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1171845

registered interest
date	20/01/2020
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	Epilepsy: Drugs
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 epilepsy is allocated one point in the General Medical Services Statement of Financial Entitlements (Amendment) Directions 2019; and what steps GPs take to ensure that women of child bearing age who are prescribed Valporate are enrolled in a pregnancy prevention programme.
tabling member constituency	Lancaster and Fleetwood
tabling member printed	Cat Smith
uin	5459
answer	answer is ministerial correction date of answer 23/01/2020 answer text <p>Changes to the Quality and Outcomes Framework (QOF)- including allocation of points- are agreed as part of wider amendments to the General Medical Services (GMS) Contract. These changes are negotiated by NHS England and the British Medical Association’s (BMA) General Practitioners Committee England. Guidance on the 2019/20 GMS Contract concerning the QOF was published by the BMA and NHS England in April 2019. This guidance includes an epilepsy indicator which states that ‘the contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy’. QOF points are generally weighted to the estimated workload associated with an indicator. Registers generally incur a lower workload than other indicators and therefore tend to attract a lower points value than other types of indicators.</p><p> </p><p>Care of patients with long term conditions in general practice is described in the essential services element of the contract and funded through the global sum payment. Patients should expect to receive high quality care irrespective of whether or not their condition is included in the QOF. The QOF indicators will continued to be reviewed going forward.</p><p> </p><p>It is a Care Quality Commission regulatory requirement for general practitioners (GPs) to follow the Medicines and Healthcare products Regulatory Agency’s (MHRA) guidance on valproate prescribing. The MHRA advises that ‘Valproate medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place’.</p><p> </p><p>NHS England are also taking broader action to support implementation of the MHRA pregnancy prevention guidelines. In April 2019, they introduced a new Quality Improvement module on prescribing safety into the QOF. As part of this module they expect practices to audit three measures, one of which is that girls and women of childbearing potential currently being prescribed valproate have had an annual specialist medication review and are taking this in compliance with the pregnancy prevention programme as documented by a specialist in the annual risk acknowledgement form. It is the responsibility of every healthcare professional involved in the prescribing and dispensing of valproate medicines to make sure women are aware of the risks and are on the pregnancy prevention programme.</p><p> </p> answering member constituency Bury St Edmunds answering member printed Jo Churchill grouped question UIN 5460 question first answered 23/01/2020 17:19:31 answering member 4380 label Biography information for Jo Churchill
tabling member	4436 label Biography information for Cat Smith

1171846

registered interest
date	20/01/2020
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	Epilepsy: Drugs
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 no points have been allocated to ongoing management for epilepsy medication in the General Medical Services contract Quality and Outcomes Framework.
tabling member constituency	Lancaster and Fleetwood
tabling member printed	Cat Smith
uin	5460
answer	answer is ministerial correction date of answer 23/01/2020 answer text <p>Changes to the Quality and Outcomes Framework (QOF)- including allocation of points- are agreed as part of wider amendments to the General Medical Services (GMS) Contract. These changes are negotiated by NHS England and the British Medical Association’s (BMA) General Practitioners Committee England. Guidance on the 2019/20 GMS Contract concerning the QOF was published by the BMA and NHS England in April 2019. This guidance includes an epilepsy indicator which states that ‘the contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy’. QOF points are generally weighted to the estimated workload associated with an indicator. Registers generally incur a lower workload than other indicators and therefore tend to attract a lower points value than other types of indicators.</p><p> </p><p>Care of patients with long term conditions in general practice is described in the essential services element of the contract and funded through the global sum payment. Patients should expect to receive high quality care irrespective of whether or not their condition is included in the QOF. The QOF indicators will continued to be reviewed going forward.</p><p> </p><p>It is a Care Quality Commission regulatory requirement for general practitioners (GPs) to follow the Medicines and Healthcare products Regulatory Agency’s (MHRA) guidance on valproate prescribing. The MHRA advises that ‘Valproate medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place’.</p><p> </p><p>NHS England are also taking broader action to support implementation of the MHRA pregnancy prevention guidelines. In April 2019, they introduced a new Quality Improvement module on prescribing safety into the QOF. As part of this module they expect practices to audit three measures, one of which is that girls and women of childbearing potential currently being prescribed valproate have had an annual specialist medication review and are taking this in compliance with the pregnancy prevention programme as documented by a specialist in the annual risk acknowledgement form. It is the responsibility of every healthcare professional involved in the prescribing and dispensing of valproate medicines to make sure women are aware of the risks and are on the pregnancy prevention programme.</p><p> </p> answering member constituency Bury St Edmunds answering member printed Jo Churchill grouped question UIN 5459 question first answered 23/01/2020 17:19:31 answering member 4380 label Biography information for Jo Churchill
tabling member	4436 label Biography information for Cat Smith

1171854

registered interest
date	20/01/2020
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	Doctors: Pensions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of reducing the annual allowance for pension growth on senior doctors and consultants in the NHS retiring early.
tabling member constituency	Gower
tabling member printed	Tonia Antoniazzi
uin	5504
answer	answer is ministerial correction date of answer 23/01/2020 answer text <p>The Department recognises that the annual allowance may contribute to decisions from National Health Service consultants to retire early or limit their NHS commitment. The Government is listening carefully to concerns raised by senior doctors and NHS employers about the tapered annual allowance.</p><p>In September 2019 guidance was issued by NHS Employers informing employers of the short-term approaches that they could take to mitigate the effect of pension tax on their workforce this tax year. The NHS has also implemented an immediate measure to preserve clinical capacity amid the increased pressure on services during the winter period. This will compensate NHS clinicians for the effect on their pensions of annual allowance charged incurred in 2019-20.</p><p>The Department has consulted on introducing flexibility within the NHS Pension Scheme from 2019/20 to allow clinicians affected by annual allowance tax charges to reduce their pension accrual in deciles in order to manage any potential annual allowance tax charges.</p><p>As part of a wider drive to ensure the NHS has the staff it needs to meet demand and transform care, the Government is carrying out an urgent review of the pensions annual allowance taper problem that has caused some doctors to turn down extra shifts for fear of high tax bills. On 13 January, Ministers held a roundtable with the Academy of Medical Royal Colleges, the British Medical Association and other representative organisations as part of this review to find a long-term solution.</p><p>The review will consider the findings from the Department’s consultation on pension flexibility and will report at the Budget on 11 March.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Charnwood answering member printed Edward Argar grouped question UIN 5505 question first answered 23/01/2020 12:14:14 answering member 4362 label Biography information for Edward Argar
tabling member	4623 label Biography information for Tonia Antoniazzi

1171855

registered interest
date	20/01/2020
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	Doctors: Pensions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what representations he has received from senior doctors and consultants on changes to the NHS Pension Scheme.
tabling member constituency	Gower
tabling member printed	Tonia Antoniazzi
uin	5505
answer	answer is ministerial correction date of answer 23/01/2020 answer text <p>The Department recognises that the annual allowance may contribute to decisions from National Health Service consultants to retire early or limit their NHS commitment. The Government is listening carefully to concerns raised by senior doctors and NHS employers about the tapered annual allowance.</p><p>In September 2019 guidance was issued by NHS Employers informing employers of the short-term approaches that they could take to mitigate the effect of pension tax on their workforce this tax year. The NHS has also implemented an immediate measure to preserve clinical capacity amid the increased pressure on services during the winter period. This will compensate NHS clinicians for the effect on their pensions of annual allowance charged incurred in 2019-20.</p><p>The Department has consulted on introducing flexibility within the NHS Pension Scheme from 2019/20 to allow clinicians affected by annual allowance tax charges to reduce their pension accrual in deciles in order to manage any potential annual allowance tax charges.</p><p>As part of a wider drive to ensure the NHS has the staff it needs to meet demand and transform care, the Government is carrying out an urgent review of the pensions annual allowance taper problem that has caused some doctors to turn down extra shifts for fear of high tax bills. On 13 January, Ministers held a roundtable with the Academy of Medical Royal Colleges, the British Medical Association and other representative organisations as part of this review to find a long-term solution.</p><p>The review will consider the findings from the Department’s consultation on pension flexibility and will report at the Budget on 11 March.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Charnwood answering member printed Edward Argar grouped question UIN 5504 question first answered 23/01/2020 12:14:14 answering member 4362 label Biography information for Edward Argar
tabling member	4623 label Biography information for Tonia Antoniazzi

1171856

registered interest
date	20/01/2020
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	Dental 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 children under ten years old had tooth extractions in Bradford in each year since 2010.
tabling member constituency	Bradford East
tabling member printed	Imran Hussain
uin	5449
answer	answer is ministerial correction date of answer 28/01/2020 answer text <p>The data is not held in the format requested.</p> answering member constituency Bury St Edmunds answering member printed Jo Churchill question first answered 28/01/2020 17:59:39 answering member 4380 label Biography information for Jo Churchill
tabling member	4394 label Biography information for Imran Hussain

1171858

registered interest
date	20/01/2020
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	Dental 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 children aged under ten years old in Bradford were admitted to hospital for tooth decay in each year since 2010.
tabling member constituency	Bradford East
tabling member printed	Imran Hussain
uin	5450
answer	answer is ministerial correction date of answer 29/01/2020 answer text <p>A table showing the count of finished admission episodes with a primary diagnosis of dental caries (tooth decay) for patients aged under 10 years old and that are resident in the Bradford area is attached.</p> answering member constituency Bury St Edmunds answering member printed Jo Churchill question first answered 29/01/2020 11:26:52 answering member 4380 label Biography information for Jo Churchill attachment 1 file name PQ5450 table formatted.xlsx title pq5450 table
tabling member	4394 label Biography information for Imran Hussain

1171859

registered interest
date	20/01/2020
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	Dental Services: Bradford
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what the cost was to the public purse of tooth extractions in Bradford in each year since 2010.
tabling member constituency	Bradford East
tabling member printed	Imran Hussain
uin	5451
answer	answer is ministerial correction date of answer 29/01/2020 answer text <p>The information is not available in the format requested.</p> answering member constituency Bury St Edmunds answering member printed Jo Churchill question first answered 29/01/2020 10:29:14 answering member 4380 label Biography information for Jo Churchill
tabling member	4394 label Biography information for Imran Hussain

1171860

registered interest
date	20/01/2020
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	Dental Services: Bradford
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how much revenue was raised by NHS England from dental practices in Bradford in each year since 2010.
tabling member constituency	Bradford East
tabling member printed	Imran Hussain
uin	5452
answer	answer is ministerial correction date of answer 28/01/2020 answer text <p>Data is not held in the format requested.</p> answering member constituency Bury St Edmunds answering member printed Jo Churchill grouped question UIN 5453 question first answered 28/01/2020 18:00:55 answering member 4380 label Biography information for Jo Churchill
tabling member	4394 label Biography information for Imran Hussain

1171862

registered interest
date	20/01/2020
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	Dental Services: Bradford
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how much revenue raised by NHS England's dental practices was re-invested in dental practices in Bradford in each year from 2010.
tabling member constituency	Bradford East
tabling member printed	Imran Hussain
uin	5453
answer	answer is ministerial correction date of answer 28/01/2020 answer text <p>Data is not held in the format requested.</p> answering member constituency Bury St Edmunds answering member printed Jo Churchill grouped question UIN 5452 question first answered 28/01/2020 18:00:56 answering member 4380 label Biography information for Jo Churchill
tabling member	4394 label Biography information for Imran Hussain

1171869

registered interest
date	20/01/2020
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	Accident and Emergency Departments: 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 plans he has forreplacement for the four-hour A&E target time to improve the efficiency of (a) health services and (b) patient care.
tabling member constituency	Ceredigion
tabling member printed	Ben Lake
uin	5506
answer	answer is ministerial correction date of answer 23/01/2020 answer text <p>At the Government’s request, NHS England and NHS Improvement are working with clinical leaders across the system to review our standards as part of the clinically-led review of access standards. The recommendations of the review will be carefully studied, and any recommended changes will be based on clinical evidence to ensure the best outcome for patients. We will update on this in due course.</p><p> </p><p> </p><p> </p> answering member constituency Charnwood answering member printed Edward Argar question first answered 23/01/2020 14:46:28 answering member 4362 label Biography information for Edward Argar
tabling member	4630 label Biography information for Ben Lake