Asked by: Lord Willis of Knaresborough (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 using paper-based systems for prescribing medicines on the efficacy of homecare medicines services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
An assessment, through a commissioned piece of user-research of homecare paper-based prescribing, was done during the COVID-19 pandemic. NHS England will use the information in this assessment to understand the issues in homecare, as well as to inform future improvement actions, particularly developing and adoption of the Electronic Prescription Service (EPS).
No assessment has been made of the impact of requirements under the Human Medicines Regulations 2012. The only advanced electronic signature (AES) is through EPS. Not many e-prescribing systems used in secondary care have the capability to meet this AES requirement.
Asked by: Lord Willis of Knaresborough (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 requirements under the Human Medicines Regulations 2012 (SI 2012/1916) for prescriptions to have either a wet signature or an advanced electronic signature on the efficiency of homecare medicines services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
An assessment, through a commissioned piece of user-research of homecare paper-based prescribing, was done during the COVID-19 pandemic. NHS England will use the information in this assessment to understand the issues in homecare, as well as to inform future improvement actions, particularly developing and adoption of the Electronic Prescription Service (EPS).
No assessment has been made of the impact of requirements under the Human Medicines Regulations 2012. The only advanced electronic signature (AES) is through EPS. Not many e-prescribing systems used in secondary care have the capability to meet this AES requirement.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve interoperability of (1) NHS information management systems, and (2) homecare medicines services information management systems.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
An Information Standard Notice (ISN) which puts in place definitions that are to be used when a health professional sends or receives patient medication and allergy/intolerance information, by computer system, between care locations, has been published under section 250 of the Health and Social Care Act 2012.
The purpose is to ensure that medication and allergy information is transferred between systems and locations in a machine-readable format. This will be achieved by: transferring medication information using the newest version for the United Kingdom of Fast Healthcare Interoperability Resource, by use of either ‘Medication Codable Concept’ or ‘Medication Resource’ as is most appropriate to the use case; usage of dose syntax to transfer the amount of medication per dose as a simple coded quantity; and transferring allergy/intolerance information using Systematized Nomenclature of Medicine Clinical Terms and dictionary of medicines and devices codes.
All clinical IT systems that will be used for prescribing homecare medicines will be required to be compliant with this ISN.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to enable prescriptions to be shared electronically between (1) NHS services, and (2) homecare medicines service providers.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Homecare Medicines Committee’s (NHMC) vision for digital transformation, including e-prescribing in homecare, is available in a short video in an online-only format on the YouTube website. The digital subgroup of the NHMC is working with the National Health Service, Electronic Prescribing and Medicines Administration (ePMA) systems vendors and homecare providers to produce an output-based specification for an Electronic Prescribing System (EPS), particularly focusing on the technical aspects of homecare requirements for EPS. This will include interoperable prescribing systems. Any ePMA systems used in secondary care need to be Dictionary of medicines and devices compliant and this applies for homecare medicines too; this is needed to support interoperability.
The output-based specification aims to standardise requirements in homecare medicines e-prescribing, accelerating adoption of e-prescribing system development in homecare. This specification is undergoing final review by NHS England before publication by the NHMC.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they anticipate all NHS Trusts to have implemented Electronic Prescribing and Medicines Administration systems.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The COVID-19 pandemic and the subsequent focus on recovery has seen some National Health Service trusts delay implementing Electronic Prescribing and Medication Administration, meaning the timeline for implementation has been pushed to 2025. However, the implementation of e-prescribing in NHS trusts remains a key and appropriate deliverable as part of the vision to digitally transform the NHS. Additionally, the Electronic Prescription Service, which has been widely used in primary care over the past 18 years, is being made available to all NHS trusts by March 2025, should they want to utilise it.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the estimated cost of VAT to the NHS applied to the purchase of patient drugs in each of the past five financial years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested is not held centrally.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps are being taken to (1) significantly reduce, and (2) reform, the amount of regulators and regulatory systems in the health and care sector.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to reforming the system of regulation for healthcare professionals in the United Kingdom, making it faster, fairer, more flexible and less adversarial. A modernised regulatory framework will be introduced first for anaesthesia associates and physician associates, who will be brought into regulation under the General Medical Council by the end of 2024, before the reformed legislation is rolled out to doctors, and to the professions regulated by the Nursing and Midwifery Council and the Health and Care Professions Council over the following couple of years.
The Care Quality Commission has set out plans to introduce a new single assessment framework for care providers, local authorities, and integrated care systems, which will prevent duplication and provide a consistent and accessible means of ensuring safe and high-quality provision of care at all levels.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government which minister is directly responsible for the ‘Homecare Medicines Service’; and what arrangements are in place to (1) coordinate, and (2) evaluate the service.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Minister of State for Health, Will Quince MP, is the minister responsible for the Homecare Medicines Service.
Providers of Homecare Medicine services to National Health Service patients do so under framework agreements which may be held at different authority levels as follows:
- National level, via NHS England;
- Regional level, via NHS procurement hubs; or
- Local level via hospital trusts.
This therefore requires a high degree of centralised co-ordination for which the National Homecare Medicines Committee (NHMC) supports and advises the NHS on matters relating to homecare medicines services.
Homecare medicines services are regulated by three different regulators, namely the Medicines and Healthcare products Regulatory Agency, the General Pharmaceutical Council, and the Care Quality Commission, depending on the service being provided. The NHMC acts as the national focus for developing and improving administration and governance processes for homecare medicines services and has published a large volume of guidance and templates to support consistent best practice across the country.
Each Chief Pharmacist within each NHS trust is the responsible officer for the homecare medicines services that the hospital provides and is responsible for the monitoring and performance management of its contracts for these services.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the Care Quality Commission is responsible for ensuring that home-based health and community care meets acceptable national standards; and if not, who is.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Care Quality Commission (CQC) do not have a role to routinely ensure that entrants to England on Health and Social Care visas and work permits are employed under the same terms and conditions as United Kingdom domiciled staff. However, as part of CQC’s regulatory role, staffing governance is considered during CQC inspections at providers. If CQC identify areas of incorrect practice they would work with relevant agencies such as the Home Office to rectify any issues raised.
CQC regulate all health and care services that want to conduct a Regulated Activity, as defined by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. CQC’s scope of registration document defines the types of organisations which need to register, including domiciliary care providers, community nursing services or integrated care teams, including district nursing, community matrons and specialist nursing services, community therapy services such as occupational therapy and physiotherapy, community intermediate care, community rehabilitation or reablement services and community outpatient and diagnostic services.
All services are regulated by CQC to ensure they meet the minimum fundamental standards of care. CQC’s regulatory frameworks refer to national best practice, and CQC expect regulated providers to demonstrate how they meet these, or how alternative methods achieve the same or better outcomes for people using services.
Asked by: Lord Willis of Knaresborough (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the Care Quality Commission is responsible for ensuring entrants to England on Health and Social Care visas and work permits are employed under the same terms and conditions as UK domiciled staff; and if not, who is responsible for their conditions of employment.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Care Quality Commission (CQC) do not have a role to routinely ensure that entrants to England on Health and Social Care visas and work permits are employed under the same terms and conditions as United Kingdom domiciled staff. However, as part of CQC’s regulatory role, staffing governance is considered during CQC inspections at providers. If CQC identify areas of incorrect practice they would work with relevant agencies such as the Home Office to rectify any issues raised.
CQC regulate all health and care services that want to conduct a Regulated Activity, as defined by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. CQC’s scope of registration document defines the types of organisations which need to register, including domiciliary care providers, community nursing services or integrated care teams, including district nursing, community matrons and specialist nursing services, community therapy services such as occupational therapy and physiotherapy, community intermediate care, community rehabilitation or reablement services and community outpatient and diagnostic services.
All services are regulated by CQC to ensure they meet the minimum fundamental standards of care. CQC’s regulatory frameworks refer to national best practice, and CQC expect regulated providers to demonstrate how they meet these, or how alternative methods achieve the same or better outcomes for people using services.