Healthcare Law Policy and Ethical Practice August 2019

UNIT 1
Law, Policy and Ethical Practice
In Health and Social Care
By: Oguchi Martins Egbujor 1

The Aim
Health and social care practitioners are regulated by, and must adhere
to, a range of law and policy when working within the most common
settings of health trusts, primary care and other public authority
settings. The aim of this unit is therefore to equip learners with the
understanding of how laws are made and applied in health and social
care setting. This unit will require learners to acquire good knowledge
and understanding of law and policy in order to practice proficiently,
safely, ethically and legally. It will enable learners to develop
knowledge and appreciation of the need to be thoroughly informed
about relevant law and policy. At the completion of this unit, learners
would be presented with the opportunities to apply relevant law and
policy in practice settings, both actual and realistic, and to consider the
place of codes of practice and ethics in their day-to-day work.

What Is Law
Law is a set of binding rules of conduct meant to
enforce justice and prescribe duty or obligation,
and derived largely from custom or formal
enactment by a ruler or legislature. These laws
carry with them the power and authority of the
enactor, and associated penalties for failure or
refusal to obey. Law derives its legitimacy ultimately
from universally accepted principles such as the
essential justness of the rules, or the sovereign
power of a parliament to enact them.

What Is Policy
In Politics, policy is the basic principles by which
a government is guided. It is a set of declared
objectives that a government seeks to achieve
and preserve in the interest of national
community.

Clarification of Policy
In Management, Policy is the set of basic
principles and associated guidelines, formulated
and enforced by the governing body of an
organization, to direct and limit its actions in
pursuit of long-term goals.

Ethical Practice
Ethical Practice is the moral principles that
govern a person's behaviour or the conducting
of an activity. It is the code of conduct that sets
out the standard of behaviour in every
profession

Learning Outcomes
1. Explore the legal framework within which health and
social care practitioners operate
2. Describe key legislation, national and organisational
policy of fundamental importance to the health, care
or support service practitioner
3. Interpret the law in relation to key ethical and
professional Practice Themes in health and social care
4. Apply law and policy in line with regulatory and
ethical requirements in a relevant practice setting.

LO1
Explore the legal framework within which health
and social care practitioners operate

Legal System
Legal system refers to a procedure or process for
interpreting and enforcing the law. It elaborates
the rights and responsibilities in a variety of
ways. There are three major legal systems of the
world consisting of:
 Civil law
 Common law
 Religious law

Classification Of Law
Criminal
• The criminal law is concerned with offences
against society at large – crimes. Prosecuted by
the State. Punish and deter.
Civil
• Civil law is concerned with disputes between
private parties, for example, consumer and
supplier, employer and employee. Injured party
sues. Damages or injunction.
By: Oguchi Martins Egbujor
10

Justice System
The legal system must uphold fairness in society:
both in business and for individuals. The
government wants to ensure justice for victims
of crime and better rehabilitation for criminals,
with a reduction in the rate of reoffending. The
justice system must punish the guilty, protect
liberties and rehabilitate offenders.

Equity
Equity essentially means fairness. The legal
system is based on these rules and this area of
law gave birth to the law of trusts. Equity is
based on a judicial assessment of fairness as
opposed to the strict and rigid rule of common
law.

The Purpose of Law
In a free society each and every man lives under
a rule of law, as opposed to a whim-ridden rule
of men. Such a rule of law has only one purpose:
to protect the rights of the smallest minority
that has ever existed — the individual.

Evolution Of English Law
English law has an evolving history dating from the local
customs of the Anglo-Saxons, traces of which survived until
1925. After the Norman Conquest they grew up, side by side
with the Saxon shire courts, the feudal courts of the barons
and the ecclesiastical (church) courts. From the king’s council
developed the royal courts, presided over by professional
judges, which gradually absorbed the jurisdictions (legal
powers) of the baronial and ecclesiastical courts. By 1250 the
royal judges had amalgamated the various local customs into
the system of common law – that is, law common to the
whole country. A second system known as equity developed in
the Court of Chancery, in which the Lord Chancellor
considered petitions.

Law of Precedent
A judicial precedent is a decision of the court
used as a source for future decision making. This
is known as stare decisis (to stand upon
decisions) and by which precedents are
authoritative and binding and must be followed.
http://nuweb.northumbria.ac.uk/bedemo/Sourc
es_of_English_Law/page_10.htm

Due Process
Due process and the Rule of Law are important
together as due process would only see a person
imprisoned or punished if there was substantial and
sufficient evidence of their guilt. Due Process is
more concerned with every person getting a fair
trial rather than proving guilt. If a person’s liberty is
taken away from them and the courts cannot show
their guilt by evidence then that person may be
entitled to be awarded damages for the loss of their
personal liberty.

Common and Contract Laws
In common law, a promise is not, as a general
rule, binding as a contract unless it is supported
by consideration (or it is made as a deed).
Consideration is "something of value" which is
given for a promise and is required in order to
make the promise enforceable as a contract.

P1
Describe how the legislature, the
executive and the judiciary set the
legal and policy landscape for health
and social care practitioners

Different Sources of Law
• Statutes: Legislation from the UK Parliament
and devolved parliaments.
• 'Common' law: law made through principles
established in cases over the centuries during
the standardisation of law throughout England
and Wales from the eleventh century
onwards.
• Law from the EU.

Common Law
Common law is in effect legal precedent that is
made by judges sitting in court. Unlike statutory
provisions, which are laws that are codified as
Acts of Parliament, the common law is
constantly changing.

Bill Becomes Law
A Bill is a proposed law which is introduced into
Parliament. Once a Bill has been debated and then
approved by each House of Parliament, and has
received Royal Assent, it becomes law and is known
as an Act (Cabinet Office, 2013)
https://www.gov.uk/guidance/legislative-process-
taking-a-bill-through-parliament

The Role of Government
If a government department has a proposal for a
Bill that it wants to be included in the legislative
programme for a session, it must submit a bid for
the Bill to the Parliamentary Business and
Legislation (PBL) Committee of the Cabinet. The bid
will usually be needed about a year before the
beginning of the session in question. PBL
Committee will consider all of the bids for that
session and make a recommendation to Cabinet
about the provisional content of the programme.

The Rule Of Law England/Wales
The Rule of Law is a Doctrine whereby every person
no matter who they are must obey the law, there is
no leniency for a person because of their peerage,
sex, religion or financial standing. England and
Wales do not have a written constitution therefore
the Rule of Law, which along with Parliamentary
Sovereignty, was regarded by Legal analyst A.C
Dicey, as the pillars of the UK Constitution, the Rule
of Law was said to be adopted as the “unwritten
Constitution of Great Britain”.

Legal Responsibilities
• Legislation
• Regulations
• Standards

Legislation
Legislation (or “statutory law”) is law which has
been produce by a governing body in order to
regulate, to authorise, to sanction, to grant, to
declare or to restrict. In terms of events,
Legislation defines the governing legal principles
outlining the responsibilities of event organisers,
and other stakeholders such as the local
authority, to protect the safety of the public.

Regulation
A regulation is a statutory instrument. A
regulation is often passed by the executive
branch of government. For example, the federal
cabinet meeting in session endorses a
regulation. But a regulation has a unique
feature: it must draw its authority from a
statute. Every regulation must have some
statute which enables it.

Standard
In essence, a standard is an agreed way of doing
something. It could be about making a product,
managing a process, delivering a service or
supplying materials – standards can cover a
huge range of activities undertaken by
organizations and used by their customers.

Legislations and Regulations
• The Work Place (Health, Safety and Welfare) Regulations
1992
• Manual Handling Operations Regulations 1992
• Lifting Operations and Lifting Equipment Regulations
(LOLER) 1998
• The Regulatory Reform (Fire Safety) Order (RRO) 2005
• Confidentiality: NHS Code of Practice 2003
• NHS England: Confidentiality Policy, June 2014
• NICE Managing Medicine In Care Home Policy March 2014
• Personal Protective Equipment at Work (PPE) Regulations
1992

P2
Summarise key features of legislation, statutory
guidance, codes of practice, and national and
organisational policy

Key Features of Law and Policies
• Legislation
• Regulation (Statutory Instrument)
• Code of Practice
• National Policy
• Organisational Policy

Features of Legislation
• Green Paper
• White Paper
• Government Bill
• House of Commons
• House of Lords
• Royal Assent

Green Paper
Green Papers are consultation documents
produced by the Government. The aim of this
document is to allow people both inside and
outside Parliament to give the department
feedback on its policy or legislative proposals.
https://www.parliament.uk/site-
information/glossary/green-papers/

White Paper
A White Paper is a more authoritative report,
and is seen as a statement of government policy.
A White Paper may also consult public and
stakeholders on policy, it does signify clear
intention on the part of the Government to pass
a law.
(Shepherd & Wedderburn, 2006)

Green and White Paper
Green Paper is the first step towards legislation.
Each Green Paper will contain several alternative
policies which will be discussed before a final
decision is made. A White Paper is a more
authoritative report, and is seen as a statement
of government policy.

Regulation
Regulations is a Statutory Instruments (SIs) and
are a form of legislation which allow the
provisions of an Act of Parliament to be
subsequently brought into force or altered
without Parliament having to pass a new Act.
They are also referred to as secondary,
delegated or subordinate legislation.

Code of Conduct for Healthcare
Support and Adult Social Care Workers
The Code of Conduct sets the standard of
conduct expected of healthcare support workers
and adult social care workers. It outlines the
behaviour and attitudes that you should expect
to experience from those workers signed up to
the code. It helps them to provide safe,
guaranteed care and support. The Code of
Conduct is voluntary but it is seen as a sign of
best practice (Skills for Care)

Code of Conduct: Support Workers
And Adult Social Care Workers
1. Be accountable by making sure you can answer for your actions or
omissions.
2. Promote and uphold the privacy, dignity, rights, health and
wellbeing of people who use health and care services and their
carers at all times.
3. Work in collaboration with your colleagues to ensure the delivery
of high quality, safe and compassionate healthcare, care and
support.
4. Communicate in an open, and effective way to promote the
health, safety and wellbeing of people who use health and care
services and their carers.
5. Respect a person’s right to confidentiality.
6. Strive to improve the quality of healthcare, care and support
through continuing professional development.
7. Uphold and promote equality, diversity and inclusion.

Access To Codes of Conduct
http://www.skillsforhealth.org.uk/standards/ite
m/217-code-of-conduct

M1
Explain in details how ethics informs health, care
and support service practice, giving practical
examples from own experience and current
codes of ethical practice

Ethics In Healthcare
The Royal College of Nursing stated that healthcare
workers, including nurses, doctors and social
workers, are bound by ethical codes of conduct.
These set out standards of performance to ensure
that their practice is fair, non-judgemental,
respectful and non-prejudicial. They make
individual professionals aware of their own
responsibility to follow the steps of their code at all
times in promoting the health, welfare and interests
of the people they care for. The codes also define
individuals’ accountability for the things they do as
professionals.

2018 National Framework on NHS
The revised 2018 National Framework sets out the
principles and processes of NHS Continuing Healthcare
and NHS-funded Nursing Care. This guidance replaces the
previous version of the National Framework, published in
November 2012, and will be implemented on 1 October
2018. It includes Practice Guidance to support staff
delivering NHS Continuing Healthcare. This revised 2018
National Framework follows an extensive period of
external engagement with stakeholders, across the NHS,
Local Authorities, and patient representative groups. The
2018 National Framework has been collaboratively
written by the Department, NHS-England and Local
Authorities

The National Framework on NHS
National Framework for NHS Continuing
Healthcare and NHS-funded Nursing Care
October 2018 (Revised) Published March 2018
https://assets.publishing.service.gov.uk/govern
ment/uploads/system/uploads/attachment_dat
a/file/746063/20181001_National_Framework_
for_CHC_and_FNC_-
_October_2018_Revised.pdf

D1
Evaluate own national system of government in
relation to its effect on health, care and support
service practice and practitioners

HealthCare Organisations and Their
Legal Duties
In addition to Health and Social Care Act 2008 (Regulated
Activities) Regulations 2014, there is also Care Act 2014
that focuses on the wellbeing of care users. For
organisations offering services in healthcare sector to
satisfy their customers (patients or care users), there are
legislations, regulations (statutory instruments) and
policies designed to guide practices and compliance at
workplace. Under the Health and Safety at Work Act
1974, and Management of health and Safety at Work
(MHSW) Regulations 1999, employers have legal duties to
maintain care safety standard in the United Kingdom. The
above guide daily routines at healthcare workplace, and
the implementations of patients’ safety and wellbeing

The NHS
On the 5th of July 1948, the NHS was launched
by the then Health Secretary, Aneurin Bevan, at
Park Hospital in Manchester (known today as
Trafford General Hospital). For the first time,
hospitals, doctors, nurses, pharmacists,
opticians and dentists were brought together
under one umbrella to provide services for free
at the point of delivery (2018 NHS70)
https://www.nhs70.nhs.uk/about/nhs-history/

Care Quality Commission (CQC)
Pressure to reduce the number of regulators
following reviews by the government and by the
Department of Health (Office of Public Sector
Reform 2003, Reconfiguring the Department of
Health’s Arm’s Length Bodies, 2004) led to the
establishment of the CQC, which brought together
the Healthcare Commission, the Commission for
Social Care Inspection and the Mental Health Act
Commission (which safeguarded people detained in
hospital under the Mental Health Act 1983). The
CQC became fully operational in 2009, taking over
most functions of the Healthcare Commission.

Registration With CQC
To reduce the number of regulators, all
providers of healthcare in England, including
NHS providers, independent providers and
foundation trusts have been legally obliged since
2010 to register with the CQC. Registration
requirements cover areas such as the
management and training of staff, the state of
premises and provision of information.

Reducing Inequality
Clinical commissioning groups and local
authorities share responsibility for reducing
health inequalities by addressing priorities and
outcomes in local Joint Strategic Needs
Assessments (JSNA) and Health and Wellbeing
Strategies. Other system partners including third
sector organisations can also play a role in
reducing health inequalities

Governance and Regulation
Videos
https://www.kingsfund.org.uk/audio-video/nhs-
white-paper-regulation-john-appleby
Key Legislations
https://www.england.nhs.uk/about/equality/eq
uality-hub/resources/legislation/

Health Inequality
The Health and Social Care Act 2012 introduced the first
legal duties about health inequalities. It included specific
duties for health bodies including the Department of
Health, Public Health England, Clinical Commissioning
Groups, and NHS England which require the bodies to
have due regard to reducing health inequalities between
the people of England. The Act also brought in changes
for local authorities on public health functions.
The Equality Act 2010 established equality duties for all
public sector bodies which aim to integrate consideration
of the advancement of equality into the day-to-day
business of all bodies subject to the duty.

Understanding The NHS
• The HM Treasury
• Department of Health
• NHS England
• Clinical Commissioning Groups
• Nationally Commissioning Groups
• Locally Commissioning Groups
• https://www.nhs.uk/NHSEngland/thenhs/abo
ut/Documents/simple-nhs-guide.pdf

LO2
Describe key legislation, National and
organisational policy of fundamental importance
to health, care or support service practitioner

P3
Describe the relationship between key
legislation and national policy, of direct
relevance to health and social care practice

• Health and Social Care Act 2008 (Regulated Activities)
Regulations 2014
• Care Act 2014
• Health and Safety at Work Act 1974
• Management of Health and Safety at Work Regulations
1999
• Safety Representatives and Safety Committees Regulations
1997
• Data Protection Act 1998
• Equality Act 2010
• Human Rights Act 1998
• Safeguarding Vulnerable Group Act 2006

• Health and Safety (Fire Aid) Regulations 1981
• International Development (Gender Equality) Act 2014
• Freedom of Information Act 2005
• Care Quality Commission (Registration) Regulations 2009
• Control of Substances Hazardous to Health (COSHH)
Regulations 2002
• Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations (RIDDOR) 1995
• Disclosure of Barring Services (DBS) established by Police
Act 1997 (Criminal Records) (Registration) Regulations 2006
• Provision and Use of Work Equipment Regulations (PUWER)
1998

Legislation
• Employment Mental Health Act 1983
• Mental Capacity Act 2005
• NHS Act 2006
• NHS redress (Wales) Measure 2008
• Mental Health (Wales) 2010
• Health & Social Care (Reform) Act (Northern
Ireland) 2009
• Social Services and Wellbeing (Wales) Act 2014
• Nursing Staffing Levels (Wales) Act 2016

Constitutional Reform Act 2005
The Act provides for the Lord Chief Justice,
‘President of the Courts of England and Wales’,
to head the judiciary, no longer the Lord
Chancellor

Legal Reform 2005
• The Lord Chancellor was replaced as presiding
officer in the Lords by the new Lord Speaker
• Judicial Appointments committee has primary
responsibility for appointments, ensuring
independence, albeit there is still some
limited executive involve

P4
Compare national and organisational policy
against national professional standards in terms
of their impact on health and social care
practice

A Guide To Confidentiality
Caldicott Seven (7) Principles (To Share or Not to Share) September 2013
Dame Fiona Caldicott, Chair of Information Governance Review, and Kingsley
Manning, Chair of Health and Social Care Information Centre, published “A
Guide to Confidentiality in Health and Social Care in September 2013, and
identified seven principles on protection and sharing of confidential
information:
1. Justify the purpose(s)
2. Do not use personal confidential data unless it is absolutely necessary
3. Use the minimum necessary personal confidential data
4. Access to personal confidential data should be on a strict need-to-know
basis
5. Everyone with access to personal confidential data should be aware of
their responsibilities
6. Comply with the law
7. The duty to share information can be as important as the duty to protect
confidential information

National Policy
• Confidentiality: NHS Code of Practice 2003
• NHS England: Confidentiality Policy, June 2014
• NICE Managing Medicine In Care Home Policy
March 2014

Safeguarding Policy
According to the Office of the Public Guardian
(OPG), Safeguarding Policy, May 2013, abuse is a
violation of an individual’s human and civil rights
by another person or persons:

Types of Abuse
• Physical Abuse
• Financial Abuse
• Sexual Abuse
• Psychological/Emotional Abuse
• Neglect/Acts of Omission
• Discriminatory Abuse
• Institutional Abuse
• Abuse of Trust
• Mate Crime

National Framework Standards
National Framework Standards and Safeguarding
• Standard 2: Partners recognise/accountable Safeguarding
• Standard 3: SA Policy to include rights to live free of abuse
• Standard 4: Policy on Zero-Tolerance of Abuse and Neglect
• Standard 5: Ensure appropriate development/training
• Standard 6: Access to info on safety from abuse/violence
• Standard 7: Local Multi-Agency policies and procedures
• Standard 8: Partners have policy/procedures in line with LP
• Standard 9: Multi-Agency has detailed procedures of stages
• Standard 10: Safeguarding procedures be accessible to all
• Standard 11: Include service users as partners at all stages

Safeguarding Policies
1. The Charities Act 2006
2. The Protection of Freedoms Act 2012 (DBS)
3. Charities Commission May 2013
4. Sir Michael Bichard Report 2004
5. Fraser Guidelines (House of Lords 1985)
6. Gillick Competency Assessment (Lord Scarman 1985)
7. SOVA (Safeguarding of Vulnerable Adult)
8. Safeguarding Children and Young People (Under
18yrs) Policy Paper 14th July 2014
9. Disclosure of Barring Services (DBS)
10. Deprivation of Liberty (DoL)

M2
Reflect on ways in which specific tasks in health,
care or support service practice meet national
professional standards of safe and non-
discriminatory practice

Organisational Policy
The organisational policies and procedures must be
designed to comply with the provisions of
legislations and regulations. It is duty bound for the
management of any organisation to draw up
policies and procedures to implement national
policies. Most of these legislations and regulations
concerning healthcare industry are monitored and
enforced by Care Quality Commission for England
and Local Authorities. The Health and Social Care
Act 2008, part 1, chapter 1, section 1, paragraph 1
and 2 set out the Care Quality Commission (CQC) to
be the regulating body for health and social care.

Person-Centred Values
There are person-centred values that must be followed to
achieve positive result in healthcare. These values are:
• Individuality
• Independence
• Dignity
• Privacy
• Respect
• Trust
• Choice
• Partnership

6CS Care Values
• Care
• Compassion
• Commitment
• Communication
• Courage
• Competence

Fundamental Standards
Regulation 5: Fit and proper person
Regulation 8: General
Regulation 9: Person-centred care
Regulation 10: Dignity and respect
Regulation 11: Need for consent
Regulation 12: Safe care and treatment
Regulation 13: Safeguarding service users from abuse and improper treatment
Regulation 14: Meeting nutritional and hydration needs
Regulation 15: Premises and equipment
Regulation 16: Receiving and acting on complaints
Regulation 17: Good governance
Regulation 18: Staffing
Regulation 19: Fit and proper persons employed
Regulation 20: Duty of candour

Fundamental Standards
https://www.cqc.org.uk/sites/default/files/2014
0725_fundamental_standards_and_enforcemen
t_consultation_final.pdf

LO3
Interpret the law in relation to key
ethical professional Practice Themes
in health and social care

P5
Explain how specific national and
international human rights law
influence and inform the equal and
fair treatment of others in health,
social and support services

Human Rights
• European Convention on Human Rights (1950)
• Human Rights Law (1998)

European Convention on Human
Rights (1950)
• Right to life
• Right to liberty and
security
• Prohibition of torture
• Prohibition of slavery
and forced labour
• Right to a fair trial
• Right to respect for
private and family life
• Freedom of thought,
conscience and religion
• No punishment without
law
• Freedom of expression
• Right to marry
• Freedom of assembly
and association
• Prohibition of abuse of
right

ECHR 1950
The European Convention on Human Rights
(ECHR) is an international human rights treaty
between the 47 states that are members of the
Council of Europe (CoE). This is not to be
confused with the European Union. It is a treaty
to protect the rule of law and promote
democracy in European countries.
(Amnesty International 21 Aug 2018)

P6
Implement different and relevant
legislation and policy in regard to
safe and healthy conduct in own
practice

Safeguarding Law and Policy
• SOVA (Safeguarding of Vulnerable Adult)
• Safeguarding Children and Young People (Under
18yrs) Policy Paper 14th July 2014
• Disclosure of Barring Services (DBS)
• Deprivation of Liberty (DoL)
• Health and Safety (Fire Aid) Regulations 1981
• International Development (Gender Equality) Act
2014
• Freedom of Information Act 2005

M3
Analyse recent health and social care
legislation or national policy in
relation to its importance in
informing rights and responsibilities
of health, care or support services
practitioners

Rights and Responsibilities
• Safeguarding Children and Young People (Under 18yrs)
Policy Paper 14th July 2014
• Social Services and Wellbeing (Wales) Act 2014
• Nursing Staffing Levels (Wales) Act 2016
• Equality (2010)
• Human Rights Act (1998)
• Un Convention on the rights of a Child (1989)
• Female Genital Mutilation Act (2003) as amended by the
serious Crime Act (2015)
• Health and Social Care Act 2008 (Regulated Activities)
Regulations 2014
• Care Act 2014

Recent Legislation and Policy
• Equality (2010)
• Human Rights Act (1998)
•

D3
Critically review ways in which health,
care and support service practitioners
can ensure currency and compliance
with relevant legislation and national
policy through ethical practice

Ethical Practice
A code of ethics document may outline the
mission and values of the business or
organization, how professionals are supposed to
approach problems, the ethical principles based
on the organization's core values and the
standards to which the professional is held

Compliance-Based Code of Ethics
For all businesses, laws regulate issues
such as hiring and safety standards.
Compliance-based codes of ethics not
only set guidelines for conduct, but also
determine penalties for violations.
Read more: Code of Ethics
https://www.investopedia.com/terms/c/code-of-
ethics.asp#ixzz5Y93HBj00

Healthcare Law Policy and Ethical Practice August 2019

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