26/11/2020

The growing impact of the Coronavirus (COVID-19) is having an unprecedented generational impact on the health and wellbeing of society across the UK and around the world. The impact is being felt in our everyday lives and is now having far reaching consequences for everyone. If you or your organisation needs advice relating to Coronavirus, Bevan Brittan has set up a COVID-19 Advisory Service which draws upon the expertise of a range of Bevan Brittan legal and regulatory teams. Please feel free to contact us.

Bevan Brittan provides high quality, comprehensive advice to the NHS, independent healthcare sector and local authorities. 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, independent sector and local authorities which have been published in the last month. 

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Training Events / Knowledge transfer

Mental Health

Acute and emergency care

Primary Care

Children/young people

Procurement 

Clinical Risk/Patient Safety

Providers

Commissioning

Public Health

Digital Health

Regulation

Employment/HR

Social Care

Finance

General

Inquests

 

 

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 

Clinical Risk Webinars
Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training -
These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your employer organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility.

Mental Health

Mental Health update 8th December 2020 12.30pm-1.30pm  

Employment

Employment Update 10th December 2020 - an update on the key developments in employment law.

New year, new immigration system…an overview of the UK’s point based immigration system 20th January 2021 11am - 11.45am.

Knowledge Transfer

Training. In addition to our free training programme for 2021 (ask Claire Bentley if you want a copy), 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.  All these sessions are available remotely via our webinar facility.

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Acute and emergency care

Publications/Guidance

Assessment of mental health services in acute trusts programme: how are people’s mental health needs met in acute hospitals, and how can this be improved? This report reviews the findings from more than 100 acute hospital inspections. It looks at how well people with mental health needs were cared for across emergency departments, acute medical wards, maternity wards, and children and young people’s services. It also tries to identify where trusts, and the wider system, need to improve.

Investigation into COVID-19 transmission in hospitals. The investigation teams visited six acute NHS trusts to carry out observations and interviews and the resulting report examines a number of factors: development and use of guidance, testing, personal protective equipment, infection prevention and control practices, hospital design, staff and organisational response.

Report of the independent review of NHS hospital food This review, advised by chef and restaurateur Prue Leith, highlights the main challenges for NHS catering and makes recommendations on how NHS trusts can prioritise food safety and provide more nutritious meals to both staff and patients. The review covers: workforce; nutrition and hydration; food safety; facilities; technology; sustainability; enforcing standards; and the way forward to improving hospital food for patients, staff and visitors.

Delays and destitution: an audit of Doctors of the World's Hospital Access Project (July 2018–20) This report finds that migrants living in extremely vulnerable circumstances in England are waiting up to 224 weeks to receive medical care because of laws forcing hospitals to carry out immigration checks and withhold care from patients deemed not eligible for free NHS treatment – even when the patient has no income, or the upfront payment would push them into severe debt or further poverty.

Securing the right support for ambulance services This briefing, produced together with the Association of Ambulance Chief Executives, calls for a focus on ambulance service funding as part of November's spending review. Securing the right support for ambulance services highlights the key role that they have played in dealing with the pandemic.

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

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Children and young people 

Publications/Guidance 

JCHR reports on the detention of young people with learning disabilities or autism: government response  Response to the Joint Committee on Human Rights (JCHR) recommendations on the rights of people with a learning disability or autistic young people in inpatient settings.

Mental Health of Children and Young People in England, 2020: wave 1 follow up to the 2017 survey This is the first in a series of follow-up reports to the Mental Health and Young People Survey (MHCYP) 2017, exploring the mental health of children and young people in July 2020, during the coronavirus (Covid-19) pandemic, and changes since 2017. Experiences of family life, education and services, and worries and anxieties during the Covid-19 pandemic are also examined.

Children and young people’s mental health review: findings from a questionnaire to health and wellbeing boards on local actions This report contains an update on work carried out in 2018 looking at the quality of mental health services for children and young people, as well as the access to these services. It sets out the findings of a 2019 independent follow-up self-assessment questionnaire, to find out the extent to which health and wellbeing board areas in England had progressed with implementing the local recommendations made. 

Child death overview panels: contacts Contact details of the people in child death overview panels (CDOPs) who are responsible for receiving child death notifications. 

Moving, always moving: the normalisation of housing insecurity among children in low income households in England This report looks at the impact of insecure housing on children and young people. It reviews previous studies on the impact on health and finds that children who frequently move home are likely to have worse health outcomes (both physical and mental) and that this can follow through to adulthood.

Special Educational Needs: support in England This House of Commons Library briefing sets out the system of support for children and young people in England aged 0-25 with special educational needs (SEN). The briefing provides an overview of the new system introduced in 2014, the transitional arrangements, and how the new system differs from that which preceded it. It also includes a brief history of the movement towards reform that preceded the 2014 changes, and information on the impact of the new system available to date.

How we can help

We can assist in relation to the statutory responsibilities for children under the Coronavirus Act 2020 including decisions around:-

  • commissioning and the provision of healthcare and social care;
  • isolation and duties toward children in the care and those classed as vulnerable under the Coronavirus ( COVID19 );
  • guidance on vulnerable children and young people;
  • the delivery of EHCP plans; 
  • safeguarding; and,
  • all aspects of educational provision including for key workers.

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 

Delays to intrapartum intervention once fetal compromise is suspected This review aimed to identify improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell. It was compiled after a review of 289 maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9 per cent of cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays.

Chair criticises lack of urgency to safeguard patient care In a letter to Health Secretary Matt Hancock and Chief Executive of NHS England and Improvement Sir Simon Stevens, the Health and Social Care Committee has criticised the failure of the Department for Health and Social Care and NHS England and Improvement to acknowledge and respond to calls for urgent action to safeguard patient care and the NHS. Noting their failure to respond to the recommendations of the Committee's report, "Delivering core NHS and care services during the pandemic and beyond", by the initial deadline, Chair of the Committee requested that substantive responses to the recommendations are provided by 16 November 2020.

Elective care in England: assessing the impact of Covid-19 and where next This analysis shows there were 4.7 million fewer people referred for routine hospital care – such as hip, knee and cataract surgery – between January and August 2020 than during the same period in 2019, representing a potential hidden backlog of unmet care needs.

The Nursing and Midwifery Council's response to NHS Improvement's consultation on the draft "Framework for involving patients in patient safety." A Nursing and Midwifery Council publication summarises its response to the NHS Patient Safety Strategy, which describes how the NHS will continuously improve patient safety, building on the foundations of a safer culture and safer systems. The response covers areas including whether the draft framework provides sufficient guidance about supporting patients to be involved in their own safety, challenges to involving patients more in their own safety that have not been recognised, and whether the Council is taking any additional approaches to involving patients and the public in patient safety work.

Claims scorecards for 2020. It is important that NHS trusts and independent sector providers review their up-to-date claims record and use this to target interventions to improve patient safety. To assist, NHS Resolution 2020 claims scorecards are now available members to review. 

Cases

Henderson v Dorset Healthcare University NHS Foundation Trust [2020] UKSC 43 A patient who had killed her mother during a severe psychotic episode was not entitled to recover damages against the health authority for its negligent failure to return her to hospital prior to the killing. Applying the public policy approach in Gray v Thames Trains Ltd [2009] UKHL 33, the claims were precluded by the illegality doctrine which prevented a claimant from being compensated for losses suffered in consequence of their own criminal act.

Telefonica UK Ltd v The Office of Communications [2020] EWCA Civ 1374 the Court of Appeal overturned the decision of the trial judge not to award additional interest on damages and costs in a case where a claimant had beaten its Part 36 offer. 

Hewes v West Hertfordshire Hospitals NHS Trust.[2020] EWCA Civ 1523 The dismissal of clinical negligence claims against a GP and an NHS Trust was upheld where the judge had been entitled to prefer the defendants' evidence as to what was a reasonable time within which the claimant should have received treatment in the context of the case. She had also applied the correct tests as to whether there had been a breach of duty.

News/articles

Doctors seek bar on legal action over who is treated during COVID-19 due to scarcity of medical resources In a letter to Prime Minister Boris Johnson, the Medical Protection Society has called on the Government to pass emergency legislation to prevent criminal or disciplinary action being taken against doctors over clinical decisions made because of scarcity of medical resources where doctors are forced to choose who will be treated during the coronavirus pandemic and who will be left to die. The request is supported by the medical campaign group, the Doctors' Association UK.        

Clinical negligence cases generate £1.1bn legal revenue The Clinical Negligence 2020 Market Report by IRN Research finds that clinical negligence cases generated over £1.1bn in legal revenue in 2019/20, an annual rise of 8.8%. However, it also suggests that the number of clinical negligence cases is decreasing because the coronavirus pandemic has made it difficult for lawyers to investigate cases.

Re-launch of the third year of the maternity incentive scheme. NHS Resolution have announced the re-launch of year three of the maternity incentive scheme from 1 October 2020, with a deadline for submissions of 12 noon on Thursday 20 May 2021. They have launched a series of recorded webinars to support trusts in understanding the requirements for year three.

General practice in focus. Since the launch of the NHS Resolution general practice indemnity schemes in April 2019 and April 2020, they have been committed to supporting beneficiaries of these schemes, including through the sharing of learning from claims.  

Research into concerns raised by healthcare organisations about practitioners. Practitioner Performance Advice are embarking on a new insights programme and will be sharing research about NHS Resolution work to support healthcare organisations where there are concerns about doctors, dentists or pharmacists.

Bevan Brittan Updates

COVID-19 transmission in hospitals: management of the risk A prospective safety investigation conducted by HSIB - Joanna Lloyd

Supreme Court Update: Defence of Illegality - Zara Bhakri

'Decision Making and Consent': New Guidance is Published by the General Medical Council - Ruth Atkinson-Wilks

Bevan Brittan Events

Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team 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. If you would like to receive more information about our webinar programme just ask Claire Bentley.

If you would like to receive the Education Lunch Programme for 2021 just ask Claire Bentley. 

How we can help

We are working with clients on formulating policies and making it easier to balance treatment with finite resources. We are helping with social care policies and day to day activities such as contact and isolation, human rights issues and life/death decisions. We are working on notifications of harm and death, RIDDOR, CQC compliance, judicial review, infection control law and grappling with the new regulations and guidance. For more information click here.

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

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Commissioning

Publications / guidance

Public health commissioning in the NHS: 2020 to 2021 Information about NHS England’s objectives and funding arrangements as it commissions public health services in the ongoing context of coronavirus.

Continuing Healthcare: getting it right first time NHS Continuing Healthcare (CHC) is administered by local NHS clinical commissioning groups (CCGs) with oversight from NHS England and NHS Improvement. This report draws on 60 cases resolved in the past three years relating to CHC. It has found not only significant failings in care and support planning but also failings in reviews of previously unassessed periods of care. The report's recommendations are rooted in the findings from the casework and point to essential changes that should be made to prevent similar failings for future care users.

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

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Digital Health

Publications/guidance

Cost effectiveness analysis: health economic studies How to use a cost effectiveness analysis to evaluate your digital health product.

Building and enabling digital teams This publication aims to help trust leaders make the next step in the digital agenda and become truly digital organisations. It sets out the practical steps boards can take to build effective, open and responsive digital teams that will deliver transformational services.

What does the future hold for digital health and care? Eight key technologies explained The Covid-19 pandemic has seen many health and care services turn to digital technology to continue meeting patients’ needs. But beyond remote consultations, what are the key technologies to look out for in the future? We explain eight key innovations and their potential to transform health and care delivery.

Digital transformation in the NHS This report says the Department of Health and Social Care (DHSC) and the NHS have a long way to go to deal with, and move on from, the legacy of their track record of failed IT programmes over almost two decades. It finds that the DHSC has not achieved its target to achieve 'a paperless NHS', which has now been watered down and moved back by six years, and expresses concerns that the DHSC and NHS bodies now risk repeating the mistakes that led to those failures and wasting taxpayers’ money.

News

£16 million to introduce digital prescribing in hospitals. 16 hospitals across England will receive a share of nearly £16 million to introduce electronic prescriptions.  

Bevan Brittan Updates

Rapid, mass adoption of digital health technology - Article from Daniel Morris published in Health Europa.   

If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.

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Employment/HR  

Publications/guidance

Workforce flexibility in the NHS: utilising Covid-19 innovations This briefing argues that the speed at which workforce innovations and flexibilities have been implemented in the NHS since the outbreak of Covid-19 has been both impressive and encouraging. It explores and makes recommendations on six key areas of change: staff wellbeing; flexibility in staff deployment and roles; cross-organisational working and regulation; technology; making use of new roles; and funding.

Covid-19 insights: impact on staff and priorities for recovery This report reveals the extensive mental and physical health impact on the NHS, and health and care professionals across the UK, as a result of working and living through Covid-19. It also identifies organisational priorities for recovery, both as the country enters the next phase of the pandemic and for the longer term.

Is there a doctor in the house? Averting a post-pandemic staffing crisis in the NHS The UK ranks 27th out of 36 OECD countries for number of physicians, and around 30 per cent of doctors on GP and specialist registers are over 55 years old. The UK relies more heavily on foreign-trained physicians than comparable countries – but within a decade it could become increasingly difficult to meet demand this way. While population growth and ageing have increased demand for doctors, such demographic factors could mean a staffing crisis is on the horizon. This paper suggests a range of cost-effective solutions to plug doctor shortages once the Covid-19 crisis has passed.

Consultant workforce shortages and solutions The NHS workforce faces a perfect storm of consultants choosing to retire earlier, a significant proportion approaching retirement age and a growing trend of younger doctors walking away from their career. Covid-19 added significant additional pressure on the workforce with doctors working long hours, in new settings, while risking their own lives. Now the NHS is facing a growing backlog of unmet need on top of the existing staffing and resourcing shortages. This report sets out the actions that the government and employers need to take, now and in the future, to ensure consultants are retained in the NHS.

Voices from the frontline of critical care medicine In October, the Faculty of Intensive Care Medicine surveyed its members about their experiences and feelings during the first wave of the Covid-19 pandemic. It finds that a majority of intensive care staff have increased their working hours, had leave cancelled and have covered sickness absences for colleagues during the pandemic. The report argues that supporting and maintaining the wellbeing of critical care staff is vitally important not only for attracting and recruiting multidisciplinary team members, but also for retaining them in the specialty.

Building and enabling digital teams This publication aims to help trust leaders make the next step in the digital agenda and become truly digital organisations. It sets out the practical steps boards can take to build effective, open and responsive digital teams that will deliver transformational services.

NHS-funded library and knowledge services in England value proposition: the gift of time According to this report, specialist library services are freeing up the time of clinicians, enabling them to devote more hours to patient care, and could be saving the NHS as much as £77 million a year. It finds that if the ratio of librarians to health professionals was increased to the level recommended by Health Education England, it’s thought that figure could rise to as much as £106 million. It also finds that health librarians and knowledge specialists make the gathering of information as easy as possible for health care professionals, relieving the burden of sourcing and making sense of evidence. This helps NHS organisations meet their statutory duty to use evidence from research within the service.

The state of the adult social care sector and workforce in England This report shows there had been a slight reduction in job vacancies, but employers still need to fill around 112,000 job vacancies on any given day. The report also reveals that the percentage of days lost to sickness in adult social care across England during the pandemic increased to 7.5 per cent between March and August 2020, compared with 2.7 per cent pre Covid-19.

Time to bring our care workers in from the cold This report looks at staff shortages and levels of pay within the care workforce and calls for pay equalisation with the NHS.

News

Over 13,700 more nurses working in the NHS The number of nurses in the NHS in England increased by 13,718 compared with last year, and the number of doctors has risen by 7,810, figures to the end of July show.

Thousands more health workers to benefit from visa extensions More than 6,000 frontline health workers will have their visas extended for a year for free, including doctors, nurses and paramedics.

Bevan Brittan Events

Employment Update 10th December 2020 - an update on the key developments in employment law.

New year, new immigration system…an overview of the UK’s point based immigration system 20th January 2021 11am - 11.45am.

How we can help

We can offer support and advice on managing many workforce issues including flexing your workforce to respond to the pandemic, managing bank staff, redeployment, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home working, through FAQs, helpline or policy guidance and practical day to day advice.  

If you wish to discuss any employment issues generally please contact Jodie Sinclair, Alastair Currie or James Gutteridge.

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Finance 

Publications/Guidance

Spending Review 2020: priorities for the NHS, social care and the nation's health This analysis highlights the scale of funding increases needed to meet the demands of Covid-19, make the improvements to services laid out in the NHS long-term plan, fix social care and secure the nation’s health for the long term. It warns that the government risks losing sight of the action needed now to shore up the future of health and care post Covid.

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

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Inquests 

Publications/Guidance

Report of the Chief Coroner to the Lord Chancellor - Sixth Annual Report: 2018-2019, Seventh Annual Report: 2019-2020 The Chief Coroner's annual report details the operation of the coroner service in 2018 to 2019 and 2019 to 2020. It sets out: the work that he as well as coroners, their investigating officers and administrative staff have achieved to manage the effects of the coronavirus (COVID-19) pandemic; progress in promoting consistency in coroner practices across England and Wales; guidance for coroners and the training he has facilitated for coroners and their investigating officers, supported by stakeholder events for local authorities and bereavement support organisations; and recommendations to improve coroner services further.

Cases 

R (on the application of Maughan) v HM Senior Coroner for Oxfordshire [2020] UKSC 46 The civil standard of proof applied to both narrative and short-form conclusions at inquests where the issue was whether the deceased had taken their own life, and at inquests where the issue was whether there had been an unlawful killing.

R (Skelton) v Senior Coroner for West Sussex and the Chief Constable of Sussex Police & Robert Trigg (interested parties) [2020] EWHC (Admin)  The Divisional Court held that when considering arguability, coroners should apply the test in Maguire, asking whether there is a ‘credible suggestion’ that a breach of substantive Art 2 rights may be established after the further and fuller investigation of all the evidence which will be available at a Middleton inquest.

Bevan Brittan Updates

A lower threshold for unlawful killing and suicide at inquests Supreme Court delivers key judgment with implications for health and safety, corporate manslaughter and suicide. - Stuart Marchant

If you wish to discuss any queries you may have around inquests please contact Toby De Mellow.

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Mental Health 

Publications/guidance 

Coronavirus (COVID-19): looking after people who lack mental capacity Guidance for health and social care staff who are caring for, or treating, a person who lacks the relevant mental capacity.

COVID-19: supporting adults with learning disabilities and autistic adults Guidance for care staff who are supporting adults with learning disabilities and autistic adults during the coronavirus (COVID-19) outbreak.

Mental health for all? This final report of the Commission finds that mental health inequalities mirror wider economic and social inequalities. Wealth and power inequalities put at risk the mental health of people experiencing poverty, racial injustice and discrimination. This creates sharp social divisions, meaning that many groups of people face two or three times the risk of mental ill health. Yet the same groups of people find it harder to get help for their mental health, and in some cases also get poorer outcomes when they do. This report highlights, however, that effective action is possible. It sets out what a system designed for equality would look like, and how communities, local organisations, public services and national government can work together to generate change at scale.

Deaths of people identified as having learning disabilities with Covid-19 in England in the spring of 2020 This review, commissioned by the Department of Health and Social Care, looked at: deaths from Covid-19 of people with learning disabilities; factors impacting the risk of death from Covid-19 of people with learning disabilities; and deaths in care settings of people with learning disabilities. It found the death rate up to six times higher from coronavirus during the first wave of the pandemic than the rate in the general population.

Assessment of mental health services in acute trusts programme: how are people’s mental health needs met in acute hospitals, and how can this be improved? This report reviews the findings from more than 100 acute hospital inspections. It looks at how well people with mental health needs were cared for across emergency departments, acute medical wards, maternity wards, and children and young people’s services. It also tries to identify where trusts, and the wider system, need to improve. 

JCHR reports on the detention of young people with learning disabilities or autism: government response  Response to the Joint Committee on Human Rights (JCHR) recommendations on the rights of people with a learning disability or autistic young people in inpatient settings.

Mental Health of Children and Young People in England, 2020: wave 1 follow up to the 2017 survey This is the first in a series of follow-up reports to the Mental Health and Young People Survey (MHCYP) 2017, exploring the mental health of children and young people in July 2020, during the coronavirus (Covid-19) pandemic, and changes since 2017. Experiences of family life, education and services, and worries and anxieties during the Covid-19 pandemic are also examined.

Children and young people’s mental health review: findings from a questionnaire to health and wellbeing boards on local actions This report contains an update on work carried out in 2018 looking at the quality of mental health services for children and young people, as well as the access to these services. It sets out the findings of a 2019 independent follow-up self-assessment questionnaire, to find out the extent to which health and wellbeing board areas in England had progressed with implementing the local recommendations made.

Flu vaccination for people with learning disability and autism This short film presentation supports general practice and pharmacy teams to carry out flu vaccinations for people with a learning disability and autistic people who may be eligible for a vaccination.

Out of sight – who cares?: Restraint, segregation and seclusion review. This report looks at the use of restraint, seclusion and segregation in care services for people with a mental health condition, a learning disability or autistic people. The main recommendations are:-
1.People with a learning disability and or autistic people who may also have a mental health condition should be supported to live in their communities. This means prompt diagnosis, local support services and effective crisis intervention.
2.People who are being cared for in hospital in the meantime must receive high-quality, person-centred, specialised care in small units. This means the right staff who are trained to support their needs supporting them along a journey to leave hospital.
3.There must be renewed attempts to reduce restrictive practice by all health and social care providers, commissioners and others. 
4.There must be increased oversight and accountability for people with a learning disability, and or autistic people who may also have a mental health problem. There must be a single point of accountability to oversee progress in this policy area.

Advancing mental health equalities strategy This strategy summarises the core actions all mental health services need to take to better address inequalities in access, experience and outcomes across the sector. It is also an important element of the overall NHS plans to accelerate action to address health inequalities in the next stage of responding to Covid-19.

Mental health rehabilitation inpatient services: results from the 2019 information request This report raises concerns about the high number of beds situated a long way from the patient’s home, which could result in people becoming isolated from their friends and families and cut off from the local services that will provide care following discharge. It makes recommendations to improve the care for people in mental health rehabilitation inpatient services.

COVID-19: providing unpaid care to adults with learning disabilities and autistic adults Guidance for people who are providing unpaid care to adults with learning disabilities and autistic adults during the coronavirus (COVID-19) outbreak.

Cases

Lancashire CC v G Family Division | [2020] EWHC 2828. It was in the best interests of a teenager, who was at high risk of serious self-harm or suicide, to authorise the deprivation of her liberty in an unregulated placement notwithstanding that it was sub-optimal from the perspective of meeting her welfare needs. The brutal reality facing the court was that if not deprived of her liberty in an unregulated placement, there was an unacceptable risk that she would end her own life or cause herself, and possibly others, very serious physical harm. The teenager had nowhere else to go; there was a shortage of secure placements and the priority needed to be to keep her safe.
Mazhar v Birmingham Community Healthcare Foundation NHS Trust. [2020] EWCA Civ 1377 The Court of Appeal gave interim guidance on making and determining without-notice, out-of-hours applications to authorise the deprivation of liberty of vulnerable adults under the inherent jurisdiction of the High Court.

A Local Authority v GP (Capacity - Care, Support and Education) [2020] EWCOP 56 This hearing was listed to determine whether the P was able to make a capacitous decision to accept or refuse care, support and education.

An NHS Trust v AF & Anor [2020] EWCOP 55 The Applicant NHS Trust was seeking a declaration that it was in the P's best interests to re-insert a PEG tube which had fallen out. The declaration was made.

TC (Urgent Medical Treatment) [2020] EWCOP 53 Application by the NHS Trust to undertake urgent medical treatment on the P who was suffering from advanced cancer of the larynx. The application was granted.

Legislation

Mental Capacity (Amendment) Act 2019: Liberty Protection Safeguards (LPS) Legislation and guidance on the Liberty Protection Safeguards (LPS) and the latest information on progress towards their implementation.

News

Judge highlights lack of accommodation for self-harming 16 year old  A High Court ruling has highlighted the chronic shortage of accommodation to support vulnerable children, with Lord MacDonald saying the lack of places left him with the choice of sending a 16 year old girl, with a history of self-harming behaviours and two apparent suicide attempts, to an unregulated placement or into the community. In his written ruling, Lord MacDonald noted the teenager was "in urgent need of a secure placement" but that "as of this morning, no such placement is available anywhere in the United Kingdom".

Bevan Brittan Updates

A lower threshold for unlawful killing and suicide at inquests Supreme Court delivers key judgment with implications for health and safety, corporate manslaughter and suicide. - Stuart Marchant

'Decision Making and Consent': New Guidance is Published by the General Medical Council - Ruth Atkinson-Wilks

Case Summary: TC (Urgent Medical Treatment) [2020] EWCOP 53 - Lauren Howe

Case Summary: A County Council v LW and another [2020] EWCOP 50 - Claire Leonard

Case Summary: Re JB (Costs) - Jane Bennett

Case Summary: SB (capacity assessment) [2020] EWCOP 43 - Ellen Lloyd

Case Summary: Re AB [2020] EWCOP 47 - Sarah Clarke

Case summary: DP v London Borough of Hillingdon [2020] EWCOP 45 - Sam Minchin

Case Summary: The Health Service Executive of Ireland v IM & Anor (Rev 1) [2020] EWCOP 5 - Jennifer
Nwachukwu

Case summary: P v Griffith [2020] EWCOP 46 - Ruth Atkinson-Wilks

Case summary: Cornwall Council v NP [2020] EWCOP 44 - Julia Jones

Bevan Brittan Education Lunches 

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. Please contact Claire Bentley if you would like to attend any of our webinars remotely/would like to receive our education lunch programme for 2021. 

Mental Health Webinars coming up are:-

8th December 2020 12.30pm - Mental Health update

If you wish to discuss any mental health issues facing your organisation please contact Hannah TaylorSimon Lindsay or Stuart Marchant

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Primary Care  

Publications/guidance

GP premises survey: post Covid-19 With the emergency response to the Covid-19 pandemic disrupting many patients’ access to GP services, this survey investigated what patients felt about their GP’s premises, and whether they would be confident to return to them. It found ongoing high levels of confidence about visiting GP premises, and a strong expectation among patients that they would feel welcome, confident and safe on future visits. The survey responses also shed further light on patients’ access to GP services during the pandemic, with many being offered phone consultations, and relatively few getting online video calls. For a substantial minority of patients, online contact was not sufficient to resolve their issue, and they needed to make an in-person visit.

Guidance on workload prioritisation during Covid-19 pandemic level rising This guidance reflects the increasing prevalence of Covid-19 around the country and helps to support GPs and their teams in making local decisions based on local circumstances.

Early evidence of the development of primary care networks in England: a rapid evaluation study Primary care networks are groups of general practices brought together in July 2019 to develop new services using a shared budget, in response to NHS England/Improvement policy. This study examined the early implementation of primary care networks, especially what has helped or hindered progress, how they operate in relation to pre-existing collaborations, and issues for rural networks.

Accessing government-secured flu vaccines: guidance for GPs How GP practices in England can access the extra stock of flu vaccines this winter that the government has secured.

COVID-19 testing in general practice Information for general practices on providing coronavirus (COVID-19) testing.

Deafness and hearing loss toolkit This educational toolkit, produced in collaboration with RNID and NHS England and Improvement, aims to support GPs to consult effectively with deaf patients by offering tips on how to communicate during face-to-face and remote appointments.

News

General practice in focus. Since the launch of the NHS Resolution general practice indemnity schemes in April 2019 and April 2020, they have been committed to supporting beneficiaries of these schemes, including through the sharing of learning from claims.

Management of the long-term effects of COVID-19 A survey of the Royal College of General Practitioners (RCGP) members in September 2020 showed 67% of those who responded were looking after at least one patient with ongoing symptoms of COVID-19 lasting more than 12 weeks.

Introducing digital prescribing in hospitals Hospitals across England will receive a share of nearly £16 million to introduce electronic prescriptions.             

Bevan Brittan Updates/Videos

Bevan Brittan has collaborated with NHS Resolution to produce a series of videos outlining key areas in general practice that frequently give rise to claims. Members of our clinical negligence team draw on their wealth of experience in dealing with claims to highlight the common areas of risk, provide guidance on how to mitigate or avoid these issues, and what steps to take if a complaint or a claim is received. The first three videos in this series are available to watch now. See below:-
Consent - Daniel Morris
Medical record keeping - Ben Lambert
Administrative errors - Susan Trigg
What to do if you receive a complaint or claim - Joanne Easterbrook
Common pitfalls - Helen Carrington

Other useful resources from NHS Resolution for primary care are set out below:-
1. General Practice Indemnity schemes
2. Understanding the Clinical Negligence Scheme for General Practice
3. Handling claims under the Clinical Negligence Scheme for General Practice
4. Covid-19 guidance for general practice 

How we can help   

We can offer support and advice on managing contractual and operational issues affecting the delivery of primary care services, including emerging legislative changes, updated guidance and policy arrangements, workforce issues and any transactional – related matters relating to vertical integrations, STPs, PCNs, etc.

If you wish to discuss any commercial, corporate or regulatory issues in primary care then please contact Vincent Buscemi.  

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Procurement 

Publications/Guidance  

Investigation into government procurement during the Covid-19 pandemic This report finds a lack of transparency and adequate documentation of some key decisions (such as why particular suppliers were chosen or how the government identified and managed potential conflicts of interest) in the awarding of some contracts while the government was procuring large volumes of goods and services at high speed to respond to the Covid-19 pandemic.

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

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Providers 

Publications/Guidance  

Claims scorecards for 2020. It is important that NHS trusts and independent sector providers review their up-to-date claims record and use this to target interventions to improve patient safety. To assist, NHS Resolution 2020 claims scorecards are now available for members to review.

Funding agreed for video consultations in secondary care £10 million will be available to NHS providers and systems to support video consultation software provision in secondary care for 2021/22.

The future of integrated care in England With the government expected to introduce new primary legislation affecting the NHS over the coming year, NHS leaders have set out the factors they believe should be central to a new framework for integrated care systems in this report which summarises feedback from a six-month engagement process. The report argues that joint working across health and care should be embedded in law and encouraged through a new statutory duty for all providers, commissioners and other partners in local systems.

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

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Public Health 

Publications/guidance

Public health commissioning in the NHS: 2020 to 2021 Information about NHS England’s objectives and funding arrangements as it commissions public health services in the ongoing context of coronavirus.

NHS public health functions agreements. Agreements setting out the outcomes to be achieved and the funding provided for NHS England to commission public health services.

Review of NHS Health Checks: terms of reference The Department of Health and Social Care has commissioned Public Health England to undertake an evidence-based review of how NHS Health Checks can evolve in the next decade to maximise the future benefits of the programme. Specifically. the review will look at how the programme can be improved to prevent ill health and reduce health inequalities.

Saving a lost decade: how a new deal for public health can help build a healthier nation This report reveals the wider consequences of inaction on health improvement and prevention. It argues that the decision to transfer health protection functions from Public Health England to a new National Institute for Health Protection presents an opportunity to reimagine and design a better public health system.

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

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Regulation 

Publications/guidance

CQC reports on the findings of its coronavirus (COVID-19) inpatient experience survey The Care Quality Commission's coronavirus (COVID-19) inpatient survey illustrates that most people are positive about the care and treatment they received in hospital during the first wave of the pandemic, but those diagnosed with coronavirus had poorer experiences than those without the virus. The results also reveal some concerns that certain groups found some aspects of their hospital stay more difficult, such as: people with dementia or Alzheimer's; and those with a mental health condition.

Consultations

MHRA draft guidance on randomised controlled trials generating real-world evidence to support regulatory decisions. A Medicines and Healthcare products Regulatory Agency consultation seeks comments on the clarity and wording of its new guidance on randomised controlled trials generating real-world evidence to support regulatory decisions. Comments by 11 December 2020.

News

CQC reports on the findings of its coronavirus (COVID-19) inpatient experience survey The Care Quality Commission's coronavirus (COVID-19) inpatient survey illustrates that most people are positive about the care and treatment they received in hospital during the first wave of the pandemic, but those diagnosed with coronavirus had poorer experiences than those without the virus. The results also reveal some concerns that certain groups found some aspects of their hospital stay more difficult, such as: people with dementia or Alzheimer's; and those with a mental health condition.

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

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Social Care  

Publications/Guidance 

CQC – The State of healthcare and adult social care in England 2019/2020 CQC Reviews the challenges and inspection findings in social care over the past year, both pre pandemic and during the pandemic.

CQC – Infection Control Report – November 2020 Sets out the findings of CQC during their first 440 infection control inspections of care homes.

CQC – The world of health and social care is changing. So are We. CQC’s Draft for discussion. The new strategy is due in March 2021.

Local Government and Social Care Ombudsman Annual Report 2019/2020 This report calls for a statutory requirement to be placed on care providers to sign post people to the local complaints process and to their right to seek independent review of the Ombudsman.  

CQC – Out of Sight – who cares? A review of restraint, seclusion and segregation for autistic people, and people with learning disability and/or mental health condition.

Adult social care: coronavirus (COVID-19) winter plan 2020 to 2021 The government's ambitions for the sector and the challenges facing adult social care this winter.

Care Homes Visitor Guidance

Coronavirus: Adult social care key issues and sources This Commons Library briefing paper provides an overview of key issues facing the adult social care sector during the coronavirus (Covid-19) outbreak, and provides links to some of the key official guidance for the sector.

Social care: funding and workforce This report calls for a £7 billion annual increase in social care funding as a starting point for reform. It backs the introduction of a lifetime cap to protect against potentially high care costs as originally proposed by the Dilnot Commission and endorses further consideration of free personal care.

Guidance for the health and care sector from 1 January 2021 Information for industry and organisations involved in health and care to prepare for the end of the Brexit transition period on 31 December 2020.

Coronavirus (COVID-19): reducing risk in adult social care An update to the framework for how adult social care employers should assess and reduce risk to their workforce during the coronavirus pandemic.

The state of the adult social care sector and workforce in England This Skills for Care report shows there had been a slight reduction in job vacancies, but employers still need to fill around 112,000 job vacancies on any given day. The report also reveals that the percentage of days lost to sickness in adult social care across England during the pandemic increased to 7.5 per cent between March and August 2020, compared with 2.7 per cent pre Covid-19.

A telling experience: understanding the impact of Covid-19 on people who access care and support – a rapid evidence review with recommendations This report aims to identify what worked well, and to highlight areas that people found difficult, both generally and in relation to social care during the first phase of the coronavirus pandemic, seen through the lens of personalisation.

Amnesty International – As if Expendable A report claiming the UK’s failure to protect older people in care homes during the Covid 19 pandemic.

Coronavirus: Adult social care key issues and sources This Commons Library briefing paper provides an overview of key issues facing the adult social care sector during the coronavirus (Covid-19) outbreak, and provides links to some of the key official guidance for the sector.

News

COVID-19: providing unpaid care to adults with learning disabilities and autistic adults Guidance for people who are providing unpaid care to adults with learning disabilities and autistic adults during the coronavirus (COVID-19) outbreak.

Bevan Brittan Updates

All Change: Care Home Manager Role and Liberty Protection Safeguards (LPS) - Julia Jones

Considering the New Guidance for Visiting Arrangements in Care Homes - Hannah Taylor

A lower threshold for unlawful killing and suicide at inquests Supreme Court delivers key judgment with implications for health and safety, corporate manslaughter and suicide. - Stuart Marchant


If you wish to discuss any queries you may have around social care please contact Siwan GriffithsCarlton Sadler, or Stuart Marchant.

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General 

Publications/Guidance 

Updating ethnic contrasts in deaths involving the coronavirus (Covid-19), England and Wales : deaths occurring 2 March to 28 July 2020 This report confirms that when adjusting for age, rates of death involving Covid-19 remain greater for most ethnic minority groups, and most notably so for people of black African, black Caribbean, Bangladeshi and Pakistani ethnic backgrounds. The statistical modelling shows that a large proportion of the difference in the risk of Covid-19 mortality between ethnic groups can be explained by demographic, geographical and socio-economic factors. It also found that although specific pre-existing conditions place people at greater risk of Covid-19 mortality generally, this does not explain the remaining ethnic background differences in mortality.

Coronavirus (COVID-19) testing: privacy information Privacy notice for NHS Test and Trace virus testing for all users of the service.

Social media giants agree package of measures with UK Government to tackle vaccine disinformation Platforms and UK government agree a package of measures to reduce vaccine disinformation.

The state of ageing in 2020 This report provides a snapshot of how people are ageing in the UK through the analysis of nationally available data. It explores the state of our health, our finances and our communities when Covid-19 hit and the impact it has had so far. It finds that the pervasiveness of poor health, unsafe and low-quality housing, and a lack of social connections – particularly among the poorest in our society – has exacerbated the impact of the pandemic on those who already faced the most challenging prospects in later life. It argues that if the current trajectory is allowed to continue, the gap between those who are able to enjoy later life and those who struggle through it will be even wider for future generations.

The Independent SAGE report 21: Covid-19 and health inequality This report examines health inequalities in Covid-19, contextualising them within the wider issue of health inequalities. It outlines key recommendations that local government and devolved authorities, the NHS and national government should follow to reduce these inequalities.     

News

Coronavirus causes spike in serious cyberattacks The National Cyber Security Centre's annual review has revealed an 11 per cent spike in the number of incidents requiring a response from the agency. It also reports that more than 160 'high-risk and critical vulnerabilities' were reported to NHS trusts during the period from 1 September 2019 to 31 August 2020.

The future unmasked: predicting the future of healthcare and life sciences in 2025. Prediction two: better public health drives better productivity This is the second of ten predictions from Deloitte, informed by emerging evidence of the impact of the Covid-19 pandemic on society and on health and care systems. It predicts that in 2025, most countries will have established well-funded statutory public health organisations supported by regionally co-ordinated public health agencies, a diverse and well-qualified workforce, and modern data systems. It also predicts that digital inclusion and equality of access to innovations in health protection and prevention will have reduced health risks and improved health outcomes.

If you wish to discuss any queries around this general topic please contact Claire Bentley.

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