28/02/2023
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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Bevan Brittan Free Training Events
Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training - These are internal hour long lunch time training sessions. You can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley.
HE spring webinar series: Employment and immigration issues affecting higher education in 2023. 8 March 2023 12pm
In discussion: the future of anonymity in health and social care cases. 23 March 2023 12.30pm
Understanding autism and assessing capacity 30 March 2023 12.30pm
Please note that registration for each webinar will close one hour before the webinar starts, so please do ensure you have booked your place in advance to guarantee attendance.
Acute and emergency care
Publications/guidance
Accident and emergency (A&E) waiting times. Accident and emergency (A&E) waiting times are one of the most high-profile indicators of how hospitals are performing. How is A&E performance measured and what influences how long people wait?
Delayed hospital discharges and adult social care
This explainer sets out what the government is doing to reduce the number of people staying in hospital longer than necessary.
The A&E crisis: what’s really driving poor performance?
This briefing paper seeks to understand what is actually happening in emergency departments and, using publicly available data, challenges some of the arguments frequently heard about the A&E crisis. It identifies areas for further investigation that the authors believe could be key to stabilising the system.
An NHS in crisis: patients are now waiting longer for almost every type of emergency care
As patients wait longer and longer for care, what can be done to reduce waiting times and restore emergency services? Danielle Jefferies from The King's Fund argues that action needs to be taken right across emergency and inpatient pathways.
Delivery plan for recovering urgent and emergency care services
To support recovery, this plan sets out a number of ambitions, including: patients being seen more quickly in emergency departments, with the ambition to improve to 76 per cent of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25; and ambulances getting to patients more quickly: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels.
Interim bulletin 3: Harm caused by delays in transferring patients to the right place of care. A third interim report by the Healthcare Safety Investigation Branch (HSIB) on its investigation exploring the impact of staff wellbeing on patient safety focuses on staff wellbeing across the urgent and emergency care systems. The investigation concluded that whilst staff are trying their best to give good care, harm is happening and that affects the outcomes for patients and the ability for them to stay well. The report shows the strong link between patient safety and wellbeing and has emphasised that the two national plans overseeing both areas are not interlinked (The NHS People Plan 2020 and the NHS Patient Safety Strategy) as yet. The reports states that NHS England have recognised this and to support this, HSIB have made a safety recommendation that they include staff health and wellbeing as a critical component of patient safety in the NHS Patient Safety Strategy.
Minimum service levels in event of strike action: ambulance services: open consultation. A Department of Health and Social Care consultation seeks comments on minimum service levels in England, Scotland and Wales during passage of the Strikes (Minimum Service Levels) Bill 2022-23 to ensure that patient safety is protected. It seeks views on introducing regulations on minimum service levels to support the health service during strike action. Comments by 23.45 on 4 May 2023.
News
New A&E target branded ‘extremely unambitious’.
NHS to expand services to keep vulnerable out of hospital. Tens of thousands of elderly and vulnerable people will receive tailored support at home as part of a new NHS plan to improve waiting times for emergency care.
Major plan to recover urgent and emergency care services
If you wish to discuss any queries you may have around acute and emergency issues please contact Claire Bentley.
Children and young people
Publications/Guidance
DfE Regulating Supported Accommodation consultation: Response by the Youth Justice Board for England and Wales. In response to the Department for Education (DfE) consultation on proposed regulations and guidance for supported accommodation for looked after children (LAC) and care leavers aged 16 and 17, the Youth Justice Board for England and Wales is pleased to see that the standards are strengths-based with a strong emphasis on the individual needs of children. It supports the decision to make the standards part of OFSTED's inspection regime, and notes that it is positive to see that the protection standard states that the registered provider must carry out a location assessment for their accommodation focusing on any safeguarding concerns. It expresses minor concerns with the decision not to introduce a ban on the use of non-permanent settings when placing children.
Digital mental health tech for children and young people recommended by NICE in first rapid healthtech guidance. The National Institute for Health and Care Excellence (NICE) has announced that four digital technologies that can help children and young people aged 5 to 18 with mild to moderate symptoms of anxiety or low mood have been recommended for use in the NHS once they achieve regulatory approval by NHS England. NICE guidance is to be reviewed following a final early value assessment on the use of the technologies to include this additional evidence and make a recommendation on the routine use across the NHS.
Kettering General Hospital NHS Foundation Trust v C. Source: [2023] EWFC 12. Where it was likely that a mother had transmitted HIV to her unborn baby, it was necessary and proportionate for the court to use its inherent jurisdiction to allow a hospital trust to administer antiretroviral treatment to the baby almost immediately after birth, in the event that the mother refused to consent. It was clearly in the baby's best interests to be given the best chance of becoming HIV negative, notwithstanding that the mother had a deep-rooted distrust of medical services.
The SEND and AP improvement plan confirms investment in training for thousands of workers so children can get the help they need earlier, alongside thousands of additional specialist school places for those with the greatest needs – as 33 new special free schools are approved to be built.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah or Ruth Shedlow.
Clinical Risk / Patient Safety
Publications/Guidance
Covid clinical negligence protocol cut number of litigated claims. The COVID-19 clinical negligence protocol, a collaboration between NHS Resolution, Action against Medical Accidents and the Society of Clinical Injury Lawyers, that was launched in August 2020 and last updated in June 2021, which was agreed in the wake of COVID-19 to better manage clinical negligence claims during the pandemic, is remaining in place after it appeared to reduce the number of contested cases. There has been a 6% reduction in litigated cases in the last two financial years, equating to 572 cases, where the average difference in costs paid to claimant solicitors on litigated versus non-litigated closed cases was around £57,000 per claim. However, NHS Resolution has cautioned that it had still to investigate the impact of COVID on the number of claims before it could be certain about the extent to which the fall in litigated claims was due to the protocol.
Independent health care and the NHS. The Kings Fund set out some of the trends in public and private spending on independent sector health care providers. They consider what factors may be driving these trends, look at the impact this has on household spending among different groups, and consider some of the implications for the public and the NHS.
Patient Safety Commissioner: 100 days report
Dr Henrietta Hughes, England’s Patient Safety Commissioner, has released a report of her first 100 days in the role. The report outlines how Dr Hughes has heard from patients, families, health care professionals and senior leaders on what needs to change to improve the safety of medicines and medical devices. In it, she calls for a cultural change throughout the health system and sets out her plans for the future.
Urgent action needed to prevent eating disorder deaths. Highlighting little progress since the publication of its 2017 report, "Ignoring the alarms: How NHS eating disorder services are failing patients", which highlighted serious failings, the Parliamentary and Health Service Ombudsman (PHSO) has warned that people with eating disorders are being repeatedly failed by the system and radical changes need to be made to prevent further tragedies. Conceding that some progress has been made, such as scaling up early intervention services to support children and young people and the General Medical Council's work to identify and address gaps around eating disorders in medical curricula, the Ombudsman insists that unacceptable recurrent issues within the service can lead to avoidable deaths and notes that, since the beginning of April 2019, it has received 234 complaints relating to eating disorder services.
Professional Standards Authority consultation on their Draft Strategic Plan 2023-26: AvMA response. Responding to the Professional Standards Authority report on the challenges affecting the quality and safety of health and social care across the UK and recommendations to ensure safer care for all, Action Against Medical Accidents (AvMA) makes several observations on two of the Authority's three strategic aims: Strategic aim 1 - to protect the public by delivering highly effective oversight of regulation and registration; and Strategic aim 3 - to promote and support safer care for all. It also states the view that the Authority's role in "overseeing" the work of the 10 statutory bodies that regulate health and social care professionals in the UK could be made more expansive in that it is in a unique position to see the totality of the effectiveness of professional regulation and where each could learn from each other and improve, as well as try and ensure that the totality of regulation is as joined-up as possible in what is a fragmented system.
Terms of reference for rapid review into data on mental health inpatient settings. Department of Health and Social Care guidance sets out the terms of reference for the rapid review into data on risks to patient safety in inpatient mental health settings and pathways. A report will be produced in spring 2023 on the findings, including a set of agreed recommendations for improvements in the way local and national data is gathered and used to monitor patient safety in mental health inpatient services.
Access to critical patient information at the bedside. An independent report by the Healthcare Safety Investigation Branch on critical information about patients and how, in an emergency, it is accessed at a patient's bedside on a hospital ward by healthcare staff recommends that the Office of the National Data Guardian supports local interpretation of the Caldicott Principles to give organisations and staff the confidence to display full patient names at the bedside to support correct patient identification for safer care. It also recommends that: NHS England develops guidance to providers to help ensure critical patient information is available to clinical staff when accessing electronic patient record systems; and that the British Standards Institution provides symbology to standardise how information relating to a patient's resuscitation status can be displayed in digital systems.
News
Healthcare Safety Investigation Branch: Transition Update. A written statement by the Department of Health and Social Care provides an update on the Government's timetable to establish the Health Services Safety Investigations Body (HSSIB) under Health and Care Act 2022, and the Maternity and Newborn Safety Investigations Special Health Authority (MNSI), both of which were expected to be operational in April 2023. However, there will be a delay of six months until October 2023 to the expected establishment of both, which will enable all the necessary work to be completed to ensure a smooth transition of these investigation programmes.
Lord O'Shaughnessy to lead independent review into UK clinical trials. Lord James O'Shaughnessy has been appointed to conduct an independent review into the UK commercial clinical trials landscape. The review will offer recommendations on how commercial clinical trials can help the life sciences sector unlock UK growth and investment opportunities. This will also advise on how to resolve key challenges in conducting commercial clinical trials in the UK. Lord O'Shaughnessy will publish his advice this spring. This will include recommendations of priority actions to make progress in 2023, as well as setting out longer-term ambitions for UK clinical trials.
Bevan Brittan Updates
Government consultation outcome: appropriate clinical negligence cover.
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 Joanne Easterbrook or Tim Hodgetts.
Digital Health
Publications/guidance
New strategy to boost NHS access to innovative medical technology. The medical technology strategy will ensure patients can access safe, effective and innovative equipment and medical devices.
Evaluation of government commitments made on the digitisation of the NHS. This report from an independent panel of experts has found the government is making inadequate progress on vital commitments to digitise the NHS. Government commitments evaluated by the panel include the delivery of integrated health and care records, the rollout of the NHS app and ensuring a workforce had the necessary digital skills. Despite some encouraging progress, the panel found that key government commitments on workforce and the use of patient information were either not met or were not on track to be met. It found that overall progress towards improving the digital capabilities of the NHS was too slow, and often lacked support and funding.
Care data matters: a roadmap for better data for adult social care
This draft document sets out the government’s roadmap for transforming adult social care data in England and seeks views on the data needed to commission, deliver and oversee care and support. The responses should be submitted by 31 July 2023.
Digital mental health tech for children and young people recommended by NICE in first rapid healthtech guidance
NICE has recommended four digital technologies to help children and young people who have mild to moderate symptoms of anxiety or low mood. These technologies could be rolled out once they have achieved regulatory approval.
Greater access, better insight, improved outcomes: a strategy for data-driven care in the digital age. A Scottish Government publication outlines Scotland's first data strategy for health and social care, which aims to transform the way that people access their own data to improve health and wellbeing, and how care is delivered through improvements to its systems and infrastructure.
Using technology and digital devices to make a positive impact on health and wellbeing for people experiencing care: Practice guide. Care Inspectorate guidance for those who rely on digital connectivity and technology to support their wellbeing and daily activities in the care industry: highlights good practice that supports good outcomes; helps care services, their staff and Care Inspectorate staff to achieve positive experiences of digital technology to support care; and supports care providers to better understand and offer good quality digital engagement.
Evaluation of Government commitments made on the digitisation of the NHS: Fourth Special Report of Session 2022-23. A Health and Social Care Committee report highlights the conclusions of an independent panel of experts that the Government is making inadequate progress on vital commitments to digitise the NHS. Despite some encouraging progress, the panel found that key Government commitments on workforce and the use of patient information were either not met or were not on track to be met. The panel found that overall progress towards improving the digital capabilities of the NHS was too slow, and often lacked support and funding. The experts concluded that social care was often missed out in commitments, stifling progress across the health and care system.
Artificial intelligence (AI) and digital healthcare technologies capability framework. HEE commissioned the University of Manchester to perform a learning needs analysis and develop a framework outlining the skills and capabilities to ensure health and care professionals can work in a digitally enhanced environment.
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
NHS Workforce Race Equality Standard (WRES): 2022 data analysis report for NHS trusts. This report aims to provide a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda. It also seeks to enable organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice.
The Department of Health and Social Care's written evidence to the NHS Pay Review Body (NHSPRB) for the 2023 to 2024 pay round
The NHSPRB has been asked to make pay recommendations for the pay round 2023 to 2024. This written evidence aims to enable the NHSPRB to make independent recommendations, weighing all of the evidence, within the current challenging economic and fiscal context, along with recruitment and retention trends and staff motivation.
The Department of Health and Social Care's written evidence to the Doctors' and Dentists' Remuneration Body (DDRB) for the pay round 2023 to 2024
The DDRB has been asked to make pay recommendations for the pay round 2023 to 2024 on: uplifts for consultants, doctors and dentists in training; the minimum and maximum pay ranges for salaried general medical practitioners; and the pay element of remuneration for dentists employed by, or providing services to, the NHS.
Minimum service levels in event of strike action: ambulance services in England, Scotland and Wales
The DHSC is seeking views during passage of the Strikes (Minimum Service Levels) Bill on, subject to parliamentary approval, introducing regulations on minimum service levels in England, Scotland and Wales to support minimum service levels in the health service during strike action to protect patient safety. The consultation closes at 11.45am on 9 May 2023.
Long Covid & employment
This report calls on the government to introduce guidance for employers on long Covid alongside a compensation scheme for frontline workers.
Basis of negotiation: recommendations to improve the NHS pay review process
With the NHS pay review process recently coming in for criticism, this long read presents an 11-point plan to help make it more fit for purpose. It sets out practical recommendations – for the UK governments, pay review bodies and unions – to improve the current pay review arrangements.
Who cares? The experience of social care workers, and the enforcement of employment rights in the sector
This report finds that social care workers have higher levels of job satisfaction and stronger job attachment than those in other low-paying sectors, but many have to contend with unsafe working conditions and unlawful underpayment of the minimum wage. This report combines new statistical analysis with findings from a series of focus groups with frontline social care workers, to shine a light on the nature of the jobs they do, the challenges they face, and the priorities for improvement.
Clinical academics in the NHS inquiry
Clinical academics are qualified doctors who combine working as a specialist doctor with research and/or teaching responsibilities. The House of Lords Science and Technology Committee have concluded an inquiry into clinical academics in the NHS. This letter to Steve Barclay MP, Secretary of State for Health and Social Care, sets out their findings as well as their conclusions and recommendations. The overarching conclusion is that, rather than an additional pressure on the resources of the NHS, engagement with research can help to mitigate workforce challenges and improve patient outcomes. However, they also conclude that the clinical research environment in the NHS is on a precipice and without action these benefits could be lost.
NMC supports forcibly displaced professionals to join the register. The Nursing and Midwifery Council (NMC) has published a new policy to support forcibly displaced people to join its register safely. The policy explains how NMC will work with eligible applicants to take account of alternative evidence that shows how they meet its standards when applying to join this register, when it is safe and reasonable to do so.
Managing NHS backlogs and waiting times in England. This report finds that cancer waiting times are at their worst recorded level and NHS England will not meet its first cancer recovery target, and that the wider NHS recovery plan may not be achieved on time. It argues that the NHS is still not planning properly for the staffing and other resources it needs to deliver additional diagnostic and treatment capacity, though much of it was already needed before the Covid-19 pandemic.
Future proof: the impact of parental and caring responsibilities on surgical careers. Support for working parents is vital for ensuring staff currently employed by the NHS achieve work–life balance, particularly amidst a workforce crisis driven by poor retention as well as recruitment. The Royal College of Surgeons of England commissioned the Nuffield Trust to explore the impact of parental and caring responsibilities on surgical careers in order to understand the issues within that profession.
Progression of parents in NHS medical and nursing careers. This report examines how the length of parental leave and rates of progression after having children vary by specialty, gender and other staff characteristics among doctors, dentists, nurses and midwives in the English NHS.
The NHS workforce in England. This briefing covers the NHS workforce in England, including key targets, recruitment and retention issues, workforce planning and government policy.
News
Trust must pay £200k to whistleblower it subjected to ‘campaign of harassment’.
Bevan Brittan Events
HE spring webinar series: Employment and immigration issues affecting higher education in 2023. 8 March 2023 12pm
Bevan Brittan Updates
Government consultation: Calculating holiday entitlement for part-year and irregular hours workers.
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, James Gutteridge or Andrew Uttley
Health Inequalities
Publications/Guidance
UK poverty 2023: the essential guide to understanding poverty in the UK. This report sets out recent trends in poverty across the UK and how levels of poverty differ between groups of people and regions. It also describes the impact it has on people’s lives, including physical and mental health.
The rising cost of living: a review of interventions to reduce impacts on health inequalities in London. This report presents the results of the second in a series of rapid reviews looking at the impact of the cost-of-living crisis in London. It explores interventions that local authorities, the GLA and other system partners could make to help reduce health inequalities at this time.
Investing to reduce tobacco usage and tackle associated health inequalities. This short briefing brings together the key messages from the policies and guidance that support work to reduce tobacco usage in England. It also identifies the funding streams in place to enable the work to be undertaken.
The role of estates in reducing health inequalities. NHS England has developed guidance to help estates, facilities and other relevant colleagues to understand the role they can play in reducing health inequalities.
Access to care: reducing health inequalities for people living with sickle cell disorder. Joni Jabbal outlines how people living with sickle cell experience discrimination when trying to access health care, and considers how we can reduce these health inequalities.
10 steps hospitals can take to tackle ethnic inequalities in elective waiting lists. Across England, hospital activity continues to be seriously impacted by the Covid-19 pandemic with large falls in routine care resulting in millions of patients now subject to vast backlogs. Data analysis shows people from Asian groups faced larger falls in planned hospital care – both before and during the pandemic – than people from White, Black or Mixed ethnic groups. This infographic resource, designed in collaboration with the Nuffield Trust, aims to support the health care system by highlighting 10 key ways to tackle these disparities, and to take practical actions to address the ethnicity gap in care provision.
Healthcare inequalities: access to NHS prescribing and exemption schemes in England
This report looks at health care inequalities in relation to NHS prescribing and exemption schemes in England. It considers uptake in deprived and other under-served communities, providing actionable insights with a focus on three clinical areas of prescribing: chronic obstructive pulmonary disease, hypertension, and severe mental illness.
Health inequalities: cold or damp homes. Cold or damp homes can exacerbate existing health inequalities. This briefing discusses the prevalence, cause, and health impacts of cold or damp homes in the UK, with a focus on England.
How we can help
We have a multidisciplinary team advising NHS commissioners and providers on all aspects of tackling health inequalities, ranging from:
- advising on the new legal framework and compliance with the relevant statutory duties, particularly in the context of service reconfiguration;
- addressing workforce inequalities;
- taking action on patient safety to reduce health inequalities;
- the role of the Care Quality Commission in tackling health inequalities; and
- lessons to be learnt from the Covid-19 pandemic.
If you wish to discuss any queries you may have around health inequalities please contact Olivia Carter or Julia Jones.
Housing and homelessness
Publications/Guidance
Health inequalities: Cold or damp homes: Research Briefing. A House of Commons Library briefing discusses the prevalence, cause, and health impacts of cold or damp homes in the UK, with a focus on England. It includes discussion on Government action to address damp and mould in rented housing; rented housing standards and tenants' rights; and building standards for new homes.
No more sticking plasters: repairing and transforming the NHS estate. This report finds that the NHS's efforts to deliver national priorities including elective recovery and improvements in productivity are being put at risk because of a damaging lack of investment in buildings and facilities. It argues that major capital investment is crucial to enabling trusts to improve productivity, operational performance and patient care across all sectors.
The cost of poor housing by tenure in England. This report analyses the impact of substandard housing to the NHS, broken down by tenure type (owner occupied, private rental and social housing). The research finds that more than 700,000 homes in England are defined as excessively cold and that the NHS spends more than £540 million a year treating people affected by the worst properties.
If you wish to discuss any queries you may have around housing and homelessness please contact Julia Jones.
Independent Health
Publications/guidance
Independent health care and the NHS. The Kings Fund set out some of the trends in public and private spending on independent sector health care providers. They consider what factors may be driving these trends, look at the impact this has on household spending among different groups, and consider some of the implications for the public and the NHS.
Does it matter that people are opting out of the NHS into private treatment? More people are making the choice to opt out of long NHS waiting lists and into private health care provision. Does it matter? Sally Warren explains why she thinks the answer to this question is both ‘yes’ and ‘no’.
For more information contact Tim Hodgetts or Julie Charlton
Information Sharing/Data
Publications/Guidance
Good record keeping: Guide for care providers. A Local Government and Social Care Ombudsman guide to help care providers learn from its complaints involving record keeping. It focuses on a number of case studies highlighting the common issues the Ombudsman sees, and also includes good practice tips to help providers avoid the problems from occurring in their own settings. Issues covered include providers fabricating records after a serious incident, customers being given wrong or no medication or food because records were not updated properly, and delayed treatment for another customer because of inaccurate records.
NHS Covid-19 Data Store and NHS National Data Platform: a summary of a private roundtable.
This publication is a summary from a roundtable discussion with public servants and others on the NHS Covid-19 Data Store and NHS National Data Platform.
Medical technology strategy
This report outlines the government's plans to work with the UK medtech sector and help the health and care system access new medical technologies.
When will the government and national agencies act to ensure that ethnicity coding in health records is fit for purpose?
All governments in recent decades have committed to reducing health inequalities, including among ethnic minority groups. But, asks The King's Fund's Veena Raleigh, is ethnicity coding in health records fit for purpose?
Making the most of your electronic patient record system
This guide is for trusts who have an electronic patient record system (EPR) already in place and want to realise the transformational opportunities it presents. It focuses on the role of the board in leading these changes. In December 2022, NHS England estimated that 181/211 trusts in England had some form of EPR and it is expected that at least 90 per cent of trusts will have implemented an EPR by December 2023.
Data sharing during coronavirus: lessons for government. An Institute for Government report explores the lessons learned from six case studies and other research on government data sharing during the COVID-19 pandemic. It recommends that the Government retain data protection officers and data protection impact assessments within the Data Protection and Digital Information Bill 2022-23, and consider strengthening provisions around citizen engagement and how to ensure data flows during emergency response. it also suggests that the Department for Levelling Up, Housing and Communities consults on how to improve working around data between central and local government in England.
Terms of reference for rapid review into data on mental health inpatient settings. Department of Health and Social Care guidance sets out the terms of reference for the rapid review into data on risks to patient safety in inpatient mental health settings and pathways. A report will be produced in spring 2023 on the findings, including a set of agreed recommendations for improvements in the way local and national data is gathered and used to monitor patient safety in mental health inpatient services.
Good record keeping: Guide for care providers. A Local Government and Social Care Ombudsman guide to help care providers learn from its complaints involving record keeping. It focuses on a number of case studies highlighting the common issues the Ombudsman sees, and also includes good practice tips to help providers avoid the problems from occurring in their own settings. Issues covered include providers fabricating records after a serious incident, customers being given wrong or no medication or food because records were not updated properly, and delayed treatment for another customer because of inaccurate records.
Access to critical patient information at the bedside. An independent report by the Healthcare Safety Investigation Branch on critical information about patients and how, in an emergency, it is accessed at a patient's bedside on a hospital ward by healthcare staff recommends that the Office of the National Data Guardian supports local interpretation of the Caldicott Principles to give organisations and staff the confidence to display full patient names at the bedside to support correct patient identification for safer care. It also recommends that: NHS England develops guidance to providers to help ensure critical patient information is available to clinical staff when accessing electronic patient record systems; and that the British Standards Institution provides symbology to standardise how information relating to a patient's resuscitation status can be displayed in digital systems.
Bevan Brittan Updates
For more information contact James Cassidy or Jane Bennett.
Mental Health
Publications/guidance
Kettering General Hospital NHS Foundation Trust v North Northamptonshire Council [2023] EWCOP 12. Providing treatment to an unborn child whose mother has HIV. See BBC report
Progress in improving mental health services in England
This report finds that despite funding and staffing levels for mental health services increasing, and more patients being treated, millions of people with mental health needs are still not accessing services, with some facing lengthy waits for treatment.
Practice Guidance (CP: Closed Hearings and Closed Material). The Court of Protection issued guidance applicable to the rare occasions when it was necessary to consider whether a hearing should be closed and/or for material to be closed. The guidance sought to provide clarity as to the principles to be applied and considerations to be taken into account in the very limited circumstances under which such steps might be appropriate. Nothing in the guidance was intended to increase the number of closed hearings or applications for material to be closed.
Terms of reference for rapid review into data on mental health inpatient settings. Department of Health and Social Care guidance sets out the terms of reference for the rapid review into data on risks to patient safety in inpatient mental health settings and pathways. A report will be produced in spring 2023 on the findings, including a set of agreed recommendations for improvements in the way local and national data is gathered and used to monitor patient safety in mental health inpatient services.
Hospitals: Discharges: Question for Department of Health and Social Care. In response to a written question asking what steps the Department of Health and Social Care (DHSC) has taken to ensure that NHS Trusts are complying with the Mental Capacity Act 2005 when discharging people from hospital, DHSC states updated statutory guidance on discharge, which includes information on the application of the Act, is due to be published shortly. In the meantime, NHS trusts should continue to follow the existing hospital discharge and community support guidance and Act code of practice where relevant.
Report - Progress in improving mental health services in England: Department of Health & Social Care. A National Audit Office report on the progress made by the Department of Health and Social Care (DHSC) and NHS England (NHSE) on expanding NHS-funded mental health services concludes that: while funding and workforce for mental health services have increased, and more people have been treated, both DHSC and NHSE must learn the lessons from their efforts to date and demonstrate a firmer grip on the significant ongoing risks to their ambitions in order to ensure value for money in their expansion efforts. It also suggests they must set out what is required to achieve equality between mental and physical health services.
Reforming the Mental Health Act. This paper covers reforms to the Mental Health Act 1983, including the Independent Review, white paper, draft Mental Health Bill and pre-legislative scrutiny.
News
Black Women Are ‘Disproportionately’ Detained Under The Mental Health Act
Government launches national safety review after scandals.
Mrs Justice Theis named Vice President of Court of Protection
Bevan Brittan Events
In discussion: the future of anonymity in health and social care cases. 23 March 2023 12.30pm
Understanding autism and assessing capacity 30 March 2023 12.30pm
How we can help
We are experts in advising commissioners, providers and care co-ordinators on the relevant legal frameworks. We deal with complex issues such as deprivation of liberty, state involvement, use of CCTV monitoring, seclusion, physical restraint and covert medication. We can help providers with queries about admission and detention, consent to treatment, forensic service users, transfers, leave, discharge planning and hearings. We can advise commissioners on all matters concerning commissioning responsibility, liability and disputes. For more information click here
If you wish to discuss any mental health issues facing your organisation please contact Simon Lindsay, Hannah Taylor or Stuart Marchant.
Provider
Publications/Guidance
Good record keeping: Guide for care providers. A Local Government and Social Care Ombudsman guide to help care providers learn from its complaints involving record keeping. It focuses on a number of case studies highlighting the common issues the Ombudsman sees, and also includes good practice tips to help providers avoid the problems from occurring in their own settings. Issues covered include providers fabricating records after a serious incident, customers being given wrong or no medication or food because records were not updated properly, and delayed treatment for another customer because of inaccurate records.
If you wish to discuss any queries you may have around regulation please contact Vincent Buscemi.
Regulation
Bevan Brittan Updates
Regulating healthcare professionals, protecting the public: consultation response. Between 24 March and 16 June 2021, the government sought views on proposals to reform the regulation of health care professionals and to introduce statutory regulation for anaesthesia associates (AAs) and physician associates (PAs). In response to the feedback received and following an extended period of stakeholder engagement and policy development, the government has set out its finalised policy positions. These positions underpin the draft legislation that will give the General Medical Council the power to effectively regulate AAs and PAs and provide a template for subsequent regulatory legislative reforms.
Reviewing how we approach fairness and bias: Actions for 2023. An internal review of the risk of bias in the way the General Medical Council (GMC) operates has resulted in a series of actions the regulator is to implement during 2023. The report's recommendations cover: the GMC's approach to auditing the fairness of its work, which will be more consistent and will involve seeking more external feedback; introducing a single set of decision-making principles to increase consistency across the organisation; tailoring equality, diversity and inclusion (ED&I) training for GMC staff across different roles; publishing more detailed data about GMC fitness to practise processes; and making sure fairness and ED&I are embedded into the way the GMC operates in future, when the Department of Health and Social Care introduces a new regulatory framework for healthcare professionals.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.
Social Care
Publications/Guidance
Workforce development framework for care co-ordinators. The frameworks provide guidance for people employed in these roles and those employing them helping to increase understanding of where they can have most impact in supporting and empowering people to improve their health and wellbeing. They also set professional standards and competencies, give guidance on supervision, training, and continuous professional development.
Care data matters: a roadmap for better data for adult social care
This draft document sets out the government’s roadmap for transforming adult social care data in England and seeks views on the data needed to commission, deliver and oversee care and support. The responses should be submitted by 31 July 2023.
Delayed hospital discharges and adult social care
This explainer sets out what the government is doing to reduce the number of people staying in hospital longer than necessary.
Social care charging for local authorities: 2023 to 2024
This document contains information for local authorities about the social care charging arrangements for 2023 to 2024. It includes details about capital limits, personal expenses allowance, minimum income guarantee and savings credit.
How we can help
For ways in which we can help with Social Care issues click here.
If you wish to discuss any queries you may have around social care please contact Siwan Griffiths.
General
Publications/Guidance
NHS continuing healthcare in England. This House of Commons Library briefing paper is intended to help Members respond to queries from constituents about eligibility to NHS continuing healthcare in England. Equivalent provision in Scotland, Wales, and Northern Ireland is covered in the final section.
Guidance No.45: Stillbirth and Live Birth Following Termination of Pregnancy. A Courts and Tribunals Judiciary publication provides guidance to help coroners understand and apply the current law relating to stillbirth, and live birth following termination of pregnancy, to promote consistency in the scrutiny of unnatural neonatal deaths.
Dying well at home: commissioning quality end-of-life care. Increasingly people are dying at home rather than in hospital and this trend is set to continue. This report from The King's Fund, and accompanying policy brief, offer recommendations for commissioners, integrated care boards and national bodies who want to improve care for those dying at home.
Fixing the foundations: why it’s time to rethink how we support older people with health problems to stay well at home
This report provides a first-hand account of older people’s difficulties in getting the good, joined-up health and social care they need to manage at home, leaving them at risk of crisis that often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided.
Nobody’s listening: what families say about prison healthcare
According to this report, involving families more proactively in prisoners’ health care would reduce deaths in custody, relieve pressure on the NHS and the criminal justice system, and cut crime. It makes a series of recommendations to improve the way that health care providers and prisons can involve families more proactively. They include: diverting more appropriately risk-assessed people with mental health problems to community treatment and secure treatment settings; training for staff to
Supporting clinical leadership in virtual wards: a guide for integrated care system clinical leaders
This guidance supports integrated care system clinical leadership to create and develop their virtual ward service.
Introducing integrated care systems.
Integrated care systems (ICSs) are an attempt to bring NHS and local government services together, to improve services and health outcomes for people in their area. This report concludes that the benefits of ICSs for patients have not been made clear and that reform of the NHS will not work until issues in the service are addressed.
Reducing did not attends (DNAs) in outpatient services
This national guidance covers how providers can effectively reduce their DNA rates to release capacity for elective recovery and improve patient experience.
Invisible Women: Understanding women's experiences of long-term imprisonment: Briefing 2: Hope, health, and staff-prisoner relationships. A Prison Reform Trust briefing, produced in collaboration with women who will spend at least eight years in prison, reveals that women serving very long sentences feel that their health needs are being overlooked. The briefing highlights the key themes of maintaining hope, access to healthcare and staff-prisoner relationships, and makes recommendations, including for HM Prison and Probation Service to adhere to expectations set out by Public Health England in its "Gender specific standards for health and wellbeing for women in prison in England". The report also recommends governors of women's prisons prioritise women-specific health issues, and, where possible, involve women who are in prison in developing resources.
Delayed hospital discharges and adult social care. What is the Government doing to reduce the number of people staying in hospital longer than necessary?
News
Improved system of organ use to save lives. The Government has supported recommendations to improve the system of organ transplants in a report from the Organ Utilisation Group. These include placing the patient at the centre of the service, developing better systems so more organs are used and sharing best practice to raise standards across transplant centres. The report also includes recommendations on how to quickly identify and adopt proven technologies and scientific advances to put innovations into practice.
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