Asked by: Baroness Walmsley (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 availability to UK patients of fenestrated endografts, developed in the UK, manufactured in Scotland and used around the world, if the current draft NICE guidelines on Abdominal Aortic Aneurysm are implemented.
Answered by Lord O'Shaughnessy
We have made no such assessments. The National Institute for Health and Care Excellence (NICE) is an independent body and has not yet published final guidance on the diagnosis and management of abdominal aortic aneurysm. NICE has recently consulted on its draft guideline and will take the comments it has received in response to the consultation fully into account in finalising its recommendations.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have conducted an impact assessment of the draft NICE Guidelines on Abdominal Aortic Aneurysm, including the impact (1) on patients over 65 years old who may be medically unsuitable for open surgical repair, and (2) of removing certain treatment options when clinical professionals have indicated that patients require such treatment.
Answered by Lord O'Shaughnessy
We have made no such assessments. The National Institute for Health and Care Excellence (NICE) is an independent body and has not yet published final guidance on the diagnosis and management of abdominal aortic aneurysm. NICE has recently consulted on its draft guideline and will take the comments it has received in response to the consultation fully into account in finalising its recommendations.
Asked by: Baroness Walmsley (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 impact of minimum waiting times on patients awaiting surgical procedures in (1) the South West Lincolnshire CCG area, and (2) England.
Answered by Lord O'Shaughnessy
No such assessment has been made.
How trusts schedule surgical procedures is for local determination but national guidance and support is available from NHS England and NHS Improvement to support trusts to meet maximum waiting times standards. Clinical priority is the main determinant of when patients should be treated followed by the chronological order of when they were added to the waiting list.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to hold a consultation exercise on social care provision for adults of working age, with a particular focus on those with learning disabilities; and if so, what are the details of the work streams and timetable.
Answered by Lord O'Shaughnessy
The Government recognises the challenges faced by people of working age with care needs. We are committed to ensuring that people with disabilities and complex conditions can live healthy, independent lives, and participate fully in society.
The Government has committed to publishing a Green Paper, by summer 2018, setting out proposals for reform of adult social care. This Green Paper will focus on care for older people, but many of the issues and questions about the sustainability of the care system will be relevant to adults of all ages. Once the Green Paper is published, it will be subject to a full public consultation.
To ensure that issues specific to working-age adults with care needs are considered in their own right, the Government will take forward a parallel programme of work which is being led jointly by the Department of Health and the Department for Communities and Local Government, which will focus on this group. This work will also be overseen by the Inter-Ministerial Group to ensure alignment with the Green Paper.
As part of our initial engagement, a round table meeting with key stakeholders on issues facing working age adults with care needs is expected to take place in the new year. It would be jointly chaired by the Parliamentary Under-Secretary of State for Care and Mental Health (Jackie Doyle-Price) and the Minister for Local Government (Marcus Jones).
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what action they are taking to reduce the waiting time for treatment by Child and Adolescent Mental Health Services.
Answered by Lord O'Shaughnessy
We have introduced a new waiting time standard for treatment of children and young people with eating disorders, setting an expectation that by 2020, 95% of those referred will start treatment within one week if the case is urgent and four weeks if the case is non-urgent.
National data on the number of young people receiving treatment within this timeframe in England shows that over 73% of patients started urgent treatment within one week in Quarter 1 2017-18 (206 out of 281 patients started treatment within one week) and nearly 78.9% of patients started routine treatment within four weeks in Quarter 1 2017-18 (1,067 out of 1,355 patients started treatment within four weeks).
This is positive initial progress some three years before the 95% level of the standard comes into force.
We are also currently exceeding the waiting time standard for Early Intervention in Psychosis, with nearly 75% of patients starting treatment within two weeks in July 2017.
The upcoming children and young people’s mental health Green Paper, which will be published by the end of the year, will include plans to improve timely access to specialist mental health services for those children and young people who need it most.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many schools have received mental health first aid training.
Answered by Lord O'Shaughnessy
To date, 280 schools have received training during June, July and September (262 secondaries and 18 primaries) with a total of 401 people trained. We anticipate that over 1,000 schools will receive training by the end of 2017.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government when the next meeting of the Crisis Care Concordat Steering Group will take place.
Answered by Baroness Chisholm of Owlpen
Departmental officials are liaising with Home Office officials to make arrangements for the next Crisis care Concordat Steering Group meeting later this year.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 1 November (HL2501), what steps they are taking to encourage the 58 CCGs who have currently not uploaded data from GRASP-AF to CHART online to do so.
Answered by Lord Prior of Brampton
CHART Online allows NHS England’s Sustainable Improvement Team to easily track the use of the Guidance on Risk Assessment and Stroke Prevention in Atrial Fibrillation (GRASP-AF) amongst general practitioner (GP) practices. However, there are a number of other tools in addition to GRASP-AF that are available to GPs to help audit management of atrial fibrillation (AF) patients. The Sustainable Improvement Team cannot easily track the use of these alternative tools, and many of the 58 clinical commissioning groups (CCGs) not using GRASP-AF, may be using one of these alternative tools. However, the Sustainable Improvement Team’s partnership with NHS RightCare will enable it to revisit practices in these CCGs to confirm the use of an alternative tool and to encourage the use of GRASP-AF in those practices that are not using, currently using it or an alternative.
The Sustainable Improvement Team uses aggregate data at CCG level or higher to help raise awareness of its work and to promote local improvement in the management of AF and has published a paper on the use of GRASP-AF and what it shows about the management of AF. A copy of the paper The use of anticoagulants in the management of atrial fibrillation among general practices in England is attached. The team also shares high level CHART Online data with organisations such as the Atrial Fibrillation Association and Public Health England.
The following table sets out information on variation in the prevalence and management of patients with AF.1
CCG level variation in the recorded prevalence and management of patients with AF
| Mean | Range |
AF Prevalence | 1.88% | 0.75-2.91% |
% of AF patients at high risk of stroke (CHADSVASc of 2 or more2 ): | 58.6% | 51.8-65.9% |
% of AF patients at high risk and on oral anticoagulant (as recommended by the National Institute for Health and Care Excellence [NICE]): | 63.5% | 48.3-80.8% |
% of AF patients at high risk and on aspirin alone (not recommended by NICE)3: | 27.9% | 11.3-42.5% |
Source: NHS England
1. These figures include only those CCGs which have at least 50% of their practices uploading to CHART Online, to avoid the data being skewed by individual practices.
2. CHADSVASc calculates stroke risk for patients with atrial fibrillation.
3. The removal of aspirin from the Quality Outcomes Framework some time ago may filter into the system as will continued adoption of the NICE guidance from 2015.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 1 November (HL2501), whether they intend to publish the key findings from the data collected through the GRASP-AF tool, saved on CHART online, to allow variations in services, diagnosis and care for patients with atrial fibrillation to be identified and addressed.
Answered by Lord Prior of Brampton
CHART Online allows NHS England’s Sustainable Improvement Team to easily track the use of the Guidance on Risk Assessment and Stroke Prevention in Atrial Fibrillation (GRASP-AF) amongst general practitioner (GP) practices. However, there are a number of other tools in addition to GRASP-AF that are available to GPs to help audit management of atrial fibrillation (AF) patients. The Sustainable Improvement Team cannot easily track the use of these alternative tools, and many of the 58 clinical commissioning groups (CCGs) not using GRASP-AF, may be using one of these alternative tools. However, the Sustainable Improvement Team’s partnership with NHS RightCare will enable it to revisit practices in these CCGs to confirm the use of an alternative tool and to encourage the use of GRASP-AF in those practices that are not using, currently using it or an alternative.
The Sustainable Improvement Team uses aggregate data at CCG level or higher to help raise awareness of its work and to promote local improvement in the management of AF and has published a paper on the use of GRASP-AF and what it shows about the management of AF. A copy of the paper The use of anticoagulants in the management of atrial fibrillation among general practices in England is attached. The team also shares high level CHART Online data with organisations such as the Atrial Fibrillation Association and Public Health England.
The following table sets out information on variation in the prevalence and management of patients with AF.1
CCG level variation in the recorded prevalence and management of patients with AF
| Mean | Range |
AF Prevalence | 1.88% | 0.75-2.91% |
% of AF patients at high risk of stroke (CHADSVASc of 2 or more2 ): | 58.6% | 51.8-65.9% |
% of AF patients at high risk and on oral anticoagulant (as recommended by the National Institute for Health and Care Excellence [NICE]): | 63.5% | 48.3-80.8% |
% of AF patients at high risk and on aspirin alone (not recommended by NICE)3: | 27.9% | 11.3-42.5% |
Source: NHS England
1. These figures include only those CCGs which have at least 50% of their practices uploading to CHART Online, to avoid the data being skewed by individual practices.
2. CHADSVASc calculates stroke risk for patients with atrial fibrillation.
3. The removal of aspirin from the Quality Outcomes Framework some time ago may filter into the system as will continued adoption of the NICE guidance from 2015.
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 1 November (HL2501), within the CCGs which have uploaded data to CHART online, what variation exists regarding the management of patients with atrial fibrillation.
Answered by Lord Prior of Brampton
CHART Online allows NHS England’s Sustainable Improvement Team to easily track the use of the Guidance on Risk Assessment and Stroke Prevention in Atrial Fibrillation (GRASP-AF) amongst general practitioner (GP) practices. However, there are a number of other tools in addition to GRASP-AF that are available to GPs to help audit management of atrial fibrillation (AF) patients. The Sustainable Improvement Team cannot easily track the use of these alternative tools, and many of the 58 clinical commissioning groups (CCGs) not using GRASP-AF, may be using one of these alternative tools. However, the Sustainable Improvement Team’s partnership with NHS RightCare will enable it to revisit practices in these CCGs to confirm the use of an alternative tool and to encourage the use of GRASP-AF in those practices that are not using, currently using it or an alternative.
The Sustainable Improvement Team uses aggregate data at CCG level or higher to help raise awareness of its work and to promote local improvement in the management of AF and has published a paper on the use of GRASP-AF and what it shows about the management of AF. A copy of the paper The use of anticoagulants in the management of atrial fibrillation among general practices in England is attached. The team also shares high level CHART Online data with organisations such as the Atrial Fibrillation Association and Public Health England.
The following table sets out information on variation in the prevalence and management of patients with AF.1
CCG level variation in the recorded prevalence and management of patients with AF
| Mean | Range |
AF Prevalence | 1.88% | 0.75-2.91% |
% of AF patients at high risk of stroke (CHADSVASc of 2 or more2 ): | 58.6% | 51.8-65.9% |
% of AF patients at high risk and on oral anticoagulant (as recommended by the National Institute for Health and Care Excellence [NICE]): | 63.5% | 48.3-80.8% |
% of AF patients at high risk and on aspirin alone (not recommended by NICE)3: | 27.9% | 11.3-42.5% |
Source: NHS England
1. These figures include only those CCGs which have at least 50% of their practices uploading to CHART Online, to avoid the data being skewed by individual practices.
2. CHADSVASc calculates stroke risk for patients with atrial fibrillation.
3. The removal of aspirin from the Quality Outcomes Framework some time ago may filter into the system as will continued adoption of the NICE guidance from 2015.