DHRegistered Focus on the safety & quality of care - A new framework to regulate the safety & quality of health & social care services has been published by the Department of HealthSubject to Parliamentary approval, from 2010/11, the Care Quality Commission (CQC) will register all providers of health & adult social care services against a single set of registration requirements that are focused on the safety and quality of care.

The new registration requirements replace the core Standards for Better Health (which apply to the NHS) and the National Minimum Standards & Regulations (which apply to social care & independent sector health providers).

Without registering with the CQC, it will be illegal for health & adult social care organisations to provide services that are in the scope of the new framework.  To maintain their registration, providers will need to demonstrate an ongoing ability to meet all the requirements.

In addition, all 8,500 GP practices and 9,000 high street dental practices will be required to register with the CQC, regardless of whether they provide solely private, solely NHS services, or a mix of both.  For the NHS, registration with the CQC against requirements on healthcare associated infections (HCAI) will be implemented from April 2009.

A March 2008 consultation on the ‘framework for the registration of health & adult social care providers’ sought views on which services should be within the scope of the new registration system and what requirements providers need to meet to be registered.  The response has now been published, together with a new consultation (closes 29 May 2009) asking whether the proposed content of the draft regulations fulfils CQC’s stated policy aims.
Press release ~ Care Quality Commission ~ The future regulation of health and adult social care in England (closed) ~ Proposed changes to the private and voluntary healthcare regulations ~ A response to consultation on the framework for the registration of health and adult social care providers and consultation on draft regulations

Newswire – SDCContinual Growth is not always beneficial - The Sustainable Development Commission’s report - Prosperity without growth? - says that ‘the current global recession should be the occasion to forge a new economic system equipped to avoid the shocks & impacts associated with our reliance on growth’.  It calls on leaders to adopt a 12-step plan to make the transition to a fair, sustainable, low-carbon economy.

The report finds that our current financial crisis is directly linked to our pursuit of growth.  Our reliance on debt to finance the cycle of growth has created a deeply unstable system which has made individuals, families & communities inherently vulnerable to cycles of boom & bust, while increasing consumption does not make us happier.

The report shows that economic growth has delivered its benefits at best unequally, with 20% of the world’s population earning just 2% of global income.  Even in developed countries, huge gaps remain in wealth & well-being between rich and poor.

The pursuit of growth has also had disastrous environmental consequences.  Based on a moderate level of growth of 2% per year, meeting 2050 carbon reduction targets would mean achieving a carbon content of no more than 6gCO2 for each dollar spent - a staggering 130 times lower than the average carbon intensity today.

The report proposes a plan for government to develop a new macro-economics for sustainability, which does not rely for its stability on growth and expanding material throughput.
Press release ~ Prosperity without growth? ~ ESRC Research Group on Lifestyles, Values and Environment (RESOLVE) ~ Sustainable Development Commission’s 2-year Redefining Prosperity project

DHDeprivation of liberty is a serious issue - Some of the most vulnerable people in society will be better protected against abuse and poor care as a result of new legislation which came into force on 1 April 2009.  People who ‘lack capacity’ in hospitals & care homes will now be protected by a new law known as the 'Mental Capacity Act Deprivation of Liberty Safeguards'.

It introduces new safeguards, so that, if a care home or hospital needs to deprive someone of their liberty for their own safety or wellbeing, they must now apply for permission.  The law only applies to people in care home and hospital settings who are unable to make decisions on their own care or treatment and who need to be deprived of their liberty ‘in their own best interests to protect them from harm’.

These safeguards mean that, if a hospital or care home wants to deprive someone of their liberty to keep them safe from harm, they must apply to the local health trust or council for permission.  This triggers a series of six assessments carried out by trained assessors.  At any stage, the person or their representative will be able to appeal against their deprivation of liberty to the Court of ProtectionIn an emergency, the hospital or care home can issue an urgent authorisation, for 7 days, which speeds up the normal process of authorisation.

Primary Care Trusts (PCTs) and local authorities (designated as 'supervisory bodies' under the legislation) will have statutory responsibility for operating & overseeing the MCA DOLS whilst hospitals and care homes ('managing authorities') will have responsibility for applying to the relevant PCT or local authority for a Deprivation of Liberty authorisation.
Press release ~ The Mental Capacity Act Deprivation of Liberty safeguards ~ Deprivation of Liberty Safeguards: regulations and assessor training ~ National Autistic Society ~ British Institute of Learning Disabilities (BILD) ~ The Mental Capacity Act 2005 Deprivation of Liberty Safeguards and you ~ Court of Protection

CQC:  CQC given a bigger stick - The Care Quality Commission has published details of the new enforcement powers that will help it protect the health, safety and welfare of people who use health & adult social care services and to improve the quality of these services.

CQC has new powers to issue warning notices & penalty notices, and in extreme circumstances, to suspend or cancel the registration of organisations who do not meet essential standards of quality.  Alongside the policy, CQC has set out nine priority actions that address points made as part of a consultation on the powers.
Press release ~ Care Quality Commission enforcement policy ~ Health and Social Care Act 2008Priority actions

DHPiloting models of Care - Patients in 16 pilot sites will benefit from a trial to see how health & social care services can join together to increase quality of care.  The £4m scheme has been designed to look beyond traditional health & social care boundaries to explore how services for patients & service users can be improved and best practice identified.

Each site has developed new methods to help respond to particular local health needs.  The health issues being tackled in each pilot include dementia, care for the elderly, substance misuse, chronic obstructive pulmonary disease and end of life care.  The methods involved vary widely and include: partnerships, new systems and care pathways that span primary, community, secondary & social care.

The pilots start in April 2009 and will run for two years.  They will be evaluated over three years against a set of national and local measures, including impact on health outcomes, improved quality of care, service user satisfaction, and effective relationships and systems.
Press release ~ DH – Integrated Care ~ DH – Social Care ~ DH – Health Care ~ BBC: Social care thresholds - council breakdown

HC45+ years of tax NI contributions ignored! - People over 65 are often denied access to the full range of mental health services available to younger adults, according a Healthcare Commission (HC) report published recently.  In its study of services for older people at 6 specialist mental health trusts, the Commission found some evidence of high quality care where there was good integration of health & social services.  It also found good support & training for carers at some trusts.

However, the study showed older people were often unable to access the full range of services, including: out of hours services; crisis services; psychological therapies; drug and alcohol misuse services.  The HC is also concerned that there is limited national data available on the quality of specialist older people’s mental health services, which would allow performance in key areas to be analysed more fully.

Findings show that older people were often prevented from accessing care because of stretched services or a lack of age-appropriate care.  Some staff said patient groups considered to be of high risk to the public or where government targets were applicable were often prioritised, leaving older people’s services lagging behind with little funding.
Press release ~ Equality in later life (national study of older people's mental health services) ~ Department of Health’s ‘new horizons’ project ~ National Mental Health Development Unit

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