Asked by: Roger Williams (Liberal Democrat - Brecon and Radnorshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will bring forward legislative proposals to set minimum nurse staffing levels on wards in English hospitals.
Answered by Dan Poulter
It is not for the Government but for local hospitals to decide how many staff they employ and they are best placed to do this based on the needs of their patients.
In November 2013 the National Quality Board supported by Jane Cummings, the Chief Nursing Officer in England, published guidance on ‘How to ensure the right people, with the right skills, are in the right place at the right time’.
In addition to this and to support trusts further, the Department commissioned the National Institute of Health and Care Excellence (NICE) to produce independent and authoritative evidence based guidance on safe staffing.
NICE published guidance on ‘Safe Staffing for Nursing in Adult In-Patient Wards in Acute Hospitals’ on 15 July 2014. The guidance does not endorse a staffing ratio. It says that no single ratio can be applied across all wards and patient populations, but makes recommendations on safe nursing and identifies indicators that should be used by trusts to demonstrate safe and effective nursing care is being provided.
The NICE guidelines will ensure that National Health Service trusts have the tools they need to make decisions to secure safe staffing. These staffing decisions will then be subject to external scrutiny and challenge by commissioners, regulators and the public, and inspection by the Chief Inspector of Hospitals.
Asked by: Roger Williams (Liberal Democrat - Brecon and Radnorshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to improve care for lung cancer patients diagnosed through emergency routes.
Answered by Jane Ellison
The Government is investing £450 million in raising awareness and achieving earlier diagnosis to ensure people are diagnosed with cancer before they present through an emergency route. NHS England are currently working on developing the new care models set out in the Five Year Forward View, which will help ensure that there are sufficient numbers of general practitioners (GPs) working in larger practices with greater access to diagnostic and specialist advice.
The National Institute for Health and Care Excellence (NICE) is in the process of updating the Referral Guidelines for Suspected Cancer (2005) to ensure that it reflects latest evidence and can continue to support GPs to identify patients with the symptoms of suspected cancer and urgently refer them as appropriate. NICE’s draft is currently out for consultation until 9 January 2015. The anticipated publication date for the revised guidelines is May 2015.
The Department ran a national Be Clear on Cancer lung cancer campaign from May to July 2012 to raise awareness of persistent cough as a symptom of lung cancer and to encourage people with this symptom to visit their GP. Public Health England took over running of Be Clear on Cancer campaigns in April 2013 and have since run two repeat national lung cancer campaigns in July-August 2013 and March-April 2014.
In 2012, to increase the awareness of cancer amongst GPs and support GPs to assess all patients more effectively, the Department funded the British Medical Journal (BMJ) Learning to provide an e-learning tool for GPs. The modules include tackling late diagnosis; risk assessment tools; and cancer pathway and the role of primary care.
In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support (CDS) tool for GPs to use in their routine practice. It is designed to help GPs recognise the symptoms of cancer and identify patients that they might not otherwise refer urgently for suspected cancer. The CDS covers lung cancer and a number of other cancers. Following the pilot, Macmillan is now offering the tool free of charge to all GPs in the United Kingdom.
In March 2012 NICE published the Lung cancer Quality Standard. This quality standard describes markers of high-quality, cost-effective care that, when delivered collectively, should contribute to improving the effectiveness, safety and experience of care for people with lung cancer.
We know from the 2013 National Lung Cancer Audit that there have been continued increases in curative surgery for lung cancer patients. The audit report supports providers and commissioners and NHS England to reduce variation in services and drive improvement locally. We are also providing improved access to treatment through other means, such as the Cancer Drugs Fund. With the development of the chemotherapy dataset, we now have detailed information about chemotherapy drug treatment for lung cancer patients.
Work is also underway to support early diagnosis through delivery of transparent data about performance in outcomes. For example, indicators on stage of diagnosis of cancer and diagnosis through emergency routes are part of the clinical commissioning group outcomes indicator set, which support clinical commissioning groups to understand how their local communities are performing in relation to cancer outcomes.