Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the role of the Care Quality Commission when inspecting dental businesses; and whether they have any plans to ask them also to consider the availability of NHS appointments when carrying out dental inspections.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Care Quality Commission (CQC) regulates all health and social care services including dental services in England. CQC carries out assessments of primary dental services to determine if they are compliant with regulations. CQC inspects 10% of dental services each year, as they are considered to pose a lower risk to patient safety than other regulated sectors, though they can, and do, inspect more frequently if concerns are raised. Instead of a single rating, CQC displays ticks and crosses against each of their five key questions to show if any enforcement or improvement actions are required.This results in a ‘regulations met’ or ‘regulations not met’ judgement. The availability of NHS dental appointments is not a condition of registration, nor is it a regulated activity, and so is not something that would be inspected. CQC does not currently look at wider areas, such as access to dental services, equity of access, efficiency of care provision, or the effectiveness of dental services. The ongoing review of the CQC by Penny Dash – and the broader regulatory landscape – will consider wider issues of how to assess, and improve, access to care, innovation in care delivery and use of resources – for all health and care services.
Integrated Care Boards took control of commissioning NHS dental activity in April 2023.
Activity in NHS dentistry is measured by the number of Units of Dental Activity (UDAs) commissioned and delivered and by the number of courses of treatment delivered. The number of appointments delivered are not used as a measurement of dental activity. Data on the number of UDAs commissioned and delivered is published each month on the NHS Business Services Authority Open Data Portal in an online format only.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what payments they have made to whistleblowers in the NHS in each of the last five years (1) as part of non-disclosure agreements reached through out-of-court settlements, and (2) as the result of a decision by an employment tribunal.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold the information requested. National Health Service organisations are independent employers and have their own policies and procedures in resolving workplace disputes, which should be aligned to current employment law and good human resources practice. Whistleblowers cannot waive their rights to make a protected disclosure, regardless of whether they sign an out-of-court settlement agreement. The Government is committed to ensuring we genuinely protect whistleblowers and create a culture of honesty and openness, which will include a review of current enforcement measures, to give a clear message that any misuse of confidentiality clauses will not be tolerated in the NHS.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of the scrutiny of NHS Foundation Trusts in cases where the chair of the board of directors is the same person as the chair of the council of governors.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
By law, the chair of a foundation trust is also the chair of the council of governors. This requirement is set out in paragraph 12 of Schedule 7 to the National Health Service Act 2006.
The rationale is to ensure that the chair, who oversees the foundation trust’s board, which is itself comprised of executives and non-executives and is responsible for the trust’s operation and plan development, serves as the link between this board and the council of governors, who are elected by the foundation trust’s members and represent the local population.
The Department has not carried out an assessment of the effectiveness of scrutiny into the dual-chair role.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many cases of whistleblowing there have been in the past five years across all the health and care services that are within the remit of the Department of Health and Social Care; and how many of these cases were within the NHS and how many were within the private sector.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the total number of Freedom to Speak Up cases reported to the National Guardian’s Office (NGO), and the number and proportion raised by workers in independent organisations and National Health Service trusts, each year from 2019 to 2024:
Year | Total cases | Number and proportion of cases from independent organisations | Number and proportion of cases from NHS trusts |
2019/20 | 16,199 | 61 (0.4%) | 16,032 (99.0%) |
2020/21 | 20,388 | 304 (1.5%) | 18,687 (91.7%) |
2021/22 | 20,362 | 521 (2.6%) | 18,982 (93.2%) |
2022/23 | 25,209 | 955 (3.8%) | 23,219 (92.1%) |
2023/24 | 32,167 | 1,951 (6.1%) | 29,204 (90.8%) |
Notes:
Speaking up cases brought to Freedom to Speak Up Guardians may include whistleblowing, however they may also be issues for improvement or wider matters which would not meet a formal definition of whistleblowing. Whistleblowing is when someone who works for an employer raises a concern by making a disclosure in the public interest via provisions in the Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998. Speaking up is about encouraging a positive culture where people feel they can speak up about anything that gets in the way of providing good care, that their voices will be heard, and their suggestions acted upon.
The above data is collected anonymously from individual organisations and provided voluntarily to the NGO by Guardians, and as such may represent an incomplete picture. Guardians are one of many routes to speaking up internally within an organisation. Employees may also speak up to regulators, some of which may be captured as whistleblowing.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many NHS whistleblowers were heeded and were satisfied with the response of their employers.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the data reported to the National Guardian’s Office (NGO) on the total number of workers that provided feedback about their experience of speaking up to Freedom to Speak Up Guardians, and the proportion of those workers who said they would speak up again, each year from 2019 to 2024:
Year | Number of workers who provided feedback on their experience of speaking up | Proportion of cases where workers provided feedback | Number of workers that provided feedback and said they would speak up again |
2019/20 | 4,770 | 29.4% | 4,065 (85.2%) |
2020/21 | 6,491 | 31.8% | 5,473 (84.3%) |
2021/22 | 6,005 | 29.5% | 5,112 (85.1%) |
2022/23 | 7,204 | 28.6% | 5,995 (83.2%) |
2023/24 | 8,441 | 26.2% | 6,734 (79.8%) |
Note: feedback received may be about cases that were raised in a previous financial year
Speaking up cases brought to Freedom to Speak Up Guardians may include whistleblowing, however they may also be issues for improvement or wider matters which would not meet a formal definition of whistleblowing. Whistleblowing is when someone who works for an employer raises a concern by making a disclosure in the public interest via provisions in the Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998. Speaking up is about encouraging a positive culture where people feel they can speak up about anything that gets in the way of providing good care, that their voices will be heard, and their suggestions acted upon.
The above data is collected anonymously from individual organisations and provided voluntarily to the NGO by Guardians, and as such could represent an incomplete picture. Guardians are one of many routes to speaking up internally within an organisation. Employees may also speak up to regulators, some of which may be captured as whistleblowing.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to introduce a statutory right of patients to be registered as an NHS patient of a dentist.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We have no immediate plans to introduce a statutory right for patients to be registered as a National Health Service patient. The Government will tackle the immediate crisis with a rescue plan to provide 700,000 more urgent dental appointments, and to recruit new dentists to the areas that need them most.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the triage system used by some GP practices which requires all contact by patients seeking a GP appointment to be conducted online.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We published our Delivery Plan for Recovering Access to Primary Care in May 2023, which sets out how we are moving toward a Modern General Practice (GP) model. This plan is backed by £240 million of retargeted funding, going to providing digital services, with the goal of increasing access. The plan sets out how, by improving digital access to GPs, we will free up capacity for those patients who want to contact their practice by telephone or in-person. We are also clear that online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing GPs.
The sole method for GPs to procure these digital services is via NHS England’s procurement frameworks, which list pre-approved suppliers for digital and IT services. This is to ensure consistency in service provisions, as each supplier must meet a set of requirements to be entered into a framework.
As of March 2024, 93% of GPs now have digital telephony systems. This has enabled GP teams to manage multiple calls, helping to end the 8:00am rush for appointments. Trials show that this has increased patients’ ability to get through to their practice by almost a third.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the number of (1) patient safety incidents, and (2) duty of candour events, that have occurred in relation to homecare medicines services in each of the past five years.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England cannot provide relevant information to these questions without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.
To monitor industry trends, the home care providers association, the National Clinical Homecare Association, aggregates all providers’ KPIs and they have provided written evidence to the House of Lords Public Services Committee as part of their current investigation into the Homecare Medicines service which has been published. This includes data on patient safety incidents and duty of candour reports, of which a copy is attached.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the national average for reports of duty of candour events as a percentage of active patients for NHS trusts.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England cannot provide relevant information to these questions without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.
To monitor industry trends, the home care providers association, the National Clinical Homecare Association, aggregates all providers’ KPIs and they have provided written evidence to the House of Lords Public Services Committee as part of their current investigation into the Homecare Medicines service which has been published. This includes data on patient safety incidents and duty of candour reports, of which a copy is attached.
Asked by: Lord Shipley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of delayed deliveries in homecare medicines services on patients, including on the extent of harms.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England cannot provide relevant information to this question without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.