Archive for the ‘Health’ Category
Monday, January 30th, 2012
The future structure and operation of the NHS Commissioning Board is set to be discussed at its board meeting this week.
Its board will consider a 63-page document outlining the NHS Commissioning Board’s future structure. It will have an “hour glass” shape – an 800-strong central office, four commissioning sectors (based on SHA cluster locations) and, at least initially, 50 local offices (covering PCT cluster areas). Each commissioning sector and local office is expected to have about 50 staff.
Whilst there is logic behind the structure, some might question how lean this structure really is. However, it seems that the NHS Commissioning Board’s budget represents a reduction of about 50% compared to the running costs of the functions transferring to it.
The board will also be asked to approve and adopt Clinical Commissioning Group guidance that has been in circulation (some in draft form) for a few months. Don’t ignore the board papers accompanying each item either, as they also contain some useful information.
Posted by Jonathan Hayden, specialising in: advising health and social care clients including clinical commissioning groups, primary and secondary care contracting, commercial contracts, joint ventures, statutory powers/duties and governance.
Jonathan Hayden
0121 237 4551
jhayden@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: clinical commissioning groups, health, NHS, NHS commissioning board, primary care trusts, Public Sector, Social Care
Posted in Health, NHS, Public Sector, Social Care | No Comments »
Thursday, January 26th, 2012
Last week we commented on proposals for a new national property company (“PropCo”) to be set up to manage the primary care trust (PCT) estate. The Secretary of State for Health has now confirmed the details.
PropCo is to be a government-owned limited company, NHS Property Services Limited. It will be wholly owned by the Department of Health and its role will be to own and manage that part of the PCT estate not required by community care providers. Property that is needed for clinical services, and mainly occupied by providers for that purpose, will be transferred to them. Support for the PCT estate will continue to be provided through existing contractual arrangements in place with service providers that already deliver and maintain NHS properties.
Now that the principle of a single management company for the estate has been established, there is real opportunity for structured management of the entire portfolio and long called for clarity on the future of the estate.
Posted by Stewart Gregory, specialising in: property law, particularly its application within the healthcare sector; advises the commercial and residential sector on site acquisitions and completed development disposals.
Stewart Gregory
0115 976 6299
sgregory@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: community care providers, Department for Health, health, NHS, primary care trusts, propco, secretary of health
Posted in Health, NHS | No Comments »
Friday, January 6th, 2012
Around half of public sector senior leaders have expressed concerns over growing public-private sector collaborations according to a recent report by global management consulting firm the Hay Group.
The report, Relationship Counselling, surveyed around 200 senior leaders from local government, healthcare, uniformed services and universities.
The report highlights growing opposition and resentment to closer ties with the public sector amid increasing concerns over risks to service delivery.
This is an issue that is clearly taxing the minds of public sector managers as was evidenced at our December Claims Club session on shared services, outsourcing and private sector delivery of local government services.
With the report predicting public-private sector collaborations will double over the next three years these are unsettling findings.
Then again following the very public failure of private sector providers of care services in 2011 perhaps we ought not to be that surprised by the research findings.
Posted by Bridget Tatham, specialising in: high value complex litigation relating to disease and stress and bullying at work; experienced in regulatory matters including advocacy, investigations and inquests.
Bridget Tatham
0121 237 3916
btatham@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: hay group, healthcare services, local government, private sector, Public Sector, relationship counselling, service delivery, uniformed services, universities
Posted in Government bodies, Health, Litigation, Public Sector | No Comments »
Wednesday, December 21st, 2011
Yesterday the publication of the European Parliament and European Council’s proposed revisions to the procurement directives was published, setting out their vision for the future of procurement law.
One of the key issues during the consultation was whether the traditional distinction between Part A and Part B Services – a key issue in the health sector – would remain? The answer in short is no but as ever there are exceptions. Healthcare service contracts below €500,000 will be presumed to have no cross border interest and be outside the application of the procurement rules. However, for those contracts over €500,000 there is a specific regime and an obligation to comply with the principles of equal treatment and transparency.
A step forward? The clear statement on no cross-border interest below the threshold is definitely to be welcomed. However, even where there is no cross border interest the principles and rules for cooperation and competition still remain and healthcare bodies will still be required to adhere to those.
Posted by Rachel Whitaker, who specialises commercial contracts, projects, competition law, procurement and state aid; clients include NHS bodies, local authorities, RDAs and national and international private sector clients.
Rachel Whitaker
0115 976 6538
rwhitaker@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: European Council, European Parliament, health bodies, part a and part b services, procurement law, proposed procurement directive
Posted in Health, NHS, Procurement | No Comments »
Friday, December 16th, 2011
The Ministry of Justice has published its response to the consultation on the charter for coronial services.
In our response to the consultation, we raised concerns about the confidentiality of documents disclosed for an inquest. We were not alone in doing so and it seems this plea has been heard with the response confirming that the statement dealing with this issue will be strengthened.
The charter will not be limited to bereaved people and so will be applicable to all interested parties, including NHS Trusts and local authorities.
However, whilst stating its intended purpose is to set out nationwide standards, emphasis is placed on the fact the charter is voluntary, begging the question whether those standards will truly be consistent.
The final charter will be published in early 2012 and it remains to be seen how much of a difference it will make. After the Government abandoned wholesale changes to the coronial system, one cannot help but feel that it is another opportunity missed.
Posted by Mark Barnett, who specialises in clinical negligence; health law; responding to general health law queries including judicial reviews, consent, confidentiality and the Mental Health Act.
Mark Barnett
0121 237 3942
mbarnett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 4.0/10 (3 votes cast)
Tags: coroner's charter, inquests, Ministry of Justice
Posted in Health, Local Authorities, NHS | No Comments »
Friday, November 25th, 2011
The NHS Operating Framework for 2012/2013, has announced new rules on the size and shape of Clinical Commissioning Groups. It states that:
- CCG’s should be co-terminus with a single Health and Wellbeing Board
These announcements differ to the original policy set out in the NHS White Paper which gave CCGs the freedom to develop as they deemed appropriate. Whilst the DH has since sought to limit this by introducing requirements for CCGs to assess any risks associated with their size and shape and consider whether merging is appropriate, the boundaries have been moved yet again meaning that around 60 CCGs should explore alternative options.
CCGs are expected to review their arrangements, with the support of their SHA cluster, to ensure that any “remaining configuration issues” are resolved before March 2012. CCGs which cannot provide this assurance will be expected to start exploring alternatives to full authorisation.
Posted by Emily Birkett, who specialises in advice to NHS bodies ; their local authority partners and related organisations in commercial law, contracting, procurement , competition governance and all aspects of primary care.
Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: clinical commissioning groups, health, NHS, nhs operating framework for 2012/2013, risk management
Posted in Health | No Comments »
Friday, November 18th, 2011
The Food Standards Agency (FSA) has launched a consultation on whether to remove the controls remaining on UK farms imposed after the Chernobyl disaster 25 years ago. The disaster caused a plume of radioactivity to travel across Europe and deposit on upland areas in the UK. Restrictions had originally been in place on 9800 farms, but today only 342 farms are still affected by restrictions, 334 of them in Wales.
The FSA has recently carried out extensive surveys of radio caesium levels in sheep on the restricted farms, finding that the levels rarely exceeded the permitted limit and the risk posed to consumers is now very low.
A spokesperson said “The control measures are now no longer considered proportionate to the very low food safety risk and are no longer required to comply with European food safety law.” The control measures were originally issued to comply with the food safety standards set out in EC Directive 96/29/Euratom.
The consultation closes on 8 February 2012.
Kassra Powles
0115 908 6200
kpowles@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: browne jacobson, environment, food safety controls, food safety laws, food standards agency, health
Posted in Food & drink, Government bodies, Health, Health & Safety | No Comments »
Friday, November 11th, 2011
Case law has already established that workers continue to accrue annual leave entitlement during sickness absence and that this annual leave can be taken at the same time as the sickness absence.
However, in Fraser v St George’s Hospital the employment appeal tribunal held that in order to exercise this right an employee must notify their employer of their intention to take annual leave in line with requirements of the Working Time Directive. An employer does not need to pay accrued annual leave when the employment relationship ends if the employee has not previously requested the annual leave.
On the face of it it can only be good news for employers particularly as the EAT expressly stated that there is no duty on an employer to inform employees of their rights in these circumstances. However, given the number of inconsistent decisions on this issue it will come as no surprise if it is appealed.
Posted by Gemma Steele, who specialises in contentious and non-contentious employment matters including; contractual issues, unfair dismissal, redundancy and all areas of discrimination.
Gemma Steele
0121 237 4561
gsteele@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: annual leave, employment appeal tribunal, fraser v st george's hospital, sickness absence, working time directive
Posted in Employment, Health | No Comments »
Thursday, November 10th, 2011
Examples of possible interim governance documents for pathfinder clinical commissioning groups (CCGs) have this week been shared via the Pathfinder Learning Network. The documents have been co-produced by NHS North East and its pathfinder CCGs.
The documents contain a template interim constitution for pathfinder CCGs and associated documents relating to the involvement of CCGs in PCT/cluster decision-making via a committee structure.
Although these documents are likely to be a useful reference point, they may not be appropriate for every CCG and, if used, they will need to be tailored to individual CCG circumstances. It is also worth noting that, as we are in an interim stage pending CCG authorisation, they will also need to be kept under review as the requirements for CCGs develop.
Posted by Emily Birkett, who specialises in advice to NHS bodies ; their local authority partners and related organisations in commercial law, contracting, procurement , competition governance and all aspects of primary care.
Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: CCG's, clinical commissioning groups, health, NHS, pathfinders
Posted in Health, NHS | No Comments »
Thursday, November 10th, 2011
“Deprivation of Liberty” has always been a slippery concept, in a health and social care setting, but with huge risks – damages legal costs, and adverse publicity – if you get it wrong.
A Court of Appeal Judgment yesterday (P v Cheshire West and Chester Council, 9 November) has totally changed the way we will have to look at this, overruling an earlier judgment that a 39 year old man with learning disabilities and autism, who lacked capacity to make decisions about his accommodation and care was deprived of his liberty.
Staff had complete and effective control of his life, sometimes using a “body suit” zipped at the back to prevent him getting to his continence pads, which he had a habit of eating. The Court of Appeal said, in essence, that this care was required as a result of his condition, was “normal” for people like him, and therefore no deprivation.
This seems close to going full circle to before DOLS, deferring to a clinical assessment and an idea of “necessity”.
Posted by Ben Troke, who specialises in clinical negligence; health law; access to NHS and social care and funding; Court of Protection / Mental Capacity Act; Deprivation of Liberty Safeguards; NHS Constitution and patient rights.
Ben Troke
0115 976 6263
btroke@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: ben troke, browne jacobson, capacity to make decisions, clinical assessment, Court of Appeal, deprivation of liberty, dols, health
Posted in Health, Social Care | 1 Comment »
Monday, October 31st, 2011
The Health and Social Care Bill brings new duties to local government in the care they are required to deliver.
Bringing public health to a local level will involve engaging in and creating partnerships that connect local public services together. This will need time, resource and money, things which aren’t easy to come by these days.
Councils should remember that using their enforcement role they already play an important role in ensuring that the environment in which we live, work, and play enhances our health and so it may be possible to meet the new duties at minimal cost.
For example, a PCT recently commissioned a council’s housing team to undertake additional enforcement/inspection activity, combined with referrals to GPs/community health teams. Council inspectors reached members of the community who might otherwise not be seen by GPs and the project showed that enforcement had a role to play where landlords showed a disregard for their tenants’ health.
This is a good example of the NHS and a Council working together to perform their legal duties improving health outcomes.
Helene Maillet-Vioud
0115 976 6213
hmaillet-vioud@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: health and social care, Health and Social Care Bill, NHS, social and health care partnerships, Social Care
Posted in Health, Social Care | No Comments »
Wednesday, October 19th, 2011
Early in 2012, the NHS Constitution will be amended again, to add:
- An expectation that staff raise concerns at the earliest possible opportunity
- Clarity around the legal rights of staff when raising such concerns
There may also be an independent authority for staff to turn to when they feel that their organisation is not listening or responding appropriately.
NHS employers will need to review and update their existing whistleblowing policy in light of these changes, and we can expect a surge of whistleblowing employment tribunal claims.
The Constitution was published in January 2009, to be reviewed every 10 years, but was revised in March 2010 to add further patient “rights” eg to treatment within 18 weeks. Our experience is that the more the language of “rights” is used, the more people litigate when expectations are not met.
Posted by Gemma Steele, who specialises in contentious and non-contentious employment matters including; contractual issues, unfair dismissal, redundancy and all areas of discrimination.
Gemma Steele
0121 237 4561
gsteele@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: employment, employment tribunal, legal rights of staff, NHS constitution, whistleblowers
Posted in Employment, Health, NHS | No Comments »
Wednesday, October 19th, 2011
The annual report on NHS complaints handling by the Parliamentary and Health Service Ombudsman, Ann Abraham, published today (18 October), makes for familiar reading.
The NHS Constitution promises that mistakes will be acknowledged, and things put right quickly and effectively, but all too often the process of dealing with complaints is another unhappy experience for all involved, and last year the Ombudsman recommended £500,000 in compensation for poor complaints handling. The litigation that followed would have been much more costly.
Particularly eye catching in the report, and extensively covered by the media, is the issue of GP practices removing patients from their list after a complaint, which comes at a particularly bad time as greater control over the health service is handed over to GPs.
Alongside the proposed new duty of candour, the ever rising gap between expectations and resource limited delivery, will make dealing with complaints effectively more difficult and more important than ever.
Posted by Ben Troke, who specialises in clinical negligence; health law; access to NHS and social care and funding; Court of Protection / Mental Capacity Act; Deprivation of Liberty Safeguards; NHS Constitution and patient rights.
Ben Troke
0115 976 6263
btroke@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: Ann Abraham, complaints, Duty of candour, GPs, NHS, NHS complaints handling, parliamentary and health service ombudsman
Posted in Health, NHS | No Comments »
Tuesday, October 11th, 2011
The Department of Health reaffirmed the Government’s commitment to increasing openness within the NHS by launching a consultation which aims to explore how it might impose a contractual ‘duty of candour’ on providers.
The consultation proposes to introduce obligations for providers to always be open with patients about incidents where things go wrong into the NHS Standard Contracts for acute, community, ambulance and mental health services.
Sanctions could include, amongst others, a deduction in the annual contract value, independent investigation or a written apology to the patient from the organisation’s Chief Executive.
The duty is purported to have the potential to support the development of stronger commissioner-provider relationships and to improve quality. However, it isn’t yet clear how the duty would interact with or improve upon existing duties to let patients know when things go wrong or whether patients would gain any additional support or direct benefit from the existence of a statutory, as opposed to a non-statutory, duty.
If you would like to contribute to the consultation click here.
Posted by Emily Birkett, who specialises in advice to NHS bodies ; their local authority partners and related organisations in commercial law, contracting, procurement , competition governance and all aspects of primary care.
Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 7.0/10 (1 vote cast)
Tags: acute trusts, ambulance services, browne jacobson, Duty of candour, Emily Birkett, government, Government consultation, health, health consultation, mental health services, NHS, NHS standard contracts, patient relationship, patient well being
Posted in Health, NHS | No Comments »
Tuesday, October 11th, 2011
2012/13 will see various changes to PbR, as announced in this Dear colleague letter.
PbR will be expanded to include adult mental health services. Service users will be allocated to care categories (or “clusters”) and each cluster will be allocated a unit price (agreed locally for 2012/13). Draft mental health PbR guidance has also been published (feedback is required by 4 November).
The letter also details various other proposals for 2012/13, including:
- more “best practice tariffs”;
- certain currencies and tariffs being mandated, and the introduction of some new non-mandatory currencies;
- acute providers being responsible for 30 day post-discharge support for a small number of conditions; and an update to the ICD-10 disease classification system.
A “sense check” on the revised tariff is underway. This will be followed later this year by road testing of the tariff and associated PbR guidance.
Provider organisations will always be wary of changes to PbR. Mental health providers will be relieved that there should be a cost-neutral impact for 2012/13.
Posted by Oliver Pritchard, who specialises in health and social care sectors for both public & private sector clients; corporate acquisitions & disposals; corporate governance; director’s duties; shareholders’ agreements and GP consortia.
Oliver Pritchard
0115 976 6292
opritchard@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: adult mental health, browne jacobson, health, mental health, mental health providers, mental health services, NHS, payment by results, pbr
Posted in Health, NHS, Social Care | No Comments »
Monday, October 10th, 2011
On 1 October 2011 a ban came in to force on the sale of tobacco products from vending machines in England. Displays of tobacco advertisements on vending machines are also banned.
A person found guilty of selling tobacco from a vending machine will face prosecution, and if convicted in the Magistrates court could be ordered to pay a fine of up to £2,500.
The ban is intended to reduce smoking among young people. This will particularly affect 11-15 year olds, who apparently regularly use vending machines as their source of cigarettes.
There is clear public support for a ban on the sale of tobacco from vending machines. However, the tobacco industry argues that vending machines could be modified to require tokens or ID cards, rather than having an outright ban. Nevertheless, you may be in the 65% of people who are in favour of a ban? ( according to a YouGov survey commissioned by ASH).
Posted by Fiona Carter, who specialises in commercial regulation, compliance advice and investigations; is head of Browne Jacobson’s advertising and marketing team and food and drink group.
Fiona Carter
0115 976 6224
fcarter@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: advertising, advertising ban, ASH, Brands, browne jacobson, cigarette advertising, cigarette advertising ban, cigarette sales, Fiona Carter, health, tobacco advertising, tobacco advertising ban, tobacco industry, tobacco sales, underage smokers, underage smoking
Posted in Advertising & Marketing, Health, Regulatory | No Comments »
Wednesday, October 5th, 2011
The Government has announced that the length of service needed for the right to bring an ordinary unfair dismissal claim will increase from one year to two, from April 2012. It claims the move will reduce the number of unfair dismissal claims brought against employers each year by 2,000. The move has been welcomed by the CBI, but are unfair dismissal claims by employees with between one and two year’s service really the problem for employers? Of more concern to employers must surely be unfounded allegations of discrimination (for which there is no service requirement), which often require long and costly employment tribunal hearings to defend.
The qualifying period of service for claiming unfair dismissal used to be two years, before it was successfully challenged in Europe in the late 1990’s as being indirectly discriminatory against women. It will be interesting to see if such a challenge is brought following this latest announcement, and whether such a challenge would stand up.
Posted by Tom McLaughlin, who specialises in contentious and non-contentious employment matters including; contractual issues, unfair dismissal, redundancy and all areas of discrimination.
Tom McLaughlin
020 7337 1033
tmclaughlin@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: browne jacobson, CBI, Claims, discrimination, employment, employment tirbunal, government, length of service, qualifying service, Tom McLaughlin, unfair dismissal, unfair dismissal claim
Posted in Employment, Health, Retail | No Comments »
Wednesday, September 28th, 2011
“M” is a 52 year old woman who suffered permanent brain damage in 2003, leaving her in a “minimally conscious state”. A judge today refused a request from her family for treatment (including nutrition and hydration) to be withdrawn to allow her to die, as she would not have wanted to live like this.
Where a person cannot make a decision for themselves, it must be made in their best interests. This can include what the person would have wanted, but unless they have made a valid advance decision (or appointed an Attorney) that is not decisive. The court recognised the family’s good intentions, but said that M still has positive experiences, and held she should continue to receive treatment.
This is not like Tony Bland’s case (in 1993), where ongoing treatment would have been futile as he was in a persistent vegetative state. The judge emphasised the need for accurate diagnosis and that decisions in these cases must still be referred to the court every time.
Posted by Ben Troke, who specialises in clinical negligence; health law; access to NHS and social care and funding; Court of Protection / Mental Capacity Act; Deprivation of Liberty Safeguards; NHS Constitution and patient rights.
Ben Troke
0115 976 6263
btroke@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: court, health, M, Tony Bland, withdraw treatment
Posted in Health | No Comments »
Monday, September 19th, 2011
A “Dear Colleague” letter (15 September 2011) provides a useful update on the development of the clinical senates and networks recommended by the NHS Future Forum. The letter also provides further clarity on the different roles these networks and senates are likely to fulfil, and invites interested parties to engage in their development.
It seems that clinical networks will usually be specific to a particular patient/professional group or disease, and will support improvements in pathways and outcomes. Clinical senates (of which there are likely to be about 15) will involve a range of experts, professionals and others from across health and social care, and will offer advice about quality improvements or reforms across geographical areas.
The stated intention is that these organisations will help, rather than constrain, commissioners. However, the suggestion that the senates may also be involved in the quality aspects of a clinical commissioning group’s authorisation or annual assessment may set alarm bells ringing.
Posted by Emily Birkett, who specialises in advice to NHS bodies ; their local authority partners and related organisations in commercial law, contracting, procurement , competition governance and all aspects of primary care.
Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: browne jacobson, clinical network, clinical senate, clinical senates, clinical senates NHS Future Forum, Emily Birkett, health, NHS, Social Care
Posted in Health, NHS, Social Care | No Comments »
Friday, September 16th, 2011
A series of strikes are scheduled as a result of the proposals to increase member contributions to public sector pension schemes
The publication of the final Hutton report earlier this year brought with it rumblings of discontentment amongst recipients and future recipients of the various public sector schemes to which it outlined reforms including the NHS pension scheme
The Government clarified that although it accepted all of Hutton’s 27 recommendations for reform, implementation would only occur following consultation with unions and members. The first consultations have been opened for a number of public sector pension schemes and they relate to increasing member contributions with effect from April 2012.
This consultation is only the first issued in respect of the 27 recommendations and the reaction amongst unions and members to these initial consultations signifies that there could be a lot more strikes ahead. It remains to be seen whether the Government determine that financial pressures and the “need” for reform of the public sector schemes will outweigh the upheaval to public services as a result of the planned strikes.
Posted by Victoria Leybourn, who specialises in advising companies and trustees in all aspects of pensions law and local authorities and contractors on their obligations regarding public sector pension schemes.
Victoria Leybourn
0115 976 6160
vleybourn@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: browne jacobson, government, Hutton report, NHS, NHS pension scheme, pension schemes, Pensions, Public Sector, public sector pensions, public sector strike, public sector strike action, Victoria Leybourn
Posted in Employment, Health, Pensions, Public Sector | No Comments »
