Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to provide care and respite funding for young adult amputees.
Answered by Dan Poulter
Information on specific funding for young adult amputees is not held centrally.
NHS England has advised that the rehabilitation and re-ablement of all patients is provided by a specialised Multi-Disciplinary Team (MDT) which should be consultant led. The needs of patients of all age groups are addressed including physical, psychological, social, emotional and spiritual with the emphasis on individual outcomes, independence and prevention keeping patients dexterous, mobile and safe. Secondary injuries should be minimised.
The NHS Standard Contract for Complex Disability Equipment – Prosthetics, which applies to all ages, sets out how the specialist centres should operate and the required level of service delivered. It also recognises that children, young adults, veterans and other patients require a flexible model of care which provides longer term involvement with the full MDT. The specification also recognises that child growth is a recognised clinical need.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what proportion of long-term conditions which entitle patients to free prescriptions are curable.
Answered by George Freeman
The list of medical conditions that give entitlement to apply for a National Health Service prescription charge medical exemption certificate are:
- a permanent fistula (including caecostomy, colostomy, laryngostomy, or ileostomy) which requires continuous surgical dressing or requires an appliance forms of hypoadrenalism (including Addison's disease) for which specific substitution therapy is essential;
- diabetes insipidus or other forms of hypopituitarism;
- diabetes mellitus (except where treatment of the diabetes is by diet alone);
- hypoparathyroidism;
- myasthenia gravis;
- myxoedema (that is, hypothyroidism requiring thyroid hormone replacement);
- epilepsy requiring continuous anti-convulsive therapy;
- continuing physical disability which prevents the patient from leaving his residence without the help of another person; and
- patients undergoing treatment for cancer, the effects of cancer or the effects of current or previous cancer treatment. (From 1 April 2009).
Clinical advice from NHS England is that the majority of these conditions are considered to be permanent, incurable conditions. Only in exceptional cases would a person have the possibility of curative treatment for one of these conditions.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the average waiting time is for pain management in each region.
Answered by Norman Lamb
The information requested is shown in the following table. These data are from hospital episode statistics and measure the time waited between decision to admit and admission to hospital. They are not the same as referral to treatment waiting times, which measure waiting times from referral to the start of consultant-led treatment by 18 treatment functions (subdivisions of consultant main specialties), but which do not include condition specific information.
The average (median) number of days waited for pain management treatment, 2012-13
Average (median) waiting time (days) | ||
Area Team of Residence | Admissions | First Outpatient Attendances |
Cheshire, Warrington And Wirral Area Team | 59 | 46 |
Durham, Darlington And Tees Area Team | 65 | 52 |
Greater Manchester Area Team | 64 | 42 |
Lancashire Area Team | 55 | 38 |
Merseyside Area Team | 58 | 50 |
Cumbria, Northumberland, Tyne And Wear Area Team | 44 | 49 |
North Yorkshire And Humber Area Team | 57 | 55 |
South Yorkshire And Bassetlaw Area Team | 41 | 26 |
West Yorkshire Area Team | 84 | 54 |
Arden, Herefordshire And Worcestershire Area Team | 49 | 49 |
Birmingham And The Black Country Area Team | 47 | 52 |
Derbyshire And Nottinghamshire Area Team | 47 | 29 |
East Anglia Area Team | 61 | 50 |
Essex Area Team | 56 | 55 |
Hertfordshire And The South Midlands Area Team | 84 | 68 |
Leicestershire And Lincolnshire Area Team | 63 | 54 |
Shropshire And Staffordshire Area Team | 64 | 61 |
Bath, Gloucestershire, Swindon And Wiltshire Area Team | 56 | 60 |
Bristol, North Somerset, Somerset And South Gloucestershire Area Team | 18 | 50 |
Devon, Cornwall And Isles Of Scilly Area Team | 77 | 49 |
Kent And Medway Area Team | 58 | 49 |
Surrey And Sussex Area Team | 66 | 59 |
Thames Valley Area Team | 69 | 56 |
Wessex Area Team | 65 | 48 |
London Area Team | 70 | 63 |
England | 63 | 51 |
Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre
Notes:
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many patients with long-term health conditions which entitle them to free prescriptions have been fined for not renewing their certificates in each of the last five years.
Answered by George Freeman
The Prescription Exemption Checking Service is delivered by the NHS Business Services Authority (NHSBSA) as commissioned by NHS England. NHSBSA assumed the responsibility for this service from 17 September 2014. Prior to this date it was the responsibility of primary care trusts and NHS England Area Teams, for which no data is held.
From 17 September 2014 to 16 January 2015 a total of 1,475 patients who have declared they hold a valid certificate which indicates that they are entitled to free prescriptions due to a long-term health condition have paid a penalty charge in full with a further 898 patients who have opted to pay the penalty charge by instalments.
The NHSBSA cannot identify from the exemption checking process which patients claiming medical exemption have been sent a penalty charge notice as a result of the patient not renewing their medical exemption certificate.
For those patients who have paid a penalty charge the cause for the incorrect claim for free prescriptions is not known. There are various reasons which could include:
- expiry of current medical exemption certificate; and
- never been in receipt of a medical exemption certificate.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to publicise the fact that certificates of entitlement to free prescriptions for chronic and incurable conditions are time-limited.
Answered by George Freeman
The NHS Business Services Authority (NHSBSA) sent all English pharmacies and general practitioner practices a supply of posters and booklets entitled ‘Claiming free prescriptions?’ in October 2014 as part of the centralisation of the prescription exemption checking process within the NHSBSA. The poster warns patients of the consequences of claiming free prescriptions incorrectly and directs them to the booklet for more information on eligibility, which states that medical exemption certificates are valid for five years. The poster and booklet are also published on the NHSBSA website at:
http://www.nhsbsa.nhs.uk/PrescriptionServices/4666.aspx
The covering letter sent to patients by the NHSBSA along with their medical exemption certificates also references that certificates are liable for renewal, and the expiry date is printed on the certificate itself. The letter also directs recipients to the NHSBSA website and the NHS Help with Health Costs Facebook page where more information is available. The NHS Choices Help with Health Costs pages also contain information about eligibility for free prescriptions, including details on medical exemptions and certificate duration.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make it his policy that the NHS Business Unit should contact GPs when a certificate of entitlement to free prescriptions is due to expire.
Answered by George Freeman
We do not believe it would be appropriate for the NHS Business Services Authority to contact general practitioners about renewal of medical exemption certificates. Information is already sent directly to patients about the validity of these certificates, which includes the date of expiry printed on the certificate and a reminder sent to the patient one month before the certificate expires. The wording of the declaration on the prescription form is also a prompt to a patient to check that their certificate is valid.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what research his Department has commissioned into complex regional pain syndrome.
Answered by George Freeman
The Department has not commissioned specific research into complex regional pain syndrome (CRPS) but a range of related research is funded by the National Institute for Health Research (NIHR).
The NIHR Clinical Research Network is currently recruiting patients to two studies relating to CRPS:
- Development of an Electrical Sensory Discrimination Therapies device for the relief of chronic pain in CRPS. A proof of concept study
- An Intervention Trial to Investigate the Effectiveness of Visual Illusions in Manipulating Body Perception Disturbances to Reduce Chronic Pain and Improve Movement Performance
There is also an active Efficacy and Mechanism Evaluation (EME) Researcher-Led project (which is funded by the Medical Research Council and managed by NIHR):
- Low-dose Intravenous Immunoglobulin Treatment for Complex Regional Pain Syndrome (‘LIPS’) Randomised Controlled Trial.
Other research, carried out within the last two years, includes:
A Health Services and Delivery Research project:
- Meeting the support needs of patients with Complex Regional Pain Syndrome through innovative use of wiki technology
CRN studies:
- A Multi-Centre International Study Exploring the Patients' Definition of Recovery from Complex Regional Pain Syndrome
- Visually Manipulating Body Perception Disturbances to Treat Chronic Pain: An Exploratory Study
NIHR Career Development Fellowships:
- Understanding sensorimotor integration and its role in pain. Feasibility study to evaluate the potential of multi-modal imaging systems in CRPS
- Sensorimotor conflict and its relationship to behavioural and neurophysiological variables in CRPS, FMS, arthritis and healthy volunteers
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people have been fined for falsely claiming free prescriptions in each of the last five years.
Answered by George Freeman
The Prescription Exemption Checking Service is delivered by the NHS Business Services Authority (NHSBSA) as commissioned by NHS England. NHSBSA assumed the responsibility for this service from 17 September 2014. Prior to this date it was the responsibility of primary care trusts and NHS England Area Teams, for which no data is held.
From 17 September 2014 to 16 January 2015 5,572 patients have paid a penalty charge in full with a further 2,252 patients opting to pay the penalty charges in instalments.
Asked by: Andrew Bingham (Conservative - High Peak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what progress his Department has made in treating pain since the Chief Medical Officer's annual report in 2008 called for the issue to receive greater priority.
Answered by Norman Lamb
In response to the Chief Medical Officer’s (CMO’s) report 2008 report, the Healthcare Quality Improvement Partnership working with The British Pain Society and Dr Foster undertook the first ever National Pain Audit, which launched in 2009. The findings from the three year study, which appeared in three reports, highlighted variation in service provision and made a number of recommendations for the National Health Service to improve quality of care for patients suffering from chronic pain.
Since 1 April 2013, NHS England became responsible for the commissioning of specialised pain services for patients with chronic pain. NHS England has published a service specification for patients with chronic pain that sets out what providers must have in place in order to deliver evidence-based, safe and effective services. It supports equity of access to a nationally consistent, high quality service for patients. The specification can be found at the following link:
www.england.nhs.uk/wp-content/uploads/2013/06/d08-spec-serv-pain-mgt.pdf
In the time since the CMO report, the National Institute for Health and Care Excellence (NICE) has produced a range of guidance to support clinicians to diagnose and treat a range of conditions causing ongoing pain, most recently publishing the 2013 guideline Neuropathic pain: The pharmacological management of neuropathic pain in adults in non-specialist settings. Finally, the British Pain Society collaborated with the Map of Medicine to produce a range of evidence-based pain care pathways, published in October 2014. These support NHS commissioners, providers and patients to access to high-quality, practice-informed care pathways that map the journey from initial presentation through to ongoing management of chronic pain. This can be accessed on the NHS Choices website at the following link:
http://www.nhs.uk/aboutNHSChoices/aboutnhschoices/partners/MapofMedicine/Pages/Introduction.aspx.