Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many ophthalmologists there are currently (1) in training, and (2) in post-training practice.
Answered by Lord Prior of Brampton
Health Education England estimates there are currently 539 ophthalmologists and seven medical ophthalmologists in training. This information is based on data from the Electronic Staff Record.
NHS Digital publishes statistics on National Health Service staff working in hospital and community health services. The latest data as at 31 July 2016, published on 25 October, shows that there are 2,608 full time equivalent medical ophthalmology and ophthalmology doctors working in the NHS in England, of which 1,787 are in post training practice. These include consultants (certificate of completion of training holders) as well as associate specialists, specialty doctors, staff grade doctors and hospital practitioners/clinical assistants.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what alternatives to a sugar tax they have considered to reduce levels of childhood obesity.
Answered by Baroness Chisholm of Owlpen
In developing Childhood Obesity: A Plan for Action we looked at everything that contributes to a child becoming overweight and obese. The policies in the plan focus on the ones that are likely to have the biggest impact on childhood obesity. In addition to the soft drinks industry levy, this includes the sugar reduction programme, helping all children to enjoy an hour of physical activity every day and a healthy rating scheme for primary schools.
The plan is informed by the latest research and evidence, including from the Scientific Advisory Committee on Nutrition report Carbohydrates and Health, Public Health England’s evidence package Sugar reduction: the evidence for action, other government departments, debates in this House and various reports from key stakeholders including the Health Select Committee.
We are confident that the measures we have announced will make a real difference and estimate could reduce childhood obesity rates by about a fifth (330,000) over the next ten years. Though we are clear in our goals and firm in the action we will take, the launch of this plan represents the start of a conversation, rather than the final word.
Copies of Childhood Obesity: A Plan for Action, Carbohydrates and Health and Sugar reduction: the evidence for action are attached.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many cancer referrals in England were not made within the two week waiting time target for each of the last three years.
Answered by Baroness Chisholm of Owlpen
The Handbook to the NHS Constitution, which is attached, sets out the right for patients to be seen by a cancer specialist within a maximum of two weeks from general practitioner (GP) referral for urgent referrals where cancer is suspected. The operational standard is that 93% of patients should wait less than two weeks from GP urgent referral to first consultant appointment. This standard has been met in each of the last three years.
The information for how many patients waited more than two weeks from GP urgent referral to first consultant appointment is shown in the table below.
Table: Two week wait from GP urgent referral to first consultant appointment, in England, 2013/14 to 2015/16
Year | Number of patients that waited less than two weeks to be seen | Number of patients that waited more than two weeks to be seen | Total number of patients referred | Performance against the standard |
2013/14 | 1,297,849 | 63,496 | 1,361,345 | 95.3% |
2014/15 | 1,459,084 | 90,610 | 1,549,694 | 94.2% |
2015/16 | 1,624,981 | 101,140 | 1,726,121 | 94.1% |
Source: Cancer waiting times quarterly time series, NHS England
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have plans to revise the boundaries of Clinical Commissioning Groups in the light of regional devolution deals.
Answered by Baroness Chisholm of Owlpen
NHS England has no plans to revise the boundaries of clinical commissioning groups in light of regional devolution deals.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government which five clinical procedures have the highest average waiting time in England.
Answered by Baroness Chisholm of Owlpen
Patients have a legal right, set out in the NHS Constitution, to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. The NHS Constitution for England is attached, as is the Handbook to the Constitution, which provides a further level of detail regarding the rights and pledges. Performance is measured against an operational standard that 92% of patients who have not yet started treatment should have been waiting less than 18 weeks from referral at the end of each month. These referral to treatment waiting times are collected for 18 treatment functions (e.g. trauma and orthopaedics), but not for individual conditions or procedures. They are different from the data derived from hospital episode statistics, which show only the waiting time from decision to admit to admission, and not the waiting time from referral to start of treatment.
Table: The five treatment functions that had the highest average waiting time from referral to treatment in July 2016, in England
Treatment Function | Average (median) waiting time (in weeks) |
Neurosurgery | 8.4 |
Oral Surgery | 7.3 |
Neurology | 7.0 |
Trauma and Orthopaedics | 7.0 |
Cardiothoracic Surgery | 7.0 |
Source: Consultant-led referral to treatment waiting times, NHS England
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the relationship between those NHS Trusts in the greatest level of deficit and those with the highest proportion of private finance initiative income.
Answered by Baroness Chisholm of Owlpen
In 2012, the Department identified a small cohort of major acute trusts where the private finance initiative schemes were one of the factors affecting financial sustainability. These trusts have been given access to a £1.5 billion support fund over a period of 25 years which has been available since 2013/14.
It is the role now of NHS Improvement to ensure that National Health Service trusts and NHS foundation trusts assess the impact of different expenditure items at NHS trusts to ensure that NHS trusts and NHS foundation trusts have arrangements in place to secure financial health. NHS Improvement’s focus is then on supporting that individual provider to fix its financial problems, for example through interim financial support or longer term solutions in that health economy.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the impact of private finance initiatives on NHS hospitals' budgets in the last 12 months for which figures are available.
Answered by Lord Prior of Brampton
It is the role of NHS Improvement (and NHS Trust Development Agency and Monitor before it) to assess the impact of different expenditure items at National Health Service trusts to ensure that NHS trusts and NHS foundation trusts have arrangements in place to secure financial health. Where individual providers find themselves in financial distress, identifying the root cause of issues is often complex. In some cases the situation may be attributable to the long-term fixed costs of Private Finance Initiative (PFI) schemes, whilst in others the principal causes may lay elsewhere (although it is possible the PFI may exacerbate the issue). However NHS Improvement’s focus is then on supporting that individual provider to fix its financial problems, for example through interim financial support or longer term solutions in that health economy.
Information on the reporting of PFI payments in terms of trust’s total income and expenditure and other statutory reporting requirements is contained within individual trust accounts.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many post-surgery follow-up appointments were missed by patients in the last 12 months for which figures are available.
Answered by Lord Prior of Brampton
Information is not collected centrally in the format requested.
Did not attend rates for outpatient appointments in England are collected by NHS England in the Quarterly Activity Return. This data distinguishes between first and follow-up appointments but does not distinguish between types of appointments, so it is not possible to identify how many missed appointments relate to post-surgery.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the current and future financial impact of private finance initiative projects on NHS Hospital Trusts (1) nationally, and (2) in Yorkshire and Lincolnshire.
Answered by Lord Prior of Brampton
HM Treasury holds information on the current estimated revenue payments for the lifetime of each health sector private finance initiative (PFI) in a live online database. This shows that for the 106 National Health Service PFI schemes that have now been signed, the estimated total revenue payments (over the lifetime of their contracts) are £79.0 billion (in nominal terms i.e. including an inflation assumption). This is from the date of the first construction completions in 2000-01 to the date of the very last payment in 2049-50. The revenue payment figures include not just the financing costs (debt repayment and interest) for initial construction but also the costs of all the other services such as building maintenance and support services (cleaning, catering, portering etc) provided over the lifetime of the contract. The payments are subject to meeting agreed performance and quality standards and include an annual uprate assumption for inflation of 2.5%.
This Government launched an initiative in 2011 to extract savings and optimise value for money in operational PFI contracts. This included a pilot exercise at a major NHS PFI scheme which resulted in guidance with appropriate methodology and lessons learned being issued to all relevant NHS trusts in 2012. The Department has specialist officials to assist trusts in implementing the guidance.
An extract giving details of PFI schemes in Yorkshire and Lincolnshire is attached.
Further information on PFI projects nationally can be accessed via HM Treasury’s website as follows. The files are too large to attach to this reply, however when searching, the ‘Current projects as at 31 March 2015’ spreadsheet should be opened. This will show the latest estimates collected from each department as at the end of March 2015; the health sector schemes are clearly marked “Department of Health” and then “DH-Acute (i.e. Hospitals)”. The initial capital cost of each scheme is shown in Column R and the annual revenue payment in the columns headed ‘Unitary Charge Payment’ (UCP). The total of UCPs (England) for 2014-15, the latest audited figure (Column AO), is £1.9 billion.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking through early diagnosis and screening programmes to reduce the risk of cancer.
Answered by Lord Prior of Brampton
On the advice of the UK National Screening Committee, breast cancer screening, bowel cancer screening and cervical cancer screening are offered to eligible people to help them reduce their risk of dying from cancer.
Cervical screening is not a test for cancer but for abnormalities which, if left undetected and untreated, may develop into cancer. The NHS Cervical Screening Programme in England offers screening to women aged 25 to 49 every three years, and women aged 50 to 64 every five years. Experts estimate the programme saves up to 5,000 lives per year in the United Kingdom.
The NHS Breast Screening Programme invites women aged 50 to 70 for breast screening every three years. Women over 70 can request free three yearly screening. The 2012 UK independent review of breast cancer screening (Marmot review) estimated that inviting women between the ages of 50 to 70 reduces mortality from breast cancer in the invited population invited by 20% and saves an estimated 1,300 lives a year in the UK.
The NHS Bowel Cancer Screening Programme offers screening using a self-sampling kit, the guaiac Faecal Occult Blood test (FOB), every two years to men and women aged 60 to 74.
The UK National Screening Committee has recommended that the Faecal Immunochemical Test (FIT) be used as the primary test for bowel cancer instead of the currently used FOB test. Ministers are now considering the UK NSC’s recommendation.
The NHS Bowel Cancer Screening Programme is currently rolling out Bowel Scope Screening (BSS), an additional one off examination which will play a significant role in preventing bowel cancer. Both men and women are being invited for BSS around the time of their 55th birthday with the aim of detecting and removing any adenomas (polyps) at an early stage to prevent bowel cancer from developing. Evidence shows that men and women aged 55-64 attending a one-off bowel scope screening test for bowel cancer could reduce their individual mortality from the disease by 43% (31% on a whole population basis) and reduce their individual incidence of bowel cancer by 33% (23% on a whole population basis).