01/10/2024
Bevan Brittan provides high quality, comprehensive advice to the NHS, independent healthcare sector and local authorities. This update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS, independent sector and local authorities which have been published in the last month.
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Bevan Brittan Free Training Events
There is no charge for any of the events listed below
Webinars
These are internal hour long lunch time training sessions. You can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley.
Mental Health in Education - Supporting the Child. 3 October 12.30pm
Scientific Developments in the causation of birth injuries. Is clinical negligence behind the curve? 8 October 12.30pm
An updated view on Cauda Equina Syndrome, clinical management and litigation. 15 October 12.30pm
Case Law Update – Mental Health Act 1983 24 October 12.30pm
Please note that registration for each webinar will close one hour before the webinar starts, so please do ensure you have booked your place in advance to guarantee attendance.
Acute and emergency care
Publications/guidance
Virtual wards operational framework. This framework supports consistency across the NHS and the relevant goals in line with the Year 2 urgent and emergency care (UEC) recovery plan and the 2024/25 priorities and operational planning guidance: maintaining virtual ward capacity and optimising occupancy so it is consistently above 80%.
If you wish to discuss any queries you may have around acute and emergency issues please contact Claire Bentley.
Children and young people
Publications/Guidance
Child mental health services. The Education Policy Institute has published a report on the availability of non-specialist mental health services for children and young people in England. Key findings include: variation across the country in the range of mental health support services delivered outside of NHS settings; no clear link between the level of need and the range of support available; and a lack of targeted services for underserved groups including LGBTQ+ young people and those from ethnic minority groups. The report recommends that the Department for Health and Social Care commissions research exploring the existence, quality and accessibility of non-specialist mental health services.
Experiences of children in care. The BBC has published a news story on children in care and young care leavers in Wales having to move their personal belongings in bin bags. The BBC heard from young people who saw their belongings go missing as a result and explored the impact this had on them. The National Youth Advocacy Service (NYAS) is running a campaign, called My Things Matter, asking local authorities in England and Wales to pledge never to ask a young person to move their belongings in a bin bag or throw away a young person’s belongings without their consent. They are also asking local authorities to work with children in care to ensure they feel supported while moving.
Children’s services. Frontline has published a new report into children’s social work in England in 2024. The charity surveyed 570 social workers to build a picture of children’s social care. Key findings include: social workers identified an increased risk of harm to young people outside the family home, such as criminal and sexual exploitation; and they highlighted that children and families with social workers are struggling with poverty. The report includes calls for national and local government to tackle child poverty and extra -familial harm.
Supported accommodation. Ofsted has published a blog post on the use of supported accommodation for children in care and care leavers. The blog explains that some children are in need of a higher level of care than supported accommodation is equipped to provide and shares information around guidelines for providers.
Children in care. Action for Children has published a blog post collating information on the care system in the UK. The blog sets out figures on: the number of children in care; outcomes following care; siblings in care; and the demand for foster families.
Listening to the stories of women who have experienced child removal due to drug and alcohol use. This report, written in collaboration with REFORM, shares the stories of three women with experience of drug addiction during pregnancy and the early days of motherhood. It aims to shine a light on their experiences and centre their views on what is needed to improve the journey for others in a similar situation. The main three themes of the report are: the level of stigma that exists for women experiencing drug addiction, and/or are at risk of having their children removed; the need for improved support through training of health care professionals and investment in peer support and advocacy programmes; and the importance of hope.
From left behind to leading the way: a blueprint for transforming child health services in England. This report finds that children are waiting longer than adults to access health care, paediatric services are not recovering at the same rates as adult services, and there is a growing gap between demand and capacity. This has coincided with an unprecedented increased demand for children’s health services, which is forecast to grow further due to both preventable and non-preventable increases in childhood illness.
SEND code of practice: 0 to 25 years. Guidance on the special educational needs and disability (SEND) system for children and young people aged 0 to 25, from 1 September 2014.
Reporting Pilot Guidance. See the guidance from the President of the Family Division and the Transparency Implementation Group. Note this guidance replaces the guidance issued in January 2023
Joint inspections of the response to children who are victims of domestic abuse. In light of a new programme of inspections starting in September 2024, which will scrutinise how local services link up in response to domestic abuse, updated guidance provides advice for inspectors carrying out joint targeted area inspections (JTAIs) of the multi-agency response to children who are victims of domestic abuse. The upcoming JTAIs will evaluate local areas' strategic arrangements for all children, with a specific focus on unborn babies and children aged 0 to 7 years old.
Domestic abuse: multi-agency working. Ofsted has published updated guidance for inspectors carrying out joint targeted area inspections (JTAIs) of the multi-agency response to children living with domestic abuse in England. Upcoming JTAIs will evaluate local areas’ strategic arrangements for all children, with a specific focus on unborn babies and children aged 0 to 7-years-old. They will look at how children’s welfare is promoted and protected through effective and timely responses to adult victims of domestic abuse – such as through maternity and adult mental health services.
Unaccompanied asylum-seeking children. The Refugee and Migrant Children’s Consortium (RMCC) has published a briefing on the age determination process for unaccompanied asylum-seeking children. The briefing discusses age disputes and highlights how children can be incorrectly classified as adults based on appearance and demeanour, leading to their placement in adult accommodation or detention. The RMCC is calling on the Government to ensure accurate age assessments for unaccompanied asylum-seeking children. Key recommendations include: reduce the risk of misclassification; ensure age assessments are local authority-led; and protect the right to challenge age decisions.
News
Councils warned charging parents for children in care will undermine safeguarding
Age assessments. The Independent Chief Inspector of Borders and Immigration (ICIBI) has announced an inspection of the Home Office’s use of age assessments. The inspection will examine the effectiveness of age assessments, focusing on the Illegal Migration Intake Unit, the Asylum Intake Unit and the National Age Assessment Board. A call for evidence has been launched to hear from individuals with experience or who have worked with individuals who have undergone a Home Office age assessment. The deadline to submit evidence has been extended to 9 October 2024.
Children staying longer in care due to inequalities in kinship carer payments
Bevan Brittan Events
Mental Health in Education - Supporting the Child. 3 October 12.30pm
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk / Patient Safety
Publications/Guidance
Independent investigation of the National Health Service in England. In July 2024, the Secretary of State for Health and Social Care commissioned Lord Darzi to conduct an immediate and independent investigation of the NHS. Lord Darzi’s report provides an understanding of the current performance of the NHS across England and the challenges facing the health care system. Lord Darzi has considered the available data and intelligence to assess: patient access to health care; the quality of health care being provided; and the overall performance of the health system.
The Harmed Patient Pathway – A consultation document issued by AvMA and Harmed Patients Alliance. This Harmed Patient Pathway is a collaboration between people with a wealth of experience of the impact on patients caused by an avoidable medical accident. The project was launched, and is being led, by the patient-safety charity Action against Medical Accidents (AvMA) and the Harmed Patient Alliance (HPA). The core group that developed the draft pathway includes colleagues from the Maternity and Newborn Safety Investigations programme and the charity, Making Families Count. And, at various points, there has been input from patient-safety specialists at NHS trusts who kindly offered views and suggestions.
DHSC publishes Lord Darzi NHS summary letter. The Department of Health and Social Care (DHSC) has published the Lord Darzi National Health Service (NHS) investigation summary letter. In July 2024, Lord Darzi was commissioned to conduct an immediate and independent investigation of the NHS. Lord Darzi’s report gives an expert understanding of the current performance of the NHS across England including the challenges facing the healthcare system.
The Darzi investigation: what you need to know. This report is a summary and analysis of Lord Darzi's independent investigation of the NHS in England. The report was commissioned to investigate and understand the performance of the NHS and provide evidence for existing issues in the NHS system that will set out a baseline for the upcoming 10-year health plan.
National review of maternity services in England 2022 to 2024. This report presents the findings from a recent national maternity inspection programme. It highlights common issues impacting on the quality and safety of NHS hospital maternity services across the country.
What maternity services are like in England: September 2024. A Care Quality Commission (CQC) report presents the findings from its national maternity inspection programme, when between August 2022 and December 2023, it inspected 131 maternity units as part of a targeted programme to assess all hospital maternity locations that had not been inspected and rated since March 2021. The report finds that the safety of maternity services remains a key concern, with no services inspected as part of its inspection programme rated as outstanding for being safe: 47% were rated as requires improvement, 35% were rated as good and 18% were rated as inadequate. The report recommends that NHS trusts and integrated care boards should improve their collection of demographic data, including information on ethnicity and levels of deprivation, to improve outcomes for women. It also recommends that NHS England develops guidance and definitions of a patient safety event, where something unexpected or unintended happens in maternity services, ensuring reporting in line with Learn from Patient Safety Events, to tackle the issue of inconsistency in interpretation.
Medical certificate of cause of death (MCCD): guidance for medical practitioners. Guidance for medical practitioners completing a medical certificate of cause of death in England and Wales.
Investigation Report: Workforce and patient safety: temporary staff - integration into healthcare providers.
A Health Services Safety Investigations Body report on its investigation into the working conditions of temporary staff in the NHS finds that: temporary workers are discriminated against by some staff, organisations, and national bodies because of their working status, and in some cases because of their ethnicity; some temporary workers feel unable to raise concerns about patient safety because they fear they will lose future opportunities to work; where temporary workers are needed to fill workforce gaps, such gaps are advertised with limited information about required knowledge and skills; the knowledge, skills, and levels of experience of temporary workers may be unknown to their place of deployment; temporary workers are often redeployed to different areas of organisations to meet fluctuating demands; local inductions to new places of work are not always effective; and temporary staff do not always have the necessary access to electronic clinical systems. It recommends that the National Guardian's Office identifies barriers that prevent temporary staff from speaking up and develops mechanisms to address such barriers.
Safeguarding allegations. The Department for Culture, Media and Sport has created a safeguarding tool for charities on handling allegations of abuse. The tool aims to support charities in England with handling the reporting of safeguarding allegations about the behaviour or actions of a person in their charity.
Whistleblowing disclosures report 2024. The General Medical Council (GMC) has published the annual report on whistleblowing disclosures, alongside eight other health and social care professional regulators. The report shows that, between April 2023 and March this year, 60 concerns were raised with the GMC by whistleblowers, up from 48 in the previous year. In 2021/22 the number was 62. Of the 60 concerns raised, 23 were by doctors, 14 by other healthcare professionals and 23 were anonymous.
Infected Blood Inquiry: compensation: Research briefing. A House of Commons Library briefing discusses the background to the Infected Blood Public Inquiry, which recommended that the Government should set up a compensation scheme for those infected and affected by contaminated blood, blood products and tissue, and the Government's response in accepting this recommendation and establishing the Infected Blood Compensation Scheme in August 2024.
Consultations
The Harmed Patient Pathway: A consultation issued by Action against Medical Accidents (AvMA) and the Harmed Patients Alliance (HPA). A consultation by Action against Medical Accidents and the Harmed Patients Alliance proposes the Harmed Patient Pathway which is intended to encourage providers to recognise harmed patients as suffering a particular form of trauma for which there should be a pathway that seeks to optimise recovery. It is also intended as an obligation for providers to do what is possible to ease suffering and avoid causing further distress. The pathway aims to promote the exploration of the use of restorative principles and practices in any alternative dispute-resolution process to try to achieve a non-adversarial, safe and dignifying experience for all affected thereby avoiding the compounded harm and significant financial costs associated with traditional legal processes. Comments by 2 December 2024.
Legislation
Personal Injuries (NHS Charges) (Amounts) (Amendment) (No 2) Regulations 2024. SI 2024/895: These Regulations are made to increase the charges recoverable by the NHS for an injury which occurs on or after 1 October 2024 under the NHS Injury Cost Recovery Scheme (ICR Scheme). Under the ICR Scheme charges are recoverable from persons who pay compensation to a person for an injury where that injured person receives NHS hospital treatment or ambulance services. They come into force on 1 October 2024.
News
NHS Resolution announces new Clinical Negligence Claims Agreement 2024
The UK Parliament has announced the personal injury discount rate review commenced by the Lord Chancellor (the Chancellor), Shabana Mahmood. This is required by the Damages Act 1996 (DA 1996), as amended by the Civil Liability Act 2018. DA 1996 requires that the Chancellor, in conducting the review, must consult an expert panel (which has already been appointed for this review in June 2023) and HM Treasury. Both consultees are then required by the Act to respond to the Chancellor’s consultation within 90 days. In accordance with these statutory requirements, the Chancellor commenced this review on 15 July 2024, with the consequence that the Chancellor must conduct the review and make the determination regarding the rate on or before 11 January 2025.
Bevan Brittan Articles
Clarity in consultations. The importance of clear phrasing and issues arising from miscommunications - Harriet Wheeler and Tim Hodgetts
World Patient Safety Day 2024 - Joanna Lloyd
Bevan Brittan Events
Scientific Developments in the causation of birth injuries. Is clinical negligence behind the curve? 8 October 12.30pm
An updated view on Cauda Equina Syndrome, clinical management and litigation. 15 October 12.30pm
How we can help
We are working with clients on formulating policies and making it easier to balance treatment with finite resources. We are helping with social care policies and day to day activities such as contact and isolation, human rights issues and life/death decisions. We are working on notifications of harm and death, RIDDOR, CQC compliance, judicial review, infection control law and grappling with the new regulations and guidance. For more information click here. If you wish to discuss any clinical risk or patient safety issues please contact Joanne Easterbrook or Tim Hodgetts.
Digital Health
Publications/guidance
AI in health care: navigating the noise. This guide aims to support health care leaders to make sense of artificial intelligence and explore what is currently possible. It includes a jargon buster and various case studies on how AI is currently being used in some NHS trusts.
News
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
Investigation Report: Workforce and patient safety: temporary staff - integration into healthcare providers.
A Health Services Safety Investigations Body report on its investigation into the working conditions of temporary staff in the NHS finds that: temporary workers are discriminated against by some staff, organisations, and national bodies because of their working status, and in some cases because of their ethnicity; some temporary workers feel unable to raise concerns about patient safety because they fear they will lose future opportunities to work; where temporary workers are needed to fill workforce gaps, such gaps are advertised with limited information about required knowledge and skills; the knowledge, skills, and levels of experience of temporary workers may be unknown to their place of deployment; temporary workers are often redeployed to different areas of organisations to meet fluctuating demands; local inductions to new places of work are not always effective; and temporary staff do not always have the necessary access to electronic clinical systems. It recommends that the National Guardian's Office identifies barriers that prevent temporary staff from speaking up and develops mechanisms to address such barriers.
Priorities for the NHS workforce: the NHS trust perspective. This briefing provides an overview of the following areas of NHS workforce policy: building an NHS fit for the future, pay, and culture and staff wellbeing.
The management mission: how better leaders improve public services. This report brings together the highlights of detailed studies into the value of leadership and management in the UK’s health care, education system, and local government. It concludes that investing in managers, both current and future, will ensure they have the basic set of skills required to navigate stretched budgets, but also the tools needed to manage the change that comes with new technologies, changing demographics and evolving demands of the workforce.
Just about managing: the role of effective management and leadership in improving NHS performance and productivity. This report – based upon more than forty interviews and the findings of FOI requests to every trust and integrated care board in England – considers the role that management and leadership can play in enhancing NHS performance and productivity. It argues that a greater focus on the competencies, permissions and placement of management is required, noting that a weak and anecdotal evidence base has often defined the public debate. The report sets out sixteen recommendations to improve NHS management, including a reduction to vertical, tiers of NHS management, including the abolishment of NHS England and (re)merging its functions with Department of Health and Social Care (but for a delivery function to exist in the form of an NHS management board).
Understanding the factors underpinning suicidal ideation among the UK nursing workforce from 2022 to 2024. This report says that all health and social care employers have a duty to prevent workplace pressures contributing to suicidal thoughts among nursing staff. It found that more than two-thirds of nursing staff who had contacted the Royal College of Nursing advice service between February 2022 and February 2024 said workplace issues were a key factor in why they were seeking help. The report describes how nursing staff have been put under pressure at work, with workload, bullying and harassment, and a lack of work–life balance cited as the key factors contributing towards suicidal thoughts.
What community health providers are doing to recruit and keep the staff they need. This briefing from NHS Provider's Community Network showcases the work of four community providers that are innovating to improve recruitment and retention at a local level.
Without a safety net: the impact of no recourse to public funds on internationally educated nursing staff. This report finds that two thirds of migrant nursing staff are considering leaving the UK due to cost-of-living pressures. It also highlights the impact of ‘no recourse to public funds’, a rule that denies migrants on temporary visas, such as the Health and Care Worker visa, access to benefits. Migrant nursing staff pay tax, but without Indefinite Leave to Remain they are unable to access benefits such as Universal Credit, Child Benefit or Housing Benefit, leaving them and their families at a greater risk of poverty and destitution.
Information for patients who have been subject to sexual misconduct by a doctor. This information is for patients who have been subject to any form of sexual misconduct by a doctor, as well as those supporting them.
Allegations of sexual misconduct: support for employers and Responsible Officers. This information is for senior doctors responsible for clinical governance processes at their places of work, to support them in preventing, identifying and responding to cases of sexual misconduct.
Bevan Brittan Updates
- Supporting NHS organisations to continue to implement the Sexual safety charter, new resources include Bevan Brittan’s update on the new Sexual Harassment guidance from the EHRC: EHRC updates its harassment guidance - eight-step guide for employers and the new resources from the GMC to support patients and colleagues who have been subject to sexual misconduct by doctors: New GMC resources to support victims of sexual misconduct by doctors - GMC
How we can help
We can offer support and advice on managing many workforce issues including flexing your workforce to respond to the pandemic, managing bank staff, redeployment, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home working, through FAQs, helpline or policy guidance and practical day to day advice.
If you wish to discuss any employment issues generally please contact Jodie Sinclair, Alastair Currie, Oonagh Sharma, James Gutteridge or Andrew Uttley.
Finance
Publications/guidance
Fiscal risks and sustainability: September 2024. Based on current policy and the latest demographic projections, public debt is projected to almost triple from just under 100% of GDP to more than 270% of GDP over the next 50 years. The estimated damage to the economy and public finances from a changing climate could add between 20% and 30% of GDP to these pressures on debt, while improving the health of the population could reduce them by more than 40% of GDP by the mid-2070s. Chapter 3 of the report updates the assumptions driving the OBR's long-term projections of health spending and looks at the economic and fiscal consequences of alternative health scenarios.
A new fiscal model to deliver prevention. This paper argues for the introduction of a national health insurance model in the UK to support a mission-led approach to growth and health, provide stability and predictability to health budgets, and fix a system that has been funded by short-sighted investments to plug short-term gaps. The paper argues that by formally and fiscally accounting for the value of prevention and population health, the government can use its finite resources more effectively to help UK citizens live healthier, more productive lives.
If you wish to discuss any queries you may have around finance issues please contact Claire Bentley.
Health Inequalities
Publications/Guidance
Empowering healthy places: Unveiling the powers and practices of local councils in fostering healthy neighbourhoods. A Local Government Association guide presents a practical report for councils, outlining their powers in relation to planning and public health. It sets out a holistic approach for thinking about how to create healthy neighbourhoods and a summary of the relevant powers and practices available to councils. The intention is for the guide to empower councils to make use of the powers already available to shape and create healthy neighbourhoods and reduce health inequalities. It also provides recommendations to councils and national government, arguing the latter should take urgent action to empower local authorities to create healthier communities.
Review of NHS trust strategies for addressing health inequalities. This review sets out the key components of a successful trust strategy for reducing health inequalities. It is based on desk-based research into a selection of published trust strategy documents and follow-up interviews to better understand the extent to which action on health inequalities has been prioritised.
What are the enablers for improving outcomes and reducing inequalities in maternal and neonatal care? This long read shares learning from NHS Providers' Health Inequalities, Race Equality and Improvement programmes around improving maternity and neonatal outcomes.
Fairer, Healthier Leeds: reducing health inequalities. To better tackle health inequalities in Leeds and enable the city to maximise its opportunities, the Fairer, Healthier Leeds programme was launched in June 2023. This report draws on learning from the programme’s first year. It provides a short analysis of health inequalities in Leeds, recommends action to reduce them, and ways to improve the social determinants or building blocks of health.
A call for change: tackling inequalities in access to mental health support for children with social work involvement and those living in poverty. This report finds that children with social work involvement for current concerns are more likely to be rejected by NHS mental health services compared to their peers. Research undertaken with Cambridge University found that, overall, children from the most deprived areas are twice as likely to be rejected than those from the least deprived areas.
Review of NHS trust strategies for addressing health inequalities. NHS trusts play a crucial role in addressing health inequalities by focusing on providing equitable access to services and ensuring patients receive a consistent level of care. Taking a strategic approach is identified as key to making progress; it can provide a helpful roadmap to achieve long-term objectives that are aligned with the trust’s overall strategy and identify the opportunities and risks to making progress. This review sets out the key components of a successful trust strategy for reducing health inequalities. It is based on desk-based research into a selection of published trust strategy documents and follow-up interviews to better understand the extent to which action on health inequalities has been prioritised.
Men's health: the lives of men in our communities. This report finds that men in England are facing 'a silent health crisis', dying nearly four years earlier than women, while suffering disproportionately higher rates of cancers, heart disease and type 2 diabetes. The report highlights severe inequalities, with men in deprived areas living up to 10 years less than their affluent counterparts and facing a 20-year gap in healthy life expectancy. It found socio-economic and behavioural factors, including higher levels of smoking and excessive drinking, as contributory factors. In addition, the report says four out of every five suicides are by men. The LGA is urging the government to implement a men's health strategy similar to the women's health strategy of 2022.
Tackling health inequalities: seven priorities for the NHS. Drawing on The King’s Fund’s five-year programme of work on health inequalities and tackling the worst health outcomes, which includes insights from stakeholders, partners, and people with lived experience, this long read outlines what we think the anticipated 10-year health plan should focus on to help the NHS do more to tackle these challenges.
How we can help
We have a multidisciplinary team advising NHS commissioners and providers on all aspects of tackling health inequalities, ranging from:
- advising on the new legal framework and compliance with the relevant statutory duties, particularly in the context of service reconfiguration;
- addressing workforce inequalities;
- taking action on patient safety to reduce health inequalities;
- the role of the Care Quality Commission in tackling health inequalities; and
- lessons to be learnt from the Covid-19 pandemic.
If you wish to discuss any queries you may have around health inequalities please contact Julia Jones.
Housing
Publications and guidance
People power: lessons from the health care response to the Grenfell Tower fire. This report documents the experiences of people from the community and those responsible for commissioning and providing health care services in the area in the months and years after the fire.
News
Why the NHS is broken for homeless people
If you wish to discuss any queries you may have around housing please contact Julia Jones
Independent Health
Publications/Guidance
Is the use of privately funded health care on the rise? This analysis explores trends in attitudes, activity and spending on privately funded health care. Where possible, it draws on data covering the whole of the UK, but some data sources exclude Northern Ireland or only cover England. While there may be some distinctive regional trends at play, The Health Foundation believes the findings generally hold true for the UK overall.
If you wish to discuss any queries you may have around independent health, please contact Tim Hodgetts or Julie Charlton
Information sharing/data
Publications/guidance
Data centres to be given massive boost and protections from cyber criminals and IT blackouts. The Government has announced that it has classed UK data centres, the buildings which store much of the data generated in the UK, as "Critical National Infrastructure", meaning that data housed and processed in these locations, from photos taken on smartphones to patients' NHS records and sensitive financial investment information, is less likely to be compromised during outages, cyber attacks, and adverse weather events. Critical National Infrastructure status will also deter cyber criminals from targeting data centres that may house vital health and financial data, minimising disruption to people's lives, the NHS and the economy.
If you wish to discuss any queries you may have around information sharing please contact Jane Bennett.
Inquests and Inquiries
Publications/guidance
Guidance No 47: The Death Certification Reforms. A Courts and Tribunals Judiciary publication provides guidance for coroners on the reform of the death certification system. Areas of focus include: what happens when the coroner decides to investigate; methods of referring deaths to coroners; and post-mortem examinations during preliminary enquiries.
Medical certificate of cause of death (MCCD): guidance for medical practitioners. Guidance for medical practitioners completing a medical certificate of cause of death in England and Wales.
If you wish to discuss any queries you may have around inquests, please contact Amanda Wright- Kluger or Claire Leonard.
Integrated Care
Publications/guidance
What can integrated care systems in England learn from the devolved nations? Approaches to integrating health and care services to improve efficiency and meet population needs have varied across the United Kingdom’s four devolved nations. Given the differences in approach to integration across the four nations, the NHS Confederation, supported by Novartis, has developed this resource to showcase both examples of good practice and lessons learned in Wales, Scotland and Northern Ireland.
How ICSs are meeting workforce challenges: four case studies. The NHS has one of the biggest workforces in the world but recruiting and retaining the right staff can be challenging: it currently has more than 1.5 million staff but more than 100,000 vacancies. This set of case studies explores how four integrated care systems are tackling workforce issues across the health and care system.
The state of integrated care systems 2023/24: tackling today while building for tomorrow. A new survey of integrated care system (ICS) leaders has found that while 9 in 10 are committed to shifting more care out of hospitals, there are widespread concerns that a lack of long-term investment and planning is holding them back.
If you wish to discuss any queries you may have around integrated care, please contact Claire Bentley
Mental Health
Publications/Guidance
Giving gifts. Legal guidance for deputies and attorneys on the rules about giving gifts on behalf of the person they act for.
Child mental health services. The Education Policy Institute has published a report on the availability of non-specialist mental health services for children and young people in England. Key findings include: variation across the country in the range of mental health support services delivered outside of NHS settings; no clear link between the level of need and the range of support available; and a lack of targeted services for underserved groups including LGBTQ+ young people and those from ethnic minority groups. The report recommends that the Department for Health and Social Care commissions research exploring the existence, quality and accessibility of non-specialist mental health services.
Cases
Stockport MBC v NN & Anor [2024] EWCOP 51 (T1). Short judgment concerning attendance of an observer where NN, the protected party, objected.
MA v A Local Authority & Ors [2024] EWCOP 48 (T2). Application for permission to appeal, with appeal to follow, against a final order regarding contact between a couple who have been married for 60 years but who now both have dementia.
Pindo Mulla v. SPAIN (Application no. 15541/20). Decision from the Grand Chamber of the ECHR regarding emergency medical treatment for a Jehovah's Witness who wished to refuse blood transfusions.
PG (Serious Medical Treatment), Re [2024] EWCOP 49 (T3). Capacity and best interests decision regarding possible medical treatment for PG, a 57 year old woman with a history of severe mental illness.
Bevan Brittan Events
Mental Health in Education - Supporting the Child. 3 October 12.30pm
Case Law Update – Mental Health Act 1983 24 October 12.30pm
How we can help
We are experts in advising commissioners, providers and care co-ordinators on the relevant legal frameworks. We deal with complex issues such as deprivation of liberty, state involvement, use of CCTV monitoring, seclusion, physical restraint and covert medication. We can help providers with queries about admission and detention, consent to treatment, forensic service users, transfers, leave, discharge planning and hearings. We can advise commissioners on all matters concerning commissioning responsibility, liability and disputes. For more information click here
If you wish to discuss any mental health issues facing your organisation please contact Simon Lindsay or Hannah Taylor.
Prison Health
Publications/Guidance
Sexual and reproductive health competency framework for caring for women in prison. This competencies framework has been developed for nurses, midwives, and those supporting nursing teams, who provide sexual and reproductive health care to women in prison. It takes account of nursing teams who may have limited experience caring for pregnant women.
Health care provision in prisons: emergency care response. Ambulance crews spend significant time diverting resources to 999 callouts in prisons that are cancelled or not a serious emergency. The HSSIB estimates that these calls use 1,250 hours of ambulance crew time per year. There is a particular need to improve communication and collaboration between organisations.
Purposeful prisons: time out of cell: A key findings paper by HM Chief Inspector of Prisons. An HM Inspectorate of Prisons report explores how much time prisoners spend out of their cells and the impact of this across the closed prison estate. The report reveals that: of the 38 adult prisons visited in 2023-24, just one establishment's score for purposeful activity improved while 18 declined. More than half were assessed as "poor"; overall, more than two-thirds of prisoners were spending most of their days in their cells with little to occupy them; and there is a striking correlation between prisoners' own perception of the likelihood of them reoffending and the amount of time they reported spending unlocked and engaged in constructive activity, suggesting that purposeless prisons are not only harmful for prisoners, but that this harm could extend to wider society.
Intermediaries Guidance (July 2024 V1.0). Guidance for panels to identify if/when the support of an intermediary may be required for a prisoner.
If you wish to discuss any issues in prison health please contact Joanne Easterbrook.
Social Care
Publications/Guidance
Adult social care elearning. This elearning resource has been designed to promote ten public health tips that can be used by the adult social care workforce to maximise their public health impact in improving population health and reducing health inequalities.
Learning and Development Support Scheme for the adult social care workforce: a guide for employers. Eligible adult social care employers in England can claim staff training costs from the Adult Social Care Learning and Development Support Scheme (LDSS). The LDSS is available for non-regulated care staff, including deputy and Care Quality Commission-registered managers and agency staff, within the adult social care workforce. Staff taking the training must be in qualifying roles.
Care and support statutory guidance. Department of Health and Social Care (DHSC) updated guidance to support local authorities in their implementation of the Care Act 2014 Pt 1. The Health and Care Act 2022 revoked Sch.3 and amended s.74 of the Care Act 2014 on 1 July 2022. This guidance confirms the DHSC's position on the determination of ordinary residence disputes in light of the outcome of R. (on the application of Worcestershire CC) v Secretary of State for Health and Social Care (SC).
Social care in England: Current situation, case for a strategy and further support for unpaid carers: In Focus. A House of Lords Library article examines the workforce, resource and funding pressures facing social care in England, the need for further support for unpaid carers, and the Government's announcement that it intends to create a "National Care Service" and to improve NHS and social care integration as part of a 10-year plan for reform.
How we can help
For ways in which we can help with Social Care issues click here.
If you wish to discuss any queries you may have around social care please contact Siwan Griffiths.
General
Publications/Guidance
Mirror, mirror 2024: a portrait of the failing US health system – comparing performance in 10 nations. This report compares health system performance in 10 countries. It provides analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the United States, where health system performance is dramatically lower.
Protection zones around abortion clinics in place by October. Safe access buffer zones will be in force around abortion clinics from 31 October to bring in stronger safeguards for women accessing services.
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