Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to reduce health spending inequalities between (a) the UK and other European countries and (b) UK health authority districts.
Answered by Philip Dunne
Based on the latest internationally comparable Organisation for Economic Co-operation and Development (OECD) data, total health spending in the United Kingdom, as set out by the OECD for 2014 (published 30 June 2016), and which includes public (Government) and private spend, is at 9.9% of Gross Domestic Product (GDP), above the OECD average1 of 9.0% and the EU-15 average of 9.8%.
Reducing health spending inequalities is part of the core formula that is used to determine the funding that is allocated to clinical commissioning groups (CCGs), which are the equivalent of UK health authority districts in England. Responsibility for CCG allocations rests with NHS England. NHS England also has a duty to reduce health inequalities.
The formula includes an adjustment for unmet need and health inequalities, which has been refined for 2016-17 to 2020-21 allocations.
The unmet need and health inequalities adjustment continues to be based on the standardised mortality ratio for those aged under 75 years. The latest data has been used and the adjustment refined to give a higher weight per head to the areas with the worst standardised mortality ratio for those aged under 75 years and to be based on the size of each CCG’s registered lists in place of Office for National Statistics populations, on which it was previously based.
NHS England has published a technical guide to allocations which sets out all the individual factors used in determining the allocation levels. The guide is available here:
https://www.england.nhs.uk/2016/04/allocations-tech-guide-16-17/#
Funding for other parts of the UK is a matter for the devolved administrations.
Note:
1The reported averages reflect the simple average of countries’ figures without weighting that for population or GDP of the respective countries.
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what scientific evidence led to the promotion of the care closer to home model adopted by the north, east and west Devon Success Regime.
Answered by Philip Dunne
The proposals developed by the north, east and west Devon Success Regime have drawn upon a range of evidence, including studies of the potential benefits of care closer to home. This included a number of national and local studies, such as the Torrington Community Care Test of Change in Social Care which can be found at:
www.northdevonhealth.nhs.uk/wp-content/uploads/2015/06/Appendix-7-Evidence-Review.pdf
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what plans he has to ensure that public consultations on local NHS changes involve patients and the public.
Answered by Philip Dunne
National Health Service bodies have a statutory duty to engage with patients and the public about service change. Principles for service change are enshrined in the four reconfiguration tests as mandated by the government to NHS England. All local reconfiguration plans should satisfy these tests which are: (i) strengthened public and patient engagements, (ii) support from GP commissioners, (iii) clarity on the clinical evidence base and (iv) support for patient choice.
NHS England guidance on service change states that “effective involvement means being open and transparent about proposals enabling local stakeholders to have the opportunity to influence change.”[1]
[1] Planning, assuring and delivering service change for patients, NHS England, October 2015 Pg 14
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to improve public and patient involvement in the NHS.
Answered by Philip Dunne
Patient and Public Involvement (PPI) is enshrined in S.242 of the National Health Service Act 2006. The Health and Social Care Act 2012 amended S.242 and included complementary duties for clinical commissioning groups (CCGs) and NHS England.
Since the 2012 Act NHS England has published statutory guidance for NHS commissioners and revised guidance for CCGs will be published in spring 2017. A further guide on engaging communities, for areas developing Sustainability and Transformation Plans, was published by NHS England in September 2016. NHS England has also recently launched an Involvement Hub, an online resource to support patients, carers, staff and the public, which also includes examples of good practice and links to learning and involvement opportunities.
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps the Government is taking to ensure local authorities can adequately fund learning disability services.
Answered by Alistair Burt
In the national service model and Building the Right Support published in October 2015, NHS England, the Local Government Association and the Association of Directors of Adult Social Services set out how areas would be supported to deliver lasting change to people with a learning disability and/or autism who display behaviour that challenges.
This includes service transformation – shifting money from some services, such as inpatient care, into others, such as community services.
To support this NHS England is making available up to £30 million of transformation funding over three years, to be matched by clinical commissioning groups, and £15 million in capital funding. This funding is in addition to the £10 million which was made available to six fast track areas in 2015/16.
The Government has supported adult social care, which includes care for those with learning disabilities, by giving local authorities access to up to £3.5 billion of new support by 2019/20. This includes the adult social care precept, allowing councils to increase council tax by 2% above the existing threshold, as well as additional social care monies to be included in the Better Care Fund.
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps other than the social care precept the Government is taking to ensure that local authorities are able adequately to fund services for people with learning disabilities.
Answered by Alistair Burt
In addition to the social care precept, which gives local authorities access to up to £2 billion for adult social care by 2019/20; the Government has supported adult social care, which includes care for those with learning disabilities, by giving local authorities access to up to £1.5 billion of new support by 2019/20. This is based on the additional social care monies to be included in the Better Care Fund.
In the national service model and Building the Right Support published in October 2015, NHS England, the Local Government Association and the Association of Directors of Adult Social Services set out how areas would be supported to deliver lasting change to people with a learning disability and/or autism who display behaviour that challenges.
This includes service transformation – shifting money from some services, such as inpatient care, into others, such as community services.
To support this NHS England is making available up to £30 million of transformation funding over three years, to be matched by clinical commissioning groups, and £15 million in capital funding. This funding is in addition to the £10 million which was made available to six fast track areas in 2015/16.
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the future effect of the introduction of the national living wage on sleep-in payments used by the learning disability sector.
Answered by Alistair Burt
We have not made a specific assessment of the effect of the introduction of the National Living Wage on sleep-in payments used by the learning disability sector.
However, as part of the recent Spending Review, the Department considered adult social care expenditure and the future demand for services, and engaged closely with providers within the sector. This included the impact of the new National Living Wage on local authority finances as part of an overall assessment of spending pressures.
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what plans his Department has for the next National Clinical Audit of avoidable deaths in relation to epilepsy.
Answered by Jane Ellison
The Healthcare Quality Improvement Partnership commissions, develops and manages the National Clinical Audit and Patient Outcomes Programme (NCAPOP), on behalf of NHS England, Wales and other devolved administrations. Whilst there is no specific audit planned that covers all cases of deaths from epilepsy, the following NCAPOP audits and reviews are of relevance:
- The audit for paediatric epilepsy, which is being re-commissioned this year, covers the quality of health care services for children and young people with epilepsy in the UK. The audit is managed by the Royal College of Paediatrics and Child Health (RCPCH) and the first audit report can be found at the following link:
www.rcpch.ac.uk/news/variation-care-children-epilepsy-revealed-first-uk-wide-audit;
- The 2013 review report into cases of mortality and prolonged seizures in children and young people with epilepsies that was managed by the RCPCH. The report is available at the following link:
www.rcpch.ac.uk/child-health-reviews-uk/programme-findings/programme-findings-chr-uk;
- The recently commissioned national mortality case record review programme for England and Scotland which aims to improve understanding and learning about problems in care that may have contributed to a patient’s death:
www.rcplondon.ac.uk/news/rcp-hosts-pioneering-national-mortality-case-record-review-programme
- The maternal, newborn and infant clinical outcome review programme will be undertaking a review of cases of mortality and morbidity for pregnant women with severe epilepsy that will report in December 2017. This will be carried out by MBRRACE-UK at The University of Oxford. Further information can be found at the following link:
www.npeu.ox.ac.uk/mbrrace-uk/topic-proposals
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to the NICE quality standards on rheumatoid arthritis, what steps he has taken to ensure patients with early inflammatory arthritis are referred from their GP to rheumatology services within three days.
Answered by Jane Ellison
Quality standards (QS) are important in setting out to patients, the public, commissioners and providers what a high quality service should look like in a particular area of care. Whilst providers and commissioners must have regard to the National Institute for Health and Care Excellence (NICE) QS in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.
The first annual report of the national clinical audit of rheumatoid and early inflammatory arthritis, commissioned on behalf of NHS England by the Healthcare Quality Improvement Partnership (HQIP), was published on 22 January 2016. This report, which includes data from 1 February 2014 to 30 April 2015, assesses the quality of care by specialist rheumatology services using criteria derived from sources, including the rheumatoid arthritis quality standard, published by the NICE in June 2013. The report identifies that although most services offer prompt educational support and agree targets for treatment with their patients, performance against criteria for referral and assessment could be improved. Since the audit, HQIP has reported that a number of trusts have successfully reconfigured their services in order to improve patient care.
More information can be found at the following link:
www.hqip.org.uk/national-programmes/a-z-of-nca/arthritis-rheumatoid-and-early-inflammatory
Asked by: Geoffrey Cox (Conservative - Torridge and West Devon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what account the Government took of arthritis and other musculoskeletal conditions in its Childhood Obesity Strategy.
Answered by Jane Ellison
Our Childhood Obesity Strategy, which will be launched in the summer, will look at everything that contributes to a child becoming overweight and obese.