Victim Support Schemes: North Yorkshire
Hugh Bayley: To ask the Secretary of State for Justice how much core grant was provided to fund Victim Support services in the (a) Crown Court Witness Service and (b) Magistrates Court Witness Service in North Yorkshire in each year since 2004-05. [198526]
Damian Green: The Ministry of Justice provides a core grant of £38 million to Victim Support of which £12 million is used to fund the provision of emotional and practical support for witnesses at criminal courts who wish to receive this service.
The Ministry of Justice does not routinely collect data on how this funding is distributed by Victim Support.
Health
Air Pollution
Luciana Berger: To ask the Secretary of State for Health with reference to the answer of 8 April 2014, Official Report, column 178W, from the Parliamentary Under-Secretary of State for Health, on air pollution, for what reasons an assessment has not been made of the deaths caused by short-term exposures to elevated levels of air pollutants in the years since 2010. [200164]
Jane Ellison: Estimates of deaths attributable to long-term exposure to particulate air pollution in United Kingdom local authorities in 2010 were published by Public Health England in April 2014. The mortality burden for the UK was estimated as an effect equivalent to nearly 29,000 deaths.
Public Health England does not routinely estimate the deaths associated with short-term exposure to elevated levels of air pollutants, as these effects are thought to
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overlap with the mortality effects of long-term exposure to air pollution. Long-term exposure to air pollution is understood to be a contributory factor to deaths from respiratory and, particularly, cardiovascular disease, for example, unlikely to be the sole cause of deaths of individuals. This means that it is likely that air pollution contributes a smaller amount to the deaths of a larger number of exposed individuals rather than being solely responsible for a number of deaths equivalent to the calculated figure of ‘attributable deaths’.
Ambulance Services: Yorkshire and the Humber
Dan Jarvis: To ask the Secretary of State for Health what the average ambulance response times in (a) Doncaster, (b) Barnsley, (c) Rotherham and (d) Sheffield was in each year since May 2010; and what the national average response time was in each of those years. [200245]
Jane Ellison: The information is not available in the format requested. Such information as is available is shown in the following table.
Information is not available before 2011.
| Median ambulance response times to treatment for category A1 (red 1 and red 2 calls require staff to arrive at the scene of the incident within eight minutes in 75% of cases) calls for Yorkshire Ambulance Service NHS Trust, April 2011 to April 2014 | |
| Month | Median time to treatment for Category A calls (in minutes) |
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| 1 Category A calls are defined as those that are the result of immediately life threatening incidents. Note: It is not possible to calculate the median time to treatment for England from the medians for individual Ambulance Trust. Source: Ambulance quality indicators, NHS England www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators | |
Armed Forces: In Vitro Fertilisation
Luciana Berger: To ask the Secretary of State for Health for what reasons the policy of NHS England on the number of cycles of IVF it provides to armed forces personnel is to provide fewer than the number recommended by National Institute for Health and Care Excellence. [200338]
Jane Ellison: NHS England has a number of interim policies in place, including the policy for the provision of in vitro fertilisation (IVF) for armed forces personnel.
A review of the interim policy in relation to the provision of IVF for armed forces personnel has recently been undertaken. Following detailed costing of a move to the levels recommended in the National Institute for Health and Care Excellence guideline, it was agreed in May 2014 to increase the number of cycles of IVF to three if clinically appropriate and if eligibility criteria are met.
Cancer
David Heyes: To ask the Secretary of State for Health what discussions his Department has had with Public Health England over a possible nationwide roll-out of the recent Be Clear on Cancer pilot study for oesophago-gastric cancer in the North East. [199746]
Jane Ellison: We want to lead the world in cancer care and are investing over £750 million, over four years up till 2014-15, including £450 million in the early diagnosis of cancer, including oesophago-gastric cancers.
The earlier diagnosis money is designed to support earlier diagnosis of cancer by improving public awareness of cancer signs and symptoms through centrally-funded Be Clear on Cancer campaigns; increasing general practitioner access to key diagnostic tests; and to pay for extra testing and treatment in secondary care.
Be Clear on Cancer campaigns are tested at a local and regional level, before a decision is taken on whether to run them nationally throughout England. Following a local pilot which ran from April to July 2012, we ran a regional Be Clear on Cancer pilot campaign from 10 February to 9 March 2014 raising awareness of the signs and symptoms of oesophago-gastric cancer in the north-east and north Cumbria. The campaign included television, radio, press and outdoor advertising. The findings of this pilot are being evaluated by Public Health England, which works closely with the Department and NHS England to ensure that health care professionals are targeted with campaign information to encourage
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earlier diagnoses and referrals, before a decision is taken on whether to roll out the campaign nationally throughout England.
Luciana Berger: To ask the Secretary of State for Health what discussions he has had with the National Clinical Director for Cancer on the performance of the NHS against the waiting time targets for cancer treatment. [200342]
Jane Ellison: The Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), has had a number of discussions with senior members of NHS England’s executive team on the performance of the national health service against the waiting time targets for cancer treatment, but not with the National Clinical Director for Cancer.
Continuing Care
Mr Betts: To ask the Secretary of State for Health what steps his Department is taking to ensure that the Clinical Priorities Advisory Group takes account of evidence from (a) patients, (b) clinicians and (c) patient groups when making decisions on the availability of treatments for progressive conditions. [199558]
Jane Ellison: NHS England has advised that the Clinical Priorities Advisory Group (CPAG) is an advisory group and not a decision-making body. It considers policy and makes recommendations to the Directly Commissioned Services Committee which makes the final decisions on NHS England's commissioning position.
The group's membership includes four Patient and Public Voice members and senior clinicians from NHS England. The policies that are presented to CPAG for consideration are developed by Clinical Reference Groups (CRGs) who are made up of patients, clinicians, and key stakeholders including patient groups. These members are involved in the development of policies.
Prior to submission of any documents to CPAG, a two week stakeholder testing phase is undertaken where registered CRG stakeholders, including clinicians, patients, and patient groups, as well as industry, have an opportunity to make comments. These are considered as well as the evidence base for the policy by CPAG.
Cystic Fibrosis
Chi Onwurah: To ask the Secretary of State for Health if he will review prescription charges for adults with cystic fibrosis. [200281]
Dr Poulter: In 2010, responding to Professor Sir Ian Gilmore’s review into extending entitlement to free prescriptions to all those with a long-term condition, the Government made clear that in light of the challenging financial context, no changes would be made to the current list of exemptions. Prescription charges in England raise valuable income, in the region of £450 million each year, which helps the national health service to maintain vital services for patients.
The extensive system of exemption arrangements, including for those on low incomes who may struggle to pay for their prescriptions, which is in place means that around 90% of all prescription items are already dispensed free of charge. Prescription prepayment certificates (PPCs) are also available for those who have to pay NHS
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prescription charges and need multiple prescriptions. This is the fifth year the cost of an annual certificate, and the third year the cost of a three-month certificate, have been frozen. Both certificates will also remain at £104 and £29.10 respectively, next year. There is no limit to the number of items that can be obtained through a PPC. The annual certificate benefits anyone needing more than 12 items a year, and the three-month certificate, anyone needing more than three items in that three-month period.
Dementia
Mr O'Brien: To ask the Secretary of State for Health what meetings have taken place with the (a) OECD, (b) WHO and (c) European Commission following the G8 Dementia summit; and what the outcome of these meetings was. [199458]
Norman Lamb: A number of key meetings and telephone calls have taken place between departmental officials and colleagues in the Organisation for Economic Co-operation and Development. One of which was a key meeting to discuss their support to the World Dementia Council.
To maintain momentum following the G8 summit, a dementia side event was held during the World Health Assembly (the decision body of World Health Organisation (WHO)), in Geneva in May 2014. The Secretary of State for Health, the right hon. Member for South West Surrey (Mr Hunt), launched the Global Dementia and Alzheimer’s Action Alliance. This will be the first global body to bring together Government, the health and care sector, charities, the voluntary sector and wider civil society.
Dr Dennis Gillings CBE, the World Dementia Envoy and departmental officials met Margaret Chan, director general of WHO on 5 June 2014. Discussion took place in relation to supporting the World Dementia Council in an advisory capacity and the G8 declaration. Dr Chan welcomed the great efforts and leadership of the United Kingdom Government and the envoy. Dr Chan agreed to collaborate with the envoy and the UK on a joint work programme. There was also positive discussion in relation to WHO supporting further meetings and hosting platforms.
No meetings have taken place with the European Commission as yet, but plans are under way for this to happen in July 2014.
Dental Services: North West
Andrew Stephenson: To ask the Secretary of State for Health (1) how many children have been seen by a dentist in (a) Pendle constituency and (b) the North West in each of the last five years; [199656]
(2) how many people have been seen by a dentist in (a) Pendle constituency and (b) the North West in each of the last five years. [199657]
Dr Poulter: Information is not available in the format requested.
The following tables show the number of children (less than 18 years of age), and the number of patients, seen in the specified national health service organisations for dental care in the 24-month period ending 31 March each year.
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| Table 1: Number of children (less than 18 years of age) in the specified NHS organisations in the 24-month period ending 31 March each year | |||||
| 2010 | 2011 | 2012 | 2013 | 2014 | |
| Table 2: Number of patients seen in the specified NHS organisations in the 24-month period ending 31 March each year | |||||
| 2010 | 2011 | 2012 | 2013 | 2014 | |
| Notes: 1. The Health and Social Care Information Centre publishes the numbers of patients seen by an NHS dentist, including work undertaken by dentists under vocational training and orthodontic patients. It does not, however, cover dental treatment carried out in hospital under Hospital Dental Services, nor under services provided privately. 2. Latest information is available at clinical commissioning group (CCG) and area team (AT). Earlier years are only available at primary care trust (PCT) and strategic health authority (SHA). It is not possible to map earlier information to the new NHS organisation structure. 3. East Lancashire Teaching PCT and East Lancashire CCG have been provided as the closest proximity to Pendle constituency. 4. The patients seen measure shows the unique number of patients who received NHS dental care in the previous 24 months. An equivalent measure covering the 12 month period is not available. Source: The Health and Social Care Information Centre | |||||
Exercise: North West
Andrew Stephenson: To ask the Secretary of State for Health what estimate he has made of how many adults in (a) East Lancashire, (b) Lancashire and (c) the North West exercised for at least 30 minutes a week during the most recent period for which figures are available. [199551]
Jane Ellison: The Department has made no such estimate. However, the Active People Survey commissioned by Sport England measures the proportion of adults (aged 16 and over) who undertake some form of physical activity at moderate intensity (or higher). Data from the most recent survey can be found in the following table.
| Proportion of the adult population (age 16 years and over) participating in 30 or more equivalent minutes of moderate activity per week—Active People Survey (APS) data, 2012 | |
| Area | 30+ minutes (Percentage) |
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| Notes: 1. The data were collected between January 2012 to January 2013 (APS6 Quarter 2 to APS7 Quarter 1). 2. The APS is commissioned by Sport England and measures the proportion of adults (aged 16 and over) participating in sport and/or undertaking some form of physical activity at moderate intensity (or higher). 3. The survey uses a 28-day reference period to record the number of minutes of physical activity (of at least 10 minutes) and then divides the number of minutes by four to come up with a weekly average (e.g. two hours of physical activity over the 28 days equates to 30 minutes per week). Number of minutes presented is the equivalent minutes of moderate activity, which consists of moderate activity plus double the number of vigorous minutes of activity. 4. The activities included in the APS are; sport, recreational cycling and walking, walking and cycling for active travel purposes, dance and gardening. 5. The percentages are weighted to adjust the results so that they are representative of the whole population at local authority, regional and national level. 6. Further information and data are available at these websites: www.noo.org.uk/data_sources/physical_activity/activepeople www.sportengland.org/research/active_people_survey.aspx Source: Active People Survey, Sport England | |
Eyesight
Jim Shannon: To ask the Secretary of State for Health how many people had eye tinnitus in the latest period figures are available. [200073]
Dr Poulter: These data are not collected.
We understand the term ‘eye tinnitus' stems from a recent study which claims to have identified this new condition in a set of patients previously diagnosed as suffering from migraines or other neurological disorders.
Fertility
Luciana Berger: To ask the Secretary of State for Health whether the forthcoming National Institute for Health and Care Excellence quality standard on fertility will be considered for a CCG outcome indicator. [200339]
Jane Ellison: The National Institute for Health and Care Excellence (NICE) has not yet published its final quality standard on fertility. NICE’s Clinical Commissioning Group Outcomes Indicator Set (CCGOIS) Advisory Committee makes recommendations on potential indicators derived from its published guidance and quality standards for inclusion in the CCGOIS which are then considered by NHS England.
General Practitioners
Jim Fitzpatrick: To ask the Secretary of State for Health at the end of the process what assessment he has made of how many practices in (a) Tower Hamlets and (b) England will (i) lose and (ii) gain financially from the seven-year reduction of the minimum practice income guarantees. [199459]
Dr Poulter: The minimum practice income guarantee payment is unfair because practices serving very similar populations are paid very different amounts per patient. The payments are being phased out over a seven-year period to allow practices time to adjust.
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The money released by doing this will be reinvested in the basic payments made to all general medical services practices, which are based on numbers of patients and key determinants of practice workload, such as the age and health needs of patients.
NHS England has undertaken an analysis to identify the small number of practices that will lose the largest amount of funding per patient as a result of the phasing out of the minimum practice income guarantee, and will work with those practices to ensure that high quality services for their local populations are maintained.
Mr Jamie Reed: To ask the Secretary of State for Health how many training places for general practice were (a) commissioned and (b) filled in each of the last five years. [200007]
Dr Poulter: The Department set up Health Education England (HEE) to deliver a better health and healthcare workforce for England. HEE is responsible for ensuring a secure workforce supply for the future balancing need against demand, taking into account factors such as the age profile of the existing workforce, the impact of technology, and new drugs.
The Department has recognised the need to increase the general practitioner (GP) workforce and between September 2010 and September 2013 the number of full-time equivalent GPs has risen by 1,051. Additionally, the Department has included in the HEE mandate a requirement that “HEE will ensure that 50% of trainees completing foundation level training enter GP training programmes by 2016”.
Further work is being undertaken by HEE to improve applications and fill rate in to GP training to support the mandate target of 3,250 appointments into GP training by 2016 in England. This includes a review of the GP recruitment process, developing a pre-GP year to give exposure to prospective GP applicants of the specialty and careers advice for foundation doctors and medical students.
In recognition of the contribution the GP workforce makes in the NHS, HEE will also undertake additional work on GP recruitment and retention, return to practice and reducing attrition rates, all of which will play a part in increasing the GP workforce.
The following table indicates the number of posts commissioned and filled and the fill rate for GP training in England for the last five years. The number of posts has been increased for 2014 to 2,946 to support the Government’s mandate requirement for HEE to increase GP training.
| Posts commissioned | Posts filled | Percentage filled | |
| Source: HEE data. | |||
Deferment resulting from factors such as maternity leave can cause a higher than 100% fill rate in some years.
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Andrew Gwynne: To ask the Secretary of State for Health which GP practices have been identified by NHS England as potentially losing more than £3 per patient in 2014-15 following the withdrawal of the Minimum Practice Income Guarantee. [200213]
Dr Poulter: NHS England has published an anonymised list of ‘outliers’ which can be found at:
www.england.nhs.uk/wp-content/uploads/2014/02/gp-gms-practices.pdf
Because the information is commercially sensitive, details that could identify individual practices have not been released.
The Minimum Practice Income Guarantee is being phased out over a period of seven years because it is inequitable, and the money released will be reinvested into basic payments made to all General Medical Services practices.
NHS England is supporting the most affected practices.
Andrew Gwynne: To ask the Secretary of State for Health what assessment he has made of the effect of being able to access a GP appointment within 48 hours on levels of patient satisfaction. [200214]
Dr Poulter: Overall patient satisfaction is driven by a range of factors, including accessing a general practitioner (GP) appointment at a convenient time, ability to see a preferred GP and the quality of the conversation with the GP.
The Government recognise the importance of timely access to general practice. The PM Challenge Fund has allocated £50 million to pilot ways to improve access around the country, to give GPs the flexibility to meet the needs of the local population.
In addition, the new GP contract introduced a new enhanced service, which includes a commitment to same day phone consultations with a professional in the GP surgery, where necessary, for the most at risk in the population.
Mr Hoban: To ask the Secretary of State for Health with reference to the answer to the hon. Member for Suffolk Coastal of 8 January 2014, Official Report, column 265W, on general practitioners: Suffolk, how much his Department spent funding each general practice in England in 2012-13; and what spending type and GP Practice code applies in each case. [200278]
Dr Poulter: The requested information is not collected centrally. The Investment in General Practice report published by the Health and Social Care Information Centre includes the investment in General Practice and the reimbursement of drugs dispensed in General Practices at national level. A copy has been placed in the Library.
Health Centres: Burntwood
Michael Fabricant: To ask the Secretary of State for Health for what reasons NHS England has refused to proceed with the proposed new health centre for Burntwood in Staffordshire; and if he will make a statement. [199565]
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Dr Poulter: NHS England is responsible for deciding on the funding given to general practitioner (GP) practices to reimburse them for their premises costs.
We are advised that capital development schemes that had not been formally approved by former primary care trust boards by 1 October 2012 have been reviewed by NHS England. This includes the Burntwood Leisure Centre development. NHS England concluded, following assessment, that the scheme did not meet the requirements for prioritisation, and it was therefore not approved. These requirements include, but not exhaustively, service continuity, affordability and value for money. It was noted that the project had not received an unequivocally clear commitment from a number of the potential occupiers of the centre.
We understand from NHS England that discussions are ongoing regarding alternative schemes to replace the Burntwood Leisure Centre development. NHS England continues to work with the GPs and other partners.
My hon. Friend may wish to approach the NHS England Shropshire and Staffordshire Area Team for further information.
Health Services: North East
Tom Blenkinsop: To ask the Secretary of State for Health if he will meet the hon. Member for Middlesbrough South and East Cleveland to discuss the proposed closure of (a) minor injuries units at Guisborough and East Cleveland Hospitals, (b) Skelton Medical Centre, (c) Park End Clinic and (d) Skelton NHS Walk-in-Centre. [200221]
Dr Poulter: These are matters for the local national health service. The hon. Member should engage with the NHS at a local level.
The Government are committed to devolving decision-making about local NHS services to local clinicians and communities. It is general practitioners clinicians, patients and local authorities who are best placed to determine the nature of their NHS services.
Tom Blenkinsop: To ask the Secretary of State for Health what assessment he has made of the quality of provision of primary care in Middlesbrough South and East Cleveland. [200222]
Dr Poulter: No assessment has been made centrally. NHS England is responsible for the commissioning of primary care health services and for securing the best possible outcomes for patients.
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Health: Business
Luciana Berger: To ask the Secretary of State for Health what estimate his Department has made of the number of companies who have signed up to one or more pledges set out in the Responsibility Deal; and what estimate he has made of the proportion of those companies which are meeting all of the pledges they have signed up to. [200341]
Jane Ellison: 675 partners are currently signed up to the Responsibility Deal. Details of these partners, the pledges they are committed to taking action on and their annual updates are available in full on the Responsibility Deal website at:
https://responsibilitydeal.dh.gov.uk/partners/
Health: Disadvantaged
Dr Thérèse Coffey: To ask the Secretary of State for Health what assessment he has made of the performance of Public Health England in reducing inequalities of health outcomes by making improvements in (a) housing conditions and (b) employment capability. [199563]
Jane Ellison: Housing and work are two areas that influence health outcomes. In his strategic review of health inequalities, Professor Sir Michael Marmot reminded us all of the link between people’s health and “the conditions in which they are born, grow, live, work and age”.
Public Health England (PHE) has a key role in highlighting the health impact of these issues on health outcomes and health inequalities. It is undertaking a range of work on housing, homelessness and health issues to support and inform national and local stakeholders, including its National Conversation on Health Inequalities, which will help focus future work in this area.
PHE also launched the Healthy People, Healthy Places programme in November 2013—helping to improve the nation’s health through better planning and design to reduce the impact of a poor physical and natural environment is a PHE priority.
Heart Diseases
Andrew Stephenson: To ask the Secretary of State for Health how many keyhole surgery operations for heart surgery were carried out in (a) East Lancashire and (b) Airedale in each of the last three years. [199552]
Jane Ellison: The information is shown in the following table.
| Count of finished consultant episodes (FCEs)1 with a main or secondary procedure2 performed on the heart using a minimal access approach or performed percutaneous transluminally using image control3 for Bradford and Airedale Primary Care Trust (PCT) and Blackburn with Darwen PCT of treatment for the years 2010-11 to 2012-134 | ||||||
| Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector | ||||||
| PCT of treatment | Provider | 2010-11 | 2011-12 | 2012-13 | ||
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| 1. Finished Consultant Episode (FCE) A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year. 2. Number of episodes with a main or secondary procedure The number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and 4 prior to 2002-03) procedure fields in a Hospital Episode Statistics (HES) record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a ‘cataract operation’ would tend to have at least two procedures—removal of the faulty lens and the fitting of a new one—counted in a single episode. 3. OPCS 4 Codes K01 to K78 Heart Y74 to Y76 Minimal access approaches (must appear immediately after a code from K01 to K78) Y79 Approach to organ through artery (must appear immediately after a code from K01 to K78) Y53 Approach to organ under image control (can appear in any procedure position following a code from K01 to K78) Y78 Arteriotomy approach to organ under image control (can appear in any procedure position following a code from K01 - K78) 4. Assessing growth through time (Inpatients) 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. 5. 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 "*". Where the symbol "-" (dash) appears this represents the absence of data. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | ||||||
Hepatitis
Luciana Berger: To ask the Secretary of State for Health whether his Department plans to include a specific hepatitis C indicator in the public health outcomes framework. [199806]
Jane Ellison: The public health outcomes framework for 2013-16 (PHOF) already includes an indicator on under-75 mortality rate from liver disease (PHOF indicator 4.6), which is shared with the NHSOF (indicator 1.3) and an indicator on mortality from communicable diseases (indicator 4.8). Both of these indicators cover hepatitis C.
In support of these indicators, Public Health England is working to reverse the current trend in hepatitis C, so that the rates of death and disability are reduced, including working with local authorities and the NHS in those areas with high levels of hepatitis C to put effective strategies in place.
The Department is not planning to add new indicators to the PHOF until April 2016 to provide local authorities with stability in planning and commissioning public health interventions. The Department is planning to begin a review of the current PHOF in 2015.
Luciana Berger: To ask the Secretary of State for Health (1) what steps he is taking to ensure that people who are homeless are (a) able to access hepatitis C services and (b) supported in completing treatment for that condition; [199807]
(2) what steps his Department is taking to improve hepatitis C diagnosis and treatment rates among (a) South Asian populations, (b) homeless people, (c) injecting drug users and (d) other at-risk groups. [199809]
Jane Ellison: The commissioning of local hepatitis C services, including bespoke services for homeless people or other at-risk groups, is the responsibility of local clinical commissioning groups (CCGs). NHS England expects that decisions made by local CCGs will take account of the needs of their local populations.
A range of materials has been published to help CCGs commission relevant services. The National Institute for Health and Care Excellence has published guidance on improving uptake of testing and diagnosis for hepatitis C in risk groups. Public Health England has published a commissioning template to support commissioning of hepatitis C diagnosis and treatment services. Guidance for commissioning bespoke services for homeless people has been published by the Faculty for Homeless and Inclusion Health.
The Department supports the Inclusion Health programme which champions the health and health care of vulnerable groups, including homeless people. The programme seeks to improve the health data for these groups, and set out practical steps for assessing needs (eg through Joint Strategic Need Assessments) and commissioning services. We are also involved in funding work in this area through the Homeless Hospital Discharge Fund to improve hospital discharge arrangements for people who are homeless (£10 million 2013-14) and £40 million capital fund for hostel refurbishment with a focus on improving health outcomes (2014-15).
Luciana Berger: To ask the Secretary of State for Health what steps he is taking to ensure that hepatitis C services are prioritised at local level. [199808]
Jane Ellison: Commissioning of local hepatitis C services is the responsibility of local clinical commissioning groups (CCGs). NHS England expects that decisions made by local CCGs will be based on clinical insight and take account of the needs of the local population overall.
Public Health England supports work on local prioritisation of hepatitis C services by producing factsheets for local government, publishing a template to support commissioning by estimating the number of people infected with hepatitis C locally and the costs of treatment.
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Public Health England is also developing local liver profiles (to be published) at local authority level which includes key local statistics and prevention guidance on hepatitis C and questions which should be asked locally by local authority Health and Wellbeing Boards.
Luciana Berger: To ask the Secretary of State for Health what incentives are in place to improve the uptake of hepatitis C treatment nationally. [199810]
Jane Ellison: Clinical commissioning groups have considerable local flexibility to introduce incentives where they wish to prioritise a particular issue, based on their population needs. There are no national incentives in place to support improved uptake of hepatitis C treatment in England.
Home Care Services
Jason McCartney: To ask the Secretary of State for Health (1) what steps he is taking to ensure that high-cost drugs are delivered to cystic fibrosis patients on time; [199708]
(2) what recent assessment he has made of the effectiveness of the commissioning of homecare services by the NHS. [199709]
Dr Poulter: It is important that patients, including those with cystic fibrosis, get those high cost drugs provided through homecare services on time.
The Department commissioned a review of homecare medicine supply arrangements to ensure they deliver the best value for patients, the national health service and the provider market. The review report, Homecare Medicines: Towards a Vision for the Future, was published in December 2011 and is available at:
http://media.dh.gov.uk/network/121/files/2011/12/111201-Homecare-Medicines-Towards-a-Vision-for-the-Future2.pdf
The outcome of subsequent improvement work is summarised in the further report, Homecare Medicines: Towards a Vision for the Future—Taking Forward the Recommendations, published in May 2014 and available at:
www.uhns.nhs.uk/AboutUs/NHSHomecareMedicinesinEngland.aspx
NHS England issued a patient safety alert on minimising the risks of omitted and delayed medicines for patients receiving homecare services on 10 April 2014. This recommended that all health care organisations that commission clinical homecare services:
establish if medicine homecare services were used by their organisation and if incidents of omitted and delayed medicines had occurred;
consider whether immediate action needed to be taken locally and, if required, develop an action plan, to reduce risk and the potential risk to patients;
disseminate the alert to all medical, nursing, pharmacy and other staff involved in the care of homecare patients; and
report patient safety incidents concerning homecare to the National Reporting and Learning Service.
A copy of the patient safety alert is available at:
www.england.nhs.uk/wp-content/uploads/2014/04/psa-omitted-delayed-meds.pdf
The Department continues to work with NHS England, homecare companies, pharmaceutical suppliers and the NHS to ensure that homecare arrangements are safe and deliver value for the NHS and improved outcomes for patients.
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Human Papillomavirus
Luciana Berger: To ask the Secretary of State for Health how many (a) women and (b) men have cancers caused by the human papillomavirus. [200153]
Jane Ellison: At present the number of people living with Human papillomavirus (HPV) related cancers is not known for several reasons:
there is no nationally collated database of individual patients’ records containing the HPV status of their cancers;
prevalence figures are not known for all types of cancer i.e. the number of people who have been diagnosed and are still alive; and
many people alive after treatment of cancer will have been cured and will not consider themselves to be still living with a cancer.
However, it has been estimated by Parkin1 that the number of new cases per year of cancers in the United Kingdom which may be HPV related as 5,088 (1.6% of all newly diagnosed cancer cases). Of these, 4,058 are females and 1,030 are males. This is based on incidence rates for 2010.
1 Parkin, D M. Cancers attributable to infection in the UK in 2010
British Journal of Cancer (2011) 105, S49 – S56; doi:10.1038/bjc.2011.484
Public Health England (PHE) has calculated a prevalence estimate for the number of women who are currently alive following treatment of their cervical cancer and this is at least 19,000. Many of these will be cured.
Later this year PHE will publish prevalence estimates i.e. the number of people living with the other types of HPV related cancers.
Luciana Berger: To ask the Secretary of State for Health what estimate he has made of the cost in each year since 2010 of treating cancers caused by the human papillomavirus. [200155]
Jane Ellison: This information is not held centrally.
Maternity Services
Chris Heaton-Harris: To ask the Secretary of State for Health how the money allocated by his Department to improve birthing environments was spent in (a) 2012-13 and (b) 2013-14. [199589]
Dr Poulter: Information on the breakdown of the money allocated by the Department to improve birthing environments in 2012-13 and 2013-14 has been placed in the Library.
Chris Heaton-Harris: To ask the Secretary of State for Health what discussions his Department has had with NHS England about ensuring that all trusts provide the necessary facilities and support to ensure that families can be with their babies while they are in neonatal care, as set out in the national service specification for neonatal critical care. [199590]
Dr Poulter: The Department and NHS England regularly discuss maternity and newborn care.
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NHS England's Neonatal Service Specification requires that all commissioned providers of neonatal services provide appropriate family facilities. The current service specification states that:
Facilities should be available to support family centred care including access to parent accommodation, private and comfortable breastfeeding/expressing facilities, and private room for confidential conversations and so on.
A revised specification has recently been drafted, within which this statement has been strengthened. The revised draft specification has been out to public consultation and the Clinical Reference Group is currently responding to the comments received. It is anticipated that the revised service specification will be included in NHS England contracts with providers from April 2015.
As part of NHS England's Service Specification Compliance process, all units will have assessed their level of compliance against the service specification. Where relevant, units will have highlighted where they are not yet meeting this requirement. In those circumstances, the Area Team Commissioner and the relevant provider will have agreed an action plan for achievement of the standard, where is it not currently being met, within 12 months. The actual facilities provided for families are locally determined and the exact number of overnight beds may therefore vary from service to service.
Chris Heaton-Harris: To ask the Secretary of State for Health (1) what savings are planned for neonatal care under the Quality, Innovation, Productivity and Prevention Initiative for 2014-15; [199591]
(2) how the Quality, Innovation, Productivity and Prevention savings for neonatal care will be realised. [199592]
Dr Poulter: NHS England, as part of its direct commissioning responsibilities for specialised services, has an ongoing programme in place to identify both local and national opportunities to identify potential efficiencies as part of its management and prioritisation of available resources.
NHS England’s Clinical Reference Groups (CRGs), involving lead clinical, patient and professional representatives, are assisting NHS England in this work, particularly in respect of proposals that might be considered nationwide.
Specialised neonatal care is one of NHS England’s most significant areas of expenditure and the Neonatal CRG has therefore been involved in identifying potential neonatal specific schemes, which may have the potential to deliver savings while maintaining safety and quality. The schemes will be subject to a confirm and challenge process to determine their deliverability, before being worked up into schemes which could be implemented on a national basis.
It is therefore not possible, at this stage in the programme’s development, to quantify the level of savings that might be generated nationally or the specific savings approach that will be adopted.
It is unlikely that the national schemes currently being considered will generate savings in 2014-15. The schemes are more likely to be transformational in design and therefore are more likely to deliver savings in the longer term.
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Mrs Hodgson: To ask the Secretary of State for Health how many children spent (a) up to two weeks, (b) two to four weeks, (c) four to six weeks and (d) more than six weeks in hospital immediately after being born in England in the last year for which figures are available. [200003]
Dr Poulter: The information requested is set out in the table.
This is based on finished discharge episodes with a primary or secondary diagnosis of “Z38—Live born infants according to place of birth”, by length of stay for the year 2012-13 and covers activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.
It should be noted that the length of stay in hospital is only available on the final episode of care in a hospital provider. Therefore the total of “other/unknown” lengths of stay recorded includes those births that have not resulted in a discharge, such as where the baby has been transferred to the care of another consultant.
| Length of stay | Finished discharge episodes |
| Notes: 1. Finished Discharge Episode: 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. 2. Primary or secondary diagnosis: The number of episodes where this diagnosis was recorded in any of the 20 diagnosis fields in the Hospital Episode Statistics (HES) record. Each episode is counted once, even if the diagnosis is recorded in more than one diagnosis field of the record. 3. ICD10 code: The following ICD10 code was used to identify a live born infant: Z38—Live born infants according to place of birth. 4. Length of stay (duration of spell): The difference in days between the admission date and the episode end date (duration of episode) or discharge date (duration of spell), where both dates are given. LOS is based on hospital stays and only applies to ordinary admissions not day cases (unless otherwise stated). Information relating to LOS, including discharge method/destination, diagnoses and any operative procedures, is based only on the final episode of the spell. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | |
Medical Records: Databases
Charlotte Leslie: To ask the Secretary of State for Health, with reference to the statement on the What About Youth? website, that approval has been received to use young people's contact details from NHS registration data and the National Pupil Database, when that data were supplied; and on what register the decision to disclose that data was recorded. [200053]
Dr Poulter:
On behalf of the Department, the Health and Social Care Information Centre (HSCIC) has commissioned the “What about Youth?” trial survey to test the processes and methodology. It was carried out by Ipsos Mori and ran from November 2013 to February 2014. The trial survey was posted to just under 7,000 younger people using information obtained from the
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Medical Research Information Service Integrated Database and Administration System, approval for which was obtained on 15 August 2013 via the HSCIC Data Linkage and Extract Services application process:
http://www.hscic.gov.uk/dlesaac
The decision to approve the request for provision of an extract will be included in the next Data Release Register due in early July.
The National Pupil Database (NPD) is a Department for Education resource. HSCIC gained approval to use NPD data by applying via the formal process:
https://www.gov.uk/national-pupil-database-apply-for-a-data-extract#approval-process
and received approval to use NPD for the trial survey on 18 March 2014; however, this was too late for the trial and the data were not used. Ipsos Mori was granted access to the extract on 10 April. The decision to approve the request for provision of an extract is shown on row 139 of the “National pupil database: requests received” at:
https://www.gov.uk/government/publications/national-pupil-database-requests-received
Melanotan
Luciana Berger: To ask the Secretary of State for Health what assessment he has made of the (a) prevalence and (b) effect of the sale of the unlicensed drug Melanotan (i) online and (ii) in shops. [200340]
Dr Poulter: There are strict legal controls governing the sale and supply of medicinal products in the United Kingdom.
The Medicines and Healthcare products Regulatory Agency (MHRA) considers Melanotan products to be medicinal products within the meaning of the Human Medicines Regulations 2012 and as such, the manufacture, sale and supply are subject to UK regulatory control. No Melanotan product holds a marketing authorisation (product licence) for use in the UK and consequently advertising and sale or supply would be in breach of regulatory requirements.
The MHRA is aware that Melanotan is being sold through some outlets such as gyms and beauty salons and is available more widely on the Internet through certain websites.
During the past 12 months, the MHRA has worked with Internet Service Providers in the UK and abroad to suspend more than 100 websites illegally trading in Melanotan.
The MHRA issues regular warnings to the public about the dangers involved in the use of unlicensed medicines, including Melanotan and officials have participated in Press campaigns and specific media coverage of the problem.
As of 12 June 2014, the MHRA has received a total of 22 reports of Adverse Drug Reactions associated with the use of Melanotan (product names Melanotan I, Melanotan II and Ubertan), describing a total of 93 adverse reactions. However, it is important to note that the reporting of a suspected adverse reaction does not necessarily mean it is related to the drug.
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Meningitis: Vaccination
Ms Ritchie: To ask the Secretary of State for Health what progress has been made on procuring the vaccine for Meningitis B as part of the primary infant immunisation schedule; and if he will make a statement. [199972]
Jane Ellison: Work is nearing completion to gain approvals to commence the procurement. The Department and Public Health England will start negotiations with Novartis, which produces the only licensed Meningitis B vaccine, as soon as possible.
Mental Health Services: Young People
Charlotte Leslie: To ask the Secretary of State for Health, with reference to the answer of 18 March 2014, Official Report, column 572W, on mental health services: children, when he expects NHS England's review of Tier 4 Child and Adolescent Mental Health Services to be published. [200127]
Luciana Berger: To ask the Secretary of State for Health, with reference to the answer of 28 April 2014, Official Report, column 460W, on mental health services: young people, when NHS England's review of Tier 4 Children and Adolescent Mental Health Services provision will be published. [200156]
Norman Lamb: I refer the hon. Members to the answer I gave to the hon. Member for Truro and Falmouth (Sarah Newton), on 9 June 2014, Official Report, column 57W.
NHS: Staff
Liz Kendall: To ask the Secretary of State for Health (1) how much NHS trusts have spent (a) on agency and contract staff and (b) on all staff in each financial year since 2009-10; [200211]
(2) how much NHS trusts (a) planned to spend and (b) spent on agency and contract staff in 2013-14. [200212]
Dr Poulter: As part of the response to the issues in Mid-Staffordshire hospital, and following the recommendations of the Francis report, many trusts have increased agency spend in the short-term to protect patients and improve patient care. Over the longer term, a key objective for the NHS is to keep agency spend to a minimum, an increase in the number of permanent front-line staff is vital to both improving patient care and delivering value for money. The number of front-line clinical staff has increased by more than 16,300 since 2010.
In 2013-14, NHS foundation trusts planned to spend £523 million on agency and contract staff and spent £1,373.0 million. NHS trusts spent £1,209.1 million; how much they planned to spend is not available.
Sources:
For NHS trusts—unaudited data in NHS trust summarisation schedules; for NHS foundation trusts—quarterly monitoring information.
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Plans are in place in Better Procurement to reduce by £450 million spend on agency and contract staff by the end of 2016.
NHS Trusts spent £1,209.1 million on agency and contract staff in 2013-14.
Source:
Unaudited data in NHS Trust Summarisation Schedules.
Amounts for 2009-10 to 2012-13 were not separately identified from other non-permanent staff.
Spend by NHS Foundation Trusts on agency and contract staff is in the following table.
| £ million | |
| Note: For 2009-10 to 2012-13 actual figures are based on gross staff costs as per notes in the NHS FT consolidated accounts. The figures from the consolidated accounts may differ to the Board reports due to adjustments made on redundancy, early retirement, capitalisation of staff costs and costs of R&D staff. 2013-14 figures are from quarterly monitoring information. | |
Information available about spend on all staff is set out in the following tables.
| NHS Trusts | |
| £ million | |
| Note: Total staff costs for 2013-14 are not yet available. Source: NHS (England) Summarised Accounts 2009-10, 2010-11; NHS Trust Audited Summarisation Schedules 2011-12, 2012-13. | |
| NHS Foundation Trusts | |
| £ million | |
| Note: For 2009-10 to 2012-13 actual figures are based on gross staff costs as per notes in the NHS FT consolidated accounts. The figures from the consolidated accounts may differ from the Board reports due to adjustments made on redundancy, early retirement, capitalisation of staff costs and costs of R&D staff. 2013-14 figures are from quarterly monitoring information. | |
Organs: North West
Andrew Stephenson: To ask the Secretary of State for Health what proportion of people in (a) Pendle constituency, (b) East Lancashire and (c) the North West are registered organ donors. [199658]
Jane Ellison: The information requested is in the following table:
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Out of Area Treatment: Wales
Jesse Norman: To ask the Secretary of State for Health if he will take steps to ensure that pregnant women living in England but registered with GPs in Wales have the option of a nuchal translucency scan as part of their antenatal care. [199843]
Dr Poulter: Nuchal translucency scans are offered to pregnant women as part of the NHS Fetal Anomaly Screening programme (NHS FASP). This is a public health function of the Secretary of State which, through an arrangement under section 7A of the National Health Service Act 2006, is exercised by NHS England.
NHS England has confirmed that women living in England and registered with a GP in contract with the Welsh NHS who opt to give birth in an English hospital are offered nuchal translucency scans, in line with NHS FASP's 2011-14 Model of Best Practice. I understand that nuchal transparency scans are not currently routinely offered by the Welsh NHS.
As part of its review of the protocol for cross-border health care, NHS England is giving consideration to a number of issues, including this one.
Jesse Norman: To ask the Secretary of State for Health what steps he is taking to ensure that people living in England but registered with GPs in Wales have full access to services provided by NHS England. [199847]
Jane Ellison: The Department has asked NHS England to work with the Welsh Government to review the protocol for cross-border health care. NHS England aims to complete that work by the end of this calendar year.
Parkinson's Disease
Mr Betts: To ask the Secretary of State for Health (1) what steps his Department is taking to prevent unnecessary delays in the prescription of Duodopa for people with Parkinson’s; [199571]
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(2) what steps his Department is taking to improve patient choice and reduce avoidable harm for people with advanced Parkinson’s. [199567]
Norman Lamb: From April 2013, NHS England assumed responsibility for commissioning adult specialist neurosciences services, including the majority of services for patients with Parkinson’s disease, with some being the responsibility of clinical commissioning groups.
NHS England has advised that it does not routinely fund Duodopa (co-careldopa) for the treatment of Parkinson’s disease. Clinicians can submit individual funding requests for this treatment on behalf of their patients as per NHS England’s individual funding requests standard operating procedure, which is found at the following link:
www.england.nhs.uk/wp-content/uploads/2013/04/cp-04.pdf
NHS England has advised that its individual funding request process is monitored against the standard operating procedure to ensure that referring clinicians are informed of outcomes in a timely manner.
Treatments for Parkinson’s are largely drug-based and there is a choice of therapies available. “Parkinson’s disease: Diagnosis and management in primary and secondary care”, published by the National Institute for Health and Care Excellence in 2006, makes it clear that communication with people with Parkinson’s disease should be aimed towards empowering them to participate
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in the judgments and choices about their own care. With regard to decisions about the drugs available for treatment of the disease in its later stages, the guidance states that the patient preference should be taken into account, once they have been informed of the short- and long-term benefits and drawbacks of the different types of drugs available.
To reduce avoidable harm, through the mandate, we have asked NHS England to make measurable progress by 2015 to embed a culture of patient safety in the NHS including through improved reporting of incidents. The NHS Outcomes Framework contains a range of indicators designed to measure progress in this area of care which will be relevant to patients with all conditions, including, Parkinson’s disease.
Prisoners: HIV Infection
Sadiq Khan: To ask the Secretary of State for Health how many cases of HIV were reported in prisons in England and Wales in each of the last four years. [199548]
Jane Ellison: The following table provides information on the number of adults (aged 15 and above) identified as being resident in prison at the time they received human immunodeficiency virus (HIV) treatment from specialist services. The source of the data provided is the Survey of Prevalent HIV Infection.
| Number of prisoners | |
| Notes: 1. Prisoners were identified if an adult's residential postcode was a prison postcode. However, the completeness and accuracy depends on clinicians' reports. Although completeness of full postcode is high (>90%) in each of these four years, it is still possible that partial postcode, missing postcode or clinic postcode instead of residential postcode was provided. This may lead to an underestimate of numbers in the table. 2. Data on patients (including prisoners) seen for care at non-national health service funded services are not included. 3. Prisoners with a short sentence might be seen for care after release and therefore are not captured in this table. | |
Recording of prison status is not routine and numbers are likely to be under-reported. The data do not imply that transmission of infection happened while the person was in prison or that the diagnosis was made during the period of incarceration.
Genitourinary Medicine Clinic Activity Dataset data show that the number of new HIV infections diagnosed in serving prisoners in England in 2011 was nine and in 2012 was 17.
Prisoners: Sexually Transmitted Infections
Sadiq Khan: To ask the Secretary of State for Health how many incidences of sexually transmitted diseases were reported in prisons in England and Wales in each of the last four years. [199549]
Jane Ellison: Data on sexually transmitted infections (STIs) are now sourced from the Genitourinary Medicine Clinic Activity Dataset, Genitourinary Medicine (GUM) services return. Data from GUM clinics on prisoners are unavailable prior to 2011.
For the most recent two years for which data are available, the following table shows all new STI diagnoses among prisoners in England. Data from Genitourinary Medicine Clinic Activity Dataset relate only to GUM services which are located in England.
| Number | ||
| 20111 | 20122 | |
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| 1 Data on prisoners are significantly under-reported in 2011. 2 2012 data for chlamydia and all new STIs are not comparable to data from previous years. 3 All new STIs include new HIV infections diagnosed when a person was a prisoner, explained further at point 4 of the explanatory notes for table one. Notes: 1. Data follow calendar years (January to December), not financial years (April to March). 2. Data represent the number of diagnoses reported and not the number of people diagnosed. 3. 2012 data for chlamydia and "All new STIs" are not comparable to data from previous years. Chlamydia diagnoses made among prisoners in GUM clinics that were reported as "previously diagnosed at another service" have been excluded from 2012 data only. 4. Data for "All New STIs" include: chancroid; lymphogranuloma venerum (LGV); donovanosis; chlamydia; gonorrhoea; herpes: anogenital herpes (1st episode); HIV: new diagnosis; molluscum contagiosum; non-specific genital infection; pelvic inflammatory disease (PID) and epididymitis: non-specific; scabies; pediculus pubis; syphilis: primary, secondary and early latent; trichomoniasis and warts: anogenital warts (1st episode). 5. Data on prisoners are significantly under-reported in 2011 due to the phased introduction of Sexual Health and HIV Activity Property Types (SHHAPT) STI surveillance codes. 6. Number of diagnoses between 1 and 4 with a population <10,000 are presented as ‘<5' to prevent deductive disclosure. Please see link for further details on data sharing and confidentiality: www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1247816526850 | ||
The following table also contains the number of chlamydia diagnoses among prisoners aged 15 to 24 years in England for 2009-11. Data are sourced from the National Chlamydia Screening Programme (NCSP). Data from NCSP relate only to NCSP services which are located in England.
Radioactive Waste: Fife
Mr Gordon Brown: To ask the Secretary of State for Health what the reason is for the time taken for his Department to publish COMPARE’s report on radium contamination at Dalgety Bay. [199621]
Jane Ellison: The Department has been engaged with the Committee on Medical Aspects of Radiation in the Environment throughout the production of its report on Dalgety Bay, and our priority throughout has been to make sure that it is comprehensive, accurate and up to date.
During this process, information was provided to the committee for due consideration prior to final publication.
Respite Care: Pendle
Andrew Stephenson: To ask the Secretary of State for Health what steps he is taking to improve respite care provisions in Pendle constituency. [199652]
Norman Lamb: We have provided £400 million to the national health service over four years from 2011 for carers to have breaks from their caring responsibilities.
In the 2013 spending review, we announced the £3.8 billion Better Care Fund, which includes £130 million funding for carers’ breaks for 2015-16.
In 2015-16, East Lancashire Clinical Commissioning Group will receive £8.1 million from the Better Care Fund.
Staff
Mr Jamie Reed: To ask the Secretary of State for Health how many roles exist within the Economic Regulation Unit in his Department; what the job title is of each such role; and what the salary level is of each such role. [200006]
Dr Poulter: There are 12 posts within the Economic Regulation Unit (ERU) at the Department. ERU comprises a deputy director, four senior policy advisers, two policy advisers, one policy officer, three policy support officers and a junior analyst.
The pay bands represented are one SCS1, four grade 7s, two senior executive officers, one higher executive officer, three executive officers and a fast streamer.
Salary ranges for the posts within the ERU are as follows:
| Department of Health pay scales: London-based posts as of 1 April 2014 | |||
| £ | |||
| Minimum | Maximum | ||
Tobacco: Packaging
Catherine McKinnell: To ask the Secretary of State for Health on what date he plans to publish the consultation referred to by the Minister of State for Health in his Department's announcement entitled “Government Response to Tobacco Standardised Packaging Review”, published in April 2014. [200093]
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Jane Ellison: The consultation could not be published in the period leading up to the European and local elections. It is now being finalised and will be published shortly.
Tomography
John Woodcock:
To ask the Secretary of State for Health what provision is made for the use of non-NHS
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facilities for MRI scans where the patient's weight precludes the use of an NHS-standard scanner. [200163]
Jane Ellison: Arrangements for deciding the most appropriate way for individual patients to access NHS services based on their clinical needs is for local determination.