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BHCR Vol 3 Issue 38
Brunswicks Health Care Review Volume 3 Issue 38

(Click the icon to download)
© Brunswicks LLP 2008

This week's article

Editorial

Last week I ‘binned’ my prepared editorial in view of the

news of the conviction of the men who murdered Baby P.

In the past week newspapers, TV and radio have been full

of more of the details and more of the apparent conduct of

Haringey council officers, regulators, the police and others.

It is truly shocking that such apology as has been

forthcoming from Haringey has seemingly been dragged

from the council. It’s officers had haughtily asserted that in

their investigation into Baby P’s death they had found

some good practice.

There will be a number of long-running investigations and

enquires.

There will probably be referrals of individuals to bodies

such as the General Council of Social Care whose duty it is

to monitor the conduct of social workers and has power to

strike them off the register and prevent them practicing.

However, I wonder whether and how many individuals are

truly culpable, beyond the three convicted for the death of

Baby P.

My colleagues and I have a great deal of contact with

council strategy meetings, mostly, though not exclusively

concerning adults. These meetings are infrequently well

organised and are poorly resourced, often without a

properly trained minute-taker – essential if one is to

properly record events and matters agreed upon.

Government asks much of those connected with the

provision of social and health care, rightly so. However, if

it wants a top class, world leading service it will have to be

properly funded.

I fear that a theme running through this and other, yet to be

realised, future tragedies will be the cutting of corners,

containment of cost and managing budgets upon which the

demand is overwhelming.

I fear Lord Laming’s review of services across the country

will reveal a lamentable level of service held together largely

on the goodwill and professionalism of those at frontline.

I hope I am mistaken.

Parliament

17.11.08 – HoC – Oral questions of the Sec of State

for Children, Schools and Families. Much

questioning about Baby P and Haringey, Minister did

not stick with convention of keeping replies to 1 min;

therefore the Speaker of the House regarded some

answers as ‘statements’ and will call him back to be

questioned further by MPs.

Next

Abuse

1. In full: Haringey Council apology

18 November 2008 – BBC News

Council George Meehan, the leader of Haringey Council,

has formally apologised for the death of Baby P at a

cabinet meeting in the borough.

For full statement click here

2. Case worker wanted Baby P in care

17 November 2008 – BBC News

Panorama has learned that a senior social worker

and police did not want Baby P returned to the home

where he later died from severe abuse.

Its investigation found that social worker Sylvia

Henry wanted him to go into foster care after he was

taken to a north London hospital in 2006 with nonaccidental

injuries. But her bosses decided Baby P

should be looked after by family or friends.

For full report click here

3. Councillors meet over Baby P case

16 November 2008 – BBC News

Labour Party councillors in Haringey have held a

closed doors emergency meeting over the death of

Baby P.

Two men and Baby P's mother have been convicted

of involvement in his death and will be sentenced on

15 December.

For full report click here

4. Revealed: sister of Baby P ‘was also

abused’

16 November 2008—The Sunday Times

Front page additional information about the ‘family’

and its encounters with Haringey Social Services.

5. This wel-feral state abandoned Baby P

16 November 2008 The Sunday Times

Dominic Lawson wrote about the approach of ‘the

authorities’ to the latest scandal; the Dept for Children,

Schools and Families said “proper procedures

were followed”; he pointed out that Lord Laming reported

the response of Haringey’s social services to

his investigations into the death of Victoria Climbie

“Too often they attempted to justify their position in

terms of bureaucratic activity rather than in terms of

outcomes for children.” He traces the tragic reports

into the deaths as long ago as Maria Colwell in 1973

6. How many more Baby Ps are there?

16 November 2008—The Sunday Times

Full page listing the ‘missed chances’, opportunities

to have saved Baby P from his fate. And reporting

the actions of the whistle blowing social worker’s lawyer

in trying to engage the authorities in the apparent

failings in Haringey’s children’s services. It also reports

on the environment in which Baby P lived and

the ‘family’ structure. Lastly, the article considers the

report produced for Haringey by Fergus Smith.

7. Whistleblower: Council falsely accused me

of abusing child. I feared I’d lose my daughter

16 November 2008—The Mail on Sunday

Interview over three pages with the social worker who

raised the alarm in relation to Haringey’s dire treatment

of children at risk a full six months before Baby

P’s death, and how the council tried to destroy her

life.

Ed. If the report is accurate and provable, managers

in the children’s services of Haringey should

hang their heads in shame and consideration

should be given to prosecutions and reports to

the General Social Care Council – based on the

report, some are not fit to be in post.

8. What I saw left me a victim of violence, unable

to sleep at night

16 November 2008—The Guardian

A senior paediatrician who has specialised in child

protection for 30 years described the difficulties faced

by professionals.

When I started working in child protection in the early

Seventies, a seven-year-old girl called Maria Colwell

was beaten to death by her stepfather, despite a series

of warnings to social services. An inquiry found

that there had been a breakdown of communication

between the agencies involved and a lack of training

for the social workers. Almost 30 years later, Victoria

Climbié died under similar circumstances. Now we

have seen it again.

9. The Hardest Question

15 Nov 2008 The Times

Heart-rending individual cases should not blind society

to the full implications of choosing to end life –

comment on the Hannah Jones case in which a 13 yr

old refused a heart transplant.

10. Council was cleared just before he died

15 Nov 2008 The Times

CSCI visited Haringey on 12.03.07 as a result of a

whistleblower’s warning that statutory procedures

were not being followed. Haringey was given the ‘all

clear’.

11. On the other side of the tracks, a dark

world of careless morality

15 Nov 2008 The Times

A three-star report – and a tortured child

Jeremy Lawrence reports on findings concerning

why Haringey social services was lauded by inspectors

despite the killing of Baby P and a whistleblower's

claim that sex abusers were not being tackled.

12. Haringey: The regulator’s verdict

"Child protection work is generally of a satisfactory

standard: most performance indicators are now in

line with those in comparator authorities. This reflects

good and sustained improvements in practice

and management since 2001 when practice was

poor... Staff are well managed and supported to

carry out their roles... general and specialist child

protection training for all relevant staff, including voluntary

partners, is very good."

13. Ofsted report (Joint Area Review), October

2006, three years after Victoria Climbié

inquiry and one month before abuse of Baby

P began.

"The number of children on the child protection register

continues to decrease and is now in line with statistical

neighbours. Thorough quality assurance systems

are in place ... all children on the child protection

register have an allocated social worker and all

reviews are held to timescale. The Local Safeguarding

Children Board continues to demonstrate good

ownership of the broader safeguarding agenda."

14. Baby P before the scars of abuse

15 Nov 2008 Daily Mail

Two pages of analysis and comment together with a

tracking of events from the initial whistle-blowing via

the courts and a CSCI & Ofsted inspection

15. Child abuse 'missed' by register

15 November 2008 – BBC News

Figures obtained by the Guardian newspaper shows

that over 80% of children killed or seriously hurt

through neglect or abuse were not on England's child

protection registers.

Only 33 of the 189 children whose death or injury in

2005 to 2007 led to a review were on the registers,

according to figures obtained by the Guardian.

For full report click here

16. PM rejects Baby P 'buck-passing'

14 November 2008 – BBC News

The Prime Minister has responded to allegations by the

Tory party of “buck-passing” in the Baby P case. He

rejected the allegations and said that the correct procedures

had been followed.

For full report click here

17. Haringey ‘ignored abuse warning before

Baby P died’

14 November 2008—The Times

Article about the efforts made by social worker,

Nevres Kamal, and her solicitor, Lawrence Davies, to

alert the authorities, including the then Secretary of

State for Health, Patricia Hewitt, to concerns that Haringey

was not properly dealing with cases of suspected

child abuse.

18. Britain in shock over abuse death of toddler

14 November 2008—Associated Press

The toddler had been visited 60 times by social workers.

A doctor examined him but missed the fact he

had a broken back and eight fractured ribs. His

mother managed to explain away his constant

bruises time and time again.

19. ‘He blocked the door and pulled a knife’

‘Being constantly suspicious is part of the

territory’

The lessons that need to be learned

13 November 2008—The Times

Two pages of the lives of social workers and the challenges

that they face on the front line.

20. Investigation into brutal death of Baby P

increases the pressure on council chiefs

13 November 2008—The Times

Item about the Prime Minister becoming drawn into

the row over the death of Baby P; ministers have ordered

HM Inspectorate of Constabulary, Ofsted and

the Healthcare Commission to investigate Haringey

and report in two weeks, by 01.12.08, to Ed Balls.

The director of children’s services in Hampshire, John

Coughlan, took control of the work of children’s services

in Haringey undermining the authority of Sharon

Shoesmith, head of the service. She steadfastly

failed to issue an apology for the death of the child.

21. 'Accountability' pledge on Baby P

13 November 2008 – BBC News

The Children’s Minister, Ed Balls, has said that staff will

be held accountable if a report finds failures in the case

of Baby P.

An initial investigation found evidence of "poor quality

practice, management and supervision of staff" in Haringey,

north London.

For full report click here

22. Baby P council is 'truly sorry'

13 November 2008 – BBC News

Haringey Council has said it is "truly sorry" for not doing

more to protect 17-month-old Baby P. Baby P died

after suffering horrific abuse.

The apology came as the north London council promised

its own review - the fourth separate inquiry into

Haringey Council has said it is "truly sorry" for not doing

more to protect 17-month-old Baby P. Baby P died

after suffering horrific abuse.

The apology came as the north London council promised

its own review - the fourth separate inquiry into

Baby P's death.

For full report click here

23. Tragic life of Baby P raises old questions

12 November 2008 - The Times

Front page item – Lord Laming who chaired the inquiry

into the death of Victoria Climbié has been mobilised

to review social work practice across the

country to check whether they are following the practice

he recommended

24. After 17 months of unimaginable cruelty,

Baby P finally succumbed

12 November 2008 - The Times

Ministers threaten inquiry as Haringey

closes ranks

12 November 2008 - The Times

Why well-meaning social workers must be

sceptical

Two full pages covering the behaviour which led the

conviction of two men for causing or allowing the

death of a child, Baby P. The articles recount some

of the missed opportunities to prevent the continuing

abuse.

25. Baby P staff ‘must own up and pay price

for tragedy’

12 November 2008 - Evening Standard

Item about the murder and particularly at six individuals

who had an involvement in the care process

meant to protect Baby P.

26. We’ve had a raft of excuses and no apology

12 November 2008 - Evening Standard

David Cameron MP, Leader of the Opposition, calling

for the deployment of common sense when suspicious

of child abuse.

27. Review ordered after abuse death

12 November 2008 - BBC News

The death of a 17-month-old boy after

months of abuse, despite him being on an at

risk register, has sparked a review of child

protection in England.

It comes as two men were found guilty of causing his

death in August 2007.

Haringey said that it had found "numerous examples"

of good practice in the case although there had been

"weaknesses" in information flow.

Sharon Shoesmith, chair of the board, said: "The very

sad fact is that we can't stop people who are determined

to kill children."

For full report click here

Ed. After what has come out into the public domain

over the past week Haringey’s handling of

its position and reputation has been abysmal and

the continuation of Ms Shoesmith in role of head

of children’s services must be in doubt.

28. We can’t be surprised by the death of

Baby P

12 November 2008 - The Times

Theodore Dalrymple opines that in a country that cant

properly organise rubbish collections it is hardly surprising

that the complexities of child protection demonstrate

everyday incompetence. The author also

predicts the outcome of the inevitable inquiry.

29. 'Safety net' failed tortured baby

11 November 2008 – BBC News

A short life of misery and pain

11 November 2008 – BBC News

Tricky balance for social services

11 November 2008 – BBC News

A child protection review has been sparked after the

death of a 17-month-old boy after months of abuse.

Two men were found guilty of causing his death in

August 2007 and took place in Haringey, north London.

The boy suffered 50 injuries, and the case has revealed

a series of failings by social workers, health

workers and police and is described as worse than

that of Victoria Climbie, who was murdered in Haringey

in 2000.

For 1st report click here

For 2nd report click here

For 3rd report click here

For 4th report click here

30. 'No child murders' in Jersey home

12 November 2008 – BBC News

No murders at Jersey home, says police

chief

12 November 2008—Evening Standard

Police doubt that any of the articles they have examined

point to evidence of abuse or murder at Haut de

la Garenne.

For BBC report click here

31. Sir Michael Parkinson and Phil Hope

launch first dignity in care award

10 November 2008

The first ever award which recognises people who

treat patients with dignity and respect and who provide

outstanding care was launched by Sir Michael

Parkinson and Care Services Minister Phil Hope.

The People's Award for Dignity in Care is open to

everyone. Anyone can nominate individuals or teams

who have gone above and beyond the call of duty to

improve patient dignity in care.

Nominations for the Dignity Awards open soon and

close 6 March 2009. To register interest, go to http://

www.healthandsocialcareawards.org.uk and click on

'Register your Interest'. You will be sent details of

how to make a nomination.

The criteria are for a person or a team who are focussed

on the person, by providing simple, clear and

accessible information about services; provide a better

service by striving to deliver a service that's personal;

and show dignity and respect by supporting

people to express their needs and wants.

Business News

Nothing to report

Care Homes

32. SWANTON OPEN NEW FACILITY

"Bringing Much Needed Service to Cambridgeshire"

13 November 2008

Swanton Care & Community which provides for people

with complex needs, last week formally opened

its new purpose-built-and-designed rehabilitation service

Eden View, located in Bottisham, Cambridgeshire,

for people aged 18-65 with an Acquired Brain

Injury (ABI) or complex neurological condition.

33. £6,000 care home funding gap exposed

by Age Concern

13 November 2008 – NCF

Care home concern

12 November 2008 - The Times

Elderly people in care homes will be the first to suffer

from new rules to restrict jobs for workers from outside

Europe according to Martin Green, the head of

the English Community Care Association, who said

homes were likely to close and fees would rise as a

result of a new list of jobs available to non-EU workers.

For full report click here

34. Care home safety in spotlight at HSE

event in North Wales

10 November 2008

Safety at care homes in Wales is the subject of a free

event launched by the Health and Safety Executive

(HSE) in North Wales.

Care home owners and managers from across North

Wales will attend the Safety and Health Awareness

Day in Ruthin Castle, the first of four seminars being

held during November and December.

The events follow a series of inspections on care

homes across Wales carried out by HSE earlier this

year. A total of 28 homes were visited and inspectors

issued 31 improvements notices. Reported in BHCR

V.

HSE Principal inspector Steve Scott said: "Care

homes are responsible for some of the most vulnerable

people but our inspection programme last spring

revealed a number of risks that some, though not all

care homes were not adequately dealing with.

"Fortunately, where we identified a problem the owners

and managers of the care homes were very keen

to take our advice and put these matters right. However,

we consider seminars like these to be an important

opportunity to remind people of the risks that can

be present and to offer advice on the best way to

manage those risks."

The seminars will cover a range of topics including:

management and administration of medicines; electric

profiling beds; management of bed rails; management

of asbestos and legionella; food safety management;

slips and trips and stress.

Further seminars are being held in Cardiff (18 November),

Carmarthenshire (3 December) and Aberystwyth

(4 December).

Care home owners or managers who cannot attend a

seminar but need advice from HSE can contact the

HSE Infoline free of charge on 0845 345 0055.

Case Reports

Law Reports

Nothing to report

Disciplinary cases

Nothing to report

Cases in the news

35. Coma patient’s horror at sex attack

15 November 2008 - Daily Mail

A 31 yr old has been told she was the victim of a sex

attack after the perpetrator allegedly filmed the attack

on his mobile ‘phone.

36. Care home boss fights conviction

13 November 2008 – BBC News

Daniel Purgaus, a care home owner from Bristol, has

been released from prison pending an appeal against

his conviction for assaulting an elderly resident.

He was convicted of attacking Ronald Thomas, 80, at

Overnhill House in Downend in January.

For full report click here

37. Family fury at not being told about care

home 'assault’

12 November 2008 – Liverpool Echo

The family of William Perry have expressed their fury

at not being told about the care home assault by two

care home staff.

The two men were suspended from duty for allegedly

ill-treating an 86-year-old resident at a Rowan Garth

nursing home in Liverpool.

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

local-news/2008/11/12/family-fury-at-not-being-toldabout-

care-home-assault-100252-22238406/

38. HSE sends out clear warning after death

of care home resident

12 November 2008

The HSE warned the care industry to ensure it identifies

the risks in their workplaces and manage them,

following the death of a 56-year-old man at a residential

care home in St Albans.

MacIntyre Care, head office based in central Milton

Keynes, was fined £10,000 and ordered to pay full

costs of £2,476, at St Albans Magistrates' Court after

pleading guilty to breaching Section 3(1) of the Health

and Safety at Work etc Act 1974.

On 26 February 2007, a resident of MacIntyre Care

home on Crosby Close in St Albans, fell whilst being

hoisted from a chair to his bed. It was necessary to

use the hoist as the resident had profound physical

disabilities. As a result of the fall the resident suffered

fractures to one of his hip bones and his elbow -

and later died of sepsis, with the coroner highlighting

the fall as a contributing factor to his death. An inadequately

trained employee was entrusted to hoist

the resident and failed to attach the sling properly to

the hoist.

HSE Inspector, Rubeena Surnam said:

"This was an avoidable accident. I hope it demonstrates

to care home employers that they need to

take positive steps to identify the risks in their workplaces

and manage them.

"Employers must be sure they adopt safe systems of

work and care staff are trained in the use of equipment

such as hoists and aware of the potential risks

involved."

Ed. Section 3(1) of the Health and safety at work

etc Act 1974 states: "It shall be the duty of every

employer to conduct his undertaking in such a

way as to ensure, so far as is reasonably practicable,

that persons not in his employment who

may be affected thereby are not thereby exposed

to risks to their health or safety."

39. Outrage as thieves steal heating oil from

care home for the elderly

10 November 2008 – North Wales Chronicle

Callous thieves stole heating oil from Ty Gwyn care

home in Gwalchmai which could have left residents

freezing to death. The 22 residents, many of who suffer

with dementia or Alzheimer's disease, were awakened

on Saturday morning to near freezing temperatures.

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

news/BREAKING-NEWS--Outrage-as.4664997.jp

Children

40. Children’s contact details stolen

15 November 2008 - The Times

Another laptop goes missing; this time in Surrey containing

personal data of 7,800 children who use

school transport.

41. Girl wins fight to turn down transplant

11 November 2008 - The Times

Hannah Jones, 13, had been embroiled in litigation

persuaded medics to withdraw High Court proceedings

forcing her to undergo a risky heart transplant

after speaking to a member of the child protection

team. It is thought that the process has been ongoing

since the beginning of the year.

Conferences & Courses

To follow next week

Consultations

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

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/SocialCare/

Socialcarereform/Safeguardinganddealingwithabuse/

index.htm

49. Consultation on final dates for social service

workers to register with the SSSC

Closing Date: 31 December 2008

A consultation paper has now been issued for the

Introduction of final dates for prescribed descriptions

of social service workers to achieve registration with

the Scottish Social Services Council (SSSC).

For consultation click here

50. Reviewing the Mental Capacity Act 2005:

Forms, supervision and fees – Consultation

Closing Date: 15 January 2009

Consultation seeking views on proposed changes to

three areas of the work of the Office of the Public

Guardian and the Court of Protection following the

implementation of the Mental Capacity Act 2005 in

October 2007.

It aims to cover a redesign of the lasting power of

attorney forms, the restructuring of the supervision of

deputies by the public guardian and alterations to fee

structures.

For consultation go to http://www.justice.gov.uk/publications/

reviewing-mental-capacity-act.htm

51. Care Quality Commission unveils first

two initiatives aims at improving quality and

safety of services

Closing Date: 16 January 2009

The Care Quality Commission has published two

documents which set out how it aims to:

drive further improvements in how the NHS

deals with healthcare associated infections,

such as MRSA

use its new enforcement powers to improve

the quality and safety of health and

adult social care services for the people

who use them

The CQC is launching a 12-week consultation with a

wide variety of stakeholders on how it intends to use

its new enforcement powers, together with publishing

guidance to NHS trusts about additional requirements

for registering with the new Commission in relation to

healthcare associated infection (HCAI).

For full consultation go to http://www.cqc.org.uk/news/

hcai_and_enforcement_policy.aspx

52. Consultation: Draft guidance on NHS patients

who wish to pay for additional private

care

Closing Date: 27 January 2009

A consultation seeking views on draft guidance on

how to proceed in situations where NHS patients

want to buy additional secondary care services that

the NHS does not fund.

For full consultation click here

53. Consultation on GP Quality Incentive

Scheme launched

Closing Date: 2 February 2009

Delivering the best possible care for patients and

addressing health inequalities will be at the heart of

proposed changes to the GP quality incentive

scheme, the Quality and Outcomes Framework

(QOF), Health Minister Ben Bradshaw announced

today.

The QOF rewards GP practices for managing some

of the most common chronic diseases such as diabetes

or heart failure; improving health; organising

practices well; how patients view their experience at

the surgery and the quality of extra services offered

such as child health and maternity services.

Under new proposals set out in a public consultation

published today, the National Institute for Health and

Clinical Excellence (NICE) would in future oversee

the annual process of reviewing clinical indicators.

From April 2009, NICE would review the benefits

to patients and the cost effectiveness of the indicators

used to assess the quality of care provided by

GP practices. NICE would be responsible for developing

a more transparent and inclusive review process

with input from patients and carers, primary care

professionals and other stakeholders.

The final choice of QOF indicators would remain a

matter for negotiation with the British Medical Association

(BMA), based on the advice produced by

NICE.

The 12-week consultation is seeking views on how

the new process for assessing evidence for QOF

indicators should work. The key elements that will be

considered in the consultation will be how best to:

* Review existing QOF indicators and develop new

indicators for clinical quality and health outcomes,

based on evidence of clinical effectiveness;

* Allow a range of stakeholders, including patients,

carers and clinicians to identify potential QOF priorities;

* Set up a panel of independent experts that will prioritise

areas for developing new indicators;

* Pilot new indicators with GP practices; and

* Give flexibility to the local NHS to select some indicators

to reflect local health needs.

Health Minister Ben Bradshaw said:

"We have come a long way in addressing health inequalities

thanks to the current GP scheme for quality

incentives and the UK leads the world in providing

incentives to GPs to improve quality of care for patients.

"The latest figures for the Quality and Outcomes

Framework show that practices have continued to

deliver improvements in services for patients. But we

want to ensure that GP practices continue to deliver

more improvements to patient care, and the system

needs to evolve to support practices in achieving

even better outcomes for patients.

"Asking NICE to manage a more independent, open

and transparent process for reviewing QOF indicators

will make sure that we make the best use of our annual

investment in the scheme and continue to support

GPs in delivering the best care possible for patients,

allowing the QOF to adapt and respond to the

latest medical advances."

A full explanation of how the current scheme operates

and details of how to become involved in the consultation

can be downloaded from: http://www.dh.gov.uk/

en/Consultations/index.htm

Ed. Future issues of BHCR will have this consultation

referred to under ‘CONSULTATIONS’ only.

54. Department of Health: Developing the

quality and outcomes framework - Proposals

for a new, independent process

Closing Date: 2 February 2008

Consultation seeking views on proposals for a new

independent and transparent process for recommending

quality outcome framework indicators.

For full consultation click here

55. DH: End of Life Care Strategy: Quality

Markers Consultation

Closing Date: 6 February 2009

The DoH has launched a consultation on Quality

Markers for End of Life Care which was promised in

the End of Life Care Strategy published in July.

The document is aimed at commissioners, performance

managers and providers of end of life care services,

from the NHS, voluntary and independent sectors.

For full report click here

56. 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

57. RNHA accuses CSCI of ’mixed messages’

14 November 2008 – NCF

A report by the Registered Nursing Home Association

has revealed that the outcome of its recent review of

eligibility criteria for social care has been dubbed ‘a

mish-mash of mixed messages’.

The regulator represents around 1,200 nursing homes

across the UK and says that the Commission for Social

Care Inspection (CSCI) has failed to map out a clear

vision for the way in which people’s entitlement to public

funding towards their care costs is determined.

For full report click here

58. Review of safeguarding of children in Haringey

13 November 2008 – Healthcare Commission

The Healthcare Commission is working with Ofsted and

the Her Majesty's Inspectorate of Constabulary to undertake

a requested urgent review of safeguarding of

children in Haringey.

A specialist inspector from the Commission will be assessing

whether local healthcare services are fulfilling

their obligations to safeguard and promote the welfare

of children.

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

newsandevents/mediacentre/pressreleases.cfm?

cit_id=1486&FAArea1=customWidgets.content_view_1&usecach

e=false

59. Healthcare Commission longed for government's

embrace

12 November 2008 – HSJ

Healthcare Commission chair, Sir Ian Kennedy, has

sent a frank message to staff revealing how the Government

failed to embrace the regulatory body and left it

"handicapped".

Sir Ian's article was published in an internal newsletter

and is a candid reflection on the commission's achievements

and failures as it prepares to make way for the

Care Quality Commission next April, as well as providing

an insight into the regulator's relationship with the

government.

For full report go to http://www.hsj.co.uk/news/2008/11/

government_

treated_regulator_as_part_of_the_problem__sir_ian_kenne

dy.html;jsessionid=2D3AB5A06E3D399F0AD408B5B301F237?

tmcsTrackingInfo=$FcLLePElFeSaZI2MAKqESIN6vNwBdg2yObI_

dtvnJKUflajmDS8pxGyMDw51EjrSm9cf2SXNyt

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60. HandsOnScotland Toolkit

10 November 2008 – SCRC

The HandsOnScotland Toolkit is an online resource for

anybody working with children and young people and it

provides practical information and techniques on how to

respond helpfully to children and young people's troubling

behaviour, build up their self-esteem and promote

their positive mental well-being.

Further information can be found at http://

www.handsonscotland.co.uk/

Dementia

61. Newly designed dementia unit open

14 November 2008 – BBC News

A newly designed dementia centre, the first of its kind in

the UK, has been opened in Sheffield.

Health chiefs said the £1.1m renovation of the unit could

create a blueprint for similar developments across the

country. New features at the Grenoside Grange unit

include 24 en-suite bedrooms and a calming colour

scheme.

For full report click here

Ireland, Scotland & Wales

Ireland

Nothing to report

Scotland

62. New targets for healthcare

14 November 2008 – Scottish Government

New waiting time targets for drug treatment and access

to child and adolescent mental health services are to be

introduced for the first time in Scotland.

The new targets include:

Maximum wait from decision to treat to first treatment

for all cancer patients of 31 days

Inequalities targeted cardiovascular health checks

Reducing energy consumption

Faster access to treatment for drug misusers

Faster access to child and adolescent mental health

services

Reducing the rate of C.diff infections in hospitals by

at least 30 per cent by 2011

12 week maximum waits for outpatient appointments

and inpatient / day case treatment

For full report click here

63. Patients unaffected by NHS 'cuts'

13 November 2008 – BBC News

NHS Forth Valley bosses have denied that proposed

efficiency savings demanded by the Scottish Government

will impact on patient care.

NHS Forth Valley said the savings would be made

through property sales and schemes to reduce transport

costs and restructuring.

For full report click here

64. Scottish hospitals to face surprise hygiene

inspections

11 November 2008 – HSJ

Health Secretary, Nicola Sturgeon has declared that all

hospitals in Scotland will face unannounced inspections

to check they are clean and preventing the spread of

infection.

The measure is being introduced as part of a consultation

on infection control.

Proposals include establishing a care environment inspectorate,

which will make unannounced visits to hospitals

and will provide a national overview for ministers

and parliament and each hospital board will be given

reports and be expected to publish an improvement

plan based on the inspectorate's visits.

Ms Sturgeon also announced that all new Scottish hospitals

must provide single rooms for every patient.

For full report go to http://www.hsj.co.uk/news/2008/11/

scottish_

boards_to_face_surprise_inspections_in_superbug_crackd

own.html?

tmcsTrackingInfo=$

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65. NHS Car Parks Rake In GBP1m . . . But

Fees Are GBP4000 Short Of Covering The

Costs

11 November 2008 – Evening Times

An investigation by the Evening Times shows that patients,

visitors and health workers have had to pay

nearly £1million to park at Glasgow's hospitals since

charges were introduced last year. However, figures

released under freedom of information laws show that

despite the massive amount earned by the controversial

charges, NHS Greater Glasgow and Clyde is still operating

its car parks at a loss of £4464.

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

display.var.2467216.0.0.php?utag=28804

66. Child hearings reach record level

11 November 2008 – BBC News

A report by the Scottish Children's Reporter Administration

reveals that a record number of children's

hearings were held in Scotland during 2007.

Children can be referred to the hearing system because

they have been the victims of abuse or neglect,

or because they have been accused of a crime.

For full report click here

67. New research to target superbugs

11 November 2008 – BBC News

A Scottish project, Aeropath, is looking to find new

medications for infections relating to the bacterial superbugs.

The superbugs are also especially dangerous for patients

with a weakened immune system, such as

those who have undergone chemotherapy. Researchers

at the universities of Dundee and St Andrews

are involved.

For full report click here

Wales

68. Debate on paying for elderly care

11 November 2008 – BBC News

The Welsh Assembly Government says that it is

launching a "genuine debate" on how care services in

Wales should be funded.

Wales has a larger elderly population than the rest of

the UK, which is putting an increasing strain on the

care system.

The consultation will run in parallel with one in England,

prompted by predictions services will face a

£6bn funding gap across the UK in 20 years.

For full report click here

69. Free housing for junior doctors

10 November 2008 – BBC News

Health Minister, Edwina Hart has announced that all

junior doctors training in Wales can stay free in hospital

accommodation until July 2010.

She had previously agreed to extend the provision of

free on-site housing until summer 2009.

For full report click here

70. Trial tackles hospital infections

10 November 2008 – BBC News

Hospital infections such as C. difficile will be the target of

a £1.2m clinical trial by researchers in Swansea and

County Durham. The team will tackle the downside of

antibiotics given to elderly patients, which can lead to

diarrhoea and will look at whether supplements of

healthy bacteria - robotics - can help.

For full report click here

Learning Disabilities

71. Budgets not best for all

November 2008 - Caring Business

Research from almost 1,000 people shows that not

all are keen to have personal budgets – people with

learning disability were more likely to feel that they

had control over their daily lives.

Legislation Update

72. Children and Young Persons Act 2008

c.23

14 November 2008 – OPSI

For full legislation click here

73. No. 2927 The Council for Healthcare

Regulatory Excellence (Appointment, Procedure

etc.) Regulations 2008

14 November 2008 – OPSI

For full legislation click here

74. No. 2870 (C.127) The Children and Adoption

Act 2006 (Commencement No. 3) Order

2008

12 November 2008 – OPSI

For full legislation click here

75. CHILDREN AND YOUNG PERSONS, ENGLAND

AND WALES

The Safeguarding Vulnerable Groups Act

2006 (Prescribed Criteria and Miscellaneous

Provisions) Regulations 2008

12 November 2008 – OPSI

For full legislation click here

76. PROTECTION OF VULNERABLE ADULTS,

ENGLAND AND WALES

The Safeguarding Vulnerable Groups Act

2006 (Prescribed Criteria and Miscellaneous

Provisions) Regulations 2008

12 November 2008 – OPSI

For full legislation click here

77. No. 355 The Scottish Commission for Human

Rights (Specification) Order 2008

11 November 2008 – OPSI

For full legislation click here

Mental Capacity

Nothing to report

Mental Health

78. Statistics lay bare inequalities in mental

healthcare

14 November 2008 - Health Service Journal

The most comprehensive set of data ever collated on

hospital and community mental health services has

revealed stark variations in the levels of care being

offered to different sections of the population.

79. Statistics lay bare inequalities in mental

healthcare

13 November 2008 – HSJ

The most comprehensive set of data ever collated on

hospital and community mental health services has revealed

massive variations in the levels of care which is

offered to different sections of the population.

The data shows that women aged 36-64 are around a

third more likely to benefit from the care programme

approach - in which they receive planned, co-ordinated

treatment - than teenage boys. This has been interpreted

as revealing that government pledges to improve

early intervention are failing to impact sufficiently.

For full report go to http://www.hsj.co.uk/news/2008/11/

statistics_lay_bare_inequalities_in_mental_healthcare.html?

tmcsTrackingInfo=$CtacY00FZVn4p78VT4Gr1CSUewE8aWmyObI_

dtvnJKv48nVl8OsQCGyMDw51Ejr1ZxkWhM7QU1$

80. Charity urges direct payments for Mental

Health Act clients

Mental Health Foundation demands direct

payments for detained clients

11 November 2008 – Community Care

The Mental Health Foundation has attacked the Government’s

discriminatory” proposal to bar people detained

under the Mental Health Act the same access to

their direct payments as other client groups.

A consultation which has just closed has said that local

authorities would be able to use their discretion in offering

payments to people receiving compulsory treatment.

For full report click here

Miscellaneous

81. Power to the patients

15 November 2008 - The Times

Two pages on the internet forums for people to swap

advice about the full range of medical conditions – as

it says, from headaches to hernias.

82. Hundreds of Britons die on waiting list

every year despite 16m donors

14 November 2008 - The Times

The biggest hurdles to improving the rate of organ

transplants are shortages of intensive care staff,

transplant co-ordinators and funding.

83. Presumed consent: life-saver or imaginary

solution

14 November 2008 - The Times

In January 2008 the Prime Minister, Gordon Brown,

called for a national debate on organ donation and

suggested thousands of lives would be saved if the

country introduced a system of ‘presumed consent’.

Informed individuals put the arguments for and

against.

84. The Council for Healthcare Regulatory

Excellence (CHRE) draft Regulations 2008:

consultation report

14 November 2008 – DoH

A summary response to the public consultation on the

draft regulations setting out proposals for the Council

for Healthcare Regulatory Excellence (Appointment,

Procedure etc.) Regulations 2008.

For full report click here

85. Life Expectancy and All Age All Cause

Mortality Monitoring (Overall and Health Inequalities)

- Update to include data for 2007

13 November 2008 – DoH

The latest annual update on life expectancy data was

released on 13 November 2008 according to arrangements

approved by the UK Statistics Authority.

The information consists of all age all cause mortality

rates, with data updated to 2005-07, which are used to

monitor progress against Department of Health targets

for overall life expectancy in England, and for the gap in

life expectancy between the areas with the worst health

and deprivation indicators (the Spearhead group) and

the England average.

For full report click here

86. A new Act is born

13 November 2008

Royal Assent for Human Fertilisation and Embryology

Act

New laws that will help maintain the UK's position as

a world leader in embryo research, enable scientists

to investigate cures for serious illnesses such as

Parkinson's disease and regulate assisted reproductive

treatments, received Royal Assent.

Key elements include:

* "Human-admixed" embryos created from a combination

of human and animal genetic material, purely

for laboratory research will be allowed and strictly

controlled. There will be a 14 day limit, after which the

e m b r y o m u s t b e d e s t r o y e d .

* Sex selection of offspring for non-medical reasons

is banned. Sex selection is only allowed for medical

reasons - for example to avoid a serious disease.

* Same-sex couples are recognised as legal parents

of children conceived through the use of donated

sperm, eggs or embryos. This recognises, for example,

the civil partner of a woman who carries a child

via IVF as the child's legal parent.

* Valuing the role of all parents by replacing the reference

to "the need for a father" with "the need for supportive

parenting". This retains a duty to take account

of the welfare of the child when providing fertility

treatment.

87. Life Expectancy and All Age All Cause

Mortality Monitoring (Overall and Health Inequalities)

- Update to include data for 2007

13 November 2008

Life Expectancy and All Age All Cause Mortality Monitoring

(Overall and Health Inequalities) - Update to

include data for 2007 The main points are:

- The overall life expectancy and all age all cause

mortality (AAACM) trends for both males and females

are broadly on course to deliver the PSA life expectancy

target of 78.6 years for men and 82.5 years for

women by 2010 (2009-11).

- In 2005-07, life expectancy at birth in England continued

to increase for both males and females, and

reached its highest level on record at 77.5 years for

males and 81.7 years for females.

- Three-year average AAACM rates for England have

fallen in each period since 1995-97.

- In 2005-07, average life expectancy at birth in the

Spearhead Group was 75.6 years for males and 80.2

years for females, having increased in each period

since 1995-97.

More detail can be found in the bulletin available at

the link below.

http://www.dh.gov.uk/en/Publicationsandstatistics/

Publications/PublicationsStatistics/DH_090133

88. £400m spending limit forced on NHS

13 November 2008 - Health Service Journal

NHS organisations will be permitted to spend just

£400m of their £1.7bn surplus next financial year and

will not get the full increase in resources pledged to

them by the Treasury.

89. Assisted deaths to be debated in Commons

12 November 2008 - The Times

A ‘glimmer of hope’ for terminally ill adults as Govt

promised debates in the House of Commons on the

issue of assisted dying.

90. New Deputy Chief Dental Officer

11 November 2008

Sue Gregory has been appointed as the new Deputy

Chief Dental Officer at the Department of Health replacing

Tony Jenner, who is leaving the Department

of Health after six years.

The appointment will take effect in January 2009.

91. Their Full Potential: Improving specialist

disability employment services consultation

- Summary of responses

11 November 2008 – DWP

Publication presenting the responses to a consultation

on proposals to combine several schemes into a

single new programme to improve access to work

resources.

For full report go to http://www.dwp.gov.uk/resourcecentre/

des-consultation.asp

92. The Medical Profession (Miscellaneous

Amendments) Order 2008 Consultation Summary:

November 2008

11 November 2008 – DoH

A document setting out the outcome of a consultation

on a draft order to implement two of the reforms set

out in the white paper Trust Assurance and Safety:

The Regulation of Health Professionals in the 21st

Century.

For full report click here

93. Statistical press notice: GP extended

opening hours - Monthly update

11 November 2008

GP extended opening hours for month ending October

2008.

This data shows the number of GP practices within

each Commissioner area (PCTs and Care Trusts)

and how many of those practices were offering extended

opening hours on the census date (21st October

2008).

Key findings this month:

* Of 8,263 practices, 4,864 (58.9%) offered extended

opening hours on the census date. This compares

with 51.4% in September.

* The average percentage of GP Practices offering

extended hours within each Commissioner area was

59.1%. This has changed from 51.5% in September.

* 1 Commissioner had no GP practices offering extended

opening hours (0.7%). In September there

were 6 (3.9%).

* 111 (73.0%) Commissioners have achieved the Operating

Framework aim of 50% of their GP Practices

offering extended opening hours. In September there

were 89 (58.6%) Commissioners that had achieved

the aim.

Links:

GP Extended Opening Hours data: http://

www.performance.doh.gov.uk/hospitalactivity/data_requests/

index.htm

94. Short-term setbacks and political squabbles

have knocked confidence in the care

home sector. If you’re looking for reassurance,

start with the statistics

11 November 2008 - Health Investor’s ‘take on the

Colliers Report

The care home sector might have seen some high

profile difficulties of late, but new data from property

consultants Colliers CRE suggests that the market’s

fundamentals are more robust than ever.

95. Industrial Action Update

7 November 2008 – CRB

Ongoing civil action taking place within the CRB has

been suspended as from Monday 10th November and

therefore the CRB service will return to normal.

The CRB website will keep you updated of any

changes.

www.crb.gov.uk

96. Older people’s ‘super charity’ names Dianne

Jeffrey as chair

Caring Times, October 2008

Help the Aged and Age Concern England have announced

the appointment of Dianne Jeffrey as chair

of the new UK charity for older people when the two

older people’s lobby groups merge next year.

Ms Jeffrey took up the role on 1st October.

97. People have a say...

November 2008 - Caring UK

An initiative by the County Council means the people

in Kent have been given the chance to tell Government

what they think about care.

Ed. I hope the people take that opportunity to tell

them how it is – namely, that Kent has not increased

payments made for care this year having