Brunswicks is a specialist law firm offering strategic regulatory advice nationwide.

Making the most of BHCR

BHCR is distributed primarily by email and in pdf form. It is best viewed as a pdf where you will find embedded hyperlinks. We cannot guarantee that these links work or will remain working although they did at the time the edition was first published. This edition of BHCR is reproduced on this web-page. You can re-size the font and use the Search this Site facility to identify useful text. The hyperlinks are not activated directly from this web-page. If you wish to use them you are advised to use the pdf version.

Both editions are © Brunswicks LLP 2008

BHCR 2008 Vol 3 Issue 30
Brunswicks Healthcare Review 2008 Volume 3 Issue 30

(Click the icon to download)
© Brunswicks LLP 2008

This week's article

Editorial

I applaud the increase in adult abuse alerts; not

because I believe there is increased abuse, rather,

that there is increased knowledge of what might

comprise unacceptable conduct and there is better

understanding of the mechanisms for bringing such

matters to the attention of ‘the relevant authorities’.

Many councillors and officers have, in my view,

become unduly worried about the fact of the increase

in the number of reports themselves – examples are

reported in this issue of BHCR (items 2 & 4). The

statistics to focus on are whether:

1. there was evidence found of abuse/mistreatment;

and, if so,

2. what was done to address the issues identified.

Worryingly, I had a senior officer of a council suggest

this week that an increase in numbers of such alerts

was, in and of itself, an indication of poor care

delivered by care homes! When challenged, the

officer retreated. However, the response betrayed

the no doubt deeply held view that all is not well with

a care provider who is subject of an abuse alert.

Many care providers I now actively encourage

people to raise concerns and to become engaged in

the process on the basis that if there is little wrong

there is little to fear. That will not last. Why?

Because there are some councils who, when an alert

is raised with them the first reaction is not to

investigate. No, the first reaction is to enforce a

‘stop’ on all referrals and placements in the

establishment. And for some, like Birmingham, say

that it will be at least three months before they begin to

investigate. Now THAT IS a scandal.

This week’s article

There are many myths surrounding the issue of radon gas in enclosed spaces, Gareth Thomas of the Health and

Safety Executive seeks to enlighten us all and to remind us of our obligations to employees and others who are in

enclosed spaces such as care homes, hospitals and the like.

We are very grateful to Gareth for taking the trouble to provide us with this article as HSE and councils ramp up

their activities in relation to radon.

To read article in full click here.

Parliament

The Summer recess began on 22.07.08 and lasts

until 06.10.08.

Next

Abuse

1. The vilest mind games

3 August 2008 - The Sunday Times

Full page article about the first UK cop to go undercover

in order to infiltrate the world of paedophiles.

2. 'Serious concerns' over care for vulnerable

Blackburn and Darwen adults

1 August 2008 - Lancashire Telegraph

In a new blow to Blackburn with Darwen’s adult social

care department, until recently rated “excellent”,

the service has been criticised in a new study by the

Commission for Social Care Inspection.

The report, presented to the council’s health scrutiny

committee raised two “recent and ongoing cases of

serious concern” about care providers contracted by

the council and said the council’s safeguarding

adults team lacked sufficient experience and knowledge.

David Kerambrum, acting director of adult services,

said that councils throughout the country were having

to cope with an increase in adult abuse allegations

because more information is being made available

to victims and others.

3. Jersey child abuse: case not closed

1 August 2008 - The Times online

Jersey's Government should take a more robust

stance over the child abuse investigations, and

should prevent closure of a murder investigation.

There was a note of resignation in the statement of

Lenny Harper, deputy chief officer of States of Jersey

Police, that there may never be enough evidence to

mount a murder inquiry into the partial remains of

five children found at Haut de la Garenne.

The Jersey government should take a more robust

stance over what has happened. For Britain, this is a

delicate matter. Jersey, a Crown dependency, is not

part of the United Kingdom and not subject to Home

Office control.

Ministry of Justice officials held talks with those involved

in the case and although there are ways of

intervening - either directly or through the Privy Council

- the British Government is reluctant to do so or

pre-empt the findings of an investigation still under

way. However baffling the case, it remains a homicide

investigation. There is no reason to curtail or

curb it. What happened in the dark cellars of Haut de

la Garenne must be revealed, whatever the financial

or political cost.

4. Big increase in abuse claims

30 July 2008 - Hartlepool Mail

Reports of abuse against vulnerable adults has continued

to increase over the past year. However,

council chiefs say that while increased awareness

about the issue has resulted in more reports being

made, the actual number of investigations has fallen

in the period to April 2008. The number of possible

abuse cases being brought to the council's attention

increased from 148 last year to 229 this year.

Alan Dobby, the council's assistant director of adult

and community services, said: "The number of cases

investigated are relatively small, and national research

suggests that abuse and neglect often goes

unreported.

"The committee is working to raise awareness and

ensure that concerns are picked up and reported."

Councillor Ged Hall, portfolio holder for adult and

public health services, said: "By bringing the issue

into the pubic domain it is a way of showing people

that this isn't being swept under the carpet.

"People should be encouraged to speak up if they are

being abused or if they know of someone that is, because

the support framework is there."

5. Home staff suspended in abuse claim

27 July 2008 - Press Association

Two members of staff have been suspended from

Kerrvale Nursing Home a nursing home in Glasgow

after allegations of abuse were made.

Bosses launched an investigation into the claims approximately

six weeks ago. It is understood the allegations

involve the behaviour of the workers towards

residents, but do not involve sexual abuse.

Business News

6. RJD buys big stake in Raphael

3 August 2008 - Mail on Sunday

Private equity group RJD Partners has bought a

multi-million pound stake in specialist mental health

provider Raphael valuing the women-only mental

health business at £30m.

The company was founded in 2006 by healthcare

entrepreneur John Lamb and Arthur Robinson, a former

NHS Trust Director of Mental Health, with a 30-

bed hospital in Nottinghamshire. It has added 11

beds and new units to that hospital, employing 101

people.

7. The Livingstone brothers, two of the UK's

biggest property investors, have put a

£400m portfolio of care homes on the market

in what could be one of the biggest property

deals of the year

3 August 2008 - Sunday Telegraph/

telegraph.co.uk

The properties are leased to Southern Cross, the

listed healthcare group which itself is trying to sell

property having previously breached banking covenants

on debt relating to care homes.

The Livingstone brothers are selling the properties

through their investment vehicle London & Regional.

Sources said the properties had been offered

to a select group of investors but had not been put

‘on the market’.

With prices dropping by up to 2% a month most investors

are waiting for more pressure to be put on

sellers before they enter the market.

All parties declined to comment.

8. Health group to meet lenders in £1.5bn

debt talks

1 August 2008 - Financial Times

The management of Four Seasons Healthcare and

its advisers will meet with lenders for the first time

next week in an effort to find a solution for a repayment

of its £1.5bn ($2.9bn) debt.

Four Seasons said on Wednesday that Murdoch

McKillop, a partner at Kroll Talbot Hughes, its financial

adviser, was to be appointed to its board. The

company has hired Kroll to "work with the management

team to negotiate the successful refinancing or

restructuring of the Group's capital structure".

Royal Bank of Scotland, the leading lender to Four

Seasons, has made available some £900m in financing

that could be used as part of a sale of the business

or debt restructuring. However, RBS, wants

£60m and a 2.5 per cent arrangement fee for providing

the financing

9. Care UK Plc

1 August 2008

The Board of Care UK announced the Admission of

4,666,666 New Ordinary Shares to trading on the

Official List of the London Stock Exchange had occurred.

Accordingly Care UK announces that the

acquisition of PHG has completed. The New Ordinary

Shares rank pari passu with the Existing Ordinary

Shares of 10p in all respects.

Following Admission of the New Ordinary Shares, the

Company announced that its share capital now consists

of 61,549,098 ordinary shares of 10p each with

voting rights. The Care UK Plc Employee Benefit

Trust holds 519,140 ordinary shares subject to options

in the Company, which it has agreed not to

vote.

Therefore, the total number of voting rights in

Care UK is 61,029,958.

10. Care UK Plc

30 July 2008

Care UK, today announced that the Company

had received written consent from the Department of

Health for the proposed acquisition of 50 per cent. of

Partnership Health Group Limited. The acquisition

remains subject to Shareholder consent at the

General Meeting to be held on 31 July 2008 and Admission

is expected on 1 August 2008 as stated in

the Circular dated 1 July 2008.

Care Homes

11. Watchdog criticises 13 care homes

1 August 2008 – BBC News

For full report see Ireland—item 43

12. Pet pigs 'success' at care home

1 August 2008 - BBC

Owning dogs and cats has long been considered to

have health benefits, but Birmingham care home,

Neville Williams House, operated by Broadening

Choices For Older People has gone a step further

and set up an on-site Pet Farm which has pigs, chickens,

rabbits and guinea pigs.

For full report click here

Ed. I am delighted to see this organisation and

care home, both of which I know well, get plaudits

for a novel a approach which has clearly enriches

the lives of the residents of the care home.

Case Reports

Law Reports

Nothing to report

Disciplinary cases

Nothing to report

Cases in the news

13. HSE and Kent police decide not to investigate

Maidstone and Tunbridge Wells NHS

Trust

30 July 2008 - COI

No charges over C. diff outbreak

30 July 2008 – BBC News

The Health and Safety Executive (HSE) and Kent

Police announced the conclusion of a joint review of

a Healthcare Commission report published in October

2007 into outbreaks of Clostridium difficile (C.

difficile) at Maidstone and Tunbridge Wells NHS

Trust.

HSE and Kent Police reviewed the Healthcare Commission's

report through a series of interviews with

the Commission's lead investigators and others and

concluded that there is insufficient information to

launch a criminal investigation.

The Healthcare Commission published a report into

failings of infection control at Maidstone and Kent

NHS Trust on 11 October 2007 - the report can be

found at http://www.healthcarecommission.org.uk//

n e w s a n d e v e n t s / p r e s s r e l e a s e s . c f m ?

cit_id=5875&FAArea1=customWidgets.content_view_1&usec

ache=false

HSE undertook the joint review of the Healthcare

Commission report with Kent Police. Their statement

on today's announcement can be found at http://

www.kent.police.uk/News/Latest_News/index.html

Further information on HSE's work with the Health

Services can be found at http://www.hse.gov.uk/

healthservices/index.htm

For BBC report click here

14. Body 'lay in care home for two days’

30 July 2008 – Islington Gazette

Islington Council has ordered Care UK to launch an

investigation into why the body of an elderly woman

was left in her room for two days.

A visitor to the Lennox care home in Durham Road,

Holloway reported that flies were buzzing around the

room of 98-year-old Winifred Staines and had started

to smell.

The council has confirmed that Mrs Staines was a

dementia sufferer and she died on July 14. It was

also reported that her body was not taken to the mortuary

and that the coroner was not informed until July

16.

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

islington/gazette/news/story.aspx?

brand=ISLGOnline&category=news&tBrand=northlondon24&t

Category=newsislg&itemid=WeED30%20Jul%202008%2014%

3A45%3A13%3A890

15. Patient's sex attack carer jailed

29 July 2008 – BBC News

Gareth Jones, a care worker, has been jailed for nine

years for carrying out a “vicious” sex attack on an

elderly patient at a nursing home. After the attack the

patient needed emergency surgery.

The court had previously heard the assault took place

on the night of 13 February 2007 as Jones was on a

night shift and was putting the woman to bed.

For full report click here

Also reported in BHCR, Vol 3, Issue 27 – item 30

16. Nurses suspended from care home

30 July 2008 – BBC News

Orchard Manor Home, currently owned by Southern

Cross has had seven nurses suspended after an inspection

body ruled that it was currently in breach of

some regulations.

The home said that seven residents were admitted to

Antrim Hospital in the last five weeks and that this

was not unusual.

The Northern Health Trust said that the residents admitted

were with a range of medical conditions.

For full report click here

Children

17. Early years inspections disrupted by pay

freeze dispute

28 July 2008 – Nursery World

Nursery and childminding inspections are being disrupted

due to Ofsted inspectors in early years and social

care being locked in a pay dispute over a three-year pay

freeze.

Unions have warned that the crisis is hitting preparations

for the new inspection framework for the EYFS, which

starts in September, as inspectors are now working a

36-hour week to rule, refusing to do overtime or use their

personal cars for business, which means that many are

unable to complete work allotted to them.

For full report click here

Conferences & Courses

To follow next week

Consultations

18. Consultation on Assessment of Adult Social

Care

Closing Date: 8 August 2008

The Commission for Social Care Inspection (CSCI) is

seeking views on its proposed modifications to the

body’s performance assessment of adult services in

2008-09.

For full consultation click here

19. The Nursing and Midwifery Council

(Constitution) Order 2008: a paper for consultation

Closing Date: 21 August 2008

A draft order setting out a proposed constitution for

the NMC. It provides details of the composition of the

council, the terms of office of council members, and

criteria for the disqualification, suspension or removal

of members from office.

For full consultation click here

20. Transforming the Quality of Dementia

Care: Consultation on a national dementia

strategy

Closing Date: 11 September 2008

A consultation seeking views on proposals for a national

dementia strategy. It draws on evidence from a

range of reports and stakeholders, a series of listening

events involving more than 3,000 people and the

recommendations of an external reference group.

For full consultation click here

21. Consultation on the Publication of Children's

Homes Inspection Reports

Closing Date: 16 September 2008

A consultation seeking views on whether or not Ofsted

should publish children's homes inspection reports

on its website.

For full consultation click here

22. The Council for Healthcare Regulatory

Excellence Draft Regulations 2008: A paper

for consultation

Closing Date: 16 September 2008

Consultation seeking views on proposals for the

membership of the reformed Council for Healthcare

Regulatory Excellence Council. Its proposals provide

details of the terms of office of council members, criteria

for the disqualification, suspension or removal

of members from office, committees appointed by the

Council and transitional arrangements in terms of

appointments.

For full consultation click here

23. Volunteering in health and social care

Closing Date: 30 September 2008

A volunteering strategy for health and social care will

initiate the key actions needed to address the perceived

obstacles to making a refreshed vision for volunteering

in health and social care a reality. The

plan is to publish a final strategy and implementation

plan in early 2009.

For full consultation click here

24. Towards a Strategy to Support Volunteering

in Health and Social Care: Consultation

Closing Date: 30 September 2008

A consultation seeking views on a proposed volunteering

strategy for health and social care that will

articulate the key actions needed to address the perceived

obstacles to volunteering.

For full consultation click here

25. The NHS Resilience and Business Continuity

Management Guidance 2008: Interim

strategic national guidance for NHS organisations

– Consultation

Closing Date: 30 September 2008

A consultation seeking views on a set of general principles

to guide all NHS organisations in developing

business continuity management processes.

For full consultation click here

26. Removing or suspending chairs and nonexecutives

of health bodies: consultation on

introducing new powers of suspension

Closing Date: 9 October 2008

A consultation document on proposals to introduce

powers of suspension, and a single approach to the

removal of chairs and non-executives of Strategic

Health Authorities and other health bodies.

For full consultation click here

27. A Consultation on the NHS Constitution

Closing Date: 17 October 2008

This consultation seeks views on a proposed NHS

constitution that aims to empower both staff and patients,

containing clear pledges on the ways in which

the NHS will strive to go beyond the stated rights to

improve the working environment.

For full consultation click here

28. CSCI: Give us your views on Comprehensive

Area Assessment

Closing Date: 20 October 2008

This is a second consultation on the Comprehensive

Area Assessment (CAA) that has been launched. The

CAA is the framework due to be launched in April

2009. This will assess how well councils deliver all

local services to their residents.

For full consultation click here

29. Responsible officers and their duties relating

to the medical profession - consultation

document

Closing Date: 24 October 2008

The White Paper 'Trust, Assurance and Safety' set

out an ambitious programme for the reform of professional

regulation including the creation of responsible

officers, who will be senior doctors with personal responsibility

for evaluating the conduct and performance

of doctors and making recommendations on

their fitness to practice as part of revalidation.

For full consultation click here

30. 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

31. Health services respond to Shipman inquiry

with better monitoring of controlled

drugs

1 August 2008 – Healthcare Commission

But more work still needed, says healthcare watchdog.

The Healthcare Commission has published a report

outlining steps that have been taken to improve the

monitoring of controlled drugs since the Controlled

Drugs (Supervision of Management and Use) Regulations

came into force in England on 1 January

2007.

The report points out that NHS and private healthcare

providers have taken positive steps to improve

the monitoring and management of controlled drugs

following the Shipman Inquiry but also states that

more work is necessary to ensure all concerns are

picked up, investigated and, where appropriate, action

is taken.

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

n e w s a n d e v e n t s / p r e s s r e l e a s e s . c f m ?

cit_id=6532&FAArea1=customWidgets.content_view_1&usec

ache=false

32. The Safer Management of Controlled

Drugs

1 August 2008

The English Community Care Association has given

strong support for the recommendation relating to

care homes in the Healthcare Commission’s report

The Safer Management of Controlled Drugs’, which

states that healthcare professionals who prescribe or

administer medicines to people living in care homes

must ensure that the care home has a written record

of the prescription and/or administration.

Martin Green, Chief Executive of ECCA, said:

“It is vital that care homes are included and respected

by health professionals when they prescribe or administer

drugs. Too often care homes receive criticism

on issues related to drug administration when in

fact it is failures by primary care and medical practitioners

that are at the root of many problems.”

“If we are to ensure safe and appropriate drug administration

to care home residents this must be done

by developing a team approach which has to include

good communication between users, care home staff,

prescribers and those who administer the drugs.”

33. Statement from the Healthcare Commission

in response to Kent Police and HSE's

announcement on Maidstone & Tunbridge

Wells NHS Trust

31 July 2008 – Healthcare Commission

The Head of Investigations at the Healthcare Commission,

Nigel Ellis, said:

“This entire process will undoubtedly have been difficult

for friends and relatives of those who died during

the Clostridium difficile outbreaks at Maidstone and

Tunbridge Wells NHS Trust. Our investigation catalogued

failures in management and leadership and

practices on the wards that were simply unacceptable.”

“Since publishing the findings of our investigation, our

focus has been on ensuring that this is never allowed

to happen again. We have conducted two follow-up

inspections at the trust and will be back in again

soon. We note the significant improvements they

have made, but will make our final judgement on progress

when we publish the follow-up report later this

year. “

“The entire NHS must learn the lessons from the

events at Maidstone and Kent hospitals. There are

signs that the recent focus on infection control within

the NHS is starting to turn the tides, with rates of

Clostridium difficile finally showing signs of decline.

This must be sustained and infection rates brought

down further across the country.”

For case report see item 13 in this issue

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

newsandevents/pressreleases.cfm?

cit_id=6530&FAArea1=customWidgets.content_view_1&useca

che=false

34. New In Focus bulletin published

August 2008 - Newsletter from CSCI

Providing appropriate services for black and minority

ethnic people.

CSCI has published a new bulletin which aims to

address the needs of black and minority ethnic people

using care services. This is the second bulletin in

our series Diversity matters: Putting people first.

Read the bulletin

35. ‘Regulation 37 notifications’

New notifications forms

August 2008 - Newsletter from CSCI

CSCI has amended the notifications forms so that it

is easier for you to notify deaths, illnesses and other

serious events.

There are now two simpler forms for each type of

service:

The first is for notifications about people who use

the service

The second for notifications about the service's

premises, registered provider(s), registered manager,

staff, or statement of purpose

Read guidance on the new notifications forms

36. Appeals against Star Ratings...

CSCI National Quality Board meets next on

02.09.08

The meeting will consider quality ratings nationally,

trends and patterns. There will also be an

update on the CSCI Quality Ratings Review Service

(QRRS).

It is reported that there have been 45 appeals from

homes in relation to inspection reports.

20 have been deemed ineligible for review.

25 reviews are being progressed.

12 have been completed, one has had an improved

rating awarded, one has seen its rating reduced and

10 remained unchanged.

37. Statement from the Healthcare Commission

in response to the independent inquiry

into access to healthcare for people with

learning disabilities

31 July 2008– Healthcare Commission

The Healthcare Commission’s lead on learning disability

services, Fiona Ritchie, said:

"We welcome the findings of the inquiry. This is yet

more evidence that, in too many cases, people with

learning disabilities don't get the health services they

need.”

"We know that people with learning disabilities are

more likely to suffer from serious health problems, yet

they often lack access to healthcare services.”

"We must make sure that the findings of the inquiry

engender real change. Leaders in trusts must assure

themselves that they are providing services to people

with learning disabilities that are robust, fair, or good

quality and compliant with the Disability Discrimination

Act 2005. They should take action where they

are falling short.”

"Strategic health authorities and Monitor should

check up on trusts and take an active role in making

sure that the NHS is meeting the health needs of

people with learning disabilities."

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

newsandevents/pressreleases.cfm?

cit_id=6531&FAArea1=customWidgets.content_view_1&useca

che=false

38. New health guidance - infection control

1 August 2008 – Scottish Care Commission

Guidance has been issued for Service Providers, the

Public and Care Commission staff involved in regulatory

activities and focuses on the key issues contained

within the Code of Practice highlighting how it

underpins the regulations and national care standards

used by the Care Commission.

For full report click here

To access guidance document click here

39. Give us your views on the Comprehensive

Area Assessment

29 July 2008 – CSCI

The second consultation on the Comprehensive Area

Assessment (CAA) has been launched and the link to

the consultation document can be found in the Consultations

section – item 28.

For full report click here

40. Clostridium difficile - ongoing key messages

28 July 2008 – Scottish Care Commission

The Health Protection Scotland website,

www.hps.scot.nhs.uk now provides current evidence

based information on all aspects of infection prevention

and control.

For full report click here

To read NHS Scotland - Infection Control Standards for Care

Homes document click here

41. Equality Impact Assessment – Inspection

process and the introduction of grading care

services

28 July 2008 – Scottish Care Commission

The Equality Impact Assessment of the 'Inspection

process and the introduction of grading care services'

was approved by the Executive Management Team

on 3 June 2008.

For full report click here

To view the Equality Impact Assessment click here

Dementia

42. Blood pressure drug dementia hope

28 July 2008 – BBC News

American research suggests that a drug normally

used to lower blood pressure could prevent or delay

thousands of Alzheimer’s cases. People who took

angiotensin receptor blockers were up to 40% less

likely to develop dementia than those taking different

blood pressure drugs. Patients who already suffered

from dementia were less likely to get any worse.

For full report click here

Education

Nothing to report

Ireland, Scotland & Wales

Ireland

43. Watchdog criticises 13 care homes

1 August 2008 – BBC News

13 Northern Irish care homes have failed announced

and unannounced inspections by the Regulation and

Quality Improvement Authority.

Ten of the homes look after the elderly and three are

children’s homes.

For full report click here

Scotland

Nothing to report

Wales

44. NHS waiting time failure review

29 July 2008 – BBC News

Welsh Health Minister, Edwina Hart has ordered two

internal reviews into Cardiff and Vale NHS Trusts for

their failure to reach waiting time targets. She expressed

her disappointment and stated her concerns

over the management of waiting lists for orthopaedic

and heart treatments.

For full report click here

Learning Disabilities

45. Residents moved as two homes shut

1 August 2008 – BBC News

Twelve people with learning and physical disabilities

were forced to move from two care homes with just

one week’s notice after the company running them,

shut them down.

The Wey Forward Initiatives Ltd went into liquidation

and closed the homes in Guildford, Surrey.

For full report click here

46. The Protection of Vulnerable Adults list:

an investigation of referral patterns and approaches

to decision-making

31 July 2008 – DoH

The Department of Health has introduced the Protection

of Vulnerable Adults (POVA) list on 26 July 2004,

as part of the implementation of the Care Standards

Act (2000).

This is also a complement to the requirement for the

development of local multi-agency adult protection

policies and procedures.

For full report click here

47. Independent Inquiry into Access to

Healthcare for People with Learning Disabilities:

Dear colleague letter

30 July 2008 – DoH

Disabled 'face suffering in NHS'

29 July 2008 – BBC News

This is a letter from Chief Executive of the NHS in

England David Nicholson announcing the publication

of an independent inquiry into access to healthcare

for people with learning disabilities, which concludes

that people with learning disabilities have worse

health and receive a worse quality of care in the NHS.

For DoH report click here

For BBC report click here

48. Learning disability healthcare report welcomed

30 July 2008 – NCF

Chief Executive of Mencap, Dame Jo Williams said:

“Mencap welcomes the Independent Inquiry report". It

proves that people with a learning disability are being

discriminated against in the NHS, which is leading to

unnecessary pain and death.”

“It is clear that there is a desperate need for mandatory

learning disability training for all health care professionals,

and for people with a learning disability

and their families and carers to be at the centre of all

decisions made surrounding their healthcare".

“The findings and recommendations will bring some

comfort to the families in Mencap’s Death by indifference

report, who bravely told their stories to highlight

the widespread discrimination and ignorance.”

For full report click here

49. People with learning disabilities let down

by NHS, inquiry finds

30 July 2008 - Health Service Journal

The independent inquiry into access to healthcare for

people with learning disabilities has published its

findings and its recommendations have been welcomed

by the NHS Confederation.

Healthcare For All says people with learning disabilities

have higher levels of unmet need and receive

less effective treatment, despite the Disability Discrimination

Act and Mental Capacity Act setting out a

clear legal framework for the delivery of equal treatment.

50. Foundation for People with Learning Disabilities

charity responds to “Healthcare For

All” report

29 July 2008

In response to the publication of ‘Healthcare For All’,

report of the independent inquiry into access to

healthcare for people with learning disabilities, Alison

Giraud-Saunders, Co-Director at the Foundation for

People with Learning Disabilities, said:

“While the report it is to be welcomed, it must not be

allowed to join the growing pile of paper promises

that people with a learning disability have become

used to. Immediate action needs to be taken to implement

the inquiry’s recommendations. One Strategic

Health Authority set out comprehensive plans

addressing the health needs of people with learning

disabilities following on from Lord Darzi’s NHS review.

We would like to see other Strategic Health

Authorities follow this good example.

“This report is a blueprint for what needs to happen

to end the difficulties many people with a learning

disability face when trying to access the healthcare

most of us take for granted. It’s completely unacceptable

that anyone should be disadvantaged in our

healthcare system simply because they have a disability.”

Legislation Update

51. No. 1716 (W.163) The Childcare Act 2006

(Provision of Information) (Wales)

(Amendment) Regulations 2008

1 August 2008 – OPSI

For full legislation click here

52. No. 1716 (W.163) The Childcare Act 2006

(Provision of Information) (Wales)

(Amendment) Regulations 2008

1 August 2008 – OPSI

For full legislation click here

53. No. 1971 (C.95) The Education and Inspections

Act 2006 (Commencement No.7

and Transitional Provisions) Order 2008

29 July 2008 – OPSI

For full legislation click here

54. Health and Social Care Act 2008 c.14

28 July 2008 – OPSI

For full legislation click here

55. No. 1972 (C.96) The Health Act 2006

(Commencement No. 5) Order 2008

28 July 2008 – OPSI

For full legislation click here

Mental Health

56. First Office of the Public Guardian Annual

Report Shows Widespread Use of the Mental

Capacity Act

1 August 2008 - COI

More people are taking steps to ensure their rights

and those of their loved ones, are respected by registering

plans setting out what should happen to their

financial and health matters should they lose mental

capacity, according to figures published in the Office

of the Public Guardian's first Annual Report and Accounts.

* Nearly three times more people have applied to register

their Lasting Power of Attorney (LPAs) than in

previous years.

* The number of applications to the Court of Protection

for a finance or health and welfare decision have

significantly exceeded expectations.

* Nearly three times more investigations into the actions

of deputies and attorneys compared to last year.

* More than 50 applications made to the Court of Protection

by the Public Guardian in cases where there

are concerns about a deputy or attorney

The Public Guardian and Chief Executive, Martin

John, said:

"The introduction of the Mental Capacity Act has resulted

in a high volume of applications to register

Powers of Attorney, a sign that people are increasingly

thinking about and planning for their futures.

Due to the unexpected and considerable demands

on our services, we are continually improving our

processes and deploying our staff to help manage

the workload. We expect to see a return to our published

standards over the summer period.”

"We will continue to work closely with customers and

stakeholders to make sure that we can deliver the

service they expect."

57. Implementation of the Mental Health Act

2007: Transitional arrangements

31 July 2008 – DoH

Guidance explaining the transitional provisions associated

with changes to the Mental Health Act that

come into force in November 2008.

For full report click here

58. Mental Health Act 1983 Approved Clinician

(General) Directions 2008

31 July 2008 – DoH

These directions explain the changes to the Mental

Health Act that come into force in November 2008.

For full report click here

Miscellaneous

59. 'I would never know who's in the Priory',

says Philip Scott

3 August 2008 - The Sunday Times

Significant item about Philip Scott:

Born: Belfast, 1964

Education: Orangefield Primary, Belfast; Grosvenor

Grammar School, Belfast

Career:

2008 to date Chief executive, The Priory Group

2002–07 Chief executive, Southern Cross;

2000-02 Managing director, Southern Cross;

1998–2000 UK managing director, Tamaris;

1993–98 UK managing director of Crestacare;

1990-93 manager of an independent care home;

Other interests: football, running

Philip Scott, the chief executive of the Priory, has offered

the NHS fixed-price terms for patients to boost

occupancy – a detailed look at his achievements and

his growth plans for the Priory.

60. Care home bills Aberdeen council for 14

dead residents

3 August 2008 - The Sunday Times

Southern Cross Healthcare Group, the largest UK

care provider, collected £60,000 from debt-ridden

Aberdeen City Council over eight months after failing

to notify the council of 14 deaths. The money has

been repaid.

A council spokeswoman said there had been no

criminal intent on the part of Southern Cross and put

it down to an “unfortunate mistake”.

61. Is the law bleeding the NHS to death

3 August 2008 - The Sunday Times colour supplement

A look over five pages at the cost of medical mishaps

and the cost and compensation which drains some of

the resources away from front-line care – more than

£9bn.

62. The bank that invests in life

2 August 2008 - The Times

A look at Britain’s largest blood cord bank which is

due to open in September.

63. Millions fail to take their medication as

prescribed

1 August 2008 - The Times

More than 8million people failed to take prescribed

medication correctly according to the NHS Information

Centre

64. Elusive doctors

31 July 2008 - The Times

Millions of patients continue to struggle to get a GP

appointment according to a Healthcare Commission

study of 69,000 people in England suggests:

41% of people wanting an appointment were seen

on the same working day;

33% waited one or two days; and

13% waited longer than two days because no appointment

was available.

65. Doctors complain about rating website

Doctors have complained to the Information Commissioner

about the doctors’ rating website iwantgreatcare.

org.

66. London GP patients 'wait longest'

31 July 2008 – BBC News

Patient survey reveals GP delays

31 July 2008 – BBC News

A survey by the Healthcare Commission shows that

some patients in parts of London have to wait longer

than anyone else to see their GP. The poll of over

69,000 found that 25% waited longer than two days

for an appointment, whereby in Tower Hamlets, the

figure rose to 57%.

41% of patients served by east London Primary care

trusts had to wait over two days for a GP appointment

and only 15% of patients in Kingston waited longer

than the official target.

For full report click here

67. The Protection of Vulnerable Adults List:

An investigation of referral patterns and approaches

to decision-making

31 July 2008 – DoH

Research which explores factors leading to the

placement on the protection of vulnerable adults list,

and which in turn helps to safeguard vulnerable

adults in care.

For full report click here

68. Patients praise the care they get in GP

practices and health centres

31 July 2008– Healthcare Commission

A national survey of 69,000 people raises questions

about access to NHS services but overall most patients

say they are “completely satisfied” with care in

GP practices and health centres, with high proportions

saying they are treated with dignity and listened

to carefully.

The survey was coordinated for the Commission by

the Picker Institute Europe and it covered topics such

as access to appointments, waiting times and patients’

relationships with NHS staff.

The Commission will also release on its website a

national overview with comparative scores for all 152

primary care trusts in England, the organisations that

buy services from GPs and dentists.

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

newsandevents/pressreleases.cfm?

cit_id=6528&FAArea1=customWidgets.content_view_1&usec

ache=false

NHS

69. More improved healthcare facilities

1 August 2008

A new national framework procurement, Express

LIFT, was launched by the Department of Health today

to extend access to the LIFT (Local Improvement

Finance Trust) scheme, to all Primary Care Trusts

who want to make use of it. Currently, about half of

Primary Care Trusts in England benefit from

LIFT, using it to build and finance new, modern GP

surgeries, health centres and walk-in centres.

The national procurement framework will generate a

list of approved private sector partners, each of whom

will have demonstrated a track-record of delivering

the services required of a successful LIFT Company.

The framework is intended to greatly accelerate the

procurement process for infrastructure projects and

vastly reduce costs to bidders compared to the current

process, cutting the length of time for completion

on bids to four to five months (depending on the number

of bidders), with local procurements from the

framework able to be completed within about four to

six weeks rather than two years as is currently the

case.

Mark Britnell, Director General, Commissioning and

System Management at the Department of Health

said:

"LIFT has proved highly successful, allowing Trusts

to upgrade inadequate or ageing facilities around the

country and address the historic legacy of underinvestment

in NHS primary care facilities.

"Allowing the LIFT scheme to rapidly expand will enable

more Primary Care Trusts and local authorities

to take advantage of its benefits - faster builds, improved

working conditions for staff, better care environments

for patients, and better overall facilities

available for the local community.

"Only the best companies will make it onto the framework

list and we know that private sector developers

will welcome this development, both because of the

potential future work and the quicker and cheaper

procurement process."

70. NHS launches online one-stop shop for

mums-to-be

1 August 2008 - COI

The first NHS online maternity guide, offering a

wealth of information on pregnancy and birth, at just

the click of a mouse, has been launched.

The new Pregnancy Care Planner gives the latest

and most comprehensive advice on all aspects of

pregnancy, from getting pregnant, early pregnancy,

the scans, to the birth, and the most up to date comparative

guides to what is on offer at local maternity

units.

Health is the most researched subject on the internet,

and pregnancy is the most researched health subject.

This new service is available on the national NHS

website, NHS Choices (http://www.nhs.uk) and the

link to the planner is: http://www.nhs.uk/pregnancy.

71. Department of Health (National)

(DH) NHS inpatient and outpatient waiting

times figures 30th June 2008

Main Points This Month

Tables available in word document or the Dept of

Health website.

Inpatient Waiting times

* The number of patients, for whom English commissioners

are responsible, waiting over the 26 weeks

standard at the end of June 2008 was 41. Of these

41, none were English residents waiting in Welsh

hospitals.

* The number of patients, for whom English commissioners

are responsible, waiting over 13 weeks at the

end of June 2008 was 37,600, a decrease of 2,400

(6.1%) from May 2008, and a fall of 62,300 (62.4%)

from June 2007.

* The percentage of patients waiting under 13 weeks

was 93.0%, compared to 92.5% in May 2008 and

84.9% in June 2007. The median waiting time of

those still waiting at the end of June 2008 was 4.0

weeks.

Outpatient Waiting times

* The number of patients, for whom English commissioners

are responsible, waiting over the 13 weeks

standard for a first outpatient appointment following

GP referral at the end of June 2008 was 251. Of

these 251, 56 were English residents waiting in

Welsh hospitals.

72. MRSA Screening: Operational guidance

1 August 2008 – DoH

Letter sent from the Chief Nursing Officer and the

Director General of NHS Finance, Performance and

Operations to NHS trusts to give support and guidance

in introducing MRSA screening for all elective

patients by the end of March 2009.

For full report click here

73. NHS 'confusion' over asylum rules

1 August 2008 – BBC News

An article in the British Medical Journal reports that

due to confusion over the rules on NHS care for

failed asylum seekers, many are being turned away

from hospitals and GP practices.

The Department of Health has said that the situation

is currently under review.

For full report click here

74. NHS in East sees £376m turnaround

1 August 2008 – BBC News

The East of England Strategic Health Authority has

managed to move from a £290m debt two years ago

to a £86 surplus in 2007/2008.

This means that this is one of the biggest reductions

achieved so far within the UK.

For full report click here

75. A new website...

31 July 2008 - CSIP

Care Services Improvement Partnership has

launched a new website resource. Visit the new-look

website at www.networks.csip.org.uk and download

the Darzi briefing and information sheets at

www.networks.csip.org.uk/darziSummary

76. HSE and Kent police decide not to investigate

Maidstone and Tunbridge Wells NHS

Trust

30 July 2008 - COI

The Health and Safety Executive (HSE) and Kent

Police announced the conclusion of a joint review of a

Healthcare Commission report published in October

2007 into outbreaks of Clostridium difficile (C. difficile)

at Maidstone and Tunbridge Wells NHS Trust.

HSE and Kent Police reviewed the Healthcare Commission's

report through a series of interviews with

the Commission's lead investigators and others and

concluded that there is insufficient information to

launch a criminal investigation.

The Healthcare Commission published a report into

failings of infection control at Maidstone and Kent

NHS Trust on 11 October 2007 - the report can be

found at http://www.healthcarecommission.org.uk//

n e w s a n d e v e n t s / p r e s s r e l e a s e s . c f m ?

cit_id=5875&FAArea1=customWidgets.content_view_1&useca

che=false

HSE undertook the joint review of the Healthcare

Commission report with Kent Police. Their statement

on today's announcement can be found at http://

www.kent.police.uk/News/Latest_News/index.html

Further information on HSE's work with the Health

Services can be found at http://www.hse.gov.uk/

healthservices/index.htm

77. Impact Assessment of Moving Ahead with

Electronic Prescription Service (Release)

30 July 2008 – DoH

The report is called Enabling Completely Electronic

Prescriptions in Primary Care and assesses the impact

of switching over to an electronic system for prescriptions

in order to reduce the rising and indirect

cost to NHS organisations and primary care contractors.

For full report click here

78. Hospitals clean-up to cost £3.7m

30 July 2008 – BBC News

A hospital trust is spending £3.7m to tackle superbugs

to avoid the possibility of stiff fines.

Bradford's Royal Infirmary and St Luke's hospital are

spending the money on cleaning measures and other

initiatives to meet targets.

For full report click here

79. Big rise in NHS feeding concerns

29 July 2008 – BBC News

The National Safety Agency has revealed that the

number of incidents related to poor nutritional care

reported by NHS staff has nearly doubled over the

course of three years.

The Agency put this down to better reporting, rather

than an actual increase. The figures included procedures

such as feeding tube insertion and stated that

most incidents resulted in little or no harm to patients.

For full report click here

80. Campaign against medicine 'waste'

29 July 2008 – BBC News

NHS Greater Glasgow and Clyde has revealed that

unused and wasted medicines cost them £24m every

year. The figure was revealed to coincide with a

campaign to persuade patients to help cut waste.

Its statement said the money saved could pay for an

additional 4,000 hip replacements, 3,158 heart bypass

operations and 622 community nurses.

For full report click here

81. Engagement Analysis: NHS next stage

review - What we heard from the 'Our NHS,

Our Future' process

28 July 2008 – DoH

This is a report which sets out a summary of responses

received as part of a review paper 'Our

NHS, our future' which actively engaged, involved

and solicited the views of patients, public, staff and

stakeholders.

For full report click here

82. Bed-blocking costs the NHS £200m a year

28 July 2008 – The Daily Telegraph

Figures released under the Freedom of Information

Act shows that bed-blocking costs the NHS about

£200m a year.

In one case, a patient blocked a bed for six years at a

hospital run by the Bolton Hospital NHS Trust.

Nursing

83. Standards to support learning and assessment

in practice

August 2008 - issue NMC Newsletter

Since the last publication in 2006, the NMC received

a lot of enquiries and comments from teachers about

the best way to use the standards.

The updated publication now includes all of the information

needed to implement the standards in practice.

The NMC also carried out a series of road shows

about the standards to help teachers share best practice.

84. Do you want to be part of the new NMC

Council?

August 2008 - issue NMC Newsletter

Last month we told you about new NMC Council,

which will be in place by the end of this year.

The deadline the post of chair has now passed, and

recruitment will soon start for the remaining 13 lay

and registrant members from each of the four countries

of the UK.

If you are interested in applying, please visit our website

for further information.

Find out more about how to apply to join the new NMC Council

85. English take Welsh nurse degrees

30 July 2008 – BBC News

English would-be nurses are doing their degrees in

Wales because they will automatically receive bursaries

of £6,372.

Currently, student nurses on degree courses in England

the National Health Service bursaries are means

tested.

The Royal College of Nursing (RCN) is calling on the

Government to equalise the system throughout the

UK.

For full report click here

Older People

86. Text of letter sent to participants in the

consultation exercise on the future funding

of long term care

29 July 2008 - Department of Health

For items in BHCR reporting on the consultation see

Issue 28—article.

“Thank you for joining me and officials from the Department

of Health at the Manchester regional stakeholder

event on 16 June to debate the important issues

on the future of the care and support reform system.

I hope you found the event useful and worthwhile.

Your input during the day is invaluable and will

be carefully considered in the development of the

Green Paper on this crucial reform.

I am pleased to attach a summary of the points discussed

on the day. All the feedback we receive from

the events and additional engagement strands - including

the website and citizens events - will be used

to inform the development of the Green Paper, which

is due to be published next year. We are also currently

putting together a package of materials to enable

you to continue the debate by running events

with your own networks. This will be available in

early August for you to download via our website.

For fur ther information, please visit

www.careandsupport.direct.gov.uk. The site is being

regularly refreshed so I would encourage you to register

to receive these updates. Alternatively, you can

contact the Green Paper team at careandsupport@

dh.gsi.gov.uk or write to:

Care and Support

Room 543, Richmond House

79 Whitehall

London SW1A 2NS

I look forward to continuing this important debate

with you and hearing your feedback.

Best wishes,

Ivan Lewis

Minister for Care Services

Department of Health”

Social Care

87. Ivan Lewis challenges adult care sector

to deliver

1 August 2008 – Community Care

Care services Minister Ivan Lewis is urging councils

to deliver on opportunities created "by the most profoundly

important year in a generation" for the sector.

For full report click here

88. National Carers' Strategy - regional

events

31 July 2008 – DoH

The purpose of each event will be to help create a

common sense of purpose and foster collective responsibility.

It also aims to ensure that carers have

the services they need in their caring role whilst being

enabled to have a life outside caring.

For full report click here

89. New Deal for Carers: Task force reports

29 July 2008 – DoH

Reports describing the work done by four task forces

in charge of developing a new carers' strategy.

For full report click here

90. The OU wants your views

28 July 2008 – NCF

The Open University’s aim is to investigate how much

is understood about services available and how they

are accessed. This is whether a carer or being cared

for, economic factors and forward planning are key

determinants of what is available and at what cost.

The outcome will contribute to the current government

consultation exercise looking into public expectations

and mapping these against costs and reality.

The survey can be found at www.open2.net/

caresurvey.

For full report click here

Staff, employment and

disciplinary

91. Crackdown on rogue employers

A new Government drive to crack down on rogue employers

who abuse vulnerable workers and undercut

honest businesses has been unveiled.

The strategy includes a single telephone helpline for

vulnerable workers to report abuses to the Government's

workplace enforcement agencies, breaking

down barriers so agencies can share vital information

to catch rogue employers and a £6 million information

campaign to raise awareness of employment rights

and how to enforce them.

This initiative will be overseen by a new Fair Employment

Enforcement Board which will co-ordinate the

work of the government enforcement agencies covering

minimum wage, health and safety, employment

agencies and gangmasters. The new Board will be

chaired by the Employment Relations Minister and

will include representatives from business and trade

unions, as well as the enforcement agencies.

More details here.

With thanks to specialist barrister Daniel Barnett at

www.danielbarnett.co.uk

Radon in workplaces (Care

Homes): HSE and Local Authorities

step up communication

with employers to help to

reduce risks to employees and

others

Radon is a naturally occurring radioactive gas that

can seep out of the ground from the sub-soil underneath

buildings to enter through cracks and gaps in

the floor and build up in houses and indoor workplaces.

Radon (more properly known as radon-222)

comes from uranium, which occurs naturally in many

rocks and soils. Since granite contains relatively

high levels of uranium, many people think that it is

only granite areas of the UK, such as the South West

of England, that have high radon levels. This is untrue

and many parts of the country have high radon

levels.

When radon gas is breathed in it can cause significant

damage to the sensitive cells in the lung and it

is now recognised to be the second largest cause of

lung cancer in the UK after smoking. The Government

has designated radon Affected Areas where

there is a significant likelihood of individual buildings

having elevated levels and recommends homeowners

in these areas test for it and take relatively simple

building modifications to reduce it where appropriate.

In workplaces, the Management of Health and Safety

at Work Regulations require employers to assess,

and where necessary reduce, the risks to their employers

.

The Health Protection Agency (HPA) has carried out

extensive measurements from across the UK over

many years. In November 2007, together with the

British Geological Survey (BGS), they completed collation

of new radon mapping data for England and

Wales and published an Indicative Atlas of Radon in

England and Wales. The new data replace the previous

Atlas, NRPB W26. [Radon maps for Scotland are

due for publication later in 2008.] The areas most

seriously affected by radon are Wales and the South

West of England leading up through West Oxfordshire

and Northamptonshire to Lincolnshire and Derbyshire.

Elevated levels have also been found in

small pockets in many other areas such as Northumberland

and the Grampian and Highlands regions of

Scotland.

HSE has recently revised its guidance on radon in the

workplace in order to take account of the new mapping

data and radon Affected Area identification criteria

and this may be found on the HSE website at:

www.hse.gov.uk/radiation/ionising/radon.

They have also taken the opportunity to improve the

user-friendliness of its radon web pages and to clarify

the circumstances in which employers should carry

out radon risk assessments. Advice is also given on

checking the efficacy of radon protection measures

initially installed in accordance with the building regulations,

winter corrected measurement results, and

risk assessment review periods.

HSE and Local Authorities are aware that the vast

majority of employers with workplaces located in radon

Affected Areas have not assessed the radon hazard

in relation to the protection of their employees.

Their inspectors have therefore devised various programmes

of initiatives targeted at increasing the numbers

of workplaces assessed with the longer-term aim

of reducing workplace exposures and any possible

resultant fatalities. Annual radiation doses have been

found to be high in many types of workplaces and the

health risks significant; especially amongst employees

who smoke tobacco.

All employers in the newly defined radon Affected

Areas or those who have parts of their premises below

ground, must assess radon exposure risks in their

workplaces. Some employers who were not in an Affected

Area before publication of the new Atlas will

find that they now are and should therefore be in the

process of assessing the risks to their employees.

All employers in the newly defined radon Affected

Areas or those who have parts of their premises below

ground, must assess radon exposure risks in their

workplaces. Some employers who were not in an Affected

Area before publication of the new Atlas will

find that they now are and should therefore be in the

process of assessing the risks to their employees.

All employers in the newly defined radon Affected

Areas or those who have parts of their premises below

ground, must assess radon exposure risks in

their workplaces. Some employers who were not in

an Affected Area before publication of the new Atlas

will find that they now are and should therefore be in

the process of assessing the risks to their employees.

Radon will be a new topic to some of these

employers and, therefore, HSE encourages safety

practitioners throughout England and Wales to increase

employers’ awareness of radon risks by referring

them to the HSE website guidance.

G Thomas, HM Specialist Inspector of Health and

Safety (Radiation)

HSE Radiation Team