Editorial
Last week we reported on the decision by the
Administrative Court in a judicial review case
concerning an impact assessment of a proposed
decision by Harrow London Borough Council (BHCR
Vol 3, Issue 2, item 9).
The council, being short of cash, had been looking to
make savings wherever it could. It decided to see
what could be saved from the budgets and was
proposing to restrict its adult care services to
individuals whose needs were identified as ‘critical’
under the Fair Access to Care Guidance.
The council lost the case.
I was asked to express a view about the decision this
week, particularly as the council were said to have
been ‘fairly laid back’ about the decision.
I bet they were.
The case succeeded against the council as the
council had, technically, failed to properly inform the
decision takers (councillors) of the legal obligations
on the council under the Disability Discrimination Act
1995 to promote equality of opportunity and the
implications. Crudely, all the council probably needs
to do now is to re-run the whole process, properly
addressing the duty to promote equality and take the
decision again. However, there may then be Human
Rights based claims which can be brought by the
disabled affected by the decision.
However, the main point that struck me about all of
this was that but a few short years ago social
services were people assessed as having ‘moderate’
needs were considered to be in need of
intervention.
I know it is a politically unpopular thing to say, but,
such conflicts are set to become
more frequent without the ‘ringfencing’
of monies paid by
Government for social services.
This week’s article
In the past eight weeks we have reported a number of successful prosecutions of NHS hospitals where patients have fallen or jumped from upper floor windows which did not have the width of opening restricted. Care homes would do well to pay attention to such matters; Brunswicks has acted for a number of care homes where there has been a fall from a window. This week we review the issue and offer some thoughts.
To read article click here.
Parliament
24.01.08 – HoL - Earl Howe to ask Her Majesty’s
Government what are their aims in reviewing Part IX
of the Drug Tariff, with particular reference to stoma
and incontinence products
Next
Back Next
**STOP PRESS**
CRB HOLDING FEES DOWN FOR THE SECOND
YEAR RUNNING
21 January 2008
Fees for Criminal Record Disclosure checks have been frozen for the second year
running. The Criminal Records Bureau says it is able to freeze its fees as a direct
result of year-on-year efficiency savings and increasing demand for its service.
Abuse
1. Hampshire vulnerable adults abused
18 January 2008 - This is Hampshire.net
Over 400 cases of suspected abuse of vulnerable
adults were reported in Hampshire last year. However,
criminal prosecutions occurred in only four
cases. A senior county councillor is now calling on
the police and social services to do more to investigate
alleged adult abuse and, where appropriate,
press charges.
Cllr Alan Dowden, Lib-Dem opposition spokesman
for adult care, said the reported cases were sadly
"only the tip of the iceberg."
Business News
2. Hewitt takes Boots consultancy role
19 January 2008 - Daily Mail
Item about former Health Minister, Patricia Hewitt,
taking new roles with Boots and also with Cinven -
which last year bought the BUPA portfolio of hospitals.
Care Homes
3. Counsel and Care publishes a new guide
to standards in care homes
17 January 2008 – NCF
National charity Counsel and Care has published a
new guide for older people and their families on the
standards they have a right to expect when living in a
care home.
For full report click here
4. Home truths
16 January 2008 - Society Guardian
Letter from Martin Green, Chief Executive of English
Community Care Association in response to last
week’s article on residential care ‘Home Truths’:
“Residential care provides vital support to many older
people and, contrary to popular belief, is enjoyed and
greatly valued by many. With increases in the numbers
of older people who will suffer from severe dementia,
we must start to recognise the role of residential
care in providing support for this very vulnerable
group and start to respect and resource the service
appropriately”.
5. Bid to give residents human rights continues
despite bill failure
16 January 2008 – NCF
A proposed amendment to the Health and Social
Care Bill has failed in its bid to make all health and
social care providers regulated by the new Care
Quality Commission liable under the Human Rights
Act.
The amendment is designed more to draw out the
government's view on closing the loophole, rather
than change the Bill immediately.
For NCF report click here
Case Reports
Law Reports
6. Birmingham City Council v P and seven
others
The welfare of five children, aged from a few days old
to seven years, required that parental consent for a
placement order for their adoption be dispensed with
under the Adoption and Children Act 2002 s.21, and
that there be no ongoing contact with their family
once adoptive placements had been found.
7. JFM v (1) Neath Port Talbot Borough Council,
(2) TM, JM and CM (children by their
Guardian)
A judge in care proceedings was entitled, on the evidence,
to make findings of sexual abuse and to hold
that the threshold criteria under the Children Act 1989
s.31 had been satisfied in relation to three children.
8. R (David Grant Juncal) v (1) Secretary of
State for the Home Department, (2) East London
& City Mental Health NHS Trust, (3) Scottish
Ministers and (4) Secretary of State for
Northern Ireland
Subordinate legislation permitting the detention in
hospital of an accused following a finding that he was
unfit to be tried was lawful, since the detention was
not arbitrarily determined, but achieved by informed
opinion, and the court had significant safeguards to
protect those individuals likely to be acquitted.
Disciplinary cases
Nothing to report
Cases in the news
9. Carers sentenced
18 January 2008 - The Times
A care home manager left three mentally handicapped
men in an unventilated car for three hours on
a warm afternoon while he visited a bookmaker.
Chris Williams, 43 and Agnes Price, 41, his
employee, were sacked, however, a court failed to
sentence them to prison.
10. Man's choking death 'avoidable'
17 January 2008 – BBC News
An inquiry has found that a man’s death from choking
while in community care could have been easily
avoided. Graham Rattray, 42, had severe learning
disabilities and choked to death on 26 December
2005 in his own home in North Lanarkshire.
Sheriff Petra Collins found Mr Rattray's death might
have been avoided if carers knew he had a choking
risk and knew what first aid to administer.
For full report click here
11. £5m hospital bug payout for Ash
16 January 2008 – BBC News
Actress Leslie Ash has won a record £5m compensation
payout after contracting a hospital-acquired
infection, MSSA (Methicillin-Sensitive Staphylococcus
Aureus) at Chelsea and Westminster Hospital in
London in 2004.
Ms Ash, 47, now walks with a stick and the money
includes compensation for what she would have
earned if she had carried on working.
For full report click here
12. Elderly woman's fall sparks fine
16 January 2008 – BBC News
A mental health partnership, Victoria Hospital has
been fined £20,000 after an elderly patient fell from a
window. The Wiltshire hospital is now closed. Iris
Carey, 77, was suffering from depression and had
previously threatened to throw herself out of a window.
The Avon and Swindon Mental Health Partnership
was taken to court by the Health and Safety Executive
(HSE) who argued that the trust did not have sufficient
safety standards in place to stop vulnerable
people harming themselves between May and October
2005.
For full report click here
13. HSE prosecutes NHS Trust after elderly
woman injured in fall from first floor window
16 January 2008 - GNN
The Health and Safety Executive (HSE) reminded
hospitals and others providing care services to vulnerable
people to ensure that they take appropriate
action to manage the risk of falls from windows following
prosecution of the Avon and Wiltshire Mental
Health Partnership NHS Trust after an incident in
which a 77-year old woman fell approximately 5.5
metres from a window at a Swindon hospital which
was not adequately restricted.
Iris Carey was a patient at the hospital and suffered a
broken ankle and a compressed fracture of a vertebrae
after falling from the open window on the Dean
Ward at Swindon's Victoria Hospital.
The trust pleaded guilty to a charge under Section 3
(1) of the Health and Safety At Work etc Act 1974 and
was fined a total of £20,000 and ordered to pay
prosecution costs of £12,502, at Swindon Magistrates
Court.
14. Care home fined over poor hygiene
15 January 2008 – BBC News
A Suffolk care home operated by Four Seasons
Healthcare has been fined £11,000 for poor hygiene
standards. The company admitted six offences under
food hygiene regulations after inspection by environmental
health offices.
The owners said they have since spent £3,000 on
new equipment and had carried out a thorough cleaning
operation.
For full report click here
15. Superbug test case gets under way
15 January 2008 – BBC News
Elizabeth Miller, 71, from North Lanarkshire has
launched a landmark test case in her bid to win damages
from a hospital where she contracted the MRSA
superbug. She contracted the bug while recovering
from a heart operation at Glasgow’s Royal Infirmary.
Her legal team allege the hospital failed to properly
implement a hand hygiene policy.
For full report click here
16. Health worker attacks 'alarming'
15 January 2008 – BBC News
Since the laws to protect health workers were
passed in 2005, almost 600 people have been convicted.
The figures were revealed as MSPs backed
a move to extend the Emergency Workers Act to
cover community health professionals.
The Scottish Parliament's justice committee backed
the legal changes, which the full parliament will be
asked to approve.
For full report click here
17. Trust in clear over lost papers
15 January 2008 – BBC News
An internal investigation by St. Bartholomew’s Hospital
in the City of London has revealed that the hospital
was not responsible for the breach that left confidential
medical papers strewn in a Hertfordshire
street.
Documents were found last week in residents' gardens
in Northaw, near Potters Bar, and revealed serious
illnesses suffered by patients.
For full report click here
18. Unregistered private healthcare provider
sentenced
On 9 January 2008 the Healthcare Commission
(CHAI) secured the conviction of Mohammed Sadiq,
an unregistered private healthcare provider, for the
illegal delivery of laser services while not holding the
proper registration. The provider was required under
the Care Standards Act 2000 to be registered prior to
being able to practice legally.
The court sentenced Mr Sadiq to five months’ imprisonment
suspended for two years, that he undertake
100 hours of community service and pay £30,000
costs.
Anna Walker, Chief Executive of the Healthcare
Commission, said: “Patients have a responsibility for
their own safety too. The first thing they should do
before opting for any treatment from an independent
healthcare provider is to check with us that the organisation
is registered if it needs to be.”
More information on the conviction of this unregistered provider
Children
Nothing to report
Conferences & Courses
19. Self-care and self-management
Managing long-term conditions seminar series:
seminar two
Wednesday 6 February 2008, 9.30am–1.00pm,
King's Fund, London
** Programme now available **
In his first major speech on the NHS the Prime Minister,
Rt Hon Gordon Brown MP, pointed to a key challenge
for the NHS to support and care for patients
with long-term conditions. He stressed the importance
of those with long-term conditions taking an
active role in managing their own care. As a health
care professional you will be increasingly involved in
ensuring patients understand their condition and in
supporting them to self-manage it.
This seminar will feature case studies from:
Helena Jordan, National Project Manager, Self Care
for Primary Care, Working in Partnership Programme,
sharing best practice on how self-care is being developed
in primary care.
Nanette Kerr, General Manager, Professional Services,
Boots, on how a high street retailer can provide
health care information and professional advice on
self-care and self-management to the public.
We are delighted to announce our keynote speaker:
Claire Whittington, Head of Long-term Conditions,
Department of Health
plus:
Mary Simpson, Deputy Director, Patient and Public
Empowerment, Department of Health, focusing on
how patients and the public are being engaged in
self-care and self-management, with a look at the
NHS choices website.
Places at this event are limited so we recommend
that you reserve a place as soon as possible by
downloading a registration form from our website or
booking online. For further information and to
download the full programme, please visit our website
or email us and we will be happy to provide you with
more details.
Sushma Sangyam
Conference Manager
20. National Children's Commissioning Conference:
"Accountability for Outcomes"
11 and 12 February 2008
Hilton Metropole, London"Effective joint planning and
commissioning is at the heart of improving outcomes
for children and young people." (DCSF, October
2007).
11 and 12 February 2008
Following the success of our first national health and
social care commissioning conference in July, CareandHealth
has decided to hold the first National Children's
Commissioning Conference and Exhibition of
its kind. We intend to lead the way in defining and
developing the meaning of commissioning in children's
services from 2008.
Along with key messages from the government and
DCSF, we will also have the opportunity to hear from
commissioning experts in local authorities and beyond,
service providers and voluntary agencies.
The conference will explore the significance and application
of service commissioning, as a means to
deliver Every Child Matters outcomes in integrated
children's services, and to provide a learning and
networking environment that energises all service
stakeholders to develop a greater national consensus
about joint commissioning for results and all the
accountabilities of the local authority.
To be at the forefront of discovery - to find new ways
to improve outcomes for children and young people,
be inspired by sector experts, learn about best practice
and share your experiences - join us for this unmissable
two-day national conference and exhibition.
To find out more about this stimulating and informative
event, and to reserve your place, click here to
visit our website, which has details of our themes,
speakers, venue and exhibition space.
21. Retirement Housing - One Day Conference,
27th February 2008
Thistle City Barbican, London, EC1
10.00 Surveying the market for retirement housing
including demographic trends across
the market
Barbara Laing, Managing Director - Housing Services,
Anchor Trust
10.30 Exploring opportunities in the growth of
Retirement Villages in the UK
Nick Sanderson, CEO, Raven Audley
11.30 Analysing the impact of retirement housing
on the wider residential market
Jim Ward, Head of Residential Research, Savills
12.00 Charting the growth of supply in luxury
retirement properties and challenges for
existing and new market entrants
Anthony Oldfield, Senior Associate, Healthcare, King
Sturge LLP
12.30 Exploring housing policy and partnerships
for retirement property development
Mark Wagstaff, Policy Advisor, Housing Corporation
14.00 Focusing on lending and finance for retirement
housing and the emergence of
specialist finance including mortgages,
tax, and equity
Paul Moran, Area Director - Head of Healthcare,
Bank of Ireland
14.30 Managing land acquisition and planning
strategies for retirement property
Neil Rowley MRTPI, Associate Director, Commercial
Planning, Savills
15.30 Evaluating marketing strategies to reach
retirement property customers
Martin James, Director, Retirement Homesearch
16.00 Case Study - St George’s Park Augustinian
Living – working with community
stakeholders to create added value in retirement
living
Philip Smith, Marketing Director, Augustinian Living
FAX the completed form to +44 (0) 20 7970 4799
Call +44 (0) 20 7970 4770
Book Online @ www.housing-strategy.com
Post a copy of this form together with your payment to
Centaur Conferences, 50 Poland Street, London, W1F
7AX
22. Extracare Housing - One Day Conference
- 28th February 2008
Thistle City Barbican, London, EC1
10.00 Surveying the market for extracare provision
and niche opportunities for the independent
sector
David Driscoll, CEO, Signature Senior Lifestyle
10.30 Reviewing partnerships and funding in extracare
housing projects
David Weiss, Head of Partnerships and Property,
Kent Adult Social Services
11.30 Health and social care partnerships in extracare
provision
Trevor Edwards, Housing LIN, Department of Health
12.00 Choices in Long Term Care
Sue Collins, Principal Policy and Public Affairs Manager,
Joseph Rowntree Foundation
Charting the trends and gaps in the development
of extracare housing supply
Tom Whittington, Head of Healthcare Research,
Savills
14.00 Designing sustainable extracare housing
Anne-Marie Nicholson, Director, PRP Architects
14.30 Developing medicare and extracare assistive
technology in housing
Denise Gillie, Associate, Care Services Improvement
Partnership, Department of Health
15.30 Promoting total care concepts including
self support, independent living and well
being in extracare services
Sarah Vallelly, Research Manager, Housing 21
16.00 Developing Sustainable Retirement Communities
Simon Evans, Senior Research Fellow, Health Training
& Research Centre, University of the West of
England
FAX the completed form to +44 (0) 20 7970 4799
Call +44 (0) 20 7970 4770
Book Online @ www.housing-strategy.com
Post a copy of this form together with your payment to
Centaur Conferences, 50 Poland Street, London, W1F
7AX
23. RCN Independent Nurse Managers Forum
Conference: Improving practice...improving
care
The RCN will be holding a conference on Saturday 8
March 2008 at Cowdray Hall, RCN Headquarters,
London. The conference will examine the evolution
in the provision of health care and how independent
providers can look for ways to better assist the community
they serve. For further information please
contact the organiser: Guillia Ward; independent@
rcn.org.uk or visit www.rcn.org.uk/events
24. ICHA Annual Conference : Investing in
Children
The intelligent use of residential child care
Wednesday 27 February 2008, Regent’s College
Conference Centre, London
The ICHA Annual Conference, organised in partnership
with CareandHealth will provide a unique opportunity
to explore with providers and commissioners
why investment in high quality residential care for
children must be sustained and developed and to
consider the impact of the plans laid out in Care Matters:
Time for Change White Paper and the new legislation
in the Children in Care Bill.
The conference will also allow providers for residential
care to consider with Local Authority senior managers
and commissioners how to ensure they can
help meet the challenge of ensuring that every child
in care has the 'right placement' and is able to experience
both stability and also the continuity of relationships
which, together, can lead to succesful outcomes.
Speakers include:
Christine Gilbert - Chief Inspector of Ofsted, Kevin
Brennan, Minister at DCFS, Andrew Christie - Director
of Children's Services, London Borough of Hammersmith
and Fulham and ADCS lead on Care Matters,
Jonathan Stanley, Principal Officer at the National
Centre for Excellence in Residential Care,
Benni-Jo Tyler - A National Voice.
Chair for first session: David Kidney - Chair of All
Party Parliamentary Group on Children in Care.
For more details go to www.careandhealth.com
Email: conferences@careandhealth.com
Tel: 0845 055 9207
Fax: 0871 901 7774
25. Action on Elder Abuse National Conference
‘Making Changes’ – 31st March & 1st April
University of Warwick
Action on Elder Abuse will be hosting its fifteenth 2
day National Conference in 2008, and it is set to be a
major event in the Health and Social Care calendar.
With a keynote speech by Ivan Lewis, Parliamentary
under-Secretary of State, and speakers to include:
• Dru Sharpling, Crown Prosecution Service
• Ronnie Monks, Department of Health
• Richard Brook, Office of the Public Guardian
• Representatives from the Association of Chief
Police Officers and the Healthcare Commission
Workshops will include subjects on:
• Hate crime
• Deprivation of liberty
• Financial abuse
• Review of ‘No Secrets’
• Domestic violence, elder and vulnerable adult
abuse
• Learning Disabilities and Safeguarding Adults
£220 + VAT for members
£255 + VAT for non-members
A full, detailed programme and booking form will be
available shortly, but to register your interest and
request a booking form, please contact Natalie Fernandez
on natalie@elderabuse.org.uk
Consultations
To follow next week
CSCI, CSSIW, Healthcare
Commission &
Scottish Care Commission
26. Reminder for Care Service Providers
18 January 2008 – SCRC
The Scottish Care Commission is reminding providers
that the closing date for submission of annual
returns is 29 February 2008.
For full report click here
27. Government response to Professor Crerar's
review
17 January 2008 – SCRC
The Government’s published response to Professor
Crerar's review of regulation, inspection and complaints
handling of public services in Scotland.
For full report click here
28. Exclusive: leaked letter shows tensions
over C diff outbreak
17 January 2008 – HSJ
A letter leaked to HSJ reveals a relationship that is
now strained between the government and the
Healthcare Commission following the Maidstone and
Tunbridge Wells infection outbreak.
29. Service providers - need help completing
your information online?
15 January 2008 – SCRC
The Scottish Care Commission is asking for information
about the care provided so they can regulate and
inspect care services more effectively.
For full report click here
30. Use of Minibuses - Potential Legal Issues
14 January 2008 – SCRC
The Care Commission has received several enquiries
regarding the use of minibuses by care services to
transport people who use the service and seek to
clarify the queries in this article.
For full report click here
31. Care in the UK
14 January 2008 – CSCI
CSCI has contributed to a BBC series focusing on
social care in the UK.
For full report click here
Education
Nothing to report
Ireland, Scotland & Wales
Ireland
Nothing to report
Scotland
32. Experts Cast Doubt On Study Backing
A&E Cuts
19 January 2008 – The Herald
Medical leaders have now signalled a major shift in
their position on the centralisation of hospital services.
The move now casts fresh doubt on the drive
to cut accident and emergency departments across
Scotland.
33. Voice box warns of hospital bugs
18 January 2008 – BBC News
Forth Valley hospitals have installed an automated
voice box to remind patients and staff to wash their
hands. The system is being trialled in a bid to reduce
infection rates.
The battery-operated boxes are attached to walls,
and issue a message to use the alcohol gel provided.
For full report click here
34. Care Commission fees to be frozen
18 January 2008 – Scottish Government
The Care Commission has frozen its maximum fees
for 2008-09.
This means that the maximum fee levels set in 2005
will continue to apply next year as well and any
shortfall in the Care Commission's costs as a result
of this decision will be met by the Scottish Government.
For full report click here
35. Free personal and nursing care
18 January 2008 – Scottish Government
Pledge to increase care payments
18 January 2008 – BBC News
Free personal and nursing care payments to older
people in care homes will rise in line with inflation
from April thanks to regulations laid before Parliament
on 18 January 2008.
The proposed regulations sought agreement to the
inflation-matching increase which will benefit over
9,000 people.
For full report click here
For BBC report click here
36. Hospital car parking charges
18 January 2008 – Scottish Government
New guidance on hospital car parking was issued to
the NHS by a review group set up to look at parking
charges. The recommended maximum charge will
be determined by further analysis.
As an interim measure, boards were advised at the
end of last year that they will not be able to charge
more than £3 a day for hospital car parking.
For full report click here
37. More home places for the elderly
15 January 2008 – BBC News
Edinburgh is set to have more care home places for
the vulnerable, more often elderly people leaving hospital.
A joint initiative by NHS Lothian and Edinburgh
City Council will now provide funds over the next two
years for patient care after they have left hospital.
The first of four homes, Marionville Court, opened last
summer with the Craigmillar opening before Christmas.
For full report click here
38. Fears For The Vulnerable As District
Nurses To Be Scrapped
15 January 2008 – The Herald
The Scottish Government is proceeding with the controversial
overhaul of community nursing by scrapping
district nurses and health visitors in parts of
Scotland. The move comes despite widespread fears
that the shake-up will erode patient care.
Research by Dr Linda Pollock, a recent adviser to the
health department, found staff fear work to support
vulnerable pensioners and children will suffer.
39. Health Board Caves In Over Plan To Shut
Vital Casualty Units
14 January 2008 – Evening Times
HEALTH chiefs have now pledged to keep open accident
and emergency units at Ayr Hospital and Crosshouse
Hospital in Kilmarnock after a report from experts
which said local health chiefs had provided misleading
and biased information to support the downgrading
of casualty services.
Health Secretary Nicola Sturgeon said the report confirmed
the Scottish Government's view that the closure
decisions were wrong.
40. What the A&E scrutiny panel said
14 January 2008 – BBC News
A report by an independent panel has stated that
health boards in Lancashire and Ayrshire did not
make a “convincing case for significant changes to
emergency services”.
The panel was headed by Dr Andrew Walker and was
initiated by the Scottish Government to assess the
health boards’ proposals. Its two reports criticised the
proposals to remove consultant-led A&E services
from Ayr and Monklands hospitals.
NHS Lanarkshire was said to have used out-of-date
evidence.
For full report click here
41. Home care charge 'blocking beds'
14 January 2008 – BBC News
Latest figures from ISD Scotland show that health
board statistics have put Fife as the worst authority
for bed blocking. As a consequence, the new care
home charges in Fife are feared to be the main cause
for bed blocking.
The authority insists that bed blocking and home care
charges are not linked.
For full report click here
Wales
42. Five-hour ambulance wait apology
17 January 2008 – BBC News
The Welsh Ambulance Service has apologised to a
91-year-old cancer patient who had to wait almost
five hours to be taken to hospital. Doctors wanted
him taken as an urgent case to the Royal Gwent
Hospital, Newport when his health suddenly deteriorated.
Harold Griffiths’ family said that they have lost faith in
how the service is run.
For full report click here
Learning Disabilities
43. On a roll
16 January 2008 – SocietyGuardian
A documentary is featuring a bakery run by people
with learning difficulties by way of making a mark on
the film festival and awards circuit.
Breadmakers is an 11-minute documentary, can be
viewed at:
www.SocietyGuardian.co.uk/learningdisability
Legislation Update
44. No. 16 The Safeguarding Vulnerable
Groups Act 2006 (Barred List Prescribed Information)
Regulations 2008
14 January 2008 – OPSI
For full legislation click here
Mental Health
Nothing to report
Miscellaneous
45. They want your body
20 January 2008 – The Sunday Times
Article by Rachel Johnson about the opposing views
of libertarian versus utilitarian view of ‘ownership’ of
our bodies and contrasts the proposal by the state
that it will ‘own’ cadavers but that in life the individual
is paramount.
46. Leonard Cheshire Disability
20 January 2008 - The Sunday Times
The UK charity is seeking a new chief exec to replace
Bryan Dutton who retires later this year.
Remuneration discreetly not mentioned.
47. Business Development Director for BUPA
20 January 2008 - The Sunday Times
New role, no mention of salary and benefits – however,
it should be safe to assume a private health
plan for the appointed person and family members!
48. Judges could make key health decisions
17 January 2008 - The Times
If plans for an NHS constitution as suggested by the
Prime Minister come to pass the Kings Fund has suggested
that it will result in “endless legal wrangling”
where judges decide who will get life-saving treatments.
49. Organ supply ‘can be boosted without
new law’
17 January 2008 - The Times
Drawing from experience in Spain – where organ donation
is three times greater than the UK – a task
force headed by Elizabeth Buggins has made 14 recommendations
which are expected to increase organ
donation without the need to change the law to
‘presumptive consent’.
50. Doctors 'taking on dental care'
16 January 2008 – BBC News
A GP in Bradford has said that medics at his practice
have been seeing several patients every week with
dental problems they can’t treat.
A poll by Citizens’ Advice has found that one in six
people have been unable to visit a dentist for almost
two years (see article below).
For full report click here
51. Dentist shortage hits 'millions'
16 January 2008 – BBC News
Citizens Advice surveyed 1,800 people in England
and Wales and found that as many as one in six people
have not been able to visit a dentist for nearly two
years. The poll questioned people about treatment
since April 2006 when the new NHS contract was
brought in.
Extrapolating from their poll result, the authors estimated
that of the 7.4m who tried and failed to see an
NHS dentist, 4.7m eventually opted for private treatment,
and 2.7m decided to go without treatment altogether.
For full report click here
52. Whose body is it, anyway? Yours, naturally
15 January 2008 - The Times
Libby Purves sets out her analysis of the Prime Minister’s
pronouncement on presumed consent to organ
donation.
53. Dear Colleague Letter: Modernising
medical careers - Improvement to junior doctors'
access to recruitment communications
15 January 2008 – DoH
A letter has been sent to trusts asking for support for
junior doctors applying for specialty training in 2008
by expanding workplace access to external email
providers for the purpose of job searches and receiving
email notifications
For full report click here
54. The New Multiple Application Tracking
Tool Goes Live
14 January 2008 – CRB
The CRB has announced the launch of a multipleapplication
online tracking-tool.
The new tracking service will allow
a countersignatory to track all of the applications they
have made and all those made by other countersignatories
within their own organisation.
For full report click here
55. PM backs automatic organ donation
13 January 2008 – BBC News
Organ donations help us make a difference
13 January 2008 - The Sunday Telegraph
Brown seeks to make everyone an organ donor
–with opt-out
14 January 2008 - The Times
Gordon Brown wrote in The Sunday Telegraph that a
system of presumed consent to organ donation was
under consideration by the Govt as a way of increasing
the availability of organs for transplantation with
individuals having the opportunity to opt-out if they
wish.
For BBC report click here
NHS
56. Clegg attacks health 'inequality'
20 January 2008 – BBC News
Lib Dem leader, Nick Clegg has attacked the way the
NHS is run and called it a service in “crisis”.
In his first major television interview since becoming
leader, he said: "It is one of the most unequal health
services in the modern world" and suggested that he
would hand over control of the NHS to the people.
For full report click here
57. Kidney swap reversed in data blunder
20 January 2008 - The Mail on Sunday
Royal Liverpool and Broadgreen Hospitals Trust due
to incorrect data entry on the computer system performed
a kidney transplant on a patient providing a
wrong tissue-type match. It would appear that data
entry in relation to two patients resulted in the wrong
blood group being entered in the computer database.
A further surgical procedure was required to remove
the transplanted organ.
Ed. Is any better demonstration needed of some
of the dangers posed by the National IT database
for the NHS. One mis-entered item of data and
kapow!
58. Together we can beat obesity
20 January 2008 - The Sunday Times
Article by Alan Johnson, Health Secretary, about the
advice he has received concerning the potential cost
to the healthcare budget if obesity climbs as predicted
and the consequent adverse health effects.
He identifies some of the steps he and others
in Government are taking to create ‘healthy towns’.
59. NHS performance 'kills thousands'
18 January 2008 – BBC News
Campaigners, the TaxPayers’ Alliance has said over
17,000 deaths in the UK are unnecessary and due to
poor NHS performance.
The group made the claim after comparing World
Health Organisation data for five leading European
countries and found the NHS had 17,157 extra
deaths in 2004 compared with the other countries’
average when taking into account age and burden of
disease.
For full report click here
60. Insects found in children's ward
18 January 2008 – BBC News
The Patient Public Involvement Forum for Kent has
criticised Pembury Hospital, after finding dirty bathrooms
and toilets in a children’s ward as well as insects
crawling in an en-suite.
Pembury is one of three hospitals run by Maidstone
and Tunbridge Wells NHS Trust, involved in the C.diff
scandal.
For full report click here
61. Primarolo: NHS health research shapes
up for the future
17 January 2008 - GNN
A progress report published by the National Institute
for Health Research (NIHR), which summarises all
the progress that has been made putting in place the
infrastructure, programmes and systems to facilitate
health research - since the government launched the
Best Research for Best Health strategy in January
2006.
The main progress highlighted includes:
* NIHR clinical research networks have been set up
to support clinical trials throughout England, and promote
patient and public involvement in health research.
They are already boosting the numbers taking
part in clinical trials improving their speed, quality
and co-ordination.
* A good example is cancer research. The UK now
has the highest national per capita rate of cancer trial
participation in the world.
* Creating world class centres of excellence around
the country. £450 million has been invested in eleven
new biomedical research centres which are investigating
major causes of illness and death such as
cancer, heart disease, asthma, HIV, mental illness,
blindness, childhood diseases and ageing.
* The NIHR is now commissioning more research
through our new and expanded programmes and
world class research centres. In 2006/07 our Health
Technology Assessment Programme funded 22 new
projects at a cost of more than 15 million pounds. In
the same period we expanded our Service Delivery
and Organisation programme to include new topics
and areas and funded £45 million in programme
grants.
62. Hospital loses staff pay details
17 January 2008 – BBC News
Queen Mary’s Hospital in Sidcup, south-east London
is under investigation after it lost 20 years worth of
payroll data on its staff.
The police was informed, and the data was believed
to include N.I. for staff employed between 1974 and
1996.
Nine NHS trusts in England have so far admitted losing
a variety of information held on patients.
For full report click here
63. Big variations in hospital stays
17 January 2008 – BBC News
Research has shown large variations in the length of
time a patient remains in hospital after having standard
surgery in England. The study, by analysts Dr
Foster found that the differences were as much as up
to three weeks for hip replacement patients.
For full report click here
64. Call to curb rising NHS drug bill
17 January 2008 – BBC News
The Commons public accounts committee has said
that more has to be done to curb the NHS spending
on prescription drugs in England. The figures suggest
that £8.2bn has been spent in a year which
shows it has more than doubled in a decade.
The Commons public accounts committee has suggested
that GPs use more generic drugs instead of
expensive, branded ones and printing the cost of
drugs on packets to discourage patient waste.
For full report click here
65. An NHS constitution could be beneficial,
but only if drafted correctly, says King’s
Fund
17 January 2008 – King’s Fund
A King’s Fund report published on 17 January said
there is a case for an NHS constitution but there are
pitfalls to avoid when drafting one.
The Prime Minister has indicated that he is considering
plans for a new ‘NHS constitution’ as part of Lord
Darzi’s review of the NHS, and Niall Dickson, chief
executive of the King’s Fund, said:
“A constitution could provide real benefits but there
are dangers if it is not thought through with care.”
“A detailed list of patients’ rights could become
caught up in endless legal wrangling. On the other
hand, a constitution which simply reiterates core principles
or restates existing targets, such as 18-week
waiting times, without any enforceable rights for patients
would lack credibility.”
For full report click here
66. Transforming health research: the first
two years - National Institute for Health Research
progress report 2006-2008
17 January 2008 – DoH
Report outlining the progress made by the National
Institute for Health Research in implementing the
Government's Best Research for Best Health research
strategy.
For full report click here
67. PL CMO (2008)1: Changes to the mandatory
healthcare associated infection surveillance
system for Clostridium difficile infection
(CDI) from 1 January 2008
16 January 2008 – DoH
A letter setting out the new requirements for the reporting
of C. difficile cases by acute Trusts from 1
January 2008 and the need for Trusts to review data
entered onto the web-based system since its introduction
by 10 March 2008.
For full report click here
68. Patient's tattoo tribute to NHS
16 January 2008 – BBC News
Mark Bellerby from Teesside has had the image of a
nurse and the words “NHS – My Angels” tattooed on
his arm in tribute to his treatment for a lifethreatening
disease. Mr Bellerby was treated at hospitals
across the North East after developing pancreatic
and suffering multiple organ failure in 2004.
He had to be put in a drug-induced coma for several
weeks and undergo five major operations following
his diagnosis. He was left with nerve damage and
had to undergo months of rehabilitation.
For full report click here
69. Commissioning NHS Primary Care Dental
Services: Meeting the NHS operating framework
objectives
15 January 2008 – DoH
This document gives information on the Government's
commitment to maintaining and expanding
NHS dental services. it also covers the expectations
of the NHS to deliver year on year increases in access,
as set out in the NHS Operating Framework
2008-09.
For full report click here
70. Hospital deep cleaning under fire
14 January 2008 – BBC News
NHS managers and cleaning companies are questioning
the need for the £50m deep clean of hospitals.
The firms say that the deep clean could be better
done by funding day-to-day cleaning properly and
the NHS Confederation expressed scepticism as to
whether infections would be stamped out as a result.
Other initiatives in the pipeline include MRSA screening
for all hospital patients and extra infection control
nurses.
For full report click here
71. The Health Act 2006: Code of practice for
the prevention and control of healthcare associated
infections
11 January 2008 – DoH
This code of practice aims to help NHS bodies to plan
and implement how they can prevent and control
healthcare associated infections. It sets out criteria by
which managers of NHS organisations are to ensure
that patients are cared for in a clean environment and
where the risk of health care associated infections is
kept as low as possible.
For full report click here
Nursing
Nothing to report
Older People
72. NEW USER-FRIENDLY GUIDE TO STANDARDS
OLDER PEOPLE HAVE A RIGHT TO
EXPECT FROM THEIR CARE HOME
17 January 2008
National charity Counsel and Care published a guide
for older people and their families on the standards
they have a right to expect when living in a care
home.
Care homes should be exactly what they say they are
– both caring and homely. Your care home – is it up
to standard? explains what the key standards are and
what older people and their families should expect
from the staff and the care home.
Updated from Counsel and Care’s original publication
by John Burton, an acknowledged expert on care
practice and management with more than 40 years’
experience, the guide has been written on the premise
that older people living in a care home and their
relatives are the best judges of the quality of their
home and how the standards are being met.
John Burton said: “If residents, their families and
friends are clear about what they have a right to expect
from their care home, they’ll feel more confident
about asking for it. And that makes everyone’s job
easier and it’s how care homes improve and maintain
high standards. Using this guide – and the satisfaction
survey and complaints form that go with it – will
support good homes and involve the people who live
in them. Like the best care, Your Care Home puts
residents at the centre, in control. After all, that is the
whole point of a care home: CARING and HOMELY,
no more, no less.”
Copies of Your care home – is it up to standard? are
priced £5.99 each (plus postage and packaging), and
can be ordered by completing the order form on
Counsel and Care’s website at: http://
www.counselandcare.org.uk/influence/publications/ or
by writing to Counsel and Care at Twyman House, 16
Bonny Street, London, NW1 9PG, 020 7241 8555.
73. Wisdom family makes care decision
16 January 2008 – BBC News
The family of comic Sir Norman Wisdom have spoken
about their decision to admit him to a care home. His
son, Nick Wisdom, said his 92-year-old father, who
suffers from vascular dementia, was no longer able to
interact with his family as he used to. The strain of
caring for him became too much, the family said, and
he is now living in a residential home on the Isle of
Man.
A TV program on 15.01.08 showed the efforts being
made by family members to care for Sir Norman –
the program was candid and showed the tensions
between Sir Norman and each of his children and the
novel solution they tried.
For full report click here
Social Care
74. Personalised care found to save money
and please users
18 January 2008 – Community Care
Think-tank Demos have issued a research paper
which shows personalised budgets resulting in better
outcomes and lower costs for countils.
The study ‘Making it Personal’ on self-directed support
found that the personalised budgets led to average
council savings of 10% on care packages and
achieved greater service user satisfaction compared
to traditional services.
For full report click here
75. LAC (DH)(2008)1: Transforming social
care
17 January 2008 – DoH
A Local Authority Circular sets out information to
support the transformation of social care as signalled
in the Department of Health's social care Green Paper,
'Independence, well-being and choice' (2005)
and reinforced in the White Paper, 'Our health, our
care, our say: a new direction for community services'
in 2006.
For full report click here
76. ADASS calls for pooled budgets for
health and social care
16 January 2008 – NCF
ADASS is calling for health and social care agencies
to take “bold measures” to redirect resources towards
community-based services in order to promote health
and wellbeing,
Anne Williams, President of the Association of Directors
of Adult Social Services said:
“preventive care and care closer to people’s homes is
often cost effective, and usually works better. ADASS
strongly believes that investment in prevention will
help diminish the current high demand for acute and
crisis-orientated services. Ultimately we must diminish
the requirement for costly acute hospital services
- whether they relate to physical or mental ill health.”
For full report click here
77. GSCC welcomes positive view
15 January 2008 – NCF
The General Social Care Council (GSCC) welcomed
a report looking at the views of social care workers in
the UK.
For full report click here
78. Social care staff in England love work,
finds survey
14 January 2008 – Community Care
The largest national survey of the social care workface
has found nine out of ten employees are happy
in their jobs.
Care workers interviewed for the Skills for Care survey
listed job satisfaction and chatting with and meeting
service users as their favourite parts of the job,
with cleaning up mess, dealing with challenging behaviour
and service users' deaths being the least favoured
elements.
For full report click here
79. Raising the profile of long term conditions
care: A compendium of information
14 January 2008 – DoH
A document originally launched in January 2008 updates
the first compendium of information on LTCs,
published in May 2004 and will further inform all those
who are involved in both commissioning and providing
care and support services for people with LTCs.
For full report click here
80. Brown 'to listen' to home carers
14 January 2008 – BBC News
Prime Minister, Gordon Brown has said he will “listen”
to the six million British people who spend their time
caring for others.
The Prime Minister made the statement whilst on
BBC Radio 4’s You and Yours programme and said
he would personally oversee Government policy
which could see changes to the Carer’s Allowance.
The allowance is worth £48 a week - which is lower
than out-of-work benefits.
For full report click here
81. Interactive care tool goes online
14 January 2008 – BBC News
The BBC has launched an interactive tool on its website
to enable people to calculate how much social
care support they are entitled to and how much it will
all cost.
The Care Calculator is part of the Care in the UK
series on Radio 4.
The Calculator is accompanied by a care map which
shows how services differ.
For full report click here
Staff, employment and
disciplinary
Nothing to report
Falls from windows in care
homes
In a two year period 2002/03 to 2004/05 the Health
and Safety Executive identified that there were at
least seven fatalities and 30 major injury incidents
associated with falls from windows in health and social
care settings.
In the past six months I have become conscious that
there have been more prosecutions than ever before
and a greater number of convictions against providers
of care/operators of care establishments arising
out of injuries caused to patients and residents who
have fallen from windows. Distressingly, there have
been deaths too.
Most of the prosecutions are brought by the Health
and Safety Executive (HSE); although, in some areas
of the country the power and authority to investigate
incidents and to commence prosecutions is
delegated by the HSE to the local authority.
Most of the successful prosecution of cases, reported
in the last six months, have been against hospitals
operated by the National Health Service rather
than private hospitals and care homes. However,
the misfortunes of others provide a valuable reminder
of one’s responsibilities and an opportunity to
learn from those misfortunes.
Recent Prosecution
The most recent example of such a prosecution was
on 16th January 2008 R v Avon and Wiltshire Mental
Health Partnership NHS Trust which was successfully
prosecuted under section 3(1) of the Health and
Safety at Work etc. Act 1974 (see box for the language
of the statutory provision) after a 77 year old
woman, Iris Carey, fell 5.5 metres from a window at
Swindon Victoria Hospital. Ms Carey sustained a
broken ankle and compression fracture of vertebrae
as a result of the fall. The window from which she fell
was not adequately restricted in terms of the extent to
which it could be opened.
Having pleaded ‘guilty’ to the offence the Trust was
fined £20,000 and ordered to pay £12,502 towards
prosecution costs.
After the hearing the HSE Inspector, Alison Fry, said
"There are sensible and simple steps which should
be have been taken to prevent this accident from occurring.
Where appropriate, suitable safeguards
should be provided to restrict window openings to no
more than 100mm. There should also be suitable
maintenance arrangements to ensure control measures
are in place and functioning properly." It was
also revealed that the incident involving Iris Carey
was “entirely avoidable” as the Trust had already
identified a risk associated with the windows on the
particular unit/ward concerned as the window restrictors
in situ did not meet the required standard.
So, in short, the Trust knew of the problem, was
aware of the sort of incident that might ensue, but, did
not, apparently, remedy the defect – until after the
incident.
Health and Safety at Work etc. Act 1974
Section 3 (1)
It shall be the duty of every employer to conduct his
undertaking in such a way as to ensure, so far as is
reasonably practicable, that persons not in his employ
who may be affected thereby are not thereby exposed
to risks to their health and safety.
Management of Health and Safety at Work Regulations
1992
Risk assessment
3.—(1) Every employer shall make a suitable and
sufficient assessment of—
(a) the risks to the health and safety of his
employees to which they are exposed whilst
they are at work; and
(b) the risks to the health and safety of persons
not in his employment arising out of or in
connection with the conduct by him of his undertaking,
for the purpose of identifying the measures he
needs to take to comply with the requirements
and prohibitions imposed upon him by or under
the relevant statutory provisions.
Health and Safety at Work etc. Act 1974
(continued…)
(2) Every self-employed person shall make a suitable
and sufficient assessment of—
(a) the risks to his own health and safety to
which he is exposed whilst he is at work; and
(b) the risks to the health and safety of persons
not in his employment arising out of or
in connection with the conduct by him of his
undertaking,
for the purpose of identifying the measures
he needs to take to comply with the requirements
and prohibitions imposed upon him by
or under the relevant statutory provisions.
(3) Any assessment such as is referred to in paragraph
(1) or (2) shall be reviewed by the employer
or self-employed person who made it if—
(a) there is reason to suspect that it is no
longer valid; or
(b) there has been a significant change in the
matters to which it relates;
and where as a result of any such review changes
to an assessment are required, the employer or
self-employed person concerned shall make
them.
(4) Where the employer employs five or more
employees, he shall record—
(a) the significant findings of the assessment;
and
(b) any group of his employees identified by it
as being especially at risk.
Keith M Lewin
The design and construction of new care facilities are
undertaken, in the main, by very experienced professionals
who are aware that when a new facility is
handed over to the operator it must be fit for purpose
including effectively securing the safety of those work
in and using the building and can be expected to design
into the building the necessary safety features –
such as restricting the opening of a window to 100mm
where the window is at or higher than 2 metres above
ground level. They will also have in mind the British
Standard code of practice on Windows, doors and
roof lights BS 8213 – 1:2004 and the NHS Technical
Memorandum 55 on Windows.
Reasons for Falls from Windows in Care Settings
There are three broad categories of falls in such settings:
Accidental falls;
Falls arising from a confused mental state; and
Deliberate self-harm.
The majority of falls are not accidental. The majority
of reports refer to the mental state of the people who
are injured in such settings – whether that is as a result
of dementia, senility, illness or otherwise. Of
course, the use of medication, alcohol and nonprescription
drugs can all add to a state of confusion.
New builds
The health and safety of service users is embraced
by the general requirements of the Health and Safety
at Work etc. Act 1974, in particular by section 3 and
by the requirements to undertake risk assessments
pursuant to Management of Health and Safety at
Work Regulations – regulation 3.
The design and construction of new care facilities are
undertaken, in the main, by very experienced professionals
who are aware that when a new facility is
handed over to the operator it must be fit for purpose
including effectively securing the safety of those work
in and using the building and can be expected to design
into the building the necessary safety features –
such as restricting the opening of a window to
100mm where the window is at or higher than 2 metres
above ground level. They will also have in mind
the British Standard code of practice on Windows,
doors and roof lights BS 8213 – 1:2004 and the NHS
Technical Memorandum 55 on Windows.
However, there remains a responsibility to risk assess.
Similarly, for older premises and those which
have been converted to use as a care home, private
hospital and the like there is a responsibility to conduct
risk assessments and to reduce the risks identified.
Risk Assessments
Undertaking risk assessments is part and parcel of
daily life for those engaged in the provision of health
and/or social care. Clearly, one must consider the
needs of individual service users, carefully considering
all foreseeable situations likely to give rise to risk
– such as falling from a window. Additional responsibility
will rest on the shoulders of those caring for
psychiatric patients and others who are likely to injure
or try to kill themselves.
Safety Device
Restricting window opening to 100mm is achieved
usually by the fitting of some form of mechanical device.
On old Victorian sash windows I have seen the
restrictor as a block of wood nailed or screwed into
the rebate of the moving window so that it provides
an opening of not more than 100mm. However, HSE
recommends that restrictors should be of a type that
can be disengaged by means of a special tool or key.
I recently visited a brand new care home, incorporating
state of the art technology of all types from its
information technology solutions to recycling of rainwater
and waste. However, the window restrictors
were capable of being disengaged with a couple of
fingers.
This is a consideration when risk assessing.
Maintenance
Do not forget, once you have satisfied that there are
suitable and effective window restrictors in place that
is not an end of matters. One must ensure that there
are regular checks to ensure that all of the restrictors
are in place and operating effectively. Those checks
should be carried out with reasonable frequency and