Editorial
I was invited to Portcullis House, House of Commons
for the launch of the Quality Care Campaign earlier this
week (see item 11).
English Community Care Association, National Care
Association, Social Care Institute for Excellence, Boots
and RDB Star Rating supported by a group of large and
midsized care providers have called for ‘Five Star
Quality in:
The campaign provides a focal point for providers to get
their quality care to the highest levels, underpinned by
the five domains identified.
This is a well-timed campaign as it is becoming
increasingly clear that, for example, many local
authorities commission almost exclusively on one issue,
PRICE. It is now three years ago that the then Health
Minister responsible for social care, Stephen Ladyman,
ran a series of training events for social services in
commissioning excellence.
From the clients who consult me about their contractual
relationships with councils, whatever lessons might
have been learned at the Ladyman events, it is long
forgotten. Councils continue to want to ‘squeeze’ price
– even where there are agreed mechanisms to
calculate annual fees there are some councils who
simply disregard their contractual obligations.
This is to abdicate their responsibility. Yes, as a ratepayer
I do not want to be ‘fleeced’. However, as
someone who will be needing care for ageing relatives I
want high quality care. Directors of Adult Social
Services are acting as a brake on improvement where
they pay the lowest fee possible and
where all providers are paid the same
irrespective of the quality they
currently provide.
Parliament
06.05.08 – HoC – Health, oral questions
09.05.08 – HoC - Education Children with Autism Bill
– Private Members’ Bill
Next
• The workforce
• Regulation
• Reputation
• Commissioning; and
• funding
**NEWSFLASH**
Legality of POVA scheme is appealed to House of Lords
R (on the application of June Wright and Others) v (1) Secretary of State for Health (2) Secretary
of State for Education and Skills
Regular readers of this publication will be aware of the 2007 Court of Appeal decision in this case in which the court found aspects
of the Protection of Vulnerable Adults scheme was unlawful and required a change in the process so that a person referred
to the Secretary of State for having harmed or placed at risk of harm a vulnerable adult should not, as a matter of course,
be placed on the provisional list of persons banned from the workforce.
The court held that someone so referred should first have a right to respond and ‘be heard’ in relation to what is alleged against
him.
We have today (01.05.08) learned from the Judicial office, House of Lords that on 21.04.08 leave was given by the House of
Lords to further appeal the case.
A petition of appeal is due to be lodged by 05.05.08 and the hearing will take place within the next 6-18 months.
At the time of writing we do not know which of the parties has appealed, it may be that all parties have, if not, I am sure that
there will be cross appeals as there are a number of points with which each of the parties to the case might be expected to be
dissatisfied.
We hope to bring more information next week.
Volume 3 Issue 16
Abuse
1. Reforms could leave vulnerable adults in
danger, CSCI chief says
25 April 2008 – Community Care
Paul Snell, chief of the Commission for Social Care
Inspection body has warned that personalisation
might leave vulnerable adults more at risk of abuse.
He urged ADASS members to renew their efforts to
increase safeguarding efforts when personalised
budget schemes roll out over the next three years.
For full report click here
2. Shadow over the sunshine island
25 April 2008 - The Times
Concerns that the anxiety surrounding the investigation
into the apparent crimes committed against children
and young people at Haut de la Garenne may
damage both the tourist industry and the continuation
of the degree of independence that the State of Jersey
has had over the centuries.
3. CHILD EXPLOITATION AND ONLINE PROTECTION
(CEOP) CENTRE PUBLISHES 2ND
YEAR RESULTS AND LAYS OUT THE CHALLENGE
AHEAD
21st April 2008 - UKPolicing.info
131 CHILDREN SAFEGUARDED FROM SEXUAL
ABUSE
297 SUSPECTED CHILD SEX OFFENDERS ARRESTED
- A THREE FOLD INCREASE
6 ORGANISED PAEDOPHILE RINGS DISMANTLED
1.7 MILLION UK CHILDREN RECEIVING "SAFETY
FIRST" EDUCATION
Second year results from the Child Exploitation and
Online Protection (CEOP) Centre - the UK's dedicated
organisation for tackling the sexual abuse of
children - shows the battle against child sex offenders
continues to gathers pace.
The CEOP Centre was set up in 2006 to deliver a
national policing focus that would track some of the
UK's highest risk sex offenders, provide services
across the wider child protection community and deliver
an inclusive response that would get to the heart
of the crime.
That focus has led to the safeguarding of 131 children
and the arrest of 297 suspected offenders during
the last twelve months, with the arrest figures
alone being a three-fold increase on the organisation's
first year results.
During the last year the organisation has processed
almost 1 million images of child sex abuse - using
each unique image to help either build up intelligence,
track and bring offenders to account, or as
vital parts of an investigative jigsaw leading to 18
young victims being identified from this area of work
alone.
And suspected offenders have been targeted not only
individually, but also where they have formed intricate
paedophile networks with 6 such groups infiltrated
and dismantled throughout the year - all with international
footprints.
Reports from both the child protection community
within the widest sense and members of the public -
through the CEOP Centre's unique report abuse virtual
environment - continue on an upward trend with a
total of 5,812 reports received and activated during
the past year - a 76% increase on the monthly average
from 2006/07.
But tracking and bringing offenders to account is only
part of the CEOP operation. The past twelve months
has also seen extensions to the organisation's "safety
first" education programme - Thinkuknow. This programme
provides a dedicated array of education materials
that have now reached over 1.7 million UK children
and which have been delivered by 11,000 specially
trained professionals - from teachers through to
carers and boosted by new services for parents.
4. When the talking has to stop
April 2008 – Healthcare Business
The CEO of the English Community Care Association,
Martin Green, comments that the £2m funding
announced recently by the DoH and Comic Relief is
symptomatic of talking and less about taking action to
address deficiencies – government just spends too
much on external consultants undertaking research or
supposedly implementing change.
Business News
5. The Sunday Times Rich List
27 April 2008 - The Sunday Times
Once again there are a number of people who have
made their fortunes from or are involved or linked to
health and social care. My selection is:
44 £1,600m Baroness Howard de Walden & family.
Owns a 92 acre estate comprising Harley
Street, London centre of private practice of all
things medical.
158 £500m Douglas & Dame Mary Perkins. Founders
of Specsavers
214 £400m Ramesh & Pratibha Sachdev. Care
homes, Life Style Care
214 £400m Lawrence Tomlinson. Care Homes,
Orchard Care Homes and the LNT group which
includes Coolblue
264 £320m HM The Queen
267 £310m Duncan Bannatyne. Of BBC TV’s
Dragons’ Den made a fortune from a chain of
care homes
312 £260m Clinton, Spencer & John McCarthy.
Churchill Retirement Living
453 £180m Judith & Fergus Wilson Intend to
build a chain of dental surgeries near motorway
junctions. They will bring 1,000 European
dentists into the UK to staff them.
501 £160m Dr Nick Dhandsa & family. £100m
from sale of Associated Nursing Services in
2005. Has cosmetic surgery clinic in London.
501 £160m Julian & David Schild. Sale of medical
equipment company Huntleigh Technology
525 £150m Nigel Doughty. Through the private
equity vehicle he owns stake in a number of
health and social care businesses.
564 £140m Keith Bradshaw & family. From sale of
Takecare a care home business to BUPA plus
other assets.
644 £120m Brian & Alan Stannah. You guessed it;
Stannah lifts...stair lifts.
759 £105m Gordon Sanders. Runwood Care
Homes.
6. Mears Group announce £57 million of new
contract wins for Social Housing Division
25 April 2008
Mears Group is announced further new contract wins
by its social housing division as follows:
Watford Community Housing Trust
Watford Community Housing Trust (WCHT) subject
to contract and to completion of the Trust's leaseholder
consultation process, appointed Mears as one
of two partners for a 5-year Decent Homes partnership.
The contract is said to be worth approximately
£33 Million over the 5-year period for each partner.
Castle Morpeth Housing
The Company has been appointed to assist Castle
Morpeth Housing deliver a major works, improvement
and repair programme to the recently transferred
housing stock. The partnership is for an initial term of
4 years and Mears' share is valued at £12 million for
this period, other partners have been appointed and
the total scheme is valued at £32 million.
Catalyst Communities Housing Association
A further partnership agreement has been made with
Catalyst to provide voids and major cyclical maintenance
repairs services. The contract is worth £12
Million over 4 years and supports our strategy of
growing our business with existing customers.
Commenting, Bob Holt, Chief Executive of Mears
Group, said:
“These new wins by our social housing division add
additional important contracts to our order book which
is at record levels and we believe that Mears is in a
very strong position to benefit further from our current
bid pipeline.”
Care Homes
7. People with dementia wrongly given drugs,
say MPs
25 April 2008 – Community Care
A parliamentary inquiry has revealed that overprescribing
drugs is a significant problem in many
care homes, with up to as many as 105,000 people
with dementia wrongly being given antipsychotic
drugs. Experts have estimated that 70% of prescriptions
are inappropriate.
For full report click here
8. Mental Health Foundation to fund innovation
in care home dementia services
24 April 2008
For full report see Older People—item 76
9. Stakeholders accuse DH of broken promise
over care home payment
23 April 2008 – Community Care
The Department of Health has been accused of
backing down on its promise to consult on this year’s
increase in personal expenses allowance for care
home residents.
Age Concern, Local Government Association, Mencap,
Counsel & Care and Help the Aged all signed a
letter written to Care Services Minister, Ivan Lewis
about the promise he made to that effect in parliament
in January 2008.
For full report click here
10. Inspection of Care Homes: Speech by
Kevin Brennan
23 April 2008 – DCSF
A transcript of the speech by Children's Minister
Kevin Brennan in the House of Commons on 22 April
2008. He spoke at length about using new inspection
standards for children's care homes to improve children's
services.
For full report go to http://www.dcsf.gov.uk/speeches/
search_detail.cfm?ID=775
11. Call for unity as Quality Care Campaign
launches in London
A number of key organisations within the care industry
have united to call on the sector to “rise to the
challenge” of delivering quality care for all. More than
100 people gathered at the House of Commons on
Tuesday (April 29) for the official launch of the campaign.
Those leading the Quality Care Campaign include the
English Community Care Association (ECCA), National
Care Association (NCA), the Social Care Institute
for Excellence (SCIE) and Boots together with
independent accreditation company RDB Star Rating.
Dame Denise Platt chairman of CSCI welcomed the
campaign saying: “This campaign really matters. We
have to raise the game for everyone, and that is what
this campaign is about”.
Martin Green, Chief Executive of ECCA, described
the campaign as a “cross-sector initiative to challenge
people’s perceptions of residential care. The campaign
will fight for a world class service by calling for
a five-star workforce, five-star regulation, five star
commissioning and five star funding”.
Nadra Ahmed, chair of the NCA stated “We have to
work towards a model of care which inspires confidence.
A campaign like this has an opportunity to
bring back the confidence of the public. We need to
create a positive image of social care that is so desperately
needed.”
And SCIE chair Allan Bowman said: “SCIE is delighted
to be part of this campaign because our remit
is to identify the best practice in social care and promote
its adoption across the whole of the UK.”
The Quality Care Campaign will promote quality provision
by highlighting case studies of best practice,
including work by schools to encourage students to
consider careers in the care sector.
Among such case studies is Hove Park School in
East Sussex, which has given more than 150 students
direct experience of working in local care
homes as part of its Health and Social Care Curriculum.
Its staff are also working with the Specialist
Schools and Academies Trust to deliver the scheme
nationally.
Tim Barclay, Headteacher of Hove Park School
said “The work we do [with the care sector] helps us
take our students out of school into real environments
where they meet real people. These opportunities are
crucial in terms of challenging people’s perceptions
and in engaging students with vulnerable people and
understanding opportunities about their careers. This
is why we are passionate about joining this campaign.”
12. A user guide to care planning
April 2008 – Healthcare Business
Anil Mittal shares his views about the approach to the
care planning process.
13. Meridian Healthcare – the business
April 2008 – Healthcare Business
A two page profile on the origins of the Meridian business
– local authorities- and which now has 1238 registered
beds... and counting as it continues its plan of
new build.
Case Reports
Law Reports
Nothing to report
Disciplinary cases
14. 'Catalogue of errors' over death
25 April 2008 – BBC News
A coroner has ruled that an elderly man died after “a
catalogue of errors” by medical staff in Gloucester.
Albert Rush, 76, from Sea Mills, was wrongly fitted
with a neck collar after a fall at his daughter's home,
which in turn caused him to become paralysed.
Gloucestershire Hospitals NHS Foundation Trust
said it would review all the issues raised from the
inquest.
For full report click here
15. Home nurse stole residents' cash
24 April 2008 – BBC News
Anthony Stephan Griffiths has been struck off by the
Nursing and Midwifery council for stealing more than
£20,000 whilst working as a nurse. He stole the
money from vulnerable residents in his care at Cedars
Care Home in Doncaster.
Griffiths was not present at the hearing and was
struck off immediately.
For full report click here
Cases in the news
16. OAP 'neglected' by nursing staff
23 April 2008 – BBC News
Eight nursing home workers have been charged with
the neglect of a patient who died within 5 weeks of
being admitted into their care. Gladys Thomas, 84,
was found to have fractures to her collar bone and
rib when admitted to hospital.
For full report click here
17. Paediatrician's doctor ban lifted
22 April 2008 – BBC News
Paediatrician David Southall has won his bid to overturn
his ban which stopped him working as a doctor.
The General Medical Council (GMC) struck off
Dr Southall in December for serious professional misconduct,
but the body admitted that it was wrong to
apply 2004 guidelines in enforcing the ban.
Dr Southall was barred from working as a doctor after
the GMC decided he had abused his position after he
accused a mother of drugging and murdering her
son.
For full report click here
Children
18. Database to help children in need
22 April 2008 – BBC News
Somerset now has a newly-developed database containing
the personal details of 47,000 children in need
in the area. Children’s details include where they
attend school, sexual abuse and crime incidents and
any mental issues.
A spokesman for the County Council said "All users
will receive mandatory training before being given
access".
For full report click here
Conferences & Courses
To follow next week
Consultations
19. CSCI begins new study into safeguarding
4 March 2008
CSCI is going to carry out a new study into how well
people are protected from abuse or neglect in adult
social care. The study into safeguarding will look at
how good the way adult social care is provided is at:
• Raising awareness of abuse issues and giving
priority to safeguarding
• Preventing abuse
• Recognising and acting on allegations
• Continually improving safeguarding systems and
practice
CSCI inspectors will, apparently, be asking some additional
questions in key inspections of care services
carried out from 5 to the 16 May.
Between 21 April and 16 May it will also be carrying
out some thematic inspections that focus on safeguarding.
20. Consultation on the Medical Profession
(Miscellaneous Amendments) Order 2008
Closing Date: 5 June 2008
A consultation paper asking for comments on a draft
order. The changes proposed in the draft order seeks
to implement two of the reforms set out in the White
Paper: Trust Assurance and Safety. The draft order
also provides an additional route to the Specialist
Register for NHS consultants. All amendments relate
to the functions of the General Medical Council.
For full consultation click here
21. Private and voluntary healthcare: Care
Standards Act 2000. Regulations and national
minimum standards consultation
document
Closing Date: 10 June 2008
DoH plans to make sweeping changes to the way
that health and adult social care is regulated and performance
managed, from April 2009 (a date which
may ‘slip’). The consultation document contains the
proposed changes to the regulations and proposed
changes to the associated National Minimum Standards
(NMS).
For full consultation click here
22. The Future Regulation of Health and
Adult Social Care in England: A consultation
on the framework for the registration of
health and adult social care providers
Closing Date: 17 June 2008
A consultation seeking views on the future regulation
of health and adult social care. It seeks to consider
which health and adult social care services should
require registration with the Care Quality Commission
and what the requirements for registration
should be. It also considers when providers of regulated
services should be required to have a registered
manager and how primary care services should
be included in the new registration system.
For full consultation click here
23. Consultation: Human rights inquiry
Closing Date: 21 June 2008
Consultation seeking views on how public authorities,
such as hospitals, schools or local and national
government offices, make sure they treat people well
and in line with legal requirements under the Human
Rights Act.
For consultation go to http://www.equalityhumanrights.com/
e n / p r o j e c t s / h u m a n r i g h t s i n q u i r y / P a g e s /
Gatheringevidence.aspx
24. Consultation: Statutory guidance for children's
trusts on the duty to cooperate
Closing Date: 26 June 2008
This consultation seeks views on draft statutory guidance
for children's trusts on inter-agency cooperation
to improve the well-being of children, young people
and their families.
For full report go to http://www.dcsf.gov.uk/consultations/
conDetails.cfm?consultationId=1544
25. NICE Consultation: The 2008 update to
the guidelines manual
Closing Date: 1 July 2008
Consultation seeking views on a draft update of a
manual that describes the detailed process and methodology
used to produce NICE clinical guidelines.
For full report go to http://www.nice.org.uk/aboutnice/
howwework/developingniceclinicalguidelines/
clinicalguidelinedevelopmentmethods/
guidelinesmanualconsultation2008update.jsp
26. Proposals to change NHS structure in
Wales
Closing Date: 2 July 2008
The Welsh Assembly has announced proposals to
change the NHS's structure in Wales.
The proposals are part of a three-month consultation,
include plans to abolish the internal market by providing
funding from the Welsh Assembly or an NHS
Board for Wales directly to trusts and local health
boards.
For full report go to new.wales.gov.uk
27. Call for Evidence: The Child and Adolescent
Mental Health Services review - Next
steps to improving the emotional well-being
and mental health of children and young people
Closing date: 7 July 2008
This consultation calls for evidence on how universal,
targeted and specialist services can be improved to
meet the needs of children and young people who are
experiencing, or are at risk of, mental health problems.
For consultation click here
28. NICE: Current consultations
To browse through consultations go to http://www.nice.org.uk/
page.aspx?o=consultations.current
CSCI, CSSIW, Healthcare
Commission &
Scottish Care Commission
29. Care Commission heads into an exciting
and challenging new phase
CSCI at Community Care Live 08
24 April 2008 – CSCI
The Commission for Social Care Inspection will have
a presence at Community Care Live event for social
care professionals this year.
For full report click here
30. Healthcare watchdog launches biggest
ever inspection programme in acute NHS
trusts to check infection control
24 April 2008 – Healthcare Commission
The Healthcare Commission has launched the biggest
inspection programme ever carried out in NHS
acute trusts to check whether the trusts are meeting
standards on infection control.
For full report go to http://www.healthcarecommission.org.uk/
n e w s a n d e v e n t s / p r e s s r e l e a s e s . c f m ?
cit_id=6429&FAArea1=customWidgets.content_view_1&usec
ache=false
31. Corporate Plan 2008-11
23 April 2008 – SCRC
The Scottish Care Commission’s Corporate Plan
2008-11 has been published.
For full report click here
32. Dementia now a national priority: Alzheimer
Scotland welcomes Ministerial statement
21 April 2008 – SCRC
Shona Robison MSP, has issued a ministerial statement
on dementia confirming the Scottish Government’s
recognition of the scale of dementia in Scotland.
For full report click here
Education
Nothing to report
Ireland, Scotland & Wales
Ireland
Nothing to report
Scotland
33. Older people care scheme planned
23 April 2008 – BBC News
The Highlands are set to run a new project where
older people look after each other rather than go into
care homes. The scheme is called O4O Older for
Older, and will be launched this year in the summer in
four areas due to be chosen.
For full report click here
34. £2.5m payout in negligence cases
21 April 2008 – BBC News
A Scottish Government response has revealed that
NHS Dumfries and Galloway has paid out over £2.5m
to settle medical negligence claims since 1996.
The figures were announced in response to a parliamentary
question.
For full report click here
Wales
35. GP patients 'wait over fortnight'
25 April 2008 – BBC News
A study has found that patients in parts of South
Wales end up having to wait more than two weeks for
an appointment with their doctor, one case being that
Gwent Community Health Council could not book an
appointment with a surgery within a month.
The health council quizzed 93 GP surgeries across
five local authorities with a "mystery patient" calling
receptions in both the morning and afternoon.
For full report click here
36. Welsh patients barred in hospitals cash
row
24 April 2008 – Daily Express
Welsh patients are being refused treatment in English
hospitals due to a row over who foots the bill.
The extraordinary move by an NHS trust in Bristol
was likened to the erection of the Berlin Wall.
37. MPs force NHS violence law U-turn
24 April 2008 – BBC News
The Ministry of Justice has reversed a decision which
excluded Wales from a new law offering hospital
workers extra legal protection against violence.
Welsh Assembly Government ministers had initially
said that it had no need for the law in Wales.
For full report click here
38. NHS hygiene drive to save lives
21 April 2008 – BBC News
Wales is going to launch a campaign to stamp out
mistakes and infections in hospitals causing accidental
deaths. The ‘1,000 Lives Campaign’ aims to save
1,000 lives over the next two years by improving hygiene
and drug management.
All NHS trusts and local health boards have chosen
to sign up to the campaign.
For full report click here
Learning Disabilities
39. Mencap: 73% of people cannot name a
single learning disability
21 April 2008 – Community Care
Mencap’s latest survey has exposed widespread public
ignorance about learning disabilities. A poll of over
1,600 people found that 73% of people could not actually
name what a learning disability was when
asked to name up to three.
For full report click here
Legislation Update
40. No. 1147 (C.50)The Health Act 2006
(Commencement No. 4) Order 2008
25 April 2008 – OPSI
For full legislation click here
Mental Health
41. Mental Health Act 2007 (Commencement
No. 5 and Transitional Provisions) Order
2008 - guidance on transfers between places
of safety
24 April 2008 – DoH
Guidance covering legislation on places of safety for
people suffering from mental disorders and came
into force 30 April 2008. The guidance aims to help
NHS bodies and local social services authorities to
ensure that their staff are aware of the change.
For full report click here
42. Mental Health Foundation response to
Children’s Society report into mental health
24 April 2008
In response to the release by the Children’s Society
of the fifth report from The Good Childhood Inquiry,
which concentrates on children’s mental health, Dr
Andrew McCulloch, Chief Executive of the Mental
Health Foundation, said:
“It seems as if we are finally waking up to the devastating
impact modern life can have on the emotional
wellbeing of children. Clearly, there’s an urgent need
to listen to the voices of the young people and health
professionals in this report.
However, we need to move beyond hand-wringing
and speculation about what’s making our kids miserable
and take action to provide children and young
people with the support and services they
need. Young people do not choose what kind of society
they’re born into, but as a society we do have a
choice when deciding how much help we offer them.
There are signs that government has taken this on
board, but if we are serious about helping children
then the rest of us need to play our part, too, whether
it be as parents, health and social care professionals
or teachers.
Ultimately, children and young people represent the
future of this country and it’s in all our interests that
we give every troubled youngster the best chance to
overcome his or her problems so that they’re able to
go on and live their life to the full.”
43. Mental Health Foundation to fund innovation
in care home dementia services
24 April 2008
For full report see Older People—item 76
44. Flimsy evidence
April 2008 – Healthcare Business
Tony Thompson, Executive Director of Nursing &
Governance, Regency Lodge Independent Hospitals,
sets out his views on the conflicts and clashes between
separate parts of Government-sponsored policy
and his concern that there is a risk of mental
health services again being regarded as something of
the ‘poor relation’ in health care.
Miscellaneous
45. C. diff kills one patient every hour
27 April 2008 - The Mail on Sunday
In advance of the BBC TV Panorama programme
(reported in last week’s issue of BHCR) How safe is
your Hospital? Rates of infection are believed to be
between 16% and 35% higher than the official rate
due to a change in the way in which cases are
counted.
Ed. I would recommend that those responsible
for managing NHS Trusts consider the potential
liability of their organisation to a prosecution under
the Corporate Manslaughter and Corporate
Homicide Act 2007 – see this week’s article on
page 16.
46. UK C.Diff deaths 'rising sharply'
Panorama: How Safe is Your Hospital?
26 April 2008 – BBC News
For full report click here
47. False claims of doctor who ‘can reverse’
Alzheimer’s
27 April 2008 - The Mail on Sunday
It has been revealed that the doctor who claims to be
able to bring about rapid and dramatic improvements
in Alzheimer’s sufferers was disciplined last year for
making claims that the same medication used in the
latest trials could halt back pain.
48. Junior doctors attack NHS reforms
25 April 2008 – BBC News
Ram Moorthy, chairman of the British Medical Association’s
Junior Doctor Committee is to announce
that patient care could suffer as a result of planned
NHS reforms. He will state that his members are still
angry about changes to their training.
The Department of Health said it “greatly valued” the
role of doctors.
For full report click here
49. Drug errors 'communication link'
25 April 2008 – BBC News
Researchers have found that most “medication errors”
happens a result of poor communication. People
end up in hospital as a result and limited access
to patient’s medical notes is cited as a contributory
cause.
The study was published in Quality and Safety in
Healthcare by a team of researchers at the University
of Reading.
For full report click here
50. Recent Statistical Publications in Health
and Social Care - Updated
25 April 2008 – DoH
Statistics for October to December 2007 on mandatory
surveillance of MRSA bacteraemia and clostridium
difficile have been published at the link below.
For full report click here
51. CRB on TV
24 April 2008 – CRB
Vince Gaskell, Chief Executive of the CRB, appeared
on BBC One’s Watchdog programme on Monday 21
April to answer points about three specific cases and
about the general performance of the CRB.
For full report click here
52. Drop in MRSA infections 'stalls'
24 April 2008 – BBC News
The Health Protection Agency’s latest figures show
that recent drops in the number of new MRSA infections
has stalled. Cases in England rose by 0.6%
between October and December 2007 to a total of
1,087.
This could hinder the government target of halving
the number of cases by 2008.
For full report click here
53. Top doctors 'not ready for posts'
24 April 2008 – BBC News
The Royal College of Surgeons said that English doctors
are being allowed to apply for jobs as hospital
consultants before they are actually ready.
College president Bernard Ribeiro said the Postgraduate
Medical Education and Training Board had
been overruling his college's rejection of some candidates,
but the board insists its procedures are sound.
For full report click here
54. GP's surgery set for Boots store
24 April 2008 – BBC News
Dr Adolfo Gracia is set to move his surgery to a specially
built suite at Brighton’s biggest Boots store. His
practice and 2,000 registered patients will move in
mid-May and the new centre is believed to be one of
the first NHS surgeries in England to relocate to a
Boots pharmacy.
For full report click here
55. Fifth of GP surgeries 'at risk'
21 April 2008 – BBC News
The Conservative party is claiming that up to a fifth of
England’s GP surgeries are threatened with closure
under the Government’s plan for new “polyclinics”.
In a speech to the King's Fund, leader David Cameron
accused Labour of "trying to abolish the family
doctor". Heath Secretary Alan Johnson responded by
saying that Mr Cameron is "misleading the public"
and insisted that GP services will not be cut.
For full report click here
56. The Lancashire Social Care Partnership:
a new paradigm?
April 2008 – Healthcare Business
The CEO of Lancashire Care Association expresses
his views of how care providers and councils can collaborate
for the benefit of all, especially service users.
57. Health and Social Care Bill continues to
rumble on through Parliament
April 2008 – Healthcare Business
Chris Calland talks about the suggestions (threat) to
amend the Bill so as to extend the application of the
Human Rights Act to all publicly funded residents of
care homes.
Ed. Bizarre idea of the Government this; the Human
Rights Act is already in force in hospital settings
and council run care homes - however, it
didn’t protect people from the abuse exposed at
learning disability services provided by Primary
Care Trusts in Cornwall and Sutton and Merton.
Nor did it help the tragic deaths high lighted
by Mencap in its seminal report Death by Indifference
published over a year ago.
We have reports of older people starving to death
in NHS hospitals. I am sure that care staff do not
intend it, but tragically it happens. Extending the
application of the law will not prevent things going
wrong in care homes; it doesn’t prevent
things going wrong in hospitals so why does anyone
think it will in other care settings?
There is masses of legal ‘protection’ of and for
service users. We don’t need more.
What we need is to direct greater resources at
education and training. Everyone is valuable,
everyone deserves to be cherished, everyone
deserves to be nurtured.
More laws will not achieve that.
We live in an age where there is the ‘cult of
youth’. We need to remind ourselves of the value
of older people and their contribution to society.
Some of the greatest thinkers, musicians
and artists created their best work in later
life. Only in mathematics does that not seem to
be the case – if you haven’t cracked a world bamboozling
problem by 30, you probably wont do it
at all!
Sorry, I seem to have gone on a bit...
58. Opening a residential care home
April 2008 – Healthcare Business
Tom Welland of Fireco discusses some of the issues
to consider in terms of fire precautions for new
homes.
59. Caring about IT? IT for care homes –
why should you care?
April 2008 – Healthcare Business
Article by Barry Giddings, Chairman Alezara Associates
Ltd, providing some hints and tips on information
technology.
60. Why you can’t reach your goals
April 2008 – Healthcare Business
David Waters, MD of insurance broker CHIS, expresses
his thoughts on setting goals and taking
steps to achieve them.
61. The evidence, the whole evidence – concede
nothing except on full evidence
April 2008 – Healthcare Business
Paul Ridout warns care providers to test what is asserted
by regulators who sometimes act in defiance
of the law.
NHS
62. Nurses admit patient dignity is neglected
27 April 2008 - The Sunday Times
Patients ‘humiliated’ on NHS wards, say
nurses
27 April 2008 - The Mail on Sunday
Almost 66% of nurses report that, due to time pressures,
they are not able to provide dignified care for
patients. The ratio of patients to nurses is reported
as high as 16:1 – “verging on the dangerous”.
Lord Mancroft who spoke of sub-standard care when
he was treated from nurses when in an NHS hospital
(see BHCR Vol 3, Issue 9, item 83) says he has
been contact by others who say that they had similar
experiences.
63. Hospital superbug rise
25 April 2008 - The Times
After months of decline MRSA is responsible for an
increase in the numbers of those infected. Alan
Johnson, Health Secretary, has ordered an inspection
of infection control measures in hospitals.
Ed. NHS Trust managers must really get to grips
with the contents of the Corporate Manslaughter
and Corporate Homicide Act 2007 – see this
week’s article on page 16!
64. NHS IT too big for one boss: NHS needs
two at £200,000 each
24 April 2008 - The Times
Following the resignation of Richard Granger as Director
General of the NHS IT project after five years
in the post the NHS is inviting applications from people
for part of his former responsibilities. The project
is already two years behind schedule.
65. NHS seeks two highly paid bosses for
failing IT system
24 April 2008 – The Daily Telegraph
The NHS seems to be seeking to hire two information
technology chiefs on a combined salary of almost half
a million pounds.
66. NHS 'chaos' over surgical tools
24 April 2008 – BBC News
The Royal College of Surgeons have announced that
operating theatres are being thrown into chaos and
operations cancelled because of broken, missing or
dirty surgical instruments.
The statement came after the College said it had contacted
250 doctors with most reporting problems.
But the Government insisted that it was working with
trusts and private providers to resolve any issues.
For full report click here
67. Man fights for kidney cancer drug
23 April 2008 – BBC News
David Blackett, suffering from kidney cancer is calling
for an expense drug to be made available on the NHS
in Norfolk. He is currently using his retirement savings
to pay private for the drug Sutent after Norfolk Primary
Care Trust said the £27,000 a year treatment
was not cost effective.
For full report click here
68. Anger over arthritis drug refusal
23 April 2008 – BBC News
The National Institute for Health and Clinical Excellence
(NICE) has been criticised for not recommending
a new drug for severe rheumatoid arthritis for
NHS use. The body said that Abatacept did not represent
good value for money.
The National Rheumatoid Arthritis Society, whose
appeal was rejected, described the decision as "short
sighted and perverse" whilst drug maker Bristol-
Myers Squibb claimed 3,500 UK patients could have
benefited.
For full report click here
69. Dying patients given greater choice to
die at home at no extra cost to the NHS,
King’s Fund report concludes
23 April 2008 – King’s Fund
An independent King’s Fund evaluation has revealed
that significantly more people have been helped to
choose to die in their own homes at no greater cost
to the NHS as part of a Marie Curie-led pilot project.
For full report click here
70. Patient experience PSA scores update
including results from the 2006 patient surveys
22 April 2008 – DoH
A publication updating the patient experience scores
previously published on 29 January 2007.
The new results have been updated to include
scores derived from survey results published by the
Healthcare Commission for 2006/07.
For full report click here
71. Cardboard nurses tackle infection
21 April 2008 – BBC News
Two Nottinghamshire hospitals are using cardboard
“cut-out” nurses to prevent the spread of infections.
The life-size figures play an electronic message to
remind patients, visitors and staff to wash their hands
whenever people walk past them.
The cut-outs are being used at the King's Mill and
Newark hospitals.
For full report click here
72. National Health Service Act 2006: Pharmaceutical
Services (Fees for Applications)
Directions 2008
21 April 2008 – DoH
Documents explaining the directions for the National
Health Service Act 2006 that come into force on 21
April 2008.
For full report click here
Nursing
73. The iPad: A highly technological granny
flat for your digital old age
21 April 2008 – Daily Mail
Research commissioned by The Life Group has
come up with a vision that in 40 years time the elderly
will live in "virtual granny flats".
The group claims that by 2048, pensioners will be
able to live independently in their homes, and will use
video conferencing to watch and chat with family and
friends.
For full report go to http://www.dailymail.co.uk/pages/live/
articles/news/news.html?
in_article_id=561172&in_page_id=1770
Older People
74. Savings to be handled with care
26 April 2008 - The Times
A financial ‘MOT’ of the income and savings of a 95
yr old whose finances needed to be organised to enable
care home fees to be paid for.
75. Son solves his lonely father’s drink problem
with pub-visit job share
24 April 2008 - The Times
A retired doctor and a former army man have been
appointed by a son to accompany his father, Jack
Hammond, 88 to the pub. Mr Hammond recently
moved into a care home where there was only one
other male resident. The rate, £7 plus expenses.
For previous note on this item see BHCR Vol 3,
Issue 13 item 107.
76. Mental Health Foundation to fund innovation
in care home dementia services
24 April 2008
A new source of funding is available from today for
innovative projects that aim to improve the quality of
life of people with Alzheimer’s and other forms of dementia
in care homes. The Home Improvements programme
from the Mental Health Foundation is offering
grants of between £5000 and £25,000 for new
projects that can demonstrate a pioneering approach
to dementia care.
A third of people with dementia live in care homes,
where around two-thirds of residents – roughly a
quarter of a million people - are thought to have
some form of dementia. Despite this, many care
homes do not provide specialist dementia
care. There is a high level of concern throughout the
country that services for people with dementia are
not adequate and the government is currently developing
a national strategy for dementia.
Toby Williamson, Associate Head of Service Improvement
and Workforce Development for the Mental
Health Foundation, said:
“If we are going to get to grips with the challenge of
providing good dementia services then we need to
encourage innovation and service improvement
within the care home sector. The projects selected
for this funding will play an important part in developing
new ways of providing care that’s vital for the
hundreds of thousands of people affected by Alzheimer’s
and other forms of dementia.”
To find out more about the scheme and the application
process go to www.mentalhealth.org.uk or call
020 7803 1151. The closing date for applications is
4th July 2008. Projects that receive funding will be
expected to launch during the autumn. The grants
are to be funded by a substantial legacy left to the
Mental Health Foundation to undertake work in connection
with Alzheimer’s disease. Projects can run
for up to two years and will be supported and evaluated
by the Mental Health Foundation.
77. Elder Care Week will be 1 - 7 September
2008
22 April 2008 – NCF
The National Awareness week is to be 1 – 7 September
with local groups being encouraged to host
events for the media to report on.
For full report click here
78. Help the Aged welcome the statement on
care funding
22 April 2008 – NCF
Help the Aged has welcomed comments by David
Cameron on the future funding of social care in the
UK.
While he launched the Conservative Party's local
election campaign in Dewsbury, Yorkshire, David
Cameron said:
“I think what we can do is look at schemes like they
have in American states where you say to people
during their lives ‘look, if you put a bit aside to pay for
maybe the first year, or year and a half, or two years
of residential care, and if you do that the state will
guarantee that’s all you have to pay for ... It’s like a
partnership scheme. If we did that then we’d be able
to say to people if you do that you will not need to sell
your house to pay for residential care.”
“The present system of funding is not fit for purpose.
We need a long-term solution for long-term care.”
For full report click here
79. The iPad: A highly technological granny
flat for your digital old age
21 April 2008 – Daily Mail
Research commissioned by The Life Group has
come up with a vision that in 40 years time the elderly
will live in "virtual granny flats".
The group claims that by 2048, pensioners will be
able to live independently in their homes, and will use
video conferencing to watch and chat with family and
friends.
For full report go to http://www.dailymail.co.uk/pages/live/
articles/news/news.html?
in_article_id=561172&in_page_id=1770
Social Care
80. Behan asks directors to ethuse staff over
personalisation agenda
25 April 2008 – Community Care
David Behan, Director General for social care at the
Department of Health is calling for social workers to
enforce a positive commitment towards personalisation
of health care.
He said this would be crucial to prevent any backlash
against the radical changes planned over the next
three years.
For full report click here
81. Group outlines Wanless-style reform
23 April 2008 – Community Care
The NHS Confederation is suggesting that adult social
care be partly funded by social insurance. The
body said this would help to relieve long-term pressures
on the current system.
This means that everyone deemed eligible would receive
a state-funded minimum care entitlement which
they could top up, with the government meeting the
contributions of the least well-off.
For full report click here
Staff, employment and
disciplinary
Nothing to report
Volume 3 Issue 16
Negligent businesses face
huge fines
Times are tough for many.
There is the credit squeeze, increasing inflation, lack
of funds from commissioners and bankers
alike. Something has got to ‘give’.
However, when deciding whether and where to wield
the cost-cutting axe businesses, and in particular, the
directors and business owners will need to have in
mind a great many issues, some, of very recent origin.
I speak, of course, about the Corporate Manslaughter
and Corporate Homicide Act 2007 (Act) which
came into full force and effect on 6th April. Many care
businesses and their managers do not have any
awareness of this new Act or how it might affect
them.
The Act created the new offence of ‘Corporate Manslaughter’
(‘Corporate’ Homicide in Scotland) and the
legislative purpose is to make it simpler (easier) for
the State to secure the conviction of wrongdoers.
This Act is aimed not just at companies, as
many suppose, but also at unincorporated bodies,
Government Departments, local authorities, police
forces and so forth.
Under the law, as it stood before this new Act, in order
to secure a conviction against a company for
manslaughter the prosecution had to be able to demonstrate
that there was ‘gross negligence’ and that
the ‘controlling mind’ of the company had the necessary
knowledge/guilt.
Gross negligence
So, what is gross negligence? Well, negligence denotes
carelessness – a failure, in relation to someone
to whom a duty is owed, to exercise the standard of
care that a reasonable man would. Gross negligence
arises where there is a disregard for the life and
safety of others such as to amount to a crime.
Controlling mind
However, it was the controlling mind issue which was
the most significant challenge to prosecutors when
there was a desire to prosecute a corporate entity.
This was most keenly shown where there was a
disaster for which it was considered that a large company
or organisation was culpable.
Proving the controlling mind was less of a problem in
relation to small companies, such as the ‘one-manband’
where there have been successful prosecutions
for manslaughter, although not many. This is
because it is self evident where the controlling mind
is – its the man in the one-man-band. Perhaps the
most often cited example is the prosecution which
followed the Lyme Bay disaster of 1993 in which four
school children lost their lives when canoeing in the
open sea. Few people remember the activity centre
responsible, OLL which was prosecuted and convicted
of manslaughter. However, when one looks at
the more complex management structures in large
companies it was frequently impossible for prosecutors
to identify the ‘controlling mind’.
The issue has been side-stepped by the legislative
draftsmen. The focus, where there is a death is on
the way a company organises its activities and the
way it manages them. It will be a matter for the jury
whether the conduct of the organisation was such
that the conduct of the company was such that it fell
far below what, in all the circumstances, is to be expected.
Duty of care
To be convicted the accused must have conducted
itself and/or its affairs in such a way that it ‘amounts
to a gross breach of a relevant duty of care’.
What is this duty? There is a whole section in the Act
directed to this issue; essentially, the relevant duty
can arise from (amongst others):
• the relationship with employees, volunteers, contractors
and so on;
• occupying premises
• the supply of goods or services
• carrying on any activity on a commercial basis
One will readily appreciate that the duty is wide ranging
and will be capable of arising in all activities connected
with the operation of a care business.
Keith M Lewin
How might this Act affect care providers?
The Act is, as yet untested. However, one can envisage
a wide range of scenarios.
First, what about the 90 deaths caused by C. difficile
in the Maidstone and Tunbridge
Wells NHS Trust last year? We have all read press
reports recently that the former chief executive of the
Trust suing the Trust for the value of the unexpired
term of her employment contract. I venture to suggest
that if the circumstances arose now, today, that
there is reasonable prospect that the Trust would
have been prosecuted, charged with corporate manslaughter.
Similarly, there was the scandal of the
treatment of people with learning disabilities in an
NHS setting in Cornwall, again, I suspect that corporate
manslaughter charges would made against the
NHS Trust.
What about medication errors in care homes? If it
can be demonstrated that there are no systems for
the handling and administration of medication
(unlikely) and a death occurs as a result, a prosecution
of corporate manslaughter could be anticipated.
More likely, would be that the systems were
poorly adhered to and that there was poor or nonexistent
monitoring and ‘policing’ by senior management
of the business’s own policies and procedures.
Again, one can reasonably expect a prosecution
to follow.
This past six months there have been a number of
prosecutions of the NHS under the Health and Safety
at Work etc. Act 1974 for injuries and deaths occurring
to hospital patients who fell from windows at a
height where those windows were not fitted with window
opening restrictors or where the restrictors were
damaged and ineffective. There were a number of
fines of £20,000. In future, one can expect that
prosecutions in such circumstances will be for corporate
manslaughter.
A final though under this heading; pressure ulcers.
There is a view which has gained currency in
recent years that there are almost no circumstances
in which a person should develop pressure ulcers.
However, I know from my practice that people
do. Worse, many progress to grade three and become
so severely infected that the survival of the person
is compromised. Again, one can expect that corporate
manslaughter charges will follow if it can be
shown that there was a gross breach of duty by the
care provider.
Penalties
The penalties are as before, effectively unlimited
fines.
No individual can be convicted of corporate manslaughter
nor of aiding, abetting, counselling or procuring
the commission of the offence of corporate
manslaughter.
Legal expense insurance
I am generally in favour of laying off risk through insurance.
However, look at the cover you have under your policy
now – don’t wait until you think you need to make
a claim. I am prepared to bet all of you reading this
article believe that you have legal expense insurance
to cover a range of needs including prosecutions. I
expect 90% of you to discover that the policy will only
respond after charges have been laid against the
insured – i.e. a prosecution is actually underway.
This is short sighted on the part of the insurers.
Some of the most effective work we do as lawyers,
and this is the case in the overwhelming majority of
criminal defence work, is before a client is charged
with any offence. It is not uncommon in the appropriate
combination of circumstances to avoid charges
altogether. It seems insurers are unaware of this or
are simply not sufficiently concerned to aid the insured
to avoid the charge being laid.
Conclusion
Care providers of all types must become astute to
the fact that with this Act the tables are again being
tilted in favour of prosecutors. You need to be aware
that there is a possibility of such a prosecution following
the sudden and unexpected death of a service
user and consult with experienced lawyers as
soon as possible.
My plea to company directors is: don’t pursue every
last farthing of savings in overheads, don’t squeeze
until the pips squeak. Cutting corners will follow and
therein lies the trap.
To discuss anything arising from this article or
any of the matters touched upon contact Keith M
Lewin at keith.lewin@brunswicks.eu or telephone
him on 0870 766 8400