20/11/2018

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

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Training Events

Information sharing/data

Knowledge Transfer

Mental Health

Acute and emergency care

Primary Care

Children

Prison Health

Clinical Risk/Patient Safety

Providers

Commissioning

Public Health

Employment/HR

Regulation

Finance

Social care

Housing and health

General

Independent healthcare

 

 

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

Bevan Brittan Free Training Events 

Bevan Brittan Events

Employment law and HR update: the hottest topics of 2018 and future developments
Leeds - 27 November
Bristol - 3 December
London - 5 December
Birmingham - 11 December

Housing and Asset Management Seminar - 9 January 2019. Bristol

Clinical Risk Webinars
Bevan Brittan Clinical Risk/Medical Law Training -
These are internal hour long lunch time training sessions that are attended by our team of solicitors. You can sign up to watch the training sessions remotely via our webinar facility. If you would like to receive notification of the webinars coming up just ask Claire Bentley.   

Knowledge Transfer

Training. In addition to our free training programme, we also provide bespoke knowledge transfer sessions on a range of healthcare law topics. If you wish to discuss any queries you may have around training or webinars please contact Claire Bentley.  

Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.

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

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Acute and emergency care

Publications and guidance

Better value and a better night's sleep: keeping acutely unwell children and adults out of hospital Mathew Mathai, Consultant Paediatrician at Bradford Teaching Hospitals NHS Foundation Trust, explains the concept of a ‘virtual hospital’ and how keeping patients out of hospital has helped to improve quality of care and reduce costs.

Closing five emergency departments not linked with increased hospital admissions, though ambulance call-outs increased Closure of five small emergency departments in England was not associated with change in the number of hospital admissions, urgent care attendances or deaths among the local populations, this study finds. However, ambulance call-outs increased by 14 per cent relative to comparison areas, with a four-minute increase in the time to reach a hospital with an emergency department. This National Institute for Health Research-funded study is the first to assess the impact of downgrading or closing emergency departments.

Non-urgent attendances to emergency departments are more common among younger adults This NIHR-funded study analysed three years’ worth of data (2011-14) from emergency departments within one large region of England representing rural, urban and suburban areas. It found that adults aged 16 to 44 years are more likely to attend emergency departments for non-urgent presentations than older adults. They were more than three times more likely to present for non-urgent reasons than those over 65 years. Non-urgent attendances are also more common during out-of-hours periods, especially at night.

Tackling bullying in ambulance trusts: a guide for action This guide contains analysis, advice, case studies and recommendations for how to tackle bullying and create positive cultures in ambulance trusts. It has been created by ambulance colleagues as a call to action to implement changes and improve staff experience.

News 

UK first as ambulance staff trial body worn cameras. In what is believed to be a first for the UK, a pilot scheme to be trialled in the north-east will require around 40 ambulance staff to wear body worn video cameras whilst at work. This follows a 23% rise in reported attacks by patients in 2018. The North East Ambulance Service has said that images would only be used for police inquiries into protecting staff.

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

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Children 

Publications/Guidance 

Promoting healthy weight in children, young people and families This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach. The briefings help to make the case for taking action to reduce childhood obesity, give examples of actions that can be taken, and provide key documents that form the evidence base and other useful resources. Practice examples are also given to illustrate what local areas are doing.

Each Baby Counts: 2018 progress report This report presents key findings and recommendations based on the analysis of data from 2016 relating to the care given to mothers and babies throughout the UK, to ensure each baby receives the safest possible care during labour.

All parents should be offered the opportunity to engage with the review of their baby’s death University of Bristol - When a baby dies in hospital, a Perinatal Mortality Review (PNMR) takes place. Currently, parents are largely unaware these reviews even take place and in most cases, bereaved parents are not given the opportunity to be involved and share their perspective of their care. This PARENTS study tested the hypothesis at two UK hospitals (Bristol and Manchester) that involving parents would have the potential to answer parents’ questions and therefore support them in grieving, drive patient safety improvements, and promote an open culture within healthcare.

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

Bevan Brittan Updates 

Raising Standards of Safeguarding Practice Across the Voluntary Sector - Deborah Jeremiah

Consent for the provision of medical treatment to Looked After Children - Eleanor Derry

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

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Clinical Risk/Patient Safety 

Publications/Guidance 

Ask Listen Do – Making conversations count in health, social care and education: Tips for health, social care and education organisations and practitioners. NHS England has published tips for health, social care and education organisations and practitioners with the aim of making feedback, concerns and complaints easier for people with a learning disability or autism.

Pressure ulcers: safeguarding adults protocol How to respond to individuals at risk of developing pressure ulcers, and preventing harm where they occur.

Digital maturity of maternity services NHS England has published a “digital maturity assessment” of maternity services across England, described as a baseline for improvement at both a national and local level.

Cases

Barry Frederick Hewes v (1) West Hertfordshire Hospitals NHS Trust (2) East of England Ambulance Service NHS Trust (3) Pankaj Tanna (2018) QBD (Foskett J) [2018] EWHC 2715 (QB) A master had erred in granting summary judgment at a point in proceedings when the parties had not exchanged expert evidence. There would be few cases where a summary judgment application could properly be contemplated before the relevant experts' reports had been exchanged and, in most cases, until after the experts had discussed the case and produced a joint statement.

YAH v Medway NHS Foundation Trust [2018] EWHC 2964 (QB) A mother, who had brought a claim for psychiatric injury following the birth of her baby at a hospital, could be classified as a primary victim and so there was no requirement to show that her injury had been caused by shock. The injury was not too remote from the hospital's admitted negligence to prevent recovery of damages.

News

Investigation launched into doctors' reports that settlements stop them speaking out on safety concerns. An investigation has been launched following reports that settlement agreements between trusts and employees are deliberately misleading departing staff into believing they could face financial penalties for whistle-blowing, despite a ban on "gagging clauses" in severance deals having been introduced in 2013.

Zholia Alemi: Foreign doctor checks after fake psychiatrist case. Some 3,000 foreign doctors in the UK are being urgently checked after a woman practised psychiatry for 22 years without any qualifications. 

Webinars   

Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. You can sign up to watch the training sessions remotely via our webinar facility.  Just ask Claire Bentley. 

Bevan Brittan Updates

Bawa-Garba and the importance of reflective practice - Toby de Mellow. 

Managing adverse events - when things go wrong - Stuart Marchant

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

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Commissioning   

Publications/Guidance 

Cardiovascular disease prevention return on investment tool: final report This resource has been developed to help commissioners provide cost-effective interventions to prevent cardiovascular disease.

Lessons learned from contract dispute resolution. NHS England and NHS Improvement have produced a document containing ten helpful hints for commissioners and providers to avoid conflict.

Partnership agreement between Ministry of Defence and NHS England for the commissioning of health services for the armed forces This agreement sets out a partnership approach, which enables the Ministry of Defence (MOD) to work with the NHS to plan and organise the delivery of health care for the armed forces community and support the best outcomes and experience for patients and their families and carers. This includes ensuring that those who have served in the armed forces have the best possible experience of the NHS and get the best care, regardless of whether they get help from their GP, a hospital or a specialist service.

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

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Employment/HR  

Bullying and harassment: how to address it and create a supportive and inclusive culture The BMA began its bullying and harassment project in 2017 following a survey of doctors which highlighted the impact that bullying and harassment had on the working lives and well-being of members, and growing evidence of how it harms patient care and safety. The project reviewed the existing evidence on workplace bullying and harassment in the NHS, and asked doctors and medical students to share their experiences. This report is a reflection of what was learned. It sets out key issues that need addressing, and recommendations for change.

Tackling bullying in ambulance trusts: a guide for action This guide contains analysis, advice, case studies and recommendations for how to tackle bullying and create positive cultures in ambulance trusts. It has been created by ambulance colleagues as a call to action to implement changes and improve staff experience.

Clinicians moving into senior leadership: barriers and enablers Report setting out the barriers and enablers for clinicians moving into senior leadership roles within the NHS.

Brexit and the health and social care workforce in the UK This report reveals that the NHS could be short of 51,000 nurses by the end of the Brexit transition period. The report, commissioned by the Cavendish Coalition representing 36 health and social care organisations, also highlights the increasingly crucial role that EU nationals are playing in UK social care services.

Medical CCT class of 2016: survey 2017: how have they fared? Published jointly with the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow, this is the ninth annual survey reporting the experiences of and outcomes for certificate of completion of training (CCT) holders within one year of gaining their CCT. For several years in a row it has found that CCT holders who describe themselves as being of white British ethnicity apply for fewer posts, but are more likely to be shortlisted and offered a post. Black and minority ethnic women appear to be particularly disadvantaged.

Effective clinical governance for the medical profession. The General Medical Council (GMC) has published a revised clinical governance handbook for organisations that employ, contract or oversee the practice of doctors in the UK. Effective clinical governance for the medical profession outlines the role that boards and governing bodies should play in governance for doctors, and how this can contribute to high-quality patient care. The handbook provides clearer advice about clinical governance processes for doctors including annual appraisals, managing concerns and pre-employment checks.

Consultations

An improvement resource for the deployment of nursing associates in secondary care The nursing associate role is a new one in England. It has been designed to bridge the skills gap between a healthcare support worker and a registered nurse. NHS Improvement want to hear views on this draft resource which has been written to advise NHS trusts and other provider organisations on how to safely deploy the nursing associate into the healthcare workforce. The consultation closes on 12 December 2018.

News

Zholia Alemi: Foreign doctor checks after fake psychiatrist case. Some 3,000 foreign doctors in the UK are being urgently checked after a woman practised psychiatry for 22 years without any qualifications.

Bevan Brittan Updates

Employment Eye.  Bevan Brittan's employment law report for November 2018.

Bevan Brittan Training

Employment law and HR update: the hottest topics of 2018 and future developments
Leeds - 27 November
Bristol - 3 December
London - 5 December
Birmingham - 11 December

Combatting sexual harassment training
Bevan Brittan provides organisations with essential training at a range of levels including:-
. Full coverage, workforce-wide training for all grades of employee
. Focussed training for your HR/management teams and
. Board level updates on the key issues and risks.
For more information click here.

Employment law and HR update: the hottest topics of 2018 and future developments - Bristol

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

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Finance 

Publications/Guidance

DHSC departmental spending over £500: 2018 Department of Health and Social Care transactions over £500 made using the electronic procurement card (EPC).

DHSC departmental spending over £25,000: 2018. Information on Department of Health and Social Care spending over £25,000.

‘Windrush generation’ guidance for NHS staff and NHS care providers. Establishing entitlement to NHS-funded secondary care when patients are part of the Windrush generation or may not have immigration documents readily available.

Personal Health Budget Experience Survey NHS England commissioned Quality Health to run an independent survey of people with a personal health budget (PHB) to understand their experience of it. The survey was run in spring 2018, and there were 390 responses.

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

Budget 2018: what it means for health and social care In this joint piece with the Health Foundation and Nuffield Trust, the Kings Fund analyse what was announced in the 2018 Budget and what it means for health and social care.

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

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Housing and health

Publications/Guidance

Homelessness: duty to refer – for NHS staff. Provides an overview of the duty to refer for NHS staff, including how to make a referral to a local authority.

News

The Housing Podcast: how housing can affect mental health.

Bevan Brittan Updates

Property focus Drafting overage – a crystal ball would be handy.

Modular Homes - Can they help solve the housing crisis?

Bevan Brittan Events

Housing and Asset Management Seminar - 9 January 2019. Bristol

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

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Independent healthcare

Publications/Guidance

Care homes: short guide to consumer rights for residents Information on consumer rights for residents in care homes and their families or other representatives.

Care homes: consumer law advice for providers Advice to help care home providers understand their obligations under consumer law when dealing with residents and their representatives.

Health care and adult social care in England: 2017 to 2018. This report analyses inspection and ratings data from 2016 to 2017 to provide an assessment of the state of health care and adult social care in England.

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

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Information sharing/data  

Publications/Guidance 

Information governance and technology resources. Resources to help health and care professionals use new technologies safely and securely to protect confidential patient information.

A data-driven approach to personalised cancer care Cancer survival could significantly improve if the NHS collects and uses its data more intelligently. This report advocates that NHS leaders collect much more data on cancer patients including survival, treatment, patient experience and medical history. It argues that, with better analysis, there could be improvements in the prevention of cancer, earlier diagnosis and effectiveness of treatment.

Digital maturity of maternity services NHS England has published a “digital maturity assessment” of maternity services across England, described as a baseline for improvement at both a national and local level.

News

NHS data sharing deal is scrapped. NHS Digital has announced that it has ended an agreement to share patients' details with the Home Office to track down illegal migrants. Doctors, health charities and MPs had warned that the scheme, which was actually suspended six months ago but allowed the Home Office to use data to trace people being considered for deportation for committing serious crimes, was deterring some patients from seeking care. The Home Office has said that it is now working on a new arrangement.

If you wish to discuss any queries you may have around information sharing please contact Jane Bennett.

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Mental Health 

Publications/Guidance

Fair funding for mental health: putting parity into practice The NHS is currently in the process of authoring a long-term plan that will set out what it wants to achieve with additional funding and how this funding will be allocated. This report argues that it is crucial this plan raises our ambitions on mental health, what parity of esteem looks like and how much it will cost to get there.

Ask Listen Do – Making conversations count in health, social care and education: Tips for health, social care and education organisations and practitioners. NHS England has published tips for health, social care and education organisations and practitioners with the aim of making feedback, concerns and complaints easier for people with a learning disability or autism.

Learning Disability Newsletter: Winter 2018-19. In this edition of the learning disability newsletter you can find out about supporting children and young people, sharing health information, Ask Listen Do, and lots more.

A fair, supportive society: summary report This report, commissioned by NHS England, highlights that some of the most vulnerable people in society – those with learning disabilities – will die 15-20 years sooner on average than the general population. Much of the government action needed to improve life expectancy for people with disabilities is likely to reduce health inequalities for everyone. The report recommends that action should focus on the ‘social determinants of health’, particularly addressing poverty, poor housing, discrimination and bullying.

Focused review of suicides among armed forces personnel This focused review of suicides in service personnel aims to identify additional measures for preventing suicide. This report is based on evidence drawn from a review of defence publications, an examination of published statistics relating to suicide, a systematic review of the academic literature, interviews with 53 key stakeholders across defence, a national and international benchmarking exercise and an original academic study of self-harm.

Consultations

Suicide prevention NICE is consulting on a quality standard that will cover ways to reduce suicide and to help people bereaved or affected by suicides in community and custodial settings. It does not cover national strategies, general mental wellbeing, or areas covered by other NICE quality standards such as self-harm or mental health conditions. The closing date for comments is 26 November 2018.  

Legislation

The Mental Health Units (Use of Force) Bill. A new law restricting and monitoring the use of force against patients in mental health units has been given royal ascent after an eight-year battle by the family of a young man who died after being excessively restrained.

Legislative Scrutiny: Mental Capacity (Amendment) Bill: Twelfth Report of Session 2017-19 House of Lords and House of Commons Joint Committee on Human Rights Date: Oct 26, 2018 Abstract: A Joint Committee on Human Rights report on the Mental Capacity (Amendment) Bill 2018 recognises the difficulty in defining deprivation of liberty, nevertheless the Committee believes that the lack of a statutory definition may result in persistent problems with the new scheme. It therefore recommends that a workable definition is included in the Bill.

Cases

YAH v Medway NHS Foundation Trust[2018] EWHC 2964 (QB) A mother, who had brought a claim for psychiatric injury following the birth of her baby at a hospital, could be classified as a primary victim and so there was no requirement to show that her injury had been caused by shock. The injury was not too remote from the hospital's admitted negligence to prevent recovery of damages.

SJ [2018] EWCOP 28 Application for authorisation to fit a colostomy bag to the P to reduce the chance of him developing the life-threatening illness sepsis. The authorisation was given.

University College London Hospitals v KG [2018] EWCOP 29 University College London Hospitals NHS Foundation Trust was seeking the court's authority to administer a treatment known as PRN100 to a patient who was suffering from sporadic CJD. Permission was granted.

News

Zholia Alemi: Foreign doctor checks after fake psychiatrist case. Some 3,000 foreign doctors in the UK are being urgently checked after a woman practised psychiatry for 22 years without any qualifications.

The Housing Podcast: how housing can affect mental health.

Hillgreen Care Limited fined £300,000 - for not monitoring ‘sexual predator'

Minister Orders Urgent Investigation Into Autistic And Learning Disabled Patients Being Locked Up.

Bevan Brittan Updates

Why black men are more likely to be detained: Consideration of significant racial disparity in mental healthcare. - Sumayyah Malna

How can we help?

Fixed fee training packages. We have devised a two-part fixed fee training package to ensure mental health professionals are up to speed with their duties and to enable key managers to proactively manage caseloads. We regularly deliver these sessions to provider and commissioner organisations, including their partner agencies. If you would like more information click here.

Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.

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

Bevan Brittan Mental Health Extranet 

Would you like to access the Bevan Brittan Mental Health Extranet? - It is a secure online resource containing a discussion forum, knowledge bank and information about training events. If you would like access please contact Claire Bentley.   

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

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Primary Care  

Publications/Guidance  

Quality and Outcomes Framework (QOF) – Prevalence, Achievements and Exceptions Report, England 2017-18. NHS Digital has published the annual report on the quality and outcomes framework (QOF), which contains information about the prevalence of the 21 conditions covered by the scheme.

GP online services communications toolkit This guide aims to support GP practices in promoting GP online services to patients and to encourage them to register for this service.

Improving access and continuity in general practice. A report by the Nuffield Trust sets out the evidence on continuity of care, its impact on clinical outcomes and wider health services, its importance to patients and GPs, and the relationship between improved access initiatives and continuity of care within general practice.

Urinary tract infection: diagnostic tools for primary care. Quick reference materials for primary care on diagnosing and understanding culture results for urinary tract infections

News

Artificial intelligence robots in Ipswich Hospital How robots have cut down the processing time of GP referrals by more than half.  

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

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Prison Health

Publications/Guidance

Prison health This report finds that standards inside England’s prisons have deteriorated in recent years, following budget reductions and the loss of prison officers. It concludes that prisons, as a result of staff shortages and overcrowding, are limiting prisoners’ access to healthcare and their ability to lead healthy lives. The report calls on the government to try to tackle this cycle of disadvantage, by reducing the health inequities people in prison face.

Bevan Brittan Updates

Suicide, self-harm and social care– solving healthcare problems in prison and the equivalence of care - Claire Bentley 

If you wish to discuss any prison health issues please contact Will Pickles.  

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Providers  

Publications/guidance 

‘Windrush generation’ guidance for NHS staff and NHS care providers. Establishing entitlement to NHS-funded secondary care when patients are part of the Windrush generation or may not have immigration documents readily available.

Care homes: consumer law advice for providers Advice to help care home providers understand their obligations under consumer law when dealing with residents and their representatives.

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

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Public Health 

Publications/Guidance  

Taking our health for granted: plugging the public health grant funding gap. This briefing paper argues that an additional £3.2 billion a year is required to reverse the impact of government cuts to the public health grant and ensure that it is re-allocated according to need. The grant enables local authorities to deliver vital public health services, such as obesity programmes, drug and alcohol services and sexual health services, but the paper finds that it has seen a £700 million real terms reduction in funding between 2014/15 and 2019/20 – a fall of almost a quarter per person.

Breast screening: leading a service. Information for local providers and commissioners on leading NHS breast screening services.

PHE inquiry into the fall in numbers of people in alcohol treatment: findings Alcohol treatment commissioners and providers can use this report to understand what was behind the fall in the numbers of people in treatment for alcohol dependence in England since 2013 to 2014. The findings can be used to inform local commissioning and service development plans for increasing the numbers of people in alcohol treatment.

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

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Regulation

News

Regulators missed chance to stop care scandal - report.

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

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Social Care  

Publications/Guidance  

The health care workforce in England: make or break? In advance of the publication of the NHS long-term plan, this briefing highlights the scale of workforce challenges now facing the health service and the threat this poses to the delivery and quality of care over the next ten years. It sets out the reasons why the long-term plan and supporting workforce strategy must address the urgent and mounting challenges facing the health care workforce.

Care homes: short guide to consumer rights for residents Information on consumer rights for residents in care homes and their families or other representatives.

Care homes: consumer law advice for providers Advice to help care home providers understand their obligations under consumer law when dealing with residents and their representatives.

The homecare deficit 2018. Using data obtained under Freedom of Information legislation, this report finds that the average prices paid for state-funded home care in the UK is just £16.12 per hour, almost £2 per hour less than UKHCA’s Minimum Price for Home Care of £18.01 per hour. UKHCA calculates that the UK’s home care sector needs at least £402 million per year to ensure that home care workers receive the statutory National Living Wage, while also ensuring that home care providers can meet their statutory obligations.

Amending the 2012 Act: can it be done? The Prime Minister has once again opened the door to changes to the Health and Social Care Act 2012. The Act is widely seen as dysfunctional, getting in the way of the more integrated care that it in fact seeks to achieve. Our new long read identifies some of the main complaints about how the current law operates; outlines some of the implications should attempts be made to amend it; and asks how far progress could be made within the existing legislation.

Health care and adult social care in England: 2017 to 2018. This report analyses inspection and ratings data from 2016 to 2017 to provide an assessment of the state of health care and adult social care in England.

Bevan Brittan Updates 

Allied Healthcare - continuity of care for service users. This alert highlights the implications for authorities in the event that Allied Healthcare enters into a formal insolvency process and the matters authorities should be considering now to ensure continuity of care for service users.

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

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General  

Publications/Guidance

Understanding the health care needs of people with multiple health conditions. Analysis of data from 2014 to 2016 for 300,000 people in England found that one in four adults had two or more health conditions, equating to approximately 14.2 million people in England. Over half (55 per cent) of hospital admissions and outpatient visits and three-quarters (75 per cent) of primary care prescriptions are for people living with two or more conditions. In the least-deprived fifth of areas, people can expect to have two or more conditions by the time they are 71 years old, but in the most-deprived fifth, people reach the same level of illness a decade earlier, at 61 years of age.

Preventable dehydration is a major issue in healthcare. The Water-Drop is a low-cost / high-impact innovative drinking system. It has been specifically designed for hospital patients, care home residents and vulnerable people in the community. For simplicity - picture an intravenous drip system that is used orally. It is a simple, low-cost, single patient use, disposable product which fits in with the way the NHS and care homes work at an operational level.

Outpatients: The future - Adding value through sustainability argues that the cost to patients and public health of the current approach must be considered alongside the financial cost to the NHS. Not only are patients frustrated by poor communication and long waiting times, they have to spend time and money on things like childcare and travel when attending appointments.

How should health policy respond to the growing challenge of multimorbidity? There is growing awareness internationally of the increasing number of people living with multiple long-term health conditions, known as multimorbidity. Health services, including the NHS, need to adapt to address this challenge. This policy report discusses the issue of multimorbidity, and offers a summary of recommendations.

Research integrity: clinical trials transparency - Tenth Report of Session 2017-19. A Science and Technology Committee report warns that selective non-publication of the results of research distorts the published evidence base and is a threat to research integrity. It states that despite there being a range of UK and EU rules and guidelines now in force to improve clinical trials transparency, in terms of tackling non-registration, non-reporting and mis-reporting, around half of clinical trials are currently left unreported, clinical trial registration is not yet universal in the UK, and reported outcomes do not always align with the original study proposal. It also expresses disappointment that "trusted bodies such as Public Health England and a range of NHS Foundation Trusts" are also failing to report results from clinical trials.

Call to Action: a series of practical resources to support health and social care staff to reduce delayed transfers of care. These guides are aimed to help health and social care colleagues to take prompt practical actions and use every opportunity to prevent delayed transfers of care. Through using these guides, health and social care staff can address the evidence that staying in hospital for longer than required drives adverse outcomes for patients.

Consultations

Decision making and consent. The GMC is consulting on revised consent guidance, which outlines what doctors should consider when discussing treatment and care with patients. The consultation runs until Wednesday 23 January 2019.

Legislation

Healthcare (International Arrangements) Bill 2017-19 This bill has been introduced to give the government legal powers to fund and implement healthcare deals after Brexit. It seeks to safeguard health care for 190,000 expats and 50 million people who travel abroad every year, through agreements with the European Union or member states.

News

Stronger protection from violence for NHS staff The NHS violence reduction strategy includes measures to better protect staff and prosecute offenders more easily. 

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