A non-executive director (NED) in the NHS

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Essentially the non-executive director’s (NED) role is to provide a creative contribution to the board by providing independent oversight and constructive challenge to the executive directors.

The 1992 Cadbury Report initiated a debate about the main functions and responsibilities of non-executive directors. Today, it is widely accepted that non-executive directors have an important contribution to make to the proper running of companies and, therefore, more widely to the economy at large. As the Cadbury Report said, they “should bring an independent judgement to bear on issues of strategy, performance and resources including key appointments and standards of conduct”. The NonExecutive Directors ensure the Board acts in the best interests of patients and the public. Acting as critical friends, they hold the Board to account by challenging its decisions and outcomes. They also help the Board to formulate strategies, by bringing independent, external perspectives.

TheNHS Improvement’s Non-executive Appointments Team offers a range of support in finding and developing the very best chairs and non-executive directors for NHS provider boards.  They appoint and support NHS trust chairs and non-executives.  The power to make, suspend and terminate these ministerial appointments is delegated by the Secretary of State for Health. Their recruitment processes are conducted in accordance with the Cabinet Office’s Governance Code on Public Appointments. Appointments are made on merit generally after a fair and open process so that the best people, from the widest possible pool of candidates are appointed.

The Non-executive Appointments Team provide chairs and non-executive directors (NEDs) of NHS providers with confidential advice and support on a range of issues including recruiting and appointing, performance management and appraisals, induction and development and any associated governance issues.

Non-Executive Directors have a duty to:
• scrutinise the performance of the Executive management in meeting agreed goals and objectives;
• satisfy themselves as to the integrity of financial, clinical and other information;
• satisfy themselves that financial and clinical quality controls and systems of risk management and governance are sound and that they are used;
• commission and use external advice as necessary

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Coronavirus Bill Explanatory Notes 2 – Emergency registration of social workers

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Explanatory Notes relate to the Coronavirus Bill as introduced in the House of Commons on 19 March 2020 (Bill 122).The purpose of the Coronavirus Bill is to enable the Government to respond to an emergency situation and manage the effects of a covid-19 pandemic. A severe pandemic could infect up to 80% of the population leading to a reduced workforce, increased pressure on health services and death management processes. The Bill contains temporary measures designed to either amend existing legislative provisions or introduce new statutory powers which are designed to mitigate these impacts.

Clause 5 and Schedule 4: Emergency registration of social workers
133 The clause and Schedule modify the Social Workers Regulations 2018 and the Regulation and Inspection of Social Care (Wales) Act 2016, allowing for the temporary registration of social workers in England and Wales. Social Work England (‘the regulator’) and the registrar for Social Care Wales (‘the registrar’) have the power to register a person or specified group of persons, as a social worker.
134 As with the emergency registration of healthcare professionals, the regulator or registrar must be satisfied that the emergency registration requirement is met, i.e. that the person or persons are “fit, proper and suitably experienced to be registered” with regard to the emergency. It will be at the discretion of the regulator or registrar to determine who to register on a temporary basis. Conditions of practise may be imposed, and the regulator or registrar may revoke the registration at any time including where they suspect that the person’s fitness to practise may be impaired. The regulator or registrar must revoke the registration if the Secretary of State advises the regulator or registrar that the circumstances leading to a notification of an emergency no longer exist.
135 Certain provisions of the Social Workers Regulations 2018 and the Regulation and Inspection of Social Care (Wales) Act 2016 are dis-applied with regard to the conditions of registration of social workers. These dis-applied provisions relate to the standard registration, education and training, and fitness to practise of social workers.
136 The territorial extent and application of this clause is England and Wales.

FOR FURTHER INFORMATION PLEASE CHECK OUT https://www.gov.uk/government/publications/coronavirus-bill-summary-of-impacts/coronavirus-bill-summary-of-impacts#contents

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CORONAVIRUS BILL EXPLANATORY NOTES -Emergency registration of nurses and other health and care professionals

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Explanatory Notes relate to the Coronavirus Bill as introduced in the House of Commons on 19 March 2020 (Bill 122). The purpose of the Coronavirus Bill is to enable the Government to respond to an emergency situation and manage the effects of a covid-19 pandemic. A severe pandemic could infect up to 80% of the population leading to a reduced workforce, increased pressure on health services and death management processes. The Bill contains temporary measures designed to either amend existing legislative provisions or introduce new statutory powers which are designed to mitigate these impacts.In order for the measures included in the Bill to be effective in managing the effects of a covid-19 pandemic, Royal Assent needs to be secured as soon as possible. The government will therefore ask Parliament to pass the Bill before it goes into recess on 31 March. Given the need to draft and then pass this legislation at pace, it has not been possible to give Parliament more time to scrutinise the Bill.

Clause 2 and Schedule 1: Emergency registration of nurses and other health and care professionals
115 This clause and Schedule make temporary modifications to the Nursing and Midwifery Order 2001 and the Health Professions Order 2001, allowing for the temporary registration of certain healthcare professionals.
116 On notification from the Secretary of State that an emergency has, is or is about to occur, the Registrar of the Nursing and Midwifery Council has the power to register a person or specified group of persons, as a nurse, midwife, or nursing associate. On the same emergency notification procedure by the Secretary of State, the Registrar of the Health and Care Professions Council has the power to register a person or specified group of persons as a member of a “relevant profession” i.e. physiotherapists, paramedics and others.
117 The relevant Registrar must be satisfied that the emergency registration requirement is met, i.e. that the person or persons are “fit, proper and suitably experienced to be registered” as a professional, with regard to the emergency.
118 Conditions of practise may be imposed, and the relevant Registrar may revoke the registration at any time including where the Registrar suspects that the person’s fitness to practise may be impaired.
119 The relevant Registrar must revoke the registration on notification from the Secretary of State that the emergency no longer exists, and transitional provision is made to ensure the Registrar’s power to revoke registration continues after the Act has expired.
120 There is no appeal right available where the relevant Registrar has refused to register a person under the emergency provision, or where the Registrar has revoked a person’s registration under the emergency provision.
121 If a person breaches a condition to which their registration is subject, anything that is done by the person in breach of the condition, is to be treated as if it has not been done by a professional regulated by the NMC or HCPC.
122 For the purposes of the temporary modifications made by clause 2 and Schedule 1 of the Bill, certain provisions of the Nursing and Midwifery Order 2001 and the Health Professions Order 2001 do not apply to persons registered under the emergency provision. These disapplied provisions relate to the standard registration of healthcare professionals, education and training, and fitness to practise (save for articles enabling identification of an individual).
123 It is expected members of these professions who are recently retired, students, trainees and those on sabbatical would be appropriate for emergency registration, but this is not an exhaustive list. It will be at the discretion of the Registrars to determine on the emergency registration requirement being met, who to register on a temporary basis.
124 The territorial extent and application of this clause and schedule is the England and Wales, Scotland and Northern Ireland.

FOR FURTHER INFO GO TO https://www.gov.uk/government/publications/coronavirus-bill-summary-of-impacts/coronavirus-bill-summary-of-impacts#contents

 

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Changes to the Mental Health Act due to Coronavirus – TRIBUNALS

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The Judiciary has issued a Practice Direction on a pilot basis for a period of six months, to be reviewed within that period should it become inappropriate or unnecessary and may be revoked at any time. The Lord Chancellor has approved the issue of this Practice Direction in accordance with s23 Tribunals, Courts and Enforcement Act 2007.

Below is a direct copy available at https://www.judiciary.uk/publications/pilot-practice-direction-health-education-and-social-care-chamber-of-the-first-tier-tribunal-mental-health/

PILOT PRACTICE DIRECTION: HEALTH, EDUCATION AND SOCIAL CARE CHAMBER OF THE FIRST-TIER TRIBUNAL (MENTAL HEALTH)
Background
1. During the Covid-19 pandemic, it may be necessary for tribunals to adjust their ways of working to limit the spread of the virus and manage their workloads appropriately. I have therefore decided to issue this Practice Direction on a pilot basis for a period of six months, although it may be reviewed within that period should it become inappropriate or unnecessary and may be revoked at any time.
2. The Lord Chancellor has approved the issue of this Practice Direction in accordance with s23 Tribunals, Courts and Enforcement Act 2007.
Interpretation
3. In this Practice Direction.:
(a) “the 2008 Order” means the First-tier Tribunal and Upper Tribunal (Composition of Tribunal) Order 2008;
(b) “the 2008 Rules” means the Tribunal Procedure (First-tier Tribunal)(Health, Education and Social Care Chamber) Rules 2008;
(c) “the Act” means the Mental Health Act 1983
(d) “the Composition Statement” means the Practice Statement entitled: ‘Composition of Tribunals in relation to matters that fall to be decided by the Health, Education and Social Care Chamber on or after 16 December 2015’ dated 18 December 2015.
(e) “mental health case” has the meaning given in rule 1(3) of the 2008 Rules;
(f) “registered medical practitioner” has the meaning given in paragraph 1(2) of the Qualifications for Appointment of Members of the First-tier Tribunal and Upper Tribunal Order 2008, as amended;
(g) “Standard Composition Arrangements” means the composition arrangements set out in the Composition Statement.
Composition
4. While this Pilot Practice Direction remains in force, the provisions of the Composition Statement that apply to mental health cases shall be amended so that a judge alone shall make every decision (including decisions that dispose of proceedings) unless the Chamber President, Deputy Chamber President or such other salaried judge as may be authorised by the Chamber President or Deputy Chamber President, considers it to be inappropriate in a particular case, in which event a two or three person Panel may make the decision.
Disposal of proceedings without a hearing
5. In cases where:
(a) a reference has been made under section 68 of the Mental Health Act 1983 (duty of managers of hospitals to refer cases to tribunal); and
(b) the patient is a community patient aged 18 or over the Tribunal should suggest to the patient or their representative (as appropriate) that the proceedings are dealt with on the papers, unless, having regard to the overriding objective, it considers this to be inappropriate.
6. If the patient/their representative agrees in writing that they do not require a hearing, the Tribunal may determine the matter on the papers in accordance with Rule 35(3) of the 2008 Rules.
Pre-hearing Assessments
7. Rule 34 of the 2008 Rules requires that in certain circumstances, an appropriate member of the Tribunal must, so far as practicable, examine the patient in order to form an opinion of the patient’s mental condition.
8. During the Covid-19 pandemic it will not be ‘practicable’ under rule 34 of the 2008 Rules for any PHE examinations to take place, due to the health risk such examinations present.
Involvement of Non-Legal Members not on a panel
9. If the composition arrangements for a case are altered from what they would have been under the Standard Composition Arrangements, the tribunal may seek the advice of one or more non-legal members to assist with its decision-making, provided the advice is recorded and disclosed to the parties.
Sir Ernest Ryder
Senior President of Tribunals
19/03/2020

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Emergency Changes to the Mental Health Act due to Coronavirus 3

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Changes to emergency detention of voluntary patients already in hospital

Under the Mental Health Act, in emergencies professionals have the power to detain you if you are a voluntary/informal patient. This is to stop you leaving hospital if a professional thinks that you are a risk to yourself or others.

Under these powers you can only be held for a short time:

• Under section 5 (2) of the Act a doctor can agree to hold you for up to 72 hours, and
• Under section 5 (4) of the Act a nurse can agree to hold you for up to 6 hours.

You can only be held after this time if a full Mental Health Act assessment is done, and professionals agree to further detain you. This will usually be under sections 2 and 3 of the Mental Health Act.

The emergency legislation will extend these powers, so you can be held for an increased time. This is because it might take professionals longer to assess patients who are held on these temporary sections.

The extended timeframes are:

• Under section 5 (2) – you can be held up to 120 hours, and
• Under section 5 (4) – you can be held up to 12 hours.

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Emergency Changes to the Mental Health Act due to Coronavirus 2

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Changes to how long you can be remanded to hospital for

If you are accused of a crime, the court may think that your mental health was a factor in your offence. Under Section 35 and 36 of the Act, the court can send you to hospital for your mental health condition to be assessed.

Normally you can be sent to hospital for no more than 28 days. If your doctor thinks you need to be in hospital longer, they can tell the court. And the court can extend the section for further 28-day periods, up to 12 weeks at the most.

Under the emergency measures there would be no 12-week upper limit. This means that you can be kept in hospital, under a section 36 or 37, for longer than 12 weeks.

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Emergency Changes to Mental Health Act due to Coronavirus

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Changes to the number of doctors required to detain you under the Mental Health Act for assessment and treatment

Usually 3 people have to agree that you need to be detained. These are normally an approved mental health professional (AMHP) and 2 doctors. Under the new legislation the number of doctors is reduced to 1.

The AMHP has to record the reason why the decision to detain you was made on the recommendation of only 1 doctor. And they should only take this decision if they believe that staff shortages caused by coronavirus mean it would take too long for a second doctor to assess you.

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