Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what action they have (1) considered, and (2) taken, to reduce the number of preventable amputations occurring within the National Health Service.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Diabetes is one of the most common causes of amputations in the United Kingdom and there are a variety of mechanisms in place to support the care of people with diabetes to minimise the risk of amputations. NHS England published Action for Diabetes, which sets out that in many cases amputation as a result of diabetes is avoidable.
NHS England has also piloted a diabetes service specification in a small number of clinical commissioning groups (CCGs). Feedback has been very positive and they have now published the service specification on the NHS Commissioning Assembly website so that it is available nationally for CCGs to use.
In addition, the National Diabetes Foot Care Audit was launched this year. The audit aims to establish the extent to which national guidelines on the management of diabetic foot disease are being met, and will provide local teams with the evidence needed to tackle any identified differences in practice which will lead in turn to an overall improvement in management and outcomes for patients.
Finally, NHS Improving Quality is supporting a project to reduce the high mortality associated with diabetic foot disease. People with diabetic foot disease are at particularly high risk of premature death, much of which is due to cardiovascular disease, with 5 year mortality for those with Type 1 or Type 2 diabetes and diabetic foot disease around 50%. The project will pilot an approach in several multidisciplinary foot clinics across the country over the next 18 months to introduce an additional clinical pathway which includes a cardiological test and subsequent actions to address risk.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government in how many Clinical Commissioning Groups rates of (1) major, and (2) minor, amputations are more than 33 per cent above the national average; and how the national average compares with other European Union member states.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
It is not possible to distinguish in Hospital Episode Statistics between 'major' and 'minor' amputations.
The Health and Social Care Information Centre (HSCIC) has calculated the England average rate of amputation per 100,000 population and highlighted the clinical commissioning groups (CCGs) of residence having rates more than 33% higher than the national average. There are 25 such CCGs.
This is not a count of people as the same person may have had more than one episode of care within the same time period.
We do not have information on a comparison of rates of amputation with other European Union member states.
Clinical Commissioning Group of residence | Count of finished consultant episodes | Population | Rate per 100,000 population |
NHS SCARBOROUGH AND RYEDALE CCG | 68 | 110,488 | 61.5 |
NHS EAST RIDING OF YORKSHIRE CCG | 169 | 314,504 | 53.7 |
NHS DONCASTER CCG | 159 | 302,739 | 52.5 |
NHS MANSFIELD AND ASHFIELD CCG | 101 | 192,539 | 52.5 |
NHS BLACKPOOL CCG | 72 | 141,976 | 50.7 |
NHS KNOWSLEY CCG | 74 | 145,936 | 50.7 |
NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG | 138 | 273,043 | 50.5 |
NHS KERNOW CCG | 272 | 540,178 | 50.4 |
NHS FAREHAM AND GOSPORT CCG | 98 | 196,078 | 50.0 |
NHS LANCASHIRE NORTH CCG | 78 | 158,528 | 49.2 |
NHS NORTHERN, EASTERN AND WESTERN DEVON CCG | 421 | 869,408 | 48.4 |
NHS STOKE ON TRENT CCG | 124 | 258,114 | 48.0 |
NHS TELFORD AND WREKIN CCG | 80 | 167,682 | 47.7 |
NHS HEREFORDSHIRE CCG | 88 | 184,932 | 47.6 |
NHS HULL CCG | 122 | 257,204 | 47.4 |
NHS NORTH KIRKLEES CCG | 88 | 186,706 | 47.1 |
NHS BOLTON CCG | 131 | 278,984 | 47.0 |
NHS EAST STAFFORDSHIRE CCG | 58 | 123,945 | 46.8 |
NHS COASTAL WEST SUSSEX CCG | 222 | 476,677 | 46.6 |
NHS LINCOLNSHIRE EAST CCG | 106 | 228,111 | 46.5 |
NHS HALTON CCG | 58 | 125,692 | 46.1 |
NHS NEWARK & SHERWOOD CCG | 53 | 115,897 | 45.7 |
NHS THANET CCG | 62 | 135,661 | 45.7 |
NHS SOMERSET CCG | 243 | 534,950 | 45.4 |
NHS BRADFORD CITY CCG | 37 | 82,319 | 44.9 |
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many of the 4,200 extra health visitors they are seeking to recruit by 2015 they expect (1) to work in the National Health Service, and (2) to complete training on identifying the signs of postnatal depression.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The additional 4,200 health visitors will all be providing front line services to families. Health visitor services are currently commissioned by NHS England as part of Section 7A of the NHS Act 2006*. NHS England’s Local Area Teams determine the most suitable local service provider. Currently, most provision is through a variety of National Health Service organisations, with a small proportion delivered by other organisations, including social enterprises. The trajectory for delivering growth of the health visitor workforce is not related to the type of provider. All services are based on a national model of health visiting and the NHS England service specification.
NHS England Area Teams and local authorities are working together in co-commissioning these services, prior to the lead commissioning role moving to local authorities in October 2015.
All health visitors, including the additional 4,200 being delivered by 2015, receive education and training on maternal mental health, so they can detect the early signs of postnatal depression and ensure all women get support during and after birth.
The NHS England 2014-15 service specification emphasises throughout, the role of the health visitor in promoting maternal mental health within clearly defined pathways. It makes clear that health visitors are expected to be trained and developed to be competent in delivering the evidence-based assessments and interventions set out in the Healthy Child Programme. In addition, NHS England is resourcing Area Teams to support delivery of the new model of health visiting which explicitly includes maternal mental health as a high impact area.
To supplement core training, health visitors are able to enhance their skills and knowledge in the context of their specific roles. The Department has earlier this year, commissioned the training of 375 perinatal mental health champions across England. The champions are cascading their training in local areas so as to facilitate the spread of knowledge and practice among colleagues. In addition to the champions’ training, all health visitors are able to access perinatal mental health e-learning modules.
Note:
*As amended by the Health and Social Care Act 2012.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many midwives were working in (1) Band 5, (2) Band 6, (3) Band 7 and (4) Band 8, roles in each of the last five years.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The number of full time equivalent midwives has risen from 20,126 in 2010 to 21,841 as of April 2014.
Annual data provided by the Health and Social Care Information Centre (HSCIC) 1, shows the number of registered full time equivalent midwives in Band 5, 6, 7, 8 for the last five years as shown in the following table.
|
Band 5 |
Band 6 |
Band 7 |
Band 8a |
Band 8b |
Band 8c |
Band 8d |
All staff
|
2009
|
1,641 |
12,700 |
4,896 |
161 |
37 |
7 |
3 |
19,603 |
2010
|
1,624 |
13,301 |
4,835 |
171 |
33 |
8 |
2 |
20,126 |
2011
|
1,643 |
14,022 |
4,517 |
164 |
28 |
9 |
3 |
20,519 |
2012
|
1,771 |
14,456 |
4,370 |
165 |
28 |
9 |
2 |
20,935 |
2013
|
1,956 |
14,759 |
4,197 |
195 |
31 |
8 |
1 |
21,284 |
Notes:
1. Health and Social Care Information Centre Non-Medical Workforce Census.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what proportion of pregnant women have been given a named midwife since November 2012.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Information on the number of women who have been given a named midwife is currently not collected centrally.
The Mandate between the Government and NHS England states that every woman should have a named midwife who is responsible for ensuring she has personalised, one-to-one care throughout pregnancy, childbirth and during the postnatal period. Through the assurance process with NHS England we monitor progress against all mandate commitments. A refresh of the current maternity commissioning guidance for clinical commissioning groups is under way and will include guidance on commissioning services to deliver the named midwife. NHS England is working with the Care Quality Commission on plans to monitor the commitment as part of their maternity services inspections.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is their response to the analysis by Diabetes UK of the increasing diagnosis of type 2 diabetes and the implications for the National Health Service budget.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
In January 2014, NHS England published the Action for Diabetes plan, which sets out how it intends to improve outcomes for people with, and at risk of, diabetes in England. The report acknowledges that type 2 diabetes is estimated to have cost the United Kingdom £8.8 billion in direct costs in 2010-2011 and that these costs are set to rise.
The action that NHS England is taking and will take to drive the prevention of Type 2 diabetes and earlier diagnosis of all diabetes and support better management of diabetes in primary care includes:
- Developing general practitioner contracts and incentives;
- working with primary care services to trial and roll out case-finding and decision-support tools in primary care to support earlier diagnosis; and
working with Public Health England to roll out the NHS Health Check programme.