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Mr. Bradshaw: Each primary care trust (PCT) has a statutory duty to maintain its expenditure within the resource limits set for revenue and capital. The Department monitors PCT expenditure and performance against this duty at regular intervals during the year, and reports the aggregate PCT financial position in the audited PCT summarised account after the year end.
During the financial year, the Department collects detailed information relating to the financial position of all national health service (NHS) organisations, including PCTs, on a quarterly basis. In addition, the Department also collects key financial performance data from the NHS in a number of the intervening months between each quarter. Information relating to each PCTs forecast outturn and revenue resource limit (RRL) is published in The Quarter, the Departments regular update on NHS finance and service performance.
At the end of each financial year, PCTs publish their audited statutory accounts and submit accounting summarisation schedules to the Department. These schedules are aggregated, and the result both consolidated into the Departments overall Resource account and used to produce the PCT summarised account.
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) what projections his Department has made of the change in each NHS hospital trusts income resulting from the implementation of HRG4; 
(2) how much each hospital earned under HRG3 in the latest year for which figures are available; and what estimate he has made of the income each would have earned for the same work in that period under HRG4. 
Mr. Bradshaw: Information about national health service hospital income from the national tariff is not separately identified in their accounts. However, the Department has collected this information as part of the central payment mechanism for the market forces factor (MFF) since 2005-06. The latest available information is for 2007-08, when healthcare resource group (HRG) version 3.5 was the tariff currency, and is shown in table 1.
The Department has made no estimate of what NHS hospital income would have been in 2007-08 under HRG4. However, the Department did consider the impact on NHS hospital national tariff income between 2008-09 and 2009-10 resulting from the move from HRG version 3.5 to HRG5 in 2009-10 and this is shown in table 2. Because this analysis also includes the impact of the revised MFF, and uses historical activity data from 2006-07 and 2007-08 and national assumptions which may vary locally, it is only an estimate of the actual impact of HRG4.
Mr. Bradshaw: The methodology and criteria underpinning the calculation of the national tariff are described in a step-by-step guide, which is published annually. The guide for 2009-10 has been placed in the Library and is available on the Departments website at:
Mr. Bradshaw: The following table includes information for all staff involved in work which contributes to the production of the national tariff, including the collection of reference costs and costing policy, future tariff development and governance procedures. The salary scales shown are the minimum and maximum salaries for staff, who can be based in either Leeds or London.
|Grade||Salary band in 2009-10||Headcount||Job descriptions|
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) what percentage of each local service provider contract for the National Programme for IT is apportioned to the Care Records Service; 
Mr. Bradshaw: The NHS Care Record Service (NHS CRS) comprises a number of national services, and compliant local applications, for example, trust patient administration systems and general practitioner systems. The key nationally-funded components of the NHS CRS are delivered via the spine and the local service provider (LSP) contracts.
The estimated lifetime value of the relevant contracts is in the table at 2004-05 prices. This was the basis used in The National Programme for IT in the NHS: Project Progress Report (National Audit Office 16 May 2008).
|(1) Original value £1,021 million, but including an addition for work in the South now transferred by Contract Change Notice (CCN) to BT.|
(2) This contract, with Fujitsu, was terminated at the end of May 2008. The value of future planned expenditure on national programme systems and services in the South will be determined following a review of local national health service requirements, and subject to relevant business case approval.
Costs specific to the individual components of the NHS CRS supported by the spine are not separately identified within the spine contract. The value of LSP contracts and entitlement to payment under the contracts is structured around the provision and ongoing support to NHS organisations within the LSP area of the complete raft of systems and services that will meet the agreed requirements set out in the contracts. The contracts do not specify costs relating to individual systems and services.
Mr. Bradshaw: A written ministerial statement on Mid-Staffordshire NHS Foundation Trust (FT) was issued on 30 April in response to the reports of the independent reviews undertaken by Professor Sir George Alberti and Dr. David Colin-Thomé.
There is no legal requirement for board of directors meetings to be open to the public and there are no plans to bring forward legislation to compel them to do so. However, the Government response to the Alberti and Colin-Thomé reports stated:
These reports and the Health Commission report were highly critical of the closed culture that operated at Stafford Hospital. All NHS organisations must ensure they are operating in accordance with current guidance, which promotes openness, transparency and accountability to their local populations, including boards holding meetings in public.
follow a policy of openness and transparency in its proceedings and decision making unless this conflicts with a need to protect the wider interests of the public or the NHS foundation trust (including commercial-in-confidence matters) and make clear how potential conflicts of interests are dealt with.
Mr. Bradshaw: The Department commissions and reviews numerous papers on choice. The following answer shows the details of many of the papers, research and surveys on patient choice that the Department has commissioned and reviewed in recent years.
The Department commissioned a series of national patient choice surveys to assess the implementation of choice at primary care trust (PCT) level. The National Patient Choice Survey is a series of surveys, conducted by Ipsos MORI on behalf of the Department. They monitor patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment. They were designed to provide a national overview of choice with summary results at PCT level (initially bi-monthly and now quarterly) and generally have an effective response rate around 30 per cent. Surveys also contain information on respondents' age, sex and ethnicity. The report of the December 2008 survey was published on 7 May 2009.
The Health Reform Evaluation Programme (HREP) is a programme of research being coordinated by the London School of Hygiene and Tropical Medicine (LSHTM) to evaluate the reforms set out in the Department's publication Health Reform in England: update and next steps. This includes research on a range of issues including patient choice. Final reporting will begin in 2010. As part of the HREP, LSHTM have also conducted a systematic review of the impact of patient choice of provider in the English NHS(1) (2009). An ongoing study under this programme which is yet to report is entitled Effects of choice and market reform on inequalities of access to health care.
The Department commissions a module on attitudes to health issues in the British Social Attitudes annual survey conducted by Natcen. This involves a series of questions about social attitudes towards health and health services. Some of these questions are about attitudes towards patient choice. The results of the survey are published in a report on an annual basis(2).
|Title of document/research programme||Date||Author||Available from/on|
The Department reviews research on various aspects of choice policy. Following is a table with details of many of the pieces of research that have been reviewed that are directly relevant to patient choice in the national health service.
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