Healthcare Brief market insights – June 2019

A summary of key developments, including an update on the Clinical Negligence Scheme for General Practice, the Civil Liability Act 2018 and the first review of the discount rate; the Mental Capacity (Amendment) Act 2019, a new agreement between the Care Quality Commission and the Healthcare Safety Investigation Branch, and the government’s response to the Health Service Safety Investigations Bill report.

GP indemnity scheme launched: reducing the burden of indemnity cover

The Clinical Negligence Scheme for General Practice (CNSGP) came into effect on 1 April 2019. Going forward, GPs will need to ensure that they have separate indemnity cover for any non-NHS work as well as for matters including criminal, inquests or GMC investigations.

The scheme is in response to the increasing cost of indemnity cover. Chair of the British Medical Association’s General Practitioners Committee, Richard Vautrey, stated: “In England and Wales, for every NHS GP, partner, salaried GP and locum, working in hours or out of hours, once and for all, we have taken away the burden of unsustainable indemnity payments.

Having worked closely with the Department of Health and Social Care, the Welsh Government launched a state-backed indemnity scheme for providers of GP services in Wales (as closely aligned as possible to the scheme developed in England). This scheme is also in operation from 1 April 2019.

Contact: Christopher Malla

Related item: New state indemnity scheme for General Practice

The Civil Liability Act 2018: first discount rate review

On 20 December 2018, the Civil Liability Bill received Royal Assent, starting the first review of the personal injury discount rate. The review must be completed by 5 August 2019 but the government is being pressed to set a new rate as quickly as possible.

The 2018 Act provides a helpful structure and restores stability to the insurance market, by specifying the investment assumptions and a five-year review cycle, and by obliging the Lord Chancellor to publish their reasons for each rate determination. This should allow all stakeholders to monitor investment performance and obtain rolling financial advice regarding likely discount rate projections.

Contact: Mark Burton

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Mental Capacity (Amendment) Act 2019: a shift of responsibility

On 16 May 2019, the Mental Capacity (Amendment) Act 2019 received Royal Assent. The Act will change the existing system of state authorisation for people who are deprived of their liberty by introducing new liberty protection safeguards.

The organisation where the arrangements “are mostly carried out” will be the “responsible body to authorise any deprivation of liberty”. If the cared-for person is in an NHS hospital, that will be hospital managers; but otherwise, the clinical commissioning group (CCG), local authority, private hospital or care home will be responsible.

Contacts: Rob Tobin, Amanda Mead and Matthew Angus

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Patient safety: new agreement between the CQC and Healthcare Safety Investigation Branch

Established in April 2017, the Healthcare Safety Investigation Branch (HSIB) undertakes independent investigations into patient safety concerns in NHS-funded care in England, making recommendations for improvement of healthcare systems and processes.

On 2 April 2019, the Care Quality Commission (CQC) and the HSIB published a new Memorandum of Agreement. The CQC have stated “the agreement confirms that we will share information about the safety and quality of NHS services and evidence of safety risks or emerging themes that may be indicate wider safety issues.

Collaboration should bring with it a unified approach to better patient safety.

Contact: Ed Glasgow

Health Service Safety Investigations Bill report: government response

On 4 December 2018, the government published its response to the Joint Committee’s report (published on 2 August 2018) on the draft Health Service Safety Investigations Bill.

The government has accepted many of the Joint Committee’s recommendations in full, including its recommendation to remove accreditation of Trusts to carry out ‘safe space’ investigations from the Bill. The government has not accepted a small number of the Committee’s recommendations, including the recommendation to exclude the current maternity investigations programme from the Bill.

In the foreword to the response, Minister of State for Care, Caroline Dinenage MP, writes that the government “will continue to work with system partners and stakeholders in revising the draft Bill in line with the response, and will bring forward this legislation when time allows.

Contact: Daniel Freeman

Related item: Healthcare Brief market insights – December 2018

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