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BHCR 2008 Vol 3 Issue 34

(Click the icon to download)
© Brunswicks LLP 2008

This week's article

Editorial

It has happened. The Government has engages in

so much public relations spin that it seems to be

acknowledging that the public is distrusting of what it

is told by Government and Government departments.

How do I know?

Well, if you go to item 77 in this issue you will see

that there is a tender invitation to identify an

‘independent operator’ to provide a ‘seal of approval’

assuring the public that the information provided to

them when they are making choices about their

health and care is trustworthy.

What a terrible condemnation of all of our public

bodies that they are not seen as people we can trust.

Call me naive, but I really want the public to be able

to trust what government and government bodies,

including Quangos, tell them. That the information is

authoritative and completely trustworthy.

The fact that there is the tender process must mean

that the Government acknowledges that the level of

trust has been fatally undermined. However, it is the

taxpayer who will end up footing the bill for all of this.

Turning to an error of my own; I am indebted to Hugh

Davis who drew my attention to item 66 in last

week’s BHCR. It contains an error.

The approach adopted by Oxfordshire PCT was

taken not to recover a budget overspend of £23, but,

£23 million!

You will see that the Oxfordshire approach is now

more widely adopted as all GPs are now being asked

to review hospital referrals (see item XXX in this

issue) from which they can earn up to

a further £20,000.

Its an ill wind... as they say.

This week’s article—’The No Secrets consultation—facts and fictions’

In the week that Government announces a consultation on the review of the local authority guidance ‘No Secrets’

Gary Fitzgerald, Chief Executive of campaigning charity Action on Elder Abuse, in the first of several articles sets

out his view of the consultation now underway of the No Secrets document published eight years ago.

Mr Fitzgerald while welcoming a review has identified a number of flaws not only in the review process but in the

muddled thinking surrounding many of the issues challenging those engaged in vulnerable adult ‘protection’ work.

To read article click here.

Parliament

20.10.08 – HoL - Baroness Gardner of Parkes to

ask Her Majesty’s Government whether it will

introduce co-payments for specialist NHS drug

treatments; and under what circumstances copayment

is now permitted in the National Health

Service.

Next

Abuse

1. DH: Government still open-minded on

adult protection law

17 October 2008 – Community Care

Government still open-minded on adult protection

law

17 October 2008—Counsel and Care

Action on Elder Abuse together with Voice UK and

Mind will campaign for legislation to combat elder

abuse. Gary FitzGerald chief executive of Action on

Elder Abuse said the alliance - representing the older

people's, mental health and learning disability sectors

- would seek to shape the Department of

Health's review of the No Secrets guidance.

FitzGerald said the coalition would be based on the

Making Decisions Alliance, which was set up in 2002

and successfully campaigned for a legislative framework

to support decision-making by people who lack

mental capacity in the shape of the Mental Capacity

Act 2005.

For Community Care report click here

2. Charity warns that Government review

must go further, or risk leaving older people

with less legal protection than animals

16 Oct 2008

Action on Elder Abuse has welcomed the consultation

on the review of No Secrets as an important step

towards improving the protection of older people and

other adults at risk of abuse. However, it has expressed

concern that the consultation document

does not adequately address major failings of the

current system, and in particular the need for adequate

funding of adult protection work and a legislative

requirement on agencies to collaborate and take

appropriate action.

Gary FitzGerald, Chief Executive of Action on Elder

Abuse (AEA) said, “While the Department of Health

may have held numerous listening events in order to

prepare this document, they have obviously not been

hearing what has been said to them. It is crucial for

the protection of adults at risk of abuse that we have

robust systems in place, which are appropriately

funded, and which have the necessary legal powers

and duties to ensure genuine protection. It is crucial

that the Government integrates the safeguarding of

adults into their new policy of personalisation if they

are to avoid the abandonment of people in very vulnerable

circumstances. If Scotland can understand

these issues it is unacceptable that Westminster cannot

do so.

In recent years there have been numerous high profile

cases of extreme abuse, (including Margaret

Panting in Sheffield, Stephen Hoskin in Cornwall, the

Hounslow ‘duty of care’ case, and the failings in the

South Tyneside sheltered housing situation). They

receive either no reference or just a passing reference

in the consultation document, although they are

crucial to understanding why the systems established

under guidance are failing to adequately protect.

Continued FitzGerald, “This review is crucial to the

protection of adults at risk of the most horrendous

abuses. The Government cannot afford to get it

wrong, and must not use it to promote other policies,

such as personalisation. While the current system

involves many practitioners who are hard working

and dedicated to the protection of adults facing

abuse, they are hampered by a lack of clarity on local

governance, lack of powers to intervene, lack of funding,

and the failure of agencies to share information

and to work together. If both AEA and the Association

of Directors of Adult Social Services (ADASS)

have concluded that this situation needs a legislative

response, it is difficult to understand the Government’s

reticence. While they prevaricate on these

matters, the system continues to fail, and adults (like

Margaret Panting and Stephen Hoskin) continue to

suffer and in some cases die.”

AEA is calling on the Government to introduce legislation

for:

A statutory basis for the construction and work of

Adult Protection Committees (APCs).

A duty on agencies to collaborate, actively participate

at a senior level in APCs, and work together

A duty on agencies to share information.

The right to access the adult at risk, without hindrance

or coercion

Data to inform policy planning.

Adequate funding for adult protection work

Concluded FitzGerald, “The argument is not complex.

We know from child protection and domestic

violence experiences that legislation is needed to ensure

that protection works effectively. We even know

it from animal protection too. If the Government understood

the need, and found time last year, to introduce

the Animal Welfare Act, it is not unreasonable to

ask why they can’t do at least as much for adults experiencing

abuse. Like most people, I like kittens and

puppies. But are they really more important than our

old people?”

3. Elderly to get more protection from thieving

relatives

16 October 2008 - The Times

Pensioners receive less protection from

abuse than pets, campaigners warn

16 October 2008 - Telegraph

The Government is to update its guidance on how

older people can be protected now that increasing

numbers are managing their own care, rather than

local authorities doing it.

The charity Action on Elder Abuse has warned that

new legislation must be brought in to safeguard vulnerable

people and pointed out that pets are already

protected from abuse by law. The consultation asks

whether there should be a new law against illtreatment

of a vulnerable adult.

The charity believes two-thirds of abuse of the elderly

is perpetrated in their own homes by family,

friends of neighbors, and has dealt with 900 cases of

thefts from pensioners by people they know in the

past two years alone.

Gary FitzGerald, its chief executive, said: "The argument

is not complex. We know from child protection

and domestic violence experiences that legislation is

needed to ensure that protection works effectively.

We even know it from animal protection too.

"If the Government understood the need, and found

time last year, to introduce the Animal Welfare Act, it

is not unreasonable to ask why they can't do at least

as much for adults experiencing abuse. Like most

people, I like kittens and puppies. But are they really

more important than our old people?"

Phil Hope, the care services minister, said: "The No

Secrets guidance must be updated to make sure

everyone - individuals, police, care agencies, the

NHS and local authorities prevent abuse, and also

recognise it and stamp it out if it does occur.

"The consultation is particularly relevant as more

people gain control of their own care. I want to help

people maintain this control and independence, free

from fear of abuse. I look forward to hearing people's

views and will not hesitate to take tough action to improve

safeguarding for those in vulnerable situations."

4. Review of vulnerable adult care

16 October 2008 - BBC News

The government is launching a major review of the

protection given to the elderly and other vulnerable

adults.

Charity Action on Elder Abuse says current care guidance

is often ignored, leading to "atrocious" cases of

physical, mental and financial abuse. AEA says financial

exploitation in particular is a growing problem.

It says that in the last two years it has dealt with almost

900 cases of money or assets - including 178

houses - being stolen from older people by members

of their own family.

The thefts amounted to a total of £41.5m.

The AEA is also demanding legalisation to allow the

creation and funding of adult protection committees

across Britain.

The charity cites a number of examples of abuse,

including the case of Stephen Hoskin, a man with

severe learning difficulties who died while under the

care of Cornwall social services in 2006. He was

tortured and murdered after being "befriended" by a

gang and a review later concluded that agencies involved

in his care had missed 40 warnings and

chances for intervention.

For full report click here

5. Government consults on safeguarding vulnerable

adults

16 Oct 2008

Care Services Minister Phil Hope launched a consultation

on how to improve safeguarding policy - the

protection of vulnerable adults - and address abuse in

all its forms in the care system.

The 'No Secrets' guidance for local authorities, the

police and the NHS to work together to protect adults

is already in place. The Government now wants to

make sure it keeps up with changes in the social care

system, with the new emphasis on choice and control

and changing forms of abuse.

Key issues on which Government is seeking views

are:

* Whether there is now a need for legislation,

* The feasibility of a national database of recommendations

from serious case reviews where abuse has

occurred

* What new measures are needed in the face of increased

'personalisation' of care with more people

now being in charge of their own care instead of local

authorities

* What new measures are needed in the face of

changing forms of abuse, such as financial abuse

Phil Hope said:

"I am determined to improve safeguarding of vulnerable

people. We need a greater focus on prevention,

a greater emphasis on safeguarding in commissioning

services and support, and greater empowerment

of people to determine how they wish to be safeguarded.

The No Secrets guidance must be updated

to make sure everyone - individuals, police, care

agencies, the NHS and local authorities prevent

abuse, and also recognise it and stamp it out if it

does occur.

"The consultation is particularly relevant as more

people gain control of their own care. I want to help

people maintain this control and independence, free

from fear of abuse. I look forward to hearing people's

views and will not hesitate to take tough action to

improve safeguarding for those in vulnerable situations."

The consultation on the review of No Secrets will run

from 14th October to 31st January 2009.

The consultation can be found on the Department of

Health website at http://www.dh.gov.uk/en/

S o c i a l C a r e / S o c i a l c a r e r e f o r m /

Safeguardinganddealingwithabuse/index.htm

Business News

6. The Sunday Times Britain’s 250 biggest

mid-market private companies

19 October 2008 - The Sunday Times

10 McCarthy & Stone—Retirement home builder

14 Healthcare at home—Healthcare provider

16 Spire Healthcare—Private hospital operator

38 Four Seasons Health Care—Social care provider

48 Barchester Healthcare - Care home operator

84 Waymade Healthcare - Pharmaceuticals

94 The Mawdsley Group - Pharmaceuticals

149 Priory Group—Specialist healthcare provider

7. Four Seasons Healthcare Doesn't Expect

to Be Put Up for Sale

19 October 2008 - Bloomberg

Four Seasons Healthcare Ltd., the U.K. care home

operator that defaulted on £1.2 billion of loans last

month, does not expect to be sold by the Qatar Investment

Authority as talks with creditors continue

according to spokesman Robert Mitchell. The Sunday

Times reported today that the Qatari fund may

put Four Seasons up for sale in the coming weeks

after the company failed to agree a debt restructuring

deal.

Four Seasons may attract offers of £800m or less

from bidders including private equity companies

Blackstone Group LP, KKR & Co. LP and Apax Partners

LLP, the newspaper reported, without saying

where it obtained the information.

8. CareTech Holdings PLC

15 October 2008

CareTech (AIM: CTH) a provider of residential and

supported living services for people with learning disabilities

issues the following trading update.

Trading for the year is in line with expectations

and reflects continuing progress from both organic

development and acquisition growth.

Enhanced bank facilities in April, together with the

equity fundraising which was concluded in July

have strengthened the balance sheet and provide

additional capacity for further growth.

During the year, CareTech increased its capacity by a

further 279 beds and now supports over 1,300 clients,

by way of residential and supported living services.

Of this capacity growth, 97 (35%) is attributable to

o r g a n i c d e v e l o p m e n t a n d 1 8 2

beds (65%) arising from the acquisitions of Beacon

Care and Valeo Limited. Both acquisitions are integrating

well and performing ahead of expectations.

Occupancy in established services continues

to run at 94% in line with previous years.

The pipeline of organic development and acquisition

opportunities remains strong and CareTech continues

to actively evaluate those that the Directors believe to

be capable of enhancing shareholder value.

The Board remains confident of the Group's prospects

in its specialist social care niche and looks forward

to reporting further progress.

The Board also announced the following appointments:-

Christa Echtle as a Non-Executive Director

w i t h immediate ef f e c t. Chri s ta, a

trained psychotherapist, has considerable experience

of working with high growth companies. She

was previously the Chief Executive of Reed

Health Group plc.

15 October 2008

the Chief Executive of Reed Health Group plc.

After six years as Finance Director, David Spink will

be retiring in December. Prior to his departure,

David will oversee the completion of the 2008

Report and Accounts, and is ensuring that a smooth

transition is made to his successor, David Pugh.

David Pugh trained with KPMG and has spent 14

years in senior financial posts, most recently as

Group Financial Controller at Carillion PLC. David

joined CareTech during the summer and has worked

closely with the Finance Director and the regional

management teams in preparing the business plan

for the forthcoming year. David Pugh will be appointed

to the Board of CareTech at the same time

that David Spink retires in December. A further announcement

will be made in due course.

The Board of CareTech is pleased to announce

that Christa Iris Echtle, has been appointed to the

Board of the Company as a Non-Executive Director

with immediate effect.

Care Homes

9. Joint operation identifies dangerous gas

appliances

17 October 2008

A joint initiative between the Health and Safety Executive

and Gateshead Council resulted in two care

homes being told to take action over potential dangerous

boilers.

A team of officers from HSE and the council visited a

number of privately rented properties in the Bensham

and Chopwell areas of Gateshead recently. A selection

of residential and nursing care homes were also

visited.

In one residential care home the team discovered a

potentially dangerous back boiler with insufficient

ventilation and a dangerous flue. The boiler was condemned

and its use prohibited. The owner of the

home had to make temporary arrangements to provide

hot water and heating for the residents before

replacing the outdated boiler with a brand new combination

boiler.

In addition a nursing care home was running large

commercial boilers which had been identified as being

"at risk" at the annual safety check. The burners

were damaged and needed to be replaced but the

home had continued to run the boilers for two

months. After the intervention by HSE and the council,

the boilers were replaced.

HSE Inspector, Fiona MacNeill, said: "During our visits

we found that the residential and nursing care

homes all had annual safety checks done on their

gas appliances but they had not always acted upon

the defects identified. The competence of those carrying

out the gas safety checks was also an issue. In

one case a registered engineer who was only qualified

to work on small domestic appliances had

worked on large commercial boilers.

"The visits to private properties found that the majority

of landlords were complying with their duties to

ensure that an annual safety check was being done

on gas appliances by a registered installer. However

landlords did not always act on the information in the

CP12 gas safety certificate.

"Our message to landlords and care home owners is

to heed the warning - don't just file the gas safety certificate

away. Look at it and take immediate action on

the areas requiring attention."

Key Messages for Care Homes

* Ensure that gas appliances and flues are maintained

and serviced yearly

* Have all installation, servicing, maintenance and

safety checks carried out by a registered engineer

* If you have a commercial sized installation

(above 70kW) the engineer carrying out the work

must be competent to work on 'non domestic' installations.

* Ensure that your contract with the service supplier

reflects the need for engineers competent in

commercial size installations

* Ask your home managers to check the engineer's

registration card to ensure that he or she

has the required competency

10. Online radio exclusively for care homes

to be launched

16 October 2008 – NCF

Bettercaring.com is launching England’s first online

radio network on 21 October 2008 which is specially

for care homes.

The 24-hour radio show will be transmitting music,

dedications, games and lifestyle features to Britain’s

care home residents in what is being dubbed “a revolution

in entertainment for care home residents.”

For full report click here

11. Care home residents to get more help

switching to digital

14 October 2008 – NCF

Culture Secretary, Andy Burnham, has announced

that all care home residents will get help with the

switch to digital TV following changes to the Switchover

Help Scheme.

For full report click here

Case Reports

Law Reports

12. R.K. and A.K. v United Kingdom

Parents won compensation for the taking into care of

their baby after a medical misdiagnosis that they

were abusing the child. She was later found to have

brittle bones.

Disciplinary cases

Nothing to report

Cases in the news

13. Staff question over dead care man

15 October 2008 – BBC News

A court has heard that a care home resident who

showed signs of rigor mortis when he was discovered

dead should not have been looked after by agency

staff.

Only permanent staff were supposed to be monitoring

52-year-old dementia sufferer Alan Sayers one-to-one

at the care home in Newbridge, south Wales. Four

carers, two managers and a nurse on duty on the night

of his death are denying the wilful neglect of a patient.

For full report click here

14. Trust fined over scalding death

15 October 2008 – BBC News

Servol Community Trust was fined £10,000 and ordered

to pay an additional £10,000 in costs following

the death of George Inwood, 68, who had Parkinson's

disease who was scalded in a bath.

For full report click here

15. Cumbrian care staff sign up for health

and safety advice

14 Oct 2008

More than 100 care home staff in north Cumbria have

signed up to an event that will bring them up to speed

on the latest health and safety legislation.

The Health and Safety Executive (HSE) is working

with Copeland Borough Council to provide a training

seminar for carers, which will explain exactly how

they can meet all their legal obligations and avoid

potential accidents.

The Care Homes Event in Whitehaven is being

funded by the HSE and run by local authority inspectors.

Those attending can expect to get information

on subjects including lift law, Legionella control, slips

and trips, catering safety and dermatitis.

All delegates will receive a CD-ROM containing each

of the presentations and support materials so they

can produce their own tailored health and safety

package.

Bernice Charnock, the HSE's External Relation's Coordinator,

said: "Over the last year there have been

almost one and a half million working days lost to

work-related illness and injury in care homes across

the UK.

"The overwhelming response from care home operators

in the Copeland area shows that staff and managers

are keen to get their health and safety obligations

right. So many have been interested in the

seminar that we've put on an extra event to accommodate

them, but we're all too happy to support this

worthwhile exercise."

The first full day seminar takes place at 9.30am on

Tuesday October 21 at Cumbria Sports Academy,

Overend Road, Hensingham, Whitehaven. The second

event, organised to meet huge demand, will take

place a week later on October 28.

For further Information: Jason Teasdale, Regional

Information Officer, Tel: 0161 952 4460.

Public enquiries: call HSE's InfoLine, Tel: 0845

3450 055.

16. Care home is cleared of negligence over

death

13 October 2008 – BBC News

A care home has been cleared of negligence over the

death of one its residents from blood poisoning.

A criminal investigation was launched into Victoria

House, in Darlington, after a 75-year-old man died of

septicaemia.

For full report go to http://www.thenorthernecho.co.uk/

news/3748732.Care_home_is_cleared_of_negligence_over_de

ath/

17. Care home boss faces assault charges

against residents

13 October 2008 – BBC News

Ronald Thomas, 80, has told a court how he was

dragged across the floor by the home's owner after

he asked for a fire to be turned on.

He told North Avon magistrates that the incident happened

at Overnhill House nursing home in Downend

before it was closed by the Commissioner of Social

Care Inspection in January this year.

For full report go to http://www.thisisbristol.co.uk/news/Carehome-

boss-faces-assault-charges-residents/article-392134-

detail/article.html

Children

18. Young people from Bristol hospitals have

field trip to Glastonbury

15 Oct 2008

Twelve Bristol teenagers, who have spent much of

their young lives in hospital, have exchanged their

ward classroom for the great outdoors. An excursion

to Glastonbury has allowed many of them to experience

a field trip for the first time.

For three days and two nights, young people

aged between 13 and 16, undertook experiences

which many 'well' young people, take for granted,

including night trekking and cave exploration.

The adventure allowed each one of them to

push their own boundaries and take part in opportunities

not usually available to them.

Conferences & Courses

To follow next week

Consultations

19. Responsible officers and their duties relating

to the medical profession - consultation

document

Closing Date: 24 October 2008

The White Paper 'Trust, Assurance and Safety' set

out an ambitious programme for the reform of professional

regulation including the creation of responsible

officers, who will be senior doctors with personal responsibility

for evaluating the conduct and performance

of doctors and making recommendations on

their fitness to practice as part of revalidation.

For full consultation click here

20. Changes to Arrangements for Regulating

NHS Bodies in Relation to Healthcareassociated

Infections for 2009-10: A consultation

for the NHS

Closing Date: 20 October 2008

A consultation seeking views on proposals for regulations

on the registration requirement for healthcareassociated

infections, a revised code of practice for

the prevention and control of healthcare-associated

infections and enforcement policies.

For full consultation click here

21. Public consultation on NHS plans

Closing Date: 31 October 2008

A public consultation outlining proposed improvements

for the next five years by Leicestershire NHS

Partnership Trust.

The plan is to change the partnership trust into a

foundation trust, which would be accountable to local

people and involve them in decision-making.

For full consultation click here

22. Consultation on Legislating for Sure Start

Children's Centres

Closing Date: 6 November 2008

This consultation is seeking views on proposals to

give Sure Start Children's Centres a specific statutory

legal basis, as part of the forthcoming Education and

Skills Bill.

For full consultation click here

23. Consultation on direct payments regulations

Closing Date: 11 November 2008

Direct payments are crucial to achieving the Government's

aim to increase independence, choice and

control for service users and their carers. The Health

and Social Care Act 2008 extends the availability of

direct payments to those people who lack the capacity

to consent. In addition, Government is reviewing

the current exclusions from receiving direct payments.

Government is now consulting on regulations relating

to these two changes.

For full consultation click here

24. Have you booked your place at our next

forum event?

15 October 2008 – SCRC

The Scottish Care Commission still has places left at

their next consultation event which is taking place on

Thursday 27 November in Stornoway at the Cabarfeidh

Hotel.

For full report click here

25. Consultation on a Regime for Unsustainable

NHS Providers

Closing Date: 3 December 2008

Following publication of 'Developing an NHS Performance

Regime' in 06.08, the DoH has announced

proposals detailing the steps that would be taken if

an organisation failed, either for clinical or organisational

reasons.

The regime aims to:

* underpin the NHS performance regime;

* ensure the public receive high-quality services by

supporting quality regulation;

* reinforce the NHS Foundation Trust regime; and

* protect patients and staff from failing services.

The 'Consultation on a Regime for Unsustainable

NHS Providers' picks up at the point where an organisation

has failed to turn its performance

around. The regime is the last step for providers

who are subject to previous recovery actions by

Monitor or the NHS performance regime. It proposes

that a 'Trust Special Administrator' would be appointed

to take control of the Trust to ensure that it

continues to provide safe and effective services for

patients. They would also be required to produce a

report and consult swiftly on proposals for the future

of the trust.

For full consultation click here

26. Consultation on the European Commission's

proposals for a Directive on the application

of patients' rights in cross-border

healthcare

Closing Date 3 December 2008

On 2 July 2008 the European Commission published

a draft Directive on the application of patients’ rights

in cross-border healthcare. This draft Directive is

looking to clarify and codify existing European Court

of Justice case law on when a patients can exercise

their freedom to obtain health services to which they

are entitled to in the UK, in another European Union

Member State.

For full consultation click here

27. Consultation on public, patients', and

other interested parties' views on additional

uses of patient data

Closing Date: 12 December 2008

NHS Connecting for Health is gathering people’s

views to help it make important decisions about the

ways the NHS can use information it collects about

patients.

Patient data is mainly used to provide care and treatment

but can also have additional uses such as research,

auditing the quality and safety of care, management

planning, etc. This consultation is focusing

on additional uses.

For full report click here

28. Consultation on Minimum Frequency of

Inspection for certain Care Services provided

by The Care Commission

Closing Date: 31 December 2008

The Scottish Government wants responses to a consultation

on proposals to Reduce the Minimum Frequency

of Inspections of Certain Care Services by

the Care Commission from 1 April 2009.

For full consultation click here

29. Consultation on a National Framework

For Assessing Children and young people's

Continuing care

Closing Date: 31 December 2008

A consultation on proposals for a National Framework

for assessing children and young people’s continuing

care. The Framework intendeds to assist Primary

Care Trusts to apply a consistent and transparent

approach to assessing the healthcare needs of children

and young people and to work jointly with local

authorities to provide services in the light of those

needs.

For full consultation click here

30. Government consults on safeguarding

vulnerable adults

Closing date: 31 January 2009

Care Services Minister Phil Hope launched a consultation

on how to improve safeguarding policy - the

protection of vulnerable adults - and address abuse in

all its forms in the care system.

The 'No Secrets' guidance for local authorities, the

police and the NHS to work together to protect adults

is already in place. The Government now wants to

make sure it keeps up with changes in the social care

system, with the new emphasis on choice and control

and changing forms of abuse.

Key issues on which Government is seeking views

are:

* Whether there is now a need for legislation,

* The feasibility of a national database of recommendations

from serious case reviews where abuse has

occurred

* What new measures are needed in the face of increased

'personalisation' of care with more people

now being in charge of their own care instead of local

authorities

* What new measures are needed in the face of

changing forms of abuse, such as financial abuse

30. Government consults on safeguarding

vulnerable adults (continued…)

Phil Hope said:

"I am determined to improve safeguarding of vulnerable

people. We need a greater focus on prevention,

a greater emphasis on safeguarding in commissioning

services and support, and greater empowerment

of people to determine how they wish to be safeguarded.

The No Secrets guidance must be updated

to make sure everyone - individuals, police, care

agencies, the NHS and local authorities prevent

abuse, and also recognise it and stamp it out if it

does occur.

"The consultation is particularly relevant as more

people gain control of their own care. I want to help

people maintain this control and independence, free

from fear of abuse. I look forward to hearing people's

views and will not hesitate to take tough action to

improve safeguarding for those in vulnerable situations."

The consultation on the review of No Secrets will run

from 14th October to 31st January 2009.

Notes to Editors.

The consultation can be found on the Department of

Health website at http://www.dh.gov.uk/en/

S o c i a l C a r e / S o c i a l c a r e r e f o r m /

Safeguardinganddealingwithabuse/index.htm

31. NICE: Current consultations

To browse through consultations go to http://

www.nice.org.uk/page.aspx?o=consultations.current

CSCI/Care Quality Commission

(w.e.f. 2009), CSSIW,

Healthcare Commission &

Scottish Care Commission

32. Commission for Social Care Inspection:

Council self-assessment survey report 2008

17 October 2008 – CSCI

This report contains the commission's feedback to

councils about overall trends in performance and delivery

based on councils’ self-assessment statements

for 2007-08. It makes comparisons with previous

years and with councils’ plans for 2008-09 as appropriate.

For full report click here

33. Healthcare Commission: Annual health

check 2007-08

16 October 2008 – Healthcare Commission

A report by the Healthcare Commission showing

every NHS trust in England’s rating. This consists of

two parts: a score for quality of services and a score

for use of financial resources.

For full report go to

http://2008ratings.healthcarecommission.org.uk/

informationabouthealthcareservices/overallperformance/

thebiggerpicture.cfm

34. View the webcast of the annual health

check 2007/08 press conference

16 October 2008 – Healthcare Commission

Link to the webcast of the Healthcare Commission’s

annual health check for 2007/2008 press conference.

For full report go to http://www.healthcarecommission.org.uk/

newsandevents/newsstories.cfm?

cit_id=1433&FAArea1=customWidgets.content_view_1&useca

che=false

35. Johnson and Kennedy send message of

congratulations to staff at 57 trusts across

the country

16 October 2008 – Healthcare Commission

Health Secretary, Alan Johnson and Healthcare Commission

Chairman, Sir Ian Kennedy today posted letters

publicly congratulating staff at 57 of the best NHS

trusts in the country.

For full report go to http://www.healthcarecommission.org.uk/

newsandevents/newsstories.cfm?

cit_id=1424&FAArea1=customWidgets.content_view_1&useca

che=false

36. Have you booked your place at our next

forum event?

15 October 2008 – SCRC

The Scottish Care Commission still has places left at

their next consultation event which is taking place on

Thursday 27 November in Stornoway at the Cabarfeidh

Hotel.

For full report click here

37. The King's Fund response to the Healthcare

Commission's health check

16 October 2008 – King’s Fund

The King's Fund's chief executive Niall Dickson has

commented in response to the Healthcare Commission's

annual health check:

“The health service has made significant improvements

which are undoubtedly due in part to the large

increases in funding that have been ploughed into the

system in recent years. The extra cash has been

used wisely and the NHS is showing better financial

management and delivering higher quality care

across the board. But too many trusts remain simply

adequate - all patients deserve to have the highest

standards of health care and many trusts are falling

short.”

37. The King's Fund response to the Healthcare

Commission's health check

(continued…)

“Today’s report shows major achievements in reducing

waiting times and faster cancer treatment for patients

– these are to be applauded. However, the

lack of significant progress on infection control is

very disappointing and widening the use of spot

checks to primary care, ambulance and mental

health trusts is necessary. PCTs in particular still

have significant challenges to meet – patients in a

third of trusts are not getting the access to GPs that

they deserve, and this report once again highlights

that patient choice is not universally available.”

For full report click here

Dementia

38. Button to help dementia residents

17 October 2008 – BBC News

Carers at centres across Nottingham are benefiting

from a new gadget which prevents distress over lost

clothes.

They can put an electronic button into residents'

clothes which contain people's names and room

numbers, saving distress for people with dementia,

and helps retain their dignity.

The 11mm (0.4in) button can be scanned to reveal

who the clothes belong to.

For full report click here

Ed. What a good idea. Issues relating to clothing

frequently 'haunt' care homes, particularly those

caring for those with dementia. This sounds like

it might offer a solution - if it is priced competitively,

it should do well for those marketing the

product.

Ireland, Scotland & Wales

Ireland

39. Inquiry into C. Diff bug outbreak

14 October 2008 – BBC News

The Northern Health Trust will be setting up a public

inquiry to examine the recent outbreak of C. Diff. From

July 2007 to August 2008, more than 60 deaths were

linked to the bug.

For full report click here

Scotland

40. 'Tough targets' on hospital bugs

18 October 2008 – BBC News

Scottish Health Secretary, Nicola Sturgeon has given

health boards across Scotland tougher targets to

tackle the C.diff bug.

She told the SNP conference in Perth that NHS

boards must reduce the rate of the infection in hospitals

by at least 30% by 2011 and that NHS bosses

would be told they are to be barred from putting

cleaning services out to contract.

For full report click here

41. Unused drugs costing NHS millions

16 October 2008 – BBC News

Dr James Douglas is calling for a recycling scheme to

stop hundreds of millions of pounds worth of unused

drugs going to waste. According to the NHS, as

much as £1 worth of every £20 spent on prescription

drugs is never used by patients.

For full report click here

42. NHS Scotland in probe over phones

16 October 2008 – BBC News

The European Commission is investigating the NHS in

Scotland for breaking European competition laws after a

£30m contract for a new telephone network was

awarded to BT.

Work on the new system may come to a halt although

one health board will switch to the new network shortly.

For full report click here

43. Matron role returns to fight MRSA

14 October 2008 – BBC News

Health secretary Nicola Sturgeon has announced that

senior charge nurses will assume the duties that matrons

used to have as part of the Scottish Government’s

drive to reduce hospital infections.

Nicola Sturgeon said that the move would make sure

that staff, patients and visitors followed hygiene rules

and all nurses should have assumed their new duties

by 2010.

For full report click here

44. Plan To Let Patients Have Treatment

Abroad And Reclaim Cost

14 October 2008 – The Herald

A consultation has been launched to seek views on new

rights for Scottish patients to seek treatment abroad and

claim the cost from the NHS.

For full report go to http://www.theherald.co.uk/

display.var.2460187.0.0.php?utag=28804

45. Mental health plans are approved

13 October 2008 – BBC News

NHS Dumfries and Galloway has approved plans to

develop a £27m state-of-the-art mental health facility

in the area.

The £ building will be situated on land to the east of

the former Crichton Royal hospital and will act as a

replacement for four mental health centres in Dumfries

that have been deemed unfit for purpose.

For full report click here

Wales

46. Failings 'letting down children'

16 October 2008 – BBC News

Keith Towler, the children’s commissioner for Wales

has announced in his first annual review that policies

aimed at helping children and young people are failing

to make a real difference to their lives.

For full report click here

47. New NHS target 'may lead to cuts'

16 October 2008 – BBC News

Finance experts reckon that key Welsh NHS waiting list

targets for next year can not be met without service

cuts. The proposed 3.1% Welsh budget increase may

not be enough to help meet the 26-week treatment

deadline.

For full report click here

Learning Disabilities

48. Oska bright film festival open for entries

20 Oct 08 Learning Disabilities News Bulletin

The 4th national festival of short films made by and

for people with learning disabilities invites submissions

for the 2009 festival.

More information at:

http://www.learningdisabilities.org.uk/information/news/?

EntryId17=31375

49. Minister quizzed on care report

15 October 2008 – BBC News

Richard Benyon, Berkshire MP questioned the public

health minister about a report on the treatment of people

with learning difficulties in the NHS.

The independent inquiry into the deaths of six patients -

including Emma Kemp, from Berkshire - called for

tougher inspections and more staff training but the July

report stated that new laws to ensure equal access

were not needed.

For full report click here

Legislation Update

50. No. 2563 The Inspectors of Education,

Children’s Services and Skills (No. 4) Order

2008

16 October 2008 – OPSI

For full legislation click here

51. No. 2705 (L.17) The Mental Health Review

Tribunal for Wales Rules 2008

16 October 2008 – OPSI

For full legislation click here

HEALTH CARE AND ASSOCIATED PROFESSIONS

52. The Medical Profession (Miscellaneous

Amendments) Order 2008

16 October 2008 – OPSI

For full legislation click here

CHILDREN AND YOUNG PERSONS, ENGLAND

AND WALES

53. The Safeguarding Vulnerable Groups Act

2006 (Prescribed Criteria) (Foreign Offences)

Order 2008

15 October 2008 – OPSI

For full legislation click here

54. The Safeguarding Vulnerable Groups Act

2006 (Transitory Provisions) Order 2008

15 October 2008 – OPSI

For full legislation click here

PROTECTION OF VULNERABLE ADULTS, ENGLAND

AND WALES

55. The Safeguarding Vulnerable Groups Act

2006 (Prescribed Criteria) (Foreign Offences)

Order 2008

15 October 2008 – OPSI

For draft legislation click here

56. The Safeguarding Vulnerable Groups Act

2006 (Transitory Provisions) Order 2008

15 October 2008 – OPSI

For draft legislation click here

Mental Capacity

Nothing to report

Mental Health

57. Mental Health Foundation responds to

Healthcare Commission’s findings

17 October 2008

In response to improvements in the performance of

Mental Health Trusts found by the Healthcare Commission,

Dr Andrew McCulloch, Chief Executive of

the Mental Health Foundation, said:

“These improvements seem like a real step in the

right direction, and as a testament to the hard work of

NHS staff and managers they should be welcomed.

However, we shouldn’t forget that too many people in

touch with services still aren’t getting the support

they need. In particular, we need to make sure inpatient

services provide a genuinely therapeutic environment,

not just a place of refuge during a crisis,

and that everyone has a proper care plan when they

leave hospital.

It’s also worth noting that most people with a mental

health problem aren’t in touch with mental health services

at all, which suggests we should start assessing

trusts on how they are meeting actual community

needs, rather than just on the quality of the services

that they do provide.”

58. Mental Health Act 2007: Guidance on the

extension of victims' rights under the Domestic

Violence, Crime and Victims Act 2004

17 October 2008 – DoH

Document explaining new duties on hospital managers,

responsible clinicians, approved mental health

professionals and NHS bodies who fund treatment of

domestic violence victims in the independent sector.

For full report click here

59. Mental Health Act 2007: guidance on the

extension of victims' rights under the Domestic

Violence, Crime and Victims Act 2004

17 October 2008 – DoH

Because of the Mental Health Act 2007, from 3 November

2008, victims’ rights under the Domestic Violence

Crime and Victims Act 2004 will be extended to

victims of offenders who are detained, or on supervised

community treatment, as unrestricted patients

under Part 3 of the Mental Health Act 1983. This

means that new duties will be imposed on hospital

managers, responsible clinicians, approved mental

health professionals and on NHS bodies who fund

treatment of such patients in the independent sector.

For full report click here

60. NHS Confederation Mental Health Network

calls for tougher standards

16 October 2008 – Community Care

The Healthcare Commission’s annual NHS health

check has found a huge improvement in the performance

of England’s mental health services.

In a review of all 391 NHS trusts in England, the commission

rated 66% of mental health trusts as providing

an “excellent” service. This is compared with

52% in last year’s report.

In all, 84% were rated as either “excellent” or “good”.

Just 8% were rated as either “fair” or “weak” compared

to 23% last year.

For full report click here

61. Mental Health Act 1983 information leaflets

15 October 2008 – DoH

The Department has now updated its model Mental

Health Act 1983 patient information leaflets to reflect

changes to be made by the Mental Health Act 2007

from 3 November 2008.

The leaflets will assist hospitals and local social services

authorities (LSSAs) to meet their legal obligations

under the Act to provide written information to

patients subject to detention and other compulsory

measures under the Act.

However, these leaflets are non-statutory and there is

no obligation on hospitals or LSSAs to use them.

For full report click here

Miscellaneous

62. Why Daniel chose to die

19 October 2008 - The Sunday Times

...But Matt chose to live

19 October 2008 - The Sunday Times

Paralysed in a scrum, rugby player chose assisted

death at age of 23

18 October 2008 - The Times

It’s not a bad life...it’s a different life, says

former England under 21

18 October 2008 - The Times

So terrible I find it hard to contemplate

18 October 2008 - The Times

What right does any human have to tell another

they must live with terror, discomfort

and indignity?

18 October 2008 - Daily Mail

Series of items across all of the press about Dan

James a 23yr old who went to Switzerland to the Dignitas

Clinic to end his life. Two adults a male and

female are helping police with their enquiries – they

are thought to be Mr James’ parents.

Ed. Assisting suicide is a crime in the UK punishable

with up to 14 yrs in prison. Concerned about

its image Switzerland is expected to hold a referendum

on assisting foreigners to die.

63. Care Services Minister on tour in Bristol

on 20.10.08

People in Bristol had the opportunity to shape Government

policy and tell the Care Services Minister

Phil Hope what they think about the future of the care

and support system in England.

The visit to Bristol is part of a national tour, launched

by the Prime Minister in May, to debate the future of

the care and support system. It's a chance for stakeholders,

including local councillors, representatives

from local authorities, the NHS and third sector to

have their say on how best to develop a system for

care and support that meets the needs of society

well into the future.

National Dignity Ambassador, Sir Michael Parkinson,

has been working to help raise the profile of this important

agenda.

Phil Hope will visit Bristol Royal Infirmary, which has

recently made several improvements in order to better

maintain patients' dignity and respect. The mortuary

recently received a £12,000 refurbishment to preserve

the dignity of relatives and to create a more

pleasant viewing room. In the Emergency Department

double curtains were installed to give patients

greater privacy, and new notices have been put up to

make sure patients' wishes on privacy and dignity

are respected.

64. General Medical Council (Constitution)

Order 2008: Constitution report - October

2008 - Response to consultation

This is a summary of responses to a consultation on a

proposed constitution for the General Medical Council.

For full report click here

65. GP salary surge goes into reverse

15 October 2008 – BBC News

GP earnings drop slightly

15 October 2008 - Health Service Journal

Average GP earnings before tax fell by 2.1% between

2005-06 and 2006-07 to £107,667, a report

from the NHS Information Centre has found.

Although gross GP income increased by 1% to

£247,362 in that period, GP tax returns showed a

3.5% increase in claimed expenses.

For BBC report click here

66. Many GPs 'missing waiting target'

15 October 2008 – BBC News

The Healthcare Commission’s annual report for England

has suggested many GPs were missing their waiting

time target.

A review is now being undertaken as doctors should be

able to guarantee patients an appointment within 48

hours under the terms of a new contract.

For full report click here

67. Chair of International Academic Health

Science Centre Designation Panel announced

15 Oct 2008

Health Minister, Ben Bradshaw, announced the appointment

of Sir Alan Langlands as Chair of the international

panel that is being established to designate

Academic Health Science Centres (AHSCs) in England.

The international panel will make a recommendation

to the Secretary of State for Health about the

partnerships that should be awarded AHSC

status. The panel will offer a form of "peer review"

and will identify the organisations best placed to compete

internationally alongside leading AHSCs elsewhere

in the world, such as Harvard, Johns Hopkins

and the Karolinska Institute.

The NHS Next Stage Review announced the government's

commitment to fostering AHSCs in England.

The intention is to identify and work with a

small number of health and academic partners, who

have come together to focus on world-class research,

teaching and patient care. These Centres will take

new discoveries and promote their application in the

NHS and across the world.

68. Warning over health inequalities

14 October 2008 – BBC News

A report by the World Health Organisation shows that

the life expectancy between the world’s richest and

poorest countries could vary as much as 40 years.

The report examined primary health care systems

around the world, and uncovered huge inequalities and

inefficiencies and warns shortcomings have left the

health status of different populations, both within and

between countries, "dangerously out of balance".

For full report click here

69. National Clinical Directors appointed for

Hospital and Community Pharmacy

14 Oct 2008

The appointment of two National Clinical Directors for

Pharmacy was announced by DoH. Their appointment

fulfils the commitment made in the Pharmacy

White Paper to ensure that the proposed initiatives

are supported by strong, authoritative, clinical leadership

at local and national levels.

Jonathan Mason, currently Head of Prescribing and

Pharmacy at City and Hackney Teaching Primary

Care Trust, takes on the role that will focus on community

pharmacy and primary care.

Martin Stephens, who has broad experience at all

levels in hospital pharmacy, and is currently Divisional

Clinical Director, Diagnostics and Therapy and

Associate Medical Director, Clinical Effectiveness, at

Southampton University Hospitals NHS Trust, takes

the second post that focuses on hospital pharmacy.

Key aspects to both roles will be to devise and implement

effective joint strategies and mechanisms to

promote better patient experience and pharmaceutical

outcomes for people across the different healthcare

sectors.

They will focus on promoting and stimulating the delivery

of service models which best meet the needs

of people going into and coming out of hospital. They

will also have an important part in shaping future

models of care flowing from the primary and community

care strategy.

70. Over half of GP surgeries now offer extended

opening hours

14 Oct 2008

Over 50% of GP surgeries are now offering patients

extended opening hours DoH announced.

Statistics released by the Department show that in

under six months there has been a 40% increase in

the number of practices offering more flexible early

morning, evening and weekend opening. The result

is that GPs have met the challenging Government

target of 50% of practices offering extended opening

hours by the end of this year, three months early. As

at the end of September, over 51% of the 8,275 GP

practices in England are offering extended opening

hours.

Secretary of State for Health, Alan Johnson, said:

"In a modern NHS, ensuring that busy patients have

access to a GP at a convenient time is a top priority.

I am extremely pleased to announce that so many

practices are now offering greater flexibility in their

opening hours. I also welcome today's agreement on

the new GP contract for 2009/10.

"Thanks to the hard work of GPs and the local NHS

we have achieved our challenging target ahead of

schedule. It is fantastic news for GPs and patients

that over half of GP practices up and down the country

are now offering evening or weekend appointments

and shows the progress achieved in delivering

on the goals set out in Lord Darzi's NHS review.

"GPs play a vital role in offering information and support

to help people make healthy lifestyle choices and

prevent illness and we are making real progress in

addressing health inequalities through improving access

and the record investments in primary care."

The GP extended hours statistics can be accessed at

http://www.performance.doh.gov.uk/hospitalactivity/

data_requests/gp_extended_opening_hours.htm

Ed. My doctor’s surgery opens from 08:00 until

18:00, Monday to Friday. Not much use to me. I

was rather looking forward to Saturday opening, I

would have used it. Still, I will continue as always...

seeking a domiciliary visit when I am too

unwell to get to the surgery!

71. Government action to fund gaps in health

research

14 Oct 2008

A new £5 million research programme which is intended

to lead to an increase in service quality and

patient safety through better ways of planning and

providing health services was announced today by

Public Health Minister Dawn Primarolo, during a visit

to Southampton.

The new Health Services Research (HSR) programme

will provide funding across the country for a

broader range of health services research than is already

covered by the National Institute for Health Research

(NIHR) programmes. These include the

Health Technology Assessment programme (HTA),

the Service Delivery & Organisation programme

(SDO), the Efficacy & Mechanism Evaluation programme

(EME), Programme Grants for Applied Research

and the Research for Patient Benefit (RfPB)

programme.

The first call for expressions of interest will be taking

place in January 2009. For more details and to register

your interest visit http://www.hsr.nihr.ac.uk

72. NHS dentists are accused of extra checkups

to get their cheques up

14 October 2008 - The Times

Dentist face curbs on abuse of salary system

13 October 2008 - The Independent

Dentists 'playing the system'

13 October 2008 – BBC News

It is said that dentists are recalling patients for routine

appointments far sooner than necessary, the suggestion

being that it is to boost pay.

For BBC report click here

73. Ethics expert calls for drugs to ‘enhance’

death

13 October 2008 - The Independent

Prof Robin MacKenzie, director of medical law and

ethics, addressed Exit International and proposed the

use of psycoactive drugs, including ‘ecstasy’, for dying

patients.

74. Medicines shortage looms as winter approaches

13 October 2008 - The Times

Because of the negotiated discounts negotiated by

the NHS on medicines supplied to it are due to come

into effect in January 2009 wholesalers are running

down their stocks to avoid a blow to their profits.

This is likely to result in shortages of some medicines

this winter. Ian Brownlee of Mawdsleys (see

‘Business’, item 8) said that the change should have

been implemented in the summer months to avoid

the problem.

Ed. As with some other negotiations, the NHS

seems to have got this badly wrong.

75. Industrial Action at the CRB

13 October 2008 – CRB

“The CRB does not expect that the current industrial

action by PCS union members at the CRB, from

Monday 13th October, will have any significant impact

on its ability to deliver its service to its customers.

The Criminal Records Bureau (CRB) will remain

open for business as usual. This action is a protest

against the CRB’s 2008/09 pay award of 3.75% -

which is at the very top end of the Treasury limits for

pay awards in the public sector this year. The CRB

believes that this award represents the best possible

deal for its staff given the current economic climate.”

For full report click here

76. National End of Life Care Programme

Call for Examples of Best Practice/Innovative

Practice

In line with supporting implementation of the National

End of Life Care Strategy and to facilitate and share

best practice NHS is seeking examples of innovative

practice across the following key delivery areas:

Acute Hospitals End of Life Care

And Continuing CareNHS would be interested to

receive examples on all aspects of care/service

delivery and commissioning in these areas. If you

would like to share any work with us via the

National End of Life Care website please use the

attached template and forward to

submission@eolc.nhs.uk

If you would Like to discuss any examples with us

prior to submission please contact us via Rebecca

Unwin rebecca.unwin@eolc.nhs.uk

Ed. I acknowledge with thanks, Maria Patterson

of ECCA who drew this to my attention.

77. Government seeking ‘Charter mark’ as a

seal of approval to improve health and social

care information

The Department of Health has gone out to tender to

find an independent operator for its new scheme to

provide a seal of approval ensuring health and social

care information is reliable.

The new national scheme will provide a "seal of approval"

that will assure people the information they

use when making choices about their health and care

comes from a reliable source. T he scheme will have

a broad impact, allowing the quality mark to feature

on information in any format - from websites to pamphlets.

Ann Keen, Parliamentary Under-Secretary of State

for Health Services said:- "Ensuring that patients

have access to reliable information is paramount in

maintaining patient choice and quality of care. This

scheme and the quality mark will help reassure people

that health information available to them is trustworthy."

Ed. I am concerned that Government acknowledges

that the public does not trust the Department

of Health and others who should be an authoritative

and completely trustworthy source of

reliable information. I guess that is the penalty it

pays for excessive ‘spin’ over the years. The

problem is that those responsible will not pay the

cost – it will fall to the rest of us, the weary taxpayers

to shoulder another burden that should

not be necessary!

NHS

78. Why didn’t the NHS save my Mady?