31/05/2019

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/data sharing

Acute and emergency care

Inquests

Children

Mental Health

Clinical Risk/Patient Safety

Primary Care

Commissioning

Public Health 

Digital Health

Regulation

Employment/HR

Social Care

Finance

General

Immigration

 

 

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

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.
London - 4 June 
Birmingham - 11 June 
Bristol - 12 June

Healthcare Estates Breakfast Briefings. Throughout 2019 and 2020, we are running a series of Breakfast Briefings focusing on key themes affecting healthcare estates. Our specialist lawyers will be joined by guest speakers at these engaging and interactive sessions, designed to explore issues of relevance to those involved in healthcare estates, whether in acute settings, in the community or in the provision of mental health or primary care and whether in the NHS or private sector.

Digital Health Forum - Regulation of Digital Healthcare – The Opportunities and Challenges for Healthcare Providers and Innovators. 9 July London

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.

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. An overview of the differing causes acute v chronic hypoxia, stroke and non-negligent causes such as genetics and syndromes. Dr Lewis Rosenbloom will also look at delineating damage that would have been suffered in any event v what may have been added by a culpable period of delay. 11 June 2019
2. Suicide risk management from both a hands on practical and medico legal perspective. 25 June 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

NHS pressures: winter 2018/19 - a hidden crisis This report uses NHS England figures to examine the performance of the NHS during recent winters and over the long term. The report finds that winter 2018/19 saw the NHS once again under pressure, with A&E attendances and emergency admissions up, high bed occupancy, cancer waiting times growing and 4.3 million people now waiting for treatment. Many doctors worked extra hours and morale suffered.

Progress of the emergency services network The National Audit Office is warning that the new emergency services network (ESN) is facing further delays.

Changing Places toilets in NHS hospitals: apply for funding How NHS acute hospital trusts in England can apply for funding to install Changing Places toilet facilities for severely disabled people.

Did government spending cuts to social care for older people lead to an increase in emergency hospital admissions? An ecological study, England 2005–2016 Cuts to council social care budgets are often cited as a cause of pressure on NHS urgent and emergency care services. Much of the evidence supporting this link, however, is anecdotal. This paper sets out to try to quantify the effect of cuts to social care on older people’s use of emergency health care services.

Ambulance service wants more volunteers A report by the King’s Fund for the Office for Civil Society explores the role of volunteers in ambulance services in England and identifies examples of different ways in which volunteering opportunities are being developed.

News

'Zero tolerance' for A&E waits beyond six hours proposed by NHSE chief

Ambulance shortage linked to death of patient after eight-hour delay

Bevan Brittan Updates

Procurement: Ambulance service/patient transport contracts under the EU rules

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 

Transitions to adulthood: the case for a cross-departmental taskforce One in five 16 year olds experience five or more complex issues. Their age means these young people often fall between the cracks of children’s and adults’ services and are left without support. Many face further challenges as support drops off overnight after their eighteenth birthday, making the transition into independent adulthood difficult. This report outlines steps that government departments and other agencies should take to improve transitions for young people. It recommends that the government forms a cross-departmental taskforce to look into transition planning for older teenagers as they move into adulthood, to ensure the best outcomes for vulnerable young people.

Who are they? Where are they? Children locked up Children's Commissioner for England  Anne Longfield, the Children's Commissioner for England, has published a report on the hundreds of children in England who are locked up in institutions across the country. It gathers together for the first time all the data currently available about some of the most vulnerable children in England - those living in secure children's homes, youth justice settings, mental health wards and other residential placements, either for their own safety or the safety of others.

‘Far less than they deserve: Children with learning disabilities or autism living in mental health hospitals’. The report shows how too many children are being admitted to secure hospitals unnecessarily – in some cases are spending months and years of their childhood in institutions when they should be in their community. It warns that the current system of support for those with learning disabilities or autism is letting down some of the most vulnerable children in the country.

Segregation in mental health wards for children and young people and in wards for people with a learning disability or autism This is the interim report of a review commissioned by the Secretary of State for Health and Social Care on the use of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability or autism. It calls for an independent review of every person who is being held in segregation in mental health wards for children and young people and in wards for people with a learning disability or autism. These reviews should examine the quality of care, the safeguards to protect the person and the plans for discharge.

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 

Patient safety essentials toolkit This toolkit includes documents on improving teamwork and communication, tools to help health practitioners understand the underlying issues that can cause errors, and valuable guidance about how to create and maintain reliable systems. Each of the nine tools includes a short description, instructions, an example, and a blank template. Please note that free registration is required to access the toolkit.

Investigation into recognising and responding to critically unwell patients. Problems in recognising and responding to patients who are deteriorating continues to be a major source of severe harm and preventable death in hospitals. Previous research has shown that up to a quarter of preventable deaths are related to failures in clinical monitoring.

NHS Resolution Business plan 2019/20 NHS Resolution has published its business plan for 2019/20. It sets out key objectives for year three of its five year strategy. It has six key priorities for the new financial year, and in supporting these it plans to focus its investment across three main areas: data, accommodation and workforce.

NHS injury cost recovery scheme: April 2019 to March 2020 Data on the funds collected by the Compensation Recovery Unit and funds paid to the NHS.

Practice advice: Dealing with sudden unexpected death. College of Policing guidance provides advice on dealing with the initial stages of a sudden and unexplained death, for those cases where a decision is made that medical assistance is required. It also covers the role and provision of forensic pathology assistance in police death investigations.

Practice advice: The medical investigation of suspected homicide. This guidance provides advice on dealing with the pathology aspects of an investigation into a sudden and unexplained death. Separate guidance provides advice on the initial actions before instigating a homicide investigation. Together, they replace Chapter 11 (Pathology) of the ACPO (2006) Murder Investigation Manual and have been approved by NPCC, the Chief Coroner and the Coroners' Society of England and Wales.

News

Police open fourth inquiry into more than 450 deaths at hospital Nick Downing, assistant chief constable of Kent Police, has announced a new investigation into the deaths of 456 patients between 1987 and 2001 who had been given "dangerous" doses of powerful painkillers without medical justification at Gosport War Memorial Hospital in Hampshire. The new police investigation, which will be the fourth, has been agreed after an assessment of the inquiry report to establish whether it contained sufficient information not already submitted to the Crown Prosecution Service.

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. An overview of the differing causes acute v chronic hypoxia, stroke and non-negligent causes such as genetics and syndromes. Dr Lewis Rosenbloom will also look at delineating damage that would have been suffered in any event v what may have been added by a culpable period of delay. 11 June 2019
2. Suicide risk management from both a hands on practical and medico legal perspective. 25 June 2019 

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

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 

The changing face of clinical commissioning This report is based on interviews with leaders from nine CCGs in England, highlighting the work that is taking place across the country to drive through innovations and improvements across health and social care – often in partnership with other organisations. It argues that the perspective brought by clinical commissioners – the clinical expertise, collaborative working with provider colleagues, and an understanding of the population’s needs in the system in which they operate – are essential components to developing integrated services that are fit for purpose and get the best value for each NHS pound.

Workforce race equality standard data collection for CCGs. For the first time this year, CCGs will be required to submit data for national analysis and publication in the same way as NHS trusts.

Specialised health services recommendations 2019 Recommendations by the Prescribed Specialised Services Advisory Group (PSSAG) to ministers on services that NHS England should commission.

Tools for co-production in mental health commissioning NHS England commissioned resources to support delivery of the Five Year Forward View for Mental Health and the NHS Long Term Plan.

Working well together: evidence and tools to enable co-production in mental health commissioning This resource was commissioned by NHS England to support delivery of the Five year forward view for mental health and the NHS long-term plan. This document aims to improve local strategic decisions about, and the provision of, current and future mental health services for children, young people, adults and older adults. This includes people who are not in contact with mental health services because of existing barriers to access or for other reasons. This document also talks about co-production with people who are in at-risk populations.

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

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Digital Health

Publications/Guidance

Putting patients at the heart of artificial intelligence According to this report, the spread of misinformation risks undermining public confidence in the use of artificial intelligence in health care. The report warns that the NHS and relevant bodies need to do more to improve public understanding of the use of this innovative technology if its life-saving potential is to be realised.

Clicks and mortar: Technology and the NHS estate. As health and care services face mounting financial pressures and increased demand it’s clear that services will need to change. Technology and the estate are key enablers for delivering this change. This report looks at how increased innovation might bring about a different kind of ‘estate of the future’.

News

Better tech will build better relationships between clinicians and patients The Secretary of State for Health and Social Care spoke at the King’s Fund Digital Health and Care Congress to launch the new GP IT Futures contract.

‘NHS Skype doctors and nurses’ prevent thousands of avoidable hospital trips. NHS doctors and nurses are using Skype to help older people get faster care, reduce avoidable ambulance call-outs and help people stay out of hospital.

NICE launches online resource to help development and adoption of new health technologies HealthTech Connect, a new online resource provided by NICE to help identify and support new health technologies as they move from inception to adoption in the UK health and care system was formally launched.

Trial of new generation of surgical robots claims success

China AI cancer diagnosis start-ups face capital shortage Stricter licensing regime makes it tougher to commercialise medical tech.

Bevan Brittan Events

Digital Health Forum - Regulation of Digital Healthcare – The Opportunities and Challenges for Healthcare Providers and Innovators. 9 July London

If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris

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Employment/HR  

Publications/guidance

Interim NHS People Plan. The interim NHS People Plan, developed collaboratively with national leaders and partners, sets a vision for how people working in the NHS will be supported to deliver that care and identifies the actions that will be taken to help them.

Welcomed and valued Disabled doctors and medical students can expect greater support to pursue their careers.

Outstanding models of district nursing This report, written in conjunction with the Royal College of Nursing, calls for urgent investment in district nursing, as new figures show the number of district nurses working in the NHS has dropped by almost 43 per cent in England in the past 10 years. It explores all the elements that need to be in place to support an outstanding district nursing service.

2018 Workforce Race Equality Standard (WRES) data analysis report for eight national healthcare organisations This report presents two years of workforce race equality data and enables organisations to compare their performance with others providing similar services, with the aim of encouraging improvement by learning and sharing good practice.

The NHS workforce in numbers: facts on staffing and staff shortages in England The data used in this report shows that there has recently been a sustained fall in the number of GPs relative to the size of the population across the UK nations. There has not been such a sustained fall since the 1960s. For the overall number of GPs to have kept pace with the number of people in the UK since 2014 some 3,400 more GPs would have been needed.

DHSC workforce equality information: 2019. Equality data on the Department of Health and Social Care’s (DHSC) workforce from 1 October 2017 to 30 September 2018.

Migration Advisory Committee (MAC) recommends adding to shortage occupation list. The MAC has published its review of the shortage occupation list (SOL). The committee has recommended that all medical practitioners are now added to the list. Other recommendations are:

  • nurses should remain on the list, having been removed from the Tier 2 cap in 2018
  • occupational therapists, psychologists, radiographers and speech and language therapists should be added
  • paramedics should remain on the list
  • all social workers should be added to the list.
    The government will decide on these recommendations at a later date.

Health Education England and the RCN launch new website to help nurses plan new career steps. The new online career resource aims to help registered nurses and clinical support workers plan their next career move. It also aims to help ensure continuity of service and retention in the NHS, leading to better care for patients.

News

New British Medical Association guidance has laid out how senior doctors could get a higher pension in return for cutting the number of hours they work.

Bevan Brittan Updates

Service Models: The hazards of TUPE law for public sector employers

Shining a light on wrongdoing at work

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.
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 Jodie Sinclair, Alastair Currie or James Gutteridge.

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Finance 

Publications/Guidance

Investigation into penalty charge notices in healthcare The NHS estimates that it lost around £212 million in 2017-18 from people incorrectly claiming exemption from prescription and dental charges. However, this report finds that rules around entitlement are overly complicated, leading to genuine mistakes and confusion for many people. 

Independent review of local government spending need and funding This report identifies a funding gap of over £50 billion over the next six years for councils in England. It estimates that by 2025, 78 per cent of the 36 county authorities’ spending will relate to four key service areas: adult social care, children’s services, public health and education services.

Extending legal rights to personal health budgets and integrated personal budgets: consultation response - response from the government and NHS England The Department of Health and Social Care and NHS England held a public consultation that explored giving more people the right to have personal health budgets and integrated personal budgets. This would give people more choice and control over the money spent on meeting their health and wellbeing needs. The consultation ran from 6 April 2018 to 8 June 2018 and received over 400 responses. The government and NHS England’s response to the consultation sets out: what was heard over the course of the consultation; the response to respondents’ views; and next steps.

Department of Health and Social Care: group accounting manual 2019-20 This manual includes mandatory accounting guidance for Department of Health and Social Care group bodies completing statutory annual reports and accounts. These bodies include clinical commissioning groups, NHS trusts, NHS foundation trusts and arm’s length bodies. The manual is approved by the HM Treasury Financial Reporting Advisory Board. It is based on the Treasury 2019-20 financial reporting manual, adapted for the NHS.

Did government spending cuts to social care for older people lead to an increase in emergency hospital admissions? An ecological study, England 2005–2016 Cuts to council social care budgets are often cited as a cause of pressure on NHS urgent and emergency care services. Much of the evidence supporting this link, however, is anecdotal. This paper sets out to try to quantify the effect of cuts to social care on older people’s use of emergency health care services.

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

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Immigration

Publications/guidance

Impact of NHS overseas charging regulations on patients and doctors. Regulations designed to recover NHS treatment costs from overseas visitors are deterring vulnerable people from seeking treatment, threatening public health and wasting valuable clinical time, according to the BMA.

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

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Independent Health  

Publications/Guidance 

Integrating health and social care: state or market? This report argues that better outcomes in patient care and efficiency can be facilitated only within a system that allows more competition in health care provision, with different organisations integrating health and social care according to the preferences of their customers and clients.

Clinics authorised to carry out abortions. Information about independent clinics and hospitals that are approved to carry out abortions.

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

NHS Key Statistics: England, May 2019. Summary of NHS demand, performance and capacity of services in England. Covers A&E statistics, waiting lists, ambulance data, delayed discharges, staffing levels including doctors and nurses, and more.

Untapped potential: investing in health and care data analytics This report highlights nine key reasons why there should be more investment in analytical capability. Action and investment is needed across the system so the NHS has the right people with the right tools to interpret and create value from its data. This could result in an NHS that can make faster progress on improving outcomes for patients.

NHS Pressures – Winter 2018/19; A Hidden Crisis. A report from the BMA uses NHS England figures to examine the performance of the NHS during recent winters and over the long term.

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

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Inquests  

Publications/guidance

Coroners' investigations and inquests. This briefing paper deals with the law in England and Wales. It provides information about:
•when a coroner’s investigation and inquest is held;
•the impact of human rights legislation and deprivation of liberty safeguards;
•the procedure at an inquest and when the coroner must sit with a jury;
•the standard of proof at an inquest;
•who is entitled to ask for information relating to an investigation;
•reports to prevent future deaths;
•the Government’s proposal to introduce an Independent Public Advocate to act for bereaved families after a public disaster and support them at public inquests.

Cases

R (on the application of Maughan) (Appellant) v HM Senior Coroner for Oxfordshire (Respondent) & Chief Coroner of England & Wales (Intervener) (2019) EWCA Civ 809 The standard of proof to be applied at an inquest where an issue of suicide arose was the civil standard of the balance of probabilities in all respects, whether for the purposes of a short-form conclusion or for the purposes of a narrative conclusion. The Court of Appeal recommended that that position be explicitly articulated within the Coroners (Inquests) Rules 2013.

Bevan Brittan Updates

Proof of Suicide: Maughan in the Court of Appeal

Approaching causation in the Coroner’s Court

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

Physical Health Checks for people with Severe Mental Illness. NHS England has issued “technical guidance” for commissioners collecting data on physical health checks for people with severe mental illness (SMI).

Independent review into regulation of Whorlton Hall. CQC has commissioned David Noble QSO to undertake an independent review into how it dealt with concerns raised by Barry Stanley-Wilkinson in relation to the regulation of Whorlton Hall.

New advance care planning guide A new guide from NICE and SCIE helps managers of care services to support people to prepare for a time when they do not have the capacity to make their own decisions.

Who are they? Where are they? Children locked up Children's Commissioner for England  Anne Longfield, the Children's Commissioner for England, has published a report on the hundreds of children in England who are locked up in institutions across the country. It gathers together for the first time all the data currently available about some of the most vulnerable children in England - those living in secure children's homes, youth justice settings, mental health wards and other residential placements, either for their own safety or the safety of others.

Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs. This publication gives an overview of the work the RCN is doing to address the mortality gap between people with serious mental illness and the rest of the population as well as our work towards establishing parity of esteem between mental and physical health.

‘Far less than they deserve: Children with learning disabilities or autism living in mental health hospitals’. The report shows how too many children are being admitted to secure hospitals unnecessarily – in some cases are spending months and years of their childhood in institutions when they should be in their community. It warns that the current system of support for those with learning disabilities or autism is letting down some of the most vulnerable children in the country.

Segregation in mental health wards for children and young people and in wards for people with a learning disability or autism This is the interim report of a review commissioned by the Secretary of State for Health and Social Care on the use of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability or autism. It calls for an independent review of every person who is being held in segregation in mental health wards for children and young people and in wards for people with a learning disability or autism. These reviews should examine the quality of care, the safeguards to protect the person and the plans for discharge.

Learning Disability Mortality Review (LeDeR) Programme: Action from Learning This report provides examples of the local changes that have been made to services so far and highlights the extensive work which is happening nationally in response to common themes raised through LeDeR reviews across the country.

Working well together: evidence and tools to enable co-production in mental health commissioning This resource was commissioned by NHS England to support delivery of the Five year forward view for mental health and the NHS long-term plan. This document aims to improve local strategic decisions about, and the provision of, current and future mental health services for children, young people, adults and older adults. This includes people who are not in contact with mental health services because of existing barriers to access or for other reasons. This document also talks about co-production with people who are in at-risk populations.

Position statement on antidepressants and depression This position statement sets outs the Royal College of Psychiatrists' view on promoting optimal use and management of antidepressants. It discusses the challenges with prescribing antidepressants, including considering the evidence around efficacy, benefits and harms, ensuring they are used when clinically indicated and managing withdrawal. The statement includes a range of recommendations aimed at the UK health departments, national bodies and commissioners.

Tools for co-production in mental health commissioning NHS England commissioned resources to support delivery of the Five Year Forward View for Mental Health and the NHS Long Term Plan.

Legislation

The Mental Capacity (Amendment) Act 2019 has now received Royal Assent and the LPS will replace DoLs, possibly from Spring 2020 (although the 2 regimes are expected to run side by side for up to a year). An LPS Code of Practice is also expected to be published later this year.

Consultations

Consultation on proposed changes to "The transfer and remission of adult prisoners under the Mental Health Act 1983 good practice guidance 2019" and introduction of "The transfer and remission of immigration removal centre detainees under the Mental Health Act 1983 good practice guidance 2019" An NHS England and NHS Improvement consultation seeks views on guidance relating to individuals held within prisons and immigration removal centres who have been detained under the Mental Health Act for assessment and treatment within mental health in-patient services. Comments by 19 July 2019.

Bevan Brittan Updates

Out with the DOLS, in with the LPS

Dealing with abuse claims in a care setting

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 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. An overview of the differing causes acute v chronic hypoxia, stroke and non-negligent causes such as genetics and syndromes. Dr Lewis Rosenbloom will also look at delineating damage that would have been suffered in any event v what may have been added by a culpable period of delay. 11 June 2019
2. Suicide risk management from both a hands on practical and medico legal perspective. 25 June 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

Nuffield counts the workforce and spells out the gaps A report from the Nuffield Trusts shows the biggest sustained fall in GP numbers since the 1960s.

Final report of independent evaluation of Babylon GP at Hand Ipsos MORI was commissioned by NHS Hammersmith and Fulham Clinical Commissioning Group and NHS England in May 2018 to undertake an independent evaluation of the Babylon GP at Hand practice.

The community pharmacy: a guide for general practitioners and practice staff This updated guide aims to support general practitioners and community pharmacists in developing more effective working relationships and, in turn, improve primary care services for patients. It covers key areas such as funding arrangements for pharmacies, the impact of prescribing policies, and the range of clinical and administrative functions that community pharmacies currently provide.

The impact of primary care incentive schemes on care home placements for people with dementia The interface between primary care and long-term care is complex. In the case of dementia, this interface may be influenced by incentives offered to GPs as part of the Quality and Outcomes Framework (QOF) to provide an annual review for patients with dementia. The hypothesis is that the annual reviews reduce the likelihood of admission to a care home by supporting the patient to live independently and by addressing carers’ needs for support.

Improving access out of hours: evaluation of extended-hours primary care access hubs Barking and Dagenham, Havering and Redbridge clinical commissioning groups in outer east London commissioned the Nuffield Trust to evaluate their initiative for improving public access to primary care by providing additional capacity outside of core hours.

Induction template for general practice nurses NHS England and the Queen’s Nursing Institute have launched an induction template for general practice nursing.

Fit for the future: a vision for general practice This report outlines the RCGP's vision for the future of general practice, which is informed through consultation with GPs, health professionals and patients, alongside research commissioned from The King's Fund. It makes the case for longer face-to-face GP consultation times and a wider skill-mix within general practice.

The impact of primary care incentive schemes on care home placements for people with dementia This research finds that the interface between primary care and long-term care is complex. In the case of dementia, this interface may be influenced by incentives offered to GPs as part of the Quality and Outcomes Framework to provide an annual review for patients with dementia. The hypothesis is that the annual reviews reduce the likelihood of admission to a care home by supporting the patient to live independently and by addressing carers’ needs for support.

Evaluation of Babylon GP at hand: final evaluation report Ipsos MORI, working in partnership with York Health Economics Consortium, and with advisory input from Professor Chris Salisbury (University of Bristol), was commissioned by NHS Hammersmith and Fulham Clinical Commissioning Group and NHS England in May 2018 to undertake an independent evaluation of the Babylon GP at Hand practice. This report sets out the final results of the evaluation.

GP Contract This page sets out guidance and links to further resources to support implementation of changes to General Medical Services (GMS) contractual arrangements that will apply in England.

The Centre for Mental Health and the Samaritans have produced a report called
Strengthening the frontline which explores the role of GP services in helping those at risk of suicide. This report, produced with the Samaritans, explores the role of GP services in helping people who are at risk of suicide. It identifies five areas for improvement to help GPs to offer life-saving support: the provision of effective, ongoing training for GPs; investment in the capacity of primary care services to enable longer appointments and continuity of care for patients needing ongoing support; emotional support for GPs themselves; more effective care pathways for people who feel suicidal to clinical and social support; and opportunities to refer patients who need more specialist support.

All GP practices in England will be connected to the NHS App by 1 July 2019. NHS Digital has published guidance for practices to brief their staff, prepare their systems, and tell their patients about the NHS App once they are connected. There’s also an information pack for CCG communication teams. NHS Digital is asking commissioners to spread the word so that practices are ready and can support patients.

Older men at the margins. Age UK has published guidance on how to provide support to men aged 65 and older experiencing loneliness and isolation. Based on a two-year study of men from different social backgrounds, the guidance is aimed at organisers of groups and other interventions aimed at this demographic.

All systems go. The Royal College of General Practitioners (RCGP) states in this 'tech manifesto' that a robust and joined-up IT system across the NHS needs to be prioritised before a technological 'revolution' in patient care can truly happen. The manifesto recognises the exciting potential of genomics, AI, digital medicine and robotics to revolutionise patient care and improve patient safety. However, the RCGP says that widespread improvement will only be possible once robust, secure IT systems are in place for all GP practices and all areas of the NHS have access to computer networks that seamlessly link up the patient journey.

PCC has published the first in a series of podcasts to help primary care providers and commissioners keep up to speed with the rapidly evolving story of primary care networks. The first one is on the role of the clinical director - running time 7 minutes.

Primary care networks FAQ from NHS England. NHS England has published a number of frequently asked questions to support the publication of the GP contracting documents and the development of primary care networks.

Consultations

Consultation on proposed changes to ‘The transfer and remission of adult prisoners under the Mental Health Act 1983 good practice guidance 2019’ and introduction of ‘The transfer and remission of immigration removal centre detainees under the Mental Health Act 1983 good practice guidance 2019’. An NHS England and NHS Improvement consultation seeks views on guidance relating to individuals held within prisons and immigration removal centres who have been detained under the Mental Health Act for assessment and treatment within mental health in-patient services. Comments by 19 July 2019.

News

Better tech will build better relationships between clinicians and patients The Secretary of State for Health and Social Care spoke at the King’s Fund Digital Health and Care Congress to launch the new GP IT Futures contract.

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

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Public Health 

Publications/Guidance  

Health matters: prevention – a life course approach This resource for NHS and public health professionals focuses on taking a life course approach to the prevention of ill health and explores the evidence base for this approach. It signposts to evidence-based interventions and tools, as well as to evaluation and monitoring techniques.

Using audit in commissioning sexual health, reproductive health and HIV services: guidance for commissioners This document provides guidance to commissioners on how audits can contribute to both assure quality of service provision and drive continuous quality improvement in sexual health, reproductive health and HIV services.

Call for smoking ban on hospital grounds Public Health England is calling on all NHS trusts to become completely smoke-free by banning smoking in hospital grounds. 

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

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Regulation

Publications/guidance

Independent review into regulation of Whorlton Hall. CQC has commissioned David Noble QSO to undertake an independent review into how it dealt with concerns raised by Barry Stanley-Wilkinson in relation to the regulation of Whorlton Hall.

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

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Social Care  

Publications/Guidance  

Handling sharps in adult social care CQC has published a new medicines FAQ on handling sharps in adult social care to help providers understand their health and safety responsibilities as an employer in relation to the handling of needles, including when providing support in people’s own homes.

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

The government's 2019-20 accountability framework with NHS England and NHS Improvement. The government’s accountability framework with NHS England and NHS Improvement combines the annual statutory mandate to NHS England with its remit for NHS Improvement. The financial directions to NHS England provide further detail on how NHS England’s budget is broken down. This takes into account the joint working between the two organisations to lead the NHS in taking forward its long-term plan.

Under the skin: listening to the voices of older people in influenza immunisation. This report finds that attitudes of older adults to influenza immunisation are a significant factor in influencing the vaccination rates among this group. It argues that efforts to increase the vaccination coverage rates among the older population need to move beyond associating age with vulnerability and towards presenting immunisation as a positive and healthy lifestyle choice.

21st century social care: what’s wrong with social care and how we can fix it This research paper explores the nature and extent of the serious and urgent problems affecting the provision of social care in the UK. It identifies how these problems have evolved from the institutional structures developed for providing health and social care and offers proposals for complex, long-term social care in England.

Social care: Free at the point of need - The case for free personal care in England. A paper from the Institute for Public Policy Research sets out new research and policy proposals that aim to address the growing crisis in social care.

Social care 360 This review outlines and analyses 20 key trends in adult social care in England over recent years. Using a variety of publicly available data, it provides a uniquely rounded - '360 degree' - view of the sector.

End of life care for adults: service delivery. This draft guideline, open for consultation, covers organising and delivering end of life care services for adults approaching the end of their life. It aims to ensure that people have access to end of life services in all care settings, according to their needs and wishes. It also includes advice on services for carers and other people important to adults who are approaching the end of their life. The consultation closes on 7 June 2019.

Fixing the care crisis. This report argues that the current system is financially and politically unsustainable, opaque, unfair, and actively discourages local councils from investing in social care and housing for older people. It argues that the care system should adopt the model of the state pension – with the government providing enough support for a decent standard of care via a new Universal Care Entitlement, while encouraging and incentivising people to top up this provision from their savings or housing wealth via a Care Supplement.

Did government spending cuts to social care for older people lead to an increase in emergency hospital admissions? An ecological study, England 2005–2016 Cuts to council social care budgets are often cited as a cause of pressure on NHS urgent and emergency care services. Much of the evidence supporting this link, however, is anecdotal. This paper sets out to try to quantify the effect of cuts to social care on older people’s use of emergency health care services.

Bevan Brittan Updates

Dealing with abuse claims in a care setting

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

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General  

Publications/Guidance

Independent review of national cancer screening programmes in England: interim report of emerging findings Professor Sir Mike Richards is leading a major overhaul of national cancer screening programmes as part of a renewed drive to improve care and save lives. This interim report calls for practical measures to be used across the NHS to make screening more convenient and reverse the longstanding decline in the proportion of people being tested.

Raising the equality flag: health inequalities among older LGBT people in the UK This report highlights new findings from a recent project exploring the discrepancies in health outcomes experienced by older LGBT people. The research reveals that a lifetime of prejudice and stigma is leading to worse physical and mental health, poorer access to health and social care, as well as greater levels of social isolation and loneliness among older LGBT people.

State of the nation 2018-19: social mobility in Great Britain This report assesses the progress that Great Britain has made towards improving social mobility. It highlights that inequality is entrenched in Britain, from birth to work and discusses the links between poverty and health. It also finds that being born privileged means you are likely to remain privileged, while being born disadvantaged means you may have to overcome barriers to improve you and your children’s social mobility. It concludes that urgent action needs to be taken to help close the privilege gap.

News

711,000 hospital admissions where obesity was a factor in 2017/18

NHS patients to get faster access to pioneering treatments New improvements to the Accelerated Access Collaborative will put the most promising medicines, diagnostic tools and digital services through the clinical development and regulatory approval process faster.

Bevan Brittan Updates

Local Authority View

Bevan Brittan Events

Healthcare Estates Breakfast Briefings. Throughout 2019 and 2020, we are running a series of Breakfast Briefings focusing on key themes affecting healthcare estates. Our specialist lawyers will be joined by guest speakers at these engaging and interactive sessions, designed to explore issues of relevance to those involved in healthcare estates, whether in acute settings, in the community or in the provision of mental health or primary care and whether in the NHS or private sector.

The current programme is as follows:

  • Thursday 27 June - Healthcare Estates: Opportunities across STPs – Guest speaker: Martin Rooney, Director of NHS Improvement. RSVP HERE
  • Thursday 12 September - 3PD Development: Primary Care and Beyond – Guest speaker: Senior Director, Assura PLC. RSVP HERE
  • Wednesday 4 December - "Exclusive Possession” in Healthcare Estates – the law and practical implications – Guest speaker: TBC. RSVP HERE
  • Thursday 27 February - Capital Developments, PFI, PPP and Joint Ventures – Guest speaker: TBC. RSVP HERE

 

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