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NHS England launched its “Delivery plan for recovering urgent and emergency care services” at the end of January 2023.
To support recovery, this NHS England plan sets out a number of ambitions, including:
“Patients being seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25.
“Ambulances getting to patients quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels.
“NHS England has engaged with a wide range of stakeholders to develop the plan, and it draws on a diverse range of opinion and experience, as well as views of patients and users.”
Read more: www.england.nhs.uk/publication/delivery-plan-for-recovering-urgent-and-emergency-care-services/
Positive Results from Covid Clinical Negligence Claims Protocol
The collaborative approach taken by NHS Resolution, Action against Medical Accidents (AvMA) and the Society of Clinical Injury Lawyers (SCIL) in designing and operating the Covid 19 Clinical Negligence Claims Protocol appears to have significantly reduced the number of clinical negligence claims that have become litigated, creating savings benefiting the NHS and patients.
Figures from NHS Resolution Annual Report and Accounts show that since the implementation of the Covid 19 Clinical Negligence Protocol there has been a 6% reduction in the volume of settled cases that have been become litigated between financial years 2019/2020 and 2021/2222.
There are still questions to answer, for example, the size of any Covid 19 related effects on the numbers of claims received. Further data on claims trends before, during and after COVID should help isolate these effects and provide for greater certainty on the effectiveness of the Protocol itself.
If the Protocol is shown to have permanently reduced the overall volume of litigation, then this work is likely to have saved significant costs for all parties, and most importantly the NHS.
Lisa O’Dwyer, Director of Medico-Legal services at Action against Medical Accidents (AvMA), the UK charity for patient safety and justice said:
“The impressive likely cost savings are testament to what can be achieved when key, specialist clinical negligence stakeholders come together and collaborate. More generally, it is very positive to note that both claimant and defendant practitioners have derived considerable benefit from the clinical negligence protocol.”
Simon Hammond, Director of Claims Management at NHS Resolution said:
“The Clinical Negligence Protocol has proven how collaboration can be of benefit to all parties. We look forward to working with SCIL and AvMA on the possibility of developing how the protocol could apply in a post-Covid environment.”
Read more: www.scil.org.uk/scil-news
The NHS Complaint Standards
The Parliamentary and Health Service Ombudsman has published updated guidance for complaint handling across the NHS in 2023.
“The NHS Complaint Standards, model complaint handling procedure and guidance set out how organisations providing NHS services should approach complaint handling. They apply to NHS organisations in England and independent healthcare providers who deliver NHS-funded care.”
Read more: https://www.ombudsman.org.uk/organisations-we-investigate/nhs-complaint-standards
Are the costs of a medical agency recoverable in the fixed costs regime?
In the judgment of District Judge Phillips in Wilkinson-Mulvaney -v- UK Insurance Ltd (19th January 2023) (reported via CivilLitigationBrief) it was held that they were.
The claimant pursued a claim for personal injury damages, following a road traffic accident, and the matter settled for just over £16,000. There was agreement in relation to costs and disbursements, except the costs of the medical reports and several court fees.
The defendant’s objection was that the invoices relied upon failed to differentiate between the direct costs of the report and the medical agencies fees, and that medical agency fees are not recoverable. The only recoverable element was that of the doctor, together with fixed fees for obtaining medical records.
The judge carried out analysis of the rules and the case law on the topic, noting that there was no binding authority on the issue. He concluded that “the cost of obtaining a medical report” includes the cost of any medical agency fees incurred in the obtaining of such report.
The judge stated. “Had the drafters of the Rule and the Rule Committee wanted to limit the fees recoverable to those only paid to the doctor, they could have quite easily made this clear in the Rule, they chose not to do so.”
The judge stated that it would be helpful for a breakdown to be given, since the court had to assess what sums were reasonable and proportionate.
Read more: https://bit.ly/3SsEYdg
The National Safety Standards for Invasive Procedures 2023 update
National Safety Standards for Invasive Procedures (NatSSIPs) have not been updated since they were first introduced in 2015.
NatSSIPs2 (January 2023) consists of two inter-related sets of standards:
The organisational standards are clear expectations of what Trusts and external bodies should do to support teams to deliver safe invasive care.
The sequential standards are the procedural steps that should be taken where appropriate by individuals and teams, for every patient undergoing an invasive procedure.
The NatSSIPs2 have evolved to have less emphasis on tick boxes or rare ‘Never Events’ and now include cautions, priorities and a clear concept of proportionate checks based on risk. NatSSIPs2 should form the basis of improvement work, inspections and curricula.
Read more: https://bit.ly/3xK9ENK
NICE recommends 3 treatments for COVID-19 in final draft guidance
Everyone with COVID-19 at highest risk of developing severe disease will have access to clinically and cost-effective treatments, under final draft guidance published by NICE on 21 February 2023.
People at highest risk of developing severe disease include those who are immunosuppressed, or who have other conditions such as heart disease, respiratory disease, diabetes, or neurological conditions.
The draft guidance means they will have access to treatments taken either at home or in hospital. It recommends 3 drugs as options for treating COVID-19 in adults:
Paxlovid (also called nirmatrelvir plus ritonavir and made by Pfizer);
Xevudy (also called sotrovimab and made by GlaxoSmithKline); and
RoActemra (also called tocilizumab and made by Roche).
Earlier in the month NICE issued draft guidance for public consultation, which does not recommend Evusheld for preventing COVID-19 in adults who are unlikely to have an adequate immune response to COVID-19 vaccination, or who can’t be vaccinated, because there is not enough evidence of its effectiveness against current variants and those likely to be circulating in the next 6 months.
NICE was asked to review the clinical and cost-effectiveness of treatments for COVID-19, some of which are currently being used in the NHS under interim UK-wide pandemic-specific access arrangements.
Registered consultees now have the opportunity to appeal the final draft guidance. If no appeals are received, NICE expects to publish its final recommendations on medicines to treat COVID-19 in March.
Read more: https://www.nice.org.uk/news
Justice Committee to study 2021 whiplash claims and reform
From June 2021, the personal injury claims process changed for people who suffer from low-value injuries in road traffic accidents (RTAs), following reforms in the legal framework introduced by the government.
In February 2023, the Justice Committee announced an inquiry on the impact of the changes, and whether the reforms are on track to successfully reduce insurance premiums for motorists, while ensuring injured claimants can still access justice.
“Whiplash reform was introduced in 2021 following a realisation that insurance claims for the injury were running at over £2bn per year – adding an average of £90 to everyone’s car insurance policies.
“The Whiplash Reform Programme was aimed at roughly halving the overall cost of these types of insurance claims, and then passing on savings in premiums of between £40 and £50 a year per motorist.
“As part of the reform programme, the Ministry of Justice asked the insurance industry to set up an online claiming system, or portal, known as the Official Injury Claim Service, which would deal with whiplash and claims for bruising or minor fractures.
“The reforms also required claimants to provide medical evidence of their injuries and introduced a financial limit on claims.
“The inquiry will investigate the effects of the reform programme, including any savings, and how the Claim Service portal operates.”
Until 17 March 2023, the Committee invited evidence on, among other things:
To what extent have these measures met the Government’s objective of reducing the cost of whiplash claims to the economy; and to what extent are any savings being passed on to motorists through lower insurance premiums?
What have been the effects of raising the small claims track limit from £1,000 to £5,000; the ban on settling whiplash claims without medical evidence; and the fixed tariff of compensation for whiplash injuries that last up to two years?
Why most claimants continue to use legal representation when using the online portal (90% since its launch)?
Whether the Official Injury Claim (OIC) portal is widely known about, accessible and easy-to-use for claimants and/or their legal representatives.
How effective is the OIC portal in settling claims for mixed injury claims, which cannot be settled using the fixed tariff awards?
Read more: https://bit.ly/3XV5xZw
Personal Injury firm, medical experts and others accused of collusion after “layering” whiplash claims with inflated costs
n Khan -v- Aviva Insurance Ltd (15/11/2022) District Judge Lumb held that the claim by Noreen Khan after a low-speed car accident was fundamentally dishonest, saying she “took a chance on bringing an opportunistic claim for damages”.
Ms Khan instructed the firm Simply Legal. The case did not settle in the Claims Portal and proceedings were issued with medical reports from Mr Adnan Majid, described as a medico-legal practitioner, and Dr Faisal Mir, a clinical psychologist.
Claims for injury need to exceed £5,000, and for special damages £10,000, if they are to exit the Official Injury Claim portal and move into the costs-bearing Claims Portal.
The schedule of loss claimed for 10 sessions of physiotherapy and 10 sessions of cognitive behavioural therapy (CBT) at a cost of £850 and £1,500 respectively.
A witness statement from the defendant Aviva’s solicitors, detailed claims for other accidents where Simply Legal was acting and instructed Mr Majid and Dr Mir, involving Med-Room Solutions Ltd (MRSL) providing identical physiotherapy and CBT programmes.
The judge explained in his ruling that this evidence was “demonstrating a business model of deliberately layering claims for the cost of unnecessary or non-existent rehabilitation treatment for financial gain”.
One of the directors of Simply Legal and the director of MRSL were brothers and both companies operated from the same building.
DJ Lumb said there was “clear evidence of the layering of this claim and others as alleged by the defendants”.
The entire claim was dismissed and was found to have been fundamentally dishonest.
He said the General Medical Council might consider investigating both medical experts Mr Majid and Dr Mir, while “the Solicitors Regulation Authority may also wish to investigate the handling of claims by Simply Legal”.
Miles Hepworth, from the defendant’s law firm DWF, said “claims layering has been going on since the introduction of fixed recoverable costs, as higher damages means higher costs, but has become worse since the Official Injury Claim portal went live in 2021.”
Read more: https://bit.ly/41fr3vb
GP suspended for nine months after promoting vitamins and iodine as Covid-19 treatments
The BMJ has reported that a GP in private practice has been suspended from the UK medical register for nine months, after an MPTS misconduct tribunal, for promoting unlicensed treatments and misleading claims about covid-19 online.
The medical practitioners tribunal in January heard that Sarah Myhill posted videos and articles on her website during 2020, describing “safe nutritional interventions” which she said were “now so well established that vaccination has been rendered irrelevant.”
Dr Myhill promoted the use of high doses of vitamins C and D and the inhalation of iodine through a salt pipe for the treatment of bacterial and viral infections, including covid. She also endorsed the use of ivermectin, without discussing the risks, and sold an iodine preparation on her website. The tribunal was told that the substances had potentially serious health risks and there was no evidence that they were effective.
“These agents risked patient safety in that they exposed patients to potential serious harm, including toxicity,” said tribunal chair Julia Oakford.
The tribunal found that Myhill “does not practise evidence-based medicine and may encourage false reassurance in her patients who may believe that they will not catch covid-19 or other infections if they follow her advice.”
The tribunal decided that Myhill’s individual breaches were not serious enough to constitute fundamental incompatibility with continued registration as a doctor. Erasure would “deprive the public of an otherwise good doctor with over 30 years’ experience.”
She did not attend the tribunal hearing.
Read more: https://www.mpts-uk.org/-/media/mpts-rod-files/dr-sarah-myhill-27-jan-23.pdf
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