DH_guidance for Constitution

7/31/2019 DH_guidance for Constitution

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Hdbk he d

nHS Csiui

July 2008


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DH InformatIon rEaDEr BoX

Dcue For information

Gewy eeece 10074

tile A Handbook to the NHS Constitution

auh DH

Publici de 30 June 2008

tge udiece PCT CEs, NHS Trust CEs, SHA CEs, CareTrust CEs, Foundation Trust CEs, MedicalDirectors, Directors of PH, Directors of Nursing,Local Authority CEs, Directors of Adult SSs,PCT PEC Chairs, NHS Trust Board Chairs,Special HA CEs, Directors of HR, Directors

of Finance, Allied Health Professionals, GPs,Communications Leads, Emergency CareLeads, Directors of Childrens SSs

Ciculi lis PCT CEs, NHS Trust CEs, SHA CEs, CareTrust CEs, Foundation Trust CEs, MedicalDirectors, Directors of PH, Directors of Nursing,Local Authority CEs, Directors of Adult SSs,PCT PEC Chairs, NHS Trust Board Chairs,Special HA CEs, Directors of HR, Directorsof Finance, Allied Health Professionals, GPs,Communications Leads, Emergency CareLeads, Directors of Childrens SSs, VoluntaryOrganisations/NDPBs

Descipi This handbook accompanies the draft NHS

Constitution and and the consultationdocument on this

Css eeece This handbook will be published alongsidethe draft NHS Constitution, NHS Constitutionconsultation document, and the associatedstaff and patient booklets

Supeseded dcues N/A

aci equied Guidance on NHS Constitution

tiig

Cc deils NHS ConstitutionRoom 611ARichmond House

79 WhitehallLondon SW1A 2NS0207 210 [email protected]

f ecipies use

Plicy EstatesHR/Workforce CommissioningManagement IM & TPlanning/ FinanceClinical Social care/Partnership

Working


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3

Ces

Iduci 4

P I: Pies d he public 5Access to health services 6

Quality of care and environment 13

Nationally approved treatments, drugs and programmes 16

Respect, consent and confidentiality 18

Informed choice 23

Involvement in your own healthcare and in the NHS 25Complaint and redress 28

Patient and public responsibilities 30

P II: S 32Pledges 33

Expectations 36

Rights 37

Legal duties 43

Glssy 46


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Handbook to the draft NHS Constitution

4

IduciThe aim of this document is to provide detailed information about elements of the draft NHS

Constitution, including rights, pledges and responsibilities. The Constitution itself is a concise and

enduring document which aims to provide clear statements of how the NHS works and what

patients and staff can expect from it. This Handbook describes what underpins each of these

statements. In the case of rights, this will usually be a legal basis; in the case of pledges, this is in

the form of a set of actions or commitments which the NHS will strive to achieve.

The NHS Constitution describes the ighs of patients, staff and members of the public, as

recognised by the law. This Handbook describes the basis for those rights and sets out the possible

forms of redress if your rights are infringed.

In addition, the NHS Constitution makes a number of pledges that the NHS will strive to deliver

(for example: convenient, easy access to services). These pledges are not described in full in the

Constitution itself. Although they are extremely important for patients and staff, they are not legal

rights; they are commitments that the NHS will strive to achieve certain outcomes or objectives.

This Handbook gives details of what those pledges mean, and what action is being taken to ensure

they are delivered.

The NHS Constitution also describes several ways in which patients, staff and members of thepublic can help the NHS work effectively. This Handbook gives further information on how you can

play your part, including the espsibiliies which apply to patients, the public and staff.

This Handbook is a living document, describing current policies and plans for the NHS to comply

with the proposed NHS Constitution. It provides a full account of the Constitutions content, but can

also be used as a reference point for information on individual rights, pledges and responsibilities.

It will be refreshed at least every three years to ensure that it is kept up to date as service standards

and expectations continue to improve.


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righ the suce he igh Hw yu c

Yu hve he igh toaccess local NHS services.You will not be refusedaccess on unreasonable

grounds.

Legislation on discrimination makes it unlawful for a public authority

or a person providing services to discriminate on certain groundswithout proper justification. In particular

Discrimination on grounds of race - sections 19B and 20 of the Race

Relations Act 1976

Discrimination on grounds of religion sections 46 and 52 of theEquality Act 2006

Discrimination on grounds of disability sections 19 and 21B of theDisability Discrimination Act 1995

Discrimination on grounds of sexual orientation regulations 4 and 8of the Equality Act (Sexual Orientation) Regulations 2007.

NHS Trusts and NHS Foundation trusts have the statutory function of

providing goods and services for the purposes of the health service;they provide services under arrangements with PCTs.

PCTs, NHS Trusts and NHS Foundation trusts must act in accordancewith administrative law; i.e. their policies and decisions must be inaccordance with their statutory duties, reasonable and procedurallyfair. Refusing access on unreasonable grounds would therefore beunlawful.

Note that medical care for the Armed Forces is provided by theDefence Medical Services.

Raise concernlocal PALs or

Complaint unprocess

If you are unraccess to servcomplain to tTrust who cofrom their listterminated

Judicial reviewdecision to re

Yu hve he igh toexpect your local NHS to

assess the healthrequirements of the localcommunity and to put inplace services to meetthose needs, as considerednecessary

The legislation under which Primary Care Trusts commission servicesrequire them to provide or arrange for the provision of services to suchextent as they consider necessary to meet all reasonable requirements(see section 3, 83, 99, 115 and 126 of the NHS Act 2006)

Raise concern

Complaint unprocess

Judicial reviewdecision whic

the duties un


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Yu hve he igh to seektreatment elsewhere inEurope if you are entitledto NHS treatment but you

face undue delay in

receiving that treatment.

European Community law in particular Article 49 of the EC Treaty

(which concerns the freedom to provide services within the EuropeanUnion) and Article 22(2)(c) of Regulation (EC) No. 1408/71 (whichconcerns the obligations of Member States of the EU relating to healthand social security benefits)

Complaint unprocedure.

Judicial reviewto refuse to g

treatment abr

Complaint to Commission i

Community la


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Pledge the nHS will sive ke decisis i cle d spe wy, s h pies d he public c u

e pled d deliveed.

Wh his cuely es:

As commissioners, PCTs are responsible for involving their local populations in decision-making about local services. Wcomprehensive framework of policies to strengthen the local accountability of PCTs, including:

putting a legal duty on NHS organisations to involve local people and their representatives in decisions about servic>report back publicly on how they have responded to local views;introducing Local Improvement Networks (LINks) to gather the views of local people and communities; and>strengthening partnerships between the NHS and local government, and giving councils the power to review and s>services.

These reforms are further supported by further efforts to ensure that public and patients are at the heart of local decis

the World Class Commissioning programme, to support PCTs and hold them to account for their performance.>a new NHS planning regime which distinguishes clearly between priorities that need to be decided nationally, in ord>

services across the country, and issues for local determination.


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Pledge the nHS will sive ke he sii s sh s pssible whe yu e eeed bewee sevices,

elev discussis.

Wh his cuely es:

Providing effectively integrated care is a key priority for the NHS. In particular, improving integration between health important ambition, as signalled in the Our health, Our Care, Our Say white paper and in Putting People First, t

government agreement on adult social care.

Delivery of integrated care is currently a joint responsibility of the NHS and partner organisations, such as social servicLocal Authorities. The NHS has a duty to work in partnership with Local Authorities to provide you with effective, intservices to meet your health and wellbeing needs. The delivery of services to improve the health and wellbeing of theagreed by the NHS and its Local Authority partners in a Joint Strategic Needs Assessment. Particular efforts to improvinclude:

Currently legislaton to create a joint regulator for health and social care services, the Care Quality Commission. The>over responsibility for ensuring that care is effectively integrated. Creating an integrated regulator is an important stintegrated care for patients.

Primary Care Trusts can agree a formal partnership arrangement with a local authority under regulations made und>National Health Service Act 2006 (previously section 31 of the Health Act 1999). This agreement allows the NHS apool resources and/or enable one partner to provide/commission both NHS and health related local authority servic


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(B) Quliy ce d evie

(i) thee e w rights cveig he quliy nHS ce

righ the suce he igh Hw y

Yu hve he igh to betreated with a professionalstandard of care, byappropriately qualified andexperienced staff, in aproperly approved or

registered organisation

The law of negligence imposes a duty of care on providers of healthcare.This is a duty to take reasonable care and skill in the provision of treatment

or other healthcare. For a health professional, what constitutes reasonablecare and skill will be determined by reference to professional practice. Foran NHS body or private organisation, it must take reasonable care toensure a safe system of healthcare using appropriately qualified andexperienced staff.

If a provider breaches the duty and as a result causes injury to a patient,the patient is entitled to damages to compensate for the injury andresulting financial loss.

Regulations under the NHS Act 2006 governing the provision of GP and

other primary care services require practitioners to exercise reasonable careand skill in the delivery of obligations under their contracts

Individual health professionals are also governed by the standards setunder the professional regulatory regime which applies to their profession.

For prserviceto locawho cfrom tcontra

Compregula

Medicindividfails toprofes

A claimcompe


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righ the suce he igh Hw y

Yu hve he igh to expectNHS organisations tomonitor, and make efforts toimprove the quality of

healthcare they provide,

taking account of theapplicable standards

NHS bodies have a stautory duty to have arrangements in place for thepurpose of monitoring and improving the quality of care provided for orby an NHS body (see section 45 of the Health and Social Care(Community Health and Standards) Act 2003)

From April 2010, this will be replaced by a duty on PCTs to havearrangements to secure continuous improvement in the quality of thehealth care provided by or for them ((subject to Parliamentary approval)section 134 of the Health and Social Care Act 2008)

Regulations under the NHS Act 2006 governing the provision of GP andother primary care services require providers to have clinical governancearrangements and quality assurance systems.

Compcomplto poo

For pr

servicecompl

contrato locawho cfrom tcontra

Judiciafails toduty.


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(ii) these ighs e supped by pledge ccess illy ppved pges:

Pledge the nHS will sive lwys pvide vccii d sceeig pges s eceded by he pp

dvisy bdies

Wh his cuely es:

Currently, the appropriate national advisory bodies are the Joint Committee for Vaccines and Immunisation (JCVI) fo

National Screening Committee (UK NSC) for screening programmes. They give advice on vaccinations and screening safety, quality, clinical-effectiveness and cost-effectiveness. This is the first time that Ministers have pledged explicitly tvaccination and screening programmes in the future.

Vaccines

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent committee of experts who provide anew and existing vaccines. They rigorously assess vaccines for safety and efficacy. And they make recommendations fnew national vaccination programmes, such as the one on HPV.

There are a number of national vaccination programmes in place already. For example, children are routinely given va

against serious diseases such as meningitis, polio, tetanus and measles. And all adults over 65, plus other at risk groupvaccine each winter.

We have recently announced a major new national vaccination programme against cervical cancer. All girls aged 12-1offered the HPV vaccine which protects against cervical cancer from September this year, with a two year catch up ca18 starting in September 2009.

Screening

The UK National Screening Committee (UK NSC) advises Ministers about all aspects of screening policy and supports programmes.

Screening has the potential to save lives and improve the quality of life through early diagnosis of conditions. Screenideveloping a condition or its complications. Two examples include:

Approximately 4,500 womens lives are saved each year due to cervical cancer screening>1,600 newborn babies are screened for hearing impairment every day, identifying problems 2 years earlier than pre>safeguarding educational and social development.


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18 (D) respec, cse d cideiliy

(i) thee e ive rights cveig espec, cse d cideiliy:

righ the suce he igh Hw yu c seek ed

Yu hve he igh to be

treated with dignity andrespect.

The right to be treated with dignity and respect is derived

from the rights conferred by the European Convention onHuman Rights (ECHR), as given effect in UK law by theHuman Rights Act 1998. The relevant rights under theECHR are the right not to be subject to inhuman ordegrading treatment (Article 3 ECHR) and right to respectfor private and family life (Article 8 ECHR).

It is unlawful for a public body to act incompatibly withthose ECHR rights (section 6 of the Human Rights Act)

Individual health professionals are also governed by thestandards set under the professional regulatory regimewhich applies to their profession.

Complaint under NHS

Complaint to professioGeneral Medical Counindividual health profewith professional stand

If your human rights hclaim for damages undHuman Rights Act 199

Judicial review of a decincompatible with ECH


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Yu hve he igh toaccept or refuse treatmentthat is offered to you, andnot to be given any

physical examination or

treatment unless you havegiven valid consent. If youdo not have the capacity todo so, consent must beobtained from a personlegally able to act on yourbehalf, or the treatmentmust be in your bestinterests.

The law relating to battery and assault makes it is unlawfulfor a person to be given a physical examination ortreatment unless they have given valid consent.

Investigation or treatment without valid consent may

constitute a criminal offence or the tort of battery.

If a person does not have the capacity to consent, becauseof their physical or mental state, or because they are a childwith insufficient understanding to give consent, treatmentmay take place without the consent of the individualconcerned. In such cases, treatment may be consented toby another individual for example, the parent of a child,or a personal welfare attorney appointed under the MentalCapacity Act 2005. In other cases, treatment must be in thebest interests of the patient (in some cases, the NHS may

apply to the court for a declaration that a particulartreatment is in a persons best interests).

The Mental Capacity Act 2005 contains further detailedrules about capacity and consent to treatment.


Complaint under NHS

Complaint to professio

(e.g. General Medical individual health profe

with professional stand

A claim for damages ifconsent to the treatme


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Yu hve he igh to begiven information aboutyour proposed treatment inadvance, including any

significant risks, any

alternative treatmentswhich may be available,and the risks involved indoing nothing.

Under the law of negligence, a health professional maybreach their duty of care to their patient if they fail toprovide them with sufficient information in advance oftreatment to ensure valid consent.

If no information is provided or the informations insufficientand the individual patient would not have consented if theyhad been given sufficient information, and has sufferedphysical harm as a result of the procedures, they are entitledto bring a claim for damages as compensation for the loss

suffered.


Raise concerns with yoor PCT.

Complaint under NHS

Complaint to professio

General Medical Counindividual health profewith professional stand

A claim for damages.


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Yu hve he igh toprivacy and confidentiality.

The common law imposes a duty of confidentiality invarious situations, including where individuals or bodies

providing health care receive or hold personal informationrelating to an individual patient..

In addition, legislation requires that individual or bodiesholding personal information must comply with variousdata protection principles. In particular, subject to certainexceptions, personal information may be held or disclosedonly with the consent of the individual concerned. See theData Protection Act 1998

Rights to privacy and confidentiality are also derived fromthe right to private and family life conferred by Article 8 ofthe European Convention on Human Rights (ECHR), asgiven effect in UK law by the Human Rights Act 1998.

Regulations under the NHS Act 2006 governing theprovision of GP and other primary care services requireproviders to comply with requirements re confidentiality.


Raise concerns with yoor PCT.

A claim for damages fo

For primary care (e.g. G

complain to local Primaremove provider from contract terminated

Complaint to professioGeneral Medical Counindividual health profeprofessional standards

For breach of Data Pro

complain to the Informwho may issue enforceprosecute

Obtain injunction to p

A claim for damages uHuman Rights Act 199infringed

Yu hve he igh toaccess your own health

records. These will alwaysbe used to manage yourtreatment in your bestinterests.

Legislation provides that, subject to certain qualifications,individuals have a right to access personal information

whichrelates to them and is held by a data controller (e.g. a GPor an NHS body) see section 7 of the Data Protection Act1998

Request access and if amake a complaint.

Application to court tocompelling the data cobody) to comply with


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22 (ii) In addition, there is one pledge relating to respect, consent and confidentiality:

Pledge the nHS will sive she wih yu y lees se bewee cliicis bu yu ce.

Wh his cuely es

There is evidence that when patients receive copies of letters between clinicians about their care it improves patients condition, enabling them to take control of their own health and to make decisions about their treatment. It also allowerrors. The relationship between patient and clinician works best when it is based on trust, openness and understandinenhances consultations and peoples experience of their care.

Copies of letters sent between clinicians will be shared with patients. Patients can ask for, and will receive copies of, leincluding letters on referral, letters following outpatient appointments and discharge letters that are routinely sent betof patient care.

The NHS Plan committed the NHS to provide copies of such letters to patients and the Department of Health issued gtrusts to deliver this policy. The NHS is making progress in copying letters to patients with more and more patients eaof letters as part of their care.


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(E) Ied chice

(i) thee e hee rights elig ied chice:

righ the suce he igh Hw yu c seek edes

Yu hve he igh to chooseyour GP practice, and to beaccepted by that practice, unlessthere are reasonable grounds torefuse, in which case you will beinformed of those reasons.

The right is derived from the duties imposed on theprovider of GP services by virtue of regulationsmade under the NHS Act 2006. In particular, seeSchedule 6 to the National Health Services (GeneralMedical Services) Regulations 2004 and Schedule 5

to the National Health Services (Personal MedicalServices) Regulations 2004

Raise concerns with yourPCT.

Complaint under NHS co

You could complain to yoTrust who could remove have their contract termibeen breached

Yu hve he igh to express apreference for using a particulardoctor within your GP practice,

and for the practice to endeavourto comply2.

The right is derived from the duties imposed on theprovider of GP services by virtue of the regulationsmade under the NHS Act 2006. In particular, see

Schedule 6 to the National Health Services (GeneralMedical Services) Regulations 2004 and Schedule 5to the National Health Services (Personal MedicalServices) Regulations 2004.


You could complain to yoTrust who could remove have their contract termibeen breached

Yu hve igh to make choicesabout your NHS care. Theoptions available to you willdevelop over time and dependon your individual needs.

Directions to be given by the Secretary of Stateunder section 8 of the NHS Act 2006 will requirePrimary Care Trusts to ensure that patients have aright to choose their provider.

The directions will specify which services are covered

by these arrangements, and any exceptions.The directions will also require PCTs to provideinformation to enable choice, and to makearrangements to enable a patient to exercise choiceif not offered by their GP.

Patients have been offered a free choice of providerat point of referral since April 2008.

Raise concerns with yourPCT.


Judicial review of a Primafails to comply with the d

2 Where both preferences and endeavours must be reasonable


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(f) Ivlvee i yu w helhce d i he nHS

(ii) the nHS Csiui cis w rights cveig pie d public ivlvee i he


Yu hve he igh to be involvedin discussions and decisions aboutyour healthcare, and to be giveninformation to enable you to dothis.

GP services are provided under arrangements made withPrimary Care Trusts. Those arrangements must comply withrequirements set out in regulations made under the NHS Act

2006. In particular, the relevant regulations defines the coreessential services which providers must or may provide, asservices for patients delivered in a manner determined by thepractice in discussion with the patient..- see regulation 15 ofthe National Health Services (General Medical Services)Regulations 2004.

In addition, in relation to both GP and secondary care (e.g.hospital treatment), doctors registered with the General MedicalCouncil have a duty to work in partnership with patients, which

must include listening to patients and responding to theirconcerns and preferences, and giving patients the informationthey want or need in a way they can understand (see theGeneral Medical Councils Good Medical Practice).

Other health professionals are also governed by the standardsset under the professional regulatory regime which applies totheir profession.

Raise concelocal PALs o

Complain uprocess .

In relation tcould comp

who could rlist/have hisbreached co

Complaint t

body if indivacted contrastandards.


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Pledge the nHS will sive wk i peship wih yu, yu ily d ces.

Wh his cuely es:

Partnership with patients

Working in partnership with individuals is at the heart of many DH policies presented in Our health, our care, oursay

people can take greater control over their care. For example, through Choose and book patients work in partnersharrange their care and book hospital appointments. We are developing information prescriptions for people with longclinicians signpost people to the right information at the right time.

Provision of quality, timely and relevant information is crucial, as is self care and self management support. We are wocommitment in the Our Health, Our Care, Our Say White Paper to offer a care plan to everyone with a long term co

Partnership with families and carers

There are currently many examples across the NHS of carers being treated as expert partners in care and being fully idischarge planning. The 2008 Carers Strategy has both detailed expectations and committed funds to the vision of mthe service including pilots in PCTs looking at how the NHS can better support carers and training for both GPs and h

Furthermore, a key part of respecting and treating carers as partners in care is ensuring that their does not suffer becaOne of the five outcomes of the Carers Strategy is to ensure that carers are supported to stay mentally and physicallyannual health checks in addition to the actions described above to ensure that this outcome is met.

This is also reflected in Putting People First, which highlights the need to recognise family members and carers as expalso identifies the need for support mechanisms to enable carers to develop their skills and confidence. This is particulacarers participate in providing aspects care, such as rehab exercises, wound or drug management and manual handlin


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28 (G) Cpli d edess

(i) thee e ive rights elig cpli d edess:

righ the suce he igh Hw yu c seek e

Yu hve he igh to make a complaintabout your NHS services, to have yourcomplaint dealt with efficiently, and tohave it investigated appropriately.

The right is derived from the legislationgoverning the NHS complaints procedure,which sets out various obligations on NHS

bodies in relation to the handling of complaints see the National Health Service (Complaints)Regulations 2004

In addition, regulations under the NHS Act2006 governing the provision of GP and otherprimary care services require providers to havea complaints procedure.

Complain to the pers

Complaint to Health complaint not dealt w

For primary care (e.gprovider fails to have or to operate it correcterms of contract, yoPrimary Care Trust w

from the list/have the

Judicial review of the

Yu hve he igh to know the outcomeof any investigation into your complaint.

The regulations governing the NHS complaintsprocedure impose a duty on NHS bodies toprovide a written response (regulation 13 ofthe Complaints Regulations 2004)

Complain to the pers

Complaint to the Hea


Yu hve he igh to take your complaintto the Health Service Ombudsman whereyou have exhausted any other rights ofappeal or review.

This right is derived from the legislationgoverning NHS complaints and complaints to theHealth Service Commissioner see the NationalHealth Service (Complaints) Regulations 2004and the Health Service Commissioners Act 1993

Yu hve he igh to make a claim forJudicial Review if you think you havebeen directly affected by an unlawfulNHS decision or action.

This right is derived from administrative law. Itis not a right of appeal, but is concerned withthe lawfulness of a decision or policy,


Yu hve he igh to seek compensationwhen harmed by negligent treatment.

The law of negligence (see above) Legal claim for dama


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(ii) I ddii, hee e w clsely eled pledges cpli d edess i he nHS C

Pledge the nHS will sive esue h i yu ke cpli, yu eceive iely d pppie espse,

sueed is ceced whee pssible, d h he gisi les lesss d pus i plce ecessy ipve

Pledge the nHS will sive esue h yu eceive pppie supp d e eed wih espec d cues

hdlig y cpli yu ke; d he c h yu hve cplied will ec yu uue ee.

Wh hese pledges cuely e:

Every NHS trust in England is responsible for ensuring that it is complying with the Department of Healths core standsuitable and accessible information about , and clear access to, procedures to register formal complaints and procedurservices. These core standards are monitored by the Healthcare Commission.

Currently, you may make a complaint to an NHS body about any matter reasonably connected with your health. Everto resolve your complaint locally, but where this is not possible, you have the right to ask the Healthcare Commission complaint. If the complaint is still not resolved, you may then ask the Health Service Ombudsman to look into your ca

In 2009, changes in the complaints system will place greater emphasis on the role of the commissioning body to ensu

organisations are providing a fair and effective complaints process. There will be greater emphasis on resolving a comsatisfaction and, if you prefer, you will be able to complain directly to the commissioning body. The Care Quality Comreplace the Healthcare Commission in April 2009) will not have a role in handling individual complaints, but we are pron registered providers and manager to have effective systems in place for handling complaints, and that they should The Commission will have the powers it needs to ensure registered providers are handling complaints properly. Whereto meet registration requirements, the Commission will be able to use enforcement powers.


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Yu espsibiliy yu shuld: Wh his es i pcice

Participate in important public health programmessuch as vaccination

When appropriate to you, your doctor, nurse or therapist willand benefits of vaccination programmes and other services de

health.

Ensure that those closest to you are aware of your

views about organ donation.

You can find out more about organ donation and how to bec

www.uktransplant.org.uk.Give us feedback (positive and negative) about thetreatment you have received, including and adversereactions you may have had

We will ensure that all NHS organisations provide an opportuthe NHS care that you receive. This might be through nationasurveys or through the formal grievance and complaints proce


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P II: SThis section described the elements of the NHS Constitution which refer to NHS staff. It covers:

Staff> pledges;

Expecis> of staff;

Staff> ighs; and

Staff> legl duies.

Our vision is that all staff1 commissioning and providing NHS services will have rewarding jobs. They will be able to do been designed around patients and with the input of staff. The inclusion of staff pledges, expectations, responsibilities aHandbook reflects that these are as important as those of patients and the public.

(a) S pledges

The pledges for NHS staff reaffirm the commitment that good workplaces should exist for all NHS staff they should nhighly performing organisations. Like the patient pledges, the staff pledges are policy commitments that something shlegally binding or directly enforceable in the courts.

Pledge the nHS will sive pvide ll s wih well-desiged d ewdig jbs h ke dieece p

d ces, d cuiies.

Wh his cuely es:

We will continue our work to deise cees for doctors, nurses, scientists and allied health professionals so that joopportunities continuously improve. This will not only benefit staff but will also provide more flexibility and clarity for support high quality care for patients.

Contracts of employment for most NHS staff support this pledge. For example under Agenda for Change staff jobs sh

evaluated and linked to pay rates, there should be regular appraisals, and opportunities for training and development.

1 By all staff we refer only to employees and contractors (operating under a contract to provide services) who commission and/or they work for NHS organisations or for non-NHS organisations


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Pledge the nHS will sive pvide ll s wih pesl develpe, ccess pppie iig hei

gee supp succeed

Wh his cuely es:

The Kwledge d Skills fewk (KSF) supports staff through annual appraisal, development review and traininoutline.

We will strengthen educational governance and investment in Ciuus Pesl Develpe (CPD). In particulaorganisation that receives central education and training funding to adopt the Governments Skills Pledge.

We will promote the introduction of modularised, ccedied iig pckges and strengthen educational governanhave the opportunity to develop their skills throughout their careers for the benefit of patients, employers and their ow

We will review current NHS educi udig gees to ensure that they are fairer, more transparent and promoney.

We will develop a new system-wide cie le d ledeship which is underpinned with business plans


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Pledge the nHS will sive pvide supp d ppuiies s keep heselves helhy d se.

Wh his cuely es:

We have funded a pilot project to improve the health of selected NHS staff. Ceig Helhie nHS will provide oquestionnaires linked to tailored lifestyle management programmes to help staff choose how best to improve their phbeing.

There is a significant work programme led by NHS Employers to help NHS organisations tackle bullying and harassmeto address stress. NHS Employers also published, last year, The Helhy Wkplces Hdbk.

The National Patient Safety Agency delivers the cleanyourhandscampaign across the NHS in England to improve theworkers.

The Cde Pcice for the Prevention and Control of Healthcare Associated Infection (HCAI) published in 2006 and2008 places a duty on all NHS organisations to ensure patients, staff and others are protected against the risks of acqu

Through a Secretary of State Direction uss e equied peve vilece against staff where possible and to take

including prosecution of offenders, when violence does occur.

The nHS Secuiy mgee Sevice has taken a number of steps to reduce violence against staff and is working wto help them take appropriate action.

In order to tackle antisocial behaviour affecting staff and their ability to perform their roles, legislation now provides foremove individuals not requiring treatment who are creating a nuisance or disturbance. Failure to leave hospital premexcuse will be an offence which could result in a fine of up to 1,000.


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Pledge the nHS will sive cively egge s i decisis h ec he d he sevices h hey pvide

hugh epeseives. all s will be epweed pu wd wys delive bee d se sevices p

Wh his cuely es:

The national Social Partnership Forum (SPF) offers the opportunity to discuss, debate and involve partners in the deveimplementation of the workforce implications of policy. Similar arrangements are being developed at SHA level.

The Department of Health published guidance in the Staff Involvement Handbook which Trusts are encouraged to acwww.dh.gov.uk/ Publications and statistics/ Publications/ Publications Policy And Guidance / DH_4071622

The best performing organisations have staff that are engaged with their employer and motivated by the work they dachievements of these employers and accelerate the sharing of good practices the Department of Health will work wdevelop an annual competition to identify the best places to work in the NHS.

We will developMystaffspacewhichwill be a portal to search for the best available guidance and evidence, and enabreceive the latest best practice knowledge, together with information on quality performance.

Building on our partnership approach at national and regional level we will also provide co-funding opportunities for t

developing their mechanisms and processes for involvement and partnership. The scheme will be developed with inpuPartnership Forum.

The Department will commission a long-term research project based upon the learning coming out of the best placescompetition and the co-funded local projects and will publish an annual journal of learnings.


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36 (B) Expecis hw s shuld ply hei p i esuig he success he nHS

The highest quality of patient care is delivered by staff who are ambitious in their expectations of themselves and their expectations show how staff should play their part in making the NHS successful. These expectations correspond to sompledges and chime with the NHS values.

This section sets out the expectations that employers can legitimately expect from employees they deliver the pledges texamples of what staff can do to help realise those expectations.

We expec h yu will Wh s c d (exples ly)

Sive maintain the highest standards of care and service, takingresponsibility not only for the care you personally provide, but alsofor your wider contribution to the aims of your team and the NHSas a whole.

Treat everyone as you would wish to be tre>Engage actively in your team>Work with your manager or supervisor to b>objectives

Set an example to and support your colleag>Speak well of the NHS and the organisation>Contribute to the training of others>

Sive take up training and development opportunities provided. Keep your professional and other job-relate>Actively engage in appraisal and personal d>Ensure you complete mandatory or statutor>

Sive play your part in improving services for patients andcommunities.

Contribute your ideas and welcome contrib>Inform yourself about, and be prepared to c>on issues and decisions that impact upon yoservices you provide or support

Sive to contribute to a climate where the truth can be heard andthe reporting of, and learning from, errors are encouraged.

Report errors, near misses and incidents>Be vigilant about hygiene and report unacce>

Participate in the NHS Staff Survey>Not tolerate bullying, harassment and violen>

Sive to involve patients, their families and carers in the servicesyou provide

Listen to your patients, their families and ca>Seek their views on services>


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2. Hve se wkig cdiis ee hsse, bullyig vilece

righ Whee i exiss i lw Hw yu c seek

To work within a safe workplace and anenvironment in which the employer hastaken all practical steps to ensure the

workplace is free from verbal or physicalviolence from patients, the public or staff, towork your contractual hours, take annualleave and to take regular breaks from work.

Health and Safety at Work Act 1974 andassociated Regulations made under the Act.

Working Time Regulations 1998 (for

provisions relating to leave)

Try to resolve with liunsuccessful a compSafety Executive or l

can be made under legislation.

Under the Working an internal grievanceemployer. If the empcomplaint can be matribunal within 3 mocomplained of.

3. Hve i py d cc ewk


To pay, consistent with the National MinimumWage or alternative contractual agreement

National Minimum Wage Act 1998 andRegulations made under the Act of 1999.

Also may exist in terms and conditions ofemployees contract.

Try to resolve with liunsuccessful a compemployment tribunadepending on the amclaimed. An employmaward loss of pay upcourt can award an claim in a county co

breach of contract cl

To fair treatment regarding pay Section 1 of the Equal Pay Act 1970 Try to resolve with liunsuccessful an interpresented to the emis not satisfied they c

to an employment trof act complained of


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39

4. Be ivlved d epeseed i he wkplce


For a Trade Union to represent you or to enterinto a collective agreement on your behalf

Trade Union and Labour Relations(Consolidation) Act 1992

Try to resolve with liunsuccessful an empcomplaint to an emp

3 months if choice odenied.

To be consulted in line with statutoryrequirements

Information and Consultation of Employees(ICE) Regulations (2004).

Regulations 11-16 of the Transfer ofUndertakings (Protection of Employment)Regulations 2006 (TUPE) if there is a transfer

of a function between employers.

Under ICE Regulatiomake a complaint toCommittee (CAC).

Under TUPE Regulat

make a complaint towithin 3 months of t


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40

5. C ise iel gievce d i ecessy seek edess, whee i is el igh hs bee upheld


To have disciplinary and grievanceprocedures conducted appropriately andwithin internal and legal requirements.

Employment Act 2002 (Part 3), EmploymentAct 2004 (Dispute Resolution) Regulations2004. This provides that all employers have

to have in place minimum statutoryprocedures for dealing with dismissal,disciplinary action and grievances in the

workplace. Employees have to raise agrievance in most circumstances beforepresenting a claim in the employmenttribunal. (Note that these Regulations aredue to be repealed by the Employment Bill)

Try to resolve with liunsuccessful a free sbe made by an emp

tribunal within 3 mocomplained of.

To appeal against wrongful dismissal Employment Rights Act 1996 or commonlaw right to claim for breach of contract for

wrongful dismissal

Try to resolve with liunsuccessful an emp

complaint to an empcounty court dependdamages to be claim

If internal processes fail to appeal against adismissal, you have the right to pursue aclaim in the employment tribunal, if youmeet required criteria (i.e. you are anemployee and have one years continuousservice).

Part X of the Employment Rights Act 1996 Try to resolve with liunsuccessful an empcomplaint to an emp3 months of the dism

To protection from detriment in employmentand the right not to be unfairly dismissed forwhistle blowing or reporting wrong doingin the workplace

Public Interest Disclosure Act 1998 Try to resolve with liunsuccessful an empcomplaint to an emp3 months of act com


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41

6. Be eed ily, eqully d ee disciii


To work in a diverse working environment,free from discrimination on the basis of race,sexual orientation, sex, disability, age or

religious belief

Sex Discrimination Act 1975, Race RelationsAct 1976, The Employment Equality(Religion or Belief) Regulations 2003, the

Employment Equality (Sexual Orientation)Regulations 2003, the DisabilityDiscrimination Act 1995

Try to resolve with liunsuccessful an interpresented to the em

is not satisfied a coman employment tribu

Commission for Equ

To be treated fairly in recruitment, promotionsetc. to all posts

Sex Discrimination Act 1975, Race RelationsAct 1976, The Employment Equality(Religion or Belief) Regulations 2003, theEmployment Equality (Sexual Orientation)

Regulations 2003, the DisabilityDiscrimination Act 1995

Try to resolve with liunsuccessful an interpresented to the em

is not satisfied a coman employment tribuCommission for Equ

To work in an environment where equality of

opportunity is promoted for all those whowork in it

Sex Discrimination Act 1975, Race Relations

Act 1976, The Employment Equality(Religion or Belief) Regulations 2003, theEmployment Equality (Sexual Orientation)Regulations 2003, the DisabilityDiscrimination Act 1995. Equality Act 2006that introduced the equality duties for publicbodies to adhere to

Try to resolve with liunsuccessful an interpresented to the emis not satisfied a coman employment tribuCommission for Equ


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7. Hve eplye peci (nHS eplyees ly)


You have a right to employment protectionin terms of continuity of service forredundancy purposes if moving within NHS

Employers

Employment Protection (Continuity ofEmployment of NHS Employees)(Modification) Order 1996 This Order

provides that a doctor or dentist in thetraining grades of registrar, senior registrar orspecialist registrar will have his or her

employment with a health service employertreated as being continuous for the purposesof the Employment Rights Act 1996 whenhe or she has moved to a different healthservice employer. See also section 218(8) ofthe Employment Rights Act 1996 that givesthe power for Secretary of State to make thisOrder.

Redundancy Payments (NHS) (Modification)

Order 1993 this protects qualifying servicefor redundancy payments for thoseemployees working within the health sector,therefore a change of employer would notaffect their entitlement to redundancypayments.

Try to resolve with li

unsuccessful an interpresented to the em

is not satisfied a coman employment tribubreach of contract. Ithe terms relating toor continuity if the Ocomplied with. The tdecide the matter in Order.


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8. C ji he nHS Pesi Schee (nHS eplyees d se he gups e.g. Geel Pciies)


You have rights relating to the ability to jointhe NHS Pension Scheme

Rights conferred by the NHS PensionScheme Regulations, including the NHS(Pension Scheme, Injury Benefits and

Compensation for Premature

Retirement) Amendment Regulations.

Note that the new NHS Pension SchemeRegulations (2008) apply to those staffwho started on or after 1st April 2008

Try to resolve with liIf unsuccessful an emPensions Division of

Services Authority. Ifcontent they can ma

the Schemes InternaProcedure. If an empunsatisfied they can the Pensions OmbudHigh Court if necess

(D) S legl duies

Duy Whee i exiss i lw Hw c hey be e

To be honest and truthful in applying fora job

The duty to be honest and truthful is animplied duty of trust and confidence in theemployment relationship, which emanatesfrom common law.

The duty to declare criminal convictionsexists in the Rehabilitation of Offenders Act1974 and the Rehabilitation of OffendersAct 1974 (Exceptions) Order 1975.

An employer could tfor failure to adhere confidence.

Also, obtain certificaprevious convictionsRecords Bureau undAct 1997.

To accept professional accountability andmaintain the standards of professionalpractice, as set by the appropriate regulatorybody applicable to your profession or role

As stated in relevant guidance or Regulationsof regulatory bodies

Action can be taken and practices of reguGeneral Medical CouMidwifery Council e


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To take reasonable care of health and safetyat work for you and others and to

co-operate with employers in ensuringcompliance with Health and Safetyrequirements.

Health and Safety at Work Act 1974 Disciplinary action m

Employer against wopolicies

To not discriminate against patients orcolleagues and to adhere to equalopportunities and diversity legislation

Sex Discrimination Act 1975, Race RelationsAct 1976, The Employment Equality(Religion or Belief) Regulations 2003, theEmployment Equality (Sexual Orientation)Regulations 2003, the DisabilityDiscrimination Act 1995, Equality Act (SexualOrientation) Regulations 2007

Where your human rights are engaged (e.g.Article 2 ECHR (right to life)), discrimination

may be contrary to Article 14 of the ECHR

Disciplinary action mEmployer against wopolicies.

Proceedings may becourt under

(a) section 57 of the1976;

(b) section 66 of the

1975;

(c) section 25 of the Act 1995; or

(d) regulation 20 of Orientation) Regulat

Judicial review of a dpolicy

If discrimination amo

Article 14 ECHR, clathe Human Rights A

A patient can make NHS complaints procService Commissione


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45


To protect the confidentiality of personalinformation that you hold.

Data Protection Act 1998

Also covered in professional conductguidance

Disciplinary action m

Employer against wopolicies

To act in accordance with the express and

implied terms of your contract ofemployment e.g.:

the express terms regarding hours, place andduties of work, annual and sick leaveprovisions, equality and diversity policies etc.and,

the implied duty of mutual trust and

confidence, the duty to serve and work forthe employer, exercise reasonable skill and

competence when undertaking your duties,to obey reasonable and lawful orders, toadhere to the duty of fidelity towards theemployer

These are express and implied terms of thecontract of employment under common law.The written statement of particulars ofcertain terms is also indicative of the expressterms. This is provided to an employee, notlater than 2 months after the beginning ofthe employment contract (section 1 of theEmployment Rights Act 1996).

An employer may wemployee who doesor her contract of emmay also take discipemployee for failure and implied terms, th

being dismissal afterlegal process


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Handbook to the draft NHS Constitution

46

Glssyadiisive lw the branch of law, which governs public bodies (including NHS bodies) in the exerciseof their functions.

C lw the law derived from decisions of the courts, rather than Acts of Parliament or otherlegislations.

Era 1996 The Employment Rights Act 1996. An important piece of legislation in employment law thatsets out employees rights within the work place, from the start of their employment, i.e. providing a writtenstatement of particulars of employment, through to rights on termination of employment, i.e. providing fairreasons for dismissal. The Act replaces and consolidates previous employment law Acts (eg the EmploymentProtection (Consolidation) Act 1978).

ECHr the European Convention on Human Rights. It is unlawful for a public body to act incompatiblywith the rights conferred by the Convention (section 6 of the Human Rights Act 1998).

Era 1996 The Employment Rights Act 1996. An important piece of legislation in employment law thatsets out employees rights within the work place, from the start of their employment, i.e. providing a writtenstatement of particulars of employment, through to rights on termination of employment, i.e. providing fairreasons for dismissal. The Act replaces and consolidates previous employment law Acts (eg the EmploymentProtection (Consolidation) Act 1978).

Ii Cissie the Information Commissioner enforces and oversees the Data Protection Act1998 and Freedom of Information Act 2000. For further information see the website of the Information

Commissioners Office http://www.ico.gov.uk/

Judicil eview is a type of court proceeding in which a judge reviews the lawfulness of a decision oraction of a public body. Judicial review is therefore a procedure by which you can challenge a decision of theSecretary of State or an NHS body, on the basis that it unlawful. Judicial review is not a form of appeal andis concerned primarily with how decisions are made, rather than the merits of the decision itself. To beentitled to make a claim for judicial review, a person must have a direct, personal interest in the action ofdecision under challenge. For further guidance on applying for judicial review, see Notes for guidance onapplying for judicial review published on Her Majestys Courts Service website http://www.hmcourts-

service.gov.uk/cms/1220.htm

nHS ac 2006 the National Health Service Act 2006. The main piece of legislation governing the NHS inEngland, which sets out the powers and duties of the Secretary of State and provides for the establishmentand functions of NHS bodies. The Act replaces earlier NHS Acts (e.g. the National Health Service Act 1977and the Health Act 1999).


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47

nHS cplis pcess the complaints process provided for by legislation including the National HealthService (Complaints) Regulations 2004. A complaint should initially be made to the relevant NHS body e.g.

in relation to your treatment in hospital, to the NHS trust or NHS foundation trust which manages thehospital. The Regulations require each NHS body to have a process for handling and considering complaints.If an individual is not satisfied with the outcome, a complaint may ultimately be taken to the Health ServiceCommissioner. The Commissioner (also known as the Health Service Ombudsman) carries out independent

investigations of complaints about the NHS in England further information at http://www.ombudsman.org.uk/index.html

Pessil eguly bdy this refers to a statutory body responsible for the regulation of a particularhealth profession. For example, in relation to doctors, the General Medical Council; for nurses, the Nursingand Midwifery Council. Each regulatory body has a procedure for considering complaints made againstindividual health professionals.


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DH_guidance for Constitution

Documents