Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department for Education:
To ask Her Majesty's Government, further to the Written Answer by Lord Agnew of Oulton on 25 July (HL9666), what mechanisms they use or intend to use to ensure that subcontractors to awardees of Education and Skills Funding Agency contracts for the training of apprentices are capable of delivering training of the appropriate quality and do deliver such training.
Answered by Lord Agnew of Oulton
We understand this question to refer to non-levy apprenticeship procured contracts. Under these contracts delivery started from 1 January 2018.
The Education and Skills Funding Agency (ESFA) requires all providers that subcontract to comply with its apprenticeship funding rules (attached). These rules include that providers must carry out due diligence checks on potential subcontractors. In addition, they must not use the delivery subcontractor that they assess is unsuitable, or whose quality of delivery is demonstrably inadequate.
Providers must manage and monitor all of their subcontractors to make sure that high quality delivery is taking place which meets the funding rules. This includes carrying out a regular and substantial programme of quality-assurance checks on the apprenticeship training and on-programme assessment provided by subcontractors.
The ESFA also requires all subcontractors with aggregate apprenticeship delivery of over £100,000 per year to successfully apply to its register of apprenticeship training providers.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department for Education:
To ask Her Majesty's Government, further to the Written Answer by Lord Agnew of Oulton on 25 July (HL9666), how they assess the suitability for Education and Skills Funding Agency contracts for the training of apprentices of organisations which subcontract all or part of such training.
Answered by Lord Agnew of Oulton
The procurement of contracts for the delivery of non-levy apprenticeship training was conducted in accordance with the Public Contracts Regulations 2015. Contracts were awarded on the basis of an Education and Skills Funding Agency (ESFA) assessment of information supplied by providers against a defined set of criteria set out in the invitation to tender.
The ESFA, through its funding rules, requires awarded organisations to directly deliver some of the apprenticeship training associated with the apprenticeship programme of each employer they are working with. The volume of training that the awarded organisation delivers must have some substance and not be a token amount.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department for Education:
To ask Her Majesty's Government how many contracts for the training of apprentices for small and medium-sized employers who do not pay the Apprenticeship Levy have been awarded by the Education and Skills Agency to date; what is the total value of those contracts; how many of the awardees do not have the facilities to provide such training and sub-contract; and what percentage of those contracts’ value is typically retained by an awardee who subcontracts training.
Answered by Lord Agnew of Oulton
The Education and Skills Funding Agency (ESFA) currently contracts with 713 training providers for an overall value of £562 million. These contracts run from January 2018 to March 2019 and support apprenticeship delivery for 16-18 and adult learners. The ESFA does not monitor or collect information on the size of the employers supported by these contracts.
The ESFA require apprenticeship training providers to declare details of their subcontracting relationships. The first subcontractor declaration for these particular contracts is in progress and will close on 25 July 2018. A summary of providers’ subcontracting relationships will be published by the ESFA on GOV.UK in August 2018 in a document named ‘List of declared subcontractors’. The ESFA does not hold information to indicate the percentage of funding retained by a provider when subcontracting these particular contracts.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the impact of a state-backed GP indemnity scheme in England on the number and value of clinical negligence claims made against GPs and other members of primary care teams.
Answered by Lord O'Shaughnessy
The Department understands that the rising cost of indemnity cover is a great source of concern for general practitioners (GPs) and impacts negatively on the GP workforce. We are seeking to put in place a more affordable and more stable system of indemnity for general practice. The state backed indemnity scheme will aim to protect both patients and providers from the consequences of clinical negligence and to meet the changing needs of the National Health Service.
We have not made an assessment of the potential impact of the state scheme on the number and value of clinical negligence claims, but more generally, the Government is working to produce a cross-Government strategy to tackle the rising costs of clinical negligence, as challenged by the National Audit Office in their report, Managing the costs of clinical negligence in trusts, published in September 2017. A copy of this report is attached.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the effect of the introduction of a state-backed GP indemnity scheme in England on the medical defence organisation marketplace.
Answered by Lord O'Shaughnessy
The Department is developing a state-backed indemnity scheme for general practice in England. This recognises that the rising cost of clinical negligence is a great source of concern for general practitioners (GPs). The state-backed scheme is being designed to provide more affordable and more stable cover for GPs.
We recognise the value of medical defence organisations to their members and we are working closely with them to understand the impact of the proposed scheme on their business.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what progress they have made in implementing a state-backed GP indemnity scheme in England; and what further implementation plans are currently in place.
Answered by Lord O'Shaughnessy
In October 2017, the Secretary of State for Health and Social Care announced the intention of the Department to develop a state-backed indemnity scheme for general practice in England. This announcement recognised that the rising cost of clinical negligence is a great source of concern for general practitioners (GPs).
Since the announcement, the Government has been developing the new scheme, seeking to put in place a more stable and affordable system of indemnity for general practice. The plans announced so far are as follows:
- NHS Resolution will be directed to establish and administer the scheme on behalf of the Secretary of State. This means that NHS Resolution will be given responsibility for the overall administration of the scheme;
- The scheme will include activities delivered under the primary medical care contracts (General Medical Services, Personal Medical Services and Alternative Provider Medical Services). Other professions working under the primary medical care contracts will be included in the scheme. The scheme will also include work delivered under the primary medical care contracts that are delivered in secure environments; and
- The current intention is that the scheme will exclude National Health Service primary care dentistry and private dentistry, private healthcare and community pharmacy and optometry.
We are working closely with the medical defence organisations, NHS England, and representatives of general practice professionals.
In March 2018, the Department commissioned a survey of GPs, nurses and pharmacists in general practice. The survey was designed to help the Department understand current indemnity arrangements within general practice, informing the development of the new state backed scheme.
We are currently analysing the survey results and will provide further details along with the key findings of the GP Indemnity Survey in due course.
We remain fully committed to developing and implementing the scheme from April 2019.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the average annual saving to GPs of a state-backed GP indemnity scheme in England.
Answered by Lord O'Shaughnessy
The state backed scheme is being designed to provide more stable, affordable and financially sustainable indemnity cover for general practitioners (GPs). A state backed scheme will enable the Government to have greater overall sight of costs and claims.
The scheme should meet the needs of current and future GPs and offer value for money for taxpayers. This involves complex considerations about funding which are being worked through, and we are working with HM Treasury and NHS England to assess the potential future cost of the scheme. We are unable to provide the estimates that result from these assessments as this information is commercially sensitive.
The Government is working with medical defence organisations, general practice representatives and other key stakeholders on the design of the scheme.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the total cost to the NHS of implementing a state-backed GP indemnity scheme in England.
Answered by Lord O'Shaughnessy
The state backed scheme is being designed to provide more stable, affordable and financially sustainable indemnity cover for general practitioners (GPs). A state backed scheme will enable the Government to have greater overall sight of costs and claims.
The scheme should meet the needs of current and future GPs and offer value for money for taxpayers. This involves complex considerations about funding which are being worked through, and we are working with HM Treasury and NHS England to assess the potential future cost of the scheme. We are unable to provide the estimates that result from these assessments as this information is commercially sensitive.
The Government is working with medical defence organisations, general practice representatives and other key stakeholders on the design of the scheme.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of the decision by NHS South West Lincolnshire Clinical Commissioning Group to implement contractual agreements that patients cannot receive routine elective care before 12 weeks, whether they intend to intervene to prohibit such practices.
Answered by Lord O'Shaughnessy
NHS England has made it clear to commissioners that they should not restrict access to routine elective at any stage of a patient’s referral to treatment. Clinical commissioning groups (CCGs), including South West Lincolnshire CCG, should work locally with National Health Service providers to manage appointments for routine elective care, taking into account the needs of their population and in line with waiting times standards as set out in the NHS Constitution.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to review how they can incentivise manufacturers of generic medicines to ensure off-patent medicines can be repurposed and made available to patients.
Answered by Lord O'Shaughnessy
The Association of Medical Research Charities (AMRC) has led a group of stakeholders which has produced a framework to facilitate the adoption of off-patent repurposed drugs into National Health Service clinical practice where there is robust evidence to support it and where this would benefit patients. This, alongside some recommendations which will further support drug repurposing, was published in their report last year, Facilitating adoption of off-patent, repurposed medicines into NHS clinical practice. A copy is attached.
The Department has supported this work and is playing its part in implementing the recommendations which fall within its area of responsibility. We have no plans to further review how generic manufacturers can be incentivised. The AMRC’s report includes two recommendations which relate to incentives for generic manufacturers which are for a range of other stakeholders to drive forward. However, we took an important step forward in incentivising medicines manufacturers to repurpose drugs in ensuring that the Accelerated Access Pathway announced last November is open to repurposed drugs.