Tuesday, 18 July 2017

CQC Places Kent GP Practice in Special Measures

CQC inspectors have placed Dr K E Wilcox and Partners (also known as The Medical Centre), in London Road, Sittingbourne, Kent into Special Measures following an inspection in March 2017.

Inspectors rated the service as Inadequate for being well-led and safe and Requires Improvement for being effective and Good for being caring and responsive to people’s needs.

Key Findings:

  • There was a system for reporting and recording significant events. However, not all staff understood what constituted an incident or near miss. 
  • Risks to patients were not always assessed and well managed. For example, those relating to recruitment checks. 
  • The practice was unable to demonstrate that there was an effective system for receiving and acting on medicines alerts from the Medicines and Healthcare products Regulatory Agency. 
  • The practice did not have an adequate supply of medicines and equipment to respond to medical emergencies in line with national guidance. 
  • The practice was unable to demonstrate that it had a system to track the use of blank prescription forms throughout the practice. 
  • Data showed patient outcomes were low compared to the national average. Although some audits had been carried out, we saw no evidence that audits were driving improvements to patient outcomes.
  • The practice was unable to demonstrate that all staff had received sufficient training to enable them to carry out their roles effectively, and staff did not have regular appraisals. 
  • The practice had insufficient leadership capacity and limited formal governance arrangements.

Ruth Rankine, Deputy Chief Inspector of General Practice CQC’s South region said: “Our inspectors had previously carried out an inspection at the Medical Centre in June 2015 and this new inspection was to follow up on our initial concerns and focus on the work the practice had carried out since that first visit."

“It is worrying that despite the concerns identified at that first inspection, our team found a further decline in the standards and a number of additional concerns. Patients were at risk of harm because systems currently in place were not embedded well enough to keep them safe. For example, not all staff understood what constituted an incident or near miss, leaving patients at risk of being unsafe."

“With this in mind we had no option but to place the practice into special measures. We will re-inspect the practice within six months to check whether sufficient improvements have been made. If we find that the service provided by this surgery remains inadequate, we will consider further action."

Thursday, 13 July 2017

UCAS University Applications Down

UCAS has published figures for university applications made this year. UK applications are down 4% and EU applications are down 5%.

The number of people who have applied to UK higher education courses for 2017 is 649,700, approx 25,000 fewer than at this point last year.

The Numbers by Location

  • 529,620 UK applicants (a decrease of 4% compared to this point last year)
  • 49,250 EU applicants (a decrease of 5%)
  • 70,830 applicants from other overseas countries (an increase of 2%).

Focusing on UK Applications

  • UK: 437,860 from England (a decrease of 5% on 2016) 
  • 48,940 from Scotland (down 1% on 2016) 
  • 22,530 from Wales (down 5% on 2016)
  • 20,290 from Northern Ireland (down 4% on 2016). 

By Age Group

  • There are around 321,950 18-year-old applicants, an increase of 1,510 on last year. 
  • There were 315,200 applicants at the deadline aged 19 or older (a decrease of 27,180 on last year). 

Focus on Nursing

There are additional statistics on applicants to nursing courses. Overall, there are 53,010 applicants to nursing courses, representing a decrease of 19% compared to this point last year. 

Responding to the publication of the figures, Dame Julia Goodfellow, President of Universities UK and Vice-Chancellor of the University of Kent, said: "These figures confirm what we know already from UCAS about application figures for this year. There are several possible reasons behind the drop in numbers. Last year was a record high for applications and, factors such as Brexit and changes to the way degrees in nursing, midwifery and some other allied health professions in England are funded, could also be having an impact. There has also been a fall in the number of 18 and 19 year olds across the UK population since 2010. This group makes up over half of all UK applicants to universities. The rate of applications from this age group, however, is at record levels, highlighting continued demand for university courses.

"We recognise there are a number of issues to address. Continuing to communicate to European applicants that they are welcome and enrich our education system is important. The decline in part-time and mature student entrants must also be addressed. We recognise also the concern about the total cost of going to university. Any analysis needs to cover the cost of maintenance and the interest rate on the loans."

NUS President Shakira Martin said: “These figures are further evidence that the government urgently needs to review the education funding system. Some have claimed that rising fees and the lack of proper financial support for students have not deterred people from attending University. Clearly, this is completely untrue.

We can see that there is a drop of 9% in Black and Ethnic Minority applicants: a group which have consistently shown to be more debt averse and therefore more likely to be put off by student fees. The sharp drop in mature students also highlights how completely unaffordable University is for many: applicants over 18 are less likely to be supported by their parents, more likely to have their own financial and caring responsibilities, and are more likely to be aware of the risks of taking on huge amounts of debt.

The most horrifying figure released today is the 19% drop in nursing applicants. That this huge drop follows cuts to nursing bursaries is no surprise. What is surprising is that the government could not foresee the catastrophic effect that these cuts would have. Traditionally, 50% of nursing students are parents. When students are put in a position which essentially forces them to live in poverty while completing their studies, it is unsurprising that those with children feel unable to take part.

The education funding system is not working, and as applicant numbers continue to drop the government needs to wake up to the reality that if we don’t review the system now, we will have to pay a huge price a few years down the line.”

Wednesday, 12 July 2017

Welsh Students to Get the Equivalent of National Living Wage When Studying

Welsh Education Secretary Kirsty Williams has confirmed that students from Wales will receive the equivalent of the National Living Wage while they study.

From 2018/19, Wales will be the first country in Europe to introduce equivalent maintenance support across full-time and part-time undergraduates, as well as post-graduates.

Government estimates show that a third of full-time students will receive the maximum grant, which is £8,100 for a student living away from home.

The average household income for a student in the current system is around £25,000. Under the new system such a student will receive around £7,000 a year as a non-repayable grant.

Part-time students will receive parity of support for maintenance costs on a pro-rata basis. Students will be supported through a mix of grants and loans equivalent to the National Living Wage.

Speaking in the Assembly chamber, the Cabinet Secretary also confirmed that in 2018/19 there will be a return to the pre-2012 policy of an inflation-linked maximum tuition fee level. This will be in place for the next three academic years. This follows Universities Wales’s confirmation that all Welsh universities will become Real Living Wage employers. They have also confirmed that they will sign-up to the Government’s Code of Practice: Ethical Employment in Supply Chains.

Kirsty Williams said:  “It is now widely recognised that high living costs are the greatest barrier to young people studying at university. Our new progressive system is a fundamental shift in the way we support students and our institutions.

“By investing in the success of full-time, part-time and post-graduate students, Wales will be the only country in Europe to have taken this huge step forward.

“Having confirmed that students will receive support equivalent to the National Living Wage, I welcome Universities Wales’ announcement that all Welsh universities will become living wage employers. We can be proud that Wales’ sector will be the first in the UK to achieve this.”

CQC Takes Legal Action Against Cumbrian Care Home

Beacon Edge Care Home, a residential care home in Penrith, Cumbria has been rated as Inadequate by the CQC for the second time as a result of breaches of the Health and Social Care Act (2008).  The CQC has now decided to take legal action against the home.

Beacon Edge Care Home, is run by Bupa Care Homes (CFChomes) Limited and provides personal care for older people, some of who may be living with a dementia. At the time of the inspection 24 people were using this service.

Key Findings:

  • There were too many unexplained falls and injuries for a unit of this type and size.
  • Risk assessments relating to falls were not being reviewed and updated.
  • Medications prescribed by doctors were not always being administered.
  • People were not always supported to have maximum choice and control of their lives but staff did try to support them in the least restrictive ways.
  • Nutritional assessments, monitoring and record keeping were poorly managed.
  • Inspectors observed that people did not always receive dignified care.
  • Where advice had been sought from health care professionals, this had not been followed with any consistency.
  • An action plan had been developed to help bring about improvements, but these had not been implemented with any urgency.
Commenting on the action Debbie Westhead, CQC’s Deputy Chief Inspector for Adult Social Care, said “We found six breaches in regulation at our previous inspection and disappointingly found limited progress has been made in addressing these despite us telling Beacon Edge Care Home where they must improve."

“It was very concerning that risk assessments relating to falls were still not being reviewed and updated consistently. We found that people using the service continued to experience avoidable falls, and unexplained bruising and injuries which is unacceptable."

“People were also not always receiving their medicines as their doctor had prescribed them putting them at risk."

“We are working with local partners including Cumbria County Council to ensure the safety of people using this service.”

The full report from the inspection can be found on the CQC's website.

Monday, 10 July 2017

Pitches Versus Outlines - A Guide to Scriptwriting Terms

Any aspiring screenwriter needs to get to grips with jargon if they are going to get on.

Different interpretations of your work are required at each stage of the selling and development process - you don't need to start with, and submit, a finished script - in fact if you do, your work is likely to go to the bottom of the pile, too long to read and understand quickly by editors and researchers.

It is therefore really important to get a handle on the types of document involved in the pitching and commissioning process, their content and the order in which they are required. The process can feel like a straight jacket on your creativity, but it shouldn't, it should free you up to focus in on the key components of your work, helping you work through your own ideas and take the pressure off, removing the feeling that you need to produce a polished final treatment before you begin pitching.

Selling Documents

These are about your idea in the broadest terms and about selling both your script and yourself as a writer.  

Pull out the elements of your idea that you think will appeal to each editor and shout about them, research the audience they usually cater for and try keep them in mind when working on your pitch.

You can use the same pitch for multiple companies, but, just as when applying for a job and working with your CV, tweak the pitch to highlight how it best meets the editors market/agenda.

Pitches should be as short as possible, ideally, no more than a single page, it is about sparking interest and making the editor want to find out more.  They can be hard to write because you have to leave so much out and there is always a fear that what you exclude would have been the hook that drew the editor in, but have courage - if you don't keep it short, it won't be taken seriously.

Start with an overview, detail the broad arc of the plot but also cover tone and your angle/agenda as a writer.  Knowing where you are coming from gives an editor confidence and helps them understand you as a writer, after all it is you they will have to work with if the story is developed.  WHAT is the story and WHY do YOU need to be the one to write it.  Outline the main characters, the setting, and if there any plot twists what are they?

Writing for the BBC's Writers Room, Phillip Shelley, Script Editor, Consultant and Producer, said "The less good pitches deal in empty promises. It’s a good idea to convey your sense of excitement as a writer in a project – but it needs to be backed up by hard evidence."
 

Development Documents

  • Outlines
  • Beat-sheets
Once your idea has been accepted you move onto work up outlines and beat sheets, covering plot, structure, tone and content in the broadest sense.  Phillip Shelley again, "At their best, outlines can be gripping, exciting, emotive pieces of visual story-telling that give a clear indication that the script that follows is going to be equally wonderful. I haven’t yet read an exciting, excellent outline that doesn’t become an exciting, excellent script."

"For me, the most important principles of writing effective outlines are to write visually and explain nothing. The outline has to work in the same way as the script will do. It needs to dramatise the story, and leave the interpretation of the story action up to the reader – in the same way as the best scripts/films."

The Script

Once the development documents have been discussed and tweaked, only then do you need to get started on your script - do this any earlier and you could be faced with massive re-writes in light of the feedback at the development document stage.


Read more about Philip Shellley's experience, with hints and tips, in the BBC's Writers Room.


Wednesday, 5 July 2017

CQC to Investigate How People Move Between Health and Social Care Services

The CQC has been asked by the Secretaries of State for Health and for Communities and Local Government to undertake a programme of local system reviews of health and social care in 12 local authority areas.

These reviews, exercised under the Secretaries of State's Section 48 powers, will include a review of commissioning across the interface of health and social care and an assessment of the governance in place for the management of resources.

They will look specifically at how people move between health and social care, including delayed transfers of care, with a particular focus on people over 65 years old. The review will not include mental health services or specialist commissioning but, through case tracking, will look at the experiences of people living with dementia as they move through the system.

David Behan, Chief Executive of the Care Quality Commission, said: "People should be able to expect good, safe care when they need it, regardless of how this care is delivered. And yet we know there is wide variation in how health and social care systems work together, with some local systems working together effectively to ensure people get the right care, while others struggle to do so - these reviews will seek to examine why these levels of variation exist.

"Our intention is that the review findings will highlight what is working well and where there are opportunities for improving how the system works, enabling the sharing of good practice and identifying where additional support is needed to secure better outcomes for people using services."

The purpose of the reviews is to provide a bespoke response to support those areas facing the greatest challenges to secure improvement. On completion of the reviews, the findings will be reported to each local authority area’s health and wellbeing board.

A further eight sites for review will be identified in the coming months and once all 20 reviews have been completed the CQC will be publishing a national report, detailing their findings and recommendations.

Monday, 3 July 2017

Digital Ecomony Giants Come Together To Improve Business Prospects in the UK

The government's new Digital Economy Council, brought together to stimulate new growth and deliver new jobs in the digital economy met for the first time this week.

The Council has been set up to provide a forum for collaboration as the government works to implement the UK Digital Strategy and develop a Digital Charter. Its members include TechUK, Google, Facebook, Cisco, Dotforge, Coadec, TV Squared, BT and Apple.

The seven pillars of the Digital Strategy are:
  • Building world-class digital infrastructure for the UK 
  • Giving everyone access to the digital skills they need 
  • Making the UK the best place to start and grow a digital business 
  • Helping every British business become a digital business 
  • Making the UK the safest place in the world to live and work online 
  • Maintaining the UK government as a world leader in serving its citizens online 
  • Unlocking the power of data in the UK economy and improving public confidence in its use
The overarching aim of the strategy is to make the UK the best place to start and run a digital business – creating more of the high-skilled, high-paid jobs of the future with the benefits felt in all four corners of the United Kingdom.

During the first meeting members of the tech community had the opportunity to tell the government directly how they can better work with them to take advantage of the opportunities and overcome the challenges of the digital technology.

Priorities were also set for the coming year including looking at new ways to improve small and medium businesses’ digital transformation, how to boost the digital skills pipeline and assessing how the country can better commercialise its world-leading research.

Secretary of State for Culture, Media and Sport Karen Bradley said "The Digital Economy Council will play a vital part in helping us achieve our aim of making the UK the best place in the world to start and grow a digital business with the benefits enjoyed throughout society and in every part of our country.