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1130820

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Opioids: Prescriptions
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have, if any, to ensure that individuals prescribed opioid medication for chronic pain have their prescriptions reviewed on an annual basis.
	tabling member printed	The Lord Bishop of Carlisle
	uin	HL16187
	answer	answer is ministerial correction date of answer 24/06/2019 answer text <p>The General Medical Council’s (GMC’s) ethical guidance <em>Good practice in prescribing and managing medicines and devices (2013)</em> sets out that with all prescriptions, it is expected that clinicians make sure that suitable arrangements are in place for monitoring, follow-up and review, taking account of the patients’ needs and any risks arising from the medicines.</p><p>A copy of the GMC guidance is attached.</p> answering member printed Baroness Barran question first answered 24/06/2019 15:16:33 answering member 4703 label Biography information for Baroness Barran attachment 1 file name prescribing-guidance_pdf-59055247.pdf title Prescribing_guidance
	tabling member	4307 label Biography information for The Lord Bishop of Carlisle

1130838

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Gender Dysphoria: Children
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they intend to take to prevent the illegal supply of puberty-blocking drugs to British children and adolescents by Dr Helena Webberley, who was recently suspended from the Medical Register by the General Medical Council and who is advertising services from Spain.
	tabling member printed	Lord Moonie
	uin	HL16205
	answer	answer is ministerial correction date of answer 24/06/2019 answer text <p>It is unacceptable if patients are being put at risk by a service that deliberately places itself beyond the jurisdiction of United Kingdom regulators.</p><p>The Department is working closely with the Care Quality Commission and relevant professional regulators to explore how it can close the loopholes that allow a small number of online organisations to operate without the necessary oversight.</p> answering member printed Baroness Barran question first answered 24/06/2019 15:30:40 answering member 4703 label Biography information for Baroness Barran
	tabling member	621 label Biography information for Lord Moonie

1130872

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Mental Health Services: Contracts
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, for what reasons NHS England decided that only NHS organisations can be the lead on contracts for specialised mental health services.
	tabling member constituency	Bristol South
	tabling member printed	Karin Smyth
	uin	262408
	answer	answer is ministerial correction date of answer 18/06/2019 answer text <p>NHS England has determined that provider collaboratives for specialised mental health, learning disability and autism services will be managed by a lead provider in their local area. The lead provider will be given delegated responsibility for managing the budget and patient pathway for specialised care for their local population.</p><p>They will be monitored and held to account via a contract with NHS England, which will retain ultimate accountability for the commissioning of these services. The lead provider will work in partnership with a collaborative of National Health Service and independent sector providers to deliver care locally to their population.</p><p>Although provider collaboratives will be led by an NHS organisation, independent providers can participate in provider collaboratives and enter into partnership agreements to support the effective and efficient delivery of NHS-funded care.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 18/06/2019 16:40:20 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	4444 label Biography information for Karin Smyth

1130886

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Dementia
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what comparative estimate his Department has made of the average cost of (a) caring for a dementia patient at home with care provided by family and (b) care provided in an in-patient setting.
	tabling member constituency	Birmingham, Selly Oak
	tabling member printed	Steve McCabe
	uin	262230
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>The Department has made no such comparative estimate.</p><p>The average cost of caring for a dementia patient at home by family is not collected or reported centrally.</p><p>Data on the average cost of care provided in an in-patient setting is not available in the format requested.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 13/06/2019 13:33:32 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	298 label Biography information for Steve McCabe

1130887

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Nurses: Training
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of the effect of the removal of bursaries for undergraduate nurses on the level of nursing places filled in each institution that provides such places.
	tabling member constituency	Stroud
	tabling member printed	Dr David Drew
	uin	262214
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>The education funding reforms, which came into force in 2017, unlocked the cap which constrained the number of pre-registration nursing, midwifery and allied health profession training places allowing more students to gain access to nurse degree training courses.</p><p> </p><p>Health Education Institutes (HEIs) are autonomous private institutions and are responsible for setting the number of training places they offer. It is for HEIs to work as part of their local health economy to secure training places.</p><p>The Department does not hold information on the level of pre-registration undergraduate nursing places filled at individual HEIs, compared with the number of places they made available in the given period.</p><p>The Office for Students publishes annual data on the number of entrants onto pre-registration nursing undergraduate nursing courses broken down by individual HEIs. Higher Education Students Early Statistics have published the 2018/19 data, which is available at the following link:</p><p> </p><p><a href="https://www.officeforstudents.org.uk/data-and-analysis/data-collection/get-the-heses-and-heifes-data/" target="_blank">https://www.officeforstudents.org.uk/data-and-analysis/data-collection/get-the-heses-and-heifes-data/</a></p><p> </p><p>The Department monitors student recruitment at a national level. The latest published data from the University and Colleges Admissions Service from February 2019 shows that there has been a 4.5% increase in applicants to nursing or midwifery courses at English universities when compared to this time last year in 2018. However, we know that there is further work to do with the education and healthcare sector to ensure that students continue to apply for these places.</p><p> </p><p>The NHS Long Term Plan set out the next step in our mission to make the National Health Service a world class employer and deliver the nursing workforce the NHS needs. To deliver on these commitments the NHS has published on 3 June 2019 an interim People Plan that sets out the action we will take now and over the long term to meet the challenges of nursing supply, including nursing undergraduate supply.</p><p>We recognise, however, that there is more to do which is why the NHS will publish a final People Plan soon after the conclusion of the Spending Review.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 13/06/2019 16:26:48 answering member 1585 label Biography information for Stephen Hammond
	tabling member	252 label Biography information for Dr David Drew

1130890

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	St Andrew's Healthcare: Northampton
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many placements NHS England has commissioned at St Andrew's in-patient Child & Adolescent Mental Health Service in Northampton in the latest period for which figures are available.
	tabling member constituency	Worsley and Eccles South
	tabling member printed	Barbara Keeley
	uin	262331
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.</p><p>The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.</p><p>The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.</p><table><tbody><tr><td><p>Year</p></td><td><p>Commissioned Placements</p></td></tr><tr><td><p>2016/17</p></td><td><p>4,530</p></td></tr><tr><td><p>2017/18</p></td><td><p>4,604</p></td></tr><tr><td><p>2018/19</p></td><td><p>4,635</p></td></tr></tbody></table><p> </p><p>Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.</p><p>There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.</p><p>As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.</p><p>As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.</p><p>If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf</a></p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf</a></p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 262332 262333 262334 262335 question first answered 13/06/2019 13:32:38 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1588 label Biography information for Barbara Keeley

1130891

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Health Services: Standards
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what NHS England’s policy is on moving patients in NHS commissioned placements when the setting they are in receives a rating of Inadequate from the Care Quality Commission.
	tabling member constituency	Worsley and Eccles South
	tabling member printed	Barbara Keeley
	uin	262332
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.</p><p>The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.</p><p>The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.</p><table><tbody><tr><td><p>Year</p></td><td><p>Commissioned Placements</p></td></tr><tr><td><p>2016/17</p></td><td><p>4,530</p></td></tr><tr><td><p>2017/18</p></td><td><p>4,604</p></td></tr><tr><td><p>2018/19</p></td><td><p>4,635</p></td></tr></tbody></table><p> </p><p>Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.</p><p>There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.</p><p>As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.</p><p>As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.</p><p>If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf</a></p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf</a></p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 262331 262333 262334 262335 question first answered 13/06/2019 13:32:38 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1588 label Biography information for Barbara Keeley

1130892

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Health Services: Standards
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what guidance NHS England has given to (a) clinical commissioning groups and (b) other NHS bodies on moving patients in NHS commissioned placements when the setting they are in receives a rating of Inadequate from the Care Quality Commission.
	tabling member constituency	Worsley and Eccles South
	tabling member printed	Barbara Keeley
	uin	262333
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.</p><p>The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.</p><p>The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.</p><table><tbody><tr><td><p>Year</p></td><td><p>Commissioned Placements</p></td></tr><tr><td><p>2016/17</p></td><td><p>4,530</p></td></tr><tr><td><p>2017/18</p></td><td><p>4,604</p></td></tr><tr><td><p>2018/19</p></td><td><p>4,635</p></td></tr></tbody></table><p> </p><p>Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.</p><p>There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.</p><p>As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.</p><p>As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.</p><p>If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf</a></p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf</a></p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 262331 262332 262334 262335 question first answered 13/06/2019 13:32:38 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1588 label Biography information for Barbara Keeley

1130893

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Mental Health Services: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many placements in Assessment and Treatment Units NHS England have commissioned for patients under the age of 18 in each of the past 3 years.
	tabling member constituency	Worsley and Eccles South
	tabling member printed	Barbara Keeley
	uin	262334
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.</p><p>The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.</p><p>The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.</p><table><tbody><tr><td><p>Year</p></td><td><p>Commissioned Placements</p></td></tr><tr><td><p>2016/17</p></td><td><p>4,530</p></td></tr><tr><td><p>2017/18</p></td><td><p>4,604</p></td></tr><tr><td><p>2018/19</p></td><td><p>4,635</p></td></tr></tbody></table><p> </p><p>Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.</p><p>There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.</p><p>As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.</p><p>As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.</p><p>If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf</a></p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf</a></p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 262331 262332 262333 262335 question first answered 13/06/2019 13:32:38 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1588 label Biography information for Barbara Keeley

1130894

	registered interest
	date	10/06/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Mental Health Services: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many placements in in-patient mental health hospitals for children and young people under the age of 18 with (a) autism, (b) a learning disability and (c) a mental health condition NHS England has commissioned in each of the past 3 years.
	tabling member constituency	Worsley and Eccles South
	tabling member printed	Barbara Keeley
	uin	262335
	answer	answer is ministerial correction date of answer 13/06/2019 answer text <p>In 2018/19, NHS England commissioned 57 placements at St Andrew’s in-patient Child and Adolescent Mental Health Service (CAMHS) in Northampton. This is the total number of admissions during the period. Patients may have been admitted more than once during the same period, each admission will be counted separately.</p><p>The information requested on placements in different inpatient settings is either not available in the format requested or not held centrally.</p><p>The total number of placements in CAMHS Tier 4 in-patient units commissioned by NHS England in each of the past three years is set out in the following table. These figures represent admissions for patients under the age of 18.</p><table><tbody><tr><td><p>Year</p></td><td><p>Commissioned Placements</p></td></tr><tr><td><p>2016/17</p></td><td><p>4,530</p></td></tr><tr><td><p>2017/18</p></td><td><p>4,604</p></td></tr><tr><td><p>2018/19</p></td><td><p>4,635</p></td></tr></tbody></table><p> </p><p>Whilst the Assuring Transformation data set records the number of people with learning disabilities and/or autism who are inpatient settings, we are unable to provide the information requested as such information can only be obtained at disproportionate cost.</p><p>There are a number of steps that NHS England may take following any Care Quality Commission (CQC) visit if an inadequate rating is received. A cross stakeholder quality risk profile (QRP) assessment will be undertaken where relevant parties, including the CQC, NHS England and NHS Improvement, the provider and clinical commissioning group (CCG) would meet to discuss the risks via an assessment tool and discuss them to identify any required action as a consequence.</p><p>As part of that process, there would be clear discussion regarding the areas that led to inadequate ratings and how they relate to patients in the care of that specific facility. A decision would then be taken as to whether there is enough assurance that current actions will address the concerns or whether the level of assurance is such that escalation to a single item quality surveillance group (QSG) or a risk summit with the provider is required.</p><p>As part of this process, there would be discussions around actions required and whether it would be appropriate to provide additional support to facilities in terms of additional staff and specialist staff. An individual assessment would be undertaken of patients including their capacity and ability to consent to any continuation of their care or movement of care.</p><p>If it is determined that the appropriate action is to close the inpatient facility and any patient is to be moved, there would be whole system coordination by NHS England, CCGs, the CQC and the provider, whereby information from the individual risk assessment would inform prioritisation for the move. In terms of guidance given to other stakeholders on these processes there is a Standard Operating Procedure along with guidance on risk summits and QSGs. These are available at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/risk-summit-guidance-july-2017.pdf</a></p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2017/07/quality-surveillance-groups-guidance-july-2017.pdf</a></p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 262331 262332 262333 262334 question first answered 13/06/2019 13:32:38 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1588 label Biography information for Barbara Keeley