Asked by: Justin Madders (Labour - Ellesmere Port and Neston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will list all the services directly commissioned by NHS England.
Answered by Steve Brine
NHS England directly commissions the following services:
- Military and veteran health services;
- Health services for people in prisons (including youth offender institutions);
- Primary care services, although for general practitioners this is devolved to most clinical commissioning groups through primary care co-commissioning; and
- Specialised services. A list of the specialised services is attached.
NHS England also directly commissions the following public health services:
- Neonatal hepatitis B immunisation;
- Maternal Pertussis immunisation;
- Bacillus Calmette–Guéri vaccine (against tuberculosis and leprosy);
- Diptheria, tetanus, poliomyelitis, pertussis, haemophilus influenzae type B and hepatitis B immunisation;
- Rotavirus immunisation;
- Meningococcal C containing vaccine immunisation;
- Haemophilus influenzae type B immunisation;
- Pneumococcal immunisation;
- Measles, mumps and rubella immunisation;
- Human papillomavirus immunisation;
- Td/IPV vaccination (3-in-1 teenage booster);
- Seasonal influenza immunisation;
- Seasonal influenza immunisation for children;
- Shingles immunisation;
- NHS infectious diseases in pregnancy screening;
- NHS Fetal Anomaly Screening Programme - Screening for Down’s Syndrome, Edwards’ Syndrome and Patau’s Syndrome;
- NHS Fetal Anomaly Screening Programme – 18+0 to 20+6 week fetal anomaly scan;
- NHS Sickle Cell and Thalassaemia Screening;
- NHS Newborn Blood Spot Screening;
- NHS Newborn Hearing Screening;
- NHS Newborn and Infant Physical Examination Screening;
- NHS Diabetic eye screening;
- NHS Abdominal Aortic Aneurysm;
- Breast screening;
- Cervical screening;
- Bowel cancer screening;
- NHS bowel scope screening;
- Child Health Information Systems;
- Services for children and adults in secure and detained settings in England;
- Sexual assault referral centres;
- Meningococcal group B immunisation; and
- Human papillomavirus immunisation programme for men who have sex with men.
Asked by: Lord Boateng (Labour - Life peer)
Question to the Department for Work and Pensions:
To ask Her Majesty's Government when they last issued any guidance to Department for Work and Pensions disability assessors on the functional effects of thalassaemia and sickle cell disease on claimants; and whether they have any plans to address this issue specifically in the training programme undertaken by assessors.
Answered by Baroness Buscombe
Guidance on Sickle Cell Disease, including the functional effects, was developed and first issued to Centre for Health and Disability Assessments Healthcare Professionals in June 2014. It is quality assured by external specialist practitioners and regularly updated. It was most recently reissued on 18 December 2017.
The Personal Independence Payment assessment is not a medical assessment and there is no requirement for the Disability Assessor to diagnose a condition and recommend treatment options. We do not issue guidance on specific clinical conditions to Capita and Independent Assessment Services. Their Disability Assessors are trained to be experts in disability analysis and have knowledge of the functional effects of a wide range of health conditions. Each Provider develops their own guidance as part of their ongoing training
All Healthcare Professionals have access to a range of resources as well as experienced clinicians to support them in assessing claimants with conditions that they may not be familiar with.
We work extensively with our Assessment Providers to make improvements to guidance and training to ensure that all claimants receive objective, accurate and high quality assessments and have agreed to work directly with the Sickle Cell Society and Thalassemia Society to review our current materials and approach.
Assessment Providers continue to engage with medical experts, charities and relevant stakeholders to strengthen, review and update their training programmes.
Asked by: Lord Boateng (Labour - Life peer)
Question to the Department for Work and Pensions:
To ask Her Majesty's Government what assessment they have made, in the light of the recent sickle cell and thalassaemia APPG Report How did you contract that?, of the suitability of the Personal Independence Payment Form 2 for the assessment of persons living with thalassaemia and sickle cell disease.
Answered by Baroness Buscombe
Personal Independence Payment (PIP) claims are not condition based but are assessed on how a claimant’s long-term disability or health condition affects their day-to-day life and on the majority of days over the period of a year. The PIP2 questionnaire, “How your disability affects you”, is the first step in gathering detailed information about the needs arising from an individual’s health condition or disability. The form has been designed to allow claimants to tell us, in their own words, how their health condition or disability impacts them on a day-to-day basis. The questionnaire has a mixture of tick boxes and free text boxes allowing claimants to add as much or as little detail as they wish. We also ask claimants to send in any additional information or evidence to support their claim. Although the PIP2 is a standard template, we can assure you that it has been carefully designed to capture information on people’s needs regardless of their health condition or disability.
Asked by: Lord Boateng (Labour - Life peer)
Question to the Department for Work and Pensions:
To ask Her Majesty's Government what assessment they have made of the extent to which Department for Work and Pensions disability assessors are qualified to make judgements in relation to people living with thalassaemia and sickle cell disease.
Answered by Baroness Buscombe
All Healthcare Professionals carrying out assessments are medically qualified and highly-trained practitioners in their own field. They are subject to a rigorous recruitment process followed by a comprehensive training programme in disability assessment.
The assessment is not a medical assessment requiring the Healthcare Professional to diagnose a condition and recommend treatment options. The focus is on ensuring Healthcare Professionals are experts in disability analysis with knowledge of the likely functional effects of a wide range of health conditions.
While preparing to undertake an assessment, Healthcare Professionals can access a wide range of clinical resources to research any medical conditions that they are unfamiliar with. In addition, they read in detail any further evidence that has been supplied by the claimant’s GP or specialist clinical team.
Asked by: Jim Cunningham (Labour - Coventry South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the take-up rate for sickle cell disease and thalassaemia screening for pregnant women in (a) the West Midlands and (b) Coventry was in 2017.
Answered by Jackie Doyle-Price
Screening for sickle cell and thalassaemia are carried out jointly as a blood test. The programme identifies people who are genetic carriers for sickle cell, thalassaemia and other haemoglobin disorders.
Between 1 April 2016 and 31 March 2017 Coventry and Warwickshire NHS Trusts had 5,925 women tested out of 5,989 eligible women (98.9% uptake).
Between 1 April 2016 and 31 March 2017 the West Midlands had 57,578 women tested out of 58,093 eligible women (99.1% uptake).
During 2016/17 the national average for screening uptake in England was 99.3%.
Further information is available at:
NHS England is responsible for commissioning antenatal screening services to meet programme standards including coverage. NHS England is working with providers to help identify and address any issues and is committed to improving coverage and reducing morbidity from this condition.
Asked by: Jonathan Ashworth (Labour (Co-op) - Leicester South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when the last impact assessment was undertaken of the prescription charge medical exemption list; if he will publish that impact assessment; and whether that impact assessment makes reference to the disproportionate effect on certain groups of Sickle Cell or Lupus.
Answered by Steve Brine
The Department has not undertaken a formal impact assessment on the potential cost of eliminating or reducing prescription charges for people with long-term medical conditions not already covered by a medical exemption. However, the Prescription Charges Review (the Review) undertaken by Professor Sir Ian Gilmore on behalf of the Department, and published in 2010, estimated that extending exemption, at that time, to all those with a long-term condition would lead to a loss in revenue of between £360 and £430 million. This document is publicly available at:
https://www.gov.uk/government/publications/prescription-charges-review-the-gilmore-report
The Review does not make specific reference to sufferers of lupus, however, the All Party Parliamentary Group on Sickle Cell and Thalassaemia and the Sickle Cell Society provided written evidence to the Review.
Asked by: Shabana Mahmood (Labour - Birmingham, Ladywood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people have sickle cell disease in the UK; and what assessment he has made of the adequacy of provision to improve the quality of life and life expectancy of people with that disease.
Answered by Baroness Blackwood of North Oxford
The Sickle Cell and Thalassaemia screening programme is a linked antenatal and newborn screening programme which is offered to all pregnant women and their babies. It is also offered to fathers to be, where antenatal screening shows that the mother is a genetic carrier.
Table 1 shows the number of screen positive babies detected in England since the establishment of Public Health England (PHE) in 2013.
Table 1. Sickle cell disease (SCD) screen positive babies: England | ||||
Year | Screen Positive Babies | Total Screened | Rate per 1000 | 1 in x |
2013/14 | 319 | 668,117 | 0.48 | 2,094 |
2014/15 | 278 | 661,432 | 0.42 | 2,379 |
Total for whole period | 3,003 | 6,056,663 | 0.50 | 2,017 |
Data source: PHE Screening
Although NHS England does not routinely collect the information requested on the provision to improve quality of life and life expectancy of people with the disease, it is is working to ensure excellent services for people identified with Sickle Cell disease.
NHS England has included treatment services for haemoglobinopathies within the prescribed specialised services commissioned centrally by NHS England and set up a Clinical Reference Group of sickle cell and thalassaemia experts and patient representatives specifically to advise NHS England on commissioning services for haemoglobinopathies.
NHS England is also developing a commissioning policy for the management of iron overload in sickle cell and thalassaemia patients. It is also about to under-take a national review of haemoglobinopathy services, commencing in 2016-17.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what PREMs and PROMs data his Department holds for people with (a) sickle cell disease and (b) thalassaemia.
Answered by George Freeman
NHS England does not currently routinely collect this information.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many apheresis machines are operational in the UK; and where those machines are located.
Answered by George Freeman
Apheresis machines are part of the care provided in a number of haematology services including sickle cell and thalassaemia care.
NHS Blood and Transplant is one of the main providers of Therapeutic Apheresis Services in England and has the largest installed base of therapeutic apheresis equipment in the National Health Service (32 machine platforms across the country). Additional provision of apheresis services are provided by NHS trusts and other UK Blood Services but NHS England does not currently hold information on this information centrally.
Work in relation to these services including the incentivisation of automated exchange through Commissioning for Quality and Innovation will improve the baseline information over the coming year.
Asked by: Diane Abbott (Independent - Hackney North and Stoke Newington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people have died as a result of (a) sickle cell disease and (b) thalassaemia in each (i) clinical commissioning group area, (ii) trust area and (iii) national sickle cell and thalassaemia centre area in the most recent year for which figures are available.
Answered by George Freeman
NHS England does not routinely collect this information. Data on adverse events for patients with sickle cell disease and thalassaemia is available from the National Haemoglobinopathy Registry Report 2013/14.