​While we are aware of the background behind the question, we have not specifically raised this issue with the Israeli Government. We strongly condemn all acts of terrorism and call upon Hamas and other terrorist groups to permanently end their incitement and rocket fire against Israel. We are also aware that Israeli restrictions severely restrict the movement of medical professionals and patients in Gaza, hampering the provision of quality health services. Our Embassy to Israel regularly raises the matter of medical permits with the Israeli authorities.

The movement restrictions and the serious constraints imposed by the occupation impact the health of the population as well as the further development of quality health services, especially in Gaza. We remain deeply concerned about restrictions on movement and access in Gaza, and the impact that this is having on the humanitarian situation. We have frequent discussions with the Government of Israel and Egypt about the need to ease restrictions on Gaza. We call on the Israeli Government to ease restrictions further and for Israel, the Palestinian Authority and Egypt to work together to ensure a durable solution for Gaza.

​

The number of registered patients in each of the specified clinical commissioning group (CCG) areas as at 1 April 2016 is shown in the following table.

Source: Information extracted on a quarterly basis from the General Practice payments system, which is maintained by the Health and Social Care Information Centre.

The information is not available in the format requested. Such information as is available is in the following table.

Number of patients registered in April 2015 versus April 2016:

Source: Health and Social Care Information Centre (HSCIC)

Notes:

1. The above table shows the total number of patients registered at general practitioner (GP) practices within the named CCGs, on the specified dates. This information is extracted on a quarterly basis from the GP Payments System, which is maintained by the HSCIC.
2. The HSCIC has provided the difference between the number of patients registered at GP practices in the named CCGs on 1 April 2015 and 1 April 2016. However, the HSCIC cannot provide the number of ‘new’ registrations.
3. It is possible that individuals are double counted, e.g. students registered at their home address and university. It is also possible that individuals are removed, e.g. GP cleaning off duplications.
4. The data is also published on the HSCIC website: http://www.hscic.gov.uk/catalogue/PUB20480

It is important that practices are free to meet the needs of individual patients according to clinical need. Therefore there is no requirement on general practitioner practices to offer appointments of a specific length or a specific mix of workforce to meet population need.

However, in recognition of the increased demands being placed on general practice, NHS England has:

1. Placed a requirement on clinical commissioning groups (CCGs) in the NHS Planning Guidance for 2016/17 to develop and implement a local plan to address the sustainability and quality of general practice, including workforce and workload issues. This is the first time specific requirements have been placed on local commissioners to support and develop general practice.

2. Provided advice about specific ways to invest in general practice for National Health Service leaders as they prepare Sustainability and Transformation Plans for the future. In both of these, there is a dual focus on maintaining quality and access to care in existing services, while also supporting the introduction of new ways of working. Areas where support is required include increased funding, growth and diversification in the workforce, development of premises and information technology, and specific help to develop networks and federations with patient benefit at their heart.

The ‘General Practice Forward View’ released in April 2016, announced a major new programme of development and improvement support for practices over the next three years. This will help groups of practices to redesign care in order to simultaneously release staff time and improve care for patients. As part of the development programme, support and advice will be provided to federations and CCGs on ways to engage patients and voluntary and community sector groups as partners. This will help local people shape priorities, contribute to the co-design of improved services and build assets in the community.

Patient safety continues to be paramount and the rules include a ‘break glass’ provision for trusts should there be a need to pay in excess of the agency price caps for patient safety reasons. Trust boards are responsible for monitoring the impact of price caps and ensuring patient safety. More broadly, the Care Quality Commission Chief Inspector of Hospitals has been clear that he wants to see fewer agency staff because of the patient safety implications - continuity of care being so important to good services for patients.

It is important that practices are free to meet the needs of individual patients according to clinical need. Therefore there is no requirement for general practitioner practices to offer appointments of a specific length or a specific mix of workforce to meet population need.

However, in recognition of the increased demands being placed on general practice, NHS England has:

1. Placed a requirement on clinical commissioning groups (CCGs) in the NHS Planning Guidance for 2016/17 to develop and implement a local plan to address the sustainability and quality of general practice, including workforce and workload issues. This is the first time specific requirements have been placed on local commissioners to support and develop general practice.

2. Provided advice about specific ways to invest in general practice for National Health Service leaders as they prepare Sustainability and Transformation Plans for the future. In both of these, there is a dual focus on maintaining quality and access to care in existing services, while also supporting the introduction of new ways of working. Areas where support is required include increased funding, growth and diversification in the workforce, development of premises and information technology, and specific help to develop networks and federations with patient benefit at their heart.

The ‘General Practice Forward View’ released in April 2016, announced a major new programme of development and improvement support for practices over the next three years. This will help groups of practices to redesign care in order to simultaneously release staff time and improve care for patients. As part of the development programme, support and advice will be provided to federations and CCGs on ways to engage patients and voluntary and community sector groups as partners. This will help local people shape priorities, contribute to the co-design of improved services and build assets in the community.

These data are not collected centrally.

Data on numbers of patients registered with general practitioner (GP) practices is published quarterly by the Health and Social Care Information Centre (HSCIC) in a report entitled 'Number of Patients Registered at a GP Practice'. The latest available version is April 2016 and is available from the HSCIC website at:

http://www.hscic.gov.uk/catalogue/PUB20480

The information requested is not held centrally.

We recognise the vital job that general practitioners (GPs) do. We know how hard GPs and their practice teams work and the challenges that they are facing in providing care for growing numbers of older people and patients with more complex needs.

Figures from the Health and Social Care Information Centre show that the number of patients registered with a GP has increased from 28,595,310 in 2015 to 28,893,403 in 2016, an increase of 1.0%. The GP Patient Survey, published in January 2016 shows a slight decline in the number of patients reporting that they are able to get a convenient GP appointment. Taken together, this suggests that GP workload may be increasing.

The Government is committed to providing the support GPs need so they can spend more time with patients. The new contract will see an investment of £220 million for 2016 to 2017, and we are keen to reduce administrative demands on those delivering care where practicable.

We are also investing in the primary and community care workforce and are committed to increasing the workforce by 10,000 by 2020, including an extra 5,000 doctors working in general practice.

GPs are changing the way patients can access GP appointments, not just 9am to 5pm Monday to Friday. The Prime Minister’s GP Access Fund is a £175 million investment to test improved and innovative methods of accessing general practice, including opening from 8am to 8pm on weekdays and weekends; better use of telecare and apps; more innovative ways to access services by video call, telephone and email; and more integrated services.

These are matters for the National Health Service.

It is for the local NHS, in conjunction with NHS England as specialised commissioners, to effect change.

We are advised by NHS England that following authorisation as a foundation trust, Mersey Care NHS Trust intends to acquire Calderstones.

We expect consideration of patients’ interests to be paramount. The re-provision of care will be considered on a case by case basis and we expect patients and their families to be supported throughout the transition process.

These are matters for the National Health Service.

It is for the local NHS, in conjunction with NHS England as specialised commissioners, to effect change.

We are advised by NHS England that following authorisation as a foundation trust, Mersey Care NHS Trust intends to acquire Calderstones.

We expect consideration of patients’ interests to be paramount. The re-provision of care will be considered on a case by case basis and we expect patients and their families to be supported throughout the transition process.

The publication General and Personal Medical Services contains the aggregated number of registered patients at 30 September each year, but the average over the course of the year is not held centrally. Tables for each of the last 15 years have been placed in the Library. They provide snap-shot data as at 30 September for that year.

The community pharmacy proposals for 2016/17 and beyond, on which we are consulting, are being considered in respect to the public sector equality duty, the family test and relevant duties of the Secretary of State under the National Health Service Act 2006. The latter includes the duty as to improvement in quality of services, such as the safety of services.

At this stage we would note that all pharmacists, pharmacy technicians and pharmacies are regulated by the General Pharmaceutical Council, which protects, promotes and maintains the health, safety and wellbeing of members of the public by upholding standards and public trust in pharmacy. Also, under NHS pharmaceutical services, community pharmacies are required to meet clinical governance requirements, which encourage continuing quality improvement, including through risk management.

An impact assessment will be completed to inform final decisions and published in due course.

Community pharmacy is a vital part of the National Health Service and can play an even greater role. In the Spending Review the Government re-affirmed the need for the NHS to deliver £22 billion in efficiency savings by 2020/21 as set out in the NHS’s own plan, the Five Year Forward View. Community pharmacy is a core part of NHS primary care and has an important contribution to make as the NHS rises to these challenges. The Government believes efficiencies can be made without compromising the quality of services or public access to them. Our aim is to ensure that those community pharmacies upon which people depend continue to thrive and so we are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared to others, considering factors such as location and the health needs of the local population.

The Government’s vision is for a more efficient, modern system that will free up pharmacists to spend more time delivering clinical and public health services to the benefit of patients and the public.

We are consulting the Pharmaceutical Services Negotiating Committee, other pharmacy bodies and patient and public representatives on our proposals.

Summary Care Records are being introduced to improve the safety and quality of patient care. The Summary Care Record is a single electronic record held centrally so will give healthcare staff faster, easier access to essential information and help to give patients safe treatment during an emergency or when their general practitioner (GP) surgery is closed.

55.06 million people have had a Summary Care Record created and the Summary Care Record is currently enabled in 102 out of 154 Out of Hours GP Services.

The Department is aware that three general practitioner practices in Clacton have temporarily closed their list to new patients. This is a matter for NHS England.

NHS England advises that it is working with these practices to agree actions needed to re-open their lists in the near future.

The Healthcare Travel Costs Scheme allows patients on low incomes and those in receipt of specific qualifying benefits or allowances to be reimbursed in part or in full for costs incurred in travelling to receive certain NHS services. Eligible patients can claim payment of travel expenses to appointments made to receive non-primary medical and non-primary dental services when referred by a primary care practitioner. There are no mileage restrictions on this scheme.

From 5 January 2015, all GP practices are able to register new patients who live outside the practice area.

NHS England has been reviewing the numbers of patients registering with practices away from their home address and have also been monitoring the number of patients who have had cause to seek in hours care whilst at their home address. To date, NHS England has not reviewed the effectiveness of community health services.

As at 1 November 2015, 33,347 patients in England were registered as out of area patients.