Health: Atrial Fibrillation and Stroke

Lord Patel Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O’Shaughnessy]

On the stroke strategy, a follow-on plan is being developed by NHS England and its partners, including the Stroke Association, which will take forward that approach. The noble Lord will also be pleased to know that it is an integrated-service approach including ambulances, community care and secondary care. On the point about reorganisation, he is quite right that London has seen excellent success through the specialisation and concentration of services, and we certainly encourage the rest of the country to do that too.

[Lord Patel (CB)]

My Lords, during the House of Lords Select Committee inquiry on the long-term sustainability of the NHS we heard a great deal of evidence demonstrating the great variations in care, in the treatment not only of atrial fibrillation but of other conditions. Is it not time that we made the NICE guidelines, which are very clear about the management of patients with atrial fibrillation, mandatory to reduce the variation in care and improve outcomes?

[Lord O’Shaughnessy]

As the noble Lord will know better than anyone, making them mandatory is a challenge because of the importance of clinical autonomy. What we can make mandatory is an understanding of those guidelines and that they inform every treatment pathway. That is part of what the NHS RightCare programme, which is now rolled out across the country, is doing. It is introducing new things such as stroke pathways so that there is clarity about the options available. Patient choice is at the centre of that decision.

HIV Prevention Services: Public Health Funding

Lord Patel Excerpts

Thursday 30th November 2017 Lords Chamber

[Lord O'Shaughnessy]

I quite agree with the noble Baroness. As I said, across England about 12% or 13% of gay and bisexual men and other men who have sex with men are undiagnosed. That is clearly unacceptable and means we are still not yet meeting the UNAIDS target. I will point out a couple of the interventions happening to try to address that in addition to the ones that I have already mentioned. A new contract has been awarded by Public Health England to the national HIV prevention programme for the most at-risk populations precisely to try to reach them. Another £600,000 is being given to 12 schemes under the HIV innovation fund. By definition, the people we need to reach next are the most difficult to reach because they have not come into the system.

[Lord Patel (CB)]

My Lords, as PrEP is clearly scientifically assessed through meta-analysis to be the most effective treatment for reducing incidence of HIV for the at-risk population, will the Minister say how widely this treatment is available for the at-risk population through the NHS?

Maternal Safety Strategy

Lord Patel Excerpts

Tuesday 28th November 2017 Lords Chamber

[Lord Patel (CB)]

My Lords, credit where credit is due: I commend the Government for this initiative. It was first suggested some years ago but that does not matter; it is here now. My question relates to the root cause analysis, which is rightly the way to analyse stillbirths that occur. It should take account of all the circumstances, including staffing levels, as mentioned. It is not just about the care itself. Can the Minister clarify how the system of doing root cause analysis of every stillbirth will work if, at the same time, a coroner is doing an investigation?

[Lord O’Shaughnessy]

I thank the noble Lord for his support for today’s announcements. Obviously, independent investigations are just that. They will be operated by HSIB, which will be able to delve into the causes of the tragedy, however it might have happened, and provide an opinion on that. On the interaction with the coroner’s report, obviously we have focused mainly today on these new independent investigations and we are looking at extending coronial law to take in stillbirths that were previously not included. That is one of the issues that needs to be worked out in the coming months through interaction with the Ministry of Justice.

NHS: Deficit

Lord Patel Excerpts

Wednesday 22nd November 2017 Lords Chamber

[Lord O’Shaughnessy]

My noble friend is absolutely right: there are no barriers. Indeed, the five-year forward view, in which the NHS sets out its own future, talks about integration and moving towards accountable care systems. Some capital programmes have been announced today under what will amount to a £10 billion capital programme over five years. These are precisely to deliver the transformation which is needed by making the kind of investment to provide that level of integration.

[Lord Patel (CB)]

My Lords, the Minister has said previously that he read the cross-party House of Lords report on the long-term sustainability of the NHS and adult social care with enthusiasm. No doubt he will have noticed several recommendations in it that would go a long way towards making the NHS financially stable and sustainable over the long term. Does he agree that what is now enthusiastically required from him and from the Government is to accept those recommendations? A short answer made up of a three-letter word will suffice.

[Lord O’Shaughnessy]

The noble Lord waits patiently. I pay tribute to the quality of the report and we have already accepted some of the ideas set out in it. Now that the Budget is over and the Treasury can turn its mind to additional things, we will be responding to the report very soon.

National Health Service

Lord Patel Excerpts

Tuesday 10th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I know that the noble Lord has been concerned about this issue. I hope that he heard my right honourable friend the Secretary of State announce last week not only an increase in the number of nursing associate places, where qualification is through an apprenticeship route, but a 25% increase in the number of degree training places and funding for the clinical placements that they involve.

[Lord Patel (CB)]

Can the Minister say whether he found helpful the House of Lords Select Committee report on the long-term sustainability of the NHS and social care?

[Lord O'Shaughnessy]

The noble Lord knows that I found it extremely helpful. It has pride of place on the coffee table in my office, and we will of course respond to it in due course.

NHS: Shared Business Services

Lord Patel Excerpts

Tuesday 27th June 2017 Lords Chamber

[Lord O'Shaughnessy]

Clearly, if there were such an incidence, the noble Lord is quite right that it would be dealt with very strongly—but it is important to point out that there has not been evidence that that has happened. Documents were destroyed that sat within SBS, but they were not part of the backlog and they conformed, as we understand it, to the protocols around destroying old papers when they have gone past a certain time limit. So there is no evidence that what the noble Lord described has happened in this instance—but, as he points out, if it had happened it would be of the utmost seriousness.

[Lord Patel (CB)]

My Lords, what is the governance mechanism of this joint private venture? Considering that one of the key tasks is to deliver letters and patient reports in a timely manner to GPs’ surgeries, what risk assessment was made during the process of the work?

[Lord O'Shaughnessy]

Yes, this specific case was a joint venture between a private company and the Department of Health, which has a share and director places on the board. The department had a director on the board of this joint venture throughout. Part of the problem was that the issue of this unacceptable practice was not brought to the attention of the board until far too late in the process. That is obvious from the timeline that has been set out. The particular issue about redirection is no longer the case. Mail is now returned to sender if it is not delivered, rather than creating opportunities for the things going wrong that happened through this redirection service.