What comes into effect in October 2018?


01 / 10 / 2018

Stay informed of the latest policy and legislative changes affecting NHS organisations in England from 1 October 2018.

Best value biological medicines Homelessness
Continuing healthcare
Primary care
Genomics Standard Contract requirements


Best value biological medicines

Arrival of biosimilar adalimumab

The primary patent for adalimumab will end in October 2018. Several adalimumab biosimilars – a biological medicine which has been shown not to have any clinically meaningful differences from the originator medicine in terms of quality, safety and efficacy – are due to be released from this date.

Use of biosimilars saved the NHS £210 million in 2017/18. NHS England’s ambition is to achieve a recurrent annual saving of £200-300 million by 2021 through the increased use of the best value biological medicines.

The NHS is asking clinical teams, in discussion with individual patients, to use more biosimilar medicines so that the money saved can be reinvested in new medicines and treatments. This means that some patients will be invited to switch to a biosimilar medicine.

Find out more

Access key resources, including a toolkit for commissioners and providers, from the Specialist Pharmacy Service website.

Continuing healthcare

Updated framework

The updated version of the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care takes effect on 1 October, superseding the 2012 version. The framework sets out the principles and processes of NHS continuing healthcare and NHS-funded nursing care.

Find out more
Access the updated framework and supporting tools from the Department of Health and Social Care website.


New genomic medicine service

October 2018 will see the roll out of the new genomic medicine service (GMS) which aims to embed genome sequencing into routine care.

The service will allow the NHS to use DNA testing more widely in patient diagnoses and treatments. “Hospitals will be connected to specialist centres that can test patients' cancer genomes or diagnose rare diseases and find the most effective treatments, including reducing adverse drug reactions. This is intended to allow patients to access the best treatments for their needs more quickly,” Bionews states.

As of this month, the National Genomic Test Directory will also specify which genomic tests are commissioned by the NHS in England, the technology by which they are available, and the patients who will be eligible to access to a test.

Find out more
Access further information from the Genomics England website and NHS England website.

Laboratory hubs

From October 2018, genomic testing in the NHS will be provided through a single national testing network delivered through seven genomic laboratory hubs.Each will be responsible for coordinating services for a particular part of the country.

Find out more

Head to NHS England's website for full details on the hubs.


Duty to refer

From 1 October, a number of named public bodies – including NHS organisations – will have a duty to refer service users who are homeless or may be threatened with homelessness, to a local housing authority of the service user’s choice.

Public authorities with a duty to refer include:

  • emergency departments
  • urgent treatment centres
  • hospitals in their function of providing inpatient care
  • social service authorities (both adult and children’s).

Find out more

Full guidance can be found on the Ministry of Housing, Communities & Local Government website.

The Mental Health Network has produced a briefing on innovative collaborations between housing and healthcare providers which are improving patient outcomes while also relieving pressures on public finances.

Primary care

Winter indemnity scheme for GPs

NHS England will be running a winter indemnity scheme for GPs beginning on 1 October 2018 until 31 March 2019.

“It is designed to meet the costs of personal professional indemnity for any additional work outside of core hours undertaken by GPs this winter,” NHS England states, “enabling GPs to work additional sessions without having to pay additional subscriptions to their medical defense organisation.”

Find out more

Head to NHS England’s website for full details.

Standard Contract requirements

Digital switchover

From 1 October 2018, trusts will only take electronic referrals from GPs. This is as per a requirement in the Standard Contract for 2018/19 on the full use of the NHS e-Referral Service (eRS) for all consultant-led first outpatient appointments.

Providers will only be paid for activity resulting from referrals made through eRS.

Find out more

NHS Digital's website has everything you need to know

Discharge summaries

From 1 October 2018, both discharge summaries following inpatient or day-case admission or A&E attendance) and outpatient clinic letters must adhere to a set of requirements on transfer of care documentation and for the use of a common suite of open APIs :

  • be a structured message, capable of carrying both human readable narrative and coded (SNOMED CT/dm+d) information, using or consistent with the Professional Record Standards Body endorsed clinical headings;
  • be sent by direct automatic transfer onto the GP practice electronic patient record system through a suitable secure interface (rather than being sent by post, fax or email).

Find out more

Access NHS England’s guidance on the NHS Standard Contract requirements on discharge summaries and clinic letters and on interoperability of clinical IT systems.


Pay arrangements for medical and dental staff

Updated pay arrangements for staff covered by the national medical and dental terms and conditions of service will begin to apply from 1 October 2018.

It covers hospital medical and dental staff, doctors and dentists in public health, the community health service and salaried primary dental care.

Find out more

Download NHS Employers' Pay and Conditions Circular (M&D) 3/2018.

Latest Tweets

Latest Blog Post

Tackling medicines wastage through a scalable initiative | Diar Fattah

14 / 12 / 2018 12.08pm

With estimates exceeding £300 million wasted every year in the NHS on unused or partially used medicine, Diar Fattah, associate director of medicines optimisation at Dartford, Gravesham and Swanley (DGS) CCG, believes savings and efficiency opportunities around medicines wastage are ripe for the taking.

Why Register?

Great reasons to register with NHS Confederation

  • Access exclusive resources 
    Access member-only resources and tailor member benefits and services
  • Personalise your website
    Select topics of interest for recommended content
  • Comment and recommend
    Rate and share content with colleagues
  • Never miss a thing
    Register now to keep your finger on the pulse of the NHS Confederation

Log In

To book events and access member only content you need to register with us.  This only takes a moment via our registration page. If you have already registered login using your email address and password below.