Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people at NHS England are working on the development of NHS England's updated regime for the second phase of device procurement.
Answered by Philip Dunne
There are currently two NHS England clinicians (who have other roles) working on the development of NHS England's updated regime for the second phase of device procurement, plus 0.2 staff (whole time equivalent) of clinical support. They will be joined by clinicians from the Clinical Reference Group and provider organisations once the evaluation process has started.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to page 122 of the NHS Atlas of Variation in Healthcare, published by Public Heath England in September 2016, what steps he is taking to encourage (a) clinical commissioning groups and (b) primary care clinicians to tackle variations in the provision of transcatheter aortic valve implantation procedures in (i) Rother Valley constituency and (ii) England.
Answered by David Mowat
The initial diagnosis and follow-up of those with heart valve disease across England is commissioned by clinical commissioning groups. NHS England is the commissioner of cardiac valve surgery and Transcatheter Aortic Valve Implantation (TAVI).
Service specifications and policy for the surgical and interventional treatment of heart valve disease are published by the NHS England Cardiac Clinical Reference Group (CRG), which is chaired by the National Clinical Director for Heart Disease, Professor Huon Gray. These are important in clearly defining what NHS England expects to be in place for providers to offer evidence-based, safe and effective services.
NHS England hosted a Clinical Summit in June 2016, bringing together cardiologists and cardiac surgeons and commissioners to examine the issues relating to aortic valve disease, including variations in provision. The outputs from this meeting are now part of the CRG work plan and will be likely be part of a national cardiac review in 2017/18. This will support the review of current clinical commissioning policy, will seek to address variation, clinical and cost-effectiveness and inform the future commissioning position.
TAVI has been demonstrated to be an effective intervention and the reasons for increase in demand and variation are multifactorial. The CRG have agreed that a review of the wider aortic stenosis pathway will be an appropriate way to address the issues. This will include the medical therapy and traditional surgical pathway and will include specialist centres, secondary care and primary care clinicians.
In relation to the Rother Valley, a review of variation in implant rates for TAVI was undertaken by the Yorkshire and Humber specialised commissioning hub. This has resulted in the commissioning of an additional centre to extend access.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will ask NHS England to publish the sources of data used by clinical reference groups when drawing up their recommendations.
Answered by David Mowat
The data used by the clinical reference groups in developing their recommendations on clinical commissioning policies includes clinical evidence reviews, stakeholder views which are gathered through initial stakeholder testing, and responses to the public consultation. The evidence reviews are published as part of the stakeholder and consultation testing.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to the oral contribution of Lord Prior of Brampton of 4 July 2016, House of Lords, Official Report, column 1828, on Public Health England being commissioned to update its evidence report on e-cigarettes annually until the end of the current Parliament, when Public Health England plans to publish its next evidence report.
Answered by Baroness Blackwood of North Oxford
The Department is working closely with Public Health England (PHE) and the Medicines and Healthcare products Regulatory Agency (MHRA) to encourage research into the use of electronic cigarettes (e-cigarettes) and monitor the emerging evidence.
PHE’s next updated evidence report on e-cigarettes is expected to be published before the end of the 2017. In addition to the publication of an evidence review, PHE have partnered with Cancer Research UK and the UK Centre for Tobacco and Alcohol Studies to develop a forum that brings together policy makers, researchers, practitioners and the non-governmental organisation representatives to discuss the emerging evidence, identify research priorities and generate ideas for new research projects, thereby enhancing collaboration between forum participants.
The MHRA will continue to undertake market surveillance of e-cigarettes as part of their role as the Competent Authority, feeding back any intelligence to the Department and PHE.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps are being taken by (a) his Department, (b) the Medical and Healthcare Products Regulatory Agency and (c) Public Health England to encourage research into the use of e-cigarettes.
Answered by Baroness Blackwood of North Oxford
The Department is working closely with Public Health England (PHE) and the Medicines and Healthcare products Regulatory Agency (MHRA) to encourage research into the use of electronic cigarettes (e-cigarettes) and monitor the emerging evidence.
PHE’s next updated evidence report on e-cigarettes is expected to be published before the end of the 2017. In addition to the publication of an evidence review, PHE have partnered with Cancer Research UK and the UK Centre for Tobacco and Alcohol Studies to develop a forum that brings together policy makers, researchers, practitioners and the non-governmental organisation representatives to discuss the emerging evidence, identify research priorities and generate ideas for new research projects, thereby enhancing collaboration between forum participants.
The MHRA will continue to undertake market surveillance of e-cigarettes as part of their role as the Competent Authority, feeding back any intelligence to the Department and PHE.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what data (a) Clinical Reference Groups and (b) the Prescribed Specialised Services Advisory Group are required to collect and consider in the course of making their decisions.
Answered by David Mowat
When making decisions the Prescribed Specialised Services Advisory Group (PSSAG) must consider four factors:
- the number of individuals who require the provision of the service or facility;
- the cost of providing the service or facility;
- the number of persons able to provide the service or facility; and
- the financial implications for clinical commissioning groups if they were required to arrange for the provision of the service or facility.
PSSAG therefore requests that any proposals put forward for its consideration include data which supports informed decision making in these areas. If the group does not feel that there is sufficient data to reach a decision, it may request further information to enable it to do so at a later date. More information can be found at the following address:
https://www.gov.uk/government/groups/prescribed-specialised-services-advisory-group-pssag
Clinical Reference Groups (CRGs) are not decision making groups.
However CRGs collate a large amount of data to consider when providing their clinical advice and utilise when making recommendations relating to commissioning.
From a clinical commissioning policy perspective, CRGs gather and analyse data and intelligence that is relevant to the treatment proposal they are considering, such as Individual Funding Request activity, a summary of clinical evidence and related trial statistics. They would consider prevalence and incidence data sources, search clinical databases and registries for relevant data and collect data on clinical outcomes and clinical quality aspects. The CRG would also take account of patient experience information and relevant financial information.
Similar data sources would also be used to support the development of service specifications and to inform the work on service reviews.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment his Department has made of the potential effect of proposed reductions in the level of community pharmacy funding on the adequacy of provision of pharmaceutical advice and reassurance to members of the public.
Answered by David Mowat
The Government’s proposals for community pharmacy in 2016/17 and beyond, on which we have consulted, are being considered against the public sector equality duty, the family test and the relevant duties of my Rt. hon. Friend, the Secretary of State for Health, under the National Health Service Act 2006.
Our assessments include consideration of the potential impacts on the adequate provision of NHS pharmaceutical services, including the supply of medicines, access to NHS pharmaceutical services, supplementary hours, non-commissioned services, individuals with protected characteristics, impacts on other NHS services, health inequalities, individuals with restricted mobility and access to healthcare for deprived communities.
An impact assessment will be completed to inform final decisions and published in due course.
Our proposals are about improving services for patients and the public and securing efficiencies and savings. We believe these efficiencies can be made within community pharmacy without compromising the quality of services or public access to them.
Our aim is to ensure that those community pharmacies upon which people depend continue to thrive. We are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population.
We want a clinically focussed community pharmacy service that is better integrated with primary care and public health in line with the Five Year Forward View. This will help relieve the pressure on general practitioners and accident and emergency departments, ensure better use of medicines and better patient outcomes, and contribute to delivering seven day health and care services.
The Chief Pharmaceutical Officer for England, Dr Keith Ridge has commissioned an independent review of community pharmacy clinical services. The review is being led by Richard Murray, Director of Policy at The King’s Fund. The final recommendations will be considered as part of the development of clinical and cost effective patient care by pharmacists and their teams.
NHS England is also setting up a Pharmacy Integration Fund to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in a more integrated and effective NHS primary care patient pathway.
The rollout of the additional 1,500 clinical pharmacists announced by NHS England will help to ease current pressures in general practice by working with patients who have long term conditions and others with multiple medications. Having a pharmacist on site will mean that patients who receive care from their general practice will be able to benefit from the expertise in medicines that these pharmacists provide.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment his Department has made of the potential effect of proposed reductions in the level of community pharmacy funding on the support available for frail and elderly people to live independently in their own homes.
Answered by David Mowat
The Government’s proposals for community pharmacy in 2016/17 and beyond, on which we have consulted, are being considered against the public sector equality duty, the family test and the relevant duties of my Rt. hon. Friend, the Secretary of State for Health, under the National Health Service Act 2006.
Our assessments include consideration of the potential impacts on the adequate provision of NHS pharmaceutical services, including the supply of medicines, access to NHS pharmaceutical services, supplementary hours, non-commissioned services, individuals with protected characteristics, impacts on other NHS services, health inequalities, individuals with restricted mobility and access to healthcare for deprived communities.
An impact assessment will be completed to inform final decisions and published in due course.
Our proposals are about improving services for patients and the public and securing efficiencies and savings. We believe these efficiencies can be made within community pharmacy without compromising the quality of services or public access to them.
Our aim is to ensure that those community pharmacies upon which people depend continue to thrive. We are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population.
We want a clinically focussed community pharmacy service that is better integrated with primary care and public health in line with the Five Year Forward View. This will help relieve the pressure on general practitioners and accident and emergency departments, ensure better use of medicines and better patient outcomes, and contribute to delivering seven day health and care services.
The Chief Pharmaceutical Officer for England, Dr Keith Ridge has commissioned an independent review of community pharmacy clinical services. The review is being led by Richard Murray, Director of Policy at The King’s Fund. The final recommendations will be considered as part of the development of clinical and cost effective patient care by pharmacists and their teams.
NHS England is also setting up a Pharmacy Integration Fund to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in a more integrated and effective NHS primary care patient pathway.
The rollout of the additional 1,500 clinical pharmacists announced by NHS England will help to ease current pressures in general practice by working with patients who have long term conditions and others with multiple medications. Having a pharmacist on site will mean that patients who receive care from their general practice will be able to benefit from the expertise in medicines that these pharmacists provide.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the (a) extent of the implementation of the Making Every Contact Count initiative by clinical commissioning groups and local authorities and (b) adequacy of training provided to staff to equip them to provide consistent self-care messages during consultations; and if he will make a statement.
Answered by Alistair Burt
Public Health England, Health Education England (HEE) and NHS England are collaborating with local authorities and National Health Service partners to support local uptake of the Making Every Contact Count (MECC) approach building on the many examples of implementation such as from Warwickshire, Medway and Wigan. Activities to support the commissioning, development and delivery of effective local training have been undertaken.
To support MECC uptake by clinical commissioning groups (CCGs) and local authorities a provider requirement now exists within the NHS Standard Contract; and NHS England’s person-centred care Commissioning for Quality and Innovation for CCGs includes workforce skills that support the local MECC offer. The national MECC advisory group is linking with HEE’s national workforce programme and NHS England’s New Models of Care and Self-Care teams to support and equip the workforce with person centred skills to support and enable self-care and behaviour change. HEE has regional events to support MECC implementation activity across the Sustainable Transformation Plan footprints.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will adopt the recommendations of the All Party Parliamentary Group on Primary Care and Public Health in its Inquiry Report into NHS England's Five Year Forward View: behaviour change, information and signposting, published in March 2016, that reports of self-care pilots and evidence-based initiatives in the NHS should be sent to the Self Care Forum for upload to its best practice portal.
Answered by Alistair Burt
The Self Care Forum was established in 2011 to further the reach of self-care and embed it into everyday life. Local organisations involved in self care pilots and evidence based initiatives are free to send their findings to the Self Care Forum as recommended in the All Party Parliamentary Group’s Report, should they wish to do so.
The Five Year Forward View set out how the health service needs to change, with an improved relationship between patients and communities. It made a specific commitment to do more to support people with long-term conditions to help them manage their own health.
To support this commitment, NHS England established the Realising the Value Programme to help to build an evidence base about what works best for different patients, how much extra resource may be needed to support the growth of services locally and which approaches, if any, are demonstrably cost effective. Additionally, NHS England announced that a consortium led by Nesta and the Health Foundation in partnership with Voluntary Voices (National Voices, Regional Voices, National Association for Voluntary and Community Action and Community Service Volunteers), the Behavioural Insights Team and Newcastle University, had been selected to take forward this work.
Nesta is also seeking to learn from and build on existing toolkits and learning resources and has worked to collate examples. These are hosted on the Nesta website at the following link:
www.nesta.org.uk/realising-value-resource-centre