Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what guidance his Department has issued to GPs on the assessment and treatment of foot conditions where a patient has diabetes.
Answered by Jane Ellison
The National Institute for Health and Care Excellence (NICE) is an independent organisation established by Government to provide national guidance and advice to improve health and social care. It has published clinical guidance and quality standards on the treatment of diabetes and its complications. The NICE Diabetes Quality Standard is clear that people with diabetes who are at risk of foot ulceration should receive regular reviews by a foot protection team in accordance with its clinical guidance. The Health and Social Care Act (2012) places a duty on NHS England to have regard to the NICE Quality Standards. Clinical commissioning groups (CCG) should also have regard to them in planning and delivering services, as part of a general duty to secure a continuous improvement in quality.
As part of the Quality Outcomes Framework (QOF), general practitioners are remunerated for assessing nerve damage and poor blood supply to the feet in people with diabetes on an annual basis. Information is collected annually both through QOF returns and through the National Diabetes Audit (NDA).
The NDA provides information of local practice against NICE guidelines and can be used by local areas to compare their own performance over time and against others, helping to drive service improvement. The latest published NDA report shows that more than 85% of all those with diabetes in England and Wales, received these checks in 2011-12.
In July 2014, NHS England will be launching the National Diabetes Footcare Audit. This is a new module of the NDA, and will provide information on the effectiveness and quality of the entire diabetes foot care pathway, including the elements delivered in primary, community and secondary care settings.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the quality of foot care provided in primary care to patients with diabetes.
Answered by Jane Ellison
The National Institute for Health and Care Excellence (NICE) is an independent organisation established by Government to provide national guidance and advice to improve health and social care. It has published clinical guidance and quality standards on the treatment of diabetes and its complications. The NICE Diabetes Quality Standard is clear that people with diabetes who are at risk of foot ulceration should receive regular reviews by a foot protection team in accordance with its clinical guidance. The Health and Social Care Act (2012) places a duty on NHS England to have regard to the NICE Quality Standards. Clinical commissioning groups (CCG) should also have regard to them in planning and delivering services, as part of a general duty to secure a continuous improvement in quality.
As part of the Quality Outcomes Framework (QOF), general practitioners are remunerated for assessing nerve damage and poor blood supply to the feet in people with diabetes on an annual basis. Information is collected annually both through QOF returns and through the National Diabetes Audit (NDA).
The NDA provides information of local practice against NICE guidelines and can be used by local areas to compare their own performance over time and against others, helping to drive service improvement. The latest published NDA report shows that more than 85% of all those with diabetes in England and Wales, received these checks in 2011-12.
In July 2014, NHS England will be launching the National Diabetes Footcare Audit. This is a new module of the NDA, and will provide information on the effectiveness and quality of the entire diabetes foot care pathway, including the elements delivered in primary, community and secondary care settings.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what recent work his Department has undertaken to raise awareness of the effects of diabetes on people with that condition; and if he will make a statement.
Answered by Jane Ellison
The NHS Health Check raises awareness of diabetes and its symptoms by assessing and discussing with participants the risk factors for this disease, along with other conditions relevant to the programme. Between April and December 2013, over 2 million people were offered an NHS Health Check and almost 1 million people took up the offer.
Action for Diabetes, published in January 2014, sets out NHS England's broad vision and direction for supporting improvements in outcomes for people with and at risk of diabetes in the coming years, both as a direct commissioner and by providing support to the commissioning system. The report is available at the following link:
www.england.nhs.uk/wp-content/uploads/2014/01/act-for-diabetes.pdf
In addition, NHS Improving Quality is working with NHS England's National Clinical Director for Diabetes to identify potential areas of service improvement. Work focusing on the cardiovascular health of people with diabetic-related foot disease is currently being developed and will be delivered during 2014-15.
Ministers have participated in a number of Parliamentary and external events to raise awareness of diabetes. Diabetes and its effects also feature throughout Living Well for Longer, the Department's recent publication on preventing premature mortality.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate his Department has made of the average annual change in income for GP practices in Fareham and Gosport arising from the withdrawal of the minimum practice income guarantee.
Answered by Dan Poulter
Both the Government and NHS England consider Minimum Practice Income Guarantee (MPIG) payments to be inequitable because practices serving very similar populations get paid very different amounts per patient.
As part of the general practitioner contract settlement in 2013, the Department decided to phase out MPIG payments over a seven year period, starting in the financial year 2014-15. The money released by doing this will be reinvested in the basic payments made to all General Medical Services (GMS) practices.
NHS England advises that there are 16 practices in Fareham and Gosport currently receiving a MPIG payment under GMS contracts. Practices that face particular difficulty are encouraged to contact their local NHS England Area Team to discuss any issues so that they can together plan to mitigate these.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of how many GP practices in Fareham and Gosport will lose income as a consequence of the withdrawal of the minimum practice income guarantee; and what actions his Department has put in place to mitigate the impact of any such losses on services.
Answered by Dan Poulter
Both the Government and NHS England consider Minimum Practice Income Guarantee (MPIG) payments to be inequitable because practices serving very similar populations get paid very different amounts per patient.
As part of the general practitioner contract settlement in 2013, the Department decided to phase out MPIG payments over a seven year period, starting in the financial year 2014-15. The money released by doing this will be reinvested in the basic payments made to all General Medical Services (GMS) practices.
NHS England advises that there are 16 practices in Fareham and Gosport currently receiving a MPIG payment under GMS contracts. Practices that face particular difficulty are encouraged to contact their local NHS England Area Team to discuss any issues so that they can together plan to mitigate these.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 6 May 2014, Official Report, column 127W, if he will list the outlier practices and the amount each is forecast to lose as a result of removing performance indicators from the Quality Outcomes Framework.
Answered by Jane Ellison
The Department does not hold this information centrally, but details of practices identified by NHS England have been sent to area teams.
As part of the changes to the General Medical Services (GMS) contract from April 2014, we have reduced the Quality and Outcomes Framework by more than a third. These changes are intended to free up space for general practitioners to provide more proactive and personalised care for their patients which includes their new responsibility of being accountable for all of their patients aged 75 and over.
These changes were part of changes to GMS contract negotiated with the General Practitioners Committee of the British Medical Association.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to ensure that health professionals are trained in the identification and notification of (a) all special educational needs and (b) educational needs related to cerebral palsy in children under two years of age.
Answered by Dan Poulter
The Government works with Health Education England, which provides leadership on the training of the health workforce, and the professional regulatory bodies, such as the Royal College of Paediatrics and Child Health, which set professional standards, to ensure that health professionals are appropriately trained in identification and support of children with special educational needs, or cerebral palsy.
Clinical commissioning groups are under a statutory duty to make arrangements to notify the local authority where a provider is of the opinion that a child under compulsory school age has special educational needs (having first discussed this with the child's parents). The Children and Families Act introduces new arrangements for local authorities and health services to work together to support children with special educational needs.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department for Education:
To ask the Secretary of State for Education, what steps he is taking to ensure parents are aware of the early years educational support available to children with cerebral palsy under two years of age.
Answered by Elizabeth Truss
The Early Years Foundation Stage framework makes clear that providers must have and implement a policy and procedures to promote equality of opportunity for children in their care, including support for children with special educational needs (SEN) or disabilities.
The Government is introducing wide-ranging reforms through the Children and Families Act 2014 to improve provision and support for children and young people with SEN and disabilities from birth up to the age of 25.
The Act requires local authorities to publish a local offer of services for children with SEN or a disability which will include children with cerebral palsy. The local offer will set out in one place information about provision families can expect to be available across education, health and social care for children and young people who have SEN or are disabled, including those who do not have Education, Health and Care (EHC) plans.
The local offer will also provide parents with clear, comprehensive and accessible information about the services and support available and how to access it, including that from Early Years services. This should include relevant services from agencies such as Portage and Early Support, arrangements for identifying and assessing children's needs in the early years and support available to parents to aid their child's development at home.
The offer will make provision more responsive to local needs and aspirations by directly involving families and service providers in its development and review, enabling them to have a greater say in how services and support develop over time.
The new birth to 25 SEN Code of Practice, due to come into force from September 2014, will set out clear expectations for practitioners on how they work together with families of children with SEN or disability to understand their child's needs and help them to access support quickly.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what assessment he has made of the number and proportion of employers scheduled to join auto-enrolment in April 2014 that are on track to meet their deadlines.
Answered by Steve Webb
The Pensions Regulator (TPR) has overall responsibility for monitoring compliance with the new employer duties and employers must register with TPR and state how they are meeting the duties.
We expect around 15,900 medium employers (50-249) to stage between April and June 2014 (based on PAYE information as at 1 April 2012).
Research published by The Pensions Regulator in February 2014 shows that most small to medium employers (91%) were confident that their organisation would have done everything it needed to by the deadline.
The Pensions Regulator expects to publish further information on their Compliance and Enforcement work this summer.
Asked by: Mark Hoban (Conservative - Fareham)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what steps his Department is taking to support small and medium-sized businesses that are due to automatically enrol their employees in 2014.
Answered by Steve Webb
The Pensions Regulator is focusing on educating and enabling employers of all sizes to ensure they are aware of automatic enrolment and understand what they have to do.
The Regulator has implemented an employer journey that consists of a series of letters and emails being sent to employers from 12 months prior to their staging date. As their staging date approaches each email informs the employer at what stage they should be at and also signposts employers to guidance and tools that have been provided by the Regulator.
There is a suite of tools on the Regulator's website including an interactive planning tool to assist employers in getting ready, a staging date tool to find out your staging date, and detailed guides. They have also established a customer support centre for employers to discuss any questions they may have.
The Regulator is also working with intermediaries such as software developers, payroll bureaux and trade body groups to make sure they are able to provide suitable tools, guidance or support if employers require it. Recently an employer advertising campaign has been underway to raise awareness and guide employers to the regulator's website to help them in their preparations.
Throughout the initial roll out of automatic enrolment the Regulator has been assessing the impact of their communications and updating their products to ensure they meet the needs of the changing audience, from the UK's largest employers with thousands of workers, through to those with a small workforce. The Regulator's communications are developed following testing and research and are updated to meet the needs of the changing audience.
Based on research by The Pensions Regulator, levels of employer awareness and understanding of their automatic enrolment duties are high and showing appropriate progress towards employers being able to comply with their duties.