The Prime Minster has today announced long awaited plans for the funding of the English adult social care system.
This move has been proposed on several occasions by the governments of David Cameron and Theresa May. The present government’s December 2019 election manifesto promised to reform social care but didn’t give any details of how that was to be achieved.
Today’s announcement confirms that extra funding will be achieved via an increase in National Insurance contributions of 1.25% from April 2022 onwards, rather than further contributions from higher rate taxpayers. It comes after yesterday’s promise of extra funding for the NHS to tackle backlogs created by the COVID-19 pandemic. People of a pensionable age who are still working will also have to pay this extra National Insurance contribution. There will also be a cap on lifetime individual contributions.
However the majority of the monies raised by the tax raise will be used initially to support the NHS in the first 3 years, although during this period the social care sector is due to receive an additional £5.3 billion per year. After the NHS backlog is cleared, the government say the majority of this funding will be spent on social care.
In his statement to the House of Commons announcing the plans, the Prime Minister referred to the COVID-19 pandemic having highlighted problems in social care, saying at the outset of the pandemic that there were 30,000 patients occupying hospital beds that could have been better cared for elsewhere. However, we have constantly seen that the process of discharging a patient from a healthcare to a social care setting is very complex, and many factors may affect the speed at which they can be discharged from hospital, not just the amount of funding available. Today’s announcement should not be seen as a quick fix to the complex problems the sector faces.
With the general population living longer and a larger number of adults requiring social care, especially in later life, funding is clearly desperately needed. Arguably the lack of investment in the sector over many years has contributed to a rise in claims and statutory investigations against social care providers. Whilst care providers and their insurers will of course welcome today’s announcement, it will take a long time in our view for any noticeable difference to be seen in the sector on a day to day basis, and for the effect on the claims market to trickle through.
In 2019 the NHS Long Term Plan was published, including the NHS Digital Transformation Plan. It set out the aim of the NHS to change the way in which healthcare is accessed and provided, supplying digital services to patients and digital tools to staff and providing access to joined up patient records.
The COVID-19 crisis has accelerated this transformation and digital developments have been a key part of the response. Most people will be familiar with the NHS App and the technology that has been deployed in tracking and tracing the infection. Anyone watching Chris Whitty’s slide shows will also be in no doubt as to the part that the effective use of data has played in analysing and responding to the emergency.
Against this background, the Department of Health and Social Care has published a policy paper entitled “Data saves lives: reshaping health and social care with data” setting out its vision of the part that data will play in the digital transformation of the NHS, with the declared mission to “ unleash the unlimited potential of data in health and care, while maintaining the highest standards of privacy, ethics, and accountability.”
We recently commentedon the government’s plans for vaccinations to become mandatory for all care home workers. Yesterday, MPs approved this initiative despite a small number of dissenting voices within the Conservative rank and file. Passing with a majority of 319 votes to 246, anyone working in a care home registered with the Care Quality Commission in England must have had two vaccine doses by October, unless they have a medical exemption.
The feuding within the Conservative party appears to focus on the lack of any published impact assessment of the policy before the vote (Health Minister, Helen Whately told MPs this was being worked on), something which many argue is imperative when balancing risks and imposing such measures on an entire (and already stretched) healthcare sector particularly in a group of workers which has a very low take up of the vaccine.
Last week the Commons Health and Care Select Committee published what is likely to be a very significant report examining safety issues in NHS maternity care. The primary focus of the report is improving patient safety by learning from well-documented failings in East Kent, Shrewsbury and Morecambe and the report makes important recommendations on this aspect. A second strand of the inquiry was to review the effect that the current clinical negligence claims and litigation process has on improving outcomes and to consider if changes are necessary. The Committee found that they are and this blog summarises its recommendations on that topic.
Dr Kevin Peter Newley v General Medical Council  EWHC 1538 (Admin)
The judgment in a recent High Court appeal shines a spotlight on the need for registrants to acknowledge (although not necessarily accept) the findings made by a substantive regulatory Tribunal and to demonstrate the remedial steps taken to ensure the situation does not arise again.
Dr Newley appeared before the Medical Protection Tribunal Service facing clinical allegations concerning eight patients. His fitness to practise was found impaired and a nine month suspension order was imposed. Dr Newley unsuccessfully appealed against the tribunal’s decisions on impairment and sanction. A review hearing subsequently took place which resulted in an order of conditions being imposed. Dr Newley appealed against the decision of the review tribunal but, again, was unsuccessful.
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.
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.
As shown in the BLM Policy blog of 15 December 2020 (link here), COVID-19 (C-19) compensation claims appear to be gathering some momentum although, at this point, the total number of such claims that have been officially registered with the Compensation Recovery Unit of the UK Department for Work & Pensions remains very low.
As we have noted previously, new and untested questions on standard of care and legal causation would likely arise in any litigated C-19 claim. In this blog, we re-visit certain aspects of these potential questions in the context of vaccinations for care home staff.