30/04/2019

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

Independent Health

Knowledge Transfer

Information sharing

Acute and emergency care

Mental Health

Children

Primary Care

Clinical Risk/Patient Safety

Procurement

Commissioning

Providers

Digital Health

Public Health

Employment/HR

Regulation

Finance

Social Care

Immigration

General

 

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

Annual Mental Health and Court of Protection Seminar. The pace of change in Mental Health Law gives rise to a range of challenges for mental health professionals, both clinical and in management. Our seminar will give an outline of what the changes mean for daily practice as well as how they will affect the structure and policy behind mental healthcare provision.
Leeds - 4 June
London - 5 June
Bristol - 11 June 
Birmingham - 12 June

The First 72 hours After a Health or Social Care Crisis. The purpose of this session is to focus on an organisation’s legal, regulatory and reputational response within the first 72 hours of a major incident or catastrophic event.

Employment seminars: Shining a light on wrongdoing at work. For over a year, the media spotlight has focussed on employees who have stepped forward to speak out about misconduct at work, from hostesses serving at a charity dinner through to the corridors of Westminster. Whilst the current context has been sexual harassment it is, of course, equally important that employers support and protect employees who raise concerns about all forms of inequality – as well as other serious issues, such as bullying and harassment. Please join us for our free half day training session looking at current issues relating to the raising of concerns at work.
Leeds - 23 May
London - 4 June 
Birmingham - 11 June 
Bristol - 12 June

Medical Workforce Toolkit Bevan Brittan has developed an innovative improvement led approach to medical workforce management which provides your Medical Director and Clinical Leads with the expertise, time and space to lead.

Procurement Updates - We will cover legislative and policy developments, including guidance on dealing the procurement aspects of outsourcing and corporate financial distress after Carillion, case law - with a focus on development agreements in the light of the Faraday Court of Appeal decision, and Brexit.
Birmingham 13/05/2019
Leeds 14/05/2019
London 15/05/2019
Bristol 16/05/2019

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. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. The next sessions coming up are:-
1. Defending clinical negligence claims arising out of out of hours care and health care in prisons - 14 May 2019
2. MHA/MCA case law update - 28 May 2019 

If you would like to receive more information about the webinars just ask Claire Bentley.  

Knowledge Transfer

Training. In addition to our free training programme for 2019, 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

What does the NHS England review of waiting times mean for accident and emergency (A&E) departments? The current review of the main NHS performance targets, led by the NHS England National Medical Director Professor Steve Powis, published an interim report in March 2019. The report proposes substantial changes to how waiting times for A&E, routine hospital, cancer and mental health services will operate in future. This runs through some of the issues the review raises for A&E departments.

Violence in England and Wales in 2018: an accident and emergency perspective This report finds that despite the recent spate of knife violence and homicide in some UK cities, the number of people injured in serious violence in England and Wales dropped by 1.7 per cent between 2017 and 2018. The study, which examines data by age and sex, is produced from a scientific sample of 126 emergency departments, minor injury units and walk-in centres in England and Wales. All are certified members of the National Violence Surveillance Network, which has published an annual report for the past 18 years.

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 

Improving young people’s experiences in transition to and from inpatient mental health settings A quick guide for mental health practitioners supporting young people.

Achieving consensus - on prevention, recognition and management of conflict in paediatric practice Media & External Affairs team Conflict can arise between health professionals and the parents of children not only where there is disagreement on the withdrawal or withholding of life sustaining treatment but also in more general routine care. In this paper for paediatricians and other health professionals the RCPCH attempt to suggest practices which may reduce disharmony.

Early access to mental health support This report illustrates the findings of a data collection exercise to understand spending on low-level children's mental health services across England. While the total reported spend on low-level mental health services across all areas in England increased by 22 per cent between 2016/17 and 2018/19 in cash terms, and by 17 per cent in real terms, over a third of areas around the country still saw a real-terms fall in spending – with nearly 60 per cent of local authorities seeing a real-terms fall.

News

Parental attitudes to vaccines survey 2018 Results of the latest PHE-commissioned survey of parental attitudes to the national childhood immunisation programme have confirmed that public confidence in the national programme remains very high and that self-reported vaccine coverage remains high for most childhood vaccines in the UK

PHE offers support to UK vaccine heroes Survey highlights that healthcare professionals remain the most trusted source of information while social media ranks bottom of the table.

Changing the role of assessment for young people affected by sexual exploitation Mike Williams, senior evaluator, NSPCC Mike Williams, senior evaluator, NSPCC, describes why assessment of children at risk needs to be more adaptive

NHS staff and parents to gain access to crucial child health information. NHS Digital and NHS England collaborate with IT suppliers to launch groundbreaking new service Vital child health information will be available to health professionals and parents at the point of care, thanks to a new live national service which has been launched by the NHS.

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 

New agreement between CQC and the Healthcare Safety Investigation Branch (HSIB) The Care Quality Commission (CQC) and the Healthcare Safety Investigation Branch (HSIB) have signed a Memorandum of Understanding setting out how they will work together to promote the safety and wellbeing of people receiving NHS care in England. The agreement confirms that the bodies will share information about the safety and quality of NHS services and evidence of safety risks or emerging themes that may indicate wider safety issues. They will also cooperate on national safety reviews and work together in the public interest to support improvements.

Improving treatments for mesh complications Recommendations on how to improve care for women who have experienced complications from mesh procedures will be made in autumn 2019.

Recommendations for assuring standards in the independent sector RCS is calling for independent hospitals to collect and publish equivalent data to that which the NHS routinely provides on patient safety and clinical audits. This RCS position statement sets out the changes to standards in the independent sector it believes are required to prevent a repeat of the harm caused by disgraced breast surgeon, Ian Paterson.  

Cases

Lucy Diamond v Royal Devon & Exeter NHS Foundation Trust [2019] EWCA Civ 585 A personal injury claimant who had not been properly informed of her options before consenting to a hernia repair procedure was unable to establish that a freestanding claim in damages arose from the NHS Trust's failure to warn her that a mesh-based procedure might risk future pregnancies. The facts established that she would still have opted for the mesh-based procedure had she been properly advised.

Liverpool Victoria Insurance Company Ltd v Zafar [2019] EWCA Civ 392 the Court of Appeal (Sir Terence Etherton MR, Hamblen and Holroyde LJJ) provided general guidance on the approach to be taken to sentencing an expert witness whose practice of completing expert reports placed them in contempt of court or who lied when questioned about such reports.  

News

Check insurance and indemnity cover, GMC tells doctors. The General Medical Council (GMC) has updated its guidance for doctors on insurance and indemnity to coincide with new state-backed clinical negligence schemes that has launched for GPs across England and Wales.

On 18 March the Lord Chancellor announced the start of the 140 day period for a review of the discount rate.  This means that the last date on which an announcement can be made is 5 August, although the publication of the Government Actuary’s Department Technical Memorandum on 22 January means the process is already well in hand and the announcement could be earlier than that.

Fewer full GMC investigations after pilot scheme success. Published 18 April 2019 Changes being made by the General Medical Council (GMC) will reduce the number of full investigations into one-off mistakes by doctors – known as single clinical incidents – after a successful two-year pilot scheme.

Dr Hadiza Bawa-Garba: Struck-off doctor can return to work

Improving treatments for mesh complications. Recommendations on how to improve care for women who have experienced complications from mesh procedures will be made in autumn 2019.

Communication problems are top of patients’ concerns about hospital care. Patients have different concerns from clinicians when asked about problems with their care, and may identify preventable safety issues. When trained volunteers surveyed 2,471 patients from three NHS Trusts in England, 23% of patients identified concerns about their care. The biggest category of concerns related to communication, with staffing issues and ward environment the next most common and safety issues. Although the majority of safety issues were categorised as negligible or minor, they were also seen as definitely or probably preventable. Patient-reported concerns identified new areas which may not have been picked up by staff, such as fear of other patients or delays in procedures. This is one of the largest studies to look at patient safety concerns from the patient perspective. The study suggests that inpatient surveys can identify patient safety issues and that collecting this data could help trusts identify areas where patient experience could be improved. However, for the data to be useful, it needs to be routinely collected, reviewed and acted upon, which may be difficult to implement.

Bevan Brittan Updates

CQC notifications – increased scrutiny of safety culture

Bevan Brittan Events

The First 72 hours After a Health or Social Care Crisis. The purpose of this session is to focus on an organisation’s legal, regulatory and reputational response within the first 72 hours of a major incident or catastrophic event.

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. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. You can sign up to watch the training sessions remotely via our webinar facility.  Just ask Claire Bentley. The next sessions coming up are:-
1. Defending clinical negligence claims arising out of out of hours care and health care in prisons - 14 May 2019
2. MHA/MCA case law update - 28 May 2019 

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 

Fracture Liaison Service Database: commissioner's report 2019. This report provides CCGs with a summary of the audit’s national key findings, recommendations and results for fracture liaison services (FLSs) within their locality. The report explains what an FLS is and how FLSs could help CCGs not only reduce the number and cost of unplanned admissions but also make a significant reduction in morbidity and mortality for older people. It finds that there are significantly fewer FLSs available for older people in some parts of England and Wales than others, with an estimated 54,000 preventable life-altering fractures to occur over the course of the next five years as a result.

Commissioners should submit details of agreed national tariff variations to NHS Improvement. As part the 2019/20 national tariff, which came into effect on 1 April, the local variations template has been simplified to focus on the key information needed to understand how providers and commissioners are working together and guide future price development. Submitted variations will be made available for all stakeholders to review and learn from. The updated template, and related guidance, is available on NHS Improvement’s website. Any queries should be directed to pricing@improvement.nhs.uk. Commissioners are asked to submit details of agreed variations by 30 June 2019.

Primary Medical Care Policy and Guidance Manual (PGM) This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

People living in care homes – frequently asked questions These frequently asked questions have been developed to support Clinical Commissioning Groups (CCGs) to implement the NHS England guidance for people living in care homes.

The pharmacy offer for sexual health, reproductive health and HIV: a resource for commissioners and providers. This resource discusses the capacity and capability of pharmacy teams, in both the primary and community sector, to provide consistent and high-quality sexual and reproductive health services. It aims to help commissioners and providers further embed pharmacy into key sexual health, reproductive health and HIV workstreams.

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

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Digital Health

Publications/Guidance

Embracing technology in health and social care This paper examines the potential impact of the increased use of automation in health and social care. It considers how embracing existing and developing technology can enable the health and social care system to increase productivity, reduce costs, and result in better health and social care.

We must drive tech innovation and improvement across the NHS Secretary of State for Health and Social Care Matt Hancock’s speech at The Royal Society of Medicine event ‘Medical apps: mainstreaming innovation.’

NHSX: digital experts will be part of cancer and mental health teams. Digital and data specialists will help patients, clinicians and carers benefit from better technology.

Digital tool to help reduce avoidable lengthy stays in hospital. A new digital portal is being introduced by the NHS and councils which allows health and social care staff to see how many vacancies there are in local care homes, saving hours of time phoning around to check availability and helping people to get the right care or return home as quickly as possible.

All GP practices to be on NHS App by 1 July All GP practices in England will be connected to the NHS App by 1 July 2019.

News

NHS staff and parents to gain access to crucial child health information. NHS Digital and NHS England collaborate with IT suppliers to launch groundbreaking new service Vital child health information will be available to health professionals and parents at the point of care, thanks to a new live national service which has been launched by the NHS.

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

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Employment/HR  

Publications/guidance

Reducing stress and building resilience in the NHS workforce Health Education England has launched a new framework to help health and social care employers improve the mental wellbeing of their employees.

Implementation, impact and costs of policies for safe staffing in acute NHS trusts This report finds that hospital wards across the NHS in England are still under staffed and putting patient lives at risk despite new policies coming into force as a result of the 2013 Francis Inquiry into the failings at the Mid Staffordshire Foundation Trust. New workforce guidelines have not led to significant improvements on the hospital wards. According to the study, hospitals are facing major challenges in recruiting and retaining registered nurses with an average vacancy rate reported at ten per cent across the country, and rates as high as 20 per cent in some trusts.

NHS Workforce Disability Equality Standard: technical guidance. The NHS Workforce Disability Equality Standard is designed to improve the workplace experience and career opportunities for disabled people working, or seeking employment, in the NHS. Organisations will be encouraged to introduce new measures and practices that positively support disability equality in the workplace and further the involvement and engagement of disabled communities more widely in the work and aims of the NHS. This technical guidance provides detailed information and advice to support the Standard which will apply to all NHS trusts and foundation trusts from 1 April 2019.

Caring for the mental health of the medical workforce. This report provides a summary of findings from a large-scale survey into the mental health of doctors and medical students. The survey, which was open to BMA members and non-members across the UK received over 4,300 responses. Four in ten respondents to our survey reported currently experiencing symptoms of depression, anxiety, burnout, stress, emotional distress or a mental health condition that is impacting on their work, training or study.

Staffing on wards. The nature of patient needs and ward activity is changing. Inpatients tend to be more acutely unwell than they used to be, many with complex needs often arising from multiple long-term conditions.

EU workers' qualifications will be recognised after EU Exit. Health and social care workers from the EU with professional qualifications can continue to practise in the UK as they do now. 

Employers’ motivations and practices: a study of the use of occupational health services. The Work and Health Unit (a UK government unit that brings together officials from the Department for Work and Pensions and the Department of Health and Social Care) has commissioned Ipsos MORI to conduct qualitative research with employers to understand their motivations and practices when using occupational health (OH) support. Their report looks at: how employers use OH services; why employers use OH services as they do; and why engaged employers do not purchase OH services.

Charter to strengthen relations between the Helpforce programme and staff in the National Health Service England. This charter shows how volunteers can make a valuable contribution to the NHS in England, without undermining paid staff or affecting patient safety. Its aim is to ensure that the tens of thousands of people who give up their time to provide comfort and help to patients are given guidance about their roles. It’s also intended to safeguard against their use as cheap substitutes for trained health staff.

Consultations

Consultation response: the National Health Service Pension Scheme, Additional Voluntary Contributions and Injury Benefits (Amendment) Regulations 2019. The Department of Health and Social Care has consulted on proposals to change NHS pension scheme regulations. The government received almost 1,500 responses to the consultation. This outcome document summarises the consultation findings and the government’s response.

News

Health Secretary vows to ban NHS gagging orders. Following a successful whistle blowing case, the Health Secretary has pledged to ban non-disclosure agreements (NDAs) for NHS whistleblowers to encourage them to come forward. Radiographer Sue Allison successfully argued that she had been asked to sign an NDA without legal advice after raising concerns. Howard J ruled the NDA was invalid and that she had a prima facie case of whistle blowing detriment.

Lessons from Mid-Staffordshire scandal being lost as NHS staffing levels are ‘putting patients’ lives at risk’.

Bevan Brittan Updates

Government plans to introduce cap on exit payments for public sector workers

Employment Eye April 2019

Bevan Brittan Events

Employment seminars: Shining a light on wrongdoing at work. For over a year, the media spotlight has focussed on employees who have stepped forward to speak out about misconduct at work, from hostesses serving at a charity dinner through to the corridors of Westminster. Whilst the current context has been sexual harassment it is, of course, equally important that employers support and protect employees who raise concerns about all forms of inequality – as well as other serious issues, such as bullying and harassment. Please join us for our free half day training session looking at current issues relating to the raising of concerns at work.
Leeds - 23 May
London - 4 June 
Birmingham - 11 June 
Bristol - 12 June

Medical Workforce Toolkit Bevan Brittan has developed an innovative improvement led approach to medical workforce management which provides your Medical Director and Clinical Leads with the expertise, time and space to lead.

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

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Finance 

Publications/Guidance

NHS financial sustainability: progress review. This report finds that, while the NHS did balance its overall budget in 2017/18, there is a disparity in financial health and patient experience at a local level. It concludes that the top-level picture hides warning signs that the NHS's financial health is getting worse: increasing loans to support trusts in difficulty; raids on capital budgets to cover revenue shortfalls; and the growth in waiting lists and slippage in waiting times do not indicate a sustainable position.

NHS visitor and migrant cost recovery programme. Information and resources for NHS organisations and frontline staff. Added guidance on NHS patient debts and immigration status checks to the ‘Guidance for NHS organisations’ section.

Comprehensive Investment Appraisal (CIA) model and guidance. The CIA is a model for the NHS to use to support economic appraisals in business cases. It replaces the Generic Economic Model. The user guide shows how the CIA model can be used to support economic appraisals in business cases. It provides guidance on the key economic principles, how these are used in economic appraisals and how the outcome of these appraisals is interpreted.

2019/20 Better Care Fund: policy framework. This document sets out the agreed way in which the Better Care Fund will be implemented in financial year 2019 to 2020. It includes: the level of funding for 2019 to 2020; conditions of access to the fund; national performance metrics; and the assurance and approval process.

Better Care Fund: how it will work in 2019 to 2020. The Better Care Fund (BCF) will provide financial support for councils and NHS organisations to jointly plan and deliver local services.

Productivity of the English National Health Service: 2016/17 update. This report updates the Centre for Health Economics’ time-series of NHS productivity growth for the period 2015/16 to 2016/17 and sets out trends in output, input and productivity since 2004/05

Overseas visitor charging: guidance for NHS service providers on updates to regulations. How changes to charging regulations will affect how you recover costs from overseas visitors and migrants if the UK leaves the EU with no deal.

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

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Immigration

Publications/guidance

Immigration status checks by the NHS: guidance for overseas patients. Information for patients about why an immigration status check is being made about them and what it will involve.

NHS patient debt: guidance on administration and data sharing. Information for NHS service providers on how to share information about overseas chargeable patients who have unpaid debts for NHS care.

Information sharing with the Home Office for unpaid NHS patient debts: privacy notice. Information that patients are entitled to under the Data Protection Act 2018 and the General Data Protection Regulation 2016/279.

NHS visitor and migrant cost recovery programme. Information and resources for NHS organisations and frontline staff. Added guidance on NHS patient debts and immigration status checks to the ‘Guidance for NHS organisations’ section.

Delayed, deterred, and distressed: the impact of NHS overseas charging regulations on patients and the doctors who care for them. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 currently determine the rules over charging ‘overseas visitors’ for NHS care in England. The British Medical Association has been consistently critical of the regulations, which they believe have a negative impact on both patients and doctors and have conducted a survey of their membership to gain greater insight into how the regulations affect doctors daily work. They state this survey provides clear evidence that the regulations are deterring vulnerable groups from accessing NHS treatment, threatening public health, and taking vital clinical time away from patient care.

Overseas visitor charging: guidance for NHS service providers on updates to regulations. How changes to charging regulations will affect how you recover costs from overseas visitors and migrants if the UK leaves the EU with no deal.

If you wish to discuss any queries you may have around immigration please contact Julia Jones.

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Independent Health  

Publications/Guidance 

Recommendations for assuring standards in the independent sector.RCS is calling for independent hospitals to collect and publish equivalent data to that which the NHS routinely provides on patient safety and clinical audits. This RCS position statement sets out the changes to standards in the independent sector it believes are required to prevent a repeat of the harm caused by disgraced breast surgeon, Ian Paterson.

Understanding private providers of occupational health services: an interim summary of survey research The Work and Health Unit has commissioned IFF Research to conduct a telephone survey of private providers of occupational health to understand the services they offer, their capacity for delivering the services, their workforce profile and any skills shortages, and how they market their services. This interim report contains a high-level summary of the findings from this survey.

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

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Information sharing/data  

Publications/guidance

What happens to your data: guidance for overseas patients Information for patients who have an unpaid debt for NHS care.

Information sharing with the Home Office for unpaid NHS patient debts: privacy notice Information that patients are entitled to under the Data Protection Act 2018 and the General Data Protection Regulation 2016/279.

NHS patient debt: guidance on administration and data sharing. Information for NHS service providers on how to share information about overseas chargeable patients who have unpaid debts for NHS care.

New supporting information for people using TPP Systm. One Organisations who use TPP’s system can find out how others have used the new access control functionality for sharing patient records across care settings by listening to a recording of one of the webinars hosted by NHS Digital and NHS England.

Recommendations for assuring standards in the independent sector RCS is calling for independent hospitals to collect and publish equivalent data to that which the NHS routinely provides on patient safety and clinical audits. This RCS position statement sets out the changes to standards in the independent sector it believes are required to prevent a repeat of the harm caused by disgraced breast surgeon, Ian Paterson.  

System update will help GPs remove national data opt-outs from data disclosures. Updates to GP systems are taking place from May which will allow GP practices to remove those patients who have registered a national data opt-out from data disclosures.

News

NHS staff and parents to gain access to crucial child health information. NHS Digital and NHS England collaborate with IT suppliers to launch groundbreaking new service Vital child health information will be available to health professionals and parents at the point of care, thanks to a new live national service which has been launched by the NHS.

If you wish to discuss any queries you may have around information sharing please contact Will Pickles.

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Mental Health 

Publications/Guidance

The government's response to the Joint Committee on Human Rights 7th and 12th reports. This is the government’s response to both the Joint Committee on Human Rights’ (JCHR) seventh and twelfth reports in the 2017-19 session: The right to freedom and safety: reform of the Deprivation of Liberty Safeguards, and Legislative scrutiny: Mental Capacity (Amendment) Bill. In those reports JCHR made recommendations on: the Bill; the recommendations from the Law Commission’s 2017 report on mental capacity and deprivation of liberty safeguards; and defining deprivation of liberty.

Specialist mental health support for new mums NHS England has announced that new and expectant mothers across England can now access specialist mental health care in the area where they live.

Improving young people’s experiences in transition to and from inpatient mental health settings A quick guide for mental health practitioners supporting young people.

Building better: the role of transport infrastructure and services in improving mental health According to this report, mental illness is costing the country £66.5 billion every year and better transport journeys can help. The report uses NHS Digital data to assess the prevalence and cost of mental health disorders in different English regions and finds that improving the way people travel and their experience at rail stations, airports and on roads, could play a significant role in improving their mental wellbeing.

NHS introduces mental health job coaches NHS England is to expand a scheme to help patients with serious mental health problems to find employment

Early access to mental health support This report illustrates the findings of a data collection exercise to understand spending on low-level children's mental health services across England. While the total reported spend on low-level mental health services across all areas in England increased by 22 per cent between 2016/17 and 2018/19 in cash terms, and by 17 per cent in real terms, over a third of areas around the country still saw a real-terms fall in spending – with nearly 60 per cent of local authorities seeing a real-terms fall.

Specialist nursing support for unpaid carers of people with dementia: a mixed-methods feasibility study Admiral Nursing is the only specialist nursing service in the UK that specifically focuses on supporting carers of people with dementia, but evidence of its effectiveness, costs, and relationships to other services is limited. This project, jointly undertaken with the University of York’s Social Policy Research Unit, aims to address this gap and explore the feasibility of full-scale formal evaluation.

Report on pilot of global mental health assessment tool The government has published a report on the global mental health assessment tool (GMHAT), which was piloted in 2016/17 by Public Health England, the Home Office and the International Organization for Migration. The GMHAT is a computerised clinical assessment tool developed to assess and identify mental health problems rapidly in a range of settings. The tool was tested with 200 Syrian refugees aged 18 and over in one clinic in Beirut, Lebanon who were being processed for resettlement to the UK as part of the Vulnerable Persons Resettlement Scheme.

Measuring the use of NICE guidance in mental health One in four adults experiences a mental health condition in any given year, and mental health conditions are the largest single cause of disability in the UK.

39 Essex Chambers have updated their guide to capacity assessments and their best interests guide.

Legislation

The Mental Capacity (Amendment) Bill. This passed its final legislative stage in the House of Lords on 24 April and will soon have Royal Assent. 

News

Barristers can act as deputies, Court of Protection rules Hilder J, sitting in the Court of Protection, has ruled that barristers can act as professional property and affairs deputies for those who lack mental capacity, although it is not considered a legal service by the Bar Council. She concluded that given the case was challenging and previous appointments of deputies had broken down, it was in the best interests of MBR, aged 12 and who had sustained cerebral palsy due to medical negligence, for the panel deputy to be appointed.

UK's DoLS mental capacity reform Bill now set for royal assent. House of Lords members have withdrawn their opposition to the Mental Capacity (Amendment) Bill 2018 following the Government's undertaking to provide a statutory code of practice and case studies clarifying the meaning of deprivation of liberty (DoL). The principal function of the Bill is to replace the existing deprivation of liberty safeguarding (DoLS) procedures. The Bill will return to the House of Commons and then be listed for royal assent, probably summer 2019.

New intervention doubles quit rate for smokers with mental illness. People with severe mental illnesses such as schizophrenia are three times more likely to smoke than the wider population, contributing to widening health inequalities. Smoking remains the largest modifiable risk factor for this health inequality, but people with severe mental illness have not historically engaged with smoking cessation services. Lancet report available here.

Bevan Brittan Updates

Case Summary: King's College Hospital NHS Foundation Trust v FG [2019] EWCOP 7

Freedom and Risk in a digital world – capacity, sex and social media

Bevan Brittan Events

Annual Mental Health and Court of Protection Seminar. The pace of change in Mental Health Law gives rise to a range of challenges for mental health professionals, both clinical and in management. Our seminar will give an outline of what the changes mean for daily practice as well as how they will affect the structure and policy behind mental healthcare provision.
Leeds - 4 June
London - 5 June
Bristol - 11 June 
Birmingham - 12 June

Bevan Brittan Webinars

Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. The next sessions coming up are:-
1. Defending clinical negligence claims arising out of out of hours care and health care in prisons - 14 May 2019
2. MHA/MCA case law update - 28 May 2019
If you would like to receive more information about the webinars just ask Claire Bentley. 

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

Occupancy regularisation for NHS Property Services tenants NHS England, the Department of Health and Social Care, and NHS Property Services are working together to encourage GP practices and other tenants of NHS Property Services to formalise their tenancy.

Primary Medical Care Policy and Guidance Manual (PGM) This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

System update will help GPs remove national data opt-outs from data disclosures. Updates to GP systems are taking place from May which will allow GP practices to remove those patients who have registered a national data opt-out from data disclosures.

Sharing records for direct care using TPP: regional webinars. NHS Digital and NHS England hosted a number of webinars to discuss how TPP's new record access control functionality can be used to enable and expand safe and legal sharing of patient records.

All GP practices to be on NHS App by 1 July All GP practices in England will be connected to the NHS App by 1 July 2019.

People living in care homes – frequently asked questions These frequently asked questions have been developed to support Clinical Commissioning Groups (CCGs) to implement the NHS England guidance for people living in care homes.

A summary of the Network Contract Directed Enhanced Service (DES) 2019/20 At the end of January 2019, NHS England published a five-year framework for GP services agreed. One of the major changes in the contract is the introduction of the Network Contract as a Directed Enhanced Service (DES). The aim is for general practice to take a leading role in every primary care network when it goes live on 1 July 2019. The briefing highlights aspects of relevance to local pharmaceutical committees and community pharmacy contractors.

GP contract directions 2019 to 2020 This page links to guidance setting out the legal framework under which GPs operate and are paid. The Primary Medical Services (Directed Enhanced Services) Directions 2019 sets out the legal framework under which enhanced services must be provided nationally. The General Medical Services Statement of Financial Entitlements (Amendment) Directions 2019 underpins the changes made in the 2019 to 2020 GP contract and sets out payments made to practices. The General Medical Services Statement of Financial Entitlements (Payment in Respect of Indemnity Fees) Direction 2019 underpins the state-backed indemnity scheme for all practices, which will be available from 1 April 2019.

GP Contract 2019/20: NHS England enhanced service specifications These enhanced service specifications outline more specialised services and those additional services provided by all General Medical Services practices.  

News

Health Education England invites bids for £50m Workforce Development Funding for 2019/20 Health Education England (HEE) has confirmed the arrangements for accessing funding from the £50m it has made available in the first phase of allocation through its workforce development fund to help employers develop their existing workforce in 2019/20. It has written to organisations to set out the details on how they can access the funding which is available now. Provider and primary care organisations will be asked to show how the funding is directed for suitable training and development as set out in its menu of activities such as developing new healthcare roles, upskilling their existing workforce to be able to take on new or more complex tasks, and workforce modelling and redesign.

Check insurance and indemnity cover, GMC tells doctors. The General Medical Council (GMC) has updated its guidance for doctors on insurance and indemnity to coincide with new state-backed clinical negligence schemes that has launched for GPs across England and Wales.

New indemnity scheme for general practice introduced The government-funded scheme provides GPs and others providing NHS services for general practice with comprehensive, automatic cover for clinical negligence claims.

Record breaking numbers recruited to GP specialty training. Figures released by Health Education England (HEE) show that recruitment to GP specialty training is the highest ever for this time of year with 2598 trainees accepted on to courses compared to 2533 for the same period last year.

GP scheme frees up half a million hours for patients An NHS programme has seen GP practices free up more than half a million hours of time for patients in the last year.

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

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Procurement  

Publications/guidance

Please procure responsibly: the state of public service commissioning A report by think tank Reform examines the complex systems used by central government and local councils to procure public services, how they are delivered and who delivers them.

The future of global health procurement: issues around pricing transparency. This research paper focuses on the role that price transparency may play in the efficient and effective procurement of medicines by middle- and low-income countries. It discusses whether making prices publicly available makes procurement more efficient and cost-effective medicines more accessible. The paper concludes that transparency of the procurement process significantly lowers costs by encouraging bidders.

Bevan Brittan Updates

Procurement: Framework Agreements and the need for transparency from the outset

Bevan Brittan Events

Procurement Updates - We will cover legislative and policy developments, including guidance on dealing the procurement aspects of outsourcing and corporate financial distress after Carillion, case law - with a focus on development agreements in the light of the Faraday Court of Appeal decision, and Brexit.
Birmingham 13/05/2019
Leeds 14/05/2019
London 15/05/2019
Bristol 16/05/2019  

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

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Providers  

Publications/guidance 

Community services: our time This report explores the opportunities and risks for the community services sector as a result of the NHS long-term plan. It found that there is optimism among leaders within the community services sector about delivering the ambitions of the NHS long-term plan, but there are key questions to be addressed about the relationship between community services and primary care networks.

Understanding private providers of occupational health services: an interim summary of survey research The Work and Health Unit has commissioned IFF Research to conduct a telephone survey of private providers of occupational health to understand the services they offer, their capacity for delivering the services, their workforce profile and any skills shortages, and how they market their services. This interim report contains a high-level summary of the findings from this survey.

Survey for people benefiting from personal health budgets The 2019-20 CQUIN scheme includes a CQUIN for providers of community stroke services, under the NHS standard contract, to undertake six month post stroke reviews and record these on SSNAP (Sentinel Stroke National Audit Programme).

The pharmacy offer for sexual health, reproductive health and HIV: a resource for commissioners and providers. This resource discusses the capacity and capability of pharmacy teams, in both the primary and community sector, to provide consistent and high-quality sexual and reproductive health services. It aims to help commissioners and providers further embed pharmacy into key sexual health, reproductive health and HIV workstreams.

Overseas visitor charging: guidance for NHS service providers on updates to regulations. How changes to charging regulations will affect how you recover costs from overseas visitors and migrants if the UK leaves the EU with no deal.

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

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Public Health 

Publications/Guidance  

Safeguarding in general dental practice: a toolkit for dental teams The dental team has a statutory duty of care to all patients, which includes ensuring that safeguarding arrangements are in place. This document provides an overview of safeguarding as a whole for the dental team by: clarifying the roles and responsibilities of the dental team in promoting the safety and wellbeing of children, young people and adults at risk of abuse; signposting useful safeguarding resources, including access to free training opportunities; outlining the pathways to be followed in cases of concern; and providing guidance on training requirements.

Prevention before cure: prioritising population health. A policy paper from the British Medical Association (BMA) suggests a framework for a cross-government approach to prioritising population health. The framework outlines four areas that should be considered: addressing the social determinants that influence health; increased and sustained funding for public health; prioritising prevention through the health service; and effective regulation to tackle key drivers of ill-health.

Pregnancy and early life: reducing stillbirth and infant death This planning tool examines factors that influence stillbirth and infant death at the population level, rather than in individual clinical care.

News 

Parental attitudes to vaccines survey 2018 Results of the latest PHE-commissioned survey of parental attitudes to the national childhood immunisation programme have confirmed that public confidence in the national programme remains very high and that self-reported vaccine coverage remains high for most childhood vaccines in the UK

PHE offers support to UK vaccine heroes Survey highlights that healthcare professionals remain the most trusted source of information while social media ranks bottom of the table.

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

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Regulation

Publications/guidance

New agreement between CQC and the Healthcare Safety Investigation Branch (HSIB) The Care Quality Commission (CQC) and the Healthcare Safety Investigation Branch (HSIB) have signed a Memorandum of Understanding setting out how they will work together to promote the safety and wellbeing of people receiving NHS care in England. The agreement confirms that the bodies will share information about the safety and quality of NHS services and evidence of safety risks or emerging themes that may indicate wider safety issues. They will also cooperate on national safety reviews and work together in the public interest to support improvements.

News

Campaign to tackle 'botched' cosmetic procedures

Bevan Brittan Updates

CQC notifications – increased scrutiny of safety culture

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

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Social Care  

Publications/Guidance  

Local authority spending on homelessness: understanding recent trends and their impact According to this report, nine years of government cuts have left local services for single homeless people with a shocking £1bn a year funding gap. It warns that cuts to council budgets are leaving increasing numbers of people at risk on the streets, and calls on the government to act now to make up the funding shortfall – or inevitably face missing its target of ending rough sleeping by 2027.

Social care 360. People often complain about the lack of data about social care; there is, in fact, a significant amount but it is often held in fragmented databases that are rarely explored. This review outlines and analyses 20 key trends in adult social care in England over recent years.

People living in care homes – frequently asked questions These frequently asked questions have been developed to support Clinical Commissioning Groups (CCGs) to implement the NHS England guidance for people living in care homes.

Quality Matters summary action plan: second edition Quality Matters is an initiative to improve the quality of adult social care, led jointly by the Department of Health and Social Care and partners from across the adult social care sector. This action plan sets out four areas for improvement: supporting collaborative commissioning; collecting and using data; strengthening the feedback culture in the sector; and providing support for quality improvement.

2019/20 Better Care Fund: policy framework This document sets out the agreed way in which the Better Care Fund will be implemented in financial year 2019 to 2020. It includes: the level of funding for 2019 to 2020; conditions of access to the fund; national performance metrics; and the assurance and approval process.

Digital tool to help reduce avoidable lengthy stays in hospital A new digital portal is being introduced by the NHS and councils which allows health and social care staff to see how many vacancies there are in local care homes, saving hours of time phoning around to check availability and helping people to get the right care or return home as quickly as possible.

Advance care planning A quick guide for registered managers of care homes and home care services.

People living in care homes – frequently asked questions These frequently asked questions have been developed to support Clinical Commissioning Groups (CCGs) to implement the NHS England guidance for people living in care homes.

Bevan Brittan Events

Jodie Sinclair Social Care Podcast – The Road to Outstanding

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

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General  

Publications/Guidance

Medical Examiners: Written question - 245986, 245987, 245988 In response to written questions on medical examiners, the Department of Health and Social Care states the Government is committed to introducing the reforms to death certification and to the introduction of a medical examiner system, as detailed in its response to a consultation published in June 2018. Draft regulations were published alongside that consultation and it remains the intention to bring these forward when Parliamentary time allows for amendment to the primary legislation. With the introduction of a statutory scheme of medical examiners, the Government is committed to reform of the cremation regulations, removing the requirement for separate cremation medical certification and the fees associated with that function.

Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences: Assessment of guideline An impact assessment by the Sentencing Council of the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Definitive Guideline, which came into effect in February 2016, concludes that fines for large organisations sentenced for health and safety offences have increased. It also shows an increase in fines for: food safety and hygiene offences for organisations; and corporate manslaughter offences. Analysis of Crown Court judges' sentencing remarks also suggest that the guideline is generally being applied in the manner intended.

News

Ex-supreme court justice defends those who break assisted dying law

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