Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, following the announcement by the Secretary of State for Health and Social Care regarding the statutory regulation of Physician Associates and Physician Assistants in anaesthesia on 12 October, when they intend to commence the legislative process to introduce such regulation.
Answered by Lord O'Shaughnessy
Following the Secretary of State for Health and Social Care’s announcement on 12 October 2018 that the Department plans to introduce statutory regulation for Physician Associates and Physicians’ Assistants (Anaesthesia), officials have started work to develop a suitable underpinning legislative framework.
Bringing non-regulated healthcare professions into statutory regulation is typically done using Section 60 of the Health Act 1999. This process takes around 18 to 24 months to complete, subject to Parliamentary time.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the impact of a state-backed GP indemnity scheme in England on the number and value of clinical negligence claims made against GPs and other members of primary care teams.
Answered by Lord O'Shaughnessy
The Department understands that the rising cost of indemnity cover is a great source of concern for general practitioners (GPs) and impacts negatively on the GP workforce. We are seeking to put in place a more affordable and more stable system of indemnity for general practice. The state backed indemnity scheme will aim to protect both patients and providers from the consequences of clinical negligence and to meet the changing needs of the National Health Service.
We have not made an assessment of the potential impact of the state scheme on the number and value of clinical negligence claims, but more generally, the Government is working to produce a cross-Government strategy to tackle the rising costs of clinical negligence, as challenged by the National Audit Office in their report, Managing the costs of clinical negligence in trusts, published in September 2017. A copy of this report is attached.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the effect of the introduction of a state-backed GP indemnity scheme in England on the medical defence organisation marketplace.
Answered by Lord O'Shaughnessy
The Department is developing a state-backed indemnity scheme for general practice in England. This recognises that the rising cost of clinical negligence is a great source of concern for general practitioners (GPs). The state-backed scheme is being designed to provide more affordable and more stable cover for GPs.
We recognise the value of medical defence organisations to their members and we are working closely with them to understand the impact of the proposed scheme on their business.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what progress they have made in implementing a state-backed GP indemnity scheme in England; and what further implementation plans are currently in place.
Answered by Lord O'Shaughnessy
In October 2017, the Secretary of State for Health and Social Care announced the intention of the Department to develop a state-backed indemnity scheme for general practice in England. This announcement recognised that the rising cost of clinical negligence is a great source of concern for general practitioners (GPs).
Since the announcement, the Government has been developing the new scheme, seeking to put in place a more stable and affordable system of indemnity for general practice. The plans announced so far are as follows:
- NHS Resolution will be directed to establish and administer the scheme on behalf of the Secretary of State. This means that NHS Resolution will be given responsibility for the overall administration of the scheme;
- The scheme will include activities delivered under the primary medical care contracts (General Medical Services, Personal Medical Services and Alternative Provider Medical Services). Other professions working under the primary medical care contracts will be included in the scheme. The scheme will also include work delivered under the primary medical care contracts that are delivered in secure environments; and
- The current intention is that the scheme will exclude National Health Service primary care dentistry and private dentistry, private healthcare and community pharmacy and optometry.
We are working closely with the medical defence organisations, NHS England, and representatives of general practice professionals.
In March 2018, the Department commissioned a survey of GPs, nurses and pharmacists in general practice. The survey was designed to help the Department understand current indemnity arrangements within general practice, informing the development of the new state backed scheme.
We are currently analysing the survey results and will provide further details along with the key findings of the GP Indemnity Survey in due course.
We remain fully committed to developing and implementing the scheme from April 2019.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the average annual saving to GPs of a state-backed GP indemnity scheme in England.
Answered by Lord O'Shaughnessy
The state backed scheme is being designed to provide more stable, affordable and financially sustainable indemnity cover for general practitioners (GPs). A state backed scheme will enable the Government to have greater overall sight of costs and claims.
The scheme should meet the needs of current and future GPs and offer value for money for taxpayers. This involves complex considerations about funding which are being worked through, and we are working with HM Treasury and NHS England to assess the potential future cost of the scheme. We are unable to provide the estimates that result from these assessments as this information is commercially sensitive.
The Government is working with medical defence organisations, general practice representatives and other key stakeholders on the design of the scheme.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the total cost to the NHS of implementing a state-backed GP indemnity scheme in England.
Answered by Lord O'Shaughnessy
The state backed scheme is being designed to provide more stable, affordable and financially sustainable indemnity cover for general practitioners (GPs). A state backed scheme will enable the Government to have greater overall sight of costs and claims.
The scheme should meet the needs of current and future GPs and offer value for money for taxpayers. This involves complex considerations about funding which are being worked through, and we are working with HM Treasury and NHS England to assess the potential future cost of the scheme. We are unable to provide the estimates that result from these assessments as this information is commercially sensitive.
The Government is working with medical defence organisations, general practice representatives and other key stakeholders on the design of the scheme.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of the decision by NHS South West Lincolnshire Clinical Commissioning Group to implement contractual agreements that patients cannot receive routine elective care before 12 weeks, whether they intend to intervene to prohibit such practices.
Answered by Lord O'Shaughnessy
NHS England has made it clear to commissioners that they should not restrict access to routine elective at any stage of a patient’s referral to treatment. Clinical commissioning groups (CCGs), including South West Lincolnshire CCG, should work locally with National Health Service providers to manage appointments for routine elective care, taking into account the needs of their population and in line with waiting times standards as set out in the NHS Constitution.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to review how they can incentivise manufacturers of generic medicines to ensure off-patent medicines can be repurposed and made available to patients.
Answered by Lord O'Shaughnessy
The Association of Medical Research Charities (AMRC) has led a group of stakeholders which has produced a framework to facilitate the adoption of off-patent repurposed drugs into National Health Service clinical practice where there is robust evidence to support it and where this would benefit patients. This, alongside some recommendations which will further support drug repurposing, was published in their report last year, Facilitating adoption of off-patent, repurposed medicines into NHS clinical practice. A copy is attached.
The Department has supported this work and is playing its part in implementing the recommendations which fall within its area of responsibility. We have no plans to further review how generic manufacturers can be incentivised. The AMRC’s report includes two recommendations which relate to incentives for generic manufacturers which are for a range of other stakeholders to drive forward. However, we took an important step forward in incentivising medicines manufacturers to repurpose drugs in ensuring that the Accelerated Access Pathway announced last November is open to repurposed drugs.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to facilitate the adoption of off-patent, repurposed drugs into NHS clinical practice where these would benefit patients.
Answered by Lord O'Shaughnessy
The Association of Medical Research Charities (AMRC) has led a group of stakeholders which has produced a framework to facilitate the adoption of off-patent repurposed drugs into National Health Service clinical practice where there is robust evidence to support it and where this would benefit patients. This, alongside some recommendations which will further support drug repurposing, was published in their report last year, Facilitating adoption of off-patent, repurposed medicines into NHS clinical practice. A copy is attached.
The Department has supported this work and is playing its part in implementing the recommendations which fall within its area of responsibility. We have no plans to further review how generic manufacturers can be incentivised. The AMRC’s report includes two recommendations which relate to incentives for generic manufacturers which are for a range of other stakeholders to drive forward. However, we took an important step forward in incentivising medicines manufacturers to repurpose drugs in ensuring that the Accelerated Access Pathway announced last November is open to repurposed drugs.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what processes they will adopt to ensure that eligible repurposed medicines are included in horizon scanning to identify products for the Accelerated Access Pathway, as highlighted in their response to the Accelerated Access Review.
Answered by Lord O'Shaughnessy
The Accelerated Access Collaborative (AAC) will begin product selection from April onwards. We were explicit in the response that repurposed medicines would be eligible for consideration of their suitability for the pathway. We anticipate that the AAC will publish further details on the process and criteria for the pathway ahead of the pathway opening in April 2018.