Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many unsuccessful cosmetic surgery operations have had to be corrected by further surgery in the NHS in each of the last five years.
Answered by Ben Gummer
Information data on the number of unsuccessful cosmetic surgery operations requiring further corrective surgery in the National Health Service is not held centrally.
In April 2013, the independent Review of the Regulation of Cosmetic Interventions, chaired by Sir Bruce Keogh, was published. A copy has already been placed in the Library.
We fully accept the principles of the Keogh review and the overwhelming majority of the recommendations. The response looks to strengthen standards through better training and robust qualifications, and explores how far supervision from regulated professionals might support self-regulation of the sector.
Departmental officials are working with key delivery partners including the Royal College of Surgeons, who have set up an inter-specialty committee to ensure standards for cosmetic surgery. The College is also working with the General Medical Council on a code of ethical conduct. Health Education England is leading on a review of training for providers of non-surgical interventions, such as botulinum toxin and dermal filler injections.
Under the Health and Social Care Act 2008, all cosmetic surgery providers who provide a regulated activity have to register with the Care Quality Commission (CQC) and follow a set of fundamental standards of safety and quality below which care should never fall. The CQC has a wide range of enforcement powers that it can use if a provider is not compliant with the fundamental standards of care.
Asked by: Roger Godsiff (Labour - Birmingham, Hall Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the extent to which commercial insurance companies are capable of covering the risks associated with private health providers carrying out surgery on NHS contracts.
Answered by Dan Poulter
From 1 April 2013, private health provider organisations became eligible to join the NHS Litigation Authority’s (NHS LA) Clinical Negligence Scheme for Trusts (CNST). Currently, 68 private providers are members of the NHS LA’s CNST, as are all National Health Service trusts.
Any commercial insurance taken out by private providers for the NHS must meet the liability and indemnity requirements of the NHS standard contract. As such, no formal capability assessment has been undertaken by the Department.
In addition, regulation of the United Kingdom insurance industry is the responsibility of the Prudential Regulation Authority and the Financial Conduct Authority.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what discussions his Department has had with NHS England on the implementation of BRCA1/2 gene testing for women recently diagnosed with non-mucinous ovarian cancer.
Answered by Jane Ellison
The National Institute for Health and Care Excellence’s (NICE) clinical guideline on familial breast cancer, published in June 2013, recommends that women with breast or ovarian cancer should be offered genetic testing if their combined BRCA1 and BRCA2 mutation carrier possibility is 10% or more.
NICE clinical guidelines represent best practice and we expect National Health Service organisations in England to take them fully into account in designing services to meet the needs of their local populations. Clinical guidelines are not subject to the same statutory funding regulation as NICE’s technology appraisals.
NHS England advises that moving to routine testing at a 10% risk threshold in England would require a significant capacity and funding investment. This would be for the increase needed in genetic testing and associated counselling, and also in other services such as diagnostics - more mammography for example - and other support and preventative treatments such as surgery.
However, NHS England is considering moving to a lower threshold as part of the annual prioritisation process for funding in 2015-16.
Departmental officials have raised this issue with NHS England and it will also be raised at a forthcoming Ministerial meeting.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will take steps to ensure that all women diagnosed with non-mucinous ovarian cancer are offered BRCA1/2 gene testing at the point of diagnosis.
Answered by Jane Ellison
The National Institute for Health and Care Excellence’s (NICE) clinical guideline on familial breast cancer, published in June 2013, recommends that women with breast or ovarian cancer should be offered genetic testing if their combined BRCA1 and BRCA2 mutation carrier possibility is 10% or more.
NICE clinical guidelines represent best practice and we expect National Health Service organisations in England to take them fully into account in designing services to meet the needs of their local populations. Clinical guidelines are not subject to the same statutory funding regulation as NICE’s technology appraisals.
NHS England advises that moving to routine testing at a 10% risk threshold in England would require a significant capacity and funding investment. This would be for the increase needed in genetic testing and associated counselling, and also in other services such as diagnostics - more mammography for example - and other support and preventative treatments such as surgery.
However, NHS England is considering moving to a lower threshold as part of the annual prioritisation process for funding in 2015-16.
Departmental officials have raised this issue with NHS England and it will also be raised at a forthcoming Ministerial meeting.
Asked by: Mike Gapes (The Independent Group for Change - Ilford South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he plans to ensure more effective regulation of providers of cosmetic laser treatments; and whether it is his policy to introdude a register of such providers.
Answered by Dan Poulter
On 24 April 2013, the independent Review of the Regulation of Cosmetic Interventions, chaired by Sir Bruce Keogh, was published. A copy has already been placed in the Library.
The Government Response to the Review of the Regulation of Cosmetic Interventions, was published on 13 February. A copy of the response has already been placed in the Library. We fully accept the principles of the Keogh review and the overwhelming majority of the recommendations.
The Government has undertaken to strengthen standards through better training and robust qualifications, and explore how far supervision from regulated professionals might support self-regulation of the sector.
The Royal College of Surgeons has set up an inter-specialty committee to ensure standards for cosmetic surgery and will work with the General Medical Council on a code of ethical conduct. Health Education England (HEE) is leading on a review of training and qualifications for providers of non-surgical cosmetic interventions, including lasers. On 11 September, HEE published a phase 1 report Review of qualifications required for delivery of non-surgical cosmetic interventions. A copy of the report is attached.
The Care Quality Commission has developed a new inspection methodology to cover independent health providers, reflecting the protocols used for National Health Service hospitals. The inspections will be conducted with relevant specialists within the inspection teams, including those with experience in cosmetic interventions.
The Department is also taking steps to meet relevant stakeholders to discuss cosmetic procedures and the necessity and form of any further regulation to protect the public. There are no current plans to introduce a statutory register of providers of cosmetic laser treatments.
Asked by: Annette Brooke (Liberal Democrat - Mid Dorset and North Poole)
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 ensure that regulations regarding invasive cosmetic procedures provide the same level of protection as those concerning cosmetic surgery.
Answered by Dan Poulter
On 24 April 2013, the independent Review of the Regulation of Cosmetic Interventions, chaired by Sir Bruce Keogh, was published. A copy has already been placed in the Library.
The Government Response to the Review of the Regulation of Cosmetic Interventions was published on 13 February. A copy of the response has already been placed in the Library. We fully accept the principles of the Keogh review and the overwhelming majority of the recommendations. The response looks to protect the public through clear standards, better training and robust qualifications, and explores how far supervision from regulated professionals might support self-regulation of the sector.
Officials are working with key delivery partners such as the Royal College of Surgeons who have set up an inter-specialty committee to ensure standards for cosmetic surgery and they are working with the General Medical Council on a code of ethical conduct. Health Education England (HEE) is leading on a review of training and qualifications for providers of non-surgical cosmetic interventions and those required to be responsible prescribers. On 11 September, HEE published a phase 1 report Review of qualifications required for delivery of non-surgical cosmetic interventions. A copy of the report is attached. Work is also underway on a pilot breast implant registry to reassure women that if problems arise they can be contacted, kept informed and called in for treatment if necessary.
As part of this programme of work to ensure proper training and oversight of both non-surgical and surgical cosmetic interventions, we are looking at the need for legislation to ensure public protection and will consider bringing forward proposals.
Asked by: Karen Lumley (Conservative - Redditch)
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 effectiveness of regulation of the comestic industry; and whether he plans to propose further regulations relating to that industry.
Answered by Dan Poulter
On 24 April 2013, the independent Review of the Regulation of Cosmetic Interventions, chaired by Sir Bruce Keogh, was published. A copy has already been placed in the Library.
The review highlighted how the rapid growth of the cosmetic interventions sector is exposing people who undergo these procedures to a concerning lack of safeguards. It made recommendations to improve the quality of care, to inform and empower the public and to ensure resolution and redress when things go wrong.
We fully accept the principles of the Keogh review and the overwhelming majority of the recommendations. The Government Response to the Review of the Regulation of Cosmetic Interventions, was published on 13 February. The response looks to strengthen standards through better training and robust qualifications, and explores how far supervision from regulated professionals might support self-regulation of the sector. A copy of the response has already been placed in the Library.
We want to protect the public and ensure proper training and oversight of both non-surgical and surgical cosmetic interventions and we are looking at ways to legislate where required to achieve this. Officials are working with key delivery partners such as the Royal College of Surgeons who have set up an inter-specialty committee to ensure standards for cosmetic surgery and they are working with the General Medical Council on a code of ethical conduct. Health Education England (HEE) is leading on a review of training for providers of non-surgical interventions, such as botulinum toxin (commonly known as 'Botox') and dermal filler injections. HEE will be publishing their findings on the training framework soon. Work is also underway on a breast implant registry to reassure women that if problems arise they can be contacted, kept informed and called in for treatment if necessary.
There are examples of high quality surgical and non-surgical cosmetic interventions provided by trained staff to high standards of care and satisfaction. It is these high standards that must be universal.
Asked by: Tessa Munt (Liberal Democrat - Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to section 3 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, if NHS England will publish the details of all contracts it has signed with providers of radiosurgery services in England.
Answered by Jane Ellison
Section 3 of Monitor's substantive guidance on The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 provides guidance to commissioners on publishing new contract opportunities for NHS health care services.
On page 42 of the guidance, it states that "a commissioner may decide to carry out a detailed review of the provision of particular services (for example, A&E services) in its local area in order to understand how those services can be improved in the interests of patients. The review may involve extensive public consultation and engagement with existing and potential providers and other stakeholders. Reviewing available services and providers in this way is good commissioning practice and something that commissioners should consider doing as a matter of course.”
NHS England is currently undertaking such a review of stereotactic radiosurgery services. This will inform procurement decisions for these services.
University College London Hospitals is not contracted by NHS England, nor was it contracted by former primary care trusts, to provide Gamma Knife services. It is for this reason that NHS patients cannot normally be treated at this facility. Instead, NHS patients requiring Gamma Knife treatment should be treated by the Gamma Knife services commissioned by the NHS, that have been shown to meet NHS England service specifications. These can be accessed by patients in London without a waiting time, fully maintaining the continuity of their care and normally with the same consultant and clinical team.
NHS England inherited the range of stereotactic surgery providers currently in place, of which University College Hospital London was not one. NHS England is currently undertaking a review of stereotactic radiosurgery provision and will consult widely with stakeholders and providers prior to making changes to service provision.
Finally, NHS England will publish information relating to its contracted spend in due course, in line with Regulation 9 of The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013.
Asked by: Tessa Munt (Liberal Democrat - Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to section 3 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, if he will require NHS England to publish the names of all referring consultants, patients groups, charities and any other service providers it consulted prior to making its decision not to allow patients to be treated with the Gamma Knife at University College London Hospital.
Answered by Jane Ellison
Section 3 of Monitor's substantive guidance on The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 provides guidance to commissioners on publishing new contract opportunities for NHS health care services.
On page 42 of the guidance, it states that "a commissioner may decide to carry out a detailed review of the provision of particular services (for example, A&E services) in its local area in order to understand how those services can be improved in the interests of patients. The review may involve extensive public consultation and engagement with existing and potential providers and other stakeholders. Reviewing available services and providers in this way is good commissioning practice and something that commissioners should consider doing as a matter of course.”
NHS England is currently undertaking such a review of stereotactic radiosurgery services. This will inform procurement decisions for these services.
University College London Hospitals is not contracted by NHS England, nor was it contracted by former primary care trusts, to provide Gamma Knife services. It is for this reason that NHS patients cannot normally be treated at this facility. Instead, NHS patients requiring Gamma Knife treatment should be treated by the Gamma Knife services commissioned by the NHS, that have been shown to meet NHS England service specifications. These can be accessed by patients in London without a waiting time, fully maintaining the continuity of their care and normally with the same consultant and clinical team.
NHS England inherited the range of stereotactic surgery providers currently in place, of which University College Hospital London was not one. NHS England is currently undertaking a review of stereotactic radiosurgery provision and will consult widely with stakeholders and providers prior to making changes to service provision.
Finally, NHS England will publish information relating to its contracted spend in due course, in line with Regulation 9 of The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013.
Asked by: Tessa Munt (Liberal Democrat - Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to section 3 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, if he will require NHS England to publish the objective evidence on which it based its decision not to allow patients to be treated with the Gamma Knife at University College London Hospital.
Answered by Jane Ellison
Section 3 of Monitor's substantive guidance on The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 provides guidance to commissioners on publishing new contract opportunities for NHS health care services.
On page 42 of the guidance, it states that "a commissioner may decide to carry out a detailed review of the provision of particular services (for example, A&E services) in its local area in order to understand how those services can be improved in the interests of patients. The review may involve extensive public consultation and engagement with existing and potential providers and other stakeholders. Reviewing available services and providers in this way is good commissioning practice and something that commissioners should consider doing as a matter of course.”
NHS England is currently undertaking such a review of stereotactic radiosurgery services. This will inform procurement decisions for these services.
University College London Hospitals is not contracted by NHS England, nor was it contracted by former primary care trusts, to provide Gamma Knife services. It is for this reason that NHS patients cannot normally be treated at this facility. Instead, NHS patients requiring Gamma Knife treatment should be treated by the Gamma Knife services commissioned by the NHS, that have been shown to meet NHS England service specifications. These can be accessed by patients in London without a waiting time, fully maintaining the continuity of their care and normally with the same consultant and clinical team.
NHS England inherited the range of stereotactic surgery providers currently in place, of which University College Hospital London was not one. NHS England is currently undertaking a review of stereotactic radiosurgery provision and will consult widely with stakeholders and providers prior to making changes to service provision.
Finally, NHS England will publish information relating to its contracted spend in due course, in line with Regulation 9 of The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013.