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Written Question
Hospices: Finance
Wednesday 15th May 2024

Asked by: Marsha De Cordova (Labour - Battersea)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of amending the funding model for hospices.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for determining the level of National Health Service-funded palliative and end of life care, including hospice care, locally, and they are responsible for ensuring that the services they commission meet the needs of their local population. As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an ICB must commission, which will ensure a more consistent national approach, and support commissioners in prioritising palliative and end of life care.

The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.

The Department, alongside key partners, and NHS England will continue to engage with stakeholders, including the voluntary sector and independent hospices on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England about oversight and accountability of National Health Service palliative and end of life care commissioning.

The Government recognises the difficult economic context that organisations such as hospices face, which is why we made the decision to provide additional funding to help deliver non-consolidated pay awards to eligible staff employed by non-NHS organisations, including some hospices. Funding has been made available for over 27,000 staff in non-NHS organisations to receive the two non-consolidated awards agreed as part of the Agenda for Change pay deal. Eligible organisations will receive their funding as soon as practically possible, following the receipt of their invoice.


Written Question
Hospices: Finance
Wednesday 15th May 2024

Asked by: Marsha De Cordova (Labour - Battersea)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she is taking steps to support hospices with rising costs.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for determining the level of National Health Service-funded palliative and end of life care, including hospice care, locally, and they are responsible for ensuring that the services they commission meet the needs of their local population. As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an ICB must commission, which will ensure a more consistent national approach, and support commissioners in prioritising palliative and end of life care.

The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.

The Department, alongside key partners, and NHS England will continue to engage with stakeholders, including the voluntary sector and independent hospices on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England about oversight and accountability of National Health Service palliative and end of life care commissioning.

The Government recognises the difficult economic context that organisations such as hospices face, which is why we made the decision to provide additional funding to help deliver non-consolidated pay awards to eligible staff employed by non-NHS organisations, including some hospices. Funding has been made available for over 27,000 staff in non-NHS organisations to receive the two non-consolidated awards agreed as part of the Agenda for Change pay deal. Eligible organisations will receive their funding as soon as practically possible, following the receipt of their invoice.


Written Question
Health Services: Waiting Lists
Wednesday 15th May 2024

Asked by: Damien Moore (Conservative - Southport)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress her Department has made on reducing waiting lists for planned care in the North West.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Cutting waiting lists for elective care is one of this Prime Minister’s top priorities. The Delivery Plan for Tackling the COVID-19 Backlog of Elective Care outlines how the National Health Service will bring down waiting times across all elective services. To support this plan and tackle waiting lists the Government plans to spend more than £8 billion from 2022/23 to 2024/25 to drive up and protect elective activity. We are making good progress on tackling the longest waits, to ensure patients get the care they need when they need it.

In July 2022, the NHS successfully met the first target in our plan to virtually eliminate waits of over two years, excluding patients waiting by choice or due to complex specialties. The NHS then worked hard to deliver the next ambition to eliminate waits of 18 months or more. Thanks to the incredible work of NHS staff, NHS England's official statistics show that as of March 2024, we have virtually eliminated waits of over 18 months.

Referral to Treatment (RTT) waiting times data is published monthly by NHS England:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/


Written Question
Gender Dysphoria: Children
Monday 13th May 2024

Asked by: Nadia Whittome (Labour - Nottingham East)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to help support 17-year-olds on the waiting list for gender identity services who have had their appointments with adult services cancelled and are not eligible for young people’s services.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

NHS England has asked adult gender clinics to delay offering first appointments to young people until they have reached their 18th birthday, in response to the findings of the Cass Review, and advised that clinicians should exercise extreme caution before initiating medical interventions for young people below the age of 18 years old.

The number of individuals affected is likely to be very small, and Gender Dysphoria Clinics are commissioned to provide support to individuals while they are on the waiting list, for example through the use of outreach support staff. NHS England also announced that it is bringing forward its review of the adult service specifications.


Written Question
Integrated Care Boards
Monday 13th May 2024

Asked by: Karin Smyth (Labour - Bristol South)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has she made of the adequacy of the progress towards full delegated commissioning for Integrated Care Boards by April 2025 in (a) the South West, (b) the South East, (c) London and (d) the North East.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.


Written Question
Integrated Care Boards: Training
Monday 13th May 2024

Asked by: Karin Smyth (Labour - Bristol South)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what (a) training and (b) support on specialised services is provided for staff working in integrated care boards in the (i) East of England, (ii) Midlands and (iii) North West following full delegation of commissioning in 2024-25.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.


Written Question
Health Services: Standards
Monday 13th May 2024

Asked by: Karin Smyth (Labour - Bristol South)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate she has made of the proportion of specialised services that met national standards in the (a) 2022-23 and (b) 2023-24 financial years.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.


Written Question
Health Services: Costs
Monday 13th May 2024

Asked by: Karin Smyth (Labour - Bristol South)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate she has made of the cost to (a) integrated care boards and (b) NHS England of commissioning specialised services in the (i) 2022-23 and (ii) 2023-24 financial years.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.


Written Question
Health Services
Monday 13th May 2024

Asked by: Karin Smyth (Labour - Bristol South)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of the nine statutory joint committees formed between integrated care boards and NHS England regions on specialised commissioning.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.


Written Question
Dietetics: Prescriptions
Tuesday 7th May 2024

Asked by: Andrew Western (Labour - Stretford and Urmston)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of commissioning research on the potential impact on patient care of granting independent prescribing responsibilities to dietitians.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Dieticians can currently supply and administer medicines using Patient Group Directions and train to use supplementary prescribing. At present, these are deemed to be the most appropriate medicines mechanisms for their use.

The University of Surrey is carrying out a study which looks at the effect of dietitians and therapeutic radiographers prescribing on patients, staff, and services. The project began in 2019 and is now in its final phase.

The Department works with NHS England to ensure that the prescribing responsibilities for all Allied Health Professionals, including dietitians, are regularly reviewed and updated. Where it is deemed clinically appropriate and necessary to extend prescribing responsibilities to Allied Health Professionals, the Department follows an established process for making changes that ensures proposals are safe and beneficial for patients.