Tag: Justin Madders

The below Parliamentary question was asked by Justin Madders on 2016-10-10.

To ask the Secretary of State for Business, Energy and Industrial Strategy, when his Department will implement the recommendations of the Deane Review into Self-Employment, published in February 2016.

Margot James

The Government is considering all the recommendations made in Julie Deane’s independent review of self-employment and will respond in due course.

The below Parliamentary question was asked by Justin Madders on 2016-10-17.

To ask the Secretary of State for Health, what assessment he has made of the effect on patient safety of the 10 per cent headcount reduction initiative introduced by St George’s University Hospitals NHS Foundation Trust.

Mr Philip Dunne

Responsibility for determining appropriate staffing levels rests with hospital trusts. In making their assessment, trusts should focus on the numbers and skill mix needed to deliver quality care, patient safety and efficiency.

We are advised by NHS Improvement that St George’s University Hospitals NHS Foundation Trust is implementing a financial recovery plan, part of which involves reducing pay costs by 10% by 31 March 2017.

We are further advised that the Trust plans to achieve financial sustainability by not recruiting to certain posts as and when they become vacant. We understand that the Trust is also reviewing its expenditure on discretionary pay and on employing temporary bank and agency staff.

We are assured that the Trust will take all necessary steps to ensure staff can continue to deliver services safely and effectively and that any posts judged essential to delivering services safely and effectively will continue to be filled.

The below Parliamentary question was asked by Justin Madders on 2016-10-18.

To ask the Secretary of State for Health, what level of funding has been (a) requested by and (b) allocated to NHS England for (i) 2017-18, (ii) 2018-19 and (iii) 2019-20.

Mr Philip Dunne

The Spending Review settled the level of funding that the National Health Service in England will receive over the course of this Parliament, with the NHS England Chief Executive a full party to the discussions with HM Treasury. As the Chief Executive said at the time the Spending Review was announced, “our case for the NHS has been heard and actively supported’’. Regular discussions around the finances of the NHS continue to take place between my Rt. hon. Friend the Secretary of State and the Chief Executive of NHS England.

The NHS will be receiving £10 billion more per year in real terms by 2020-21 compared to 2014-15. The following table sets out the financial settlement allocated to the NHS.

NHS budget for Spending Review period

Revenue and capital combined	2015-16	2016-17	2017-18	2018-19	2019-20	2020-21
Total (£ million)	100,500	105,975	109,337	111,824	114,929	119,035
Real terms increase on previous year (%)		3.7%	1.3%	0.3%	0.7%	1.3%
Real terms increase on 2015-16 baseline (£ billion)		3.8	5.3	5.8	6.7	8.4
Real terms increase on 2014-15 baseline (£ billion)	2.0	6.0	7.0	8.0	9.0	10.0

Note:

These figures differ from the NHS Total Departmental Expenditure Limit (TDEL) figures announced at the Spending Review due to a number of technical adjustments, including transfers of functions. The main transfer of function is the move of 0-5 public health services from NHS England to local government. There are a small number of other transfers including the move of the Leadership Academy to Health Education England. To ensure comparability of numbers, in this table £500 million has been removed from the 2015-16 baseline, representing 6 months of funding for 0-5 public health services between 1 April and 30 September 2015 and these other planned transfers.

The below Parliamentary question was asked by Justin Madders on 2015-11-02.

To ask the Secretary of State for Health, when he expects (a) Monitor and (b) the Trust Development Authority to publish their 2015-16 second quarter performance reports.

Ben Gummer

As part of the establishment of NHS Improvement in April 2016, Monitor and the NHS Trust Development Authority are aligning their quarterly reporting processes and will be publishing their reports together towards the end of the year.

The below Parliamentary question was asked by Justin Madders on 2015-12-03.

To ask the Secretary of State for Health, whether hospitals will incur financial penalties if they breach performance standards as a result of the suspended industrial action on 1 December 2015.

Ben Gummer

In the normal course of events, a hospital which misses a key national standard (such as the 18-week referral to treatment waiting time standard or the six-week diagnostic wait standard) will incur a mandatory financial sanction applied by its commissioners, as set out in the NHS Standard Contract.

However, the Contract also includes a ‘Force Majeure’ clause (General Condition 28) which would, in principle, apply to planned industrial action. Under this clause, a provider is able to claim relief from its liabilities under the Contract, to the extent that an event outside of its reasonable control has directly caused it to fail to meet its contractual obligations.

Therefore, if a hospital were to breach an operational standard for the month, but could demonstrate to the commissioner that:

* this was solely and directly due to the action it had reasonably taken in anticipation of the industrial action proceeding; and

* it had done everything reasonable to mitigate the impact of its actions on achievement of the standard in that month

then the commissioner could set aside the sanction for that month.

If the breach of the standard was only partly due to the impact of the planned industrial action, only the relevant proportion of the sanction would be set aside.

The below Parliamentary question was asked by Justin Madders on 2016-01-25.

To ask the Secretary of State for Health, pursuant to the Answer of 26 October 2015 to Question 12819, what progress he has made on introducing independent medical examiners to the death certification process.

Ben Gummer

We remain committed to the principle of medical examiners and will be setting out further information in due course.

The below Parliamentary question was asked by Justin Madders on 2016-02-01.

To ask the Secretary of State for Health, how many cases of sepsis there were in each region of England in each of the last five years.

Ben Gummer

Data for finished discharge episodes (FDEs) with a primary or secondary diagnosis of sepsis for patients in each government office region of residence in England, in each year from 2010-11 to 2014-15 are provided below.

These figures relate only to hospital admissions and do not include those patients who were diagnosed in a primary care setting, or those who attended hospital as an Outpatient.

This is not a count of patients as the same patient may have had more than one episode of care within the same year.

Count of FDEs¹ with a primary or secondary diagnosis² of sepsis³ for patients in each government office region of residence for 2010-11 to 2014-15^4. Activity in English National Health Service Hospitals and English NHS commissioned activity in the independent sector

Government office region	2010-11	2011-12	2012-13	2013-14	2014-15
North East	4,798	5,074	5,655	6,275	7,388
North West	13,258	13,109	14,708	17,221	20,922
Yorkshire and The Humber	9,182	9,189	10,146	11,338	12,857
East Midlands	7,316	8,115	9,831	10,863	12,998
West Midlands	7,772	7,915	10,518	12,297	13,812
East of England	10,380	10,432	11,647	13,108	16,029
London	14,894	15,223	15,580	17,860	19,723
South East	13,945	15,344	16,604	19,239	21,378
South West	8,013	8,292	9,805	10,967	12,722
England – Not Otherwise Specified	48	83	75	84	102
Unknown/Non-England	2,275	8,239	9,716	3,570	3,841
Total	91,881	101,015	114,285	122,822	141,772

Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

The increasing incidence of sepsis is likely to be due to people living longer and more medical and surgical interventions being performed. People with series co-morbidities are more likely to survive their illness, and for a longer period of time than in previous decades, which leads to much of the hospital-acquired sepsis that now occurs.

Notes:

¹Finished Discharge Episode (FDE) – A discharge episode is the last episode during a hospital stay (a spell), where the patient is discharged from the hospital or transferred to another hospital. Discharges do not represent the number of patients, as a person may have more than one discharge from hospital within the period.

²Number of episodes in which the patient had a primary or secondary diagnosis – The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.

³ICD-10 codes for Sepsis – A02.1 Salmonella sepsis, A20.7 Septicaemic plague, A21.7 Generalized tularaemia, A22.7 Anthrax sepsis, A26.7 Erysipelothrix sepsis, A28.0 Pasteurellosis, A28.2 Extraintestinal yersiniosis, A32.7 Listerial sepsis, A39.2 Acute meningococcaemia, A39.3 Chronic meningococcaemia, A39.4 Meningococcaemia, unspecified, A40.- Streptococcal sepsis, A41.- Other sepsis, A42.7 Actinomycotic sepsis, B37.7 Candidal sepsis, O85.X Puerperal sepsis, P36.- Bacterial sepsis of newborn
The following pair of codes is a dagger/asterisk code pair (D and A) which must be present together:
A39.1 Waterhouse-Friderichsen syndrome; E35.1 Disorders of adrenal glands in diseases classified elsewhere

⁴Assessing growth through time (Admitted patient care) – HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

Note that HES include activity ending in the year in question and run from April to March, e.g. 2012-13 includes activity ending between 1st April 2012 and 31st March 2013.

The below Parliamentary question was asked by Justin Madders on 2016-02-24.

To ask the Secretary of State for Health, what assessment he has made of the (a) scale of the difficulty experienced by trusts in recruiting to consultant posts and (b) effect of that difficulty on numbers of occupied consultant posts in cellular pathology.

Ben Gummer

Individual healthcare providers are responsible for ensuring that they have the right level of staffing to provide high quality care to their patients.

The following table taken from the monthly workforce statistics published by the Health and Social Care Information Centre (HSCIC) shows the total consultant figures for May 2010, November 2010 and for November 2015 working in the National Health Service in England. The data for November 2015 is the latest available. The HSCIC statistics do not show cellular pathology, but data is provided for those working in the pathology group.

England full-time equivalent

	May 2010	November 2010	November 2015
All Consultants	35,174	36,010	42,423
Consultants in Pathology group	2,426	2,486	2,597

Source: Health and Social Care Information Centre NHS monthly workforce statistics

The below Parliamentary question was asked by Justin Madders on 2016-03-07.

To ask the Secretary of State for Health, what steps his Department is taking to encourage GPs to undertake out-of-hours shifts in primary care.

Alistair Burt

The Department and NHS England are committed to addressing the issue of increasing medical indemnity costs for general practitioners (GPs), including those working out of hours.

Increasing costs of indemnity cover associated with out of hours work may discourage GPs from undertaking out-of-hours shifts in primary care.

The Department was represented at a roundtable event held by NHS England on 17 November 2015 to develop a shared understanding of how to address rising medical indemnity costs. A range of stakeholders, including the British Medical Association and Medical Defence Organisations (MDOs), also attended.

On 9 December 2015, NHS England announced a winter indemnity scheme to offset the additional indemnity premium for GPs who wish to work additional sessions for their out-of-hours providers. In addition they have negotiated changes to the products offered by MDOs to bring down costs of indemnity for extended access.

Discussions are ongoing between the Department and NHS England on a long-term solution.

The below Parliamentary question was asked by Justin Madders on 2016-04-13.

To ask the Secretary of State for Health, what assessment he has made of the availability of qualified paramedics within the NHS to meet demand.

Ben Gummer

Health Education England (HEE) has worked closely with all English ambulance services through the Paramedic Evidence Based Education Project programme, both to modernise the future training of paramedics and other ambulance service workers to be fit for future services.

The national commissioning of paramedic training has increased significantly since 2013 and in the last year alone HEE has commissioned an additional 605 places on 2015/16 figures, which is an increase of 53.8%.