Falls and COVID-19

Falls are often the subject of civil litigation or statutory investigation in the social care sphere, in particular when dealing with elderly residents.   We often see claims for falls arising from differing scenarios.  A fall may occur in a residential home setting or at home, whether there is domiciliary care involved or not.  A fall can lead to various serious consequences for the elderly such as a stay in hospital which may cause a decline in a person’s general health, increase the risk of contracting infections, decline in physical abilities and acceleration of the onset of dementia.  And a person’s care requirements are likely to be increased by the fall – for example residential care may be required where it was not previously. 

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No-fault compensation – could it work in the UK?

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.

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The health and care white paper and a vision for healthcare regulation

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…”.

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The effect of Brexit on the care sector

Since the new EU/UK trade agreement took effect on 1 January 2021, the free movement of labour between UK and the European Economic Area (EEA) has ceased.  Workers arriving from the EU are now subject to the same points based system as workers arriving from non-EEA countries. The system affords exceptions for most NHS workers, however carers in adult social care are not included. This places an additional obstacle for carers wanting to work from the EU to overcome.  

84% of the workforce in adult social care in England is British. 16% is non-British, of this 7% (113,000 jobs) are from EEA countries and 9 % (134,000 jobs) are from non-EEA countries [i].Prior to Brexit, charities such as Age UK and The Care Workers’ Charity wrote about their concerns for the sustainability of staffing within the care sector.  There is a chronic shortage of workers, ONS figures reveal that the adult social care workforce has a (high) vacancy rate of around 8% (equating to 110,000 vacancies)[ii]. Approximately 130,000 new care workers are required each year for social care alone to cope with current levels of demand.  Recruitment and retention for staff in the care sector is hard, with many staff leaving within the first year and the public perception of poor working conditions has led to low recruitment rates.

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CQC investigates care homes staff working with COVID-19

The recent staff shortages in care homes have been well documented.  The pandemic has meant staff have increasingly had to self isolate and have suffered sickness themselves, causing an intolerably high increase in absence across the sector. What has come to light more recently however,  is that the CQC is investigating concerns that staff with COVID-19 have  been asked to come into work, even after a COVID-19 positive test result.

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New GDC guidance on factors to be taken into account – a step in the right direction?

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.

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Clarification on non-delegable duty of care in clinical cases

In recent years there has been a significant rise in the number of clinical negligence cases involving issues of both vicarious liability (VL) and non-delegable duty of care (NDDOC). These allegations often arise in situations where private companies contract with the NHS to provide NHS services, or where private companies sub contract with medical, dental, or nursing professionals to provide services.

The recently decided case of Jaida Mae Hopkins v Azam Akramy, Badger Group and NHS Commissioning Board [2020] EWHC 3445 (QB) has provided some much needed clarity on NDDOC in these cases and when it may arise under statute or the common law.

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“Busting Bureaucracy” a step in the right direction?

On 24 November, the Department of Health and Social Care announced a new drive to ‘bust bureaucracy’, locking in changes introduced in the pandemic with the aim of allowing front line health and care staff to focus more on care provision and less on paperwork. Here, I focus on the changes that may be of the greatest interest to regulated organisations and individuals.

The report can be found here.

A call for evidence was made in July, with the message in response highlighting that changes introduced in light of the pandemic were changes made for the better. Respondees did not want to revert to old ways.

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Study suggests excess death toll in care homes from Covid-19 has been hugely underestimated

An early draft of a study from the University of Manchester suggests there may have 10,000 more deaths of care homes residents than previously reported.  The study compares statistical data on deaths in care homes between January 2017 and February 2020 with data from April to August 2020. 

This study has not yet been peer reviewed, but notes that of the excess deaths, 65% were only directly attributed to Covid-19.  That leaves the remaining 35% (10,000 deaths) that were not officially attributed to Covid-19.  The question is what caused those excess 10,000 deaths. 

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