Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many registered social care provider applications were rejected by the CQC due to issues with policies and procedures (a) in England, (b) by region, and (c) by local authority in each of the last five years.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Care providers entering and exiting is a normal part of a functioning market, and local authorities should have appropriate contingency plans in place depending on the services being provided. Under the Care Act 2014, local authorities also have a temporary duty to ensure continuity of care in the event of business failure. This means that people continue to receive the care and support they need if their adult social care provider is no longer able to carry on delivering services.

New providers registering with the Care Quality Commission (CQC) for the first time may have their application rejected if they send an application which is incomplete, for instance one that is missing documents or missing information within required documents. The CQC does not hold data at the level requested but can confirm that over the past five years, 22,629 incomplete applications across all sectors have been rejected. The following table shows a breakdown for the past five years of rejected incomplete applications across all sectors:

New providers registering with the CQC for the first time may have their application refused. In these cases, a complete application is reviewed by the CQC’s registration team who refuse the application if they are not satisfied the registering provider is able to meet the requirements as per the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. The CQC does not hold data at the level requested but can confirm that over the past five years, 1,385 applications across all sectors have been refused. The following table shows the breakdown for the past 5 years of refused applications across all sectors:

Providers already registered with the CQC may apply to vary their conditions of registration, and in some cases this may lead to a refusal or rejection by the CQC. Over the past five years, 85,822 applications to vary a registration by an adult social care provider have been received by the CQC. The following table shows the breakdown for the past five years of applications to vary a condition by an adult social care provider:

Over the past five years, 23,454 applications to vary a registration have been rejected, because the information submitted was incomplete. The following table shows a breakdown of these rejections for the past five years:

Over the past five years, 405 applications to vary a registration have been refused outright. The following table shows a breakdown of these rejections for the past five years:

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if guidance is being updated to mandate the use of technology systems to support the delivery of Jess’s Rule across the NHS.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Jess’s Rule was published in September 2024 and rolled out across England as formal clinical guidance, developed with the Royal College of General Practitioners and NHS England. It supports and strengthens general practitioners’ clinical judgement when a patient returns three or more times with worsening symptoms or without a substantiated diagnosis.

Through the Frontline Digitisation programme, NHS England has provided £2 billion to National Health Service trusts to ensure trusts meet a core level of digitisation and have electronic patient records (EPRs) in place. EPR systems allow clinicians access to critical, real-time health related information, which supports the frontline to better treat and support patients. Following Cambridge University Hospitals' deployment of its EPR, automatic EPR alerts in 2018/19 saved at least 64 lives due to sepsis alerts improving the time it took to administer antibiotics.

We will not be updating Jess’s Rule to mandate the use of technology systems, as any supporting tools are for local services to decide, in line with existing governance arrangements. We will continue to keep Jess’s Rule under review, including the case for any future updates to national guidance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to rollout of Jess’s Rule across the NHS; and if he will set out how technology is being used to make sure problems in care are being spotted and acted upon immediately.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Jess’s Rule was published in September 2024 and rolled out across England as formal clinical guidance, developed with the Royal College of General Practitioners and NHS England. It supports and strengthens general practitioners’ clinical judgement when a patient returns three or more times with worsening symptoms or without a substantiated diagnosis.

Through the Frontline Digitisation programme, NHS England has provided £2 billion to National Health Service trusts to ensure trusts meet a core level of digitisation and have electronic patient records (EPRs) in place. EPR systems allow clinicians access to critical, real-time health related information, which supports the frontline to better treat and support patients. Following Cambridge University Hospitals' deployment of its EPR, automatic EPR alerts in 2018/19 saved at least 64 lives due to sepsis alerts improving the time it took to administer antibiotics.

We will not be updating Jess’s Rule to mandate the use of technology systems, as any supporting tools are for local services to decide, in line with existing governance arrangements. We will continue to keep Jess’s Rule under review, including the case for any future updates to national guidance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much funding is being allocated to upgrade legacy IT systems in a) the NHS b) individual integrated care boards and c) local authorities responsible for delivering adult social care services.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England invests approximately £1 billion per year centrally to operate, support, and upgrade nationally managed technology systems, including the NHS App and core data services.

In addition, over the current Spending Review period, NHS England plans to invest approximately £2 billion with care provider organisations through the Frontline Productivity Programme, supporting the use of technology to improve productivity and make better use of existing digital infrastructure. This includes targeted investment where providers choose to converge on common platforms to support local system working and the priorities of the 10‑Year Health Plan.

Funding allocations for technology investment by individual integrated care boards and local systems will be determined by NHS England regions and systems in due course, in line with local priorities and national guidance.

We have no funding allocated specifically to local authorities to update their legacy social care systems, and responsibility for procuring and updating their own systems lies with them.