Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the NHS Long Term Plan, what funding his Department plans to allocate to end of life care.
Answered by Caroline Dinenage
As with the vast majority of NHS services, the funding and commissioning of palliative and end of life care is a local matter, over which individual National Health Service commissioners have responsibility. Local commissioners are best placed to understand the needs of local populations and commission services to meet those needs accordingly.
The NHS Long Term Plan, sets out significant investment and activity to improve the quality of patient care and health outcomes, including for end of life care. This includes £4.5 billion of new investment to fund expanded community multidisciplinary teams aligned with new primary care networks. Based on individual needs and choices, people identified as having the greatest risks and needs will be offered targeted support for both their physical and mental health needs, helping them to maintain independence and avoid unnecessary hospital admissions. This includes patients approaching the end of life.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effectiveness of community pharmacies in keeping NHS patients out of hospital.
Answered by Steve Brine
The Government is encouraging a much greater use of community pharmacies as a first port of call by patients, thereby helping to relieve pressure on general practitioners and hospitals. Recent evaluations of two pilot schemes, which direct patients seeking urgent medicines supply and treatment for minor illnesses from NHS 111 to community pharmacy, have indicated the contribution community pharmacy can make in this respect. Of the patients using the urgent medicines supply scheme, 19.2% would have otherwise used an urgent care centre, such as accident and emergency, and 17.8% of patients using the minor illness referral scheme would have otherwise used an urgent care centre. Due to the success of these schemes so far, an extension to the urgent medicines supply service has been agreed until 31 March 2018, and three further pilots to the minor illness referral service are due to be launched in the autumn.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to provide funding for community pharmacies.
Answered by Steve Brine
We are continuing to invest in the development of community pharmacy through the Pharmacy Integration Fund (PhIF). This funding is being used to support the integration of pharmacy within the wider healthcare network and encourage a much greater use of community pharmacy as a first port of call for patients. The PhIF includes two pilot schemes, which direct patients seeking an urgent medicines supply or treatment for minor illnesses directly from NHS 111 to community pharmacy. Funding was also made available by NHS England and Public Health England for the Stay Well Pharmacy campaign, encouraging more frequent use of community pharmacies.
In addition to the PhIF, the Quality Payment Scheme, as part of the Community Pharmacy Contractual Framework, is incentivising secure digital connectivity to other parts of the health service and the accreditation of community pharmacies as Healthy Living Pharmacies, ensuring that they are well positioned both to respond to national and local developments in out of hospital care and prevention strategies. NHS England has also recently announced investment of £1 million, to pilot the development of local system leadership for pharmacy within Sustainability and Transformation Partnerships and Integrated Care Systems to support the delivery of high quality and sustainable medicines optimisation at scale and deliver best outcomes for patients.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of the (a) 2019 Loan Charge and (b) IR35 reforms on the NHS.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
No sector wide assessment has been made of the effects of the 2019 Loan Charge and IR35 reforms on the National Health Service. While there was some anecdotal evidence of locum staff shortages when the changes were first implemented, recent HM Revenue and Customs research has identified that 58% of central public bodies have not experienced problems with filling off-payroll worker vacancies and 63% have not experienced an increase in contractor rates payable as a result of the new legislation. There is no reason to suggest that these figures are significantly different for NHS bodies.
No estimate of the number of locum doctors affected by the 2019 Loan Charge has been made. It is the Department’s expectation however that locum doctors do not enter into tax avoidance arrangements and should comply with this new legislation from its introduction in April 2019.
No estimate of the number of NHS trusts that rely on blanket IR35 assessments of non-payroll NHS staff has been made. However, as per the changes to the Income Taxes (Earnings and Pensions Act) 2003 outlined in the 2017 Finance bill, decisions as to whether or not contractors fall inside or outside of the IR35 rules should be made on an individual basis. Recent HM Revenue and Customs research has indicated that 91% of public bodies are making these decisions on an individual basis and we would expect all NHS bodies to be compliant with this legislation and not applying a blanket decision on IR35 to all their contractors.
Trusts have been advised to take their own independent advice on how they should determine whether a role and/or worker falls inside or outside IR35. We do not recognise that trusts are operating blanket decisions. While advice supplied by HM Revenue and Customs indicates that a role can be assessed as long as the contractual terms remain the same without the need for assessment on each occasion a worker changes this is not to be confused with a blanker decision - it is a balanced and reviewed decision on the role.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of locum doctors who are affected by the 2019 Loan Charge.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
No sector wide assessment has been made of the effects of the 2019 Loan Charge and IR35 reforms on the National Health Service. While there was some anecdotal evidence of locum staff shortages when the changes were first implemented, recent HM Revenue and Customs research has identified that 58% of central public bodies have not experienced problems with filling off-payroll worker vacancies and 63% have not experienced an increase in contractor rates payable as a result of the new legislation. There is no reason to suggest that these figures are significantly different for NHS bodies.
No estimate of the number of locum doctors affected by the 2019 Loan Charge has been made. It is the Department’s expectation however that locum doctors do not enter into tax avoidance arrangements and should comply with this new legislation from its introduction in April 2019.
No estimate of the number of NHS trusts that rely on blanket IR35 assessments of non-payroll NHS staff has been made. However, as per the changes to the Income Taxes (Earnings and Pensions Act) 2003 outlined in the 2017 Finance bill, decisions as to whether or not contractors fall inside or outside of the IR35 rules should be made on an individual basis. Recent HM Revenue and Customs research has indicated that 91% of public bodies are making these decisions on an individual basis and we would expect all NHS bodies to be compliant with this legislation and not applying a blanket decision on IR35 to all their contractors.
Trusts have been advised to take their own independent advice on how they should determine whether a role and/or worker falls inside or outside IR35. We do not recognise that trusts are operating blanket decisions. While advice supplied by HM Revenue and Customs indicates that a role can be assessed as long as the contractual terms remain the same without the need for assessment on each occasion a worker changes this is not to be confused with a blanker decision - it is a balanced and reviewed decision on the role.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, hat estimate he has made of the number of NHS Trusts that rely on blanket IR35 assessments of non-payroll NHS staff.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
No sector wide assessment has been made of the effects of the 2019 Loan Charge and IR35 reforms on the National Health Service. While there was some anecdotal evidence of locum staff shortages when the changes were first implemented, recent HM Revenue and Customs research has identified that 58% of central public bodies have not experienced problems with filling off-payroll worker vacancies and 63% have not experienced an increase in contractor rates payable as a result of the new legislation. There is no reason to suggest that these figures are significantly different for NHS bodies.
No estimate of the number of locum doctors affected by the 2019 Loan Charge has been made. It is the Department’s expectation however that locum doctors do not enter into tax avoidance arrangements and should comply with this new legislation from its introduction in April 2019.
No estimate of the number of NHS trusts that rely on blanket IR35 assessments of non-payroll NHS staff has been made. However, as per the changes to the Income Taxes (Earnings and Pensions Act) 2003 outlined in the 2017 Finance bill, decisions as to whether or not contractors fall inside or outside of the IR35 rules should be made on an individual basis. Recent HM Revenue and Customs research has indicated that 91% of public bodies are making these decisions on an individual basis and we would expect all NHS bodies to be compliant with this legislation and not applying a blanket decision on IR35 to all their contractors.
Trusts have been advised to take their own independent advice on how they should determine whether a role and/or worker falls inside or outside IR35. We do not recognise that trusts are operating blanket decisions. While advice supplied by HM Revenue and Customs indicates that a role can be assessed as long as the contractual terms remain the same without the need for assessment on each occasion a worker changes this is not to be confused with a blanker decision - it is a balanced and reviewed decision on the role.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will introduce itemised bills for overseas visitors using NHS services; and if he will make a statement.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
The Department has no current plans to introduce itemised bills for overseas visitors using NHS services.
The national guidance sets out that those patients who are identified as chargeable must be charged using either the national tariff or a locally agreed tariff if there is no national tariff for the treatment or service provided.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will introduce itemised bills for overseas visitors using NHS services; and if he will make a statement.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
The Department has no current plans to introduce itemised bills for overseas visitors using NHS services.
The national guidance sets out that those patients who are identified as chargeable must be charged using either the national tariff or a locally agreed tariff if there is no national tariff for the treatment or service provided.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, for what reason the bill given to foreign patients using NHS services is not itemised; and whether his Department has any plans to introduced itemised bills for such patients.
Answered by Steve Barclay - Secretary of State for Environment, Food and Rural Affairs
Entitlement to free National Health Service care is principally based on being ‘ordinarily resident’ in the United Kingdom. Broadly, this means living here on a lawful and properly settled basis for the time being, with non-European Economic Area nationals subject to immigration control also being required to have an immigration status of ‘indefinite leave to remain’. It is not based on nationality.
A person not ordinarily resident in the UK is an ‘overseas visitor’ for the purposes of the National Health Service (Charges to Overseas Visitors) Regulations (the ‘Charging Regulations’).
The national guidance sets out that those patients who are identified as chargeable must be charged using either the national tariff or a locally agreed tariff if there is no national tariff for the treatment or service provided.
If and when it is established that charges apply, the NHS body must inform the patient and present them with an invoice for the treatment they have received or an estimation of the charges they are liable for in respect of any future treatment.
Asked by: Grant Shapps (Conservative - Welwyn Hatfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the Government plans to reintroduce prescriptions for gluten-free products for children who have coeliac disease.
Answered by Steve Brine
A range of staple gluten free foods continue to be available on prescription for all patients with established gluten sensitivity enteropathies, including coeliac disease.