Archive for the ‘NHS’ Category

The NHS and social care – what’s yours should be mine too

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.

Christ Webb-Jenkins

Chris Webb-Jenkins
0115 976 6175
cwebb-jenkins@brownejacobson.com

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Elderly patients to bring age discrimination claims against the NHS

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

Gemma Steele
0121 237 4561
gsteele@brownejacobson.com

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Transforming community services – initial Department of Health guidance

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

Paul Olliff
0115 908 4801
polliff@brownejacobson.com

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NHS Reforms: What‘s the latest on the Estate?

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

Mick suggett
0115 908 4885
msuggett@brownejacobson.com

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Healthy scepticism?

Wednesday, December 1st, 2010

The Government have published a White Paper on Public Health yesterday, titled “Healthy Lives, Healthy People”.

Some of the key principles – such as moving responsibility for public health into Local Authorities – were heavily trailed in the preceding White Paper “Liberating the NHS”, which set out plans for the abolition of PCTs and SHAs, with their responsibilities to be redistributed between Local Authorities, consortia of GPs, and a new National Commissioning Board.

“Healthy Lives” confirms that there is to be a new “integrated public health service” – Public Health England – from 2012, but it is not at all clear how it will work effectively together with Local Authorities or the Commissioning Board and, crucially, with the new GP consortia, who will manage the majority of the NHS budget in future.

As with “Liberating the NHS”, there is a now consultation – open until 8 March 2011 – before we get the detailed proposals.

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

Ben Troke
0115 976 6263
btroke@brownejacobson.com

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Public sector cuts – rearranging the deckchairs on the Titanic?

Wednesday, August 25th, 2010

GP groups have branded NHS Direct’s plans to decentralise by having at least 100 of its staff working from home by March 2011 as “rearranging the deckchairs on the Titanic” given the IT infrastructure investment required.

Currently, taxpayers are broadly accepting of cuts however, if planned savings do not materialise because costs are being shifted rather than cut, it is unlikely that this tolerance will continue.

It is essential that cuts are strategically planned with a view to achieving the planned efficiencies subject to the outcome of the comprehensive spending review due in the Autumn. A failure to do this could see the ‘deckchairs’ go down with the ship!

Mark Blois

Posted by Laura Hughes
0115 976 6582
lhughes@brownejacobson.com

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Does bigger mean better? Potentially

Wednesday, August 4th, 2010

David Cameron launched the Conservative vision of a ‘Big Society’ as a central part of their election campaign earlier this year and this week announced the second wave of the NHS strand of this initiative – the Right to Request.

The Right to Request allows primary care staff the right to request to set up social enterprises and this week’s announcement includes 15 new projects which range from increasing access to psychological therapies, improving end of life care and a wider range of children services.

In an era with an increased focus on choice and effective commissioning this move has the potential to encourage the development of projects based on local knowledge. It is conceivable that this in turn may initiate different and new ways of providing personalised health and social care services which deliver greater quality and value for money and support the continued integration of these care pathways from the bottom up.

Emily Birkett

Posted by Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com

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Supporting greater integration: a trust issue?

Friday, July 30th, 2010

In case there was any doubt about the role which Government expects from local authorities in reforming public services, the NHS White Paper reiterated it when it was released two weeks ago.

Councils will lead the:

  • Promotion of integration and partnership working between the NHS, social care and public health;
  • Building of partnerships for service changes.

Perhaps the time is right for the creation of a new type of service delivery organisation – the “Adult Trust”. The Children Act 2004 gave momentum to the concept of the Children’s Trust: organisations which would bring together professionals from different public sector organisations to facilitate the delivery of a truly seamless service to children.

That momentum did not last, but budget cuts are now a fact of life, and radical service reform is essential. “Adult trusts” could combine truly multi-disciplinary teams, pooled budgets, and operational autonomy. Further they could meet the Coalitions main public sector objectives – greater efficiency without compromising greater quality of care.

Chris Webb-Jenkins

Posted by Chris Webb-Jenkins
0115 976 6175
cwebb-jenkins@brownejacobson.com

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So much to say!

Tuesday, July 13th, 2010

The long awaited White Paper Equity and Excellence: liberating the NHS launched yesterday has been proclaimed as ‘the most radical overhaul of the NHS since its creation in 1948′.

The White Paper confirmed that primary care trusts and strategic health authorities will be scrapped by 2013. Responsibility for commissioning will pass to GP Consortia under an NHS Commissioning Board whilst local authorities will become responsible for assuming PCTs public health functions and leading the integration of health and social care at a local level.

Although much of the detail of the proposals has yet to be finalised the White Paper makes one thing abundantly clear: the impetus on integration and partnership working between the NHS, social care and public health is a top priority and the need for the NHS and local organisations to build partnerships to manage these service changes now and make the NHS a ‘truly world class service’ just stepped up a gear.

Emily Birkett

Posted by Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com

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A waste of time

Tuesday, June 8th, 2010

Christopher Dearlove, a 41 year old homeless man, was recently issued with a three year criminal anti-social behaviour order (ASBO) for costing the NHS tens of thousands of pounds in wasted care. This action by the NHS CFSMS shows that Trusts acting together gives the NHS a powerful weapon to fight back.

Whilst it sends out a strong message to the wider public enforcing the ASBO could be problematic. The court will be reluctant to punish Mr Dearlove if he presents again but it is borderline as to whether he is genuinely ill.

Whilst the evidential burden to obtain an ASBO is quite low, gathering sufficient evidence for a case like this will also have been very time consuming and it no doubt took many years before anyone realised the problems.

The only failsafe way to spot this sort of problem early on would be through a national identity card system combined with an electronic patient record – so for the foreseeable future old-fashioned vigilance and common sense will have to be the watchwords for the NHS.

Ian Long

Posted by Ian Long
0115 976 6194
ilong@brownejacobson.com

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