Asked by: Luciana Berger (Liberal Democrat - Liverpool, Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many clinical commissioning groups collect (a) prevalence and (b) standardised mortality data on autistic people as part of their joint strategic needs assessments.
Answered by Alistair Burt
Information is not collected centrally on how many clinical commissioning groups collect prevalence and standardised mortality data on autistic people as part of their joint strategic needs assessments.
The National Health Service is taking action to reduce premature death among people with autism and a learning disability, and with autism by increasing annual health checks for people with learning disabilities, including for those who also have autism. The NHS is working to reduce variation and improve care for physical health conditions that disproportionately impact on people with learning disabilities who also may have autism, including epilepsy and cancer. NHS England has commissioned the world's first Learning Disability Mortality Review Programme to support local areas to review deaths of people with learning disabilities and to use the information to improve service provision. This review programme for people with learning disabilities includes those who also have autism.
Think Autism set out a clear, cross Government programme of action, developed alongside people with autism, their families and carers to improve their lives and reduce premature mortality through better access to healthcare by making adjustments to services. This includes supporting the Royal College of General Practitioners (RCGPs) Autism Initiative to improve understanding of autism amongst GPs.
Asked by: Steve McCabe (Labour - Birmingham, Selly Oak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 24 March 2016 to Question 32057, on Epilepsy Death, for what reasons his Department made the decision to retire quality and outcomes framework indicators EP002 and EP003 in 2014.
Answered by Alistair Burt
Senior NHS England clinicians and representatives of the British Medical Association reviewed and agreed all the proposed changes to the Quality and Outcomes Framework (QOF) taking into account the views of the National Institute for Health and Care Excellence and Public Health England.
The removal of QOF indicators will not mean that general practitioners (GPs) will no longer tackle important health issues, rather, the aim is that reducing QOF will help free up time to enable GPs to spend more time on providing more proactive coordinated and individual care for their patients, based on their clinical judgement. The reduction in the number of QOF indicators was intended to reduce bureaucracy, unnecessary patient testing and unnecessary frequency of patient recall and recording.
Asked by: Paul Flynn (Labour - Newport West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the implications for his Department's policies of recent Medicines and Healthcare Products Regulatory Agency guidelines on prescribing sodium valproate during pregnancy; and if he will implement stronger guidelines to minimise the risks of fetal valproate syndrome from use of sodium valproate.
Answered by George Freeman
The National Institute for Health and Care Excellence (NICE) is responsible for developing national clinical guidelines to secure consistent, high quality, evidence based care for patients using the National Health Service. The NICE guideline on epilepsy, The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care, makes clear that to enable informed decisions and choice, women and girls with epilepsy must be given accurate information and counselling about contraception, conception and pregnancy.
The Department worked with the Medicines and Healthcare products Regulatory Agency, healthcare professionals and patient groups to raise awareness and encourage discussion about the risks and benefits of sodium valproate between healthcare professionals and their patients. Several measures were put in place to minimize the prescribing of sodium valproate to women of childbearing potential (except where other drugs are ineffective or not tolerated) and to communicate the warnings around the drug sodium valproate to healthcare professionals and patients (particularly women of child bearing potential). These include:
- working with the Health and Social Care Information Service on introducing red-flag warnings on general practitioners and community pharmacy IT systems;
- updating the British National Formulary (BNF) and BNF for children (BNFc);
- using existing Departmental and NHS communication channels to raise awareness and provide information to patients; and
- working with the relevant Royal Colleges and professional bodies to communicate with their members and raise awareness.
Asked by: Lord Stoddart of Swindon (Independent Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the announcement by NHS England that general practitioners are to be paid an additional £55 for diagnosing dementia in patients, what other complaints or illnesses diagnosed by general practitioners are already rewarded by payments additional to their salaries; and whether they will review the system of additional payments of this sort.
Answered by Earl Howe - Deputy Leader of the House of Lords
General Practitioner (GP) income is made up of global sum payments for carrying out essential and additional services under the contract. Practices may also receive further payments for specific services including:
- enhanced services – those that require an enhanced level of service provision above what is required under the core contract. The additional payment for diagnosing dementia falls within this category; and
- the quality and outcomes framework (QOF) - a voluntary incentive scheme that provides payment to GP practices for how well they care for patients based on performance against a number of agreed indicators.
Specifically on diagnosis, a number of QOF indicators are concerned with the establishment of disease registers. In order to receive payment GPs are required to ensure diagnosis levels consistent with those expected for their population for the following conditions:
- atrial fibrillation;
- coronary heart disease;
- heart failure;
- hypertension;
- peripheral arterial disease;
- stroke and trans-ischaemic attack;
- diabetes mellitus;
- hypothyroidism;
- asthma;
- chronic obstructive pulmonary disease;
- dementia;
- depression;
- schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy;
- cancer;
- chronic kidney disease;
- epilepsy;
- osteoporosis;
- rheumatoid arthritis; and
- obesity.
Each year NHS Employers, on behalf of NHS England, negotiates the new GP contract with the General Practitioners Council of the British Medical Association. This includes discussion of changes to the Enhanced Services and QOF.