02/09/2024
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
There is no charge for any of the events listed below
Webinars
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.
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
Ambulances running on adrenaline: speaking up in ambulance trusts. This report makes recommendations to ambulance services to help transform their organisational culture through speaking up. It was written in response to NHS England's Culture review of ambulance trusts, which was published in February 2024.
Listening to the silence: what does the Staff Survey tell us about speaking up in the NHS? Analysis of the 2023 NHS Staff Survey by the National Guardian’s office reveals a decline in workers feeling secure raising concerns about unsafe clinical practice for the second consecutive year.
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
Children's social care. Ofsted has published new statistics on children’s social care in England. The data looks at providers of children’s social care and inspection outcomes as of 31 March 2024. Findings include: the number of children’s homes of all types increased by 12%; and over 80% of all children’s homes had an inspection judgement of outstanding or good.
Things will only get worse: why the two-child limit must go. This report, published by the Child Poverty Action Group, End Child Poverty and the Church of England, documents the impact of the two-child limit. The two-child limit restricts support through universal credit (UC) or child tax credit to the first two children in a family, for children born after 6 April 2017. Parents having a third or subsequent child after that date are not eligible for support for that child. Drawing on a survey and interviews, the report calls on the government to abolish the two-child limit as a way of reducing child poverty in the UK.
Ofsted and CQC joint registration guidance: Children's homes and health care. Updated guidance clarifies registration with the Care Quality Commission (CQC) and OFSTED, explaining which regulator(s) providers and commissioners should apply to for registering a setting and/or regulated activity, and what registration means in practice. It also describes how some providers who are registered with CQC need to register accommodation with OFSTED as a children's home.
Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust. An independent report from Professor Louis Appleby reviewing data on suicides by young patients of the gender services at the Tavistock and Portman NHS Foundation Trust.
Learning from deaths: children with a learning disability and autistic children aged 4–17 years. This report draws on data from the NCMD to investigate deaths in children with a learning disability and autistic children, and to draw out learning and recommendations for service providers and policy-makers.
A neglected generation: reversing the decline in children's health in England. This report highlights the importance of children's dietary health for ensuring their wellbeing. It argues that a lack of policies focused on this area to date has caused the deterioration of children's overall health. It challenges all political parties to commit to new measures in this area to ensure that children can grow up healthy and well nourished.
Children in care. The charity Become has published a new report revisiting the topic of children in care in England being placed far from home. The report examines what has changed since the last report and what changes the charity believe are still needed. Findings from available data and a Freedom of Information request to the Department for Education show: almost 18,000 children are living more than 20 miles from home, representing 1 in 5 children in care; children placed over 20 miles away are more likely to have significantly lower wellbeing than those placed closer to home; and children in care are living further away on average, than they were a year ago.
Kinship care. The charity Kinship has published a report examining the educational and mental health support that children in kinship care receive in England and Wales. Kinship carried out its annual survey and received 1,657 responses from kinship carers. Findings show: over a quarter of kinship carers said their children hadn’t received the emotional or therapeutic support they needed; and nearly 4 in 10 kinship carers said their children hadn’t received support to help them navigate their identity and family relationships. Kinship is calling for policy and practice that effectively assists children in kinship care to get the support they need with their mental health and education.
Finding homes for looked after children. Overview of the challenges faced by local authorities in finding suitable homes for all looked after children, followed by a summary of government policy.
A call for change: tackling inequalities in access to mental health support for children with social work involvement and those living in poverty. This report finds that children with social work involvement for current concerns are more likely to be rejected by NHS mental health services compared to their peers. Research undertaken with Cambridge University found that, overall, children from the most deprived areas are twice as likely to be rejected than those from the least deprived areas.
Domestic abuse. The charity For Baby’s Sake has published new data on infants and domestic abuse in England. The charity sent out a Freedom of Information request to 39 police forces and received responses from 15. The data indicates that infants were present at around 13% of police call outs for domestic abuse incidents from 2021 to 2023. The charity highlights a need for a coordinated, multi-sector response that safeguards babies and children from domestic abuse.
Puberty blockers temporary ban extended. The Government has renewed a temporary ban on the sale and supply of puberty-suppressing hormones, known as "puberty blockers". The continuation of the ban applies to the sale or supply of these drugs, prescribed by private UK-registered prescribers for gender incongruence or dysphoria to under 18s not already taking them. It also prevents the sale and supply of the medicines from prescribers registered in the European Economic Area or Switzerland for any purposes to those under 18.
Duties to report child abuse in England. A briefing on reporting child abuse in England, including the previous government's plans to introduce a mandatory reporting duty.
Parental responsibility in England and Wales. An overview of parental responsibility in England and Wales, including how it is gained and lost.
News
‘Worrying’ number of children wrongly placed in supported accommodation, says Ofsted chief. Some providers operating unregistered children's homes by admitting young people who need care, rather than merely support, while children with high-level needs are not having these met.
Ombudsman warns of surge in maternity investigations.
Bevan Brittan Events
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk / Patient Safety
Publications/Guidance
Clinical Negligence Claims Agreement 2024. A clinical negligence claims agreement by NHS Resolution, developed in collaboration with key stakeholders, including Action against Medical Accidents and the Society of Clinical Injury Lawyers, builds on the COVID-19 Clinical Negligence Protocol established in 2020 and aims to further improve claims management practices. Key features of the new agreement include: extended limitation periods for certain cases, providing flexibility for claimants and their representatives; emphasis on early disclosure of relevant documentation to help narrow issues and reduce investigation costs; improved communication protocols, including ongoing acceptance of electronic correspondence and service of documents; and encouragement of pre-action discussions and dispute resolution to avoid unnecessary litigation. Aspects of the previous protocol have been retained, specifically how the parties can avoid the need for litigation by undertaking a stock take prior to commencing litigation. The parties are also still encouraged to consider requests for interim payments and whether earlier exchange of evidence will promote resolution of the claim.
Patient Safety Commissioner annual report 2023 to 2024. This report summarises the work of the Patient Safety Commissioner during the financial year 2023 to 2024. It is aimed at all those with an interest in patient safety.
Infected Blood Compensation Scheme Summary: August 2024. The Infected Blood Compensation Scheme Regulations 2024, laid on 23 August 2024, give the Infected Blood Compensation Authority (IBCA) the powers to pay compensation through the Core Route to infected persons, both living and deceased, as set out in this policy paper summary. The Government expects the IBCA to begin making payments to infected persons by the end of 2024. A second set of Regulations will provide for the payment of compensation to affected persons, and for claims under the Supplementary Route.
Infected Blood Inquiry: recommendations for recognition, healthcare and patient safety: Research briefing.
A House of Commons Library briefing looks at the recommendations made by the Infected Blood Inquiry to improve patient care and safety, and strengthen the voice of patients in the healthcare system. It also looks at the Government's response.
NHS publishes annual report and accounts 2023/24. The National Health Service (NHS) has published its resolution’s annual report and accounts for 2023/24. The report highlights that a record 81% of claims in England, which amounts to over 1,800 cases, were resolved in 2023–24 without resorting to legal proceedings.
The Maternal, Newborn and Infant Clinical Outcome Review Programme. This report finds that the most common causes of stillbirth and neonatal death were unchanged for babies born in England and Wales in 2022, with congenital anomalies contributing to 17% of deaths. It also includes a number of other key findings including the facts that stillbirth rates decreased but neonatal mortality increased, and inequalities in mortality rates by deprivation and ethnicity remain.
National Child Mortality Database (NCMD). This report contains nine recommendations relating to children with a learning disability, autistic children, including calls to ensure: reasonable adjustments are discussed with and provided for all; recognition that those with underlying health conditions may be at higher risk of death from infection; and that a designated Named Lead Healthcare professional is identified to support those with multiple co-morbidities and complex health care needs.
Practitioner and healthcare organisation experiences of Professional Support and Remediation action plans. This is the second Insights paper published by NHS Resolution’s Practitioner Performance Advice Service (‘the Advice service’) which focuses on Professional Support and Remediation (PSR) action plans.
7 June 2024 CPRC minutes published.
2024 Personal Injury Discount Rate Review. A written statement from the Lord Chancellor and Secretary of State for Justice announces the commencement of a review of the personal injury discount rate. It notes that letters have been sent to the expert panel, appointed under the Damages Act 1996, and the Treasury, confirming that they can begin their period of consultation.
Changes to the death certification process. How the death certification process in England and Wales will change from 9 September 2024, including the introduction of medical examiners. The purpose of this guidance is to help those involved in the death management system to understand and prepare for the reforms. This includes:
- NHS and social care organisations
- local government
- bereavement services
- the funeral industry
- professional and regulatory bodies
- religious or faith groups
- coroner services
- registration services
- healthcare professionals
- independent healthcare providers
Listening to the silence: what does the Staff Survey tell us about speaking up in the NHS? Analysis of the 2023 NHS Staff Survey by the National Guardian’s office reveals a decline in workers feeling secure raising concerns about unsafe clinical practice for the second consecutive year.
News
Women in England settle vaginal mesh implant claim. It is understood that around 140 women who suffered complications from vaginal mesh implants have received payouts in the first successful group claim in England. They reached an undisclosed settlement with manufacturers Johnson & Johnson, Bard and Boston Scientific. The women alleged that the implants, used to treat incontinence and prolapse, caused complications including chronic pain, bladder and bowel perforations, and bleeding.
Bevan Brittan Events
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
Digital tools for online consultation in general practice. This report identifies that online tools are not always accessible and easy to use, and do not always allow general practices to collect the information they need to make decisions about a patient’s care. It concludes that patient safety must be prioritised as online consultation tools in general practice continue to be implemented.
Preparing the NHS for the AI era: a digital health record for every citizen. This report proposes a digital health record (DHR) to drive improvements to health and care, and ensure that the NHS is ready for the artificial-intelligence era. Each person’s DHR would be the 'single source of truth' for their health and care data – data that currently sits in silos across hospitals, GP practices, pharmacies and phones. It would be the fundamental building block of all modern health systems and open up a whole new way of generating health and delivering health care in the future.
Priorities for an AI in health care strategy. This long read argues that a dedicated strategy for artificial intelligence (AI) in health care is needed to co-ordinate current fragmented efforts in the NHS in England. It sets out six priorities this strategy should address and some of the steps to do so.
AI in health care: what do the public and NHS staff think? To help understand attitudes towards the use of artificial intelligence (AI) in health care, the Health Foundation commissioned a survey, conducted in June and July 2024, of 7,201 nationally representative members of the public and 1,292 NHS staff members. It found, on balance, support from both the public and NHS staff for the use of AI in health care, indicating a broadly receptive environment. However, it found that around 1 in 6 members of the public and around 1 in 10 of the NHS staff surveyed think that AI will make care quality worse.
The reality of, and potential for, digitally enabled care in the community. Could digital technology help move care closer to home? This long read by Pritesh Mistry explores how community services use digital technology and what the future could – and should – hold.
Frontline digitisation: creating the conditions for a digital NHS. Digital transformation is an important tool in improving productivity and efficiency in the NHS. This report explores integrated care systems' (ICSs) experiences of frontline digitisation and addresses current challenges in the NHS, and the next steps for ICSs to harness digital systems in health care.
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
Consultant doctors and dentists pay progression system guidance for employers. The 2024 amendments to the 2003 consultant contract introduced provisions to move to a new pay structure supported by a new pay progression system. This guidance is produced in association with the British Medical Association and the Hospital Consultants and Specialists Association.
10 actions the government can take to improve NHS working conditions. The workforce crisis is at the heart of many of the challenges facing the NHS in England. This briefing outlines early actions the government can take to enable NHS staff and leaders to deliver the highest possible quality of care in the coming months.
GPs are taking ‘collective action’: what does that mean? After GP partners voted on 1 August for collective action, this explainer describes what is behind the dispute, the action that GPs plan to take, and what it might mean for patients and the government.
The state of medical education and practice in the UK: workplace experiences 2024. This report is based on evidence from the GMC's annual survey of thousands of doctors, supported by in-depth interviews and other research. It includes data and insights, to highlight where action needs to be taken to address workplace pressures and help retain doctors across all four countries of the UK. The report finds that doctors are increasingly taking steps themselves to address workload and capacity pressures, with higher proportions of doctors reducing their hours and declining to take on additional work.
The Nursing and Midwifery Council Independent Culture Review. An independent culture review of the Nursing and Midwifery Council (NMC) by Nazir Afzal and Rise Associates, commissioned by the NMC after concerns were raised about its culture, including racism, discrimination and fear of speaking up. The report's recommendations relate to: safeguarding people involved in NMC processes; culture and regulation; and senior leadership. In response the NMC states "change starts now" with full acceptance of the recommendations. In addition to work already started on safeguarding, NMC has begun to address some of the other regulatory issues identified, including: £30 million investment in an 18-month plan to make a step change in fitness to practise, and strengthened the guidance used to make decisions on concerns about sexual misconduct and other forms of abuse outside professional practice.
Realising the potential of integrated care systems. Developing system-wide solutions to workforce challenges
Guidance for doctors who are pregnant or breastfeeding. This guidance sets out both the legal minimum requirements and key adjustments that the BMA recommends should be made for pregnant and breastfeeding NHS doctors, upon their request and within a timely manner. The guidance also provides links for further advice and support.
The NMC register: 1 April 2023 – 31 March 2024. There are more nurses, midwives and nursing associates on the NMC register than ever: 826,418. That’s an increase of 37,723 (4.8%) compared to the same period last year, and 128,184 (18.4%) over the past five years. This growth is due, in large part, to the continuous rise in first-time joiners to the register – 59,991 in the past 12 months alone. The year-on-year growth is higher among international joiners, with 29,628 being an increase of more than 18% compared to the previous year.
A workforce strategy for adult social care in England. This strategy aims to improve the quality of roles in adult social care, ensuring that the sector can attract and keep enough people with the right skills and values to provide the best possible care and support for the people who draw on it. It highlights the impact of social care on improving lives – as well as its role in supporting economic growth, with the sector currently contributing almost £60 billion a year to the economy. Its three areas of focus are attraction and retention, training, and transformation, in line with the main themes of the NHS Long Term Workforce Plan.
From ambition to reality: national policy options to improve care worker pay in England. This report by Nuffield Trust and the Health Foundation reveals how an inadequate national policy approach to social care pay and funding has trapped staff in a cycle of low wages and poor career prospects. It examines five national policy options to increase wages for social care workers in England: better minimum wage enforcement; increasing the National Living Wage; bonuses for social care staff; a sector-specific minimum wage; and a national pay scale similar to the NHS's Agenda for Change.
Care and health career academies: what good looks like. The adult social care sector has faced significant challenges with recruitment and retention. Care and health career academies support local areas to think differently about social care workforce challenges. They support the workforce pipeline, boosting recruitment and retention, and workforce development. A project was undertaken to develop a better understanding of care and health career academies in England. This guide aims to share emerging learning on the development of academies and insights as to what good looks like
NHS Providers briefing on NHS pay. This briefing outlines the importance of prioritising the announcement of the 2024/25 pay award for NHS staff and explains the pay review process in England, with an overview of: the NHS Pay Review Body (NHSPRB), covering most NHS staff; the Doctors’ and Dentists’ Remuneration Body (DDRB); and the Senior Salaries Review Body (SSRB), covering very senior public sector managers, including in the NHS.
10 facts about the NHS workforce. The NHS is the single largest employer in the UK. Although the size of its workforce is rising, the level of growth is not sufficient to meet the increasing demand for health care and complexity or level of patient need. Increases in staff numbers are not consistent across roles, and the service faces high numbers of vacancies overall. This briefing presents 10 facts outlining the current state of the NHS workforce.
National training survey: 2024 results. The results of the GMC's national training survey, the largest annual insight into the training of doctors in the UK, show that half of doctors whose roles include training junior colleagues are at high or moderate risk of burnout. The report warns that plans to boost the UK’s workforce by increasing medical school places will fail if the needs of trainers are not also prioritised.
Fifty-second report 2024. The DDRB provides independent advice on the pay of doctors and dentists to governments across the UK. This report sets out the DDRB’s recommendations for doctors’ and dentists’ pay in England, Scotland, Wales and Northern Ireland.
Thirty-seventh report 2024. This report sets out the NHSPRB’s analysis of evidence provided by relevant organisations and makes observations on the pay of NHS staff paid under Agenda for Change for 2024.
Listening to the silence: what does the Staff Survey tell us about speaking up in the NHS? Analysis of the 2023 NHS Staff Survey by the National Guardian’s office reveals a decline in workers feeling secure raising concerns about unsafe clinical practice for the second consecutive year.
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, Oonagh Sharma, James Gutteridge or Andrew Uttley.
Finance
Publications/guidance
The immigration health surcharge. Temporary migrants in the UK usually pay an annual 'surcharge', which raises funds for healthcare spending.
What is the current state of NHS finances? This briefing provides a brief history of NHS funding and outlines the current challenges NHS trusts are facing in delivering operational priorities within a pressurised financial environment.
Bringing it all together: financial strategies that address health inequalities. This explainer sums up the HFMA’s work on health inequalities, and explores how organisations can use financial strategies to address health inequalities.
NHS financial management and sustainability. This report sets out: the NHS’s current financial position and operating context; whether NHS England’s financial management processes allow accurate and timely decision-making and support for NHS bodies that are struggling; the relationship between financial management and NHS performance, productivity and efficiency; and the challenges to the NHS’s financial sustainability in the longer term.
NHS Expenditure. NHS Expenditure by Rachael Harker. Documents NHS expenditure since 1948; summary of the structure of the NHS and how it is financed.
If you wish to discuss any queries you may have around finance issues please contact Claire Bentley.
Health Inequalities
Publications/Guidance
Making sense of health inequalities. This resource, produced as part of NHS Providers’ Health Inequalities programme, looks at the current state of the nation in relation to health inequalities and the role that NHS trusts have to play in addressing them.
Delivering with dignity: a framework for strengthening commissioning and provision of healthcare services for people seeking asylum. This report finds that people seeking asylum in England often have complex health needs and yet face barriers to accessing timely, quality and appropriate health care. It sets out a framework of good practice to remove these barriers and ensure people can access the health care that they are entitled to.
A call for change: tackling inequalities in access to mental health support for children with social work involvement and those living in poverty. This report finds that children with social work involvement for current concerns are more likely to be rejected by NHS mental health services compared to their peers. Research undertaken with Cambridge University found that, overall, children from the most deprived areas are twice as likely to be rejected than those from the least deprived areas.
The real face of men's health. This report features examples, from the UK and abroad, on what is effective across four elements of health systems to successfully engage with men: health promotion programmes; a responsive health system, including health services, screenings, checks and facilities; a health workforce with the competencies to respond to men; and research that works to build, evaluate and translate its findings into practice to reach and benefit all men. The report is published alongside an interactive map containing data on premature mortality.
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 Julia Jones.
Housing
Publications and guidance
Damp and mould: understanding and addressing the health risks for rented housing providers. This guidance delivers on the government’s commitment in response to the Coroner’s ‘prevention of future deaths’ report on the death of 2-year-old Awaab Ishak due to mould in the home.
Gypsies and Travellers: Accommodation in England. This briefing looks at Gypsies’ and Travellers’ accommodation in England.
If you wish to discuss any queries you may have around housing please contact Julia Jones
Independent Health
Publications/Guidance
Changes to the death certification process. How the death certification process in England and Wales will change from 9 September 2024, including the introduction of medical examiners. The purpose of this guidance is to help those involved in the death management system to understand and prepare for the reforms. This includes:
- NHS and social care organisations
- local government
- bereavement services
- the funeral industry
- professional and regulatory bodies
- religious or faith groups
- coroner services
- registration services
- healthcare professionals
- independent healthcare providers
If you wish to discuss any queries you may have around independent health, please contact Tim Hodgetts or Julie Charlton
Information sharing/data
Publications/guidance
Preparing the NHS for the AI era: a digital health record for every citizen. This report proposes a digital health record (DHR) to drive improvements to health and care, and ensure that the NHS is ready for the artificial-intelligence era. Each person’s DHR would be the 'single source of truth' for their health and care data – data that currently sits in silos across hospitals, GP practices, pharmacies and phones. It would be the fundamental building block of all modern health systems and open up a whole new way of generating health and delivering health care in the future.
If you wish to discuss any queries you may have around information sharing please contact Jane Bennett.
Inquests and Inquiries
Publications/guidance
Government Update on the Infected Blood Compensation Scheme. A Cabinet Office publication provides an update on the Infected Blood Compensation Scheme before the Government makes Regulations to establish it. The Scheme will allow the Government to start putting in place the measures necessary to provide financial support to the infected and affected victims of this tragedy. It considers changes to the proposed Scheme following 74 recommendations made by Sir Robert Francis KC, Interim Chair of the Infected Blood Compensation Authority, including that support scheme payments will continue for life as part of the compensation package. The Government will make a first set of Regulations under the Victims and Prisoners Act 2024 by the statutory deadline of 24 August 2024. These Regulations will give the Authority the powers to pay compensation through the core route to the infected, both living and deceased. A second set of Regulations will provide for the payment of compensation to the affected, and for claims under the supplementary route. This will ensure that the Authority can begin compensation payments to the affected in 2025.
Changes to the death certification process. How the death certification process in England and Wales will change from 9 September 2024, including the introduction of medical examiners. The purpose of this guidance is to help those involved in the death management system to understand and prepare for the reforms. This includes:
- NHS and social care organisations
- local government
- bereavement services
- the funeral industry
- professional and regulatory bodies
- religious or faith groups
- coroner services
- registration services
- healthcare professionals
- independent healthcare providers
News
Call for new mechanism to oversee action on state-related deaths
Changes to the death certification process
How the death certification process in England and Wales will change from 9 September 2024, including the introduction of medical examiners.
If you wish to discuss any queries you may have around inquests, please contact Amanda Wright- Kluger or Claire Leonard.
Integrated Care
Publications/guidance
People not structures: putting people at the heart of integrated care. This report, issued jointly with the Local Government and Social Care Ombudsman, finds that integrated care systems (ICSs) are not doing enough to put the vulnerable people they support at the heart of what they do. The report details some of the things that can and do go wrong when people are not prioritised and local organisations do not work together effectively. It includes a recommendation for ICSs to agree a ‘person-first approach’ where councils and health services work together to look at how needs can be met as their first priority. It also suggests that councils and health services agree standard frameworks for effective communication.
The Hewitt review: where are we one year on? It is now just over a year since the previous government’s formal response to Patricia Hewitt’s review of ICSs' autonomy and accountability. The proposals set out in the review are still overwhelmingly supported by ICS leaders and national partners as the right direction of travel. This analysis finds that some progress has been made towards aligning with the review’s principles and approach and, in some cases, implementing the review’s recommendations, but it argues that implementation needs to go further and faster.
Enabling integrated care systems to work better. One of NHS England's roles is to take some of the management of the NHS out of the Department of Health and Social Care. Since 2022 it has done this with the help of ICSs. However, senior officials in these bodies are still complaining about various forms of micro-management. This short paper, based on interviews with those involved in ICSs, looks at how the new arrangements can be made to work better.
Keeping your integrated care system safer from cyber attacks. This briefing, from NHS Providers' Digital Integrated Care System (ICS) programme, shares five top tips and poses a series of questions to help ICS leaders ensure that they are prepared and able to respond to cyber threats.
What can integrated care systems in England learn from the devolved nations? Approaches to integrating health and care services to improve efficiency and meet population needs have varied across the United Kingdom’s four devolved nations. Given the differences in approach to integration across the four nations, the NHS Confederation, supported by Novartis, has developed this resource to showcase both examples of good practice and lessons learnt in Wales, Scotland and Northern Ireland.
If you wish to discuss any queries you may have around integrated care, please contact Claire Bentley
Mental Health
Publications/Guidance
Reforming the Mental Health Act: Research Briefing. A House of Commons Library research briefing covers reforms to the Mental Health Act 1983, including the independent review, white paper, the draft Mental Health Bill under the previous Government and pre-legislative scrutiny, updated to include the new Government's commitment to legislate in the July 2024 King's Speech.
Mental Capacity Act 2005, Deprivation of Liberty Safeguards, 2023-24. These official statistics provide findings for England from the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) data collection for the period 1 April 2023 to 31 March 2024. DoLS are a legal framework applying to individuals who lack the mental capacity to consent to the arrangements for their care. Where such care may amount to a "deprivation of liberty" the arrangements are independently assessed to ensure they are in the best interests of the individual concerned. The data is collected from local authorities in England, who are the supervisory bodies for authorising deprivations of liberty of adults in care homes and hospitals.
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.
Cases
PS (Severe short term memory loss: Capacity to engage in sexual relations), Re [2024] EWCOP 42 (T2). Judgment concerning capacity where PS, a 79 year old woman, has severe short term memory loss.
PQ (Court Authorised DOL: Representation During Review Period), Re [2024] EWCOP 41 (T3). Judgment concerning involvement of PQ in reviewing the deprivation of her liberty following earlier orders about capacity and best interests.
Health Body A v JW by her Litigation Friend, the Official Solicitor & Anor [2024] EWCOP 40 (T2). Application for declarations relating to dental treatment, and other treatment, for J, a woman who has diagnoses of learning disability, autism and Avoidant/Restrictive Food Intake Disorder.
North Tees and Hartlepool NHS Foundation Trust & Anor v KAG & Ors [2024] EWCOP 38. Judgment concerning medical treatment where there is uncertainty as to the application of the MHA 1983.
News
DoLS referral numbers hit new record but practitioners cut backlog and average case timeframes. Councils received 332,455 Deprivation of Liberty Safeguards applications in 2023-24, up 11% on the year before, but teams processed a record 323,870 cases, an increase of 12% on 2023-24.
Bevan Brittan Events
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 or Hannah Taylor.
Primary Care
Publications/Guidance
Digital tools for online consultation in general practice. This report identifies that online tools are not always accessible and easy to use, and do not always allow general practices to collect the information they need to make decisions about a patient’s care. It concludes that patient safety must be prioritised as online consultation tools in general practice continue to be implemented.
If you wish to discuss any issues in primary care then please contact Joanne Easterbrook or Ben Lambert.
Regulation
Publications/Guidance
Review into the operational effectiveness of the Care Quality Commission: interim report. In May 2024, Dr Penny Dash was asked to conduct a review into the operational effectiveness of the Care Quality Commission (CQC). The purpose of the review was to examine the suitability of the CQC’s new single assessment framework methodology for inspections and ratings of health and care providers. This interim report provides a high-level summary of the emerging findings of the review in order to inform the changes needed to start the process of improving the CQC. It makes five recommendations.
If you wish to discuss any issues in regulation then please contact Stuart Marchant
Social Care
Publications/Guidance
What can the new government learn from other countries’ attempts to reform pay in social care? This long read looks at the lessons England might learn from other countries when it comes to reforming pay for care workers, and the key principles to consider in any pay reform.
Children's social care. Ofsted has published new statistics on children’s social care in England. The data looks at providers of children’s social care and inspection outcomes as of 31 March 2024. Findings include: the number of children’s homes of all types increased by 12%; and over 80% of all children’s homes had an inspection judgement of outstanding or good.
Introducing a cap on care costs Overview of the previous government's proposals to reform how people pay for adult social care in England.
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
Feeling the pressure: what the 2023 Commonwealth Fund survey reveals about the state of the UK health system. This report finds that the UK’s performance on hospital-based care is consistently near the bottom in a public survey of 10 high income countries. The analysis of the 2023 Commonwealth Fund survey highlights key areas where the UK performs poorly, particularly on long waits for specialist care, lack of access to out-of-hours care and affordability for treatments like dental care. For hospital care, the UK had among the longest waiting times compared to the other countries in the survey, with 11% of people waiting a year or more for a specialist appointment and 19% waiting a year or more for non-emergency surgery.
Module 1: the resilience and preparedness of the United Kingdom. The UK Covid-19 Inquiry has published its first in a series of reports and recommendations following the conclusion of its first investigation. The Inquiry’s investigations are organised into modules, and module 1 examines the state of the UK’s central structures and procedures for pandemic emergency preparedness, resilience and response.
King's Speech 2024: what you need to know. This briefing from the NHS Confederation provides an analysis of what the King’s Speech means for the health service under the new government.
Independent investigation of NHS performance: terms of reference. The Secretary of State for Health and Social Care, Wes Streeting, has commissioned an immediate and independent investigation of the NHS across England. Professor Ara Darzi, Baron Darzi of Denham, has been appointed to lead the investigation, which will report in September 2024.
People not structures: putting people at the heart of integrated care. A report by the Local Government and Social Care Ombudsman and the Parliamentary and Health Service Ombudsman considers the structures of integrated care systems in local areas. It finds that a lack of communication between health and social care services is an issue that lies at the core of many system failures, and that disagreements or ambiguity about who is responsible for what service, and who pays, often sit firmly alongside the failures in communications. The report recommends that: councils and NHS bodies must use the tools that exist effectively to support a holistic approach, such as local dispute resolution processes and the National Framework for children and young people's continuing care; and where they do not already exist, councils and health bodies should put in place person-centred, standard frameworks for effective communication between organisations.
The real face of men's health. This report features examples, from the UK and abroad, on what is effective across four elements of health systems to successfully engage with men: health promotion programmes; a responsive health system, including health services, screenings, checks and facilities; a health workforce with the competencies to respond to men; and research that works to build, evaluate and translate its findings into practice to reach and benefit all men. The report is published alongside an interactive map containing data on premature mortality.
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