Bevan Brittan Health and Social Care Update - October 2015

Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

Care	Information Sharing
Clinical Risk/Health and Safety	Mental Health
Commissioning	Primary Care
Employment/HR	Public Health
Finance	Regulation
Foundation Trusts	General

Care

Publications/guidance
The state of health care and adult social care in England, 2014 to 2015. Sets out the findings of CQC's latest annual overview of health and adult social care in England. The analysis of inspections and ratings data shows that, despite increasingly challenging circumstances, many services have managed to either improve or maintain quality.

Adult social care, health and wellbeing – A shared commitment: 2015 Spending Review submission. The LGA and ADASS are warning that the ability of councils to provide dignified care for people in old age or for those with a disability is at risk unless urgent steps are taken to plug the burgeoning gap in social care funding. They argue that there is a need for a separate transformation fund with the aim of implementing a new prevention strategy to drive real change. This would, in the short-term, enable local areas to spend money on new investment in preventative services alongside ‘business as usual’ in the current system, until savings can be realised and new ways of working become commonplace.

Prevention – A shared commitment: Making the case for a Prevention Transformation Fund. The LGA is calling on the Chancellor to use the Spending Review to urgently invest £2bn to help transform the health and care system towards preventing ill health rather than waiting to fix problems only after they occur. This paper pulls together key pieces of evidence about the cost effectiveness of prevention in order to develop the LGA’s concept of a Prevention Transformation Fund. The purpose of the fund, delivered upfront for new local prevention services, would be to prevent problems arising in the first place, prevent dependency on the health and social care system, or prevent the escalation of problems which become worse for individuals and more costly to the taxpayer.

Shared principles for redesigning the local health and care landscape. The LGA has set out shared principles for local authorities, HWBs, CCGs and other health commissioners to help them when developing proposals for major service changes and configuration. The principles are intended to provide a consistent and rational framework within which to test that proposals are person-centred, locally appropriate, evidence based and focused on whole-system effectiveness.

Government response to the House of Commons Health Select Committee report on end of life care. The Government’s response to the Health Select Committee’s report on end of life care sets out what has been done recently to improve end of life care. This includes: the five priorities for the care of the dying person; the Care Quality Commission’s inspection regime; and publication of the choice review and ambitions for palliative and end of life care.

How are councils implementing the new Care Act? Research carried out by Carers Trust shows that few local authorities have outlined how they are protecting carers’ health and preventing them developing a need for support. Under the Care Act 2014, which came into force this April, local authorities have a duty to provide services to carers that prevent, reduce or delay them developing a need for support. Carers Trust found that instead of developing new approaches specifically designed to support carers, many local authorities were absorbing their new prevention duties into existing strategies.

The health and care of older people in England 2015. This report by Age UK presents the latest authoritative data on older people's health and care needs and the provision of health and care services in England. It analyses the degree to which these needs are being met by health and care services. It finds that the health and care system for older people in England is under severe stress and is underperforming, leading to higher costs, poorer health outcomes and worse patient and service user experience.

Managing demand and delivering differently: responses to the assessment capacity challenge. The demographic and financial context in which the Care Act's reforms are being embedded demands that local authorities are pro-active in transforming their ways of working and business processes, to meet demand and capacity challenges. This briefing document sets a number of innovative approaches to managing demand - drawing on councils' experiences preparing for the cap on care costs.

News
Care home provider and employee fined after care user severely burnt in bath. National care home provider Real Life Options and one of its employees were prosecuted after a care patient suffered full thickness burns while in the bath. An investigation by the Health and Safety Executive (HSE) found no risk assessment had been carried out for the risk of exposure to scalding water.  

Bevan Brittan Articles
The Care Act 2014 and Safeguarding Vulnerable Adults. In the June edition of Bevan Brittan's Healthline we considered the legislative reforms introduced by the Care Act 2014 (the Care Act) in relation to wellbeing, safeguarding vulnerable adults and funding. This article considers the practical implications of the legislative reforms in relation to safeguarding vulnerable adults. The Care Act recognises and reinforces that in addition to Local Authorities, other organisations make a significant contribution to adult safeguarding and accordingly will be held more accountable for their actions.

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

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Clinical Risk/Health and Safety

Bevan Brittan Training - If you would like to know about our free lunch time training sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.

Publications/Guidance
National audit of inpatient falls: audit report 2015. The Falls and Fragility Fracture Audit Programme is a national clinical audit run by the Royal College of Physicians designed to audit the care that patients with fragility fractures and inpatient falls receive in hospital and to facilitate quality improvement initiatives. It reveals that many trusts and local health boards have policies that include the main areas of falls prevention but that there is often no association between what the policies include and the care patients received once admitted to hospital.

Bliss baby report 2015. This report by charity Bliss has heard from neonatal units, transport services and parents across the country in order to assess the state of neonatal care in England in 2015. It found that neonatal staff are being forced to cope with consistently high demand, with far too few resources resulting in units being unable to meet national standards for high quality and safe care. Its findings reveal a system in trouble, with a significant shortage of nurses, doctors and other professionals that are needed to deliver safe and high-quality care to premature and sick babies.

Report on selected summaries of investigations by the Parliamentary and Health Service Ombudsman: February and March 2015. This report finds that too many unresolved complaints are being taken to the Parliamentary and Health Service Ombudsman which could have been resolved by public services locally, meaning that people are left waiting longer for answers and that much needed service improvements are delayed. It reveals the impact that public service failures can have on individuals and how its investigations have resulted in the organisations putting things right for people.

Consultations
Revised "Saatchi bill" is back but critics still fearful. The Access to Medical Treatments (Innovation) Bill 2015, or "Saatchi Bill", had its 2nd Reading in the House of Commons on 16 October 2015 and will now go to Committee stage. The legislation, which will allow doctors to innovate without fear of negligence actions, continues to divide opinion among MPs. See also House of Commons briefing.

Cases
Mishcon De Reya (a firm) & Mishcon De Reya LLP v Antonio Caliendo & Barnaby Holdings LLC [2015] EWCA Civ 1029. In the latest consideration by the Court of Appeal, an Appeal has been rejected against the decision to grant Relief from Sanctions. See commentary.

(1) Tim-Alexander Gunther Nikolaus Hertel (2) Artemis International Sarl v (1) John Francis Saunders (2) Liquid Strategies Ltd [2015] EWHC 2848.  An offer made by the defendants was not a Part 36 offer despite being expressed as such. The offer was expressed to relate to an additional claim which the claimants had set out in draft amended particulars of claim; that claim was not yet "part" of the claim for the purposes of CPR r.36.2(2)(d).

Judge rules it not unlawful to withdraw medical support from 11 year old. NHS Trust obtains declaration from High Court that it would not be unlawful to withdraw medical support devices that are effectively keeping 11-year-old boy alive: Re X (A Child) (Rev 1) [2015] EWHC 2778 (Fam).

News
NHS charged with corporate manslaughter for first time as doctor in court over death. Errol Cornish, a consultant anaesthetist, has been charged, along with Maidstone and Tunbridge Wells NHS Trust, in connection with the death of Frances Cappuccini, a teacher who died after giving birth by emergency caesarean section. Mr Cornish was charged alongside Dr Nadeem Azeez who is thought to have fled to Pakistan. The case is the first in which an NHS trust has been charged with corporate manslaughter since the offence was created in 2008.

Mother loses "secondary victim" award, but grief damages upheld. Lord Brodie in the Court of Session has overturned a decision from August 2014 that Martha Young, the mother of a young man who was killed by a motorist while a pedestrian, was entitled to damages as a secondary victim after she witnessed the "immediate aftermath" of the accident. The judge ruled that in order for the mother to qualify as a secondary victim, "she must have been present more or less at the time and place of the event". A separate appeal that an award of £80,000 damages for distress, grief and loss of society was excessive, was rejected by the Court.

Depressed man kills himself in private prison after 'fundamental errors' by staff A depressed young man killed himself at a privately-run prison after a series of “fundamental errors” by staff who ignored repeated warnings about his mental state, an official report has revealed.

Bevan Brittan Articles
Children – An update on consent to medical treatment and deprivation of liberty. It is well established that children can, in certain circumstances, provide or withhold consent to medical treatment.  The Family Law Reform Act 1969 tells us in no uncertain terms that young people aged 16 or 17 can consent to treatment but it has been held in the past that refusals by this group can be overridden by those with parental responsibility.  Whilst such a view is considered in most circles to be incompatible with the Human Rights Act 1998, uncertainty in practice remains.  

Duty of Candour update Discussions with providers often identify confusion on a number of issues regarding the Duty of Candour. Helpfully, a paper to CQC's latest Board Meeting  acknowledges, and refers to further work being undertaken to address, these issues. 

If you wish to discuss any clinical risk or health and safety issues please contact Joanna Lloyd or Stuart Marchant.  

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Commissioning

Publications/Guidance
Integrated urgent care commissioning standards. Outlines the standards which commissioners should adhere to in order to commission a functionally integrated 24/7 urgent care access, clinical assessment, advice and treatment service. The aim is to incorporate NHS 111 and Out of Hours services into a coherent service model that will offer patients improved access to a new 24/7 urgent clinical assessment, advice and treatment service – bringing together NHS 111, GP out of hours and clinical advice. The move is part of NHS England’s ongoing Urgent and Emergency Care Review and will see a streamlining of the way urgent care services are provided around the country.

Improving wheelchair services: Top tips for commissioners from commissioners. This document has been written by CCGs for CCGs. It aims to help commissioners who may be planning to review or understand more about their local wheelchair service by suggesting issues to consider, and proposing questions commissioners could ask themselves and their service providers to ensure they are delivering high quality services for their local population.

Guidance – Commissioning excellent nutrition and hydration 2015 – 2018. This guidance has been produced to address the issues raised within 'Hard Truths' and the Francis Report; and to the concerns of patient, carers and the public with regard to malnutrition and dehydration. It draws together the most up-to-date evidence based resources and research to support commissioners to develop strategies to help ensure excellent nutrition and hydration care in acute services and the community. It also outlines why commissioners should make this issue a priority.

Bevan Brittan Articles
Commissioning Bytes: The new public contract regulations are coming to the health sector - How to design a compliant light regime process. As from April 2016, the new Public Contracts Regulations 2015 will come fully into force for NHS commissioners and will act in parallel to the current NHS regime overseen by Monitor. The new Public Contracts Regulations replace the old Part B services approach to health and social care contracts with a more formal set of obligations called the 'Light Regime'.

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

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Employment/HR

Publications and Guidance
Statement of fitness for work: a guide for hospital doctors. This guidance explains how and when hospital doctors should use the fit note to give patients better advice about their fitness to work.

Nursing agency rules. On 1 September 2015, Monitor and the NHS Trust Development Authority published new rules on nursing agency spend for NHS foundation Trusts and other NHS Trusts. From 19 October 2015, Trusts subject to this agency spending rule will have to secure nursing agency staff via approved framework agreements.

Zero hours contracts: guidance for employers. Guidance from DBIS on zero hours contracts and how they should be used. It sets out what zero hours contracts are, how they affect employment rights, appropriate use and best practice.

Pre and post-qualification training and development of doctors. The BMA is urging commissioners and employers to adopt a series of key principles designed to future-proof doctors' training. This document seeks to establish some broad principles which must underpin the structure and process of training, and any training reforms, so that it can both evolve with patient need and continue to produce motivated, compassionate and effective doctors. Proposals include ensuring training better reflects the needs of patients, allowing for continuous learning, and improving flexibility to accommodate the needs of doctors.

Junior doctor contracts in England. This briefing provides background information on the introduction of a new contract for doctors in training in England, including a summary of the proposed changes, and an update on the current state of negotiations between NHS Employers and the British Medical Association. It also provides some brief information on the delivery of seven day services and proposed changes to the consultant contract.

Consultations
Price caps for agency staff: proposed rules and consultation. Monitor and the NHS Trust Development Authority (NHS TDA) propose to introduce caps on the total amount NHS providers can pay per hour for an agency worker. Monitor and the TDA will consider all responses to the consultation and decide whether, when and how to implement the price caps. Subject to that process, the aim is to introduce the price caps on 23 November 2015. The closing date for comments is 13 November 2015.

News
Nurses to undergo aptitude checks every three years. Nurses and midwives will undergo aptitude checks every three years in what has been labelled the 'biggest change in the history of regulation' of nurses. Following in the wake of the Mid-Staffs scandal, the checks would ensure poor healthcare standards are not tolerated.

Learning disability employment pledge launched. NHS England and NHS Employers have launched a pledge to employ more people with learning disabilities which local NHS organisations are being encouraged to sign up to.

NHS to cap agency staff pay. Health Secretary Jeremy Hunt is to announce further clampdowns on staffing agencies and highly-paid NHS managers, which will include a cap on pay. This will apply to doctors and non-clinical personnel employed by the NHS through agencies. The aim is to remove £1bn from agency spending over a three year period. The money saved is to be reinvested into frontline patient care. The pay cap, subject to a consultation, will roll out on 23 November 2015.

Bevan Brittan Articles
Employment news round-up, October 2015. The top employment law news for October 2015, selected by Alec Bennett and covering: collective redundancy; shared grandparental leave; a raft of new developments in relation to workers from overseas; proposed caps on NHS agency spending; and zero-hours contracts.  We also provide details of our free annual review of employment law, hosted at our offices.

Ready for the National Living Wage? Julian Hoskins and Nicola Stibbs brief employers on the hidden complexities of the new 'National Living Wage' and set out practical steps to take now.

Whistleblowing - back to the future In the same month and year to which the heroes of 'Back to the Future 2' travelled – October 2015 – the Employment Appeal Tribunal has sent whistleblowing law 'back to future' by winding the clock back on the new public interest whistleblowing test.  Sarah Maddock reports on this development, and also looks at a renewed focus on whistleblowing in the charity sector.

Employment seminars
Our popular annual review of the 'hot topics' of the year returns this December for another whirlwind tour of the essential employment law developments that have occurred the last twelve months. We will also take a look at what is on the horizon for 2016 in terms of forthcoming legislation and cases on appeal.
Employment Seminar Birmingham register your interest in this event
Employment Seminar Bristol register your interest in this event
Employment Seminar London register your interest in this event

If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.   

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Finance

Publications and Guidance
Auditor panels - guidance to help health bodies meet their statutory duties. This guidance from the Healthcare Financial Management Association and DH for NHS bodies who will need to appoint auditors under the Local Audit and Accountability Act 2014 for the financial year 2017/18. 

If you wish to discuss any issues raised in this section please contact Claire Bentley.   

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Foundation Trusts

Publications and Guidance
Performance of the foundation trust sector. Healthcare trusts must continue to improve how they operate and how they deliver their services, according to the health regulator Monitor. This follows a report in which 151 foundation trusts in England were found to have fallen short of their waiting time targets for the April to June 2015 period. Trusts also struggled to deal with the increasing demand for diagnostic tests.

Radical change needed from foundation trusts to tackle intense pressures. An analysis by Monitor of NHS foundation trusts' performance between April and June 2015 shows a number of national waiting times targets were missed, including in A&E, for routine operations and some cancer treatments. It also finds that the sector has recorded a deficit of GBP 445 million in the first quarter of the year, and that trusts have struggled to deal with an increase in demand for diagnostic tests, partly due to staff shortages and ineffectively organised services.

If you wish to discuss any issues relating to foundation trusts please contact Vincent Buscemi

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Information Sharing

Publications and Guidance
Accessing and sharing health records and patient confidentiality. Individuals have a right to access their own health records, and in limited circumstances, access to the records of other people. The Government has made a commitment that patients should gain access to their health records within 21 days following a request. Access to health records may also be granted in limited circumstances for relatives or in the case of deceased patients. This briefing describes how patients may request access to their records, and the circumstances in which access to the records of others may be allowed.

Bevan Brittan Articles
Producing report(s) for children proceedings: A practical guide. This article outlines some of the areas of focus to assist you in preparing a report for children proceedings.  It is by no means an exhaustive outline for all cases, but is designed as a practical reference tool to assist you generally.

If you wish to discuss any of the items raised in the above section please contact Jane Bennett.

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Mental Health

Bevan Brittan Training - If you would like to know about our free lunch time training sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office.

Publications/Guidance
Focus on: people with mental ill health and hospital use. At any time, one in six adults has a mental health condition and one in 100 has a severe mental illness. This research, conducted with the Health Foundation, explores what differences in hospital use can tell us about the quality of physical health care for people with mental ill health. It used Hospital Episode Statistics data to study planned and emergency inpatient admissions, outpatient admissions and A&E attendances over five years.

Models of dementia assessment and diagnosis: Indicative cost review. This report identifies and reviews in detail three models of dementia assessment and diagnosis currently being used in dementia care in thriving schemes at Gnosall, Northumberland, and Rotherham and Doncaster. It presents indicative costs for each model, benefits for patients and carers, key messages and considerations about developing the service, giving insight to how a local CCG might approach a review of their local services with an aim to making improvements.

Advance Decisions - Healthcare Professionals' toolkit. The purpose of this toolkit is to support healthcare professionals’ understanding of Advance Decisions. It looks at:
 the legal framework for Advance Decisions and explains healthcare professionals’ obligations when caring for someone who lacks capacity;
 what an Advance Decision is and the criteria one needs to meet;
 how to support someone to make an Advance Decision;
 what steps should be followed if a person lacks capacity and has an Advance Decision;
 challenges that healthcare professionals may face when acting on an Advance Decision and offers practical guidance to help overcome them; and
 the relationship between Advance Decisions and Lasting Power of Attorney for Health and Welfare.

Learning resources: Mental Capacity Act 2005 (MCA) in social work. These guidance documents are designed to be used by social workers at all levels, from front line practitioners to senior social workers, social work supervisors and managers, to support them to deliver the best outcomes for the people with whom they work.

A manual for good social work practice: supporting adults who have dementia. The guidance document is designed to be used by social workers at all levels, from front line practitioners to senior social workers, social work supervisors and managers, to support them to deliver the best outcomes for the people with whom they work.

Learning resources for social work with adults who have autism. Practice and curriculum guidance designed to be used by social workers at all levels, from front line practitioners to senior social workers, social work supervisors and managers, to support them to deliver the best outcomes for the people with whom they work.

Consultations
Consultation on payment proposals for mental health services for adults and older people commissioned by CCGs in 2016/17. Monitor and NHS England are considering requiring commissioners and providers of adult and older people’s mental health care to adopt one of the following payment approaches in 2016/17: a payment approach based on year of care or episode of treatment or a payment approach based on capitation. Under both approaches an element of payment should be linked to the achievement of agreed quality and outcomes measures. The consultation closes on 19 November 2015.

News
Mental Health Act detentions rise by 10 per cent. Figures from health and social care information centre also show that detentions to private hospitals rose by 24% in 2014-15

Reforming deprivation of liberty: the key debates social workers need to know about. Community Care looks at four areas of the Law Commission's consultation paper that are generating most debate

Bevan Brittan Events
Court of Protection Update - Bevan Brittan's Court of Protection team is hosting a practical update session in each of our offices which will cover relevant legislation, guidance and case law and their impact on managing cases involving incapable patients.
 Court of Protection Update - Birmingham. 03 November 2015 : 10:00 - 13:30 (registration opens at 09:30 and event will be followed by lunch)
 Court of Protection - Bristol 04 November 2015 : 10:00 - 13:30 (registration opens at 09:30 and seminar will be followed by lunch)
 Court of Protection - London 05 November 2015 : 10:00 - 13:30 (registration opens at 09:30 and seminar will be followed by lunch).

Bevan Brittan Articles
Violent and aggressive behaviour in people with mental health problems (NICE guidance). Patients can present with very challenging and sometimes violent behaviour in many healthcare settings. There were 68,683 reported assaults on NHS staff in England between 2013 and 2014. 69% of these occurred in mental health or learning disability settings involving service users and the families or carers of service users. Most violent or aggressive incidents in mental health settings occur in inpatient units and most acute hospital assaults take place in emergency departments.

If you wish to discuss any of the items raised in the above section please contact Simon Lindsay or Stuart Marchant. 

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Primary Care

Publications/Guidance
Indicators of quality of care in general practices in England. The Health Foundation has published the findings from an independent review of indicators of the quality of care provided by general practices in England. It looked at how indicators could be developed to generate meaningful information that supports improvements to care and helps the public choose which practice might best meet their needs, focusing on focused on publication of indicators for the purposes of supporting local improvement of care, patient choice and voice, and the accountability and performance management of general practices.

Making time in general practice. This report from the NHS Alliance and the Primary Care Foundation argues that perhaps 27% of GP appointments could potentially be avoided if there was more coordinated working between GPs and hospitals, wider use of other primary care staff, better use of technology to streamline administrative burdens, and wider system changes. The report finds that a significant amount of GP time could be freed up if family doctors were not having to spend time rearranging hospital appointments, and chasing up test results from local hospitals. This accounted for 4.5% of appointments in the study, an estimated 15 million appointments if repeated across England. It also estimated 1 in 6 of the patients in the study could potentially have been seen by someone else in the wider primary care team, such as clinical pharmacists, practice nurses or physician assistants, or by being supported to meet their own health needs.

Getting the most out of the fit note: guidance for GPs. Guidance for GPs about how to complete each section of the fit note, including the reassessment box, comments section and return-to-work tick boxes. The guidance is based on research evidence and feedback from doctors, patients and employers. It is designed to help doctors make the best use of the fit note to support their patients, using case studies to illustrate different situations. This updates previous guidance, covers computer-generated fit notes and has a section with instructions for gaining further support.

If you wish to discuss any queries you may have around primary care please contact David Owens.   

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Public Health

Publications/Guidance

NHS public health functions agreement: Variation to the 2015-16 agreement on public health functions to be exercised by NHS England. The NHS Public Health Functions Agreement sets out the arrangements under which the Secretary of State delegates responsibility to NHS England for certain public health services (known as Section 7A services). This variation brings in the change, that from 1 October 2015, NHS England no longer has responsibility for commissioning Children’s Public Health services as included within Service Specification No. 27 Children’s public health services (from pregnancy to age 5).

Sugar reduction: the evidence for action. This review brings together the international evidence on interventions to help reduce the nation’s sugar consumption, as requested by the Department of Health. It contains options including further regulation of promotions, restrictions on the marketing of high sugar products, the impact of fiscal measures and a voluntary reformulation programme.

Cold weather plan for England. This plan gives advice to help prevent the major avoidable effects on health during periods of cold weather in England. There is also a document Making the case on why long-term strategic planning for cold weather is essential to health and wellbeing.

Mandatory reporting of female genital mutilation: procedural information. Guidance for relevant professionals and the police on the new mandatory reporting duty for FGM that is being introduced via the Serious Crime Act 2015. The duty will require regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. It will come into force on 31 October 2015.

Public health and obesity in England – the new infrastructure examined. The Phoenix project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health. This report presents the findings of the phase one case study research and first national surveys of directors of public health and councillors who lead on public health issues.

Embedding and accelerating prevention. Sets out London Councils' response to the All Party Parliamentary Group on Primary Care and Public Health's inquiry into delivering the Five Year Forward View: Behavioural change, information and sign posting. The response calls for public health funding for local government to be protected and for government to give councils the necessary levers in licensing and planning policy to enable them to protect health. It also argues that no single organisation can take responsibility for accelerating behaviour change in the population, rather there needs to be concerted, joined up action at local, regional and national levels. It makes the point that prevention should not be seen as an add on and needs to be embedded in planning, commissioning and delivery, with a “making every contact count” approach taken wherever possible.

Must knows: children's public health transfer. This briefing outlines key information for local government ahead of the transfer of children's public health duties from the NHS to local councils on 1 October 2015.

NHS public health functions arrangement: National Pandemic Flu Service - telephony management services. Sets out the arrangements under which the Secretary of State for Health delegates to NHS England responsibility for providing a telephony routing service for the National Pandemic Flu Service (NPFS), which will direct calls from the public to the call centre providers. The arrangements do not relate to the provision of the call centres themselves. 

Consultations
Public health formula for local authorities from April 2016. Seeks views on the proposed public health allocation formula for 2016/17, which is used to allocate public health resources to local authorities. The consultation closes on 6 November 2015. 

If you wish to discuss any queries you may have around public health please contact Olwen Dutton.    

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 Regulation 

Publications/Guidance
Improving productivity in elective care. This report from Monitor aims to help NHS providers identify opportunities to improve productivity in care pathways, from first consultation to postoperative follow-up, to relieve some of the pressure to meet greater demand within constrained budgets, while at the same time improving the quality of patient care. It scrutinises a group of ophthalmic and orthopaedic elective care providers at home and abroad selected for their strong performance on quality and cost metrics. The report, a result of close collaboration with service providers, pinpoints where and how elective teams can concentrate their efforts to maximise quality and efficiency.

Care Quality Commission inquiry. The Commons Public Accounts Committee has launched an inquiry into the substantial progress the Care Quality Commission has made in implementing the changes in its transformation strategy and how it is responding to its new responsibilities. It also will also scrutinise the Commission’s access to data and how it can improve indicators of its own performance.

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

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General

Publications/Guidance

Parliamentary briefing – Cities and Local Government Devolution Bill, 2nd Reading. This paper from the Nuffield Trust looks at the potential implications of the Cities and Local Government Devolution Bill for the NHS. The Bill allows Secretaries of State to remove duties and powers from public bodies, including NHS trusts and commissioners, and transfer them to local authorities. This briefing urges MPs to investigate a series of important points about how this might work and the issues it might raise.

Personalised medicine strategy. This board paper sets out the concept of personalised medicine within the NHS. The underpinning principles are: prediction and prevention of disease; more precise diagnoses; targeted and personalised interventions; and more participatory role for patients. The paper sets out the work that will now be undertaken to develop a personalised medicine strategy.

GMC roundtable on support services for vulnerable doctors. In July, the GMC held a roundtable event with healthcare experts and leaders from across the UK to discuss one of the recommendations in the review commissioned into doctors who took their own lives while under a GMC fitness to practise investigation. This report outlines the discussions about setting up a National Support Service for doctors with mental health and addiction problems.

NHS care for overseas visitors and migrants: posters. Posters and leaflets for NHS organisations to use aimed at overseas visitors and migrants.

How fair is your local NHS? Monitoring socioeconomic inequalities in health care for local NHS quality improvement. The University of York's Centre for Health Economics equity group has developed prototype equity indicators at CCG level to support the NHS inequalities duty, in research funded by the NIHR. These indicators could be used by the NHS to find out whether some CCGs are succeeding better than others at reducing socioeconomic inequalities in health care access and outcomes, and to monitor whether such inequalities are getting larger or smaller over time. This would enable CCGs to discharge the NHS inequalities duty in a more meaningful and evidence-informed manner, and to learn lessons about more effective ways of reducing health care inequalities.

Legislation
Modern Slavery Act 2015 (Duty to Notify) Regulations 2015 (SI 2015/1743). These regulations, which come into force on 1 November 2015, set out the information that public authorities must include when discharging their duty under s.52 of the Modern Slavery Act 2015 to notify the Secretary of State where they have reasonable grounds to believe that a person may be a victim of slavery or human trafficking.

News
Current trends in the UK genomics market. An assessment of the UK genomics market, including market size, industry composition and projected growth, is presented in a report setting out the findings of a research project commissioned by the Office for Life Sciences. The report discusses the global market drivers and constraints, discussing the UK industry composition in terms of size and location. It sets out some key challenges identified by the authors’ research which need to be overcome in order to give the UK a competitive advantage. These challenges include:
 skills shortages in bioinformatics and genomics – key skills required to grow genomics commercially and improve the application of genomics in the NHS; commercialisation and scale-up are a key constraint for the UK industry – the report says it will be valuable to learn from the challenges seen in the growth of the biotech industry to help the emergence of scale genomics businesses;
 accelerating application and reducing barriers to NHS adoption – continuing to build the relationship between academic research and clinical application in the NHS will be critical, as will improving reimbursement and reviewing commissioning opportunities.

Scientists apply to genetically manipulate IVF embryos. Scientists from the Francis Crick Institute in London have applied to the Human Fertilisation and Embryology Authority for a research licence to genetically manipulate embryos to understand why some women suffer repeated miscarriages. If the licence is granted, it will be the second known occasion in the world where the chromosomes of human embryos have been genetically manipulated using a gene-editing technique called Crispr/Cas9.

Campaigners urge Health Secretary to allow cheaper breast cancer drug. A coalition of patients, clinicians and campaigners is urging the health secretary to effectively tear up the patent of a breast cancer drug after it was dropped by the NHS for being too expensive. The coalition is also asking for the import or manufacture of a generic copy of Kadcyla, which offers an extra six months of life to women with the HER2 type of breast cancer. See also blog from Adam Smith institute.

Judge rejects call to give life-saving treatment against opposition of patient. A Court of Protection judge has ruled that it would be unlawful for an NHS trust to carry out life-saving treatment against the patient’s opposition.

Using technology to improve delivery of health and care services. Life sciences minister George Freeman on how integrated data and technology can improve the delivery of effective health and care services.

UK end-of-life care 'best in world'. End-of-life care in the UK has been ranked as the best in the world with a study praising the quality and availability of services.

Work that won Nobel Prize for medicine 2015. The Nobel Prize for physiology or medicine has been split two ways for groundbreaking work on parasitic diseases.

Round-the-clock health care services announced. Details of a new voluntary contract for GPs to deliver seven day care for all patients by 2020 have been announced, including a £750m access fund. Plans have also been made for the delivery of seven day hospital services across half the country by 2018.

Speeding up the adoption of health technologies. NICE launches The Office for Market Access to work with industry to speed up the adoption of new medicines, devices, and diagnostics by the NHS. The Office for Market Access will give commercial stakeholders access to a dedicated team at NICE that they can approach for enquirers relating to health technology evaluation.

Lord Carter: reducing variation in care could save NHS £5 billion. Lord Carter is currently conducting a review into how savings can be made by the NHS, in order to help local NHS chief executives make their hospitals safer and more efficient at the same time. The activity carried out by all NHS hospitals has been reviewed together and broken down by clinical speciality. The results show huge variations in clinical costs, infection rates, readmission rates, litigation payments and device and procedure selection. The review has highlighted the huge opportunity for hospitals to tackle these variations.

Bevan Brittan Articles
Producing report(s) for children proceedings: A practical guide. This article outlines some of the areas of focus to assist you in preparing a report for children proceedings.  It is by no means an exhaustive outline for all cases, but is designed as a practical reference tool to assist you generally.

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