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Written Question
NHS
Wednesday 9th December 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department took to promote awareness of the NHS consultation paper on the Government's Mandate to NHS England to 2020 published in October 2015.

Answered by George Freeman

The consultation was announced in a Written Ministerial Statement to Parliament on 29 October 2015 (HCWS274), published online, tweeted by the Department, briefed to the Health Service Journal and circulated through a number of Departmental and NHS bulletins. They included the Health and Care Partnerships e-bulletin which is sent to over 300 health and care sector organisations, the Clinical Commissioning Group (CCG) bulletin which goes to all CCGs, and HealthWatch England’s bulletin which goes to all local HealthWatch organisations.


Written Question
Dental Services
Friday 23rd October 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the availability of NHS dentist places in (a) High Peak constituency, (b) Derbyshire Clinical Commissioning Group and (c) Tameside and Glossop Clinical Commissioning Group in each of the last five years.

Answered by Alistair Burt

NHS England is responsible for commissioning primary and secondary care dental services to meet local need. NHS England advises that oral health needs assessments for general dentistry are being conducted for areas that include Tameside and Glossop and Derbyshire.


Overall, access continues to increase with the latest access data showing 30 million patients were seen by a dentist in the 24 month period ending 30 June 2015. This is 1.7 million more patients than May 2010.


There is further to go, and this is why the Government is committed to increasing access still further through reform of the dental contract to incentivise dentists to focus on prevention as well as treatment and, by seeing patients at intervals appropriate to their clinical need, freeing up spaces for additional patients to be seen.


Written Question
Wheelchairs: Out-patients
Friday 11th September 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the adequacy of the current levels of funding within the NHS for wheelchair provision for outpatients.

Answered by Alistair Burt

Wheelchair services are the responsibility of local clinical commissioning groups (CCGs). No information is currently held centrally about CCGs’ expenditure on wheelchair services or the level of service that they provide, including information about access and patient experience, that would enable the transparent assessment and benchmarking of provision for outpatients.

NHS England has recently established a new national wheelchair dataset, which went live from 1 July. This will enable the use of data in future to drive improvement in wheelchair services.


Written Question
Orthopaedics: Young People
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps he has taken to provide care and respite funding for young adult amputees.

Answered by Dan Poulter

Information on specific funding for young adult amputees is not held centrally.

NHS England has advised that the rehabilitation and re-ablement of all patients is provided by a specialised Multi-Disciplinary Team (MDT) which should be consultant led. The needs of patients of all age groups are addressed including physical, psychological, social, emotional and spiritual with the emphasis on individual outcomes, independence and prevention keeping patients dexterous, mobile and safe. Secondary injuries should be minimised.

The NHS Standard Contract for Complex Disability Equipment – Prosthetics, which applies to all ages, sets out how the specialist centres should operate and the required level of service delivered. It also recognises that children, young adults, veterans and other patients require a flexible model of care which provides longer term involvement with the full MDT. The specification also recognises that child growth is a recognised clinical need.


Written Question
Chronic Illnesses
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what proportion of long-term conditions which entitle patients to free prescriptions are curable.

Answered by George Freeman

The list of medical conditions that give entitlement to apply for a National Health Service prescription charge medical exemption certificate are:

- a permanent fistula (including caecostomy, colostomy, laryngostomy, or ileostomy) which requires continuous surgical dressing or requires an appliance forms of hypoadrenalism (including Addison's disease) for which specific substitution therapy is essential;

- diabetes insipidus or other forms of hypopituitarism;

- diabetes mellitus (except where treatment of the diabetes is by diet alone);

- hypoparathyroidism;

- myasthenia gravis;

- myxoedema (that is, hypothyroidism requiring thyroid hormone replacement);

- epilepsy requiring continuous anti-convulsive therapy;

- continuing physical disability which prevents the patient from leaving his residence without the help of another person; and

- patients undergoing treatment for cancer, the effects of cancer or the effects of current or previous cancer treatment. (From 1 April 2009).

Clinical advice from NHS England is that the majority of these conditions are considered to be permanent, incurable conditions. Only in exceptional cases would a person have the possibility of curative treatment for one of these conditions.


Written Question
Pain
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the average waiting time is for pain management in each region.

Answered by Norman Lamb

The information requested is shown in the following table. These data are from hospital episode statistics and measure the time waited between decision to admit and admission to hospital. They are not the same as referral to treatment waiting times, which measure waiting times from referral to the start of consultant-led treatment by 18 treatment functions (subdivisions of consultant main specialties), but which do not include condition specific information.

The average (median) number of days waited for pain management treatment, 2012-13

Average (median) waiting time (days)

Area Team of Residence

Admissions

First Outpatient Attendances

Cheshire, Warrington And Wirral Area Team

59

46

Durham, Darlington And Tees Area Team

65

52

Greater Manchester Area Team

64

42

Lancashire Area Team

55

38

Merseyside Area Team

58

50

Cumbria, Northumberland, Tyne And Wear Area Team

44

49

North Yorkshire And Humber Area Team

57

55

South Yorkshire And Bassetlaw Area Team

41

26

West Yorkshire Area Team

84

54

Arden, Herefordshire And Worcestershire Area Team

49

49

Birmingham And The Black Country Area Team

47

52

Derbyshire And Nottinghamshire Area Team

47

29

East Anglia Area Team

61

50

Essex Area Team

56

55

Hertfordshire And The South Midlands Area Team

84

68

Leicestershire And Lincolnshire Area Team

63

54

Shropshire And Staffordshire Area Team

64

61

Bath, Gloucestershire, Swindon And Wiltshire Area Team

56

60

Bristol, North Somerset, Somerset And South Gloucestershire Area Team

18

50

Devon, Cornwall And Isles Of Scilly Area Team

77

49

Kent And Medway Area Team

58

49

Surrey And Sussex Area Team

66

59

Thames Valley Area Team

69

56

Wessex Area Team

65

48

London Area Team

70

63

England

63

51

Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

Notes:

  1. The data provided are finished admission episodes (FAEs) and outpatient first attendances where the treatment specialty was either pain management or paediatric pain management.
  2. An FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.
  3. Attendances at outpatient clinics. Includes first and follow-up attendances and telephone consultations, excludes did not attends and cancellations.
  4. Area Team of Residence is the area team containing the patient’s normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another area for treatment.
  5. The treatment specialty is the specialty under which the consultant responsible for care of the patient is working, which may be different to the specialty under which the consultant is registered. Care is needed when analysing HES data by specialty, or by groups of specialties (such as "acute"). Trusts have different ways of managing specialties and attributing codes so it is better to analyse by specific diagnoses, operations or other recorded information.
  6. The median, rather than the mean, time waited is given as the mean can be affected by a relatively small number of records with a long time waited, however the median is less affected by this issue.


Written Question
Prescriptions: Fees and Charges
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many patients with long-term health conditions which entitle them to free prescriptions have been fined for not renewing their certificates in each of the last five years.

Answered by George Freeman

The Prescription Exemption Checking Service is delivered by the NHS Business Services Authority (NHSBSA) as commissioned by NHS England. NHSBSA assumed the responsibility for this service from 17 September 2014. Prior to this date it was the responsibility of primary care trusts and NHS England Area Teams, for which no data is held.

From 17 September 2014 to 16 January 2015 a total of 1,475 patients who have declared they hold a valid certificate which indicates that they are entitled to free prescriptions due to a long-term health condition have paid a penalty charge in full with a further 898 patients who have opted to pay the penalty charge by instalments.

The NHSBSA cannot identify from the exemption checking process which patients claiming medical exemption have been sent a penalty charge notice as a result of the patient not renewing their medical exemption certificate.

For those patients who have paid a penalty charge the cause for the incorrect claim for free prescriptions is not known. There are various reasons which could include:

- expiry of current medical exemption certificate; and

- never been in receipt of a medical exemption certificate.


Written Question
Prescriptions: Fees and Charges
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps he has taken to publicise the fact that certificates of entitlement to free prescriptions for chronic and incurable conditions are time-limited.

Answered by George Freeman

The NHS Business Services Authority (NHSBSA) sent all English pharmacies and general practitioner practices a supply of posters and booklets entitled ‘Claiming free prescriptions?’ in October 2014 as part of the centralisation of the prescription exemption checking process within the NHSBSA. The poster warns patients of the consequences of claiming free prescriptions incorrectly and directs them to the booklet for more information on eligibility, which states that medical exemption certificates are valid for five years. The poster and booklet are also published on the NHSBSA website at:

http://www.nhsbsa.nhs.uk/PrescriptionServices/4666.aspx

The covering letter sent to patients by the NHSBSA along with their medical exemption certificates also references that certificates are liable for renewal, and the expiry date is printed on the certificate itself. The letter also directs recipients to the NHSBSA website and the NHS Help with Health Costs Facebook page where more information is available. The NHS Choices Help with Health Costs pages also contain information about eligibility for free prescriptions, including details on medical exemptions and certificate duration.


Written Question
Prescriptions: Fees and Charges
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, if he will make it his policy that the NHS Business Unit should contact GPs when a certificate of entitlement to free prescriptions is due to expire.

Answered by George Freeman

We do not believe it would be appropriate for the NHS Business Services Authority to contact general practitioners about renewal of medical exemption certificates. Information is already sent directly to patients about the validity of these certificates, which includes the date of expiry printed on the certificate and a reminder sent to the patient one month before the certificate expires. The wording of the declaration on the prescription form is also a prompt to a patient to check that their certificate is valid.


Written Question
Pain
Tuesday 27th January 2015

Asked by: Andrew Bingham (Conservative - High Peak)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what research his Department has commissioned into complex regional pain syndrome.

Answered by George Freeman

The Department has not commissioned specific research into complex regional pain syndrome (CRPS) but a range of related research is funded by the National Institute for Health Research (NIHR).

The NIHR Clinical Research Network is currently recruiting patients to two studies relating to CRPS:

- Development of an Electrical Sensory Discrimination Therapies device for the relief of chronic pain in CRPS. A proof of concept study

- An Intervention Trial to Investigate the Effectiveness of Visual Illusions in Manipulating Body Perception Disturbances to Reduce Chronic Pain and Improve Movement Performance

There is also an active Efficacy and Mechanism Evaluation (EME) Researcher-Led project (which is funded by the Medical Research Council and managed by NIHR):

- Low-dose Intravenous Immunoglobulin Treatment for Complex Regional Pain Syndrome (‘LIPS’) Randomised Controlled Trial.

Other research, carried out within the last two years, includes:

A Health Services and Delivery Research project:

- Meeting the support needs of patients with Complex Regional Pain Syndrome through innovative use of wiki technology

CRN studies:

- A Multi-Centre International Study Exploring the Patients' Definition of Recovery from Complex Regional Pain Syndrome

- Visually Manipulating Body Perception Disturbances to Treat Chronic Pain: An Exploratory Study

NIHR Career Development Fellowships:

- Understanding sensorimotor integration and its role in pain. Feasibility study to evaluate the potential of multi-modal imaging systems in CRPS

- Sensorimotor conflict and its relationship to behavioural and neurophysiological variables in CRPS, FMS, arthritis and healthy volunteers