Both Dr Sastry and Dr Okpara appealed against decisions by the Medical Practitioners Tribunal (MPT) to erase their names from the register. Both appeals were dismissed at first instance as the High Court on each occasion was reluctant to interfere with the original tribunal’s decision.
In the recent case of Towuaghantse v GMC, Dr Towuaghantse sought to argue that the critical narrative conclusion of a Coroner could not be adduced in evidence against him before his regulator. That the findings of fact made by the Coroner could be adduced was not in dispute.
On 24 March 2021 the Department of Health and Social Care published an open consultation “Regulating Health Care Professionals, Protecting the Public“. The consultation is set to run until 16 June 2021.
The consultation has been keenly awaited and follows the Government response of July 2019 to a consultation run in 2017. Whilst change has been delayed owing to issues such as Brexit and, of course, the pandemic, it seems we are edging closer to reform of professional regulation.
The CQC has completed its review of ‘do not attempt cardiopulmonary resuscitation’ decisions during the coronavirus (COVID-19) pandemic and has published its findings on 18 March 2021 CQC report – Protect, respect, connect. It has, rightly, received much publicity which will hopefully mean that the recommendations contained in the report will be followed.
We have previously written on this blog about the growing use of technology in the social care sphere, and how existing tech can be adapted and developed in particular for use in the care of the elderly. Now, an open letter has been written to the Prime Minister urging him to prioritize funding for the development of technology in the social care sector (see here for a copy of the letter ). The letter is written by PainChek, a medical technology company and is supported by various social care bodies such as Care England, the National Care Forum and the National Care Association. The letter emphasises that dementia and Alzheimer’s disease are the country’s biggest “silent killer” and seriously affect the lives of many people.
The Care Quality Commission (CQC) have published updated guidance on meeting the duty of candour.
The updated guidance, which can be viewed here, applies to all health and social care providers registered with the CQC.
The update provides a more detailed explanation of what a notifiable safety incident is and now makes clear that the apology which is required as part of fulfilling the duty does not equate to an admission of liability. As such, an apology will not affect a provider’s indemnity cover.
Early this month the Health Minister Nadine Dorries told the Health and Social Care Committee that a no fault compensation system is under review and could involve all claims against the NHS. Her comments were made to the Select Committee which is looking at the safety of maternity services in England following issues arising at Shrewsbury and Telford and East Kent NHS Trusts.
Today will see the publication of the white paper said to revolutionise the health and care systems in the UK. Despite the health service struggling in the midst of a pandemic, the Heath Secretary confirms that now is “absolutely the time” to reform the NHS, intending to “reduce bureaucracy, to sweep away the legal barriers to the NHS delivering and integrate the NHS with social care…”.
As was highlighted in this blog, the Vaccines Minister Nadhim Zahawi has announced a ‘targeted and time limited state backed indemnity’ for care homes which are registered as Designated Settings or intending to register as a Designated Setting, and which are unable to obtain commercial insurance. The question is, will this relatively short-term move have the impact that is needed right now to protect the NHS and care sector?
So what is a Designated Setting? It is essentially a care home which has applied and been assessed by the Care Quality Commission (CQC) as an appropriate setting to care for COVID-19 positive patients who are discharged from the NHS and who no longer require an acute hospital bed. The objective is of course to relieve pressure on the NHS as it copes with the winter crisis.
The aim is that there is at least one Designated Setting in each local authority ‘as soon as possible’.
How are the care homes assessed? The care homes are assessed by the CQC using its Infection Prevention and Control framework (IPC). Assessments are made to ensure patients are being physically separated, that there is a dedicated workforce and appropriate emphasis on ventilation.
The CQC is using an ‘eight ticks‘ approach in order to give the public an overview as to factors such as the availability of adequate PPE, that staff are properly trained to deal with outbreaks and the appropriate processes needed, that shielding is being complied with and hygiene practice is promoted.
How many Designated Settings are there currently? As at 12 January there were 135 approved Designated Settings providing a total of 1,624 approved beds. The coverage across the country is however currently variable – there are only 87 approved beds for instance in London, but 381 in Yorkshire and the Humber.
Testing of CQC inspectors Up until now CQC inspectors were not tested for COVID which was a source of concern for many. It is now proposed that inspectors will be tested weekly with the testing being rolled out in the coming weeks. It is not clear however why there is to be a delay since care home staff are already being regularly tested.
What is the state indemnity scheme going to cover? The indemnity will cover claims for clinical negligence and employers’ and public liability where the care home provider operating a Designated Setting has been unable to secure such cover in the commercial insurance market..
The clinical negligence aspect will be covered by the Clinical Negligence Scheme for Trusts (CNST) supervised by the DHSC and NHS Resolution.
However, as things stand this indemnity will be in place only until March 2021 and is to be reviewed in mid-February.
How helpful is this scheme going to be for the care home sector? One of the concerns for care home managers seeking to participate will no doubt be the ability to provide a dedicated COVID- 19 workforce, particularly given the pressures on staffing already apparent.
If Designated Settings are to be contained within care homes also containing those who have not been exposed to COVID-19, reassurance around dedicated staff, PPE provision, social distancing and adequate ventilation may not be enough to convince service users that they are in fact completely safe.
It remains to be seen how successful the scheme will be for care home operators who have difficulty in obtaining commercial insurance cover for COVID related claims. The impact on the NHS of course will depend on just how successful this scheme actually is in freeing up acute beds.
Given however that the indemnity scheme is limited in its time frame and scope the concern must be that it will simply be insufficient to make any real impact on the problem.
Following the joint statement published by regulators at the start of the pandemic, on 14 January 2021, the GDC published supplementary advice to decision makers on the factors to be taken into account when considering complaints arising during the pandemic.
The advice, which is to be welcomed, sets out the various contextual matters to be taken into account by decision makers which include environmental issues and resource, guidelines and protocols.