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Written Question
Patients: Safety
Tuesday 2nd December 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how the findings of the friends and family test are being used to improve patient safety in the NHS.

Answered by Dan Poulter

The Friends and Family Test (FFT) was implemented as a mechanism to provide near real-time feedback to identify both good and poor quality patient experience. Whilst the FFT aims to capture overall patient experience, part of the experience that patients may choose to comment on is whether they felt their care was safe. This information can then be used by providers to consider what they do well and make improvements where feedback is less positive. Commissioners and regulators monitor the results of the FFT and the Care Quality Commission (CQC) uses the data - together with other data such as mortality rates and ‘never events’ - as part of its new ‘Hospital Intelligence Monitoring’. The monitoring service gives the CQC an understanding of areas of care that need to be further investigated by inspectors:

http://www.cqc.org.uk/public/hospital-intelligent-monitoring

In April 2014, the Staff FFT was introduced to allow staff feedback on NHS Services based on recent experience. The Staff FFT asks staff to rate and comment on where they work as a place to work and as a place of care. This information can then be used by employers to consider what they do well and make improvements where feedback is less positive.

Commissioners and regulators also monitor the results of the Staff FFT, and the CQC uses this data as part of their Intelligent Monitoring system. The response to this question is also displayed as a key patient safety indicator on NHS Choices:

http://www.nhs.uk/NHSEngland/thenhs/patient-safety/Pages/patient-safety-indicators.aspx

In addition, hospital boards and other providers and commissioners of services can consider the results of the FFT to consider the implications for quality and safety. A NHS England review of the FFT found that it is performing well as a service improvement tool, with 85% of trusts reporting that it is being used to improve patient experience, and 78% saying that FFT has increased the emphasis placed on patient experience in their trusts.


Written Question
Patients: Safety
Monday 1st December 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what progress he has made on implementing the recommendations of the Berwick report into Improving the Safety of Patients in England, published in August 2013.

Answered by Dan Poulter

The Government has put in place a number of measures to support National Health Service orgnisations to respond positively to the Berwick Report ‘Improving the Safety of Patients in England’’ including greater transparency, openness and candour; ensuring safe staffing levels; creating a culture of learning and development with the establishment of 15 Patient Safety Collaboratives; and making patient safety a primary goal with a new ambition to halve avoidable harm and save 6,000 lives over the next three years, underpinned by the Sign up to Safety campaign.


Written Question
Patients: Safety
Monday 1st December 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the rates of (a) pulmonary embolism, (b) blood-stream infection and (c) foreign body left in after procedure has been in England in each year since 2000.

Answered by Dan Poulter

The Health and Social Care Information Centre (HSCIC) has provided data on (a) a count of finished admission episodes (FAEs) where there was a primary diagnosis of pulmonary embolism and the number of FAEs as a rate per 100,000 of the total number of FAEs and (b) a count of finished consultant episodes (FCEs) with a primary or secondary diagnosis of pulmonary embolism and the number of FCEs as a rate per 100,000 of the total number FCEs, for the years 2000-01 to 2012-13.

This is summarised in the following table:

Year

FAEs with primary diagnosis of "pulmonary embolism"

Rate per 100,000 of total FAEs

FCEs with primary or secondary diagnosis of "pulmonary embolism"

Rate per 100,000 of total FCEs

2000-01

15,179

136.5

32,937

268.6

2001-02

14,735

133.0

33,537

271.8

2002-03

15,536

136.6

37,093

291.8

2003-04

16,095

136.3

39,196

294.8

2004-05

15,621

129.1

40,059

292.3

2005-06

16,347

128.9

43,360

300.6

2006-07

16,629

128.1

46,685

315.8

2007-08

16,948

125.7

49,114

319.8

2008-09

18,214

128.7

56,029

345.2

2009-10

19,763

135.9

62,367

371.1

2010-11

20,908

140.4

67,477

390.7

2011-12

21,525

143.3

70,466

403.5

2012-13

23,578

155.7

79,058

446.3

Public Health England (PHE) collects data on blood stream infections caused by bacteria (bacteraemia) relating to specific organisms as part of its mandatory Healthcare Associated Infection surveillance programmes.

Microbiology laboratories in England, Wales and Northern Ireland also voluntarily submit data to PHE relating to episodes of bacteraemia and blood stream infections caused by fungi (fungaemia).

The data summarised in Tables 1-3, taken from PHE’s mandatory surveillance programmes, represent bacteraemia cases reported in England resulting from: Methicillin-resistant Staphylococcus aureus (MRSA); Methicillin-susceptible Staphylococcus aureus (MSSA) and E.coli where comparable data is available. Rates of all reported cases per 100,000 population are included, where available.

Table 1a: All reported cases of MRSA bacteraemia (April 2007-March 2014)

Financial year

April 2007 to March 2008

April 2008 to March 2009

April 2009 to March 2010

April 2010 to March 2011

April 2011 to March 2012

April 2012 to March 2013

April 2013 to March 2014

Count

4,451

2,935

1,898

1,481

1,116

924

862

Rate per 100,000 population

3.6

2.8

2.1

1.7

1.6

Note: Data is available at: https://www.gov.uk/government/statistics/mrsa-bacteraemia-annual-data

Table 2: All reported cases of MSSA bacteraemia (April 2011 - March 2014)

Financial year

April 2011 to March 2012

April 2012 to March 2013

April 2013 to March 2014

Count

8,767

8,812

9,290

Rate per 100,000 population

16.5

16.5

17.4

Note: Data is available at: https://www.gov.uk/government/statistics/mssa-bacteraemia-annual-data

Table 3: All reported cases of E. coli bacteraemia (April 2012-March 2014)

Financial year

April 2012 to March 2013

April 2013 to March 2014

Count

32,309

34,275

Rate per 100,000 population

60.4

64.1

Note: Data is available at: https://www.gov.uk/government/statistics/escherichia-coli-e-coli-bacteraemia-annual-data

The data summarised in Table 4, taken from PHE’s voluntary surveillance database, represents all voluntarily reported patient episodes involving either bacteraemia and/or fungaemia for the period of January 2008 to December 2012 in England, Wales and Northern Ireland.

Table 4: Patient episodes involving either bacteraemia and/or fungaemia 2008-2012, England, Wales and Northern Ireland

Calendar Year

2008

2009

2010

2011

2012

Count

95,931

94,190

92,867

94,166

95,647

Note: Data extracted from the Public Health England (PHE) voluntary surveillance database, LabBase2, on 3 December 2013.

Before 2009, information was not collated on foreign bodies retained after procedures (which is classed as a ‘never event’) and so we are unable to provide data for the period prior to 2009.

In 2009-10, there were nine retained foreign objects post procedure reported during this period.

In 2010-11, there were 67 retained foreign object never events reported to Strategic Executive Information System (STEIS) and 22 reported to the National Reporting and Learning Service (NRLS).

In 2011-12, there were 161 retained foreign object never events reported to STEIS and 86 reported to the NRLS in 2011-12.

In 2012-13, there were 130 retained foreign object never events reported to STEIS and 124 reported to the NRLS in 2012-13 (please note incidents are potentially reported to both systems but the exact degree of overlap of reported incidents during the period 2010-11 and 2011-12 is unclear).

Since April 2013 reports made to the NRLS and STEIS have been directly reconciled to provide a single total and provisional data published by NHS England shows 123 retained object never events were reported in 2013-14 and 44 in the six months to September 2014:

http://www.england.nhs.uk/ourwork/patientsafety/never-events/ne-data/

Methods for identifying and collating the data from two systems (NRLS and STEIS) have changed over the years, with specific reporting fields for Never events replacing keyword searches, and year-end attempts to reconcile events reported in both systems replaced with direct communication as and when incidents were reported. This is a further reason why events from the earlier years are not directly comparable. The numbers of Never Events reported for 2010-11 and 2011-12 were reported in Annex A of the ‘The never events policy framework: An update to the never events policy

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213046/never-events-policy-framework-update-to-policy.pdf

It should be noted that the updated policy expanded the list of never events from 8 to 25 in 2012 and the detail of definitions of retained foreign objects was also clarified in The never events list; 2013/14 update:

http://www.england.nhs.uk/wp-content/uploads/2013/12/nev-ev-list-1314-clar.pdf.

Note numbers in different years are not directly comparable due to these definitional changes.


Written Question
Patients: Safety
Monday 1st December 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many hospitals have been rated poor with regards to open and honest reporting of patient safety incidents in each month since May 2010.

Answered by Dan Poulter

As at 28 November 2014, 91 trusts were recorded as poor (red) against the open and honest reporting indicator. Data prior to June 2014 is not available in this form.


Written Question
Patients: Safety
Tuesday 18th November 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many patient safety incidents have been reported to the National Reporting and Learning System in each month since May 2010.

Answered by Dan Poulter

We do not hold information on the number of patient safety incidents that have occurred in England in each year since 2000. Patient Safety Incidents occurring in the National Health Service are reported to the National Reporting and Learning System (NRLS) whose primary purpose is to enable learning from patient safety incidents. The NRLS was established in late 2003 as a largely voluntary scheme for reporting patient safety incidents, and therefore it does not provide the definitive number of patient safety incidents occurring in the NHS. However, from 1 April 2010 it became mandatory for all providers registered with the Care Quality Commission (including all NHS trusts and foundation trusts) in England to report all serious patient safety incidents to the Care Quality Commission. To avoid duplication of reporting, providers of NHS services are encouraged to report all incidents resulting in death or severe harm to the NRLS which then reports them to the Care Quality Commission.

At present, more than 100,000 patient safety incidents (including those resulting in no harm) are reported to the NRLS each month. However, these data are collated on a quarterly, rather than monthly basis. Detailed breakdowns on incidents reported are published twice-yearly and can be accessed via the following link:

http://www.nrls.npsa.nhs.uk/resources/collections/quarterly-data-summaries/

The most recent spreadsheet providing quarterly data for the number of patient safety incidents reported to the NRLS from October 2003 to June 2014 is attached.

The NRLS is a dynamic reporting system, and the number of incidents recorded as occurring at any point in time may increase as a greater proportion of incidents are reported. Experience in other industries has shown that as an organisation’s reporting culture matures, staff become more likely to report incidents.


Written Question
Patients: Safety
Tuesday 18th November 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many patient safety alerts have occurred in each month since May 2010.

Answered by Dan Poulter

Patient safety alerts are a crucial part of NHS England’s work to alert the healthcare system rapidly to risks and provide guidance on preventing potential incidents that may lead to harm or death. They are publications providing urgent information to healthcare providers via the Central Alerting System. Prior to the establishment of NHS England, patient safety alerts were issued by the National Patient Safety Agency (NPSA).

We do not record the number of patient safety alerts issued by month; however, a list of alerts with their issue dates for the period 2013-2014 is attached.

A full list of alerts issued by NPSA from 2002-2012 can be viewed at:

http://www.nrls.npsa.nhs.uk/alerts/


Written Question
Patients: Safety
Tuesday 18th November 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what recent assessment he has made of the uptake of the Sign up to Safety campaign in each (a) region and (b) clinical commissioning group area.

Answered by Dan Poulter

As at the end of October 2014, a total number of 136 organisations have agreed to participate in the Sign up to Safety campaign. A breakdown by Academic Health Science Network (AHSN) is as follows:

By AHSN region

Yorkshire and Humber

9

West of England

7

West Midlands

8

Wessex

4

London

24

South West Peninsula

5

Oxford

4

North West Coast

15

North East and North Cumbria

8

Kent, Surrey and Sussex

13

Greater Manchester

9

Eastern

11

East Midlands

16

Other

3

136

The information has not been split by clinical commissioning group. However 16 clinical commissioning groups have signed up to the campaign to date.


Written Question
Patients: Safety
Tuesday 18th November 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many patient safety incidents have occurred in England in each year since 2000.

Answered by Dan Poulter

We do not hold information on the number of patient safety incidents that have occurred in England in each year since 2000. Patient Safety Incidents occurring in the National Health Service are reported to the National Reporting and Learning System (NRLS) whose primary purpose is to enable learning from patient safety incidents. The NRLS was established in late 2003 as a largely voluntary scheme for reporting patient safety incidents, and therefore it does not provide the definitive number of patient safety incidents occurring in the NHS. However, from 1 April 2010 it became mandatory for all providers registered with the Care Quality Commission (including all NHS trusts and foundation trusts) in England to report all serious patient safety incidents to the Care Quality Commission. To avoid duplication of reporting, providers of NHS services are encouraged to report all incidents resulting in death or severe harm to the NRLS which then reports them to the Care Quality Commission.

At present, more than 100,000 patient safety incidents (including those resulting in no harm) are reported to the NRLS each month. However, these data are collated on a quarterly, rather than monthly basis. Detailed breakdowns on incidents reported are published twice-yearly and can be accessed via the following link:

http://www.nrls.npsa.nhs.uk/resources/collections/quarterly-data-summaries/

The most recent spreadsheet providing quarterly data for the number of patient safety incidents reported to the NRLS from October 2003 to June 2014 is attached.

The NRLS is a dynamic reporting system, and the number of incidents recorded as occurring at any point in time may increase as a greater proportion of incidents are reported. Experience in other industries has shown that as an organisation’s reporting culture matures, staff become more likely to report incidents.


Written Question
Cord Blood
Wednesday 29th October 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what recent discussions his Department has had with NHS Trusts on (a) increasing the number of hospitals that are able to collect umbilical cord blood for transport and (b) promoting the donation of umbilical cord blood for transplant.

Answered by Jane Ellison

NHS Blood and Transport (NHSBT) manages the NHS Cord Blood Bank and provides specialist services related to the provision of stem cells which can turn into blood cells for the treatment of blood cancers. This service is an integral part of the Anthony Nolan and NHS Stem Cell Registry. NHSBT is also responsible for raising awareness of these issues, in collaboration with its delivery partners. NHSBT has informed the Department that it has no plans to open new collection centres at present.


Written Question
Endometriosis
Monday 9th June 2014

Asked by: Paul Uppal (Conservative - Wolverhampton South West)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps he is taking to raise awareness of endometriosis.

Answered by Dan Poulter

Information on endometriosis is readily available to healthcare professionals and the public. Both the Royal College of Obstetricians and Gynaecologists (RCOG) and NHS Choices have published information for the public on the symptoms, diagnosis and treatment of endometriosis. Further information can be found on the RCOG website:

www.rcog.org.uk/womens-health/clinical-guidance/endometriosis-what-you-need-know

and NHS Choices website:

www.nhs.uk/conditions/Endometriosis/Pages/Introduction.aspx

To support women with endometriosis all obstetricians and gynaecologists have been trained in the diagnosis, investigation and management of the condition, which is specifically listed as a topic in the core curriculum for obstetrics and gynaecology. The European Society of Human Reproduction and Embryology has published clinical guidelines on the management of women with endometriosis to assist clinicians.

In addition, NHS England has developed a service specification for severe endometriosis under the specialised commissioning area of complex gynaecology. NHS England expects all units providing a service to women with severe endometriosis to provide care which meets the standards laid out in a specification which can be found on their website:

www.england.nhs.uk/wp-content/uploads/2014/04/e10-comp-gynae-endom-0414.pdf