Posts Tagged ‘NHS’
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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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 »
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 »
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
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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
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
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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
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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, 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, 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
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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 »
Friday, September 2nd, 2011
Amendments to the health and social care bill, published 1 September 2011, set out the proposed “continuity of services” regime for foundation trusts (FTs) in the event of their financial failure.
Previously ministers could de-authorise FTs and they would revert to ministerial control. Now Monitor will be expected to intervene proactively at the first signs of difficulty.
Where early intervention proved unsuccessful a “trust special administrator” could be appointed to take over the trust’s affairs to secure the continued provision of NHS services in line with the commissioners requirements and where withdrawal of the services would have an adverse effect on the health of patients or significantly increase health inequalities.
The proposals also allow Monitor to make an order to dissolve a failing FT and to transfer its property and liabilities to another FT or to the Secretary of State.
The scope of these powers is likely to be of great interest to potential funders of FTs who urgently need to understand the extent to which their investment would be protected in an insolvency scenario.
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: continuity of services, foundation trusts, Health and Social Care Bill, Monitor, NHS, Secretary of State
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
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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
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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
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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, 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
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Tags: liquidated damages, NHS, The Department for Health, The Equality Act
Posted in Employment, Health, NHS | 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 »
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.
Posted by Emily Birkett
0121 237 3934
ebirkett@brownejacobson.com
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Rating: 10.0/10 (1 vote cast)
Tags: Commissioning, NHS, Public Sector, Social Care, Total Place
Posted in NHS, Public Sector | No Comments »
