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1 Sep 2008 : Column 1742W—continued
Malnutrition
Mr. Stephen O'Brien: To ask the Secretary of State for Health how many people in (a) care homes and (b) hospitals were rated high risk by the malnutrition universal screening tool in each of the last 24 months; and what the (i) mean, (ii) range and (ii) distribution in terms of length of time rated at high risk was. [221558]
Dawn Primarolo: This information is not held centrally.
Medical Education England
Mr. Lansley: To ask the Secretary of State for Health for what reasons Medical Education England will not have a commissioning function in addition to its advisory role, as referred to on page 73 of High Quality Care for All, Cm 7432. [221053]
Ann Keen:
The Next Stage Review document “A High Quality Workforce” sets out the role and remit of Medical Education England in more detail than “High Quality
Care for All”. It clarifies and confirms the role of the strategic health authorities (SHA) as commissioners of education. They are best placed to translate the workforce plans submitted by providers into education commissions, taking a whole system approach rather than just focussing on individual professions.
The role of Medical Education England (MEE) in an advisory and scrutiny role will enable them to provide an overview of commissions at a local and national level and enable them to provide advice to the Department. This function could not be effectively performed if MEE were also commissioners of education.
Professor Sir John Tooke provides a response to “A High Quality Workforce” in the document, in which he states
“I am particularly pleased to see the creation of Medical Education England which will give a strong voice and the scrutiny function that it needs”.
Medical Examinations: Males
Mrs. Riordan: To ask the Secretary of State for Health what steps are being taken to encourage men between the ages of 20 and 35 years to have regular medical check-ups. [220011]
Mr. Bradshaw: The Department has not targeted men in this age group specifically to encourage them to have regular medical check-ups. However, under the General Medical Services contract, general practitioner practices are required to invite all newly registered patients including men aged 20 to 35 years for a consultation within six months of registration and provide, on request, a consultation for patients aged 16-74 who have not had a consultation within the last three years.
Medical Records
Mr. Stephen O'Brien: To ask the Secretary of State for Health what data is currently being stored on the Summary Care Record. [221545]
Mr. Bradshaw: The information in the summary care record (SCR) is extracted from the general practitioner's record and, at present, is limited to basic information—personal demographic details, current medications, adverse reactions and allergies.
Whether additional information is added in the future will depend on decisions taken through the normal governance process to include clinical representations and patient preferences. Eventually, summaries of health problems and the care provided could be added and updated each time patients who choose to have a SCR receive national health service care. Clearly, the precise information stored on the SCR will differ from patient to patient.
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) how many detailed care records are currently held in data centres operated by each of the National Programme for IT’s local service providers; [221552]
(2) whether National Programme for IT’s local service providers plan to operate a data centre for the detailed care records of each NHS care provider; [221559]
(3) how many data centres each of the National Programme for IT’s local service providers plans to hold detailed care records; [221560]
(4) how many detailed care records are currently held in data centres operated by each of the National Programme for IT’s local service providers. [221561]
Mr. Bradshaw: All national programme for information technology systems which are able to be deployed to the national health service via a hosted solution from a secure, resilient, reliable, enterprise standard, data centre are supported through that means with appropriate business continuity and disaster recovery arrangements in place. By exception, there are some existing systems or additional services provided through local service providers that do not lend themselves to this technical approach at present.
Currently the number of data centres used by local service providers (LSPs) is as follows:
CSC: 4;
BT LSP: 2;
Fujitsu: 2; and
Accenture: 2, for its Picture Archiving and Communications Service.
There are no current plans to increase or decrease this number.
Information is not held centrally on the number of detailed care records currently held in data centres.
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) how much the independent evaluation of the care record system commissioned from UCL cost; [221555]
(2) what plans he has to fund further independent evaluation of the Connecting for Health programme; [221556]
(3) when he will publish a response to the independent evaluation of the care records system commissioned from UCL. [221557]
Mr. Bradshaw: The contracted cost of the independent evaluation of the summary care record (SCR) early adopters programme, carried out by a team from the Department of Primary Care and Population Sciences at University College London, was £272,204.
We have no current plans to publish a formal response to the evaluation team's findings. NHS Connecting for Health is considering and discussing the important issues raised in the evaluation report with key stakeholders, and the summary care record advisory group was asked to consider urgently the report's findings and to advise on how these will inform the future roll out of the SCR. As we have stated consistently, the findings and recommendations of the independent review will be taken into account in planning further roll out of the SCR.
Under its Health Evaluation Programme, NHS Connecting for Health has commissioned a number of further projects to evaluate aspects of the national programme for information technology. The University of Birmingham has been commissioned to manage the evaluation programme. Further information on the programme, including details of current projects and on-going work, together with final reports and publications,
is on the NHS Connecting for Health evaluation programme website, run by the university of Birmingham, at:
Mr. Stephen O'Brien: To ask the Secretary of State for Health which NHS care providers will maintain their own electronic patient records once the National Programme for IT's local service providers roll-out their strategic solutions on a national basis. [221562]
Mr. Bradshaw: All clinicians are required by their professional bodies, and for clinical governance and medico-legal reasons to keep clear, accurate, legible and contemporaneous patient records, and to keep these secure and confidential. This is most often likely to be in electronic form. This is irrespective of the national programme for IT and systems implemented by local service providers. Patients are able to opt out of having their clinical information uploaded to the “spine”, the national database of key information about patients' health and care within the national health service care records service, by choosing not to have a summary care record.
Medical Records: Data Protection
Mr. Lansley: To ask the Secretary of State for Health what assessment he has made of the risks to patient confidentiality of publishing patients' care records to HealthSpace, as referred to on page 41 of High Quality Care for All, Cm 7432. [221023]
Mr. Bradshaw: While it is never possible to eliminate all risk, stringent security controls and safeguards have been put in place to prevent unrestricted or uncontrolled access to personal information accessible through HealthSpace. Authentication of patients seeking a HealthSpace account has been designed to operate within the specified e-Government Interoperability Framework (e-gif) requirements and industry best practices. In due course, when the technology to do so becomes available, registration requirements will be uprated to the next highest level.
In addition, the HealthSpace system has been subjected to exhaustive penetration testing to demonstrate its resilience to unauthorised attempts by third parties to access data held within it. This testing will be repeated on a regular basis.
Users will also be advised that securing confidentiality of their information accessible through HealthSpace is also in part a personal responsibility. The safeguarding of access controls, including PINS and passwords, is an example of personal responsibility, along with not choosing to access records at a time or location where others may see them. Users will be supported in this by means of standard technical measures used widely in secure electronic transactions, for example by the setting of a 'timeout', so that after a given period of inactivity the user is automatically logged off the system.
Mr. Lansley:
To ask the Secretary of State for Health what assessment he has made of the impact on the security of confidential data of increasing the scope of access to the NHS Care Records Service to (a) social care, (b) voluntary sector, (c) private sector, (d)
pharmacy and (e) other organisations, as referred to on page 50 of NHS Next Stage Review: Our vision for primary and community care. [221135]
Mr. Bradshaw: The vision for the NHS Care Records Service (NHS CRS) is that it will support the delivery of care across all the settings where national health service patients may present for that care, including services provided by the private and voluntary sectors and in social care, pharmacy and other organisations. We have set out clearly in the Care Record Guarantee precisely what security and confidentiality standards must be met by all organisations that have access to the NHS CRS and all such organisations are required to provide assurance that they are meeting these standards. Compliance will be audited.
Mr. Stephen O'Brien: To ask the Secretary of State for Health how legitimate relationships are established for determining access to the NHS care records service. [221550]
Mr. Bradshaw: Legitimate relationships are a form of access control that prevent those who are not working in a team that is involved in providing national health service care to an individual from accessing that individual's clinical information. NHS organisations will determine which of their staff work within which teams for this purpose.
A new legitimate relationship is normally created when a patient is referred to a team for care. This referral may be from a different part of the NHS or may be a self-referral by a patient, for example when attending a minor injuries unit, or when registering with a general practitioner's practice.
Some clinicians, particularly those working in emergency care environments, are also able to establish a legitimate relationship with a patient when this is needed to support emergency care. These “self-declared” legitimate relationships generate an alert to staff responsible for ensuring that the facility is not misused.
Mr. Stephen O'Brien: To ask the Secretary of State for Health which applications will have access to data stored in the NHS care records service; and which applications do not require a valid smartcard in order to access data in the NHS care records service. [221551]
Mr. Bradshaw: The NHS Care Record Service links patient information from different parts of the national health service electronically so that authorised NHS staff and patients have the information they need to make care decisions. It comprises a number of national services, and compliant local applications, for example trust patient administration systems, and general practitioner systems. These local applications hold their own data and interact through messages with national services such as choose and book, the summary care record, and the personal demographics service. All local applications that interact with the national services require a valid smartcard.
A number of interim stand-alone local systems have been deployed to support the NHS. These do not interact with the national services and may not use smartcards.
Medical Records: Databases
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the Answer of 26 March 2008, Official Report, column 206W, on medical records: databases, whether (a) private sector suppliers, (b) third sector suppliers and (c) providers under the Framework for Procuring External Support for Commissioning will have access to patient data through the Secondary Uses Service. [221447]
Mr. Bradshaw: The current proposals for pseudonymised data extracts from the Secondary Uses Service are that these will be available for any supplier who agrees the terms and conditions. The terms and conditions are being agreed but include, for example, limitations on the disclosure of data to third parties and the copying of data, and termination and liability clauses in the event of unauthorised disclosure of personally-identifiable information. There will also be a right of audit to verify adherence to the terms and conditions, which will be the key condition determining permission to access for those wishing to use the service.
Once finalised, the terms and conditions will be published.
Medical Records: Lost Property
Keith Vaz: To ask the Secretary of State for Health (1) who will be responsible for the investigation aimed at finding lost patient NHS records in Leicester; [218138]
(2) what information was contained in the patients' NHS documents recently stolen in Leicester; and what investigation is taking place to retrieve the documents. [218139]
Mr. Bradshaw: The police and Leicestershire County and Rutland primary care trust are responsible for the investigation.
The East Midlands strategic health authority reports that a print out containing details of approximately 233 home oxygen patients; including name, address, national health service number and general practitioner details; and a laptop computer, containing the names, dates of birth and oxygen levels of three patients, were stolen from the boot of a nurse's car.
Medical Treatments
Mr. Lansley: To ask the Secretary of State for Health (1) how many treatments referred to the National Institute for Health and Clinical Excellence and assessed through its single technology appraisal process (a) have and (b) have not received a final appraisal determination within six months of receiving a product licence; [221141]
(2) what improvements he anticipates making to the National Institute for Health and Clinical Excellence's appraisal process, as referred to on page 44 of High Quality Care for All, Cm 7432; [221142]
(3) whether he plans to introduce a maximum time period in which the National Institute for Health and Clinical Excellence must undertake technology appraisals; and what proportion of treatments he expects will receive their final appraisal determination within (a) three and (b) six months of receiving their
product licence following the changes announced in High Quality Care for All, Cm 7432. [221147]
Dawn Primarolo: As at 21 July 2008, the National Institute for Health and Clinical Excellence (NICE) has published final guidance for 21 single technology appraisals (STAs). NICE issued a final appraisal determination for four of these within six months of licensing.
The Government are exploring with NICE options for further improving the topic selection and technology appraisal processes to support rapid appraisal of significant new drugs.
We have no plans to introduce a maximum time period in which NICE must undertake technology appraisals as the time taken to develop guidance on a treatment depends on the individual circumstances of each case. NICE'S Guide to the Single Technology Appraisal (STA) process sets out the expected timescales for the development of guidance through the STA process, and is available on NICE'S website at:
Medical Treatments: Lasers
Mike Penning: To ask the Secretary of State for Health pursuant to the Answer of 9 July 2008, Official Report, column 1708W, on medical treatments: lasers, if he will ensure that his Department’s response to the Private and Voluntary Healthcare: Care Standards Act 2000 consultation will include, in addition to an identification of organisations and individuals that responded, a list of those respondents who (a) supported and (b) opposed the Government’s proposals for the deregulation of class 3B and 4 lasers and intense pulsed light sources. [219474]
Mr. Bradshaw: The Department’s response to the Private and Voluntary Healthcare Consultation will include a full list of all the respondents and whether they supported or opposed the various proposals, including those relating to class 3B and 4 lasers and intense pulsed light sources.
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