28/02/2019

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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Training Events

Independent Health

Knowledge Transfer

Information sharing

Acute and emergency care

Inquests

Brexit

Mental Health

Children

Primary Care

Clinical Risk/Patient Safety

Procurement

Commissioning

Providers

Employment/HR

Public Health

Finance

Regulation

Housing and health

Social Care

Immigration

General

 

If someone forwarded you this email you can sign up for your own free copy here delivered directly to your inbox.   

Bevan Brittan Free Training Events 

Bevan Brittan Events

Bevan Brittan Digital Health Forum - 12 March 2019 London

Employment seminar: the impact of Brexit on workforce - 27 March Birmingham.

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. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. The next sessions coming up are:-

1. Trauma and joint replacement claims - a mix of medico legal issues and points to watch for in joint replacement, trauma themes and DVT cases. 05.03.19.

2. GMC overview - a general introduction to GMC fitness to practice proceedings and how they work 19.03.19

If you would like to receive more information about the webinars 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.

CCTV in care packages. Our team has prepared a comprehensive knowledge pack which offers guidance to commissioners, providers and care co-ordinators, using CCTV in care environments, with service users who lack capacity to consent to their care regime. If you would like more information click here.

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Acute and emergency care

Publications and guidance

Waiting times and attendance durations at English accident and emergency departments This report presents a detailed review of the demand-side, supply-side, practice and emergent factors that lead to four-hour breaches in accident and emergency departments, with a particular focus on changes that have taken place since 2010.

Air ambulance capital funding: how to apply. Guidance and application form for air ambulance charities in England to apply for a share of £10 million in funding.

Clinical guidelines for use in major incidents and mass casualty events NHS England has issued clinical guidelines for use in terrorist attacks and other major incidents. It draws on experience from both military and civilian practice.

High intensity users: reducing the burden on accident & emergency departments Dr Foster carried out a detailed analysis of accident and emergency attendances nationally, with the aim of uncovering common characteristics of high intensity users (HIUs) - people who attended ten or more times in a twelve-month period - and patterns in HIU attendances. This analysis will provide valuable insight and a better understanding of the reasons some people attend with such high frequency.

If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley. 

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Brexit 

Publications/Guidance 

Planning for a possible no-deal EU Exit: information for the health and care sector Guidance for industry and organisations involved in health and care about contingency plans for a no-deal Brexit.

Quality and safety of human organs, tissues and cells if the UK leaves the EU without a deal What you need to do to ensure continued use of human organs, tissues and cells (including reproductive cells) if the UK leaves the EU on 29 March 2019 without a deal.

18th Report of Session 2017-19: Healthcare (International Arrangements) Bill. A Select Committee on the Constitution publication on the Healthcare (International Arrangements) Bill 2017-19 recommends that the legislation should be limited to the making of arrangements for future reciprocal healthcare arrangements with countries that participate in the existing European Health Insurance Card scheme. It also calls for the broad powers in the Bill to be subject to a sunset clause, so that Parliament can scrutinise the detail of the policy in future primary legislation.

Department of Health and Social Care Update: Written statement - HLWS1325 - HCWS1358 In a written statement to Parliament, the Department of Health and Social Care provides an update on plans for the continuity of medicines and medical products in the event the UK withdrawal from the EU without a deal. Measures in place to minimise disruption include: building up buffer stocks and stockpiling before 29 March 2019 in the areas of medicines, medical devices, blood, tissues and transplants, vaccines, supplies for clinical trials and non-clinical goods and services; buying extra warehouse space; securing additional roll-on, roll-off freight capacity; making changes to, or clarifications of, certain regulatory requirements; and strengthening the processes and resources used to deal with shortages.

Legislation

The Family Procedure Rules 2010 and Court of Protection Rules 2017 (Amendment) (EU Exit) Regulations 2019. The Government has issued amendment regulations concerning and the impact that leaving the EU will have on the Court of Protection Rules. The amendments will, in the MoJ's words "remove provision in the FPR and COPR which relates to powers, processes and orders under EU instruments or international agreements which will no longer be applicable or available when those instruments or agreements are revoked by the Withdrawal Act or the statutory instruments made under it, or in some cases amend such provision where such instruments are retained in an amended form." The accompanying Explanatory Memorandum provides a useful review of the interconnection between UK rules and EU instruments, though clearly it is still a developing picture.

If you wish to discuss any queries you may have around Brexit please contact Simon Lindsay

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Children 

Publications/Guidance 

Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children Department for Education statutory guidance on inter-agency working to safeguard and promote the welfare of children has been updated to reflect how local authorities should notify the Child Safeguarding Panel.

First 1000 days of life. This report asks the government to produce a long-term, cross-government strategy for the first 1000 days of life, setting demanding goals to reduce adverse childhood experiences, improve school readiness, and reduce infant mortality and child poverty.

Mental health services for children and young people A parliamentary report finds that in 2017/18 only three in ten children and young people with a mental health condition received NHS-funded treatment, and many more faced unacceptably long waits for treatment.

NAO charts growing pressures on children’s social care The National Audit Office says it can’t understand the reasons for the sharp rise in child protection assessments by local authorities, which are growing at a much higher rate than the population of children to age 17.

This report from Teenage Cancer Trust examines the latest trends in the incidence, mortality and five-year survival rates for cancer among young people. This is the first time a detailed analysis has been conducted of cancer rates for the 13 to 24-year age group and shows an encouraging increase in survival rates.

Child death review: statutory and operational guidance (England) Statutory and operational guidance for clinical commissioning groups and local authorities as child death review partners.

If you wish to discuss any queries you may have around children please contact Deborah Jeremiah

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Clinical Risk/Patient Safety 

Publications/Guidance 

Early notification scheme staff support. The Early Notification team at NHS Resolution provides a professional advice service on issues relating to investigative practices and legal process, to any staff involved in maternity incidents and more details of the available support for staff. The team have also recently published two case studies looking at: Understanding the risk of maternal and neonatal hyponatraemia and Learning lessons in maternity from a recent Supreme Court ruling (Darnley).

Information for NHS trusts on the respective roles of the Parliamentary and Health Service Ombudsman and NHS Resolution. This document published by NHS Resolution is for NHS trusts in England, particularly those staff who manage complaints and/or compensation claims raised against their trust. ◾It outlines the roles of the Parliamentary and Health Service Ombudsman and NHS Resolution and how their services overlap and interact. ◾Staff who manage NHS complaints and/or compensation claims should use this document as a guide to decide when to involve the Parliamentary and Health Service Ombudsman or NHS Resolution in complaints or compensation claims.

Does hospital competition reduce rates of patient harm in the English NHS? Previous hospital mergers have reduced the number of distinct organisations offering publicly funded and provided care in the NHS, reducing choice and between-hospital competition in some areas. This research tests the impact of variation in concentration on a new quality indicator: the prevalence of patient harm from falls, pressure ulcers, blood clots and urinary tract infections. It finds that hospital mergers in concentrated areas without offsetting clinical benefits could significantly increase rates of patient harm.

Investigation into the management of health screening This report finds that the proportion of eligible adults receiving health screening is inconsistent across different areas in England and that services are not operating to the ‘agreed standards’. The investigation focused on: delivery of health screening programmes; performance of health screening programmes; oversight of health screening programmes; and progress in implementing change in screening programmes.

Delivering perioperative medicine in integrated care systems A report from the Royal College of Anaesthetists showcases programmes in hospitals across England that are improving patient care before, during and after surgery.

Telling patients the truth when something has gone wrong - how have professional regulators encouraged professionals to be candid to patients? This paper from the professional standards authority sets out the progress professional regulators they oversee have made in embedding the professional duty of candour (being open and honest to a patient when something has gone wrong in their care) across the UK since 2014.

Maternity services survey 2018 Findings from a national survey of more than 17,600 women who gave birth in February 2018 show that many women are positive about maternity care in England.

Setting the Personal Injury Discount Rate - Government Actuary's Department: Technical Memorandum.  A technical memorandum sets out the analytical approach the Government Actuary's Department intends to adopt as a part of the first review of the personal injury discount rate.

Legislation

National Health Service (Clinical Negligence Scheme for General Practice) Regulations 2019 (SI 2019/334) In Force: 1 April 2019 These Regulations establish the National Health Service Clinical Negligence Scheme for General Practice and come into force on 1 April 2019. The Regulations apply only in relation to services provided as part of the NHS in England.

Consultations

Reforming the courts' approach to McKenzie Friends: Consultation Response. A response to the Lord Chief Justice of England and Wales consultation on reforms to the existing guidance for "McKenzie Friends" is set out together with a summary of the responses received.

Appropriate clinical negligence cover Seeking views about indemnity cover for healthcare professionals who are not covered by any existing or proposed state-backed scheme.

Future midwife consultation The Nursing & Midwifery Council has launched a consultation that proposes to overhaul midwifery education to make the UK the best and safest place to have a baby. This UK-wide consultation sets out the draft skills and knowledge the next generation of midwives will need in order to deliver great care in the years to come. The consultation closes on 9 May 2019.

News

Decade of improved outcomes for patients thanks to Surgical Safety Checklist

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.
The next training sessions coming up are:-

1. Trauma and joint replacement claims - a mix of medico legal issues and points to watch for in joint replacement, trauma themes and DVT cases. 05.03.19.

2. GMC overview - a general introduction to GMC fitness to practice proceedings and how they work 19.03.19

If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd or Penelope Radcliffe.

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Commissioning   

Publications/Guidance 

Best Practice Update on Conflicts of Interest Management: Call to Action for CCGs. This guidance is a practical toolkit, which includes templates and case studies to support CCGs with conflicts of interest management

Governance and accountability for integrated health and care. This explainer for the NHS and local authorities, produced in association with the Centre for Public Scrutiny, outlines potential solutions to some of the key governance and accountability challenges that these organisations may face when seeking to work more collaboratively. It also highlights some of the key enablers from those systems and what is needed to support further integration.

CCG allocations 2019/20 to 2023/24 (all funding streams, spreadsheet) This document provides details for the CCG allocations 2019/20 to 2023/24 for all funding streams.

2018/19 Clinical Commissioning Groups (CCGs) Improvement and Assessment Framework Guidance for CCGs. This guidance document has been developed to support CCGs to identify and compile evidence, and to complete the evidence template for the Patient and Community Engagement Indicator in the CCG Improvement and Assessment Framework (CCG IAF) 2018/19.

Patient and community engagement indicator guidance This guidance aims to support clinical commissioning groups to identify and compile evidence on patient and community involvement for the CCG Improvement and Assessment Framework.

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

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Employment/HR  

Publications/guidance

Dorset HealthCare University NHS Foundation Trust: staff voice at the heart of organisational change This case study explores how Dorset HealthCare University NHS Foundation Trust has worked to improve its NHS Staff Survey results through a range of staff engagement actions. It demonstrates how the trust focused on these three areas of staff engagement: advocacy, involvement and motivation. This work resulted in improved survey response rates and year-on-year improvement to its staff engagement scores.

A critical moment: NHS staffing trends, retention and attrition This report highlights that NHS staff numbers are failing to keep pace with demand and that there is ongoing deterioration in workforce numbers in critical areas such as primary and community care, nursing and mental health.

The Topol Review: preparing the healthcare workforce to deliver the digital future The Topol Review, led by cardiologist, geneticist, and digital medicine researcher Dr Eric Topol, explores how to prepare the health care workforce, through education and training, to deliver the digital future. This independent report, on behalf of the Secretary of State for Health and Social Care, makes recommendations that will enable NHS staff to make the most of innovative technologies such as genomics, digital medicine, artificial intelligence and robotics to improve services.

NHS staff shortages put long-term vision for primary and community care at risk.  A new report by the Health Foundation highlights that NHS staff numbers are failing to keep pace with demand and that there is ongoing deterioration in workforce numbers in critical areas such as primary and community care, nursing and mental health.

Kark review of the fit and proper persons test. An independent review of how effectively the test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.

Junior doctors' contract: equality analysis and family test Equality analysis and family test for the new contract for doctors and dentists in training in the NHS.

Guidance for sharing staff in integrated care organisations NHS Employers has developed guidance for organisations delivering integrated care to share workforce.

Settlement agreements: a factsheet for employers and workers about speaking up This factsheet is designed to help employers and workers understand their rights when entering into a settlement agreement. It includes key information around the use of confidentiality clauses and reassures employers and workers who may wish to speak up in order to ensure high-quality safe care is maintained.

System working: staff mobility/portability guidance for employers As organisations and integrated care systems develop ways of promoting collaborative, place-based patient care, this guide supports staff movement across NHS organisations as part of workforce sharing agreements. It includes: advice on developing workforce sharing agreements; useful templates and practical issues to consider; and legal considerations to be taken into account by employers.

Training routes into the NHS This infographic shows the additional options that are available to complement traditional training and recruitment routes. The resource can help employers to identify and consider additional routes that can be used to: support workforce challenges; recruit from the local community; and build career pathways.

Safe, sustainable and productive staffing: an improvement resource for the deployment of nursing associates in secondary care. This resource describes the principles for safe staffing, including organisational, managerial and clinical setting factorsalongside governance, leadership and reporting that will ensure nursing associates are safely and effectively deployed into the workforce.

News

Expert witness skills "should be part of doctors' training" he Medical Protection Society has argued that the General Medical Council should, as part of its drive to set up new credentials for the medical register, ensure that GPs and consultants are trained in the skills of being an expert witness so that they can give evidence when other doctors are involved in a tribunal hearing or face criminal charges.

Bevan Brittan Updates

Employment Eye February 2019

Mencap / ‘sleep-ins’ decision being appealed

Bevan Brittan Training

Bevan Brittan Workforce Forum: Digitisation, Automation and the Healthcare Workforce. Digital modernisation and the warmth of human interaction are both essential for health services to thrive. What changes are we already seeing, what does the future hold, and   how will the workforce have to adapt? 

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.

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Finance 

Publications/Guidance

Air ambulance capital funding: how to apply. Guidance and application form for air ambulance charities in England to apply for a share of £10 million in funding.

Extending legal rights to personal health budgets and integrated personal budgets: consultation response The Department of Health and Social Care and NHS England held a public consultation that explored giving more people the right to have personal health budgets and integrated personal budgets. This would give people more choice and control over the money spent on meeting their health and wellbeing needs. This document summarises the main findings and conclusions from the consultation, and provides an analysis of each individual question. The document also explains the approach the government and NHS England are going to now take following the conclusion of the consultation.

National Tariff Payment System 2019/20: a consultation notice. NHS Improvement, together with NHS England, are consulting on all aspects of their proposed 2019/20 national tariff. The consultation closes on 21 February 2019.

Making outcome-based payments a reality in the NHS This report, jointly authored with RAND Europe, King’s College London and Cancer Research UK, and commissioned by Cancer Research UK in partnership with Greater Manchester Health and Social Care Partnership, explores alternative pricing models and the implications of using outcome-based payment schemes for improving access to cost-effective cancer drugs

Universal personalised care: implementing the comprehensive model Personalised care will benefit up to 2.5 million people by 2024, giving them choice and control over their mental and physical health. This document confirms how personalised care will be rolled out across England by 2023/24.

If you wish to discuss any queries you may have around finance please contact Claire Bentley.   

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Housing and health 

Bevan Brittan Updates 

Homelessness: new duty to refer for NHS staff. Julia Jones explores the new legal duty to refer patients who may be homeless or at risk of homelessness to a local authority and ways in which health organisations can seek to reduce homelessness.

If you wish to discuss any queries you may have around housing and health please contact Julia Jones

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Immigration and health

Publications/Guidance

Managing overseas visitors and migrant health charging: NHS trusts Information and resources for NHS trusts to help with the management and charging of overseas visitors and migrants.

Example letter to NHS visitor and migrant patients: assisted conception A letter that NHS trusts can send patients who are migrants or overseas visitors to explain that they need to pay for their assisted conception treatment.

Example letters to NHS visitor and migrant patients: maternity Letters that NHS trusts can send patients who are migrants or overseas visitors to explain charging for maternity services.

Report on the health of refugees and migrants in the WHO European region This report creates an evidence base with the aim of catalysing progress towards developing and promoting migrant-sensitive health systems in the 53 member states of the World Health Organization (WHO) European region and beyond. This report seeks to illuminate the causes, consequences and responses to the health needs and challenges faced by refugees and migrants in the region, while also providing a snapshot of the progress being made across the region. Additionally, the report seeks to identify gaps that require further action through collaboration, to improve the collection and availability of high-quality data, and to stimulate policy initiatives.

News

Home Office hires out staff to check on migrants. According to internal documents seen by the Observer, the Home Office is selling the services of its immigration officials to private companies at a rate of almost £60 an hour in a move attacked as an escalation of the "hostile environment" strategy. Public services including NHS trusts and local authorities, as well as private firms, are offered "real-time" access to information about someone's immigration status through an "on-site immigration official", who can be asked to attend interviews and encourage undocumented migrants to leave the country voluntarily. The Home Office has been approached to divulge how many officers have so far been deployed and to provide a list of organisations that have used them.

Migrant women denied abortions for refusing to pay. The Government has admitted that migrant women have been prevented from having abortions because NHS staff wrongly demanded payment upfront, where NHS hospitals in England were told to charge people deemed ineligible for free care before they were treated from October 2017, unless they needed urgent treatment. The Department of Health and Social Care has updated its guidance to make the NHS charging policy clearer for doctors.

If you wish to discuss any queries you may have around immigration and health please contact Julia Jones.   

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Independent Health  

Publications/Guidance 

Appropriate clinical negligence cover Seeking views about indemnity cover for healthcare professionals who are not covered by any existing or proposed state-backed scheme.

CMA guidance on the review of PPU arrangements under the Private Healthcare Market Investigation Order 2014. A Competition and Markets Authority (CMA) guidance document sets out its approach to reviewing Private Patient Unit (PPU) arrangements. These are arrangements for a private hospital operator to operate, manage, or otherwise provide privately-funded healthcare services at a private patient unit in England, Wales, Northern Ireland, or Scotland. The Private Healthcare Market Investigation Order 2014 contains a market-opening remedy in the form of a scheme to enable the CMA to review PPU arrangements.

CMA guidance on the review of PPU arrangements under the Private Healthcare Market Investigation Order 2014: Summary of responses to the consultation. A Competition and Markets Authority (CMA) publication summarises the responses to its consultation on draft guidance on its approach when reviewing Private Patient Unit (PPU) arrangements. It highlights concerns about the CMA using formal information requests as standard when gathering information from the parties, specifically that it would appear disproportionate given that the number of merger cases where the CMA faces difficulties in document gathering is very low. A number of respondents requested that the guidance include more detail on the factors that the CMA is likely to take into account when assessing whether to conduct a review of a PPU arrangement and, in the event that a review is initiated, whether competition concerns are likely to arise. 

Guidance on the review of PPU arrangements under the Private Healthcare Market Investigation Order 2014 This guidance sets out the CMA’s approach to reviewing Private Patient Unit (PPU) arrangements. That is, arrangements for a private hospital operator to operate, manage, or otherwise provide privately funded health care services at a private patient unit in England, Wales, Northern Ireland, or Scotland.

Outsourcing Oversight? The case for reforming access to information law. An Information Commissioner's Office publication argues that freedom of information laws should be extended to all bodies including those in the private sector that provide public services. It claims that present laws, particularly the Freedom of Information Act 2000 and the Environmental Information Regulations 2004, are too restrictive as members of the public may request information only from public authorities and publicly owned bodies, such as central and local government, the police, local authority schools and hospitals.

If you wish to discuss any queries you may have around independent health please contact Vincent Buscemi.

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Information sharing/data  

Consultations

National Data Guardian for Health and Social Care: a consultation about priorities. The government is consulting on the role on the national data guardian for health and social care. Since last December the guardian has been empowered to issue statutory guidance to public bodies and to charities and private providers of health and care services. The consultation will help determine priorities for guidance about the use of health and social care data. It closes on 22 March 2019.

Outsourcing Oversight? The case for reforming access to information law. An Information Commissioner's Office publication argues that freedom of information laws should be extended to all bodies including those in the private sector that provide public services. It claims that present laws, particularly the Freedom of Information Act 2000 and the Environmental Information Regulations 2004, are too restrictive as members of the public may request information only from public authorities and publicly owned bodies, such as central and local government, the police, local authority schools and hospitals.

If you wish to discuss any queries you may have around information sharing please contact Will Pickles.

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Inquests  

Publications/Guidance 

Final report: Review of legal aid for inquests A Ministry of Justice (MoJ) final report of an evidence based review of the provision of legal aid for inquests. It examines the evidence submitted as part of the review, considers the key concerns identified by respondents, and identifies potential areas for improvement to the inquest process as a whole. In addition, the MoJ has also completed a separate post-implementation review (PIR) of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO) Pt 1, which made changes to the provision of legal aid, and Pt 2, which focuses on civil litigation costs.

If you wish to discuss any queries you may have around inquests please contact Will Pickles.

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Mental Health 

Publications/Guidance

Monitoring the Mental Health Act report Monitoring the Mental Health Act is the CQC annual report on the use of the Mental Health Act (MHA). It looks at how providers are caring for patients, and whether patient’s rights are being protected.

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.

Extending legal rights to personal health budgets and integrated personal budgets: consultation response - response from the government and NHS England. Following a consultation on giving more people the right to have personal health budgets, the Department of Health and Social Care and NHS England is planning to bring forward legislation to extend the legal rights to people eligible for Section 117 aftercare services, and people who access wheelchair services, whose posture and mobility needs impact their wider health and social care needs. Mental health services will also be expanded for people with a learning disability, people receiving social care support and those receiving specialist end of life care.

STOMP-STAMP pledge resources STOMP -STAMP (Stopping over medication of people with a learning disability, autism or both-Supporting Treatment and Appropriate Medication in Paediatrics) pledge resources for organisations and individuals that work with children and young people with a learning disability, autism or both to show their commitment to STOMP and STAMP.

Mental health and the armed forces, part two: the provision of care This report recommends that a 'world-class centre for the treatment of mental injuries' suffered by service personnel should be established in the next 12-18 months if veterans and their families are to receive the provision and support promised in the Armed Forces Covenant.

Dementia 2020 challenge: 2018 review phase 1 During 2018, stakeholders from the health and social care system, and the charitable sector, were asked to comment on the progress of the actions set out in the challenge on dementia 2020 implementation plan and what else is needed to be done to complete them. This report summarises the responses and sets out revised actions for 2018 to 2020.

Working with restricted patients Forms and guidance for professionals working with restricted patients (mentally disordered offenders).

Cross-Government Suicide Prevention Workplan. An HM Government policy paper explains how the Government will work with the NHS, local government and the voluntary sector to reduce suicides. The workplan will be led by the new Suicide Prevention Minister Jackie Doyle-Price. The plan focuses on how social media and the latest technology, such as predictive analytics and artificial intelligence, can identify those at risk of suicide; addressing the increase in suicide and self-harm among young people; the causes of death among veterans; and triggers that can lead to someone taking their own life, such as debt and gambling.

Mental Capacity (Amendment) Bill: easy read Plans for a new law about how someone can be ordered to be looked after safely if they cannot make decisions for themselves.

Annual learning disabilities statistics released NHS Digital has released annual figures on the health and care of people with learning disabilities.

Mental health services for children and young people A parliamentary report finds that in 2017/18 only three in ten children and young people with a mental health condition received NHS-funded treatment, and many more faced unacceptably long waits for treatment.

Consultations

Learning disability and autism training for health and care staff: A consultation Department of Health and Social Care A Department of Health and Social Care consultation seeks views on proposals to introduce mandatory learning disability and autism training for health and care staff. It focuses on: the planned content of the training; how the training should be delivered; how to involve people with a learning disability or autistic people in training; and how the Department can mandate, monitor and evaluate the impact of training. Comments by 23.59 on 12 April 2019.

Revising the Mental Capacity Act 2005 Code of Practice: Call for evidence. The Ministry of Justice has opened a call for evidence on how it should revise the Mental Capacity Act 2005 Code of Practice. The Call for Evidence will "seek to establish the extent to which the current Code of Practice reflects changes in case law and lessons learned through practical use of the Code of Practice over the last 11 years." The consultation takes the form of an online survey with 39 questions presented into sections reflecting the current chapters of the Code. Helpfully you can save your responses and return later to complete the survey. Submissions close on 7th March 2019.

Service model for people with learning disabilities and behaviour that challenges. NICE has published a draft quality standard for services for children, young people and adults with a learning disability (or a learning disability and autism) who also exhibit challenging behavior.

News

Vulnerable patients at great risk under new laws Law Society As the Government prepares to push the Mental Capacity (Amendment) Bill 2018 through its final parliamentary stages, the Law Society said that 300,000 people vulnerable people will see their rights, specifically their right to liberty, removed by royal assent of the Bill. It highlights again that fewer cared for people will qualify for the protection of safeguards under the new scheme and their access to advocacy and independent professional support will be more limited.

Bevan Brittan Updates

Duty of Candour News Bulletin

Provision of mental health care to patients presenting at the emergency department. In November the Healthcare Safety Investigation Branch published its full report following its investigation into the provision of care to patients who present at emergency departments with mental health problems. Toby de Mellow reviews the report findings and the HSIB’s Safety Recommendations, Observations and Actions.

Making decisions on Clinically assisted nutrition and hydration. Ruth Atkinson-Wilks reviews this useful guidance which will assist healthcare professionals in the making of difficult and complex decisions regarding the use of CANH for incapacitated patients.

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.

CCTV in care packages. Our team has prepared a comprehensive knowledge pack which offers guidance to commissioners, providers and care co-ordinators, using CCTV in care environments, with service users who lack capacity to consent to their care regime. 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 TaylorSimon Lindsay or Stuart Marchant.  

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Primary Care  

Publications/guidance

Measuring general practice productivity With a rising workload, general practice in England is under increasing pressure to work more productively. This collaborative study developed and tested a measure of effectiveness called the general practice effectiveness tool, and offers learning for practices on how they think about effectiveness.

New GP contract framework marks the first major step towards delivering the NHS Long Term Plan NHS England and the British Medical Association’s General Practitioners Committee have agreed a five-year GP contract framework. It marks the biggest contract changes in over a decade and follows the news that £4.5 billion will go into primary medical and community health services by 2023/4. Alongside increases to core funding there will be a Primary Care Network (PCN) Contract that is expected to invest nearly £1.8 billion by 2023/24 including funding support for around 20,000 more health professionals (clinical pharmacists, physician associates, physiotherapists, community paramedics and social prescribing link workers). The changes mark the first major step towards delivering the NHS Long Term Plan and improved care and support for patients in and near their homes.

General Medical Services (GMS) contract changes 2019/20: letter from Ed Waller This letter from Ed Waller provides additional information on the GP contract which was published on 31 January 2019.

RCGP to support decriminalisation of abortion The Royal College of General Practitioners' (RCGP) UK Council has passed a motion to support the decriminalisation of abortion, saying that the procedure should be governed by medical regulatory frameworks, not the criminal justice system. The decision was based on a poll of members and consultation with local Faculties.

International GP Recruitment Programme national guide for Australian GPs.  This document provides details about the International GP Recruitment Programme including what the benefits of living and working as a GP in England, who is eligible for the programme, and the process for applying.

A five-year framework for GP contract reform to implement The NHS Long Term Plan. This is the full five-year framework for GP services as agreed between NHS England and the BMA General Practitioners Committee (GPC) in England.

Investment and evolution. The BMA and NHS England have published a five-year “framework” setting out changes to the GP contract to stimulate the development of primary care networks (PCNs) and multidisciplinary teams. The document includes year by year funding commitments giving practices a clearer idea of levels of investment they can expect to see in social prescribing, clinical pharmacists and other initiatives designed to take pressure off the GP workforce.

Patients’ views on making best use of GP premises Poor confidentiality at reception desks, issues with access for disabled people and dated waiting rooms are some of the biggest problems highlighted by patients in this report of people’s views of their local GP premises.

News

Daffodils set the standard for end of life care GP surgeries will now be able to display a 'daffodil mark' as a sign of commitment to improving end of life care, as part of a new partnership between the Royal College of GPs and the terminal illness charity Marie Curie. The mark, synonymous with the charity, is based on a new set of criteria called the Daffodil Standards – a set of eight quality improvement statements designed to support primary care teams in delivering care to patients living with an advanced, serious illness or at the end of their lives, and their loved ones. By adopting the Standards, GP practices commit to making improvements in at least three of eight core aspects of care each year, with the aim of having reviewed all of them after three years.

UK general practice helps avoid US-style 'opioid crisis', says RCGP

If you wish to discuss any issues involving primary care please contact Vincent Buscemi.

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Procurement  

Cases

[2019] EWHC 61 (TCC) ABBVIE LTD v NHS COMMISSIONING BOARD (OPERATING UNDER THE NAME OF NHS ENGLAND) (2019) Tender documents issued by NHS England during a public procurement exercise for the supply of drugs for the treatment and elimination of hepatitis C were not unlawful and did not breach the duty of equal treatment in the Public Contracts Regulations 2015 reg.97.

Bevan Brittan Updates

Procurement Pitfalls 1 – Pricing formulae

Procurement Pitfalls 2 – Debriefing

Procurement Pitfalls 3 – Overly restrictive threshold requirements

Procurement Pitfalls 4 – Word counts

If you wish to discuss any queries you may have around procurement please contact Vincent Buscemi.

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Providers  

Publications/guidance 

Master indemnity agreement: approved suppliers The Master Indemnity Agreement (MIA) register provides a list of all approved suppliers to NHS organisations.

EU exit actions for medical devices and clinical consumables This guidance provides information for NHS providers about the extensive planning and contingency measures that have been put in place for the health care system nationally, and the additional actions that we are asking providers to undertake as a priority as part of the wider preparations for a ‘no deal’ EU exit.

Relationships and sexuality in adult social care services. Guidance published by CQC sets out how care providers should consider people's relationship and sexuality needs.

Code of conduct for data-driven health and care technology This code of conduct contains a set of principles that set out what the Department of Health and Social Care expects from suppliers and users of data-driven technologies. The aim of the code is to make it easier for suppliers to understand what is needed from them, and to help health and care providers choose safe, effective, secure technology to improve the services they provide.

NHS can move towards more coordinated and continuous care The government is making changes to existing secondary legislation to make it easier for the first integrated care providers (ICPs) to be set up.

Upfront charging operational framework to support identification and charging of overseas visitors. Updated Department of Health and Social Care guidance supplements existing guidance on implementing the overseas visitor charging regulations, and has been developed with input from NHS Improvement. It sets out a framework on the practical steps and key considerations necessary for providers to implement cost recovery and meet the legal requirement to charge upfront.

Bevan Brittan Updates

Duty of Candour News Bulletin

If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.

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Public Health 

Publications/Guidance  

Cervical screening: implementation guide for primary HPV screening This guidance is to aid local providers of the NHS Cervical Screening Programme in implementing high-risk human papillomavirus testing. It includes information on: roles and responsibilities; service reconfiguration; screening tests; quality assurance; training; protocols for screening; protocols for colposcopy referrals and centralisation of screening laboratories.

Fit for the future. Public Health England has published its 2018 review of the public health workforce, comparing the results with the recommendations of the original report in 2016. The review covers progress so far and priorities for the future.

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

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Regulation

Publications/guidance

Telling patients the truth when something has gone wrong - how have professional regulators encouraged professionals to be candid to patients? This paper from the professional standards authority sets out the progress professional regulators they oversee have made in embedding the professional duty of candour (being open and honest to a patient when something has gone wrong in their care) across the UK since 2014.

News

Government admits failings over regulation of implants. The health and social care minister, Jackie DoylePrice, has admitted that patients have suffered "debilitating consequences" from medical implants that doctors had assured them would be safe where commercial interests were prioritised over patient safety, and other problems had included a lack of transparency and doctors' failure to warn patients of the risks. She stated that the Government was looking at establishing a national medical devices registry that would make all implants traceable and alert regulators to problems.

Bevan Brittan Updates

Non-Cosmetic Procedures - Pressure Builds for Better Regulation

Preparing for a CQC inspection

Ensuring a fair outcome from a CQC inspection

Duty of Candour News Bulletin

If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.   

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Social Care  

Publications/Guidance  

Relationships and sexuality in adult social care services This guidance sets out how care providers should consider people's relationship and sexuality needs.

Developing people – improving care: guides In 2016, this framework was introduced to help NHS and social care staff to develop four critical capabilities: systems leadership; established quality improvement methods; inclusive and compassionate leadership; and talent management. The newly published guidance provides further information for those with a deeper interest in these capabilities.

Juggling work and unpaid care: a growing issue This research reveals that 2.6 million people have quit their job to care for a loved one who is older, disabled or seriously ill, with nearly half a million (468,000) leaving their job in the past two years alone - more than 600 people a day. This is a 12 per cent increase since Carers UK and YouGov polled the public in 2013. The findings also show that more people have caring responsibilities than previously thought, with almost 5 million workers now juggling their paid job with caring – a dramatic rise compared with the Census 2011 figures of 3 million. The research emphasises the need for UK employers to support the rapidly increasing number of staff with caring responsibilities to stay in the workforce.

NAO charts growing pressures on children’s social care The National Audit Office says it can’t understand the reasons for the sharp rise in child protection assessments by local authorities, which are growing at a much higher rate than the population of children to age 17.

If you wish to discuss any queries you may have around social care please contact Stuart Marchant.

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General  

Publications/Guidance

Polypharmacy: getting our medicines right This report summarises the scale and complexity of the issue of polypharmacy. It outlines how health care professionals, patients and carers can find solutions when polypharmacy causes problems for patients and points to useful resources that can help. The guidance recommends that all health care organisations have systems in place to ensure people taking 10 or more medicines can be identified and highlighted as requiring a comprehensive medication review with a pharmacist.

Operating theatres: opportunities to reduce waiting lists This report provides the insight to support clinicians, managers and hospital leaders to improve how care is delivered and theatre resources and clinical expertise are used. To assess the scale of the opportunity to improve theatre productivity, NHS Improvement commissioned Deloitte to analyse theatre productivity across England.

Government response to the House of Commons Science and Technology Committee report on research integrity: clinical trials transparency This Command paper sets out the government’s response to the Science and Technology Committee’s inquiry report on clinical trials transparency published by the House of Commons in October 2018. 

Are patients benefitting from better integrated care? This briefing breaks down a range of indicators to see whether drives to integrate services have led to improvements for patients.

State of health. This report congratulates the government on its commitment to child health, commending those responsible for bold pledges in areas such as obesity, mental health and the integration of children’s health services. However, the scorecard also reveals that England continues to lag behind other western European countries on a range of child health outcomes and notes areas for improvement, particularly in universal public health provision, including: reducing child poverty and inequality; child deaths; tobacco and alcohol control; and breastfeeding.

News

Older patients spared dementia and falls by NHS tech roll-out

Hospital admissions for youths assaulted with sharp objects up almost 60%

Health and Social Care Secretary bans pagers from the NHS Matt Hancock has ordered the removal of pagers for non-emergency communications by the end of 2021.

NICE provides first scientific advice on patient preference study design The NICE Scientific Advice team, working with the Science Policy and Research team at NICE, has provided its first piece of advice on the design of a patient preference study.

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