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Written Question
Care Homes: Finance
Tuesday 12th May 2020

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government whether there are any regulations or requirements placed on owners of care homes to demonstrate financial strength; and what plans they have, if any, to place limits on the level of debt such companies may be allowed to have.

Answered by Lord Bethell

The Care Quality Commission (CQC) monitors the financial health of the largest and most difficult-to-replace adult social care providers through their Market Oversight Scheme. Under the scheme, they have a duty to notify local authorities if they consider that a provider’s services are likely to be disrupted because of business failure. This allows local authorities time to step in and ensure that people continue to receive the services they need. As a minimum, all providers in the Market Oversight Scheme are required to provide the CQC with financial information on a quarterly basis. However, where the CQC perceives a greater risk to continuity of care, more regular engagement is undertaken.

We recognise the pressures that all parts of the sector are facing, and we have provided councils with £1.6 billion funding in March to help local authorities deal with the immediate impacts of COVID-19. On top of this, on 18 April the Secretary of State for Housing, Communities and Local Government announced an additional £1.6 billion of funding to support local authorities delivering essential frontline services.


Written Question
Influenza: Death
Tuesday 28th April 2020

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government how many people are estimated to have died of influenza in the last five years; and whether either (1) a monthly, or (2) a quarterly, breakdown of those figures is available for each such year.

Answered by Lord Bethell

The number of flu cases and deaths as a result of related complications varies each flu season. The average number of estimated deaths in England over the last five seasons (2014/15 to 2018/19) was 17,000 deaths annually. This ranged from 1,692 deaths last season (2018/19) to 28,330 deaths in 2014/15. Of these deaths, many were in people with underlying health conditions.

The following table shows the number of deaths associated with influenza observed through the FluMOMO algorithm with confidence intervals, England, 2014 to 2015 season to 2018 to 2019.

Season

All ages

0-4 years

5-14 years

15-64 years

65+ years

2014/15

28,330 (27,462 to 29,208)

91 (79 to 104)

13 (9 to 18)

701 (635 to 769)

25,143 (24,368 to 25926)

2015/16

11,875
(11,237 – 12,2524)

84
(72 to 96)

11 (6 to 16)

1,259 (1,178 to 1,342)

9,459 (8,941 to 9,987)

2016/17

18,009
(17,260 to 18,786)

77 (66 to 89)

20 (14 to 26)

578 (519 to 639)

15,167 (14,546 to 15,798)

2017/18

26,403 (17,260 to 18,768)

6 93 to 10)

2 (0 to 5)

1,462 (1,373 to 1,553)

22,237 (21,482 to 23,000)

2018/19*

1,692 (1,352 to 2,056)

3 (0 to 7)

10 (6 to 15)

192 (142 to 241)

914 (666 to 1,186)

*Data up to epidemiological week 15 2019

Notes:

  1. Source: Surveillance of Influenza and other respiratory viruses in the UK 2018 to 2019 report,
  2. The above annual data is modelled data.

Influenza related mortality data from hospital confirmed deaths are published weekly, but the modelled data on all deaths due to flu related complications are not available at a monthly or quarterly level. However, a weekly flu report is published throughout the flu season, providing information, data on flu cases and cases of mortality.


Written Question
Care Homes
Monday 24th February 2020

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government how many care (1) homes, and (2) beds, in England, broken down by region, are operated by (a) local authorities, (b) private firms, and (c) charities.

Answered by Lord Bethell

The Care Quality Commission (CQC) has provided information relating to care homes that fall within the Market Oversight scheme.

The following table shows Market Oversight CQC registered care home beds and locations, by region, as at 1 February 2020

Number of care home beds

Region

For profit

Not for profit

Total

East Midlands

10,372

1,991

12,363

East of England

13,626

3,173

16,799

London

8,777

3,728

12,505

North East

9,207

1,291

10,498

North West

14,437

3,445

17,882

South East

18,719

6,833

25,552

South West

8,166

4,414

12,580

West Midlands

10,785

3,897

14,682

Yorkshire and the Humber

9,788

3,281

13,069

Totals

103,877

32,053

135,930

Number of care home locations

Region

For-profit

Not-for-profit

Total

East Midlands

276

70

346

East of England

295

96

391

London

201

110

311

North East

198

37

235

North West

280

94

374

South East

492

223

715

South West

242

135

377

West Midlands

278

114

392

Yorkshire and the Humber

231

74

305

Totals

2,493

953

3,446


Written Question
NHS: Drugs and Medical Equipment
Tuesday 5th November 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what preventive measures they have put in place to protect the NHS from running short of essential medicines and medical supplies in preparation for a possible no-deal Brexit on 31 October or any other date; and what estimate they have made of the costs incurred from such measures.

Answered by Baroness Blackwood of North Oxford

It has not proved possible to respond to this question in the time available before Dissolution. Ministers will correspond directly with the Member.


Written Question
Nurses: Pensions
Tuesday 5th November 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government how many NHS practice nurses in England, after working in NHS GP practices across the country, have been excluded from the NHS pension arrangements available to other NHS staff; what estimate they have made of the pension such nurses would have accrued, on average, had they been able to accrue pensions in the same way as nurses working in other parts of the NHS.

Answered by Baroness Blackwood of North Oxford

It has not proved possible to respond to this question in the time available before Dissolution. Ministers will correspond directly with the Member.


Written Question
Doctors: Pensions
Tuesday 5th November 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what is their estimate of how many NHS senior medical staff have been asked to pay extra tax as a result of their pension contributions exceeding the Tapered Annual Allowance in the (1) 2016–17, (2) 2017–18, and (3) 2018–19 tax years; and what was the average amount of tax that such staff were asked to pay in each of those years.

Answered by Baroness Blackwood of North Oxford

It has not proved possible to respond to this question in the time available before Dissolution. Ministers will correspond directly with the Member.


Written Question
General Practitioners: Nurses
Wednesday 7th August 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what assessment they have made of pension provision for GP practice nurses and, in particular, the impact of their exclusion from the NHS pension scheme until 1997.

Answered by Baroness Blackwood of North Oxford

Membership of the NHS Pension Scheme was extended to general practitioner (GP) practice nurses from September 1997, following an agreement reached with organisations representing nurses and GPs. Prior to this date, GP practice nurses were excluded because eligibility was originally limited to those directly employed by a National Health Service body. GP practice nurses are employed directly by self-employed GPs, rather than the NHS.

The pressure on NHS Pension Scheme costs, which are met mutually across all members and their employers, meant that practice nurses could not be offered retrospective membership for employment before 1997. This was accepted by staff representatives at the time of the agreement, and remains the current position.

However, GP practice nurses and their employers can make voluntary extra contributions to purchase units of ‘Additional Pension’ and so boost their NHS retirement pensions.


Written Question
NHS: Pensions
Tuesday 6th August 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what plans they have, if any, to compensate senior NHS staff who have inadvertently exceeded the tapered annual pensions allowance.

Answered by Baroness Blackwood of North Oxford

For the majority of people, their pension contributions are tax-free. This makes pensions tax relief one of the most expensive reliefs in the personal tax system. The reforms to the lifetime and annual allowance made in the previous two parliaments are expected to save over £6 billion per year and are necessary to deliver a fair system and protect public finances. Less than 1% of pension savers will have to reduce their saving or face an annual allowance charge as a result of the tapered annual allowance.

While there are no plans to compensate senior National Health Service staff who exceed their tax-free pension savings allowances, the Scheme Pays facility is there to assist NHS Pension Scheme members who breach the annual allowance, and allows them to settle their lifetime and annual allowance charges without making an upfront payment. The Scheme Pays facility was recently extended to cover tax charges of any amount and those arising from the tapered annual allowance.

The Government has launched a full public consultation setting out proposals to make the NHS Pension Scheme more flexible for clinicians, to give them more control over their pension growth and tax liabilities.


Written Question
Continuing Care: Finance
Monday 15th July 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what percentage of applications for NHS Continuing Healthcare funding in England were accepted (1) within less than one month, (2) within less than three months, (3) within three to six months, (4) within six to 12 months, and (5) after 12 months, of the date of application.

Answered by Baroness Blackwood of North Oxford

The following table provides the total number of referrals received for NHS Continuing Healthcare (CHC) for both Standard and Fast Track NHS CHC, for the years 2016/17 to 2018/19.

Number of Referrals Received

Period

Standard NHS CHC

Fast Track

Total NHS CHC

2016/17

76,945

88,420

165,365

2017/18

75,322

94,175

169,497

2018/19

73,475

97,273

170,748

NHS England collects and publishes data regarding the number of referrals completed, and of those, how many were assessed as eligible (as a percentage). A table showing these figures is attached due to the size of the data. The percentage of referrals agreed as eligible is based on the number of referrals ‘completed’ (rather than ‘referrals received’). Pre 2017/18 data did not use this counting methodology and therefore is not comparable. 2016/17 figures have therefore not been included.

The NHS CHC appeals process consists of clinical commissioning group local resolution and NHS England Independent Review. It is not possible to provide data on cases found eligible at local review or Independent Review as a percentage of applications initially assessed as not eligible.

We do not hold information on the percentage of NHS CHC referrals which were assessed as eligible within the requested time periods. NHS England does, however, hold information on the percentage of referrals completed within 28 days, and the latest annual information on this is included in the following table. This relates to Standard NHS CHC and not Fast Track NHS CHC.

% referrals within 28 days

Period

Standard NHS CHC

Referrals completed

Referrals completed in 28 days

% completed in 28 days

2018/19

76,803

53,504

70%


Written Question
Continuing Care: Finance
Monday 15th July 2019

Asked by: Baroness Altmann (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what percentage of rejected applications for NHS Continuing Healthcare funding in England were then granted on (1) first, and (2) second, appeal in each of the last three years.

Answered by Baroness Blackwood of North Oxford

The following table provides the total number of referrals received for NHS Continuing Healthcare (CHC) for both Standard and Fast Track NHS CHC, for the years 2016/17 to 2018/19.

Number of Referrals Received

Period

Standard NHS CHC

Fast Track

Total NHS CHC

2016/17

76,945

88,420

165,365

2017/18

75,322

94,175

169,497

2018/19

73,475

97,273

170,748

NHS England collects and publishes data regarding the number of referrals completed, and of those, how many were assessed as eligible (as a percentage). A table showing these figures is attached due to the size of the data. The percentage of referrals agreed as eligible is based on the number of referrals ‘completed’ (rather than ‘referrals received’). Pre 2017/18 data did not use this counting methodology and therefore is not comparable. 2016/17 figures have therefore not been included.

The NHS CHC appeals process consists of clinical commissioning group local resolution and NHS England Independent Review. It is not possible to provide data on cases found eligible at local review or Independent Review as a percentage of applications initially assessed as not eligible.

We do not hold information on the percentage of NHS CHC referrals which were assessed as eligible within the requested time periods. NHS England does, however, hold information on the percentage of referrals completed within 28 days, and the latest annual information on this is included in the following table. This relates to Standard NHS CHC and not Fast Track NHS CHC.

% referrals within 28 days

Period

Standard NHS CHC

Referrals completed

Referrals completed in 28 days

% completed in 28 days

2018/19

76,803

53,504

70%