Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what contracts NHS England and the Department of Health and Social Care have with The Phoenix Partnership and for what services; and what assessment they have made of the appropriateness of it providing such services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is the contracting authority for two consecutive framework agreements on which The Phoenix Partnership (TPP) has been appointed as a supplier, and awarded call-off contracts. These frameworks are the GP Systems of Choice (GPSoC), from 2014, and the GP IT Futures framework agreement (GPITF FA), which succeeded the GPSoC in 2020. The GPITF FA is the main contractual framework to supply IT systems and services to general practices (GPs) and associated organisations in England. The GPITF FA is operationally managed by NHS England, and the relevant contracting authorities under the call-off contracts are the individual integrated care boards, who contract on behalf of GPs.
In addition to managing the GPITF FA on behalf of the Department, NHS England is the contracting authority on three active contracts with TPP for: GP IT development and compliance; provision of Point of Care services to the NHS England Vaccination Programme; and provision of IT services to residential places of detention under the Health and Justice Information Systems contract.
The UK Health Security Agency (UKHSA) has a statutory requirement to report on the performance of the national immunisation programmes, and in June 2022, TPP was awarded a contract to extract this data directly from GPs' systems for the UKHSA, with a successor contract being awarded for the same work in October 2023. All Government contracts are awarded fairly and transparently, in line with the Public Contracts Regulations 2015. All decisions on contracts are rigorously scrutinised to assess a company’s ability to perform and deliver the best value for money for the taxpayer.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 25 March (HL2978), why they have specified how physician associates (PAs) are to be used, specifically with undifferentiated patients, rather than allowing GP practices to make their own decisions about the use of PAs.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Physician Associates (PAs) work within a defined scope of practice and limits of competence. NHS England has provided recent guidance on the use of PAs in general practice (GP) teams. As set out in the Network Contract Directed Enhanced Service, PAs should be adequately supervised by a GP when providing care for undifferentiated patients.
In terms of employment choices, GPs are self-employed contractors to the National Health Service, and it is largely up to employers to determine how best to staff their primary care network or GP, to best meet the needs of their population.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, following the protection of the titles “physician associate” and “anaesthesia associate” under the Anaesthesia Associates and Physician Associates Order 2024, when they plan to provide protection for other medical titles which are not already protected.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
All healthcare professional regulators have protected titles relating to the professions they regulate. There are currently 64 protected titles across 10 professional health and care regulators. The Government’s regulatory reform programme, which is already underway, will consider protected titles more broadly.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government why the NHS England’s Network Contract Directed Enhanced Service specifies that physician associates employed under the Additional Roles Reimbursement Scheme have key responsibility for providing first point of contact care for patients presenting with undifferentiated, undiagnosed problems.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Physician Associates have been part of the National Health Service workforce for a number of years. They are an important part of clinical teams across the NHS, providing support to thousands of patients every day, under the supervision of doctors.
The Additional Roles Reimbursement Scheme provides funding for a number of additional roles, including Physician Associates, to help create bespoke, multi-disciplinary teams. All these roles are in place to assist general practice (GP) doctors in reducing their workload and assisting patients directly with their needs, allowing doctors to focus on more complex patients and other priorities, including continuity of care. Physician Associates work alongside GPs and the wider practice team to provide care as part of the multidisciplinary team.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to amend the Additional Role Reimbursement Scheme to allow the scheme to fund additional GPs, and what assessment they have made of the number of GPs now seeking and unable to obtain employment.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Additional Roles Reimbursement Scheme aims to grow and diversify the general practice workforce. The scheme provides funding for 26,000 additional roles in primary care networks, to help create bespoke multi-disciplinary teams. General practitioners are not currently included in the scheme as they are a core role within general practice, and the recruitment of general practitioners is currently funded through global sum. We remain committed to growing the general practice workforce as well as number of doctors in general practice. There were 2,799 more full time equivalent doctors working in general practice in December 2023, compared to December 2019.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of (1) the overall burden of Long Covid, (2) the number of new cases being identified each month, (3) the percentage of sufferers who are able to receive specialist treatment, and (4) the provisions available for long-term support and assistance.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government does not currently routinely record the total amount of people with long COVID or new cases identified. However, the most recent data from the Office of National Statistics shows that for the 4-week period ending 5 March 2023, 1.9 million people, or 2.9% of the population, in private households in the United Kingdom reported experiencing long COVID symptoms; 83,000 people first had, or suspected they had, COVID-19 less than 12 weeks previously, 1.73 million people had symptoms for 12 or more weeks, 1.3 million people for at least a year and 762,000 for at least two years; and 1.5 million people reported day-to-day activities adversely affected. Of these, 381,000 reported that their ability to undertake day-to-day activities had been limited a lot.
Whilst no specific assessment has been made of the percentage of long COVID sufferers who are able to receive specialist treatment, activity data released by NHS England shows that, for the month of December 2023, there was a total of 1,104 initial specialist assessments completed during the month and an additional 8,696 follow-up appointments were carried out. In total, since the data was first published in July 2021, 101,998 patients have received an initial specialist assessment. A further 347,837 follow-up appointments have taken place.
NHS England has invested £314 million to expand long COVID treatment in the National Health Service and rehabilitation services, establishing 100 long COVID services for adults and 13 specialist paediatric hubs for children and young people. These assess people with long COVID and direct them into appropriate care pathways which provide appropriate support and treatment. Commissioning of post-COVID services will transition from the long COVID national programme to integrated care boards by the end of March 2024. Funding for long COVID services in 2024/25 is expected to be allocated based on the 2023/24 distribution.
The NHS and wider scientific community are working at unprecedented pace to better understand long COVID, supported by £50 million in research funding.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to inform and educate employers and occupational health professionals of the specific workplace adaptations that women experiencing menopause symptoms may require, and what assessment they have made of working conditions for frontline health workers experiencing menopause symptoms.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the Government’s Women’s Health Strategy, improving care and support for women experiencing menopause symptoms is a priority for the Government. Helen Tomlinson has been appointed as the Government’s first Menopause Employment Champion and is working with employers to increase understanding of menopause in the workplace and support for women. In October 2023 Helen published a report, No Time to Step Back, which provides guidance to help recruit, support and retain women experiencing the menopause and stop women considering giving up their employment.
The Government has also launched a new online only space for guidance on the Help to Grow website, providing businesses, large and small, with the resources they need to help educate their organisation and workers about the menopause.
In the 2023 Autumn Statement, the Government published the response to the Occupational Health: Working Better consultation and set out plans to imminently set up an expert group to support the development of a voluntary minimum framework for quality occupational health provision. The voluntary framework will take account of existing initiatives that support those with health conditions and disabilities in the workplace and aims to set out the minimum level of quality occupational health provision that employers can adopt to help employees return to work from sickness absence, and prevent health-related job loss.
The Government also announced that it will identify longer-term options to build multidisciplinary workforce capability in work and health, building on existing work with the sector and exploring opportunities for businesses and providers to improve support for their employees. The Occupational Health Workforce Expansion Funding Scheme launched in July 2023 funds doctors and nurses to undertake occupational health training courses and qualifications with 99 Doctors and Nurses funded as part of the first round of applications.
In terms of frontline health workers, a key focus of the NHS England National Menopause Care Improvement Programme is the development of a retention programme for the National Health Service workforce, which is looking at how best to support menopausal staff and line managers in NHS settings. In November 2022, NHS England launched Supporting our NHS people through menopause, a guidance document developed for NHS line managers and colleagues. They have launched two e-learning packages, for general guidance and occupational health colleagues, and are developing one for human resources and line managers. A health and wellbeing app, Shiny Mind, is available to the nursing workforce, and launched a menopause specific section in November 2023.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to inform and educate employers and occupational health professionals about the specific workplace adaptations that people with Hidradenitis suppurativa may require.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the Government response to the Occupational Health: Working Better consultation published last year, the Government will develop a voluntary minimum framework for quality occupational health, aiming to set out the minimum level of provision that employers can adopt to support those with health conditions and disabilities in the workplace. This builds on the development of a digital information and advice service for employers, offering tailored guidance on health and disability, to equip employers to have work and health conversations and signpost to sources of expert support. A copy of the Government response to the consultation is attached.
The Government also announced that it will identify longer-term options to build multidisciplinary workforce capability in work and health, building on existing work with the sector and exploring opportunities for businesses and providers to improve support for their employees. The Occupational Health Workforce Expansion Funding Scheme launched in July 2023 funds doctors and nurses to undertake occupational health training courses and qualifications with 99 doctors and nurses trained to date.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to reduce rates of violence experienced by front line healthcare workers; and what assessment they have made of the effect of such violence on staffing levels.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
In January 2021, and in conjunction with the Social Partnership Forum, NHS England developed and published a national Violence Prevention and Reduction Standard. This supports employers in their efforts to provide a safe and secure working environment for National Health Service staff, with a focus on risk management, training and support for those impacted by incidences of violence or aggression.
£8.4 million has been invested into the ambulance service sector to explore the efficacy of body worn cameras in reducing violence and abuse. All ambulance trusts are now trialling cameras and an independent evaluation is underway with a final report expected towards the end of 2024.
In 2022, the Government legislated through the Police, Crime, Sentencing and Courts Act to double the sentence for assaults on emergency workers to a maximum of two years.
We do not currently have a national mechanism to assess the levels of violence and aggression in the NHS on staffing levels. NHS employing organisations have a duty of care to support the health and safety of their staff and they do collect data on incidents. This is used to inform local strategies for reducing and dealing with violence and aggression.
The NHS Staff Survey does ask questions relating to incidences of violence, harassment, and abuse. The 2022 NHS Staff Survey indicated that 14.7% of NHS staff have self-reported that they had experienced at least one incident of physical violence from patients, service users, relatives, or other members of the public in the last 12 months.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to promote (1) the NHS Low Income Scheme to chronically ill patients, including Hidradenitis suppurativa patients, and (2) the use of pre-payment prescription certificates to chronically ill patients, including Hidradenitis suppurativa patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Business Services Authority and the National Health Service promote the NHS Low Income Scheme and prescription pre-payment certificates (PPCs) to professionals and patients. It does this through social media, online resources, media releases and healthcare bulletins.
Our extensive arrangements to help people afford NHS prescription charges, means that almost 89% of prescription items in England are already provided free of charge. For those not exempt from charges, PPCs can be used to cap costs at approximately £2 a week for regular prescriptions.