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General Practitioners: ICT

Mr. Stephen O'Brien: To ask the Secretary of State for Health what the licence charges are for each information system accredited under the GP Systems of Choice programme; what expenditure his Department has incurred to date on (a) upgrading GP systems to Systems of Choice level and (b) supplying infrastructure to primary care trusts under the GP Systems of Choice programme to date; and what estimate he has made of primary care trusts’ expenditure of training staff to use GP Systems of Choice to date. [277082]

Mr. Bradshaw: The GP Systems of Choice (GPSoC) initiative is aimed at improving the information technology (IT) systems and services that support general practices in England by delivering the functionality required under the national programme for IT in line with a common set of standards and performance measures to which all suppliers must adhere. GPSoC enables practices to continue to use the IT systems they already use, but under a standard contractual arrangement that improves transparency and value for money for the national health service.

The annual licence and service charges payable to suppliers for each information technology (IT) system accredited under GPSoC are given in the following table.

Supplier EMIS INPS iSOFT Microtest

Licence/service level

Software licence





Level 1 compliance





Level 2 compliance





Level 3 compliance



Not level 3 compliant

Not level 3 compliant

Summary care record (SCR) compliance

Not SCR compliant

Not SCR compliant


Not SCR compliant

System Support





1. Level 1 compliance: functionality to support core general practitioner (GP) system requirements, choose and book, Spine, and personal demographics service
2. Level 2 Compliance: Level 1, plus electronic prescription service
3. Level 3 Compliance: Level 2, plus GP to GP record transfer
Minor variations in compliance and system support charges, originally common for all suppliers, are due to indexation changes as a result of timing of when the contract became effective for each supplier.

All systems must meet GPSoC Level 2 before they are funded under the GPSoC contract and it is the suppliers who must meet the costs of upgrading their systems to achieve this level.

Funding of an average of £9,500 per GP practice was provided to PCTs in 2007 to upgrade practice IT infrastructure to ensure that practice infrastructure met the minimum standards required to support the efficient use of systems provided under GPSoC, and of other systems and services provided under the national programme for IT.

Since the initiative enables practices to retain the systems with which they are familiar and have been trained to use, training funded under GPSoC is restricted
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to that required to take advantage of new functionality. Expenditure to date, which is funded by the Department, totals some £323,000.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what timetable he has set for (a) the cessation of the temporary programme, GP Systems of Choice, as part of the National Programme for IT and (b) the commencement of the deployment of Local Service Provider solutions for General Practice. [277199]

Mr. Bradshaw: GP Systems of Choice began in August 2007, to run initially for two years, with the expectation that contracts awarded under the initiative would be extended for a further two years if the initiative proved successful. The assumption at the outset was that, by the end of the four-year period, national programme for information technology local service providers (LSPs) would have delivered their integrated general practice solutions. Depending on the rate of take up of the integrated solutions, the Department will determine in due course whether the contracts should be re-tendered to ensure continuity of service.

LSP general practitioner (GP) solutions have already been deployed to over 900 practices, with more practices migrating to TPP SystmOne, provided by CSC, than any other available GP system.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of the average cost to his Department of accrediting systems through the GP Systems of Choice programme. [277200]

Mr. Bradshaw: The Department routinely undertakes testing to demonstrate that new functionality offered by national programme for information technology suppliers meets the necessary requirements and standards. The cost of doing so would therefore arise even in the absence of GP Systems of Choice (GPSoC).

Under GPSoC, the cost varies depending on whether the system is an upgrade to an existing system or a new system. The estimated average cost of the former is around £4,500, and of the latter, around £23,300.

Headaches and Migraine

Julie Morgan: To ask the Secretary of State for Health what training in the care of people with headaches and migraine disorders is available to (a) GPs and (b) other medical staff. [277211]

Ann Keen: The Department shares a commitment with statutory and professional bodies that all health professionals are trained, so that they have the skills and knowledge to deliver a high quality health service to all groups of the population with whom they deal. The Department, along with local national health service bodies that commission professional training, continue to work with the regulators and higher education institutes to ensure that their standards and curricula reflect the changing needs of patient and service delivery.

Training needs for all NHS staff are determined against local NHS priorities, through appraisal processes and training needs analyses informed by local delivery plans and the needs of the service.

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Julie Morgan: To ask the Secretary of State for Health what recent research his Department has (a) commissioned and (b) evaluated on drugs for the relief of headache disorders and migraine. [277212]

Dawn Primarolo: The Department funds national health service research and development through the National Institute for Health Research (NIHR). The institute’s research programmes support high quality research of relevance and in areas of high priority to patients and the NHS. That research currently includes a randomised placebo controlled trial of propranolol and pizotifen in preventing migraine in children. The Department is also providing national health service support for a clinical study of clopidogrel as prophylactic treatment for migraine through the NIHR Primary Care Research Network.

The NIHR funded University College London Hospitals Biomedical Research Centre is undertaking research on headache and pain. A five-year budget of £3.7 million has been allocated to this work.

The Medical Research Council (MRC) is one of the main agencies through which the Government support medical and clinical research. The MRC, an independent body, receives its grant in aid from the Department for Innovation, Universities and Skills.

The MRC is currently funding two research projects relating to headache and migraine as follows:

A range of pharmacological interventions are available to prevent the occurrence of headaches, and to relieve the pain of attacks. It is the responsibility of health professionals to consider what treatment is the most appropriate for their patients, in consultation with the patient and informed by their medical history.

Health Professions: Working Hours

Mr. Sanders: To ask the Secretary of State for Health what his most recent assessment is of the effects of the European Working Time Directive on hospital staff. [276715]

Ann Keen: The national health service has made excellent progress in implementing this important legislation, which ensures that patients receive safe, high quality care from staff that have not been forced to work excessive hours. Only the junior doctors in training remain to become compliant by 1 August and two-thirds of them are already working a 48-hours week averaged over 26 weeks.

The United Kingdom Government notified the European Commission in January 2009 of its assessment of progress in achieving compliance with the European Working Time Directive by doctors in training. A copy of the UK notification of Derogation for Doctors in Training has already been placed in the Library. The Department is working closely with the medical royal colleges, the British Medical Association and strategic health authorities to ensure trusts are prepared for full implementation.

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Health Services: Disabled

Mr. Tom Clarke: To ask the Secretary of State for Health how much primary care trusts spent on (a) disability services and (b) children's disability services in the last five years. [276989]

Phil Hope: The information requested is not collected centrally.

However, ‘Services for children and young people with disabilities and/or special needs: Report of findings from child health mapping in England 2005 to 2007’, published in February 2009, brings together available information from some primary care trusts including financial information.

Heart Diseases

Kerry McCarthy: To ask the Secretary of State for Health (1) what arrangements are in place to consult the voluntary sector as part of his Department’s external review of implementation of the National Service Framework for Coronary Heart Disease and the future of cardiology services; [277036]

(2) when he plans to complete his Department’s assessment of the future profile of cardiology services; and what account that assessment is taking of links between cardiac conditions, stroke, kidney disease and diabetes. [277037]

Ann Keen: The Department is commissioning an external review of the implementation and delivery of the National Service Framework for Coronary Heart Disease. In addition to this, we will undertake an analysis of the trends in the burden of heart disease and look at how patient expectation and need, technology and working practices are likely to affect future demand and patterns of service provision. We will feed our findings into the discussions of the National Quality Board, which has been set up to oversee the priorities for the service in the future. As part of normal practice, the Department will consult with the voluntary sector. A completion date has not yet been set.

In addition to this, phased implementation of this NHS Health Check Programme began in April 2009. This takes a cross-vascular approach to preventing heart disease, stroke, diabetes and chronic kidney disease.

Kerry McCarthy: To ask the Secretary of State for Health whether his Department has commissioned recent research to establish which population groups have disproportionately higher levels of cardiac and vascular disease. [277046]

Dawn Primarolo: The Department’s Policy Research Programme (PRP) funds the South London Stroke Register which monitors trends in the incidence of stroke in different ethnic groups(1). The British Women’s Health and Heart Study, also funded by the PRP, is a large, nationally representative cohort study of older women that provides information about the incidence of cardio-vascular disease.

The Medical Research Council (MRC) is one of the main agencies though which the Government support medical and clinical research. The MRC is an independent body funded by the Department for Innovation, Universities and Skills.

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The MRC currently supports a broad portfolio of cardiovascular and stroke research which includes epidemiological and population based programmes. Studies included in the portfolio include:

In addition, the MRC, jointly with the British Heart Foundation, had recently agreed to fund a £2.9 million research programme led by Professor J Danesh at University College London looking at the interplay of genetic, biochemical and lifestyle factors on coronary heart disease incidence in populations across Europe.

Immediate Care

Mr. Stephen O'Brien: To ask the Secretary of State for Health with reference to the letter of 14 May 2009 from his Department’s Director, Workforce Capacity, Analysis and HR, which hospital services provide 24-hour immediate care; and what definition of immediate care his Department uses. [277045]

Ann Keen: The terminology referred to means all hospital emergency and acute services operating a 24-hour service. It could also refer to urgent non-elective surgery specialty work, for example, a heart transplant. Services vary from region to region and trust to trust.

The definition of ‘24-hour immediate care’ was agreed and was the decision of the National European Working Time Directive Reference Group as being the most appropriate term to encapsulate the services above. Membership of the group includes the Royal Colleges, strategic health authorities, deaneries, British Medical Association, NHS employers. This definition was used within the notification of derogation to the European Commission submitted in January.

National Institute for Health and Clinical Excellence

John Battle: To ask the Secretary of State for Health if he will make it his policy to set a deadline for the commissioning of NHS services to achieve compliance with National Institute for Health and Clinical Excellence clinical guidelines; and if he will make a statement. [277382]

Dawn Primarolo: We have no plans to do so. The National Institute for Health and Clinical Excellence's (NICE) clinical guidelines cover a whole pathway of care and may make a significant number of recommendations. The Government expect national health service organisations to work towards implementation of NICE'S clinical guidelines over time, in line with available resources and local priorities.

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John Battle: To ask the Secretary of State for Health if he will take steps to increase levels of public confidence in National Institute for Health and Clinical Excellence clinical guidelines; and if he will make a statement. [277383]

Dawn Primarolo: The National Institute for Health and Clinical Excellence (NICE) is an independent organisation and its clinical guidelines are based on a thorough assessment of the available evidence. They are developed in consultation with stakeholders, are widely respected internationally and have been commended by the World Health Organisation. The Department has no plans to undertake further work on public perceptions of NICE clinical guidelines.

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