Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the report by the Royal College of Physicians The National Review of Asthma Deaths, published on 6 May 2014; and what plans they have to implement that report's recommendations.
Answered by Baroness Blackwood of North Oxford
The Department collaborated with the Royal College of Physicians on the National Review of Asthma Deaths and welcomed this report. Since its publication, significant improvements have been made in asthma care.
Respiratory disease, including asthma, is a clinical priority within the NHS Long Term Plan, which aims to improve outcomes for patients through earlier diagnosis and increased access to treatments. The Respiratory Delivery Board will take forward respiratory proposals set out in the Plan by working with key partners.
The National Health Service is supporting the national asthma audit programme which provides data on a range of indicators to show improvements and opportunities in asthma outcomes. NHS RightCare will be publishing an asthma toolkit later this year to support local commissioners and systems in delivering quality care. A best practice tariff for asthma, which aims to reduce variation in asthma care, is also in development.
The current quality outcomes framework indicators for asthma are in consultation and changes for the annual review indicators may include data on asthma control; exacerbations; and written personalised action plans.
As set out in the Long Term Plan, pharmacies in primary care networks will undertake medicine reviews for asthma patients. This will include education on inhaler use and uptake of dry powder and smart inhalers where clinically appropriate.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress NHS Improvement and NHS England have made in developing new (1) outcomes-based, and (2) capitated budget, reimbursement models for the provision of specialised services.
Answered by Lord O'Shaughnessy
NHS England and NHS Improvement are working on a number of different reimbursement models for specialised services. The actual payment model will depend on the characteristics of the service, and an assessment of the approach likely to be most conducive to improved patient outcomes. NHS England and NHS Improvement are exploring models built on payment based on episodes of care, on the fixed costs of providing a service, or on the adoption of a pathway or year of care payment model.
NHS England and NHS Improvement are also working with the New Care Model Vanguards to develop a capitation-type payment model, called a Whole Population Budget, which could also be used to reimburse specialised services.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress has been made on the Data Services Platform which is being developed by the Department of Health's arm's-length bodies to standardise the collection of health and social care performance and costing data.
Answered by Lord O'Shaughnessy
The delivery of the Data Services Platform (DSP) is on-going as part of NHS Digital’s Personalised Health and Care 2020 Programme. The business case for the DSP is currently being finalised and NHS Digital are expected to seek approval for this shortly.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how NHS England will ensure that levels of data publication on outcomes and costs are maintained, once responsibility for commissioning specialised services is devolved or delegated to clinical commissioning groups.
Answered by Lord O'Shaughnessy
NHS England will continue to remain responsible for specialised services, including when the day-to-day commissioning of those services is delegated to clinical commissioning groups (CCGs).
To support CCGs to move to place-based commissioning arrangements for relevant specialised services, NHS England is in the process of developing a framework of options for CCGs, ranging from less formal ‘seat at the table’ type arrangements, to more formal joint arrangements, delegated commissioning, or devolution.
Depending on the type of arrangement that is pursued in a given geographical area, there will be different implications for governance arrangements and how reporting and assurance arrangements would operate.
NHS England is working through these various implications – including reviewing the existing reporting and assurance arrangements for specialised commissioning and determining whether these may need to change in light of moving to place-based arrangements. This will include exploring the issues set out here around ensuring adherence to national standards and data transparency.
NHS England is keen to test and engage with key stakeholders as it develops its framework of options.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how NHS England will ensure adherence to national standards, once responsibility for commissioning specialised services is devolved or delegated to clinical commissioning groups.
Answered by Lord O'Shaughnessy
NHS England will continue to remain responsible for specialised services, including when the day-to-day commissioning of those services is delegated to clinical commissioning groups (CCGs).
To support CCGs to move to place-based commissioning arrangements for relevant specialised services, NHS England is in the process of developing a framework of options for CCGs, ranging from less formal ‘seat at the table’ type arrangements, to more formal joint arrangements, delegated commissioning, or devolution.
Depending on the type of arrangement that is pursued in a given geographical area, there will be different implications for governance arrangements and how reporting and assurance arrangements would operate.
NHS England is working through these various implications – including reviewing the existing reporting and assurance arrangements for specialised commissioning and determining whether these may need to change in light of moving to place-based arrangements. This will include exploring the issues set out here around ensuring adherence to national standards and data transparency.
NHS England is keen to test and engage with key stakeholders as it develops its framework of options.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they have taken to support NHS England's engagement with interested clinical commissioning groups in developing collaborative commissioning arrangements.
Answered by Lord O'Shaughnessy
Over the past two years, NHS England has been working to support greater clinical commissioning group (CCG) engagement in specialised services through the collaborative commissioning programme. Arrangements have been put in place at a regional and sub-regional level to support engagement between NHS England and CCGs.
The programme has recently been refreshed in light of the emergence of sustainability and transformation plans (STPs). Working with STPs provides a significant opportunity to use collaborative commissioning to better join up care, improve outcomes, and benefit patients.
In January 2016, to support the move to place-based commissioning, nominal CCG allocations for 2016/17 – 2020/21 were published. The allocations included approximately £14.5 billion of the total specialised budget of approximately £15.7 billion, excluding items such as highly specialised services. These place-based allocations were included in STP control totals and supported discussions on specialised commissioning with STPs.
NHS England is developing options for its regional teams, CCGs and STPs to work more collaboratively, with a priority focus on mental health, learning disabilities, and cancer services. It is also working with a small number of STP areas to support implementation and disseminate the learning to the wider system.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what discussions they have had with NICE concerning the implementation of an abbreviated highly-specialised technologies process.
Answered by Lord O'Shaughnessy
The Government has had no such discussions. There are no plans for the National Institute for Health and Care Excellence to introduce an abbreviated highly specialised technologies evaluation process.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government when NHS England will publish the details of clinical and patient and public voice members who have been appointed to Clinical Reference Groups since May 2016.
Answered by Lord O'Shaughnessy
NHS England is in the process of refreshing the Clinical Reference Group (CRG) webpages and the names of all CRG members will be published by April 2017.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the answer by Lord Prior of Brampton on 22 November (HL Deb, col 1833), whether an independent assessment of recruitment levels will be carried out in January 2017 once the rate of applications has been calculated.
Answered by Lord Prior of Brampton
For courses beginning on 1 August 2017, the main deadline for the majority of full-time undergraduate courses through the University and Colleges’ Admissions Service (UCAS) is 15 January 2017. However, universities can accept applications up until August 2017, and applicants can also apply directly for some part-time and postgraduate courses at specific higher education institutions.
The Department of Health intends to work with the Department for Education, UCAS and other healthcare education bodies to determine the most appropriate point and method following 15 January 2017, to assess available information on applications for pre-registration nursing, midwifery and allied health profession courses.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have reassessed their plans to replace bursaries with loans for all nursing students in the light of the potential impact of the decision to withdraw from the UK on the recruitment and retention within the NHS of qualified nurses from other EU member states.
Answered by Lord Prior of Brampton
The Government has not reassessed plans to replace bursaries with loans to take into account the decision to withdraw from the European Union (EU).
The Department of Health is working with the Department for Exiting the European Union to ensure that the needs of health and social care providers and those in need of health and social care services are taken into account as we exit from the EU.
In October 2016, the Department for Education confirmed that EU students will remain eligible to apply for the standard student loan package and this will not change during their course if the Government triggers Brexit during the next few years.