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660151

	registered interest
	date	16/12/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what guidance NICE has issued on whether it is clinically appropriate to delay surgery for (a) obese patients for 12 months and (b) smokers for 6 months.
	tabling member constituency	York Central
	tabling member printed	Rachael Maskell
	uin	58010
	answer	answer is ministerial correction date of answer 23/12/2016 answer text <p>The National Institute for Health and Care Excellence has advised that it has not made any specific recommendations on delaying surgery for obese patients or patients who smoke, and that its guidelines tend to focus on the diagnosis, care and management of health conditions, rather than protocols for the delivery of services.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 23/12/2016 10:20:19 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4471 label Biography information for Rachael Maskell

391462

	registered interest
	date	20/07/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what analysis his Department and NHS England have carried out to determine what standard of high-risk general surgery a site should be providing in order to be an appropriate site for carrying out (a) complex cardiac surgery and (b) other tertiary services.
	tabling member constituency	Altrincham and Sale West
	tabling member printed	Mr Graham Brady
	uin	7987
	answer	answer is ministerial correction date of answer 08/09/2015 answer text <p>The standards a site should be providing in order to be an appropriate site for carrying out complex cardiac surgery and other tertiary services are already set out by the professional bodies (Royal College of Surgeons, Society of Cardiothoracic Surgeons of Great Britain and Ireland) and NHS England Specialised Services service specifications.</p><p> </p> answering member constituency Ipswich answering member printed Ben Gummer question first answered 08/09/2015 15:41:56 answering member 3988 label Biography information for Ben Gummer
	tabling member	435 label Biography information for Sir Graham Brady

576850

	registered interest
	date	06/09/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the potential benefits of mobile surgical health theatres; and whether such centres are included in the Sustainability and Transformation Plans.
	tabling member constituency	St Albans
	tabling member printed	Mrs Anne Main
	uin	45270
	answer	answer is ministerial correction date of answer 15/09/2016 answer text <p>Under the Directed Enhanced Services directions to NHS England, there is a Minor Surgery Scheme, the underlying purpose of which is to ensure that a wide range of minor surgical procedures are made available as part of the primary medical services provided throughout England. Minor surgery is also one of the additional services which are set out in the General Medical Services Contract Regulations. It is for local areas to decide whether they include the development of these centres in their Sustainability and Transformation Plan.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 15/09/2016 14:41:24 answering member 4080 label Biography information for David Mowat
	tabling member	1568 label Biography information for Mrs Anne Main

649497

	registered interest
	date	01/12/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps his Department and NHS England plan to take to prevent clinical commissioning groups from rationing treatments by restricting routine surgery for patients who smoke or are clinically obese.
	tabling member constituency	North Norfolk
	tabling member printed	Norman Lamb
	uin	55790
	answer	answer is ministerial correction date of answer 06/12/2016 answer text <p>Clinical commissioning groups (CCGs) are responsible for commissioning services to meet the requirements of their population, including obese patients and smokers. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, and are based on the available evidence and take into account national guidelines.</p><p> </p><p>Major surgery poses much higher risks for severely overweight patients and those who smoke. So local general practitioner-led CCGs are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their operation. Reducing obesity and cutting smoking not only benefits patients but saves the National Health Service and taxpayers millions of pounds.</p><p> </p><p>This does not and cannot mean blanket bans on particular patients, such as smokers, getting operations, which would be inconsistent with the NHS Constitution.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 06/12/2016 14:23:43 answering member 4080 label Biography information for David Mowat
	tabling member	1439 label Biography information for Norman Lamb

92945

	registered interest
	date	13/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what recent steps he has taken to ensure that surgeons do not work excessive hours.
	tabling member constituency	Strangford
	tabling member printed	Jim Shannon
	uin	210250
	answer	answer is ministerial correction date of answer 20/10/2014 answer text <p>It is the responsibility of National Health Service trusts to ensure that service rotas are designed and staffed appropriately, and are in accordance with the Working Time Regulations.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>The Department commissioned the Royal College of Surgeons to review the impact of the Working Time Directive on the health sector. A taskforce, chaired by Professor Norman Williams and comprising of representatives from across the medical profession, met on six occasions from October 2013 to February 2014 and a report was produced.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>In relation to doctors working excessive hours, the report made recommendations that NHS trusts should review best practice in the design of working rotas and that the lack of flexibility be addressed whilst recognising doctors must not suffer undue fatigue.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>The recommendations of the report have been accepted and the relevant organisations are taking them forward.</p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 20/10/2014 16:31:56 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	4131 label Biography information for Jim Shannon

155693

	registered interest
	date	17/11/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many patients have undergone orthognathic treatment in each region of England in each of the last five years.
	tabling member printed	Lord Colwyn
	uin	HL2877
	answer	answer is ministerial correction date of answer 26/11/2014 answer text <p>Due to a lack of specific procedural codes, it is not possible to identify the number of patients who have undergone orthognathic treatment or the cost of this treatment from the data held by the Health and Social Care information Centre or the Department.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2879 question first answered 26/11/2014 12:51:01 answering member 2000 label Biography information for Earl Howe
	tabling member	3394 label Biography information for Lord Colwyn

155695

	registered interest
	date	17/11/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, for each region of England in each of the last five years, what has been the cost to the National Health Service of orthognathic treatment.
	tabling member printed	Lord Colwyn
	uin	HL2879
	answer	answer is ministerial correction date of answer 26/11/2014 answer text <p>Due to a lack of specific procedural codes, it is not possible to identify the number of patients who have undergone orthognathic treatment or the cost of this treatment from the data held by the Health and Social Care information Centre or the Department.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2877 question first answered 26/11/2014 12:51:03 answering member 2000 label Biography information for Earl Howe
	tabling member	3394 label Biography information for Lord Colwyn

166009

	registered interest
	date	25/11/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many people have had to have implants replaced within five years in each of the last five years.
	tabling member constituency	Strangford
	tabling member printed	Jim Shannon
	uin	215887
	answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>Information relating to the number of implants which have been replaced within five years is not available.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 02/12/2014 14:47:53 answering member 4020 label Biography information for George Freeman
	tabling member	4131 label Biography information for Jim Shannon

228173

	registered interest
	date	18/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what the average cost to the NHS was of a (a) hip replacement, (b) knee replacement, (c) cataract operation and (d) hernia operation in England in 2014.
	tabling member constituency	Leigh
	tabling member printed	Andy Burnham
	uin	228279
	answer	answer is ministerial correction date of answer 23/03/2015 answer text <p>The information is shown in the following table and is from reference costs, which are the average unit cost to National Health Service trusts and foundation trusts of providing defined services in a given financial year. Reference costs for acute care are collected by healthcare resource group (HRG), which are standard groupings of clinically similar treatments that consume similar levels of healthcare resource. The costs cover one episode of care under one consultant and do not include other elements of the patient pathway such as outpatient appointments.</p><p> </p><p> </p><p> </p><p>Estimated average unit cost to NHS providers in 2013-14</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>Average unit cost per one finished consultant episode</p></td></tr><tr><td><p>Hip replacement</p></td><td><p>£6,803</p></td></tr><tr><td><p>Knee replacement</p></td><td><p>£6,059</p></td></tr><tr><td><p>Cataract operation</p></td><td><p>£878</p></td></tr><tr><td><p>Hernia operation</p></td><td><p>£2,010</p></td></tr></tbody></table><p> </p><p><em>Source: </em>Reference costs, Department of Health</p><p> </p><p> </p><p> </p><p><em>Notes:</em></p><p> </p><p>1. Includes the average unit costs for the following HRGs, weighted for the activity reported for each HRG:</p><p> </p><p>HA12, Major Hip Procedures for Trauma</p><p> </p><p>HB12, Major Hip Procedures for Non-Trauma</p><p> </p><p>HA21, Major Knee Procedures for Trauma</p><p> </p><p>HB21, Major Knee Procedures for Non-Trauma</p><p> </p><p>BZ01, Enhanced Cataract Surgery</p><p> </p><p>BZ02, Phacoemulsification Cataract Extraction and Lens Implant</p><p> </p><p>BZ03, Non-Phacoemulsification Cataract Surgery</p><p> </p><p>FZ17, Abdominal Hernia Procedures</p><p> </p><p>FZ18, Inguinal, Umbilical or Femoral Hernia Procedures</p><p> </p><p>2. The majority of procedures in HA12, HB12, HA21 and HB21 are for total replacements of hip or knee joints but may include other hip or knee procedures.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 23/03/2015 17:47:11 answering member 3918 label Biography information for Jane Ellison
	tabling member	1427 label Biography information for Andy Burnham

76804

	registered interest
	date	09/07/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Surgery
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what discussions he has had with NHS England on Specialised Services Circular 1407 and its potential effect on the use of robotic assisted surgery; and if he will make a statement.
	tabling member constituency	Peterborough
	tabling member printed	Mr Stewart Jackson
	uin	204682
	answer	answer is ministerial correction date of answer 16/07/2014 answer text <p>There have been no discussions between my Rt. hon. Friend the Secretary of State and NHS England regarding Circular 1407.</p><p> </p><p>NHS England is currently developing a commissioning policy for Robotic Assisted Surgery (RAS). The national commissioning policy on RAS will ensure that patients have access to procedures and technology that will benefit them, based on a robust evidence review. Until the policy is available NHS England have not requested the cessation or reduction of any existing services but rather a pause on the introduction of any new services or on expansion of current services.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 16/07/2014 15:00:57 answering member 3918 label Biography information for Jane Ellison
	tabling member	1551 label Biography information for Lord Jackson of Peterborough