Archive for the ‘NHS’ 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 »
Wednesday, January 18th, 2012
A new national property company “PropCo” could be set up to manage the primary care trust (PCT) estate.
According to media reports the Department of Health is considering plans that the PCT estate will be better managed by a single management organisation, rather than by numerous successors to the individual PCT’s. There are suggestions that the PropCo could be devolved into regional subsidiaries with regional arms, but at this stage nothing is concrete.
Early opinion appears to be mixed. However, key questions remain, such as what effect this will have on the day-to-day management and dealings with individual NHS properties. It could be suggested such an approach may create uniformity in managing the PCT retained estate “across the board”. However, will such centralisation slow down the delivery of patient services and the placing of new providers into those properties?
There will be a need to carefully review these proposals as they emerge, but guidance on future property holding arrangements will be welcome news for PCTs.
Posted by Mick Suggett, who specialises in commercial freehold and leasehold property within the public health and local authority sectors; preparation of reports on title for lenders and public bodies.
Mick suggett
0115 908 4885
msuggett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 7.0/10 (2 votes cast)
Tags: Department for Health, health, local authorities, NHS, primary care trusts, propco, property
Posted in Health & Safety, Local Authorities, NHS, Property | 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 »
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 »
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, 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, July 22nd, 2011
The EAT has decided that there was no TUPE transfer where residents of a care home were discharged home from the care of an NHS Trust, and who received support from two independent service providers who help residents live independently in their own homes. This contrasted with the care provided previously by the trust, where tasks were carried out on the residents’ behalf.
The EAT held that there could be no relevant transfer or service provision change under TUPE because the economic entity did not retain its identity after the transfer. There was a move from ‘institution’ to home and from ‘management’ to ‘support’ so that the services provided to the residents were not ‘fundamentally or essentially the same’ after the change in provider.
But where exactly is the distinction to be drawn between those care services provided before and after the transfer, so as to prevent TUPE applying? In a different factual scenario, that might be a difficult question to answer.
Hayley Roberts
0115 908 4862
hroberts@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 1.0/10 (1 vote cast)
Tags: care homes, care services, EAT, employment, NHS trusts, tupe
Posted in Employment, NHS, Social Care | No Comments »
Thursday, June 9th, 2011
Following the recent abuse scandal at Winterbourne View, a privately run care home in Bristol, the Government is planning to bring safeguarding standards for vulnerable adults further into line with those in place for children.
It is the Government’s intention that “safeguarding” boards, like those for vulnerable children, are established. More details of these boards are due to be published within a fortnight. Health Minister, Paul Burstow, has stated that the Government plan to follow through on some of the recommendations received from the Law Commission and implement statutory safeguarding rules that will require the police, NHS and social services to work together.
With the sector facing projected budget cuts of between 10% and 15%, and no sign of demand for adult services deceasing, it is not clear where the funding for these increased safeguards will be found.
Kate Mills
0115 976 6104
kmills@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: Law Commission, Paul Burstow, safeguarding, vulnerable adults, Winterbourne View
Posted in NHS, Social Care | No Comments »
Thursday, June 2nd, 2011
The Audit Commission’s briefing paper ‘Improving Value for Money in Adult Social Care’ has stated that although improvements are being made in adult social care, there is still much work to be done in order to deliver savings and make a difference to peoples’ lives.
Given the current pressures on services and finances, councils need to be more innovative in achieving efficiency. The briefing identified nine areas in which councils can make changes, but stressed that not one council made changes to all nine areas.
The report pointed out it is not just the usual issues of procurement and partnership that should be considered, but that councils need to be more innovative in addressing adult social care needs.
For social care services to meet future demands councils need to increase the pace of these improvements. One option suggested in the report was for closer working with the NHS, whether by commissioning or delivering services jointly, an option some local authorities are considering.
Laura Richards
0115 976 6249
lrichards@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: adult social care, audit commission, local authorities, NHS, social care services
Posted in Local Authorities, NHS, Social Care | No Comments »
Friday, May 27th, 2011
Today Paul Burstow, Care Services Minister, has announced that responsibility for commissioning health services for children and young people in secure Children’s homes and secure training centres is to pass to the NHS. Until now each secure home or centre has commissioned its own health services.
At first glance this makes practical sense. The NHS has had this role for young offender institutions and prisons since 2006. Claims that this will help ensure consistency between each establishment, and continuity of care once the individual leave the secure establishment, seem plausible.
But where precisely within the NHS will this responsibility sit, and for how long? Will it rest with soon-to-be-abolished PCTs or SHAs? Will it then pass to soon-to-be-established GP consortia, or the National Commissioning Board?
There is great uncertainty about the future of health commissioning generally due to the lack of detail in the Health and Social Care Bill, and exacerbated by recent political friction which casts doubt of how much of the bill will survive into law. The practical implementation of today’s announcement will be watched closely for clues as to the future.
Posted by Chris Webb-Jenkins, who specialises in defending claims against education and care providers and their insurers; risk management, stress, information management and child protection issues.
Chris Webb-Jenkins
0115 976 6175
cwebb-jenkins@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: care services minister, Commissioning, National Commissioning Board, NHS, Paul Burstow, secure home, young offenders insitutions
Posted in Health, NHS, Social Care | No Comments »
Monday, March 28th, 2011
The latest verdict of think tank the King’s Fund claims that, unless GPs are put under greater pressure to work with local authorities providing jointly-planned services, the government’s health reforms risk failing vulnerable groups.
The report criticises joint working plans under the Health and Social Care Bill, claiming they could undermine services for people with mental health problems, learning disabilities, and multiple long-term conditions, all of whom require jointly-planned services.
GPs have not traditionally had a role in tackling health inequalities; the key concern is that as councils take responsibility for public health, GPs will shun areas of care for vulnerable groups and effective joint working will fail.
The report recommends that GP performance management regimes are aligned with council targets, and that GPs should take on a new role as care co-ordinators, pointing patients towards wider forms of social care.
The effect of the reforms remains to be seen but the Government has a way to go to dispel such fears.
Posted by Dai Durbridge, who specialises safeguarding of children and vulnerable adults in education, social care and health settings; defending claims against education, social care and health providers.
Dai Durbridge
0115 976 6578
ddurbridge@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (3 votes cast)
Tags: gp, GP commissioning, Health and Social Care Bill, kings fund, local authorities
Posted in Government bodies, Health, Local Authorities, NHS, Public Sector | No Comments »
Thursday, March 17th, 2011
How will we fund the future care of the elderly? We hear a lot of public discussion on this big and difficult public policy issue. Today the King’s Fund, well respected for its impartiality and measured approach, has published a report (Social care funding and the NHS – An impending crisis?) warning that the current spending settlement undershoots current spending projections by at least £1.2 billion by 2014.
So services must be reformed. The King’s Fund calls for greater promotion of health and well-being by local authorities, a better understanding of local needs, and spending more closely targeted to those needs. All good stuff. But by far the most ambitious recommendation is to create “a single strategic assessment of the funding needs of the NHS and social care”.
In plain terms, that would effectively mean a single budget for both health and social care. To date this idea has largely been dismissed to the “too-difficult” basket. But times change. If the Dilnot Commission echoes the King’s Fund when it reports in July, the pressure for change will
grow.
Posted by Chris Webb-Jenkins, who specialises in defending claims against education and care providers and their insurers; risk management, stress, information management and child protection issues.
Chris Webb-Jenkins
0115 976 6175
cwebb-jenkins@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (2 votes cast)
Tags: budgets, health and social care, social care funding and the NHS, The King's Fund
Posted in Local Authorities, NHS, Social Care | No Comments »
Monday, February 21st, 2011
The government have announced new rights are to be given to patients to bring a claim against the NHS if they have been discriminated on the grounds of their age. The new provisions in the Equality Act will prohibit in law discrimination in the provision of services such as medical treatment and operations on the grounds of age, such as the patient is too old. This will be the first time that discrimination on the grounds of age has been prohibited in the provision of goods, facilities or services to the public.
The Department of Health has said that it is likely to seek a number of exceptions to the provision including limiting cancer screening to people under 70. However, it is likely that the DOH will have to produce medical evidence to justify such an exception.
A consultation is to be carried out in March with a view to making the change in April next year.
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: liquidated damages, NHS, The Department for Health, The Equality Act
Posted in Employment, Health, NHS | No Comments »
Monday, January 17th, 2011
The transforming community services (TCS) programme is scheduled to complete by 1st April yet it is still unclear where the NHS estate will go. However, the Department of Health have recently confirmed that community foundation trusts will be able to acquire NHS estate which they require to support the delivery of services for which they are responsible.
Any freehold or capitalised leasehold acquisitions will be financed by public dividend capital but will be subject to an overage provision, which provides for 50% profit of any future sale or disposal being payable to the Secretary of State for Health. Plus there will be options for Secretary of State to re-acquire.
The overage provisions means the Department of Health is correctly treating community foundation trusts as non-NHS bodies, so there is no reason why this format could not be introduced on TCS transfers both to NHS and private sector providers. The options to re-acquire also mean that any concerns of loss of control have been thought through. Timing is tight however, with the deadline of 1st April fast approaching.
Paul Olliff
0115 908 4801
polliff@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 10.0/10 (1 vote cast)
Tags: community foundation trusts, NHS estates, trnasforming community services
Posted in Health, NHS, Property, Public Sector | No Comments »
Tuesday, December 21st, 2010
The Department of Health has recently released two important papers; the 2011 NHS Operating Framework and the PCT Allocation. Together these two papers show how the Government is developing it’s thought process after responses to the White Paper and indicates what the NHS should do to deliver a patient centred service in the future.
Interestingly the two papers say little at all about the NHS Estate and what is to happen with the land and buildings which are currently owned by PCTs. Whilst it appears clear that services, accountability and finance are all for example discussed in detail, there is yet to be any decision on who is to retain ownership of the service environment.
Unless guidance is delivered soon there is a possibility that there will be insufficient time for PCTs to prepare and a frenzy of estate activity in the final months before the closure of PCTs. Ultimately this could lead to a messier estate being handed over to the successor organisation and a real practical headache for the successor organisation to sort out.
Posted by Mick Suggett, who specialises in commercial freehold and leasehold property within the public health and local authority sectors; preparation of reports on title for lenders and public bodies.
Mick suggett
0115 908 4885
msuggett@brownejacobson.com
VN:F [1.9.11_1134]
Rating: 0.0/10 (0 votes cast)
Tags: NHS estates, NHS reforms, PCTs
Posted in NHS, Public Sector | No Comments »
