Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the effect on primary care delivery of changes in the level of administrative demands on those delivering that care.
Answered by Alistair Burt
The Department commissions and funds independent research into general practitioners’ (GPs) working conditions. Eight national surveys have been published by the University of Manchester since 1998, recording the experience of a nationally-representative cross-section of GPs, as well as reporting on the findings from a longitudinal sample.
Since 2005, the survey has considered the amount of time GPs spend on different activities, enabling us to track the impact of changing administrative demands on primary care delivery, although this has not considered changes specifically since 2014. The results for the cross-sectional sample are shown in the table below:
Percentage of time GPs devoted to different activities, 2005-2015
Survey Year | 2005 | 2008 | 2010 | 2012 | 2015 |
% time spent on Direct Patient Care | 63.3 | 63 | 63.1 | 62.3 | 62.1 |
% time spent on Indirect Care | 18.2 | 17.5 | 18.6 | 19.3 | 19.7 |
% time spent on Administration | 11.3 | 12 | 10.7 | 10.9 | 8.4 |
% time spent on External Meetings | n/a | n/a | n/a | n/a | 3.9 (This was the first time this category was included and would account for the fall in the administration and other categories.) |
Other | 7.1 | 7.5 | 7.6 | 7.5 | 6.3 |
Note:
Figures are column percentages. Numbers may not sum to 100% due to rounding errors. N = 868 for the 2005 cross-sectional sample; 1,280 for the 2008 cross-sectional sample; 1,015 for the 2010 cross-sectional sample; 1,154 for the 2012 cross-sectional sample and 1,115 for 2015 cross-sectional sample. Data is published in the Eighth National GP Worklife Survey:
We are keen to reduce administrative demands on those delivering care where practicable, and the Making Time in General Practice study by NHS Alliance and the Primary Care Foundation
www.nhsalliance.org/making-time-in-general-practice/
was commissioned by NHS England in order to identify ways to tackle bureaucracy. It was published in October 2015 and NHS England are now working with the British Medical Association, the Royal College of General Practitioners and others to develop plans to support general practice, including through reducing burdens.
The Department has not made an assessment of the effect of changes in the level of administrative demands on the delivery of the other primary care services of optometry, dentistry and community pharmacy.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the number of GP working hours available in each year since 2010.
Answered by Alistair Burt
The Health and Social Care Information Centre (HSCIC) publishes annual statistics on the general practice workforce in England.
The full time equivalent number of general practitioners in each year since 2010 is provided in the following table. A full time equivalent equates to 37.5 hours per week.
Data for the general practice workforce as at 30 September 2015 will be published by the HSCIC on 30 March 2016.
England full-time equivalent
General Practitioners as at 30 September each specified year | 2010 | 2011 | 2012 | 2013 | 2014 |
All Practitioners, including registrars and retainers | 35,243 | 35,319 | 35,871 | 36,294 | 36,920 |
Source:
HSCIC
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make an assessment of the potential merits of reflecting NHS Trust fines in remuneration packages of the managers responsible for the Trust at the time of the incidents in respect of which those fines arose.
Answered by Alistair Burt
We have taken steps to ensure that success and failure are not rewarded equally in NHS Boardrooms. We now require all executive pay above £142,500 in National Health Service trusts for new appointments to include at least 10% of basic pay dependent on meeting individual performance targets which are set locally but could include targets set by clinical commissioning groups so that failure to meet them could trigger both a fine and a loss of basic pay for the leaders of the trust. The guidance to NHS trusts from NHS Improvement recommends that this “earn-back” arrangement should also apply to other executive posts in the trust. We also request this from NHS foundation trusts.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many children's mental health beds there are (a) in each local authority or clinical commissioning group region and (b) per head of population in each such region.
Answered by Alistair Burt
The data of how many children's mental health beds in each clinical commissioning group by region and per head of population in each such region, is contained in the below table:
| Commissioned Beds | Number of Children 0-19 | Commissioned Beds per 1,000 Children |
London | 242 | 2,198,488 | 0.11 |
East Midlands | 137 | 1,146,555 | 0.12 |
East of England | 187 | 1,461,845 | 0.13 |
West Midlands | 175 | 1,434,330 | 0.12 |
North East | 98 | 703,514 | 0.14 |
North West | 196 | 1,641,767 | 0.12 |
Yorkshire and Humber | 90 | 1,328,961 | 0.07 |
South Central | 152 | 1,154,356 | 0.13 |
South East Coast | 94 | 1,080,080 | 0.09 |
South West | 54 | 1,069,126 | 0.05 |
Totals | 1,425 | 13,219,022 | 0.11 |
Notes:
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the cost to small GP practices of providing data they are required to provide to the Government.
Answered by Alistair Burt
Although no assessment of costs for small practices is completed, annual clearance processes require an assessment of the estimated completion time for practices. In 2015/16 the estimated completion time for data collection requests was one hour and practices confirm completion time to evaluate that estimate and inform future estimates.
Provisional analysis suggested 2015/16 collection took a mean completion time of 49.3 minutes.
NHS England recognises the considerable workload challenges facing all practices. The Making Time in General Practice study:
www.england.nhs.uk/2015/10/05/gp-appointments
was commissioned in order to identify priority areas for reducing burdens on practices. This confirmed that reporting information for getting paid and satisfying regulatory requirements is a significant task for many practices, although practices vary considerably in how difficult they find it.
NHS England has committed not only to increasing investment in general practice but to taking national action to reduce burdens such as these. The uplift in investment provided through the recently agreed contract for 2016/17 is the first of a number of changes intended to support practices and freeing time for staff to spend with patients.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
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) cost to GPs of and (b) average time taken per week by GPs for administration of the new Capita patient note transfer system.
Answered by Alistair Burt
Capita are improving the process for moving medical records between general practitioner (GP) practices. The changes will ensure that records can be fully tracked and traced through the movement process, to both increase the security of the record in transit and reduce the frustration for GP practices of waiting for records to arrive and not knowing where they are.
The service will continue to be provided to GPs for free.
In designing the new solution, Capita have engaged with GP practices via a stakeholder forum, user panels, observational studies and a National Engagement Team.
The user panels and observational studies have included consideration of any additional time taken to place medical records in secure pouches for transit. This needs to be considered against the time savings that GPs will make by no longer needing to chase records for which they are waiting, since they will be able to track these on the Capita system. Although we do not have a precise estimate, the studies indicate the new process takes a few seconds per record.
A national simulation was successfully completed during February 2016, and a live pilot is being undertaken in the West Yorkshire area during March 2016 to further test the solution ahead of national rollout.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when his Department plans to announce the net allocations from the primary care transformation fund.
Answered by Alistair Burt
The Primary Care Transformation Fund is a multi-year programme and the first tranche of local estates and technology projects to improve general practitioner premises and supporting infrastructure across the country are already underway. Expenditure on 2015/16 projects will be finalised with the audit of NHS England’s national accounts, which is expected to complete in July.
Clinical commissioning groups have commissioned the development of Strategic Estates Plans that include the individual estates and technology projects for years two to four, which are due for submission later in the spring. These will then be assessed during the summer and the allocations required to support them developed later this year.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many nationals of (a) the EEA excluding the UK and (b) non-EEA countries who are doctors or dentists have been brought before a fitness to practice panel and not suspended by their professional regulator as a result of poor English language skills in the last three years.
Answered by Ben Gummer
The information requested is not held by the Department. The nine health and care professional regulatory bodies within the United Kingdom are responsible for operational matters concerning the discharge of their statutory duties including fitness-to-practise (FtP) investigations in respect of their registrants. Relevant information provided by the General Medical Council (GMC) and General Dental Council (GDC) is included below.
The GMC reports that four European Economic Area (EEA) doctors and no non-EEA doctors have appeared at a tribunal due wholly or partly to lack of English language skills, since its legislation changed in June 2014 to introduce inadequate English language skills as a grounds for finding a doctor’s fitness to practise is impaired. Of the four, two were suspended and two had conditions imposed on their registration. Conditions restrict a doctor’s practice or require them to take remedial action. In these cases, the purpose of conditions is to help protect patients while allowing the doctor to remedy any deficiencies in their practice or knowledge of English. This amends the answer given in PQ25540 on 8 February 2016.
In addition, since the GMC was given new powers in relation to the language skills of doctors, it has dealt with 3,289 registration applications from EEA doctors. 1,970 of them were able to demonstrate that they met the English language requirements as part of their application and were granted registration with a licence to practise. 1,319 doctors were registered but have not been granted a licence to practise either because they did not provide any evidence of their English language skills or the evidence they provided was insufficient. Doctors cannot practise in the United Kingdom without a licence to practise.
The GDC has been taking the requirement to be sufficiently fluent in written and spoken English into account when assessing FtP cases since it updated its Standards in 2013. Since this change there has been one EEA dentist brought before a FtP panel who was not suspended where the category of ‘not fluent in English’ was recorded as consideration. The decision of the FtP panel was to remove this dentist from the GDC register.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many nurses were brought before a fitness to practise panel for lack of competence, communication issues between 2013 and 2015; and how many such nurses (a) were and (b) were not suspended.
Answered by Ben Gummer
The information requested is not held by the Department. As an independent body the Nursing and Midwifery Council is responsible for operational matters concerning the discharge of its statutory duties including fitness-to-practise investigations in respect of its registrants.
Asked by: Charlotte Leslie (Conservative - Bristol North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many nationals of (a) the EEA, excluding the UK and (b) non-EEA countries who are (i) doctors, (ii) dentists, (iii) other dental care professionals and (iv) nurses have been (A) suspended and (B) brought before a fitness to practise panel by their professional regulator as a result of poor English language skills in the last three years.
Answered by Ben Gummer
The information requested is not held by the Department. The nine health and care professional regulatory bodies within the United Kingdom are responsible for operational matters concerning the discharge of their statutory duties including fitness-to-practise (FtP) investigations against their registrants. Relevant information provided by the General Medical Council (GMC), Nursing and Midwifery Council (NMC) and General Dental Council (GDC) is included below.
The GMC reports that four European Economic Area (EEA) doctors and no non-EEA doctors have appeared at a FtP tribunal due wholly or partly to lack of English language skills, since its legislation changed in June 2014 to introduce inadequate English language skills as a grounds for finding a doctor’s fitness to practise is impaired. Of the four, two were suspended and two had conditions imposed on their registration. Conditions restrict a doctor’s practice or require them to take remedial action. In these cases, the purpose of conditions is to help protect patients while allowing the doctor to remedy any deficiencies in their practice or knowledge of English. In addition, since the GMC was given new powers in relation to the language skills of doctors, it has dealt with 3,289 registration applications from EEA doctors. 1,970 of them were able to demonstrate that they met the English language requirements as part of their application and were granted registration with a licence to practise. 1,319 doctors were registered but have not been granted a licence to practise either because they did not provide any evidence of their English language skills or the evidence they provided was insufficient. Doctors cannot practise in the UK without a licence to practise.
The NMC reports that until legislative change took effect in January 2016, it did not record poor English language skills as a case type within FtP. Previously all cases were recorded under an umbrella category of ‘Lack of competence – communication issues’. This category covered a range of communication topics including failure to delegate appropriately. Since the new language control power was introduced in 2016 the NMC has been coding English language skills as a separate code.
The GDC reports that following an update to its Standards in 2013, it takes the requirement to be sufficiently fluent in written and spoken English into account when assessing FtP cases. Since this change there have been no suspensions and one EEA Dentist has been struck-off the GDC register where the category of ‘not fluent in English’ was recorded as a consideration. The GDC notes that as a result of recent legislative change, it is taking forward associated changes to registration processes and FtP rules, which will result in further language control requirements being introduced by the end of summer.