Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the answer by Lord Prior of Brampton on 11 October (HL Deb, col 1787), how much resource has been taken out of acute hospitals since the inception of the five-year forward view on mental health; and of this how much has been transferred to (1) mental health care, (2) community care, and (3) primary care.
Answered by Lord Prior of Brampton
All trusts will see an increase in overall funding, as we are supporting the National Health Service’s own plan by investing an additional £10 billion in real terms over the six years since the Five Year Forward View was published, including a £3.8 billion real terms increase this year alone. Official data on trusts’ exact income levels will not be known until the end of the financial year.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether it is (1) their policy, or (2) the policy of NHS England, that primary care centres should be amalgamated into larger units.
Answered by Lord Prior of Brampton
As part of the New Care Models Programme, NHS England is supporting local health and care commissioners and providers to come together to improve the health and care they provide. This includes the development of population-based care models known as integrated Primary and Acute Care Systems and Multispecialty Community Providers (MCPs). Where and how to develop new care models are decisions taken by local partnerships, in response to local conditions. The Programme is not directing or requiring the amalgamation of primary care centres.
There are 14 MCP vanguards, with a single organisation accountable for joined-up General Practitioner (GP) and community services and some specialist care, mental health services, and social care for a defined population. The building blocks of a MCP are the ‘care hubs’ of integrated teams. Each typically serves a community of around 30,000-50,000 people. These hubs are the practical, operational level of any model of accountable care provision. The wider the scope of services included in the MCP, the more hubs you may need to connect together to create sufficient scale. All 14 MCP vanguards now serve a minimum population of around 100,000.
The majority of GP practices are already working in practice groups or federations. This provides opportunities to expand services, stabilise practice income and work at scale, which has benefits for patients, practices and the wider system. These include economies of scale, quality improvement, workforce development, enhanced care and new services, resilience and system partnerships.
A new voluntary MCP contract will be introduced from April 2017, to integrate general practice services with community services and wider healthcare services. Measures from the GP Access Fund and vanguard sites that are currently piloting this approach, will be learned from to support mainstreaming of proven service improvements across all practices, and funding will be provided for local collaborations to support practices to implement new ways of working.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether it is their intention to amalgamate local primary care centres into larger units; and if so, when.
Answered by Lord Prior of Brampton
As part of the New Care Models Programme, NHS England is supporting local health and care commissioners and providers to come together to improve the health and care they provide. This includes the development of population-based care models known as integrated Primary and Acute Care Systems and Multispecialty Community Providers (MCPs). Where and how to develop new care models are decisions taken by local partnerships, in response to local conditions. The Programme is not directing or requiring the amalgamation of primary care centres.
There are 14 MCP vanguards, with a single organisation accountable for joined-up General Practitioner (GP) and community services and some specialist care, mental health services, and social care for a defined population. The building blocks of a MCP are the ‘care hubs’ of integrated teams. Each typically serves a community of around 30,000-50,000 people. These hubs are the practical, operational level of any model of accountable care provision. The wider the scope of services included in the MCP, the more hubs you may need to connect together to create sufficient scale. All 14 MCP vanguards now serve a minimum population of around 100,000.
The majority of GP practices are already working in practice groups or federations. This provides opportunities to expand services, stabilise practice income and work at scale, which has benefits for patients, practices and the wider system. These include economies of scale, quality improvement, workforce development, enhanced care and new services, resilience and system partnerships.
A new voluntary MCP contract will be introduced from April 2017, to integrate general practice services with community services and wider healthcare services. Measures from the GP Access Fund and vanguard sites that are currently piloting this approach, will be learned from to support mainstreaming of proven service improvements across all practices, and funding will be provided for local collaborations to support practices to implement new ways of working.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the NHS has the authority to require the amalgamation of local primary care centres; and if so, what is the extent of its powers.
Answered by Lord Prior of Brampton
As part of the New Care Models Programme, NHS England is supporting local health and care commissioners and providers to come together to improve the health and care they provide. This includes the development of population-based care models known as integrated Primary and Acute Care Systems and Multispecialty Community Providers (MCPs). Where and how to develop new care models are decisions taken by local partnerships, in response to local conditions. The Programme is not directing or requiring the amalgamation of primary care centres.
There are 14 MCP vanguards, with a single organisation accountable for joined-up General Practitioner (GP) and community services and some specialist care, mental health services, and social care for a defined population. The building blocks of a MCP are the ‘care hubs’ of integrated teams. Each typically serves a community of around 30,000-50,000 people. These hubs are the practical, operational level of any model of accountable care provision. The wider the scope of services included in the MCP, the more hubs you may need to connect together to create sufficient scale. All 14 MCP vanguards now serve a minimum population of around 100,000.
The majority of GP practices are already working in practice groups or federations. This provides opportunities to expand services, stabilise practice income and work at scale, which has benefits for patients, practices and the wider system. These include economies of scale, quality improvement, workforce development, enhanced care and new services, resilience and system partnerships.
A new voluntary MCP contract will be introduced from April 2017, to integrate general practice services with community services and wider healthcare services. Measures from the GP Access Fund and vanguard sites that are currently piloting this approach, will be learned from to support mainstreaming of proven service improvements across all practices, and funding will be provided for local collaborations to support practices to implement new ways of working.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they plan to amalgamate primary care centres into larger units covering approximately 30,000 patients.
Answered by Lord Prior of Brampton
As part of the New Care Models Programme, NHS England is supporting local health and care commissioners and providers to come together to improve the health and care they provide. This includes the development of population-based care models known as integrated Primary and Acute Care Systems and Multispecialty Community Providers (MCPs). Where and how to develop new care models are decisions taken by local partnerships, in response to local conditions. The Programme is not directing or requiring the amalgamation of primary care centres.
There are 14 MCP vanguards, with a single organisation accountable for joined-up General Practitioner (GP) and community services and some specialist care, mental health services, and social care for a defined population. The building blocks of a MCP are the ‘care hubs’ of integrated teams. Each typically serves a community of around 30,000-50,000 people. These hubs are the practical, operational level of any model of accountable care provision. The wider the scope of services included in the MCP, the more hubs you may need to connect together to create sufficient scale. All 14 MCP vanguards now serve a minimum population of around 100,000.
The majority of GP practices are already working in practice groups or federations. This provides opportunities to expand services, stabilise practice income and work at scale, which has benefits for patients, practices and the wider system. These include economies of scale, quality improvement, workforce development, enhanced care and new services, resilience and system partnerships.
A new voluntary MCP contract will be introduced from April 2017, to integrate general practice services with community services and wider healthcare services. Measures from the GP Access Fund and vanguard sites that are currently piloting this approach, will be learned from to support mainstreaming of proven service improvements across all practices, and funding will be provided for local collaborations to support practices to implement new ways of working.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many provider NHS trusts achieved an improvement in operating efficiency of four per cent or more without aggravating their debt position in the last financial year.
Answered by Baroness Chisholm of Owlpen
There is no nationally agreed metric for operating efficiency. However, an annual efficiency requirement is built into the tariff uplift calculation that is used by commissioners in their contract negotiation with providers. In 2015-16 this efficiency requirement was 3.5% over 2014-15. Therefore, we can assume that organisations are delivering this efficiency if they improve their financial position based on these efficiency adjusted prices.
In February 2016, the Department published Lord Carter's Operational productivity and performance in English NHS acute hospitals: Unwarranted variations report, a review of efficiency in hospitals which provided details of how operational savings can be achieved. A copy of the report is attached. This programme, along with additional funding provided by the government, will help reduce deficits in this year and bring the sector back into financial balance in future years.
The National Health Service will receive additional funding of £10 billion per year by the end of the current Spending Review period, with £3.8 billion provided in 2016-17 alone. From this £3.8 billion, we have created a £2.1 billion Sustainability and Transformation Fund that will help providers move to a sustainable financial footing.
NHS Improvement’s 2016-17 quarter 1 performance report confirmed that things are improving in this year, with lower levels of deficit, fewer trusts reporting a deficit and savings on agency staff.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many, and what percentage of, NHS providers have signed up to the first round of proposed control totals; and how they plan to respond to those providers who (1) have not signed up, or (2) refuse to do so.
Answered by Lord Prior of Brampton
NHS Improvement continues to work with those providers who have not been able to agree control totals by the end of July. At present, 213 of 238 providers (89.5%) have an agreed a control total. Those providers who have been unable to agree a control total will not be able to access the sustainability and transformation fund.
NHS Improvement is currently consulting on a new oversight regime, which details proposals on how providers will be monitored in future and this will set out how variance from financial plan or control total will be managed.
NHS Improvement does not intend to replace the boards of those providers who do not achieve financial balance by the end of 2016/17. The organisation’s new oversight regime also sets out in detail how it proposes to monitor and support providers.
The Government’s Mandate to the NHS 2016-17, a copy of which is attached, confirms that the National Health Service must ensure that it balances its budget, including commissioners and providers living within their budgets. To support this, £1.8 billion of NHS England’s budget for 2016-17 will be allocated through the Sustainability and Transformation Fund to support providers, in particular emergency services, payable through commissioning or as other support.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the membership of those NHS provider boards that do not achieve financial balance by the end of 2016–17 will be replaced.
Answered by Lord Prior of Brampton
NHS Improvement continues to work with those providers who have not been able to agree control totals by the end of July. At present, 213 of 238 providers (89.5%) have an agreed a control total. Those providers who have been unable to agree a control total will not be able to access the sustainability and transformation fund.
NHS Improvement is currently consulting on a new oversight regime, which details proposals on how providers will be monitored in future and this will set out how variance from financial plan or control total will be managed.
NHS Improvement does not intend to replace the boards of those providers who do not achieve financial balance by the end of 2016/17. The organisation’s new oversight regime also sets out in detail how it proposes to monitor and support providers.
The Government’s Mandate to the NHS 2016-17, a copy of which is attached, confirms that the National Health Service must ensure that it balances its budget, including commissioners and providers living within their budgets. To support this, £1.8 billion of NHS England’s budget for 2016-17 will be allocated through the Sustainability and Transformation Fund to support providers, in particular emergency services, payable through commissioning or as other support.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government by how much they estimate the deficit of NHS providers will have been reduced by the end of the 2016–17.
Answered by Lord Prior of Brampton
NHS Improvement continues to work with those providers who have not been able to agree control totals by the end of July. At present, 213 of 238 providers (89.5%) have an agreed a control total. Those providers who have been unable to agree a control total will not be able to access the sustainability and transformation fund.
NHS Improvement is currently consulting on a new oversight regime, which details proposals on how providers will be monitored in future and this will set out how variance from financial plan or control total will be managed.
NHS Improvement does not intend to replace the boards of those providers who do not achieve financial balance by the end of 2016/17. The organisation’s new oversight regime also sets out in detail how it proposes to monitor and support providers.
The Government’s Mandate to the NHS 2016-17, a copy of which is attached, confirms that the National Health Service must ensure that it balances its budget, including commissioners and providers living within their budgets. To support this, £1.8 billion of NHS England’s budget for 2016-17 will be allocated through the Sustainability and Transformation Fund to support providers, in particular emergency services, payable through commissioning or as other support.
Asked by: Lord Mawhinney (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what are the principal criteria which must be addressed by pharmacies in the retail sector when they provide "information governance assurances" to the NHS annually.
Answered by Lord Prior of Brampton
All National Health Service providers, including community pharmacies, are required to provide information governance assurances to the NHS on an annual basis. These assurances are provided through completion of an online assessment tool, the NHS Information Governance Toolkit.
Community pharmacies and dispensing appliance contractors currently have to assess themselves against the following requirements:
Information Governance Management
- Responsibility for Information Governance has been assigned to an appropriate member, or members, of staff;
- There is an information governance policy that addresses the overall requirements of information governance;
- All contracts (staff, contractor and third party) contain clauses that clearly identify information governance responsibilities; and
- All staff members are provided with appropriate training on information governance requirements.
Confidentiality and Data Protection Assurance
- All person identifiable data processed outside of the United Kingdom complies with the Data Protection Act 1998 and Department of Health guidelines;
- Consent is appropriately sought before personal information is used in ways that do not directly contribute to the delivery of care services and objections to the disclosure of confidential personal information are appropriately respected;
- There is a publicly available and easy to understand information leaflet that informs patients/service users how their information is used, who may have access to that information, and their own rights to see and obtain copies of their records; and
- There is a confidentiality code of conduct that provides staff with clear guidance on the disclosure of personal information.
Information Security Assurance
- Monitoring and enforcement processes are in place to ensure NHS national application Smartcard users comply with the terms and conditions of use;
- There is an information asset register that includes all key information, software, hardware and services;
- Unauthorised access to the premises, equipment, records and other assets is prevented;
- The use of mobile computing systems is controlled, monitored and audited to ensure their correct operation and to prevent unauthorised access;
- There are documented plans and procedures to support business continuity in the event of power failures, system failures, natural disasters and other disruptions;
- There are documented incident management and reporting procedures;
- There are appropriate procedures in place to manage access to computer-based information systems; and
- All transfers of hardcopy and digital personal and sensitive information have been identified, mapped and risk assessed; technical and organisational measures adequately secure these transfers.