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BHCR 2008 Vol 3 Issue 39

(Click the icon to download)
© Brunswicks LLP 2008

This week's article

Editorial

Keith has spent the past week or so

in his sick-bed.

Accordingly there is no Editorial from

him.

We anticipate Keith’s return this

week.

This week’s article

Following the outcry over Baby P and the conviction of those responsible for

his death Ed Balls as Secretary of State for Children, Schools and Families

made a statement in the House of Commons 20 November 2008. We

reproduce that statement in full in this issue of BHCR.

To go directly to the statement click here.

Parliament

26.11.08 – HoL - Baroness Barker to ask Her

Majesty’s Government what research has been

conducted into the impact of economic crises on

demand for health services; and what steps they are

taking as a consequence.

Next

Abuse

1. Our taste for all this misery lit makes ugly

reading

23 November 2008 - The Sunday Times

India Knight writes that ‘misery lit’ as opposed to

‘chick lit’ is unedifying and unnecessary.

2. Final Insult

22 November 2008 - Daily Mail

Mother of Baby P, the child she pleaded guilty to allowing

to die, is considering an application for a permanent

injunction against identifying her, a new

home and new identity on release from prison and

permanent police protection. That will add millions of

pounds to the cost of the scandal. Similar protection

has been given to Maxine Carr the former girlfriend

of the Soham murderer, Ian Huntley.

3. U-turn in Baby P case

22 November 2008 - The Times

Ed Balls has relented and has now decided that the

serious case review can be seen by senior MPs

4. Take me off Sex Offender Register, says

Gary Glitter

22 November 2008 - Daily Mail

Glitter is to appeal against the decision to put him on

the Sex Offenders Register; the hearing is scheduled

for mid Feb 2009.

21 November 2008 - TimesOnline

Police have been told to take a tough line with social

workers when dealing with suspected child abuse

cases.

5. Baby P report is released to MPs

21 November 2008 – BBC News

Ministers will release a detailed report to only a small

group of MPs of mistakes made by authorities in the

case of Baby P. Five MPs will be able to study the

report.

Children’s Secretary, Ed Balls said that he was advised

by Government lawyers not to make the full

“serious case review” available.

For full report click here

6. In today's papers

21 November 2008 – Community Care

There has been an outcry over gag on Baby P report.

Ministers are facing demands for a law change after

their declaration that the detailed report into Haringey

Council's handling of the Baby P case cannot be

made public.

7. Ed Balls: Immediate publication for Haringey

joint area review

20 November 2008 – Community Care

Children's Secretary, Ed Balls, confirmed that the

joint area review on safeguarding in Haringey will be

published early December.

He will receive the review by Ofsted, the Healthcare

Commission and the chief inspector of constabulary

by 1 December, and he said that it would be published

soon afterwards.

For full report click here

8. Websites probed over Baby P posts

20 November 2008 – BBC News

Police are investigating an internet hate campaign on

social network sites that name Baby P’s mother, her

boyfriend and her lodger.

The campaign included photos, addresses and

threats to harm the trio who were found to be responsible

for his death.

For full report click here

9. 'Clear evidence' of Baby P errors

20 November 2008 – BBC News

Children’s Minister, Ed Balls, has declared that there

is “clear evidence” that mistakes were made in Baby

P’s case.

He told MPs people are going to be held to account

for mistakes, and said inspectors had been told to

report back on Haringey Council by 1 December.

For full report click here

10. Social care: how can we help the helpless?

20 November 2008 - Health Service Journal

The death of Baby P has highlighted failings in assessing

risk. Staff must be supported in making tough

decisions if the chances of such tragedies happening

are to be minimised.

11. We are truly sorry: council issues its first

apology over the death of Baby P

19 November 2008 - The Times

Haringey Council leader, George Meehan, expresses

sorrow and apologises for the failure of “all the agencies

involved”.

12. Child abuse 'lessons not learnt'

19 November 2008 – BBC News

Ofsted’s annual report declares that lessons from

serious child abuse and death cases in England are

not being learnt quickly enough. The report also said

that some staff were not adequately equipped to respond

to signs of abuse and neglect.

For full report click here

13. Baby P doctor 'deeply affected'

19 November 2008 – BBC News

The doctor who failed to spot Baby P’s injuries two

days before the tot died in 2007 says she was

deeply affected” by his case.

Dr Sabah Al-Zayyat, is banned from working unsupervised

and faces an investigation, spoke of the

"shocking and tragic circumstances of his death".

For full report click here

14. Workers 'support Baby P sackings'

19 November 2008 – BBC News

A poll by Community Care has shown that eight out

of ten social workers think that new managers should

be brought in at Haringey Council following Baby P’s

death.

The website survey also found 86% of 250 respondents

felt that the case of Baby P reflected wider

childcare protection problems.

For full report click here

15. Baby P: Ray Jones says government

could take over at Haringey

18 November 2008 – Community Care

Ray Jones, a leading social work expert has predicted

that the government could take control of Haringey

children's services if the safeguarding review

ordered by the Department for Children, Schools and

Families finds serious failings.

For full report click here

16. GSCC: Baby P could trigger first multiple

conduct hearing

Probe into conduct of social workers could

be first of its kind by regulator

18 November 2008 – Community Care

The General Social Care Council has confirmed that

it's investigation into the conduct of social workers

involved in the Baby P case could lead to its first conduct

hearing involving more than one social worker.

The GSCC is making preliminary enquiries and would

not say how many social workers had been referred

or whether this included managers, or when the referrals

had taken place.

For full report click here

17. Baby public inquiry not ruled out

18 November 2008 – BBC News

Ed Balls, Children’s Minister has refused to rule out a

public inquiry into the death of Baby P, but has insisted

measures undertaken so far, by sending inspectors into

Haringey Council were sufficient.

The NSPCC has called on all councils to conduct an

urgent review of children on their protection lists.

For full report click here

18. Child protection plans revealed

18 November 2008 – BBC News

The Government has announced that every area of

England is to be covered by a Children's Trust Board

(CTB).

The boards, will aim to prevent abuse by co-ordinating

child protection workers and follows the failure of social

workers in Haringey to prevent the abuse and death of

Baby P.

Children's Secretary, Ed Balls acknowledged that in

some cases, protection agencies are failing to intervene

early enough.

For full report click here

19. Haringey ‘overruled’ attempt to put Baby

P into care

17 November 2008 - The Times

Ahead of a BBC Panorama programme on TV later

that day revelations that the social worker, Sylvia

Henry, had decided that Baby P should be taken into

care but was overruled by her manager.

20. Cost cutting put children at risk, whistleblower

claims

17 November 2008 - The Times

A male former social worker has come forward to say

that, in his view, Haringey failed to properly look after

children and that this was based on cost cutting an

example of a 16 yr old girl is provided, she was involved

in prostitution and was using crack cocaine –

her support from the council was reduced to five

hours a week.

21. What Happened to Baby P?

17 November 2008 - BBC 1

This TV documentary can be viewed using the BBC

iPlayer available at www.bbc.co.uk/iplayer/

Business News

22. Care UK Plc

Preliminary Results for the year ended 30 September

2008

Care UK Plc, the leading specialist health and social

care provider, is pleased to announce preliminary

results for the year ended 30 September 2008.

Including joint venture operating profit; before

amortisation of intangible assets and impairment

of goodwill and intangible assets and, for

2007 only, integration and restructuring costs.

Total borrowing facilities available of £273.7m, with

total funding headroom of over £80m including over

£54m under the main syndicated facility, which is

committed until early 2015; the group remains comfortably

within key covenants with no need to raise

additional finance to fund development plans.

Social Care:

Aggregate revenue increased by 10% and adjusted

operating profit by 4%, with solid performances

in Residential Care and much of Specialist

Care

UK's Health Care business now widely recognised

as sector's largest and most influential independent

sector provider of healthcare services to NHS

patients

Strategic acquisition of 50% of Partnership Health

Group not previously owned completed on 1 August

2008

John Nash, Chairman of Care UK, commented:

“Care UK's strong performance during 2008 demonstrates

the resilience of the group and the benefits of

investment in the emerging healthcare market.

“Both the current Government and the Conservative

party have reaffirmed their strategies for the evolution

of a competitive market for NHS services and we anticipate

further growth in both our Health Care and

Social Care businesses as a consequence. We are

currently bidding for selective opportunities in the

NHS' 'Equitable Access' procurement for primary

care services and we anticipate a further substantial

range of opportunities to flow from the NHS strategy

to separate and introduce competition for PCT Provider

Arms that represent expenditure of around

£10bn per annum.

“Having successfully created competencies strongly

aligned with the integration of secondary and primary

healthcare and with social care services,

Care UK is strongly positioned to benefit from further

service and market reform offering good opportunities

for delivering exceptional long-term value to shareholders”.

Adjusted operating profit, including joint venture operating

profit and stated before amortisation and impairment

charges, is up by 20% to £36.4m (2007:

£30.4m) on revenue, including share of joint venture

revenue, increased by 24% to £341.6m (2007:

£275.7m), and adjusted profit before tax is up by 18%

to £22.5m (2007: £19.1m). Adjusted basic earnings

per share were up by 6% to 27.92p (2007: 26.26p).

The total basic loss per share was (4.98)p (2007:

earnings of 20.27p). Operating cash flow was £46.9m

(2007: £32.5m), an increase of 44%, representing a

cash conversion ratio of 147% (2007: 128%) measured

against adjusted operating profit, excluding

share of joint venture operating profit.

Dividend

The board is recommending a final dividend of 3.10p

per share (2007: 2.80p), an increase of 11%, which

will be paid on 18 February 2009 to shareholders on

the register on 23 January 2009.

Amounts in £m unless stated

30 Sept 2008

30 Sept 2007

Revenue: group and share

of joint venture 341.6 275.7

Operating profit 12.8 23.0

Adjusted operating profit * 36.4 30.4

Profit before group taxation 1.6 14.5

Profit before group taxation,

integration & restructuring

costs, amortisation and impairment

charges

22.5

19.1

Basic (LPS)/EPS (4.98)p 20.27p

Adjusted basic EPS * 27.92p 26.26p

Total dividend, paid and proposed

4.43p 4.02p

Operating cash flow 46.9 32.5

Total net debt 180.2 170.3

23. Nestor Healthcare Group plc

Interim Management Statement - Financial performance

Group results in the period since the release of our

Interim results have remained in line with the Directors'

expectations.

Our Social Care businesses have continued to perform

well with volumes in Goldsborough / Medico

beginning to show growth over the equivalent period

in the previous year. Tender activity remains high

and competitive, and a number of useful new wins

have been achieved. The focus in recent months has

been on individual branch performance with progress

being made in the recruitment of careworkers whilst

at the same time retaining the drive to improve quality

where the Group CSCI (Commission for Social

Care Inspection) ratings continue to improve. Our

two private homecare businesses, Country Cousins

and Patricia White's continue to grow and deliver

excellent returns.

Financial position

The sale of Carewatch, net of expenses, has generated

cash of approximately £36.0m in the month of

October. Borrowings as at 13 November 2008 were

£20.0m, which compares to the last published figure

of £54.1m as disclosed in the Interim statement as

at 4 July 2008. In the period under review the Group

has made a planned payment £0.9m into our existing

defined benefit pension schemes as well as paying

deferred consideration of £0.4m in respect of acquisitions

completed in 2007.

The net proceeds from the Carewatch disposal have

been applied to pay down bank borrowings. As part

of the same agreement with the Group's bankers, our

borrowing margin has been reduced from a maximum

of 2.75% over LIBOR to a maximum of 2.00%

over LIBOR. Financial covenants have also been

amended to figures more consistent with the Group's

balance sheet and income projections following the

Carewatch disposal.

Chief Executive

John Rennocks has continued to fill the role of Chief

Executive on a three day a week basis. A search

process for a full time appointment is ongoing.

Care Homes

24. Are you entitled to a care home rebate?

23 November 2008 - The Mail on Sunday

An item about the error of St Helens Borough Council

in assessing the assets of one of the service users

whose means were wrongly assessed by council staff

who did not follow the CRAG guidelines; resulting in a

service user paying many thousands of pounds for

her care which should have been provided free of

charge. St Helens has refused to conduct a general

review of the assessments of other people.

Ed. If you live in St Helens the message must be to

demand a review if you think the calculation of contribution

may be wrong demand the calculation be rechecked.

Better still, check yourself or seek the help

of others to do so!

25. ECCA fees campaign

English Community Care Association continues to

press for public recognition of the low level of fees

paid by local authorities – ECCA is currently concentrating

on the London area.

26. Home care service licence revoked

19 November 2008 – BBC News

Working Together Specialist Care Agency has had its

registration cancelled after Walsall Council applied to

magistrates to revoke its licence.

The home care provider’s clients were judged to be at

risk after inspectors found that the level of care offered

fell below acceptable levels.

For full report click here

Case Reports

Law Reports

27. R (Purdy) v Director of Public Prosecutions

Lord Justice Scott Baker held in the Queen’s Bench

Divisional Court, by way of judicial review, that a ban

on assisted suicide does not breach a right to privacy

under Article 8 of the European Convention on Human

Rights.

Disciplinary cases

Nothing to report

Cases in the news

28. Care workers 'not fully trained'

21 November 2008 – BBC News

Two carers at Owens Way in Cowley told an inquest

that they were not fully trained in how to use a bath.

Yelena Hasselberg-Langley, 18, suffered 20% burns

after being put into the bath at a care home when the

carers thought the temperature of the bath was controlled

by a thermostat.

For full report click here

29. Charge dropped in home care case

20 November 2008 - BBCOnline

William Davies of Chippenham, Wilts, Pearl Jackson,

of Wakefield, W Yorks, Heather Bolton and Derek

Youds, both from Gloucester, all faced alleged offences

at Newsham House, Gloucester.

After two days of legal argument at Bristol Crown

Court, Judge David Ticehurst ruled the matters

should be "stayed as an abuse of process" following

the arguments.

The four accused said after the hearing they were

relieved at the judge's decision.

Mr Youds, 64, and Ms Bolton, 56, who were employees

at the home, faced 10 and eight charges respectively.

Managing Director, Pearl Jackson, 49, and operations

director, William Davies, 60, of ADL plc faced

eight charges each.

Mr Davies said a full statement on the case would be

issued by ADL after the ruling was published.

30. Bankrupt carer jailed after cruel theft

17 November 2008

A bankrupt who stole from the elderly lady she cared

for has been jailed for 18 months.

Christine Townsend, 54, from Clifton in Bedfordshire,

took nearly £20,000 from June Marden in 2004 after

starting work in her home as a care assistant.

Mrs Marden suffered from dementia and Townsend -

then known as Christine Dunville - took advantage of

her, transferring her victim's life savings into her own

bank account.

The deception came to light after Townsend was declared

bankrupt and her finances investigated by the

Official Receiver. On the transfer being discovered,

Townsend maintained that money was a gift from Mrs

Marden after she told her that she was getting married.

In sentencing Townsend at Luton Crown Court,

Judge Andrew Bright QC said:

"The breach of trust which these offences involved is

as bad an example of taking advantage of a vulnerable

old lady as it can get. In my judgement it is so

serious that the only appropriate sentence for these

offences is imprisonment."

Business Minister Pat McFadden said:

"We are determined to crack down on cheats like

these who profit by deception.

"This prosecution sends a clear message to would-be

fraudsters that they won't get away with it."

Townsend was sentenced to 15 months for two

counts of theft and a further three months for four

bankruptcy offences.

As well as stealing a total of £19,707, Townsend later

failed to provide required information to the Official

Receiver and illegally obtained credit from two banks

without informing them of her bankruptcy.

The stolen savings will now be returned to Mrs

Marden's family.

Children

31. Child safety records scrutinised

21 November 2008 – BBC News

Ofsted’s annual report of children’s services has

found that some English local authorities did not have

adequate child protection.

Last year four authorities fell into this category: Hertfordshire,

Salford, Stoke-on-Trent and Peterborough.

This year's round of inspections is currently under

way and the councils have been defending their records.

Haringey - much criticised following the death of Baby

P - was rated "good".

Ofsted's summary report on the 137 services inspected

during 2007, out of a total of 150, found "a

slightly less positive picture of councils' contribution to

all aspects of the staying safe agenda".

The proportion judged outstanding in 2007 (9%) was

smaller than in 2006 (16%), and the overall proportion

judged to be good or better (70%) was also down

(from 73%).

For full report click here

32. What is a Children's Trust?

19 November 2008 – DoH

A summary leaflet has been produced to explain what

Children's Trusts are, what they do, and the role the

NHS has to play in them.

For full report click here

Conferences & Courses

To follow next week

Consultations

33. 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

34. 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 codfiy 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

35. 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

36. 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

37. 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

38. 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

39. Enforcement policy consultation

On 24 October 2008 CQC launched a 12 week consultation

on how it intends to use its enforcement

powers under the Health and Social Care Act 2008.

Visit the CQC website to download a copy of the consultation

document. This consultation closes on Friday

16 January 2009.

40. 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

41. Independent Review of Older People's

Engagement with Government: Consultation

Closing Date: 9 January 2009

This consultation seeks views on a report that examines

the current arrangements for the engagement of

older people and the ability of those arrangements to

inform the policy and actions of Government at all

levels.

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

ind_review_older_peoples_eng_with_govt.asp

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. Consultation on Statutory Guidance: The

roles and responsibilities of the lead member

for children's services and the director of

children's services

Closing Date: 10 February 2009

This consultation seeks views on updated statutory

guidance that explains the roles of the lead member

and director of children's services and how working

together as a team, they can be most effective in driving

clear improvements in outcomes for children and

young people.

For consultation go to http://www.dcsf.gov.uk/consultations/

conDetails.cfm?consultationId=1583

49. 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

50. Latest Reports and alerts from CSCI

Medical alerts

20 November 2008

The latest alerts from the Medicines and Healthcare

products Regulatory Agency.

Management of controlled drugs in care homes

20 November 2008

Every care home must comply with legislation on the

safe management of controlled drugs in care homes.

Safe disposal of waste medicines from care homes

(nursing)

20 November 2008

This guidance is about the changes to the arrangements

that affect the disposal of medicines in care

homes (nursing).

Immunisation in care homes (nursing)

20 November 2008

This guidance gives our inspectors a guide to good

practice when vaccines are prescribed for residents

and given by registered nurses employed by the care

home (nursing).

Administration of medicines in care homes

20 November 2008

A guide to good practice in how medication should be

administered in care homes.

Christian Scientists and care homes

12 November 2008

Read our guidance for inspectors to be aware of the

needs of residents in care homes who are Christian

Scientists (CS).

51. Principles into Practice Network Awards

20 November 2008 – SCRC

A new Awards scheme has just been launched by the

Principles into Practice Network.

The scheme was set up to recognise best practice in

applying mental health Act principles in Scotland.

Awards will be presented at an event in Glasgow on

March 10th 2009, and will be given to projects or services

that have shown real commitment to putting the

needs and views of services users and carers at their

heart.

For full report click here

52. Consultation on our Corporate Health &

Safety Policy

19 November 2008 – SCRC

The Scottish Care Commission has declared its commitment

to the health, safety and welfare of staff and

visitors to its premises.

For full report click here

53. Tell us your stories about social care

19 November 2008 – CSCI

CSCI is producing 3 short pieces of animation for its

website to explain what social care is and how people

experience it. CSCI would like your help in creating

the animations.

For full report click here

54. Care services need to improve recruitment

practices

17 November 2008 – SCRC

The Scottish Care Commission has said that one in

five care services in Scotland have been found to

have unsafe procedures in place for recruiting staff,

according to its review.

For full report click here

55. Summary of Care Commission Forums

now available

17 November 2008 – SCRC

Each year the Scottish Care Commission holds at

least two Care Commission Forums.

The first event was held in Dunoon and attracted over

60 delegates and the second was in Oban with over

50 people attending.

For full report click here

56. Four senior appointments at Care Quality

Commission

18 November 2008

Four appointments have been made to the senior

management team of the Care Quality Commission.

Jill Finney has been appointed Director of Engagement

Richard Hamblin has been appointed Director

of Intelligence.

Gary Needle has been appointed Director of

Methods

Jamie Rentoul has been appointed Director of

Regulation & Strategy

Jill Finney is currently Director of Strategic Marketing

and Communications at the British Library. Before

joining the British Library in 2001, she was: National

Marketing Director and Member of Global Marketing

Council for Ernst & Young.

56. Four senior appointments at Care Quality

Commission

Richard Hamblin is currently Head of Information

Policy at the Healthcare Commission. Before joining

the Healthcare Commission he was Business Analysis

Manager, East Sussex, Brighton and Hove Health

Authority. He has also worked for the Kings Fund.

Gary Needle is currently Head of Assessment and

Methods at the Healthcare Commission. His previous

posts include Chief Executive of Brighton and

Hove City Primary Care Trust and Executive Director

of West Sussex Health Authority.

Jamie Rentoul is currently Head of Strategy at the

Healthcare Commission. Before joining the Healthcare

Commission Jamie was Executive Director of

Prime Minister's Strategy Unit (formerly called the

Performance and Innovation Unit) based in the Cabinet

Office and Head of the NHS Waiting List team at

the Department of Health.

Cynthia Bower, Chief executive of the Care Quality

Commission, said: "I am delighted that Jill, Richard,

Gary and Jamie will be joining us. They will bring a

vast amount of knowledge and experience to the

CQC and will help us ensure a smooth transition.

"We are in the process of recruiting a further three

Directors who will bring a range of experience from

across social care, mental health and health care

and give us a management team fully equipped to

deliver our vision of making care better for everyone."

The Care Quality Commission's manifesto, which

sets out its vision and values, can be found at http://

www.cqc.org.uk

57. Enforcement policy consultation

On 24 October 2008 CQC launched a 12 week consultation

on how it intends to use its enforcement

powers under the Health and Social Care Act 2008.

Visit the CQC website to download a copy of the consultation

document. This consultation closes on Friday

16 January 2009.

58. Guidance for NHS trusts on registering

with CQC in relation to HCAI

Also published on 24 October, CQC has released

guidance for NHS trusts on registering in relation to

healthcare-associated infections (HCAIs). From 1

April 2009, all NHS organisations providing care directly

to patients will be legally required to register

with CQC and must operate in a way that protects

patients and staff from such infections.

A copy of this guidance document is available to

download from the CQC website.

Ireland, Scotland & Wales

Ireland

59. Diagnosing the state of health funding

22 November 2008 – BBC News

A look at Northern Ireland’s health service and

whether it has enough money or not.

For full report click here

60. Health funds announced amid cuts

19 November 2008 – BBC News

Irish Health Minister Michael McGimpsey has announced

that new health and social care centres are

to be built in Larne, Carrickfergus and Ballymena.

It is part of a £29m investment in the Northern Health

Trust over three years.

For full report click here

Scotland

61. Sturgeon 'obstacle' To C.diff Probe

21 November 2008 – Evening Times

Holyrood Labour leader Iain Gray has said that

Health Secretary, Nicola Sturgeon, is the "only obstacle"

to a public inquiry into the deadly clostridium difficile

outbreak at Vale of Leven hospital.

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

display.var.2469715.0.0.php?utag=28804

62. New target for test waiting times

20 November 2008 – BBC News

Scottish Health Secretary, Nicola Sturgeon has

pledged that patients waiting for key diagnotistic tests

such as MRI and CT scans will have shorter waiting

times from next year.

An Audit Scotland report found the number of patients

waiting more than nine weeks for key tests had fallen

from 10,638 to just two since 2006.

For full report click here

63. C.diff cases at Scottish hospitals

19 November 2008 – BBC News

Scottish health boards have revealed the total number

of C.diff cases they recorded from the period of

December 2007 to May 2008.

Overall, 3,174 C.diff cases were recorded between

December 2007 and May 2008 at 38 hospitals.

For full report click here

64. Care staff not given crime checks

17 November 2008 - BBCOnline

For full report see Workforce—item 108

Wales

65. Wales A&E figures miss key target

20 November 2008 – BBC News

Welsh hospitals have fallen behind key targets for

waiting times at A&E departments again.

The Assembly Government set a target of 95% of

patients spending under four hours in Welsh A&E’s

but the target was missed by Wales as a whole last

year.

For full report click here

66. Foot training to avoid slip-ups

19 November 2008 – BBC News

Care home staff in Flintshire will be trained to understand

the importance of properly fitting footwear in

preventing falls by residents.

According to statistics, badly-fitting footwear like slippers

are one of the major causes of falls for older

people and they can sustain bruising, sprains or

even broken bones.

For full report click here

67. NHS staff suspensions highlighted

17 November 2008 – BBC News

Figures obtained by a Welsh Assembly member shows

that over 400 NHS staff were sacked or suspended

over the past two years. Abuse of patients, sexual harassment,

drug thefts and fraud were among the alleged

offences.

Chris Franks AM subsequently warned that suspensions

for a year or over sometimes put extra pressure

on others working in the NHS.

The figures, obtained using the Freedom of Information

Act (FOI), showed the costs of paying staff while they

were suspended was more than £850,000 over two

years.

For full report click here

Learning Disabilities

68. “I never thought anyone would give me a

real job”

20 November 2008 - MencapNewsletter

My name is Neil Beard and I was supported by Mencap

to get a job at Sainsbury’s. I was recently asked

to be in a Sainsbury’s ‘You Can’ DVD. I was very

nervous but after the first take I started to relax.

For full report go to http://www.mencap.org.uk/page.asp?

id=4816

69. Transfer of Learning Disability SC Funding

and Commissioning from the NHS to Local

Government

19 November 2008 – DoH

A letter to all primary care trusts and strategic health

authorities which updates the transfer of commissioning

responsibility from primary care trusts to local authorities

with respect to non-health care-related expenditure

for people with learning difficulties.

For full report click here

70. Craegmoor Service User Takes Important

Next Step

18 November 2008

Craegmoor Healthcare, congratulated Melanie Farr, a

resident of its Woodpecker Lodge supported living

facility, on moving into a flat of her own.

Melanie, who has been receiving support from Craegmoor

for over 5 years, will now receive 53 ½ hours of

support a week, partly shared, partly one to one, in

her new home. Melanie is one of several people supported

by Craegmoor who benefiting from the development

of the company's supported living services.

At Woodpecker Lodge, people who require

services from Craegmoor can develop their independent

living skills with the aim of living independently in

the community when they feel ready.

Melanie now will move into an apartment complex run

by her local housing association who have been very

keen to work with Craegmoor to provide suitable accommodation

for people who wish to be supported by

the company within the community rather than in a

care home setting. This is an exciting new phase in

Melanie’s life and she is looking forward to choosing

her furniture and decorating her new home. Melanie

is already incredibly active in her local community and

has for a number of years held several voluntary positions.

These include helping out in a resource centre

catering for older people, working in a local bookshop

and assisting at functions held by her local cricket

club.

With support from Craegmoor and the Learning Disabilities

team at Hereford Council Melanie hopes to

use this experience to gain paid employment somewhere

where she can put her people skills to good

use.

Woodpecker lodge manager Anne Fletcher said today:

“I am pleased that Melanie is excited about moving in

and l look forward to visiting once she has moved in

properly. I’d like to thank the team at Hereford Council

for their help and look forward to working with them

to ensure more people who use our services are able

to live the lives they want within the community.”

Craegmoor’s Chief Executive, Ted Smith, said today:

"Mel is taking an important next step in her life and I

am proud that we are able to support her. At Craegmoor,

we are committed to providing innovative options

for people to live independently in their own

homes, and personal choice is always our prime consideration."

71. Clear Thoughts

November 2008

A website has been set up specially for people who

have a learning disability.

The website is aimed at people who have a learning

disability, their family, friends and carers, and professionals

and those supporting the people and their families.

The website project is run by ARC, Association for Real

Change.

To access the website go to www.clearthoughts.info

Legislation Update

72. No. 375 Act of Sederunt (Summary Applications,

Statutory Applications and Appeals

etc. Rules) Amendment (Adult Support and

Protection (Scotland) Act 2007) (No. 3) 2008

19 November 2008 – OPSI

For full legislation click here

73. Children and Young Persons Act 2008

c.23

17 November 2008 – OPSI

For full legislation click here

74. No. 2940 The Children Act 1989 (Contact

Activity Directions and Conditions: Financial

Assistance) (England) Regulations 2008

17 November 2008 – OPSI

For full legislation click here

Mental Capacity

75. Allow dementia sufferers to die, says old

people’s ‘tsar’ Bakewell

17 November 2008 - Daily Telegraph

Joan Bakewell, the newly appointed tsar for older

people has said older people should not be kept alive

indefinitely by technology and that dementia sufferers

should be allowed to die once their identities had

faded away.

Mental Health

76. CAMHS review offers nothing new, says

Mental Health Foundation

19 November 2008

In response to the release of the Child and Adolescent

Mental Health Services (CAMHS) Review by the

Department for Children Schools and Families and

the Department of Health, Simon Lawton Smith,

Head of Policy at the Mental Health Foundation, said:

Nothing new

“This review, by its own admission, suggests no new

policy, and makes no major suggestions for structural

changes to CAMHS or Children’s Trusts. It is primarily

a plea to implement existing policy. The key question

is therefore whether the review’s recommendations

will achieve this, given the patchy implementation

of CAMHS around the country and current funding

pressures.”

New board needs teeth

“A National Advisory Council on Children's Psychological

Wellbeing & Mental Health could help speed

things up. But it will only have an impact if it is given

some teeth and can hold the government properly to

account. We also need to know what powers it will

have over local areas that are slow to commission

comprehensive CAMHS.

“Strengthening the national support programme can

also be welcomed in principle, but we would want

assurances about the level of resources that are

available for an expansion of this work.”

Unrealistic expectations

“Following this review, we expect the welcome, if

slow, improvement to CAMHS to continue. However,

we are not convinced the review will necessarily meet

the Health Secretary’s expectation of a dramatic improvement

in CAMHS services in the next 12

months.”

The purpose of the CAMHS Review was to investigate:

(i) What progress has been made, since the launch of

Standard 9 of the Children’s National Service Framework

and the publication of Every Child Matters in

2004, in delivering services to meet the educational,

health and social care needs of children and young

people at risk of and experiencing mental health problems

(including those with complex, severe and persistent

needs)?

 (ii) What practical solutions can those developing

policy and delivering, managing and commissioning

services use to address current challenges and deliver

better outcomes for children and young people

with mental health problems? And how can these

solutions be monitored?

The National Service Framework for Children (NSF),

Young People and Maternity Services was launched

in 2004, a ten year policy document describing what

services and support children and young people

should be able to expect. Standard 9 of the NSF addressed

the mental health and psychological wellbeing

of children and young people.

A key recommendation of the review is the setting up

of a National Advisory Council on Children's Psychological

Wellbeing & Mental Health to oversee the delivery

of mental health services to children and young

people.

Bright Futures: Promoting Children and Young People's

Mental Health, a 1999 report from the Mental

Health Foundation, recommended that a Standing

Commission (Advisory Committee) on the Emotional

and Mental Health of Children and Young People

should be established to provide national leadership

to oversee the production and implementation of the

national framework and to develop a framework for

cross-professional training.

The Mental Health Foundation uses research and

practical projects to help people survive, recover

from and prevent mental health problems. It works

to influence policy, including government at the highest

levels and uses its knowledge to raise awareness

and to help tackle the stigma attached to mental illness.

Log on to www.mentalhealth.org.uk

Miscellaneous

77. 'It isn't easy to say no'

23 November 2008 – BBC News

A case study of Professor David Barnett, and his

work at the National Institute for health and Clinical

Excellence (NICE).

For full report click here

78. Disability minister reveals delay in ratifying

UN rights charter

21 November 2008 – Community Care

Jonathan Shaw, Disabilities Minister, has announced

that the Government is going to delay the ratification

of a United Nations disability rights charter until 2009,

due to ongoing concerns from various Government

departments over its implementation.

For full report click here

79. Health and Care Workers to set up new

social enterprises

20 November 2008

Marking Social Enterprise Day, Care Service Ministers

Phil Hope announced that six projects will share

£450,000 to establish new social enterprises which

will help the elderly, the disabled and the homeless,

and nurses will get more help to set up services that

will help their patients.

The six projects form part of the Government's

'Innovation for Life' Challenge Fund - a fund set up to

promote commissioning of innovative health and social

care services from social enterprises.

The projects to receive funding are:

* Gateshead Council (£61,875) to develop a new initiative

which will train and enable older and disabled

people to offer their skills and knowledge to other

people who need independent assistance.

* Bristol City Council (£40,000) will bring together

partners from the voluntary, community, social enterprise

and public sectors to tackle local health and

well-being challenges.

* NHS West Midlands (£100,000) will set up schemes

for respite care for disabled young people and their

families and improved engagement with groups such

as the homeless.

* Birmingham City Council (£63,750) to encourage

the development of a framework to support the startup

of local social enterprises.

* Croydon PCT and Croydon Council (£85,000) will

set up a Partnership for Older People's (POP) Village,

which will help older people in the borough.

* Kent County Council (£100,000) will engage with

and support PCT commissioning of social enterprises.

A how-to guide, called 'Social Enterprise - Making a

Difference' which will help community health and social

care staff set up social enterprises to deliver new

and improved services, was also launched today.

The "Right to Request" to set up social enterprises is

a commitment within the Next Stage Review of the

NHS published in July 2008. It allows primary and

community care staff to establish independent social

enterprises, providing an opportunity for them to deliver

their services in new ways. This right will help

staff drive up the quality of care by empowering them

to directly address local needs and ultimately improve

the health and well-being of the people they serve.

Phil Hope said:

"Social enterprise can support the development of

vibrant services that improve patient care. For this to

happen, PCTs and councils need to work together to

encourage social enterprise. This funding supports

innovation in organisations that are committed to improvement.

"This guide empowers frontline staff to directly help

the patients and communities they serve. Social enterprises

can also give greater freedom to staff to

use their professional skills to transform services.

Healthcare professionals have a long history of providing

innovative services in a variety of settings so

they are in an excellent position to take advantage of

this 'right to request'".

More information about the Department of Health's

social enterprise programme can be found at: http://

www.dh.gov.uk/en/Managingyourorganisation/

Commissioning/Socialenterprise/index.htm

The 'How To' guide for staff considering a right to

request to set up a social enterprise can be found at

h t t p : / / w w w . d h . g o v . u k and h t t p : / /

www.socialenterprise.org.uk. It was developed in

conjunction with the Social Enterprise Coalition.