Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people paid for prescriptions in (a) 2011, (b) 2012, (c) 2013 and (d) 2014.
Answered by George Freeman
We do not hold data on the number of people who paid prescription charges, but we estimate that 40% of people in England are required to pay for their prescriptions.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether NHS England will remain the sole budget-holder and accountable commissioner for all specialised services in (a) 2015-16, (b) 2016-17 and (c) future years.
Answered by Jane Ellison
NHS England is the accountable commissioner and budget holder for all specialised services as set out in The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, with the Manual for prescribed specialised services providing further detail.
NHS England is proposing to move to a more collaborative approach to commissioning some specialised services, aligned to the vision set out in the Five Year Forward View. This should lead to improved outcomes for patients, more integrated pathways and a better patient experience.
NHS England has clarified that where there are collaboratively commissioned services, NHS England will retain the full financial risk for these services for 2015/16.
NHS England has advised us that there will be further work conducted over the next year to determine the range of specialised services for which NHS England should remain the accountable commissioner and budget holder for 2016/17 and future years.
Copies of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 and the Manual for prescribed specialised services are attached.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what scope the joint committees of NHS England and clinical commissioning groups will have to deviate from national service specifications for specialised services in (a) 2015-16 and (b) future years.
Answered by Jane Ellison
Whilst NHS England remains the accountable commissioner for a specialised service, national service specifications and policies will still apply in their entirety. This position applies even when there are services which are collaboratively commissioned with clinical commissioning groups (CCGs) through joint committee arrangements.
If a service is transferred to CCG commissioning responsibility there will need to be an agreed transition plan about the continued use of national service specifications and policies.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if his Department will allocate additional funding to assist towards delivering the new cystic fibrosis ward at King's College Hospital; and if he will make a statement.
Answered by Jane Ellison
This is a matter for King’s College Hospital NHS Foundation Trust and local NHS commissioners. The Trust is free to apply to the Department for loan funding for the development of a new cystic fibrosis ward. However, we are advised that the Department has not to date received any such application from the Trust.
We are advised by the Trust that it remains committed to developing an expanded and refurbished ward for cystic fibrosis patients at King’s College Hospital and that it is looking to secure a long term solution which is in the best interests of patients. Cystic fibrosis patients at King’s were recently moved to a new interim facility, which provides a better environment for both patients and staff.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what proportion of multiple pregnancies result in one or more babies developing (a) cerebral palsy and (b) another long-term disability.
Answered by Dan Poulter
This information is not collected centrally.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the effectiveness of the implementation of the National Institute for Health and Care Excellence clinical guidance for multiple pregnancies; and if he will make a statement.
Answered by Dan Poulter
The Department has not undertaken an assessment of the effectiveness of the implementation of the National Institute for Health and Care Excellence (NICE) clinical guidelines. These are good practice guidance, developed by experts, intended to support maternity service commissioners and providers with the delivery of evidence-based care. It is for local maternity care providers to determine how best to deliver services for women with multiple pregnancies in their area. In doing so we would expect them to give due regard to NICE guidance.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the (a) number of cases and (b) total cost of settling the claims dealt with by the NHS Litigation Authority involving the still birth, neonatal death or disability of a baby or the disability of the mother or maternal death as a result of a multiple pregnancy in each of the last 10 years.
Answered by Dan Poulter
Information on the number of obstetrics claims received between 1 April 2004 and 31 March 2014 which have involved a multiple pregnancy are set out in the following tables.
Claims not settled as a periodic payment order as at 30 November 2014:
NHSLA Notification Year | No. of Claims | Damages Paid | Defence Costs Paid | Claimant Costs Paid | Total Paid |
04/05 | 17 | 257,685 | 160,195 | 199,703 | 617,583 |
05/06 | 25 | 2,230,500 | 247,739 | 503,085 | 2,981,324 |
06/07 | 26 | 3,421,731 | 160,890 | 441,675 | 4,024,296 |
07/08 | 25 | 2,049,637 | 409,877 | 750,189 | 3,209,702 |
08/09 | 17 | 2,273,298 | 314,113 | 858,335 | 3,445,746 |
09/10 | 32 | 3,505,555 | 472,978 | 906,368 | 4,884,900 |
10/11 | 26 | 2,231,560 | 218,757 | 761,800 | 3,212,117 |
11/12 | 18 | 1,702,994 | 252,423 | 403,170 | 2,358,587 |
12/13 | 27 | 1,992,742 | 299,511 | 396,250 | 2,688,503 |
13/14 | 33 | 79,250 | 130,803 | 35,115 | 245,168 |
Total | 246 | 19,744,952 | 2,667,285 | 5,255,690 | 27,667,927 |
Source: NHS Litigation Authority (NHSLA) December 2014
Claims settled as a periodic payment order as at 30 November 2014:
NHSLA Notification Year | No. of Claims | O/S Damages | Damages Paid | Total Damages | Defence Costs Paid | Claimant Costs Paid | Total |
05/06 | 5 | 18,259,347 | 15,421,817 | 33,681,164 | 620,036 | 1,818,621 | 36,119,820 |
06/07 | 1 | 2,669,629 | 2,660,371 | 5,330,000 | 83,570 | 290,550 | 5,704,120 |
07/08 | 1 | 3,332,805 | 2,370,195 | 5,703,000 | 112,109 | 190,000 | 6,005,109 |
08/09 | 1 | 4,109,000 | 3,005,000 | 7,114,000 | 86,046 | 184,000 | 7,384,046 |
09/10 | 2 | 11,717,657 | 6,854,249 | 18,571,906 | 186,503 | 506,000 | 19,264,409 |
Total | 10 | 40,088,438 | 30,311,632 | 70,400,070 | 1,088,264 | 2,989,171 | 74,477,504 |
Source: NHS LA December 2014
‘Payments’ made in those years requested are not specifically going to be the payments made on the claims reported in the same period i.e. some will relate to claims which had been reported to the NHSLA prior to the ten year period requested here.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many patient safety cases involving a multiple pregnancy were reported to the (a) National Patient Safety Agency and (b) NHS Commissioning Board Special Health Authority in each of the last 10 years.
Answered by Dan Poulter
The information requested is provided in the following table:
Year | Reported Degree of harm (severity) | Total | ||||
No Harm | Low | Moderate | Severe | Death | ||
2005 | 363 | 73 | 64 | 16 | 6 | 522 |
2006 | 674 | 153 | 84 | 23 | 16 | 950 |
2007 | 960 | 305 | 169 | 35 | 27 | 1,496 |
2008 | 1,060 | 350 | 193 | 39 | 34 | 1,676 |
2009 | 1,373 | 438 | 253 | 33 | 28 | 2,125 |
2010 | 1,380 | 406 | 246 | 22 | 13 | 2,067 |
2011 | 1,639 | 469 | 258 | 26 | 19 | 2,411 |
2012 | 1,799 | 534 | 240 | 22 | 7 | 2,602 |
2013 | 1,868 | 543 | 257 | 32 | 10 | 2,710 |
2014* | 1,577 | 407 | 179 | 13 | 8 | 2,184 |
* Note 2014 data are incomplete
The table illustrates the number of incidents reported to the National Reporting and Learning System where the incident report contained keywords indicating multiple pregnancies, from 1 January 2005 to 30 September 2014, by degree of harm reported as caused by the incident. It is important to note that the inclusion of these keywords may not always indicate the incident directly affected a multiple pregnancy; for example, reference in the incident report may be made to previous pregnancies. The harm reported may relate to the mother or to one or more foetuses/infants.
The overall number of patient safety incidents reported to the National Reporting and Learning System has increased every year since its inception. Increasing numbers of reported patient safety incidents are considered to be a sign of an improving patient safety culture and increases in the number of incident reports should not be interpreted as deterioration in the safety of patients.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the average cost to the NHS of caring for a multiple pregnancy from conception through to the discharge home of mother and babies; and what the average tariff received by a trust for care in a multiple pregnancy was in the last 12 months.
Answered by Dan Poulter
For payment purposes, there are three separate pathway currencies covering different stages of maternity care: antenatal, delivery and postnatal. A lead provider receives a pathway price to cover the costs for the bundles of care they deliver at each of these stages. The price level is determined by patient complexity.
If a woman has one or more of the intensive resource characteristics, such as expecting twins, she is allocated to the intensive pathway for the non-delivery phases, irrespective of any other factors. The income received by the provider is the relevant tariff price multiplied by the organisation’s Market Forces Factor payment value.
Further information on the maternity pathway payment system can be found at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/300549/Annex_4A_Additional_info_on_currencies_with_national_prices.pdf
2014-15 tariff - maternity pathway |
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Delivery phase |
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Code | Name | Outpatient procedure tariff (£) | Combined day case / ordinary elective / non-elective spell tariff (£) | Long stay trimpoint (days) | Per day long stay payment (for days exceeding trimpoint) (£) |
n/a | With complications and co-morbidities | - | 2,188 | 7 | 371 |
n/a | Without complications and co-morbidities | - | 1,496 | 5 | 371 |
Non-delivery phases |
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Antenatal phase |
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Code | Name | Tariff (£) |
n/a | Intensive | 2,822 |
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Postnatal phase |
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Code | Name | Tariff (£) |
n/a | Intensive | 805 |
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will respond to the recommendations of the QualityWatch Report on Allied Health Professionals, published in September 2014, on the need to develop information systems that capture consistent and comparable information on all aspects of the quality of allied health professionals' care; and if he will make a statement.
Answered by Dan Poulter
Allied Health Professionals (AHPs) are art, drama and music therapists, dietitians, occupational therapists, orthoptists, orthotists/prosthetists, paramedics, physiotherapists, podiatrists, radiographers, and speech and language therapists. Each profession has to be registered with the Health and Care Professions Council.
The QualityWatch report on Allied Health Professionals draws on available data which suggests that AHPs are not currently fully represented in or by many of the national quality measures which systematically capture data from the medical or nursing workforce, presenting an inappropriate impression of the activities and outcomes of AHPs. Given the nature and scope of their work, AHPs are ideally placed to address some of the key challenges facing the health and care sectors. However, the report notes where their publically funded employment already spans the NHS, Local Government (Social Care and Education), housing, third sector and independent practice there is a real opportunity now to develop and build measures across sectors that both reflect the pattern of actual service delivery for patients and the outcomes AHPs achieve for them.
To ensure there is an appropriate AHP workforce to continue to supply this diversity of sectors, which reflect patient choice, will also require increasing sophistication of modelling and data capture during work.
The newly appointed NHS England Chief Allied Health Professions Officer is to take up the chair of National Allied Health Professional Informatics Strategy Taskforce and this group, supported by all the AHP professional bodies, will ensure that the findings of the report are formally reviewed and acted upon.