General Practitioners: Isle of Wight
Mr Andrew Turner: To ask the Secretary of State for Health which GP surgeries on the Isle of Wight will open for extended hours as a result of the GP Access Fund. [196522]
Dr Poulter: NHS England received more than 250 expressions of interest for the Prime Minister’s Challenge Fund. 20 successful general practitioner collaborations were awarded investment to run pilot schemes for a year. There were no successful expressions of interest from practices on the Isle of Wight.
The pilot schemes will be reviewed in the summer, with a view to full evaluation from April 2015. Following the evaluation, we intend to roll out learning and best practice from the pilots to the rest of the country.
General Practitioners: Tower Hamlets
Jim Fitzpatrick: To ask the Secretary of State for Health what meetings have taken place between officials in his Department and officers of (a) the Tower Hamlets Clinical Commissioning Group and (b) the Regional or Sub Regional NHS to discuss the effects on GP services in Tower Hamlets of changes to the Quality and Outcomes Framework and Minimum Practice Income Guarantee. [196553]
Dr Poulter: The head of primary care for NHS England for North Central and East London met with the chief officers of all London clinical commissioning groups (CCGs) on 14 February 2014 at their London-wide forum and discussed the planned changes to the Minimum Practice Income Guarantee. This included offering to meet with practices alongside the CCG if requested.
The NHS England primary care team in London has had communication on a number of occasions by telephone and email with the Chief Officer of Tower Hamlets CCG regarding the potential impact on practices of changes to the Minimum Practice Income Guarantee and Quality and Outcomes Framework.
Haemolytic Uraemic Syndrome
Mr O'Brien:
To ask the Secretary of State for Health pursuant to the answer of 24 March 2014, Official Report, column 120W, on haemolytic uraemic syndrome, what discussions NHS England has had with the National Institute for Health and Care
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Excellence (NICE) since 1 January 2014 on NICE's appraisal of eculizumab; and if he will make a statement. [196426]
Norman Lamb: We understand that NHS England was formally consulted on the scope of the National Institute for Health and Care Excellence’s (NICE) evaluation of eculizumab for atypical haemolytic uraemic syndrome. NHS England was also consulted on the evaluation consultation document, which was published on 27 February 2014.
Following the publication of NICE’s draft guidance on eculizumab, NICE sought further advice from NHS England on what considerations relating to the management of its specialised commissioning budget it considers should be taken into account in formulating a recommendation. The response from NHS England will be considered by NICE at the next meeting of the evaluation committee.
Mr O'Brien: To ask the Secretary of State for Health pursuant to the answer of 24 March 2014, Official Report, column 120W, on haemolytic uraemic syndrome, for what reasons it was felt that further advice was needed on the overall cost implications, benefits and affordability of eculizumab; when it was first concluded that such further advice was needed; for what reasons the seeking of that advice was delayed until the National Institute for Health and Care Excellence took on responsibility for assessing highly specialised technologies; and if he will make a statement. [196427]
Norman Lamb: Ministers concluded that further advice was needed on the overall cost implications, benefits and affordability of eculizumab as, while Advisory Group for National Specialised Services (AGNSS) members were convinced of the clinical effectiveness of the drug, they noted the very high costs of the drug and the increasing cost profile for the national health service.
AGNSS was informed of this decision on 17 January 2013. On 7 February 2013, the Department conveyed its decision to the National Institute for Health and Care Excellence (NICE) so that NICE could begin preparatory work in advance of taking on formal responsibility for evaluating highly specialised technologies on 1 April 2013.
While NICE carries out its evaluation, the current interim commissioning arrangements by NHS England in line with the ‘Clinical Commissioning Policy Statement: Eculizumab for atypical haemolytic uraemic syndrome’ will remain in place. The policy statement is available at:
www.england.nhs.uk/wp-content/uploads/2013/09/e03-hss-a.pdf
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Health Professions
Luciana Berger: To ask the Secretary of State for Health what assessment his Department has made of the effect that new public health structures are having on community obstetrics and gynaecology (a) workforce planning and (c) continuing professional development. [196445]
Dr Poulter: The Secretary of State has delegated to Health Education England (HEE) the responsibility for delivering a better health and health care workforce for England. HEE plans and develops the workforce to ensure a secure workforce supply for the future, balancing need against demand.
The local education and training boards, which are sub-committees of HEE, work with local health care providers, including employers, to contribute to HEE’s overall future workforce plan. It is the responsibility of health care employers to ensure they have the right staff, with the right skills to deliver high-quality care, which includes supporting their continuing professional development.
Health Services
Luciana Berger: To ask the Secretary of State for Health how many of his Department's agencies, non-departmental public bodies or sponsored bodies have developed their own global health strategies. [197370]
Jane Ellison: In addition to the cross-Government global health strategy, ‘Health is Global: An outcome framework for global health 2011-2015’, published in 2011, Public Health England is developing a global health strategy.
This will complement, and will be consistent with, ‘Health is Global’.
Health Services: Nottinghamshire
Gloria De Piero: To ask the Secretary of State for Health how many (a) nurses, (b) doctors and (c) surgeons have been employed at (i) Sherwood Forest Hospitals NHS Foundation Trust and (ii) Nottingham University Hospitals in each year since 2007. [197257]
Dr Poulter: Information on the number of (a) qualified nursing, midwifery and health visiting staff (b) hospital and community health service (HCHS) doctors and (c) surgeons employed at (i) Sherwood Forest Hospitals NHS Foundation Trust (FT) and (ii) Nottingham University Hospitals NHS Trust in each year since 2007 is shown in the following table:
| Full-time equivalents | ||||||||
| As at September each year | ||||||||
| Organisation | Type | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 |
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| Notes: 1. Surgical group includes: cardiothoracic surgery, general surgery, neurosurgery, ophthalmology, otolaryngology, paediatric surgery, plastic surgery, trauma and orthopaedic surgery, urology, vascular surgery. 2. These statistics relate to the contracted positions within English NHS organisations and may include those where the person assigned to the position is temporarily absent, for example on maternity leave. Sources: 1. Health and Social Care Information Centre Medical and Dental Workforce Census. 2. Health and Social Care Information Centre Non-Medical Workforce Census. | ||||||||
Health Services: Prisons
Sadiq Khan: To ask the Secretary of State for Health (1) how many hospital attendances there were from each prison in each of the last four years; [197046]
(2) how many hospital attendances there were from the (a) adult male, (b) adult female, (c) youth male, (d) youth female and (e) total prison estate in each of the last four years. [197047]
Norman Lamb: This information is not collected centrally by the Department or NHS England.
Hospitals: Parking
Robert Halfon: To ask the Secretary of State for Health what recent discussions he has had on affordability of hospital car parks. [196611]
Dr Poulter: The Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), has had a number of recent meetings in relation to the affordability of car parking in the national health service. He has asked his officials to produce guidance for hospitals to identify which groups should receive concessionary or free parking, including disabled patients and visitors, those whose condition demands that they make frequent visits to hospital, and patients and visitors on a low income.
Infant Mortality
Tracey Crouch: To ask the Secretary of State for Health (1) if he will consider creating the role of bereavement midwives to work exclusively with parents who have experienced the death of their baby shortly before, during or after birth; and if he will make a statement; [196273]
(2) what steps he is taking to ensure that information on bereavement support and services is made available to parents who have suffered the loss of a baby. [196274]
Dr Poulter: It is for the national health service locally to ensure appropriate facilities and services are in place to support bereaved parents following the death of a baby. In line with the Nursing and Midwifery Council’s Standards of proficiency for pre-registration midwifery education, all midwives should be proficient in providing care for women who have suffered pregnancy loss, stillbirth or neonatal death.
To assist NHS commissioners and providers, the Royal College of Obstetricians and Gynaecologists’ ‘Standards for Gynaecology and Standards for Maternity’ sets out clear standards for the level of care provided to help women and their partners experiencing pregnancy loss, including the availability of skilled staff to support parents following a stillbirth or miscarriage. A number of trusts now employ specialist bereavement midwives to provide this support.
Local NHS maternity care providers are responsible for ensuring parents receive appropriate information on bereavement support and services following the death of a baby. To complement information provided locally, information on support for parents after a stillbirth is available on the NHS Choices website at:
http://www.nhs.uk/Conditions/Stillbirth/Pages/Getting-help.aspx
Maidstone and Tunbridge Wells NHS Trust
Sir John Stanley: To ask the Secretary of State for Health what specific steps he will take to place the Maidstone and Tunbridge Wells NHS Trust on a stable and secure long-term financial footing. [197156]
Dr Poulter: The National Health Service Trust Development Authority (TDA) is working with the trust to determine its financial recovery plans. The trust’s five-year sustainability plan is currently being developed, and is due to be submitted on 20 June 2014.
The NHS TDA has also been involved in the recruitment of the trust’s new finance director, and is supportive of the appointment of the trust’s turnaround director.
NHS West Kent clinical commissioning group is also working with the trust to ensure its future sustainability.
Meat
Kerry McCarthy: To ask the Secretary of State for Health what assessment he has made of the risk that meat not fit for human consumption could enter the human supply chain; and what steps his Department is taking to reduce such risks. [196600]
Jane Ellison:
Food businesses have responsibility for producing safe meat. The Food Standards Agency (FSA) makes sure that meat not fit for human consumption does not enter the food chain, through the deployment of staff carrying out official controls or through the work of local authorities nationally. The provision of
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monitoring, sampling, surveillance and inspection across the links of the food chain are carried out in approved and registered food businesses. The legislation governing the production of meat is set out in various European Union and national regulations.
enforcement of strict regulatory standards and assessment of records relating to Food Business Operators’ food safety management systems;
approval and registration of meat premises ensuring that only premises that meet the minimum standards set may operate;
identification and labelling, animal health, animal welfare and veterinary hygiene activities;
the enforcement of EU and national rules relating to production and processing of meat, and its storage and distribution is assessed through risk-based audits and unannounced inspections;
a network of veterinary research laboratories following sampling activities to test meat products for veterinary medicine residues, campylobacter etc.;
close co-operation with the FSA and other Government Agencies on food safety issues;
reporting of food fraud issues and wider cascade of topical areas of concern for focused attention and actions; and
reporting of meat rejection results for disease surveillance and assessing the risk with a view to disease eradication and control programmes.
In slaughterhouses, official veterinarians carry out checks on live animals presented for slaughter, with inspectors carrying out post-mortem inspection checks of carcases and offal. In accordance with EU and national legislation, only meat that has passed stringent safety checks by the FSA will be health marked and allowed to enter the food chain.
Medical Records: Databases
Mr Godsiff: To ask the Secretary of State for Health in what ways NHS patient data extracted under care.data can be retrieved. [196587]
Dr Poulter: When a patient objects to information about them leaving the general practitioner practice and/or the Health and Social Care Information Centre (HSCIC), the objection will be applied from the point at which they object. Patients can also make a request for any information that identifies them to be removed from the different data collections. A patient can do this by contacting the HSCIC. To do this they need to complete a form available on the HSCIC website:
www.hscic.gov.uk/policyprocs
Mr Godsiff: To ask the Secretary of State for Health what payment the Health and Social Care Information Centre received for allowing PA Consulting to use NHS data. [196592]
Dr Poulter: The Health and Social Care Information Centre's predecessor organisation, the NHS Information Centre, received a not-for-profit charge for administering the application process and the preparing of data extracts. A charge of £2,155 excluding VAT was made to PA Consulting.
Mr Godsiff: To ask the Secretary of State for Health for what reason no risk assessment was made of the care.data programme; and which Minister in his Department authorised not making such an assessment. [196619]
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Dr Poulter: There has been no decision made not to have a risk assessment for the care.data programme. Risks and issues are considered by the care.data programme board at regular meetings.
Mr Godsiff: To ask the Secretary of State for Health pursuant to the answer of 7 April 2014, Official Report, column 44W, on medical records: databases, to which new legislation under consideration by Parliament that answer refers. [196699]
Dr Poulter: The new legislation under consideration by Parliament that the answer of 7 April refers to is the Health and Care Bill currently being considered by Parliament. It was last debated in the House of Commons on 11 March.
Mr Godsiff: To ask the Secretary of State for Health pursuant to the answer of 13 March 2014, Official Report, column 357W, on medical records: databases, if he will publish the Major Projects Authority's assurance process carried out for care.data. [196700]
Dr Poulter: The care.data programme is presently under review by the Major Project Authority in line with their standard assurance processes.
Mr Godsiff: To ask the Secretary of State for Health pursuant to the answer of 13 March 2014, Official Report, column 356W, on medical records: databases, whether all third parties to which identifiable NHS patient data have been disclosed under care.data will be routinely audited to ensure that the terms of the agreement are being followed. [196701]
Dr Poulter: No data have been collected or provided yet under the care.data programme. The Health and Social Care Information Centre is implementing plans to strengthen its audit capabilities in relation to data sharing.
Mr Godsiff: To ask the Secretary of State for Health pursuant to the answer of 13 March 2014, Official Report, column 355W, on medical records: databases, what data sharing agreements have been made by the (a) NHS Information Centre and (b) Health and Social Care Information Centre which permit the provision of additional data post 31 March 2014. [196702]
Dr Poulter: The circumstances in which the NHS Information Centre (NHSIC) and the Health and Social Care Information Centre (HSCIC) permit the provision of additional data post 31 March 2014 are:
NHSIC made an agreement for ongoing provision of data post 31 March 2014;
HSCIC made an agreement for ongoing data provision between 1 April 2013 and 31 March 2014; and
HSCIC has provided data after 31 March 2014.
For data provided to researchers, the approval is given once and then only provided on an ongoing basis, subject to review. Applications which are still live and may receive data will have been made prior to 1 April 2013 by the NHSIC.
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HSCIC has announced a review of all data releases made by the NHSIC. This review is being led by Sir Nick Partridge and will be published before the end of May 2014.
Lists of the data sharing agreements made by NHSIC and HSCIC which permit the provision of additional data post 31 March 2014 have been placed in the Library.
Mr Godsiff: To ask the Secretary of State for Health pursuant to his answer of 13 March 2014, Official Report, column 358W, on medical records: databases, on what date the extraction requirement for care.data will be finished; and whether that requirement will be publicly available. [196733]
Dr Poulter: The General Practice Extraction Service Independent Assurance Group discussed an updated customer requirement for NHS England’s care.data programme at the 27 March 2013 meeting. At the meeting, the board agreed by majority vote that this requirement should proceed.
A copy of this document can be found on the Health and Social Care website at the following link:
www.hscic.gov.uk/media/11705/Care-Data-IAG-Submission-Template---27-March-2013-NIC-178106-MLSXW/pdf/Care_Data_IAG_Submission_Template_-_27_March_2013_(NIC-178106-MLSXW).pdf
Mental Health Services: Children
Seema Malhotra: To ask the Secretary of State for Health what systems are in place for recording and publication of children's deaths in psychiatric hospitals who had been either forcefully detained or voluntary in-patients; and to which authority such deaths are reported. [196780]
Norman Lamb: From 1 April 2008, all Local Safeguarding Children Boards (LSCBs) have had a statutory responsibility to review the deaths of all children from birth (excluding still born babies) up to 18 years, who are normally resident within their area. This is known as the Child Death Review Process. Their responsibilities include setting up a Child Death Overview Panel which reviews child deaths on behalf of the LSCB. This would include deaths in psychiatric in-patient settings. The following link presents data collected from LSCBs in England to the year ending 31 March 2013.
www.gov.uk/government/publications/child-death-reviews-year-ending-31-march-2013
The Care Quality Commission (CQC) is currently developing a system of Intelligent Monitoring for Mental Health services; it is considering which indicators, including those that relate to Serious Untoward Incidents, to include in it. This will include children and young people.
The CQC is the official source of information on deaths of patients subject to the Mental Health Act. A link to the CQC’s “Monitoring the Mental Health Act 2012/13” is:
www.cqc.org.uk/sites/default/files/media/documents/cqc_mentalhealth_2012_13_07_update.pdf
Further information can be obtained from:
The Care Quality Commission (CQC)
public.affairs@cqc.org.uk
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Seema Malhotra: To ask the Secretary of State for Health how many children of each (a) age and (b) gender have died while in-patients (i) at psychiatric hospitals in total as either forcefully detained or voluntary in-patients and (ii) in each institution in each year since 2000. [196781]
Norman Lamb: Since April 2008 all Local Safeguarding Children Boards have had a statutory duty to review the death of all children from birth to age 18. Statistics on these Child Death Reviews are collated and published by the Care Quality Commission (CQC) and are available on the CQC’s website:
www.gov.uk/government/collections/statistics-child-death-reviews
Statistics on the location of child deaths are available from 2010 onward and show that in this time, no child has died in an in-patient mental health unit.
According to data from the Mental Health Act Commission, six females and one male under 18 died between 2003 and 2008. Owing to patient confidentiality these figures cannot be broken down to each institution.
Seema Malhotra: To ask the Secretary of State for Health what systems and controls are in place for recording, monitoring and oversight of the use of force and restraint against children receiving psychiatric in-patient care. [196782]
Norman Lamb: The Department does not currently collect data on restraint.
The Department is planning on categorising physical restraint as a patient safety incident. All incidents of restraint against children receiving psychiatric in-patient care will need to be reported to the National Reporting and Learning System.
Mental Health Commissioners visit patients detained under the Mental Health Act, including children, and review all aspects of their care, including restraint.
Plans for the monitoring and oversight of restraint in psychiatric in-patient services will form part of the Care Quality Commission’s (CQC’s) new inspection approach for all hospitals. The CQC is currently consulting on its handbooks for all sectors and has set out its planned approach to assessing services against five questions: Are they safe? Are they effective? Are they caring? Are they responsive? Are they well-led? Restraint will be reviewed in services against the question of whether the service is safe, and the CQC is developing guidance for both providers and inspection teams that will draw upon good practice guidance and tools. For children’s psychiatric services specifically, this would require specific key lines of inquiry to be used.
The CQC is planning to work with the NHS Confederation to look at how the CQC expects providers to implement the guidance as set out in ‘Positive and Safe’ and how this will be used in our monitoring and oversight approaches. ‘Positive and Safe’ is a two-year programme with the principal aim to radically reduce all restrictive interventions, including ending the deliberate use of face-down restraint and—outside the Mental Health Act—seclusion. The work group will be preparing guidance on restraint in the light of ‘Positive and Safe’ and using this to inform CQC tools and inspection methodology. The CQC always considers providers’ approaches to restraint when carrying out comprehensive
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inspections. Mental Health Act monitoring visits to in-patient units will also look at individual concerns relating to restraint practices. The methodology for all reviews and inspections which the CQC carries out is informed by the available guidance and the Mental Health Act Code of Practice.
Mental Health Services: Young People
Luciana Berger: To ask the Secretary of State for Health what estimate his Department has made of the increase in demand for child and adolescent mental health following the launch of the MindEd e-portal; and what steps it is taking to accommodate that increase. [196448]
Norman Lamb: The Department has not made an estimate of the increase in demand for child and adolescent mental health following the launch of the MindEd e-portal on 25 March 2014.
We know that many schools want to do more to help children who are, or may be, experiencing mental health problems. Many now have their own programmes and mental health support, such as a school-based counsellor, while others have whole school approaches to mental and emotional health. We want to ensure that such programmes offer the best support possible, but also that schools are better able to identify mental health problems in their pupils sooner.
The Department funded the MindEd website, which will help anyone working with children, including all school staff, to spot the signs of mental health problems in children and help them get the support they need. Spotting the signs of mental health problems early in children and young people is essential to prevent problems from escalating and continuing into adulthood.
The Chief Medical Officer has recommended better data on children and young people’s mental health. The Department, with arm’s length bodies (ALBs) and other key partners, is currently looking at the options available for arranging a survey of children and young people to look at prevalence of mental health conditions. We are seeking advice from colleagues in the Department’s Health and Social Care Information Centre to consider options for the survey, and what such a survey would be able to tell us.
Seema Malhotra: To ask the Secretary of State for Health what proportion of places for children and adolescents receiving mental health services are publicly funded; and what proportion of such places are provided by (a) private and (b) public sector health care institutions. [196783]
Norman Lamb: NHS England holds only information on beds for children and adolescents receiving mental health services that are funded by the national health service (i.e. publicly funded). The NHS commissions 474 beds for children and adolescents receiving mental health services from independent providers and 783 beds from the NHS.
Mental Illness
Andrew Bingham: To ask the Secretary of State for Health (1) what criteria his Department use to define illness as mental as opposed to physical; [196245]
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(2) what proportion of NHS funding is allocated to (a) mental and (b) physical health care; [196254]
(3) what estimate has he made of the cost to the economy of untreated mental illness. [196255]
Norman Lamb: The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.
The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.
Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments, which is recorded as a separate programme category.
It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example learning disabilities, neurological and social care.
The Department has made no estimate of the cost to the economy of untreated mental illness.
Midwives
Tracey Crouch: To ask the Secretary of State for Health what recent assessment he has made of the benefits of all expectant mothers being assigned one specific midwife for the duration of their pregnancy in ensuring (a) continued care, (b) correct information being received and (c) prevention of stillbirth. [196272]
Dr Poulter: The benefits of pregnant women being cared for by a named midwife are widely recognised. The latest available evidence for antenatal clinical practice was considered as part of the development of the National Institute for Health and Care Excellence’s (NICE) Quality Standard for antenatal care in 2012. Based on this evidence, NICE recommends that pregnant women are cared for by a named midwife who is responsible for providing all or most of her antenatal and postnatal care and the women’s coordinating care should they not be available.
The Care Quality Commission’s 2013 survey of women’s experiences of maternity care found that women who saw the same midwife each time tended to report more positive experiences of antenatal and postnatal care.
Health Education England is currently leading a project to explore the ambitions for personalised maternity care and consider different scenarios for how maternity services could be configured in the future, including the capability and capacity of the workforce.
Tracey Crouch: To ask the Secretary of State for Health whether he is satisfied with the current levels of recruitment to midwifery; and what steps he is taking to encourage recruitment of midwives. [196275]
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Dr Poulter: Health Education England is working with NHS England to ensure that sufficient midwives and other maternity staff are trained and available to provide every woman with personalised one-to-one care throughout pregnancy, childbirth and during the post-natal period.
Since June 2012, there are over 6,000 more midwives in training to qualify over the next three years. The latest figures show there are 21,888 qualified midwives (full-time equivalent) working in the NHS in England.
It is the responsibility of local NHS organisations to assess the health needs of their local communities and ensure they have the right staff with the right skills to deliver high-quality and safe care.
NHS England
Mr Jamie Reed:
To ask the Secretary of State for Health pursuant to the answer of 28 April 2014,
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Official Report,
column 460W, on NHS England, with reference to the people referred to in the answer who have taken up jobs at NHS England from his Department, what their job titles and salary levels
(a)
were at his Department and
(b)
are at NHS England. [197187]
Dr Poulter: The information requested is shown in the table.
It should be noted that the size and scope of the new NHS England director roles were formally evaluated and the salary reflects the significantly more complex nature of each role compared to the previous roles at the Department. In any case, the posts concerned are not directly comparable, particularly in salary terms, since one body employs staff on civil service pay and conditions and the other employs on national health service pay and conditions of service.
NHS: Management Consultants
Mr Jamie Reed: To ask the Secretary of State for Health how much (a) NHS England, (b) Clinical Commissioning Groups, (c) Commissioning Support Units and (d) Monitor spent on consultancy workers in the last financial year. [197320]
Dr Poulter: As final year accounts have not yet been produced for Monitor or for NHS England, it is not at this time possible to give actual spend figures for 2013-14.
NHS: Procurement
Mr Jamie Reed: To ask the Secretary of State for Health how much NHS England spent on tendering for clinical services in 2013-14. [197353]
Dr Poulter: NHS England has advised that it does not hold information on spend on tendering for clinical services. Staff payroll costs will form the majority of the cost of any tendering process and it is not possible to determine what proportion of each individual staff member’s time is spent on this work.
NHS: Standards
Mrs Moon: To ask the Secretary of State for Health whether the online system for members of the public to compare hospitals on the basis of safety indicators will include information on cases in which patients with conditions such as Parkinson's have not received their medication on time; and if he will make a statement. [196342]
Dr Poulter: We are working with NHS England to prepare for the publication on NHS Choices of an extended set of patient safety indicators later this year. These indicators are being gathered together in a manner that will allow patients to compare local hospitals on the basis of a more rounded picture of safety performance than has been previously available in one place. The initial focus of this presentation will be on indicators that are relevant to the general population of hospital inpatients and for which information is available. There is not currently, to our knowledge, a suitable source of data regarding delayed medication for those being treated for diseases such as Parkinson’s.
NHS: Training
Tracey Crouch: To ask the Secretary of State for Health what steps he is taking to ensure NHS staff have the appropriate training to communicate effectively and compassionately with patients at difficult times in the diagnosis and treatment process; and if he will make a statement. [196260]
Dr Poulter:
The content and standard of health care professional training is the responsibility of health care
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regulators, which are independent statutory bodies. They have the general function of promoting high standards of education and co-ordinating all stages of education to ensure that students and newly qualified professionals are equipped with the knowledge, skills and attitudes essential for professional practice.
The Government have mandated Health Education England (HEE) to provide national leadership on education, training and work force development in the national health service. HEE will work with stakeholders to influence training curricula as appropriate.
The Government have announced a series of actions that demonstrate its commitment to creating a culture of openness, candour, learning and accountability in an NHS which puts compassion at its heart. These include: placing compassionate care at the heart of the training and recruitment of NHS staff; implementing the Compassion in Practice strategy for nursing and midwifery; and a new care certificate for health care assistants.
Ophthalmology
Mr Gibb: To ask the Secretary of State for Health (1) what the waiting time is for new routine referrals to ophthalmology in each NHS hospital trust area; [196995]
(2) what the waiting time is for a routine new referral to ophthalmology in the Western Sussex Hospitals Trust area; and if he will make a statement. [196996]
Dr Poulter: Information on the median average waiting time for patients waiting to start consultant-led ophthalmology treatment for all national health service trusts and NHS foundation trusts in England is shown in the following table.
Latest data for February 2014 show that the median average waiting time for patients waiting to start consultant-led ophthalmology treatment in the Western Sussex Hospitals NHS Foundation Trust is 8.6 weeks.
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|
Luton And Dunstable University Hospital NHS Foundation Trust | |
|
Norfolk And Norwich University Hospitals NHS Foundation Trust | |
|
Royal Liverpool And Broadgreen University Hospitals NHS Trust | |
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|
The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust | |
|
The Royal Bournemouth And Christchurch Hospitals NHS Foundation Trust | |
6 May 2014 : Column 145W
| Notes: 1. Median waiting times are calculated from aggregate data, rather than patient level data, and therefore are only estimates of the position on average waits. 2. Median waiting times are not calculated for organisations (and treatment functions) with less than 50 pathways in the month. 3. The following trusts did not submit any RTT incomplete pathway data for February 2014: - Barnet and Chase Farm Hospitals NHS Trust; - Barking, Havering & Redbridge NHS Trust; - Derby Hospitals NHS Foundation Trust; - Tameside Hospital NHS Foundation Trust; - The Whittington Hospital NHS Trust; and - Ipswich Hospital NHS Trust. | |
Paediatrics
Tracey Crouch: To ask the Secretary of State for Health what assessment he has made of the effect on NHS service provision for seriously ill children and their families of the specialist senior nurses posts funded by the charity Well Child. [196249]
Dr Poulter: We have not made any central assessment of this role. We are aware of the valuable work which Well Child does, and we were able to support Well Child with a grant in 2010-11 from the £19 million we made available for funding local schemes to support children’s palliative care services.
We understand that Well Child funds each nurse for a period of three years, after which time the individual national health service health provider commits to continue the post. Each nurse is employed and managed by the
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local health care trust in which they work and therefore it would seem that the providers would be best placed to comment on the impact they have made.
Tracey Crouch: To ask the Secretary of State for Health what steps he is taking to ensure that numbers of community children's nurses meet future demand; and if he will make a statement. [196251]
Dr Poulter: The Secretary of State has delegated to Health Education England (HEE) the responsibility for delivering a better health and healthcare workforce for England. HEE plans and develops the workforce to ensure a secure workforce supply for the future, balancing need against demand. HEE’s Workforce Plan, published in December 2013, confirmed an increase of 31 (1.4%) in education and training commissions for children’s nurses for 2014-15.
The local education and training boards, which are sub-committees of HEE, work with local providers, including employers, to contribute to HEE’s overall future workforce plan. It is the responsibility of employers to ensure they have the right staff, with the right skills, to deliver high-quality care, which includes supporting their continuing professional development.
Tracey Crouch: To ask the Secretary of State for Health how many children of what age have spent three months or more continuously in hospital in each local health authority in each of the last five years. [196252]
Dr Poulter: Information is not available by local health authority. The following table gives information by strategic health authority (SHA) of the number of children (by age bands) up to 18 years who have spent more than three months in hospital in the last five years for which information is available.
| Count of finished discharge episodes (FDEs)1 for children up to and including 18 years of age with a length of stay2 of more than three months for the years 2008-09 to 2012-133 by strategic health authority of treatment | ||||||||
| Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector | ||||||||
| Age Group | ||||||||
| SHA Code | Description | 0 | 1-4 | 5-9 | 10-14 | 15-18 | Total | |
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| 1Finished discharge episodes (FDEs) A discharge episode is the last episode during a hospital stay (a spell), where the patient is discharged from the hospital or transferred to another hospital. 2Length of stay (duration of spell) The difference in days between the admission date and the discharge date (duration of spell), where both dates are given. For the purposes of this analysis records with a length of stay greater than 90 days have been included. 3 Assessing growth through time (In-patients) HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, changes in activity may be due to changes in the provision of care. Note: Small numbers: To protect patient confidentiality, figures between 1 and 5 have been replaced with “*” (an asterisk). Where it was still possible to identify figures from the total, additional figures have been replaced with "*". Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | ||||||||
Palliative Care
Dr Wollaston: To ask the Secretary of State for Health what recent assessment he has made of the data collected by the Palliative Care Funding Review Pilot sites; and whether enough data have been collected to allow a decision to be made before the end of this Parliament on implementing free social care at the end of life. [196585]
Norman Lamb: NHS England is due to receive the health and social care data from the Palliative Care Funding Review Pilots by the end of May. Once these data have been analysed, this will form the evidence base for a decision on free social care at the end of life, along with wider policy and financial considerations.
Parkinson’s Disease
Mrs Moon: To ask the Secretary of State for Health (1) what assessment he has made of the reduction of avoidable harm by better medicines reconciliation for hospital patients with Parkinson's; [196344]
(2) what steps he is taking to improve reporting of instances in which the medication regimes of hospital patients with Parkinson's are disrupted through delays or errors in medicines reconciliation; and if he will make a statement. [196360]
Norman Lamb: The Department has made no such assessment.
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The National Institute for Health and Care Excellence (NICE) and the National Patient Safety Agency (NPSA) issued joint guidance, ‘Technical patient safety solutions for medicines reconciliation on admission of adults to hospital’ in December 2007, which aims to reduce medication errors, which occur most commonly on transfer between care settings and on admission to hospital. This guidance applies to all patients, including those with Parkinson’s disease, and is available at:
www.nice.org.uk/nicemedia/live/11897/38560/38560.pdf
The NPSA also issued a Rapid Response Report on ‘Reducing harm from omitted and delayed medicines in hospital’ in February 2010. This makes reference to medicines where timeliness of administration is crucial, including those for Parkinson’s disease. This is available at:
www.nrls.npsa.nhs.uk/alerts/?entryid45=66720
NICE, the NPSA and the Royal Pharmaceutical Society have all identified the key role of pharmacists in medicines reconciliation and the majority of hospitals now have pharmacists on admission wards to help ensure patients’ medicines are reconciled promptly.
A strong reporting culture, where safety incidents are reported and monitored, is essential to improving safety for all patients, including those with Parkinson’s disease. NHS England and the ‘Medicines and Healthcare products Regulatory Agency’ jointly issued two patient safety alerts on 20 March 2014 to help health care providers increase incident reporting for ‘medication errors’ and ‘medical devices’. The alerts instruct providers to take specific steps that will improve data reporting quality; and will see the establishment of national networks to maximise learning and provide guidance on minimising harm relating to these incident types.
The measures announced by the Secretary of State for Health, the right hon. Member for South West Surrey (Mr Hunt), on 26 March, as part of his invitation to NHS organisations to ‘Sign up to Safety’, are also likely to lead to an increase in the number of reported incidents of harm in the national health service even though care will be getting safer.
Pharmacy
Dr Offord: To ask the Secretary of State for Health (1) what steps he has taken to increase public understanding of the services offered by independent pharmacies; [196241]
(2) what assessment his Department has made of the role independent pharmacies play in relieving pressures on other health and welfare services; and what steps he has taken to disseminate best practice. [196239]
Norman Lamb: Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high-quality care and support, improving people’s health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long-term conditions and helping make sure patients and the national health service get the best use from medicines.
NHS England’s public consultation, “Improving care through community pharmacy—a call to action”, which closed on 18 March 2014, has provided an important
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opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:
www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/
In the meantime, NHS England’s “The earlier, the better” campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and to reduce pressures on other parts of the NHS.
On 14 April 2014, the Department and NHS England published “Transforming Primary Care—Safe, proactive, personalised care for those who need it most”. This sets out plans for more proactive, personalised and joined- up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.
Policy
Mr O'Brien: To ask the Secretary of State for Health in what circumstances he uses a calculation of the (a) value of preventing a fatality, (b) willingness to pay and (c) cost-per-quality adjusted life year approach to quantify the value of a policy intervention; what other tools he uses to quantify the benefit of a policy intervention; and if he will make a statement. [196464]
Dr Poulter: The Green Book and associated supplementary guidance is publicly available on the Treasury website. It sets out a range of approaches and methods that may be appropriate in a number of different appraisal circumstances.
Post-traumatic Stress Disorder
Luciana Berger: To ask the Secretary of State for Health what estimate he has made of the number of people diagnosed with post-traumatic stress disorder in the last five years. [196484]
Norman Lamb: We do not collect the information requested centrally. However, the survey Adult Psychiatric Morbidity in England—2007 found that, overall, 3.0% of adults screened positive for current post-traumatic stress disorder (PTSD).
The King’s Centre for Military Health Research recently published ‘The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity’, which also recognises that PTSD rates in the United Kingdom general population are approximately 3%.
Prescription Drugs
Paul Flynn: To ask the Secretary of State for Health what steps he is taking to ensure the prescription of drugs by doctors is not influenced by financial payments from pharmaceutical companies. [196748]
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Norman Lamb: The offer of gifts and benefits to health care professionals is strictly regulated under Regulation 300 of the Human Medicines Regulations 2012. This provides that, where medicines are being promoted to health care professionals who prescribe or supply medicines, no gift, pecuniary advantage or benefit may be offered or supplied unless it is inexpensive and relevant to the practice of medicine or pharmacy. The Medicines and Healthcare products Regulatory Agency or the industry self-regulatory body, the Prescription Medicines Code of Practice Authority, would investigate any complaint about inappropriate payments made by pharmaceutical companies under this regulation.
Prescriptions
Mr O'Brien: To ask the Secretary of State for Health what discussions officials in his Department have had with the National Institute for Health and Care Excellence (NICE) on the development of NICE's highly specialised technologies programme since 1 January 2014; what the content of those discussions was; and if he will make a statement. [196411]
Norman Lamb: Departmental officials have had no such discussions. Officials may discuss individual highly specialised technology topics with the National Institute for Health and Care Excellence, including at the topic selection stage.
Mr O'Brien: To ask the Secretary of State for Health how the National Institute for Health and Care Excellence (NICE) assesses the cost-effectiveness of an intervention when the data available are uncertain; what assessment NICE has made of the average range around the most plausible cost-per-QALY in its technology appraisals; and if he will make a statement. [196424]
Norman Lamb: The National Institute for Health and Care Excellence (NICE) follows a rigorous process in the appraisal of technologies to ensure that judgments regarding the cost-effective use of NHS resources are consistently applied. This includes consideration of the uncertainty generated where available data have serious limitations.
When making judgments on cost-effectiveness, the NICE appraisal committee will consider a number of factors, including the strength of the clinical-effectiveness evidence, the innovative nature of the technology, the robustness and plausibility of the economic models, the degree of certainty around the incremental cost-effectiveness ratio (ICER), the range and plausibility of the ICERs and the likelihood of decision error and its consequences. Full details of how the Committee takes uncertainty into account is contained within sections 5.8, 6.3 and 6.4 of NICE’s Guide to the Methods of Technology Appraisal 2013, which is available at:
http://publications.nice.org.uk/guide-to-the-methods-of-technology-appraisal-2013-pmg9
NICE advises that it has not carried out an assessment of the average range around the most plausible cost-per Quality Adjusted Life Year (QALY) in its technology appraisals. We understand that although NICE usually specifies the most plausible cost-per-QALY for each technology appraisal, it does not normally specify a range for this assessment.
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Mr O'Brien: To ask the Secretary of State for Health if he will discuss with the National Institute for Health and Care Excellence (NICE) ensuring that assessments of treatments by NICE conducted through (a) normal technology appraisals and (b) highly specialised technology appraisals is consistent in its (i) engagement with stakeholders and (ii) wider methodological approaches. [196428]
Norman Lamb: We have no plans to do so. As an independent body, the National Institute for Health and Care Excellence is responsible for developing its methods and processes and applying them consistently.
Mr O'Brien: To ask the Secretary of State for Health pursuant to the answer of 31 March 2014, Official Report, column 491W, on medical treatments, what technology appraisals were conducted by the National Institute for Health and Care Excellence in the last five years; what the most plausible cost per quality adjusted life-year for each such appraisal was; what the estimated eligible patient population was for each appraised indication; on which appraisals end-of-life criteria were applied in each final appraisal determination; and on which date each such appraisal was (a) initiated and (b) concluded. [196429]
Norman Lamb: National Institute for Health and Care Excellence (NICE) technology appraisal decisions published between 2000 to end of February 2014 have already been placed in the Library.
NICE has advised that it does hold the most plausible cost per quality adjusted life-year for each technology appraisal, the estimated patient population for each appraised indication, details of appraisals where the end-of-life criteria were applied in each final appraisal determination and the dates each appraisal was initiated and concluded. However, this information could be provided only at disproportionate cost.
Psoriasis
Mrs Gillan: To ask the Secretary of State for Health (1) what data requirements are necessary to precipitate the development of Clinical Commissioning Group Outcome Indicators based on quality statements 1 and 2 of the NICE quality standard on psoriasis; [196784]
(2) if he will take steps to transpose quality statements 1 and 2 of the NICE quality standard on psoriasis into Clinical Commissioning Group Outcome Indicators. [196785]
Norman Lamb: I refer the right hon. Member to the written answer I gave her on 9 April 2014, Official Report, columns 262-63W.