Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 21 March (HL7044), why the current section 7a public health functions agreement does not include key deliverables for the provision of pneumococcal vaccination to severely immunocompromised children aged at least five years and adults, as recommended by the Joint Committee on Vaccination and Immunisation in July 2013.
Answered by Lord Prior of Brampton
The 2016-17 Section 7A public health functions agreement specifies key deliverables in relation to new or changed programmes that are being introduced within 2016-17.
The provision of pneumococcal vaccination to severely immunocompromised children aged at least five years and adults, as recommended by the Joint Committee on Vaccination and Immunisation in July 2013, is reflected in the relevant service specification for the existing pneumococcal immunisation programme and within the document Immunisation against Infectious Diseases (‘the Green Book’). The Green Book is published on the GOV.UK website in an online only format.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what actions (1) NHS England, and (2) Public Health England, are taking to improve levels of vaccination coverage of recommended vaccines for adults in areas with low levels of uptake.
Answered by Lord Prior of Brampton
Through the National Health Service public health functions agreement (S7A), NHS England commissions services from a variety of providers across England, and has a national service specification outlining the national standards and expectations. Immunisation programmes are delivered in partnership with Public Health England (PHE) and the Department, who use contracting and commissioning levers to reduce variation in local levels of performance between different geographical areas. In addition, organisations are working together on a number of priority programmes where there is variation, such as measles, mumps, and rubella to put in place effective actions for improvement.
PHE works in partnership with NHS England and Directors of Public Health to ensure that local population needs are understood and addressed by local immunisation services, and with NHS England local teams to provide leadership and coordination to sustain and improve the successful delivery of existing programmes.
PHE constantly monitors cases of vaccine preventable disease and levels of vaccine coverage.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans Public Health England has to issue guidance to healthcare professionals on the use of nationally procured vaccine stock.
Answered by Lord Prior of Brampton
Public Health England issues guidance to healthcare professionals on the use of nationally procured vaccine stock through chapter three of its publication, ‘Immunisation against infectious diseases’ titled ‘Storage, distribution and disposal of vaccines’. A copy is attached.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans NHS England has to establish performance floors setting out minimum levels of vaccination coverage in different areas of the country, in line with the commitment in its Putting Patients First business plan.
Answered by Lord Prior of Brampton
NHS England has a specific role to commission those public health services set out in the Section 7A public health functions agreement 2016-17, including immunisation programmes and to hold to account providers to ensure that they deliver the contracts that have been agreed. The agreement sets out specific outputs and outcomes to be achieved by NHS England including performance indicators that outline minimum levels of vaccination coverage for different programmes. NHS England publishes national service specifications outlining the minimum levels of vaccinations expected, which in turn are put into contracts with providers at local level.
The Section 7A agreement requires NHS England to at least maintain, or improve, national levels of performance on existing services, while also implementing planned changes. It also includes an ambition to reduce local variation in performance between different geographical areas.
There are no plans to review incentives, however a number are already in place. For example, within primary care general practitioner (GP) settings, some vaccination services such as flu for those with diabetes have quality outcome framework indicators attached, whereby GPs are rewarded for good practice. Also, as part of the contracts given outside of the primary care settings, local teams can develop Commissioning for Quality and Innovation payments that link a proportion of providers' income to the achievement of local quality improvement goals.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to carry out a review of incentives and reimbursement for the delivery of routine immunisation programmes.
Answered by Lord Prior of Brampton
NHS England has a specific role to commission those public health services set out in the Section 7A public health functions agreement 2016-17, including immunisation programmes and to hold to account providers to ensure that they deliver the contracts that have been agreed. The agreement sets out specific outputs and outcomes to be achieved by NHS England including performance indicators that outline minimum levels of vaccination coverage for different programmes. NHS England publishes national service specifications outlining the minimum levels of vaccinations expected, which in turn are put into contracts with providers at local level.
The Section 7A agreement requires NHS England to at least maintain, or improve, national levels of performance on existing services, while also implementing planned changes. It also includes an ambition to reduce local variation in performance between different geographical areas.
There are no plans to review incentives, however a number are already in place. For example, within primary care general practitioner (GP) settings, some vaccination services such as flu for those with diabetes have quality outcome framework indicators attached, whereby GPs are rewarded for good practice. Also, as part of the contracts given outside of the primary care settings, local teams can develop Commissioning for Quality and Innovation payments that link a proportion of providers' income to the achievement of local quality improvement goals.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to ensure that the section 7a agreement between the Department of Health and NHS England is automatically updated to reflect recommendations made by the Joint Committee on Vaccination and Immunisation.
Answered by Lord Prior of Brampton
The Section 7A public health functions agreement is updated on an annual basis, at which point any new recommendations from relevant expert committees, including the Joint Committee on Vaccinations and Immunisation (JCVI), are taken into account.
If the JCVI makes a recommendation which is urgent, for example in the case of a public health emergency, the agreement can be amended in-year by agreement between the Department and NHS England.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether Clinical Commissioning Groups and NHS trusts are responsible for the funding or provision of incontinence pads to residents of (1) care homes for personal care, and (2) care homes with nursing care.
Answered by Lord Prior of Brampton
The legislation under which NHS England and clinical commissioning groups (CCGs) commission services requires them to arrange for the provision of services for which they are responsible, to such extent as they consider necessary to meet all reasonable requirements.
For CCGs, this includes offering continence services as part of their obligation to provide community health. Although CCGs often focus on prevention and treatment, it is expected any standard continence service should include access to products. The criteria for the provisioning of continence products are set by individual CCGs. To support CCGs, NHS England has recently published new guidance to help improve the care and experience of children and adults with continence issues. This encourages much greater collaboration between health and social care.
A copy of the guidance Excellence in continence care is attached.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what policy the NHS has about protecting the mental health of its workforce.
Answered by Lord Prior of Brampton
NHS England’s recent announcement "A healthy NHS workforce", aims to raise staff awareness and understanding of mental health issues and ensure staff have access to help, support and treatment when they need it.
“A healthy NHS workforce” includes, for example, line manager training and, providing NHS staff rapid access to talking therapies. This is currently being tested as part of the Healthy Workforce programme led by NHS England.
NHS Employers is working with NHS England and Public Health England on improving NHS staff health and wellbeing. They offer extensive information and tools for managers to support their employees who are demonstrating signs of mental health problems, or returning to work following periods of sickness absence.
These resources, which are only available online, can be found at the following link:
www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/health-work-and-wellbeing/protecting-staff-and-preventing-ill-health/supporting-line-managers/managers-guide-on-supporting-workplace-mental-health/supporting-staff-who-are-experiencing-mental-health-problems
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of how many NHS employees have attempted, or committed, suicide in each year between 2009 and 2014.
Answered by Lord Prior of Brampton
The Government has not assessed how many National Health Service employees have attempted, or committed, suicide in each year between 2009 and 2014. The Department does not collect this information centrally.
However, the Department is not complacent and commissions NHS Employers to support trusts to improve the physical and mental health and wellbeing of their employees, which is the responsibility of employers across the NHS in England.
NHS Employers is working with NHS England and Public Health England on NHS England’s recently announced “A healthy NHS workforce", a commitment in its Five Year Forward View “which includes increasing awareness of and addressing mental health issues affecting NHS staff”. A copy of the announcement is attached.
Asked by: Baroness Greengross (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what cost was incurred by the NHS due to days lost through the sickness of healthcare workers in each year between 2009 and 2014.
Answered by Lord Prior of Brampton
The number of days lost through the sickness of healthcare workers between 2009 and 2014 were:
England | Full Time Equivalent Days Lost to Sickness Absence (includes non-working days) | Full Time Equivalent Days Available (includes non-working days) | Sickness Absence Rate |
2009-10 | 16,745,315 | 380,199,666 | 4.40% |
2010-11 | 15,947,054 | 383,278,845 | 4.16% |
2011-12 | 15,555,507 | 377,908,880 | 4.12% |
2012-13 | 15,947,518 | 376,187,354 | 4.24% |
2013-14 | 15,385,468 | 378,691,376 | 4.06% |
2014-15 | 16,423,722 | 386,388,483 | 4.25% |
Source: Health and Social Care Information Centre
The Government does not record the cost incurred by the National Health Service due to days lost through the sickness of healthcare workers.
Employers are responsible for reducing the days lost through sickness of their staff. The Department supports the NHS by commissioning NHS Employers to provide trusts with advice, guidance and good practice on improving NHS staff health and wellbeing which is available on an online only resource at:
NHS Employers is also working with NHS England and Public Health England on a £5 million initiative to improve NHS staff health announced in its Five Year Forward View. A copy of the ‘A healthy NHS workforce’ announcement is attached.