatory emergency care could relieve winter pressures. A report from the Society of Acute Medicine calls on the government and NHS leaders to realise urgently the potential of ambulatory emergency care.
Tackling Bullying: A guide for action Tackling bullying. Ambulance colleagues have produced a new guide, Tackling Bullying in Ambulance Trusts: A guide for action.
Guidance for NHS trusts and foundation trusts providing emergency departments, urgent treatment centres and inpatient services. On 1 October 2018, the Homelessness Reduction Act 2017 introduced a new legal duty on specified public services to refer service users they consider may be homeless or threatened with homelessness to a local housing authority. This guidance provides an overview of the duty to refer for NHS staff, including how to make a referral to a local authority.
Winter 2018/19 in the NHS: the solutions This report calls on the government and NHS leaders to 'realise urgently' the potential of ambulatory emergency care. It warns that the NHS is 'on borrowed time' as winter approaches but says better use of same-day emergency clinics could save at least 14,000 overnight hospital stays.
Emergency readmissions: What's changed one year on? Report – 14 November 2018 New research indicates spike in emergency readmissions to hospital over the last year.
Legislation
Assaults on Emergency Workers (Offences) Act 2018.
News
BMA analysis shows year-round crisis with services struggling in summer as badly as recent winters
If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.
Children
Publications/Guidance
Extension of HPV vaccination to boys: equality analysis Review of equality issues around extending the HPV vaccination programme in England to adolescent boys.
Young people, violence and knives - revisiting the evidence and policy discussions. In this briefing, Roger Grimshaw and Matt Ford examine recent trends in knife-related violence and assess different approaches to tackling, and reducing it. It builds on an earlier review of evidence of effective strategies for addressing gun and knife crime, published by the Centre for Crime and Justice Studies in 2009.
Developing and sustaining an effective local SEND system: a practical guide for councils and partners This report has been written as a concise, practical summary of good practice in developing and sustaining an effective local SEND system.
Children's mental health briefing This briefing finds that child and adolescent mental health services are improving in most areas in the country, yet with the exception of eating disorder services, the provision of services in the youth justice system and in perinatal mental health care, the rate of progress is slow. A vast gap remains between what is provided and what children need. As a result, the current rate of progress is still not good enough for the majority of children who require help but are not receiving it.
Mental Health of Children and Young People in England, 2017 [PAS] This survey collected information from 9,117 children and young people and combines information - depending on their age - from children and young people or their parents and teachers. It found that
•One in eight (12.8%) 5 to 19 year olds had at least one mental disorder when assessed in 2017
•Specific mental disorders were grouped into four broad categories: emotional, behavioural, hyperactivity and other less common disorders. Emotional disorders were the most prevalent type of disorder experienced by 5 to 19 year olds in 2017 (8.1%)
•Rates of mental disorders increased with age. 5.5% of 2 to 4 year old children experienced a mental disorder, compared to 16.9% of 17 to 19 year olds. Caution is needed, however, when comparing rates between age groups due to differences in data collection. For example, teacher reports were available only for 5 to 16 year olds. Please refer to the Survey Design and Methods Report for full details
•Data from this survey series reveal a slight increase over time in the prevalence of mental disorder in 5 to 15 year olds (the age-group covered on all surveys in this series). Rising from 9.7% in 1999 and 10.1% in 2004, to 11.2% in 2017
•Emotional disorders have become more common in five to 15 year-olds – going from 4.3% in 1999 and 3.9% in 2004 to 5.8% in 2017. All other types of disorder, such as behavioural, hyperactivity and other less common disorders, have remained similar in prevalence for this age group since 1999
Bevan Brittan Updates
How should local authorities capture new local safeguarding arrangements? There have been significant changes to safeguarding legislation recently, but it's fair to say that the impact of the changes has probably not yet been felt. However, the deadline for publishing the new arrangements – 29 June 2019 - is now only six months away.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk/Patient Safety
Publications/Guidance
The Independent Breast Screening Review 2018. A Department of Health and Social Care document presents the findings and recommendations of the independent review established to investigate the failings of the breast screening programme in England. The report makes 15 recommendations for the Department of Health and Social Care, Public Health England and NHS England.
The future of NHS patient safety investigation The Serious Incident framework (2015) describes how Serious Incidents should be reported and investigated in the NHS. Between March and June 2018 we sought views on how guidance could be revised to support the system to respond appropriately when things go wrong.
The Government response to the Report of the Joint Committee on the Draft Health Service Safety Investigations Bill In response to a publication by the Joint Committee on the draft Health Service Safety Investigations Bill, which examines the establishment of the Health Service Safety Investigations Body under the legislation, the Department of Health and Social Care states that the Government accepts the recommendation to remove accreditation of Trusts to carry out "safe space" investigations from the Bill, and has not accepted the recommendation to exclude the current maternity investigations programme from the Bill.
Gosport Independent Panel report: government response The government has published its response to the report of the Gosport Independent Panel into what happened at Gosport War Memorial Hospital.
Syringe drivers: review of actions around the 2010 safety alert Findings from the Department of Health and Social Care’s review of action taken since 2010 to address safety concerns with certain ambulatory syringe drivers.
Consultations
Developing a patient safety strategy for the NHS. NHS Improvement have launched a consultation seeking views on proposals for a national patient safety strategy for the NHS. Comments by 15 February 2019.
Setting the Personal Injury Discount Rate: A Call for Evidence. A Ministry of Justice consultation seeks views to obtain evidence to inform the decisions to be taken by the Lord Chancellor in the first review of the personal injury discount rate. Comments by 30 January 2019.
Appropriate clinical negligence cover. A Department of Health and Social Care consultation seeks views on indemnity cover for healthcare professionals who are not covered by any existing or proposed state-backed scheme. Comments by 28 February 2019.
Webinars
Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. You can sign up to watch the training sessions remotely via our webinar facility. Just ask Claire Bentley.
If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd or Penelope Radcliffe.
Commissioning
Publications/Guidance
Policy Research Unit in Commissioning and the Healthcare System Understanding the new commissioning system in England: contexts, mechanisms and outcomes This study explores how the new commissioning system is functioning after reorganisation of the NHS in England in 2012. The research aimed to assess the impact of the reforms on the operation and outcomes of the commissioning system.
Mental health data and analysis: a guide for health professionals. Guidance for commissioners and health professionals to make decisions about mental health services and interventions based on data and analysis.
Making screening more accessible for people with a severe mental illness. This blog encourages providers and commissioners to think about how they can meet the needs of people with serious mental illness so they do not miss out on screening invitations.
Evidence-Based Interventions Programme New guidance that comes into effect next April supports CCGs to decide when certain interventions should be commissioned and offered.
Investigating recent developments in the commissioning system: final report There is now a more complex local landscape of organisations all of which need to be involved in the planning of local services; and clinical commissioning groups (CCGs) need to be able to find ways to engage with them effectively. This project investigated the initial stages of this process, looking at how CCG decision-making processes are changing; the role of the individual CCG in the current commissioning landscape; how accountability is maintained by CCGs in the current commissioning landscape; how competition and the current pricing regime is relevant to CCGs’ commissioning decisions; and how commissioning should develop in the future?
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/guidance
Never too busy to learn: how the modern team can learn together in the busy workplace This report, supported by Health Education England, helps healthcare teams make the most of daily learning opportunities in the workplace. It explores how ‘invitational’ learning environments can be created in clinical settings and, in doing so, poses two key questions: how do we create learning opportunities in the clinical workplace and how do we maximise the impact of these opportunities?
The state of medical education and practice in the UK 2018 This report paints a stark picture of unabated pressure on health services. The report also shines a light on steps some doctors are feeling the need to take to cope with patient numbers, some of which may be piling more pressure on other parts of the system. The research indicates many doctors are considering career changes to step away from the heavy workload placed upon doctors in primary and secondary care.
The role of volunteers in the NHS: views from the front line. Commissioned by Royal Voluntary Service and Helpforce, this report looks at frontline staff's perceptions of the roles and value of volunteers in hospitals.
Improving staff retention: flexible working Offering flexible working opportunities can help employers attract and retain staff. This guide explores how to build a business case for flexible working and includes best practice, practical tips and resources to help you implement flexible working successfully. A number of case studies illustrate the range of flexible working arrangements already in place across the NHS.
Inspire, attract and recruit: an interactive toolkit to support your workforce supply This toolkit provides guidance, good practice, checklists, top tips, questions and leading examples from across the NHS, to help employers take stock of what may need to be done to sustain a workforce pipeline. It aims to provide practical information on understanding audiences, how to attract the right people and ensuring employees have the best on-boarding experience.
Advancing medical professionalism underlines how essential professionalism is in increasing job satisfaction, improving patient care and raising productivity, and looks at what this means for doctors under growing pressures from increased workload, to their own remit and to their relationship with patients. The report from the RCP points to a growing gap between what doctors are trained to do and the realities of their workplace – fraught with complexity, competing ideals of what is good practice, rising demand, and increasing regulatory and legal obligations. According to Advancing medical professionalism, doctors face ethical dilemmas and clashes in professional (and sometimes) personal values, which can include advocating for the best care of a single patient and using resources efficiently in a finite system, putting the care of the patient first while maintaining one’s own health and welfare, and speaking up about concerns while knowing this may result in reprisals.
Medical associate professions: checklist This checklist is designed to help recruit and develop medical associate professions in NHS organisations, and support them to deliver excellent patient care.
The health care workforce in England: make or break? In advance of the NHS long-term plan, the King’s Fund has issued a briefing on the scale of workforce challenges now facing the health service and the threat this poses to the delivery and quality of care over the next 10 years.
Effective clinical governance for the medical profession. The General Medical Council (GMC) has published a revised handbook for organisations that employ, contract or oversee the practice of doctors in the UK.
Empowering NHS leaders to lead. This review was led by Sir Ron Kerr and explored three challenges faced by executive leaders across the NHS: expectations and support available for leaders; alignment of performance expectations at the organisational and system level; and level of administrative burden placed upon executive leaders. The review makes a number of recommendations to address these challenges.
Consultant to Consultant Referrals Good Practice Guide This good practice guide has been developed to support health economies to manage the increasing number of consultant to consultant referrals in elective care.
Training environments 2018: key findings from the national training surveys This document is a full review of the General Medical Council's latest annual national training survey, which collates the views and experiences of more than 70,000 doctors in training and senior doctors who act as trainers. It found that while trainers and training organisations continue to provide high quality medical education, trainees rated their experience as worse when they had poor handovers, inadequate inductions and gaps in rotas.
Bevan Brittan Training
Combatting sexual harassment training
Bevan Brittan provides organisations with essential training at a range of levels including:-
. Full coverage, workforce-wide training for all grades of employee
. Focussed training for your HR/management teams and
. Board level updates on the key issues and risks.
For more information click here.
If you wish to discuss any employment issues generally please contact Julian Hoskins or James Gutteridge.
Finance
Publications/Guidance
Consultant to Consultant Referrals Good Practice Guide This good practice guide has been developed to support health economies to manage the increasing number of consultant to consultant referrals in elective care.
Record NHS funding to give patients a better alternative to hospital New funding for primary and community healthcare by 2023/4 under the NHS Long Term Plan.
If you wish to discuss any queries you may have around finance please contact Claire Bentley.
Housing and health
Publications/Guidance
Homelessness: duty to refer – for NHS staff Provides an overview of the duty to refer for NHS staff, including how to make a referral to a local authority.
Nursing care for people experiencing homelessness: a survey of the QNI Homeless Health Network This report gives a thematic analysis of comments from a survey of 206 homeless health nurses about issues facing their area of practice. Using this evidence, it explores the structural, contextual, environmental and practical changes needed to reduce, prevent and eliminate homelessness, and tackle the associated burden of disease.
Rough sleeping strategy: delivery plan. In the rough sleeping strategy, the government committed to publish a delivery plan setting out how they intended to deliver the 61 commitments made. This document provides an update on progress so far, further information including key milestones on all 61 commitments, and information on next steps.
Bevan Brittan Events
Housing and Asset Management Seminar - 9 January 2019. Bristol
If you wish to discuss any queries you may have around housing and health please contact Julia Jones.
Immigration and health
Publications/Guidance
Making sure people seeking and refused asylum can access health care: what needs to change? This research explores the experiences of people who are currently or have been in the asylum process in Britain, as well as engaging with health care professionals and analysing existing research. It finds that cost and fears about how they will be treated, or consequences for their immigration status, are preventing people who are seeking or have been refused asylum from using health services. It calls for greater separation of the immigration and health care systems.
Review of amendments made to the NHS Overseas Visitor Charging Regulations in 2017: Written statement - HCWS1174. In a written statement the Department of Health and Social Care (DHSC) states that the review into the impact of amendments made to the NHS charging regulations in 2017 has concluded that there is no significant evidence that the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 have led to overseas visitors being deterred from treatment or that the changes have had an impact on public health. The DHSC is to revise and relaunch its e-learning training programme and work with NHS Improvement's support teams to promote it.
Journal Articles
The UCL–Lancet Commission on Migration and Health: the health of a world on the move. With one billion people on the move or having moved in 2018, migration is a global reality, which has also become a political lightning rod. Although estimates indicate that the majority of global migration occurs within low-income and middle-income countries(LMICs), the most prominent dialogue focuses almost exclusively on migration from LMICs to high-income countries (HICs). Nowadays, populist discourse demonises the very same individuals who uphold economies, bolster social services, and contribute to health services in both origin and destination locations. Those in positions of political and economic power continue to restrict or publicly condemn migration to promote their own interests. Meanwhile nationalist movements assert so-called cultural sovereignty by delineating an us versus them rhetoric, creating a moral emergency.
Children and adolescents on the move: what does the Global Compact for Migration mean for their health? Published online: December 5, 2018 Delan Devakumar, Neal Russell, Lisa Murphy, Kolitha Wickramage, Susan M Sawyer, Ibrahim Abubakar The Lancet Child & Adolescent Health
If you wish to discuss any queries you may have around immigration and health please contact Claire Bentley.
Information sharing/data
Publications/Guidance
Making NHS data work for everyone This report looks at the access and use of data held by the NHS for product and service development purposes by the private sector. The private sector can provide skills and know-how to develop data-driven tools, while the NHS makes the data available alongside medical expertise - described as the 'value exchange'. However, there is a lack of clarity over what a fair value exchange looks like. Combined with the lack of national strategy on types of partnerships that could be developed, this has led to a messy patchwork on the ground.
Our data-driven future in healthcare: people and partnerships at the heart of health related technologies This report states that a radical culture change in the NHS, and across the health data and medical technology community, is needed to make sure that the NHS can deliver the benefits of new health technologies that use patient data for care, and to retain public trust.
News
If you wish to discuss any queries you may have around information sharing please contact Jane Bennett.
Inquests
Publications/Guidance
Documentary inquests. Guidance No 29. Also known as short form or rule 23 inquests. The purpose of this guidance is to assist coroners on the law and procedures to follow with regards to documentary inquests, with a view to achieving greater consistency of approach between senior, area and assistant coroners across all of England and Wales.
If you wish to discuss any queries you may have around information sharing please contact Will Pickles.
Mental Health
Publications/Guidance
Clinically-assisted nutrition and hydration (CANH). Joint guidance from the British Medical Association and Royal College of Physicians to support doctors making decisions about clinically-assisted nutrition and hydration (CANH) for adults who lack capacity in England and Wales. The guidance sets out the rules governing how and in what circumstances food and water can be withheld.
Modernising the Mental Health Act – final report from the independent review. The Independent Review of the Mental Health Act 1983 has set out recommendations for government on how the Act and associated practice needs to change.
Everybody's Business A report on suicide prevention in Wales. A National Assembly for Wales Health, Social Care and Sport Committee report on suicide prevention makes a series of recommendations focusing on better parity between mental and physical health services, improved follow-up care for those discharged from hospital, and introducing a national training framework for suicide prevention. It says that the Welsh Government should consider the introduction of meaningful targets if it is serious about achieving parity between physical and mental health.
Good Practice Guide: Carers and Confidentiality. A Mental Welfare Commission for Scotland guide provides advice to health and social care practitioners on how to respect patient confidentiality while also involving families and carers in treatment. It also provides guidance on issues relating to capacity to make decisions around confidentiality, sharing information with carers that does not breach confidentiality, and the limited exceptional circumstances where breaking confidentiality may be necessary.
Mortality Review Tool for Mental Health Trusts. The Royal College of Psychiatrists has launched a Mortality Review Tool that will support Mental Health Trusts in securing learning through reviewing the deaths of patients who are or have recently been under their care. Press review
New information leaflets for mothers and their families were released in November 2018. Written jointly by perinatal psychiatrists, women with lived experience of perinatal mental illness, and their partners, they provide details on what services are available and how to access help.
Investigation into the provision of mental health care to patients presenting at the emergency department This Healthcare Safety Investigation Branch (HSIB) report highlights the variation in mental health care across emergency departments. The investigation followed HSIB being notified of the case of Diane, a 57-year-old woman who died by suicide. The early investigation focused on her last four presentations at her local emergency department, the last one being the day before she died. The investigation also examined her interactions with local healthcare services spanning two years. The report sets out four recommendations aimed at improving patient care.
Children's mental health briefing This briefing finds that child and adolescent mental health services are improving in most areas in the country, yet with the exception of eating disorder services, the provision of services in the youth justice system and in perinatal mental health care, the rate of progress is slow. A vast gap remains between what is provided and what children need. As a result, the current rate of progress is still not good enough for the majority of children who require help but are not receiving it.
Mental Health of Children and Young People in England, 2017 [PAS] This survey collected information from 9,117 children and young people and combines information - depending on their age - from children and young people or their parents and teachers. It found that
•One in eight (12.8%) 5 to 19 year olds had at least one mental disorder when assessed in 2017
•Specific mental disorders were grouped into four broad categories: emotional, behavioural, hyperactivity and other less common disorders. Emotional disorders were the most prevalent type of disorder experienced by 5 to 19 year olds in 2017 (8.1%)
•Rates of mental disorders increased with age. 5.5% of 2 to 4 year old children experienced a mental disorder, compared to 16.9% of 17 to 19 year olds. Caution is needed, however, when comparing rates between age groups due to differences in data collection. For example, teacher reports were available only for 5 to 16 year olds. Please refer to the Survey Design and Methods Report for full details
•Data from this survey series reveal a slight increase over time in the prevalence of mental disorder in 5 to 15 year olds (the age-group covered on all surveys in this series). Rising from 9.7% in 1999 and 10.1% in 2004, to 11.2% in 2017
•Emotional disorders have become more common in five to 15 year-olds – going from 4.3% in 1999 and 3.9% in 2004 to 5.8% in 2017. All other types of disorder, such as behavioural, hyperactivity and other less common disorders, have remained similar in prevalence for this age group since 1999
Mental health data and analysis: a guide for health professionals. Guidance for commissioners and health professionals to make decisions about mental health services and interventions based on data and analysis.
Policing and Mental Health - Picking up the pieces. A report by Her Majesty's Inspectorate of Constabulary and Fire and Rescue Service has argued that police officers are increasingly being used as the service of default in responding to people with mental health problems, placing an "intolerable burden" on staff at a time of escalating knife crime and rising domestic violence. Figures from 22 of the 44 forces in England and Wales showed that there were 318,000 incidents reported between 2016 and 2018, and the Metropolitan Police received a call about mental health every four minutes and sent an officer to respond to such a call every 12 minutes
Responding to Human Rights judgments: Report to the Joint Committee on Human Rights on the Government's response to Human Rights judgments 2017-2018. A Ministry of Justice report sets out the Government's position on the implementation of human rights judgments from the European Court of Human Rights and UK domestic courts. In addition it briefly outlines wider developments in the area of human rights during 2017-18.
Right treatment, right time. This survey of over 1,600 people on their experiences of care and treatment shows that people severely affected by mental illness are often waiting longest for treatment and receiving the worst care. It found that: 28 per cent were not referred to an appropriate service by their GP; 56 per cent did not receive treatment in the appropriate time; and 51 per cent found they did not receive treatment for a sufficient and appropriate length of time.
Making screening more accessible for people with a severe mental illness. This blog encourages providers and commissioners to think about how they can meet the needs of people with serious mental illness so they do not miss out on screening invitations.
Breast screening programme: supporting women with learning disabilities. Information for health professionals to support women with learning disabilities to access breast screening.
Community mental health survey 2018. Results of the latest survey from CQC which looked at the experiences of people receiving community mental health services.
Consultations
CQC to review the use of restraint, prolonged seclusion and segregation for people with mental health problems, a learning disability and/or autism. The health secretary has asked CQC to review the use of restrictive interventions in settings that provide inpatient and residential care for people with mental health problems, a learning disability or autism.
Legislation
Parliamentary briefing: Mental Capacity (Amendment) Bill - House of Lords report stage. Law Society latest briefing note. A Law Society briefing on the Mental Capacity (Amendment) Bill 2017 highlights a number of concerns about the Bill and recommends that it should be amended to avoid the unlawful treatment of the vulnerable individuals who receive care and treatment under conditions of detention.
Consultations
Preventing and tackling forced marriage. This consultation seeks views about whether it is necessary to introduce a new legal mandatory reporting duty relating to cases of forced marriage and, if it is, what such a reporting requirement would look like. It also seeks views on how the current guidance on forced marriage could be improved and strengthened.
News
Better information for paramedics and mental health nurses. NHS Digital has taken a crucial step towards a more joined-up health and care system with the launch of the new national record locator service.
Bevan Brittan Updates
DoLS Reforms and care home providers. The Mental Capacity (Amendment) Bill 2018 (the Bill) is before Parliament. If it is passed it will result in very significant changes for the independent social care sector and will place a much greater administrative and financial burden on them than the current DoLS scheme. Care home managers will have important new responsibilities for arranging consultations and assessments.
Case Summary: Buckinghamshire County Council v RT [2018] EWCOP 12 (23 April 2018). This case will be of interest to commissioners, providers and social workers who work with young people subject to a deprivation of liberty who do not have capacity, who may shortly be approaching their 18th birthday.
Case Summary: Re RD (Deprivation or Restriction of Liberty) [2018] EWFC 47 (28 June 2018). This case will be interest to commissioners, providers and social workers who are involved in care planning for children and young people subject to care proceedings, where it is possible that the care regime may involve a deprivation of liberty. It is the latest in a line of cases which appear, on their face, to reduce the likelihood of a child or young person being considered to be deprived of their liberty.
Case Summary: University College London Hospitals v KG [2018] EWCOP 29. This case will be of interest to commissioners, providers and care co-ordinators involved with patients receiving novel and experimental treatments.
Case Summary: Re P (Sexual Relations and Contraception): A Local Authority v P [2018] EWCOP 10. This case will be of interest to commissioners and providers who care for vulnerable service users who may not have the capacity to consent to sexual relations, contact, or contraception.
Case Summary: Re KT, DR, KH and DC [2018] EWCOP 1. This case will be of interest to Commissioners and Providers who have made and/or are processing Re X streamlined applications where there is no identifiable Rule 1.2 Representative.
How can we help?
Fixed fee training packages. We have devised a two-part fixed fee training package to ensure mental health professionals are up to speed with their duties and to enable key managers to proactively manage caseloads. We regularly deliver these sessions to provider and commissioner organisations, including their partner agencies. If you would like more information click here.
Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.
Bevan Brittan Mental Health Extranet
Would you like to access the Bevan Brittan Mental Health Extranet? - It is a secure online resource containing a discussion forum, knowledge bank and information about training events. If you would like access please contact Claire Bentley.
If you wish to discuss any mental health issues please contact Hannah Taylor, Simon Lindsay or Stuart Marchant.
Primary Care
Consultations
Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs A national public consultation has been launched on proposals to update and review commissioning guidance about items that should not be routinely prescribed in primary care. In the majority of cases there are other more effective, safer and/or cheaper alternatives available. CCGs are asked to engage with their local communities on these proposals where they have not already taken action in this area.
If you wish to discuss any issues involving primary care please contact Vincent Buscemi.
Providers
Publications/guidance
UK care home providers for older people: advice on consumer law. The advice is being published as part of the Competition and Markets Authority’s (CMA) ongoing consumer protection work into residential care homes and nursing homes for the over-65s.
Making screening more accessible for people with a severe mental illness. This blog encourages providers and commissioners to think about how they can meet the needs of people with serious mental illness so they do not miss out on screening invitations.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Public Health
Publications/Guidance
Atlas of variation in palliative and end of life care in England Public Health England (PHE) has launched the first atlas of variation in palliative and end of life care in England.
Community-centred approaches to health. Public Health England has published a document to help health professionals prevent ill health and promote wellbeing as part of their everyday practice.
Health matters: air pollution. Poor air quality is the largest environmental risk to public health in the UK, as long-term exposure to air pollution can cause chronic conditions such as cardiovascular and respiratory diseases as well as lung cancer, leading to reduced life expectancy. This edition of Health matters focuses on the health impacts that air pollution can have across a person’s lifetime, the associated health inequalities, and the current and future outlook both in terms of new cases of disease and NHS and social care costs attributable to air pollution. It includes calls to action on reducing air pollution and exposure for the health service and healthcare professionals, local government, and the public.
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Publications/guidance
Putting the inspector to the test: quality ratings and the CQC How good is care in the NHS and social care system? What does a hospital inspection actually look like? A podcast from the Kings Fund about big ideas in health and care.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant or Ben Lambert.
Social Care
Publications/Guidance
Robotics in social care. This paper introduces robotic technology and the main ways it has been developed for use in social care. It reviews evidence on the impact of robotics on the costs and quality of social care and its workforce, and explores the main ethical, social and regulatory challenges to its use in social care.
National framework for NHS continuing healthcare and NHS-funded nursing care This guidance sets out the principles and processes of the national framework for NHS continuing healthcare and NHS-funded nursing care.
Post-qualifying standards for social work practice supervisors in adult social care: government response The Department of Health and Social Care sought views on the knowledge and skills statement for adult social work supervisors, to make sure it covered the key skills and knowledge needed to support high quality, reflective social work practice. This consultation response provides: a summary of overarching messages and key themes identified from the consultation and an overview of the general issues and trends identified in each of the consultation questions. The final post-qualifying standards have also been published.
A better future for adult social care In this report the pensions and risk consultancy, Hymans and Robertson, calls for cross–party political bravery to address the crisis in adult social care so that older adults and their carers can be treated with the dignity and respect they deserve. Lack of public understanding of the scale of the crisis is one of the biggest barriers to the implementation of a sustainable and fair funding system.
Home care in England: views from commissioners and providers. Our new report, produced in association with the University of York, finds that the market for home care providers is extremely fragile, with squeezed margins and low fees forcing providers to leave. In 2017 providers handed back home care contracts in more than one in three local authorities, and some of the largest providers have withdrawn from the publicly funded home care market altogether. Staff shortages are also a ‘relentless challenge’ for home care providers in many places.
Help at home: use of assistive technology for older people This review presents a selection of recent research on assistive technology for older people funded by the National Institute for Health Research (NIHR) and other government funders. The review focuses on research around the use of technology in the home, remote monitoring systems and designing better environments for older people.
UK care home providers for older people: advice on consumer law The advice is being published as part of the Competition and Markets Authority’s (CMA) ongoing consumer protection work into residential care homes and nursing homes for the over-65s.
Technology in care. A new resource on CQC's website explores the use of technology in care, looking at the benefits of innovation and updating previously published information on surveillance.
Help at Home - Use of assistive technology for older people Help at Home brings together recent NIHR and other government funded research with focus on the use of technology in the home and designing better environments for older people.
Local government green paper The Local Government Association has published the results of a consultation on its green paper on adult social care. The report sets out 14 recommendations to the government from the consultation for achieving two key objectives: stabilising and sustaining the here and now, and moving towards a system that could be better.
Review of adults social care complaints 2017 - 2018.The report, which looks at the data behind every adult social care complaint the Ombudsman has received over the 12 -month period, shows there has been a nine per cent increase in complaints about charging. And of those complaints, it is upholding 67% - higher than the average uphold rate for adult social care of 62%, and greater still than the 57% uphold rate for all complaints the Ombudsman investigates.
Seven principles for the engagement of individual providers on behalf of the wider independent and voluntary adult social care sector This new guidance aims to help overcome any concerns that local authorities or the NHS might have about engaging with individual adult social care providers on behalf of the wider sector. Based closely on the widely recognised 'Seven principles of public life', the guidance suggests how adult social care providers should approach any situation in which they are acting as representatives of the wider sector.
Ordinary residence: anonymised determinations 2018How the department resolves disputes in the health and social care sector when 2 or more local authorities cannot agree responsibility for meeting a person’s eligible needs.
The lives we want to lead: findings, implications and recommendations on the LGA green paper for adult social care and wellbeing.
UK care home providers for older people: advice on consumer law. The advice is being published as part of the Competition and Markets Authority’s (CMA) ongoing consumer protection work into residential care homes and nursing homes for the over-65s.
If you wish to discuss any queries you may have around social care please contact Stuart Marchant.
General
Publications/Guidance
Progress towards ending the HIV epidemic in the UK Public Health England (PHE) has published Progress Towards Ending the HIV Epidemic in the UK: 2018 Report, which provides analysis and public health interpretation of the latest epidemiological data [1]. This article summarises key findings and implications from the report.
How NHS charities can convert to independent status Explains the issues and processes NHS charities need to consider when becoming independent.
Delayed transfers of care resources This series of guides is aimed at helping health and social care staff to take prompt practical actions and use every opportunity to prevent delayed transfers of care. Through using these guides, health and social care staff can address the evidence that staying in hospital for longer than required drives adverse outcomes for patients.
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