RCS Publishes New Professional Standards for Cosmetic Surgery, Endorsed by the CQC

The Royal College of Surgeons (RCS) has published new Professional Standards for Cosmetic Surgery, which set out the standards of good practice expected of all surgeons who perform cosmetic surgery. The guidance addresses key areas of risk such as communication, consent and professional behaviour, and is intended to improve patient safety and standards of care.

The RCS has been working with the General Medical Council (GMC), which has published its own set of professional standards for doctors carrying out cosmetic procedures to make sure they too provide the best possible care for patients. The GMC standards will come into force in June 2016 and will make clear the ethical obligations that doctors have towards patients.

The CQC has agreed to take into account both the RCS and GMC standards during their inspections and when making a judgement about the quality and safety of services being provided.

This will include taking into account whether registered providers have implemented effective systems so that:

· Surgeons performing cosmetic surgery are skilled and experienced in the area in which they practise.

· The operating surgeon leads the consultation with the patient to ensure they are fully informed and to outline the risks of the procedure, the likely outcome and provide the information that will help them decide whether or not to undergo surgery.

· The operating surgeon is the person who will obtain written consent from the patient. It will not be delegated to a colleague or other person.

· Consent is obtained in a two-stage process with a cooling-off period of at least two weeks between the stages to allow the patient to reflect on the decision.

· Appropriate indemnity insurance is in place to cover the procedures being undertaken.

· Financial inducements such as time-limited offers and discounts are not used or promoted.

The CQC regulates all independent clinics and hospitals that provide cosmetic surgery. They regulate cosmetic treatments that involve any instrument or equipment (such as an implant) being inserted into the body.

Books by Earliest Women Writers Bought Together for First Time

The Wellcome Collection is exhibiting manuscripts from the first female writers in the English language (Julia of Norwich and Margery Kempe) together for the first time in a new exhibition. The ‘This is a Voice’ exhibition aims to cast a spotlight on the meaning and emotions conveyed through the patterns of rhythm, stress and intonation in non-verbal forms of communication.

The Book of Margery Kempe, which was digitised by the British Library in 2014, is dated between 1436 and 1438. It is the story of a middle-class Norfolk woman’s life, and is widely seen as the first autobiography in English. Her book chronicles her domestic tribulations as the mother of 14 children, her extensive pilgrimages to holy sites in Europe and the Holy Land, and her mystical conversations with God, all dictated to a scribe as she claimed to be illiterate.

Margery Kempe’s manuscript lay hidden from 1520 to the 1930s, when it was discovered during a game of ping-pong. Whilst searching for a replacement ball the book fell out of a cupboard.

The Revelations of Divine Love by the 14th century anchorite, Julian of Norwich, was written after she claimed she had experienced a series of mystical visions in 1373. Her writings indicate that she was probably born around 1342 and came from a privileged family.

She believed that God sees us as perfect and waits for the day when human souls mature so that evil and sin will no longer hinder us.

Julian first wrote a short version of her book, of which only one copy is believed to have survived, and then a longer version about 20 years later, of which only three copies survive. She is considered to be the first female writer to work in the English language.

Incredibly the two women met each other during their lives, with Margery Kempe visiting Julian of Norwich for advice on her visions.

Anthony Bale, Professor of Medieval Studies at Birkbeck University of London said “It’s wonderful that the British Library has loaned the unique manuscript of The Book of Margery Kempe to the This is a Voice exhibition – not only did Kempe describe hearing voices and sounds but she also crafted a distinctive voice for herself. It is very touching that the Julian of Norwich manuscript is displayed alongside that of Margery Kempe: the two women – who can also legitimately be called two of the earliest women writers in English – met in Norwich, probably in the year 1413,”

“Julian’s reputation as a holy woman was already established, and Kempe visited her to see if the ‘holy speeches and conversations’ that Kempe had with God were real or not,” said Bale. “Kempe describes how Julian advised and endorsed her, and the two women had ‘much holy conversation’, over the course ‘of many days’ together.”

Author and psychologist Charles Fernyhough was part of the team who put the exhibition together. “We went to the British Library and met with the curator, and put to her that having these two manuscripts would send an incredibly important message - it would say that this experience [of hearing voices] has been around for a long time. That hearing voices isn’t new, and that it has been interpreted in more positive ways in the past ... It was such a coup for us to get [The Book of Margery Kempe] as it’s one of their most precious, prized things.”

The one surviving copy of the short text of Julian of Norwich’s book was “too valuable” to be loaned, so Wellcome Collection chose a 1625 version of the long text, said Fernyhough, which exhibits the “beautiful writing style” of its scribe.

The manuscripts are on display until the end of July.

CQC to Review How NHS Trusts Investigate Deaths

The CQC is carrying out a review of how NHS trusts identify, report, investigate and learn from the deaths of people using their services.

This follows a request from the Secretary of State for Health, which was part of the Government’s response to a report into the deaths of people with a learning disability or mental health problem in contact with the Southern Health Foundation NHS foundation Trust.

The review will look at how Trusts identify, report and investigate the deaths of people in contact with a health service managed by an NHS trust; whether the person is in hospital, receiving care in a community setting or living in their own home. The review will pay particular attention to how NHS trusts investigate and learn from deaths of people with a learning disability or mental health problem.

Professor Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said:

“Very many people are under the care of secondary healthcare services at the time of their death.

“For most, the care provided has prolonged their life, eased their suffering and helped them to die with dignity. However, this is not the case for everybody. Every year thousands of people under the care of NHS trusts die prematurely because their treatment or care has not been as good as it could have been. Healthcare workers might have failed to identify an illness that could have been treated, not provided the advice that might have prevented an illness developing, not made a life-saving intervention with a person who is critically ill or made some other error that contributed to a premature death.

“It is essential that, when this happens, NHS services identify and investigate the circumstances of these deaths so that staff can learn from them and reduce the likelihood of a similar event happening in the future. It is also essential, that NHS providers are open and honest with the families and carers of people who die whilst under their care.

“CQC’s review aims to find out to what extent NHS trusts are learning organisations when it comes to investigating the deaths of people under their care and how well they support and engage with the families of people who have died.”

The CQC will be writing to all acute, community and mental health trusts seeking information about the number of deaths in their services, how they decide which of these should be investigated and how they then carry out those investigations. Asking how they involve families and how they use the learning from those investigations to make improvements.

The findings will be published in a national report towards the end of the year.

2016 IMPACT Health and Wellbeing Award Winners Announced

Congratulation to this year’s GSK IMPACT Award winners. The awards are designed to recognise and reward charities that are doing excellent work to improve people’s health. They are funded by GlaxoSmithKline and managed in partnership with The King’s Fund.
2016’s Winners

• Age UK South Lakeland – an organisation working with local older people to help them retain independence and exercise real choice in their lives.
• Body and Soul – a London-based national organisation promoting the respect, dignity and wellbeing of children, young people and adults with and affected by HIV.
• Carers in Hertfordshire – a county-wide charity supporting carers with information, problem-solving and support.
• Children North East – a charity aimed at transforming the lives of disadvantaged children.
• Falkirk and District Association of Mental Health – an organisation promoting mental health recovery for adults.
• Groundswell – a charity enabling homeless people to take more control of their lives, have greater influence on statutory services and play a fuller role in the community.
• London Friend – a charity working to improve the health and wellbeing of adult lesbians, gay men, bisexual and transgender people through providing counselling, social support groups, drug and alcohol support, and training for health professionals.
• Promoting a More Inclusive Society (PAMIS) – a Scottish charity based in Dundee aiming to improve the lives of people with learning difficulties and their families.
• Seesaw – an Oxfordshire organisation responding to the needs of bereaved children and young people.
• The Shakespeare Hospice – a Stratford-upon-Avon-based charity providing a range of services for patients and their families, including information and advice and physical, psychological and spiritual care.

Each charity will receive £30,000 of unrestricted funding, access to free training and leadership development, and the opportunity to join the prestigious GSK IMPACT Awards Network.

The following runners-up will receive a £3,000 donation.

• 42nd Street
• Acacia Family Support
• Alzheimer’s & Dementia Support Services
• Core Arts
• KIM Inspire
• North London Cares
• Redthread
• Savana
• The Alcohol Education Trust
• Windsor Women’s Centre

An overall winner will be named at an award ceremony recognising all winners, to be held at the Science Museum in London on Thursday 12 May 2016. The overall winner will receive an additional £10,000 in funding.

2016 Worldwide Young University Rankings Published

The Times Higher Education (THE) Young University Rankings for 2016 have been published, with Switzerland’s Ecole Polytechnique Federale de Lausanne topping the poll for the second year in a row, despite competition from East Asian universities including from the Nanyang Technological University, Singapore (NTU) which came in second.

Talking to THE, Bertil Andersson, NTU president, cited the institution’s continued ability to attract top established and young researchers; innovative approaches to teaching, with a goal of designing half of degree courses for “flipped classroom learning” within the next five years; and “good blend of East and West” as reasons for its rapid success.

“Teaching in English makes it easy for NTU to attract international faculty or to collaborate with many other world-class universities as English is a common platform for us,” he said.

He added that many other Asian universities are also highly driven towards academic excellence and research, as demonstrated in this ranking, and if this trend continues “Asia could well become a major driving force for the world’s knowledge production and innovation by 2050”.

The UK also fared well this year with the most institutions in the top 150, 25 in total.  Whilst Australia has the largest number in the top 100, 16 in total.

Top Ten

1.    Switzerland’s Ecole Polytechnique Federale de Lausanne

2.    Nanyang Technological University, Singapore

3.    Hong Kong University of Science and Technology

4.    Netherlands’ Maastricht University

5.    South Korea’s Pohang University of Science and Technology

6.    Korea Advanced Institute of Science and Technology (KAIST)

7.    University of Konstanz (Germany)

8.    Karlsruhe Institute of Technology (Germany)

9.    Pierre and Marie Curie University (France)

10.  Scuola Superiore Sant’Anna (Italy)

The University of Dundee is the first UK University in the list, popping up in 16^th place. 

The list is compiled using the same 13 performance indicators as the THE World University Rankings, but with less weight given to reputation.  You can view the full list and individual university stats at https://www.timeshighereducation.com/world-university-rankings/2016/one-hundred-fifty-under-fifty

CQC’s National Guardian Team to be Operational by the End of April

The CQC has confirmed that, despite the departure of Dame Eileen Sills as National Guardian, and David Bell as Interim Deputy Guardian, the office of the National Guardian will be operational by the end of this month, in line with the original plans.

While recruitment is underway for the new National Guardian, Sir Robert Francis will provide non-executive support and oversight to the office with the help of the CQC, NHS Improvement and NHS England.  This support will enable to unit to begin its vital work, without compromising the ability of Dame Eileen’s successor to shape its functionality.

The team is on course to begin operating and provide advice and support to NHS Trusts on the role of local guardians from the end of April and the office’s main functions will be phased in throughout the year as follows:

1.    Providing advice and support to NHS Trusts and local guardians operating within NHS trusts as they establish this role (by end of September 2016),

2.    Giving broader advice to NHS management on how to improve and create a culture for healthcare staff to speak up safely.

3.    Beginning to develop the process and criteria for reviewing the handling of whistle-blowing cases (by the end of the year).

The National Guardian role will be advertised later this month, with interviews planned over May and June.

Sir Robert Francis QC, CQC board member and author of the ‘Freedom to Speak Up' review, said:

“The Office of the National Guardian is a key part of the promotion of the freedom to speak up in the NHS. I remain personally committed to help see a new National Guardian appointed as soon as possible and to oversee the continuing development of the infrastructure required to support the new appointee. I am confident that the team at CQC is working hard to ensure that the new Guardian has the support in place to enable this vital work to be done.”

Data Sharing Scheme Designed to Boost Funding for SMEs

The government has launched a new small and medium size business (SME) credit data sharing scheme, designed to make it easier for new banks and alternative finance providers to check credit worthiness of potential business customers.

The scheme, governed by the new Credit Information Regulations, will make it easier for new challenger banks and alternative finance providers to check credit worthiness of potential business customers, increasing the number of funding options open to SMEs and helping more businesses find the funding they need to grow.

Under the scheme nine banks and three Credit Reference Agencies have been instructed to share, with the SME’s permission, the credit information they hold on SMEs equally with all finance providers.

The following banks have been instructed to share their data with Experian, Equifax and Creditsafe (the CRAs).

·         RBS

·         Lloyds

·         HSBC

·         Barclays

·         Santander

·         Clydesdale & Yorkshire Bank

·         Bank of Ireland

·         Danske Bank

·         First Trust Bank

The CRAs must then share this data equally with all finance providers.

A number of bodies, including the Office of Fair Trading and the Competition Commission, have all highlighted how a lack of information about the creditworthiness of SMEs has been a major barrier to competition in the SME lending market. The biggest banks currently have access to much more data than challengers and the new regulations will enable over 100 alternative finance providers to compete effectively in the SME lending market. SMEs are vital to the UK economy, accounting for over half of private sector employment and nearly half of all private sector turnover. The ability of SMEs to access finance is important for funding business investment, ensuring businesses reach their growth potential, and for facilitating new business start-ups.

Harriett Baldwin, the Economic Secretary to the Treasury, said:

“The government is determined to encourage a competitive banking system that supports growth and creates jobs.

Small businesses are the backbone of Britain’s economy and it is right we make every possible source of finance available to them.

The best way to deliver this is to increase competition in the banking sector and remove the barriers to new sources of finance for SMEs. Requiring banks to share data is a major structural reform that will level the playing field between banks and alternative finance providers.

The government expects data sharing to begin later this year when tests between banks and CRAs confirm that data can be shared accurately and securely.”

Ofsted and CQC SEND Inspections to Begin in May

Image reproduced under license: Stefano Mortellaro, Flickr

Starting in May this year the CQC and OFSTED will jointly inspect how effectively local areas fulfil their responsibilities to children and young people who have special educational needs and/or disabilities (SEND).   The inspections are designed to help raise service standards for some of the most vulnerable young people in England.

The two bodies carried out joint pilot inspections and have been consulting on their proposals over the last 3 months.  They consulted individuals and organisations who have an interest in, or expertise relating to, special educational needs and/or disabilities, in particular service users, parents and carers, and they have now published their conclusions.

Their proposals received overwhelming support with almost 90% of respondents in support, and changes have been made to the proposed model as a result of feedback.

Inspectors will visit local areas to see how they are fulfilling their responsibilities, giving 5 days notice of an inspection to ensure all partners,  especially young people, parents and carers, have ample opportunity to offer their views about local education, health and social care services, and fully engage in the inspection.

They will:

• assess how well the local area identifies children and young people who have special educational needs and/or disabilities.
• evaluate how effectively individual’s needs are met the outcomes of children and young people who have special educational needs and/or disabilities improved.
• use a wide range of information to evaluate how effectively the local area fulfils its responsibilities.
• talk to children and young people, and their parents and carers, and local partners, including nurseries, schools, colleges and specialist services.

Joanna Hall, Ofsted Deputy Director for Schools, said:

“I am pleased that there is overwhelming support for our proposals to inspect services for some of the most vulnerable children and young people in England. We have listened and will give parents and carers more notice of our inspections so that they can offer their views and insights.

I believe that the inspections will help local areas improve the services they deliver to children and young people with special educational needs or disability. These inspections will also provide reassurance to families, children and young people that local areas are being held to account.

I have no doubt that there will be some hard truths to deliver from the first inspections this summer. However, I want to stress that our inspection reports will also highlight effective practice. It is my hope that other local areas will learn from examples of how things can be done well so that there will be a long-term cultural change in the way these services are delivered.”

Steve Field, Care Quality Commission Chief Inspector of General Practice, said:

“Children and young people with special educational needs have the right to access the support they need from local health services. This critical work will for the first time highlight whether these needs are being met and while there could be some uncomfortable truths coming out of this work, we also aim to shine a spotlight on those local areas that are performing well to help services improve nationally.

Inspectors will be experienced SEND specialists. They know their local areas, will choose who they speak to when they carry out their inspection work”.

In the coming weeks, Ofsted and the Care Quality Commission will prepare an inspection handbook and framework, which will be published before the first inspections take place in May.