Law, Policy and Ethics Update – Summer 2023

The information in this update, as across the whole of the AdsFoundation website, is for education and training purposes only. If needed legal advice on a specific case should be sought from a suitably experienced and qualified lawyer. There is information on how to identify a suitable lawyer at the bottom of our resources for Patients and Carers page or our free legal advice clinic (see below) may be able to assist you.

If you would like to go on to a mailing list to receive this quarterly update, please contact the AdsFoundation using the Contact Us tab above.

AdsFoundation Updates

If you find the free resources, including this quarterly update helpful and are in a position to do so, it is now possible to make a donation to support the work of the Adam Bojelian Foundation CIC using the DONATION button on our website:

Make a Donation – The Adam Bojelian Foundation CIC (AdsFoundation) (theadsfoundation.org)

SAVE THE DATE: Charlie Jones, clinical psychologist in medicine (@charlie_psych on X/Twitter) will give the 2024 Adam Bojelian Memorial Talk in Leeds on 6th March 2024, chaired by Rob Webster. Further details of the event and a link to book your free place will be published in the autumn.

PLAYING WITH WORDS: Adam Bojelian was a multi-award winning young poet and his first book, Playing With Words containing 12 of Adam’s best loved poems and beautifully illustrated by Millie Herriott was published on 19th August 2023 and launched at the Edinburgh International Book Festival. Playing With Words is on sale at the Festival Bookshop and available on-line worldwide from the AdsFoundation shop. All profits from the sale of Playing With Words support the work of the AdsFoundation.

Shop – The Adam Bojelian Foundation CIC (AdsFoundation) (theadsfoundation.org)

Play and Health in Childhood: A rights based approach: Adam is featured as an expert case study in Julia Whitaker and Alison Tonkin’s new book ‘Play and Health in Childhood: A rights based approach’, to be published on 8 September 2023 by Taylor & Francis.

Pre-publication details states: ‘Taking a rights-based approach to the interdependence of play and health in childhood, this text argues that the child’s right to health and development cannot be satisfied without also the fulfilment of their right to play‘.

The book cites Adam ‘Our final case story in Box 8.4  from Adam Bojelian, an expert witness whose views became synonymous with action within the NHS‘.

Free Legal Advice Clinic. The Adam Bojelian Foundation CIC provides a free to access legal advice clinic.  The clinic is provided as part of the Law Works Clinics network.

Preliminary advice is provided by appointment by an experienced advisor, with the aim of making individuals aware of the law and ethics related to their issue of concern. We do not take on cases, but if you need further advice and assistance than we are able to provide in the 45-minute session, we sign post you on to third party organisations.

Advice is given on matters of healthcare law and ethics. We also provide preliminary advice on employment law to those working in health and social care or those whose employment law concerns relate to their health or that of someone they care for.

PLEASE NOTE ADVICE CAN ONLY BE GIVEN AT A CLINIC ON MATTERS OF HEALTH AND CARE LAW & ETHICS & HEALTH & CARE RELATED EMPLOYMENT LAW. CLINIC APPOINTMENTS SHOULD BE BOOKED USING THE LINK BELOW. ADVICE CAN NOT BE GIVEN BY EMAIL OR VIA SOCIAL MEDIA.

More information is available on Free Legal Clinic Page of the AdsFoundation website.

Please note the clinic will be closed from Monday 28th August and re-open on Tuesday 19th September 2023.

Law, Policy and Ethics Update – Summer 2023

New Statutes, White Papers, Bills, Policy Papers Parliamentary & Government Matters

Bills and Statutes

This guide from the UK Parliament explains the stages Bills go through to become law. You may find it useful when reading this section of this legal update.

We include Bills we think you will find of particular interest which have progressed past their Second Reading in the House of Commons or Lords. Except in exceptional circumstances, we do not include Bills which have only had a First Reading as many will never become law.  You can however see all Bills progressing through Parliament on the Parliament website.

Westminster

British Bill of Rights

Here at AdsFoundation, like others specialising in human rights, we are delighted that following the departure of Dominic Raab who championed the Bill, the new Justice Secretary Alex Chalk announced on 28th June 2023 that the Bill has been scrapped.

Several rights expert organisations who pressed for the Bill to be dropped, concerned that it would impact the human rights of the most vulnerable in society, undermine the Rule of Law and the UK’s reputation internationally, responded to the news:

Statement by British Institute of Human Rights

Statement by the Law Society

Statement by the Bar Council

Carers’ Leave Act 2023 c.18

This Act which featured in earlier AdsFoundation updates during its progress through Parliament received Royal Assent (became law) in May 2023. It will come into force in 2024.

Once in force the Act will make provision for unpaid leave for employees with caring responsibilities. Unless otherwise stated the Act extends to England, Scotland, Wales and Northern Ireland.

Bill Briefing Paper

CarersUK have produced a guide for employers to help them prepare for the new Act. The guide includes information about webinars CarersUK will be running to help in this preparation.

Neonatal Care (Leave and Pay) Act 2023

This Act was also featured in earlier editions of the AdsFoundation’s update and also received Royal Assent in May 2023.  The Act creates a statutory entitlement to leave and pay whilst a baby is receiving neonatal care. Except where otherwise stated, the Act extends to England, Scotland, Wales and Northern Ireland. The Act will come into force ( become enforceable law) on the date designated by the Secretary of State in yet to be published regulations.

The Government’s press release summarised the rights that will be introduced as:

• ‘Up to 12 weeks of paid neonatal care leave for employed parents whose children are admitted to neonatal care, so that they can spend more time with their baby at what is a hugely stressful time. This is in addition to other leave and pay entitlements such as maternity and paternity.
• Redundancy protection for pregnant women and new parents with the extension of existing redundancy protections to cover pregnancy and a period of time after parents return to work
• A new entitlement for unpaid carers to a week of flexible unpaid leave a year, for employees who are caring for a dependant with a long-term care need. This will enable carers to better balance their caring and work responsibilities, supporting them to remain in employment.’

Scottish Parliament

This link from the Scottish Parliament explains the stages a Bill must go through to become law.

There have been no new relevant Bills introduced into the Scottish Parliament since our last update.  None of the Bills featured in that update have yet become law.

Welsh Parliament / Senedd Cymru

Guide to the stages of legislation in the Welsh Parliament

There have been no new relevant Bills introduced into the Scottish Parliament since our last update.  The Health Service Procurement (Wales) Bill featured in that update has now reached Stage 3 in the Welsh Parliament, where Bill’s undergo detailed scrutiny by the Senedd.

Health Service Procurement (Wales) Bill

Explanatory Memorandum

This Bill aims to create the law which would permit Welsh government ministers to introduce a procurement (obtaining supplies, for example, medicines and medical equipment) regime specifically for Welsh NHS Services.

Policy Papers, Government & Committee Reports & Government Guidance

UK wide

General Medical Council (GMC)

The GMC  has updated Good Medical Practice their professional standards which applies to all medical doctors in the UK.

The GMC states that the new guidance puts a greater emphasis on behaviours and values to create a ‘respectful, fair and supportive’ workplace.

The new guidance will be in force from 30 January 2024

Get to know Good medical practice 2024 – GMC (gmc-uk.org)

Equality and Human Rights Commission: Progress on disability rights in the United Kingdom 2023 17 August 2023

This report from the Equality and Human Rights Commission,  gives an update on the steps taken by the UK Government and the devolved administrations to implement recommendations from the Committee on the Rights of Persons with Disabilities to improve the lives of disabled people across the UK.

It notes the progress that has been made by the UK Government and the devolved administrations, as well as the areas where improvement is still needed.

The Committee is an independent body that monitors compliance with the UN Convention on the Rights of Persons with Disabilities (CRPD).

The recommendations which are assessed in this report are from the Committee’s inquiry into the rights of disabled people in the UK, which it published in 2016.

Westminster

Department of Health and Social Care, Policy Paper:

Maternity and neonatal services in East Kent report: government response, 20 July 2023, England

This is the Westminster Government’s response to the ‘Reading the signals‘ report of the independent investigation led by Dr Bill Kirkup into maternity and neonatal services in East Kent.

Dr Kirkup’s report published in October 2022 identified four key areas for improvement. The NHS could be much better:

1. at identifying poorly performing units;
2. at giving care with compassion and kindness,
3. at teamworking with a common purpose, and
4. at responding to challenge with honesty.

The Government report, that since the publication of Dr Kirkup’s report the following has been done or is being done:

• a special data taskforce has been set up by NHS England to better monitor patient safety in maternity and neonatal care nationwide
• relevant bodies will work with DHSC to investigate how teamwork in maternity and neonatal care spaces can be improved
• relevant bodies will work with DHSC to investigate how doctors in training can be better trained to improve teamworking and their own personal development
• trusts will have to ensure there is proper representation of maternity care on their boards
• the government will continue to work with NHS England on its approach to poorly performing trusts and their leadership
• East Kent Hospitals NHS Trust will continue working to address the problems identified and improve standards.

House of Commons Health and Social Care Committee: Expert Panel evaluation of the government’s commitment in the area of pharmacy in England,  19 July 2023

In 2020 the House of Commons Health and Social Care Committee commissioned a panel of independent experts to assess the progress made by government against its commitments on healthcare policy in England. A core panel of Professor Dame Jane Dacre DBE (Chair), Professor Emma Cave, Professor Anita Charlesworth CBE, Sir Robert Francis KC, Sir David Pearson and Professor Stephen Peckham, experts investigate areas of healthcare policy alongside independent subject experts. Previously the expert panel has reported on maternity services, mental health services, cancer services, the health and social care workforce and NHS digitalisation.  This report is the expert panel’s findings in relation to pharmacy services.

This report considers

• Community
• Integrated care (including patient safety)
• Hospital pharmacy
• Workforce education and training
• Extended services
• pharmacy services.

More detail of what the Committee considered in relation to each of these services can be found on page nine of the report.  The committee concluded that overall across all government commitments, improvement is required.

House of Commons Health and Social Care Committee, Prevention in health and social care: vaccination. Tenth Report of Session 2022-2023, 27 July 2023

The House of Commons Health and Social Care Committee is carrying out a major inquiry on prevention in health and social care. This inquiry involves ten workstreams of which  vaccination is one. This is the first in a series of short reports for the inquiry.

The Report has 11 conclusions and recommendations, including:

• Challenges around take up and bureaucratic processes in clinical trials need to be addressed if the UK is not to loose its position as a world leader in vaccination.
• The government target of 95% of children receiving childhood vaccinations needs to be reached.
• The government needs to ensure that no-one misses out on routine vaccinations due to practical barriers. The Committee recommends that the government consults on whether medical and nursing students and recently retired staff have a greater role to play in the delivery of routine immunisations.
• Integrated Care Systems must step-up and take ownership of improving vaccine take up in their areas.

House of Commons, Public Administration and Constitutional Affairs Committee, Parliamentary and Health Service Ombudsman (PHSO) Scrutiny 2021-22: Government and PHSO response 16 June 2023

The Committee scrutinize the work of the PHSO annually, this includes a call for evidence from those who have had contact with the PHSO. The PHSO is responsible for investigating complaints brought by members of the public about services provided by UK government departments, public authorities and the NHS in England.  The current Ombudsman is Rob Behrens in post since 2017. The Ombudsman is appointed by the Crown on the recommendation of the Prime Minister and is accountable to Parliament.

Committee Chair, William Wragg MP, said:  

“I am pleased to see the Parliamentary Health Service Ombudsman mostly accepts our recommendations and sets out a promising plan to deliver improvements in its corporate strategy for 2022-25. However, we remain concerned by the Ombudsman’s decision to continue deprioritising less serious complaints.  It is essential that when individuals are let down by public services, they can voice their complaints and wrongs can be righted. 

Furthermore, it is disappointing that the Government has again failed to recognise the importance and urgency of sector-wide ombudsman reform. The current arrangements are outdated and needlessly complex and prevent the public from effective access to justice in cases of wrongdoing. The UK Government has already drafted the necessary legislation in 2016, yet it remains sidelined. This Committee will continue to make the case for fundamental legislative reform. 

The Committee looks forward to receiving updates from the Ombudsman and the Government on their progress in implementing accepted recommendations.” 

Scottish Government 

Scottish Government: Advice for parents on vitamin D for under 3s, 27 July 2023

Scottish Government has updated its advice to parents to ensure children and babies under the age of 3 receive enough vitamin D. As stated in the advice, vitamin D has a number of functions and is important for muscle and bone health. The lack of sunshine in Scotland means supplementation is needed.

Scottish Government: Health screening; equity in screening strategy 2023 to 2026 27 July 2023

This strategy explains how Scottish Government plans to tackle the significant inequalities in health screening found in Scotland.

Welsh Government

Welsh Government Guidance: Consent for examination or treatment 8 August 2023

This is updated guidance for NHS Staff on how to correctly obtained informed consent from patients for examination and treatment.

WELSH VERSION

Open Consultations and Inquiries

England

House of Commons Health and Social Care Committee Inquiry: Men’s Health

Life expectancy for men is consistently lower for men than for women and the Committee is calling for evidence as to potential reasons why.

The Committee in particular wish to address:

1. What factors drive lower, and falling, male life expectancy and what action would have the biggest impact on addressing this?
2. What is known about why men have a higher risk of dying from cancer and how can this risk be reduced. a) What action is needed to improve early detection of cancers specific to men, for example around awareness of symptoms, issues with screening and encouraging men to come forward? b) With nearly half a million men living with or after prostate cancer, how well does aftercare support ongoing symptoms of male specific cancers and how could this be improved?
3. What is driving higher rates of suicide amongst men and how could this be addressed?
4. What factors contribute to men using health services, like general practice, less often than women and what impact does this have on men’s health outcomes, for example from cardiovascular disease?
5. What role do community and sport-based projects play in reaching men at high risk of isolation or poor mental health, and how can it be ensured that this support is spread equitably across the country?
6. What are the challenges in delivering health equity across different population groups among men and how best can they be addressed?

Evidence can be submitted until Friday 8 September 2023.

Scotland

Scottish Government: Health and social care integration authority planning and performance reporting statutory guidance: consultation.

‘The purpose of the statutory guidance is to support integration authorities, who plan and direct the delivery of health and social care services, to produce strategic plans and annual performance reports.

The Scottish Government brought together a working group, including partners from across health and social care, to refresh the guidance. The working group included organisations that represent supported people, carer organisations, those who plan and oversee the delivery of services, and many more partner organisations.

As part of this work, [Scottish Government] do not intend to make changes or alterations to the Public Bodies (Joint Working) (Scotland) Act 2014 or the related regulations.

Re-drafts of the guidance have been produced through engagement with the working group. [Scottish Government] are seeking to capture further feedback and views on these revised guidance documents.’

Scottish Government also state that this consultation is for everyone.  They would like to hear from anyone involved in the planning and delivery of services, supported people, carers, as well as the wider public.

This consultation closes on 27 October 2023

Scottish Government: Health and Care (Staffing) (Scotland) Act 2019 statutory guidance: consultation

Scottish Government are seeking views on the Statutory Guidance that will be issued by Scottish Ministers to accompany the Health and Care (Staffing) (Scotland) Act 2019.

The Act will come into force in April 2024. Scottish Government are keen to hear whether the guidance is clear and readable and enables health and care staff to understand the duties placed on organisations by the Act.

The Act places duties on:

• Health Boards;
• Special Health Boards providing direct patient care (i.e. the State Hospital, NHS24, Scottish Ambulance Service and the National Waiting Times Centre);
• NHS National Services Scotland (NHS NSS, which is referred to in the Act as “the Common Services Agency for the Scottish Health Service”);
• local authorities;
• integration authorities;
• care service providers;
• Healthcare Improvement Scotland;
• the Care Inspectorate (referred to in the Act as “Social Care and Social Work Improvement Scotland”); and
• the Scottish Ministers.

The consultation is open until 19 September 2023

Wales

There are no relevant consultations currently open in Wales.

National Council for Health & Care Excellence (NICE) Consultations

You can use this LINK to access current NICE consultations, see individual closing dates for each consultation.

CASE LAW

We include relevant key European Court of Human Rights, Supreme Court and Court of Appeal cases, plus cases from the lower courts which are likely to be of particular interest. 

This quarter we share the redacted sentencing remarks of the Honorable Mr Justice Goss Kt in the much discussed case of nurse Lucy Letby, a neonatal nurse at Countess of Chester Hospital. Letby was found guilty of murdering seven babies and attempting to murder six others.

We, here at the AdsFoundation, send our heartfelt condolences and empathy to the families of all the babies and thanks to the courageous paediatricians who fought so hard to prevent harm and deaths.

Letby received a ‘whole life’ order. The Sentencing Council which provides guidance to judges on sentencing states:

Whole life order

For the most serious cases of murder, an offender may be sentenced to a life sentence with a ‘whole life order.’ This means that their crime was so serious that they will never be released from prison.

As of 30 June 2023, there were 65 whole-life prisoners. The list of offenders with a whole-life term includes murderers Rosemary West, Levi Bellfield, Michael Adebolajo, Wayne Couzens and Lucy Letby. (Statistics taken from the Ministry of Justice’s offender management statistics publications.)

The King -v- Lucy Letby

Manchester Crown Court

21 August 2023

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