Posts Tagged ‘health’
Friday, February 10th, 2012
NHS Gloucestershire’s plans to transfer its community services to a newly formed community interest company (CIC) have been shelved following a judicial review challenge.
The challenge was brought by a local resident who claimed that the primary care trust (PCT) had not followed a proper process before deciding to award the community services contract (reportedly worth about £80 million a year) to the CIC.
A settlement was reached yesterday at the High Court under which the PCT agreed, without accepting that there was any merit in the claim, that it would not implement its decision to award a contract to the CIC at this time. The PCT will now start a new process to explore the best option for providing community services in Gloucestershire, which will include advertising for expressions of interest.
The case (and the costs and delays resulting from it) highlights the importance of ensuring, particularly in the current climate, that procurement processes are as watertight as possible.
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
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Tags: community interest company, health, NHS, primary care trusts, Social Care, trnasforming community services
Posted in Health, Social Care | No Comments »
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
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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
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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
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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 »
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
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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
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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 »
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
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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
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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 »
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
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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
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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
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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, 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
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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
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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, August 5th, 2011
The Department of Health yesterday issued the first part of the long awaited guidance on the future ownership and management of the existing PCT estate.
The guidance specifies five core principles underpinning the final arrangements of where the estate is to go:
- Protecting assets and maintaining future flexibility
- Ensuring efficiency
- Supporting the provision of safe, fit for purpose buildings
- Ensuring value for money
- Observing effective estate management
The specific guidance deals with those premises providing community services (community properties). These may transfer to aspirant community foundation trusts, other NHS trusts and foundation trusts (recipient trusts) who occupy more than 50% of the lettable area of a property. We will have to wait for further guidance on surplus land, administrative premises and, perhaps most interestingly, LIFT and PFI premises.
The timetable in the guidance seems extremely tight. PCTs must review and provisionally agree lists of transferring properties with affected recipient trusts by 14 September 2011. Whilst the work carried out for the transforming community services transfers earlier this year will assist, this is still a lot of work and negotiation - particularly as the recipient trusts have to be ‘willing’ recipients.
Posted by Thomas Howard, who specialises in commercial property with extensive experience of advising health clients on all property related matters and advising commercial clients on site acquisitions and disposals.
Thomas Howard
0121 237 3951
thoward@brownejacobson.com
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Tags: department of health, health, PCT estates, PCTs, primary care trusts
Posted in Health, Property | No Comments »
Wednesday, June 15th, 2011
David Cameron has confirmed that the Government would accept the majority of the NHS Future Forum’s recommendations to the Health and Social Care Bill.
These include: reinstating the Secretary of State’s legal responsibility for the NHS; greater powers for health and wellbeing boards and a bigger role for patients within them; Monitor to have a focus on protecting patient interests rather than competition; additional safeguards against price competition and “cherry picking” and every commissioning group will have a governing body.
The Prime Minister accepted that some commissioning groups may not meet the 2013 deadline but stated that all GP practices would be members of either an authorised clinical commissioning group or a ‘shadow’ commissioning group by April 2013. The overall message from the Government is therefore clear, it has listened and amended and there is now no reason for the pace of change to slow.
We will be holding a seminar on the future of NHS Commissioning on 20 July in our Birmingham office. Click here to find out more and book a place.
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
0115 976 6175
ebirkett@brownejacobson.com
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Rating: 9.5/10 (2 votes cast)
Tags: GP commissioning, health, Health and Social Care Bill, nhs commissioining, nhs future forum
Posted in Health | No Comments »
Monday, June 13th, 2011
The NHS Future Forum has released its long awaited report on its two month ‘listening exercise’ into the proposals set out in the Health and Social Care Bill this afternoon.
The Forum announced a number of recommendations which included: Consortia should have a governing body which holds meetings in public and consults publicly on commissioning plans; a duty on Monitor to support choice, integration and collaboration; a duty on the National Commissioning Board and Monitor to actively promote the NHS constitution; an obligation on consortia to consult a clinical senate of health professionals on certain decisions and a choice mandate for which the NCB would be accountable.
The Forum also acknowledged that some consortia would not be ready for the 2013 deadline.
David Cameron has already conceded that concessions will need to be made.
However, the official Government response is not due until tomorrow and so it remains unclear which recommendations will be accepted and what the final timeline for transporting the NHS into the future will be.
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
0115 976 6175
ebirkett@brownejacobson.com
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Tags: health, Health and Social Care Bill, NHS, nhs future forum
Posted in Health | No Comments »
Friday, March 11th, 2011
The Department of Health recently issued a FAQ fact sheet relating to the future ownership and management of premises by aspirant Community Foundation Trusts (CFT).
The fact sheet gave some helpful advice on what may be considered the burning questions for both PCTs and CFTs in this transition process. However, whilst the fact sheet did answer some of the questions being raised, we still await guidance on how the hand back and claw back provisions proposed to apply to CFTs at the end of a Community Services Contract will operate. With 1st April fast approaching it seems there are many PCTs and aspirant CFTs who are concerned that there is still no further guidance available or standard drafting to give clarity to the position.
One particular question which may need some thought is where the property owned by the CFT is leasehold, what measures will be put in place to tackle potential objections of landlord to the assignment of the lease to another party at the end of the Community Services Contract.
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
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Tags: community foundation trusts, department of health, health, health law, management of premises, property, property law
Posted in Health, Property | No Comments »
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
0115 976 6263
btroke@brownejacobson.com
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Rating: 6.0/10 (1 vote cast)
Tags: health, healthy lives healthy people, liberating the nhs, NHS, white paper
Posted in Health, NHS | No Comments »
Wednesday, October 20th, 2010
Personal health budgets were given a boost in the comprehensive spending review today when George Osborne announced that greater freedoms would be given to patients to commission services directly from independent providers by the NHS.
The announcement builds on the personal budget initiatives which have been piloted by both local government and the NHS since the launch of the “putting people first” agenda. Granting service users greater freedoms to commission their own care raises a plethora of issues do not appear to have been addressed yet by local authorities or the NHS in the pilot schemes.
Not least the fact that many of these service users will require access to budgets in both sectors and that packages of care will therefore necessitate increasingly integrated pathways of care. It seems likely therefore that central control will be necessary for a lot longer to ensure a co-ordinated approach that puts the service user at the heart of the services and any decisions related to the same.
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
0115 976 6175
ebirkett@brownejacobson.com
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Rating: 9.0/10 (1 vote cast)
Tags: comprehensive spending review, csr, health, NHS, spending review
Posted in Comprehensive Spending Review, Health | No Comments »
Wednesday, October 20th, 2010
The Comprehensive Spending Review announced today has, for the health sector, largely confirmed what we already knew – that NHS funding will increase in real terms until 2014-2015 rising over and above inflation.
However, the Chancellor also made clear during his announcement that there is a clear onus on NHS organisations to continue to drive reform forwards and improve savings and productivity.
Any savings will be re-invested in the NHS but greater responsibility for ensuring accountability and value for money during a period of such massive organisational change surely means there is a risk not only that any savings will be lost but also (and more importantly) that the pressure of successfully delivering the most significant structural changes in the NHS since its inception just increased.
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
0115 976 6175
ebirkett@brownejacobson.com
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Rating: 9.0/10 (1 vote cast)
Tags: comprehensive spending review, csr, health, NHS, Public Sector, spending review
Posted in Comprehensive Spending Review, Health | No Comments »
