Tag: Lord Hunt of Kings Heath

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-03-14.

To ask Her Majesty’s Government how they will ensure that their review of the Cambridgeshire and Peterborough Clinical Commissioning Group contract with UnitingCare LLP for older people’s and adult community services will deal objectively with the role of the Department of Health and NHS England, in the light of the fact that both organisations undertook Gateway reviews of the contract proposals.

Lord Prior of Brampton

NHS England is responsible for the review of Cambridgeshire and Peterborough clinical commissioning group’s (CCGss) contract with UnitingCare LLP. NHS England advises that it has commissioned an independent review to ensure objectivity. The review is looking at the contract from a commissioning perspective, which means it will cover the role of NHS England, but the role of the Department is not within its scope.

The Department’s role in gateway reviews was to facilitate the review on behalf of the project owner. The procedure was that the Department’s Health Gateway Team, working with the project owner, selected a suitable review team from a pool of accredited, independent reviewers. At the end of the review, the independent review team produced a report which was presented to the project owner and was their property. The Department stopped providing this service in 2015.

NHS England advises that the CCG, as the project owner, used the Department’s Health Gateway Team to facilitate three independent gateway reviews into its procurement for older people’s and adult community services, two in 2013 before the submission of final bids and the third in November 2014. NHS England advises that these gateway reviews were not intended to undertake detailed financial reconciliation.

NHS England advises that it facilitated two gateway reviews in early 2014, before the appointment of the preferred bidder. These focused on reviewing significant service changes from a clinical pathway perspective. They were not intended to cover procurement and technical financial details.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-03-22.

To ask Her Majesty’s Government what assessment they have made of the leadership of the Parliamentary and Health Service Ombudsman.

Lord Prior of Brampton

The Government has expressed its concern on behalf of patients about some of the things that have been happening. It is important that patients have confidence in the Parliamentary and Health Service Ombudsman, but the Ombudsman is independent of Government, accountable directly to Parliament. This is therefore a matter for the relevant Select Committee of the House of Commons.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-04-14.

To ask Her Majesty’s Government what mitigating actions they propose to take in the light of the equality analysis undertaken under section 149 of the Equality Act 2010 showing that certain features of the new contract for doctors in training will have an adverse impact on carers, who are disproportionately women.

Lord Prior of Brampton

The contract published on 31 March is a huge step forward for achieving fairness for all trainee doctors. For the first time junior doctors will be paid and rewarded solely on the basis of their own hard work and achievement and pay progression will be linked to level of training rather than arbitrarily to time served.

All junior doctors should have the same terms and conditions – a level playing field – which is ultimately what employers and the British Medical Association (BMA) want and everyone deserves.

When the Secretary of State published the Equality Analysis on the new contract for doctors and dentists in training in the NHS (“Doctors”) on the 31 March 2016 on the GOV.UK website he made it clear that, as a result of considering the Equality Analysis, in accordance with his duties and obligations, he had asked for a number of changes to the draft contract to address specific issues for certain groups with protected characteristics. This has been done and the contract has been duly amended. These changes included changes that benefited staff who work part time. The new contract is not discriminatory it ensures that all junior doctors receive equal pay for work of equal value. The BMA’s own lawyers have advised that nothing in the new contract is discriminatory. Nevertheless the equality duty is an ongoing duty and it is intended that monitoring will continue after the introduction of the new contract in accordance with the public sector equality duty in the Equality Act 2010.

A copy of the Equality Analysis is attached.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-04-25.

To ask Her Majesty’s Government what evaluation has been undertaken to ensure that the £200 million National Transformation Fund for 2015–16 provided value for money.

Lord Prior of Brampton

For the new care models programme, vanguards were selected based on a transparent and rigorous process, which considered the full range of value that they could deliver for their patients and for the wider National Health Service.

New care model vanguards were required to submit ‘value propositions’ making the case for investment from the transformation fund. Money was only released once these were assessed, and approved.

National support was designed based on what the vanguards said they needed to support them to deliver, and included work with them to develop a robust monitoring and evaluation framework. The national support helped ensure that vanguards are well positioned for success, and checks that money has been spent as planned, quarterly in arrears.

An independent, multi-year evaluation will examine the longer-term impact of the new care models programme and its cost effectiveness.

Other transformation programmes (for example, the Diabetes Prevention Scheme or the Healthy New Towns programme), not directly connected with the new care models programme, each have their own evaluation work-streams based on similar principles to those being used in the new care models programme. The results from these evaluations are not yet available as the implementation of these programmes has just begun.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-05-03.

To ask Her Majesty’s Government what estimate they have made of the costs of running different education systems in respect of local education authority maintained schools, academies, and free schools.

Lord Nash

The current dual system, where maintained schools and academies (including free schools) have different requirements on a number of key areas including funding, financial compliance, performance oversight, parental complaints and how they are required to adhere to legislation, does not provide consistent expectations on professionals or clarity and assurance for pupils and parents.

This government believes a single system with all schools as academies, which affords greater autonomy to professionals and is governed by a single legal framework along with clear and robust accountability, will provide a level playing field for all and the conditions for future success. It will give clarity on roles and responsibilities and secure efficiency. Running a dual system diverts resources, time and focus away from the classroom.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-05-23.

To ask Her Majesty’s Government what action they plan to take in the light of the findings of the independent review of the handling by the Royal Wolverhampton NHS Trust of concerns raised by and related to Mrs Haynes-Kirkbright.

Lord Prior of Brampton

These are matters in the first instance for NHS Improvement. The Verita report, Independent review of the handling by The Royal Wolverhampton NHS Trust of concerns raised by and related to Mrs Haynes-Kirkbright, was commissioned by the NHS Trust Development Authority – a forerunner organisation – independently of Government.

NHS Improvement is commissioning a governance review to consider issues highlighted by the Verita report. A copy of the terms of reference for the new governance review are attached.

Verita was originally requested (under specific terms of reference) to review and provide a dedicated report on the handling by the Royal Wolverhampton NHS Trust of concerns raised by and related to Mrs Haynes-Kirkbright. Governance issues that fell outside of those terms of reference will be considered in the new review, to ensure thorough investigation.

The new review will take into account evidence provided by Mrs Haynes-Kirkbright and others in the course of the Verita review.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-07-19.

To ask Her Majesty’s Government what progress they are making in ensuring that the NHS collects data on whether return out-patient appointments are being delayed beyond the clinically recommended time due to insufficient capacity or targets for new patients that are prioritised over returns.

Lord Prior of Brampton

There are no plans to collect additional data on out-patient appointments.

Many patients will require further planned stages of treatment after their waiting time clock has stopped. This treatment should be undertaken without undue delay and in line with when it is clinically appropriate and convenient to the patient to do so.

Patients requiring initial or follow-up appointments for clinical assessment, review, monitoring, procedures or treatment must be given a clear expectation of the timeframe for this, as required by best clinical evidence. If the planned procedure is then delayed beyond that timeframe, a new waiting time clock should start and be reported in the waiting time statistics, to ensure that these patients are kept in sight.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2016-09-14.

To ask Her Majesty’s Government what assessment they have made of the waiting times for treatment in the accident and emergency department of the Royal Blackburn Hospital.

Baroness Chisholm of Owlpen

No such assessments have been made. The provision of accident and emergency (A&E) services at the Royal Blackburn Hospital is a matter for the local National Health Service. The NHS in East Lancashire has established an A&E delivery board to oversee system performance and the effective delivery of urgent and emergency care locally.

Ministers consult weekly with NHS Improvement and the Care Quality Commission about A&E performance.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-10-29.

To ask Her Majesty’s Government who are the members of, and what are the terms of reference for, the Department of Health’s Appraisal Alignment Working Group.

Lord Prior of Brampton

The current membership of the Appraisal Alignment Working Group is as follows:

Department of Health

Keith Derbyshire (Chair) Chief Analyst and Chief Economist

Danny Palnoch Senior Economic Adviser

Peter Bennett Senior Operational Research Scientist

Dr Mark Bale Deputy Chief Medical Officer

National Institute for Health and Care Excellence

Leeza Osipenko Associate Director

Meindert Boysen Associate Director

Public Health England

Prof Brian Ferguson Director for Knowledge & Intelligence

Dr Anne Mackie Director of Screening

Monitor

John Curnow Economics Project Director

Zephan Trent Impact Assessment Lead

NHS England

Dr Donald Franklin Senior Economic Adviser NHS England

Amy Lee Economic Advisor

Brunel University

Prof Martin Buxton Emeritus Professor of Health Economics

London School of Hygiene & Tropical Medicine Representing Joint Committee for Vaccines and Immunisations and Safety of Blood Tissues and Organs

Prof John Cairns Professor of Health Economics

The current Terms of Reference (agreed with ministers in February 2014) is replicated below:

Appraisal Alignment Working Group [AAWG] Terms of Reference & Objectives

The Appraisal Alignment Working Group (AAWG) is comprised of policy and analytic staff who work in, or give advice to, DH and its ALBs on the cost-benefit and cost-effectiveness of programmes, technologies and policies.

The purpose of the group is to share knowledge on the various techniques employed across the Health and Care sector, to discuss and debate the pros and cons of different approaches employed, to consider ways of rendering results comparable, and to understand the reasons for differences in approaches.

The working group is not a decision making body. Rather it is advisory. Individual members representing different organisations will take back recommendations and questions to their parent bodies for consideration.

It is proposed to have meetings every six to eight weeks to achieve the ‘Must Do’ (e.g. primary) objective described below.

The ‘Must Do’

Before the next Spending Review, (pencilled in for June to October 2015), it is essential the Department of Health (DH) and its Arm’s Length Bodies (ALBs) can present a consistent approach o HM Treasury (HMT) on the cost benefit of different programmes (e.g. vaccinations, screening new technologies). The cost benefit case for spending presented to HMT should follow public sector best practice as set out by HMT, in its Green Book. Therefore results of appraisals need to be capable of being expressed in HMT Green Book methodology terms (ie using the Green Book methodology as a “reference case”).

Having successfully achieved that, the Working Group will take stock and decide if the group (or some other forum) should continue and progress on three desiderata:

1. economic justification for methods employed in each area and clear rationale for when methods differ and/or diverge from HMT’s Green Book.
2. achieve greater alignment of techniques between the different sectors and organisations
3. serve as an expert panel to advise on the development and application of new techniques on an on-going basis.

This work would be less time critical and could be pursued by meetings every eight to twelve weeks.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-11-10.

To ask Her Majesty’s Government how they will ensure that NHS Improvement ring-fences its activities in relation to NHS Foundation Trusts in order to fulfil statutory provisions, in particular those in the Health and Social Care Act 2012.

Lord Prior of Brampton

NHS Improvement will bring together Monitor, the NHS Trust Development Authority, and patient safety and improvement functions from across the health system, under a single leadership and operating model. These arrangements will not change the current statutory duties of Monitor or any of the other bodies involved.