‘Centralised procurement’ can sometimes be used to refer to the services of NHS Supply Chain. NHS Supply Chain offers a procurement and logistics service to all National Health Service trusts in the United Kingdom under a central service contract on behalf of NHS Business Services Authority.

There is currently no centralised procurement model mandated to the NHS by the Department, and as such no assessment has been made as to an effect on patients or patient choice. NHS trusts may choose to utilise the service offering of NHS Supply Chain, or choose an alternative. It is for NHS trusts to make their own choices with regard to products and services they purchase; therefore it is for individual trusts to assess any impact on patients and patient choice.

The information is not held in the format requested.

The National Information Board’s strategy document Personalised Health and Care 2020 (published November 2014) set out the aim to support greater uptake of the use of digital systems in health and care to create a National Health Service paper free at the point of care by 2020. This will remove the system’s reliance on paper and will help reduce postal service costs for the NHS.

In the case of appointment letters for patients the new NHS e-referral system, introduced last year, already allows healthcare providers to choose not to send out appointment letters, instead allowing patients to access the information directly from the NHS e-referral system. Patients have an option to print off the details of their appointment if they prefer to have a paper copy of the information. We expect increasing numbers of providers will use this functionality to help contain costs.

The NHS Constitution includes the following pledge: “The NHS commits to inform you of research studies in which you may be eligible to participate”. The Department, via the National Institute for Health Research (NIHR), has a number of initiatives to deliver on the pledge, including the UK Clinical Trials Gateway (https://www.ukctg.nihr.ac.uk/) which is a public website where patients, carers and clinicians can find out about clinical studies current studies underway.

The NIHR runs an annual national campaign called ‘Ok to ask’, to encourage the public to ask their clinician about research participation; more specifically, in 2014, the NIHR launched Join Dementia Research to encourage 100,000 people to volunteer to participate in dementia research by 2020; finally, through the NIHR Clinical Research Networks, last year 618,000 patients were recruited by NHS Providers into clinical trials.

The latest figures available for November 2015 show 7.97 million patients are registered to enable them to book and cancel appointments online. This represents 13.9% of the general practitioner registered population.

Responsibility for issuing patient safety advice to the healthcare system in the form of patient safety alerts transferred from the National Patient Safety Agency to NHS England in June 2012. Between June 2012 – December 2013 one Patient Safety Alert (NHS/PSA/W/2013/001: ‘Placement devices for nasogastric tube insertion DO NOT replace initial position checks’) was issued on 5 December 2013. To date, all providers have reported this alert as either ‘complete’ or ‘action not required’.

During the period in question NHS England maintained a constant review of patient safety incidents reported to the National Reporting and Learning System involving death and severe harm and, had an urgent patient safety issue needing alerting been identified, an alert would have been issued.

No patient communications will occur until the independent expert Dame Fiona Caldicott, as National Data Guardian, has reviewed them and provided advice.

NHS England currently has no plans to ask the Department to consider making any changes in respect of those provisions of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, as amended, that relate to dispensing appliance contractors. If NHS England were to undertake a review of the regulatory arrangements concerning dispensing appliance contractors, it would take account of a range of factors including the views of patients, consumers and business.

NHS England currently has no plans to ask the Department to consider making any changes in respect of those provisions of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, as amended, that relate to dispensing appliance contractors. If NHS England were to undertake a review of the regulatory arrangements concerning dispensing appliance contractors, it would take account of a range of factors including the views of patients, consumers and business.

The CPRD GOLD primary care database (former GPRD) includes information about all prescriptions issued in primary care for a subset of approximately 8% of the United Kingdom population. This database has previously been used to study prescribing of anxiolytic, hypnotic and psychotropic medication, commonly referred to as tranquilisers.

It would be possible to use the database to estimate the number of patients in the UK with a long-term dependency on prescription tranquilisers. However, as dependence will not be systematically identified by general practitioners, expert clinician advice would also be required to develop a definition. This could be based on frequency of prescribing and medication strength but could also include clinical codes for medical conditions including indications for these products, drug dependency and substance abuse, if recorded.

This work would represent a research project and as such, a scientific protocol would need to be submitted to the Medicines and Healthcare products Regulatory Agency’s Independent Scientific Advisory Committee for assessment and possible approval.

Even with such an approach, the rate of drug dependency in the population could only be estimated, and in order to assess whether this estimate was a true representation of the actual rate of drug dependency in this population, a validation study would be encouraged.

The Department is looking into the feasibility of commissioning further research on patterns of long-term prescription of dependency-forming medicines, including analyses of relevant prescribing data.

This is a historic partnership between local organisations in Greater Manchester (GM), with general practitioners as clinical leaders working with elected leaders to improve services for people living in the area.

The National Health Service bodies involved, including NHS England and the relevant clinical commissioning groups, will remain statutorily accountable for the exercise of their functions. GM will work collaboratively with local non-GM bodies and take into account the impact of GM decisions upon non-GM bodies and their communities.

The fundamental national policies including Choice, inspection regimes, guidance and regulations will continue to apply to GM but, in line with the Five Year Forward View published by NHS England, GM will exercise greater freedom in how they are implemented so that local services better reflect the priorities of local patients and service users.

There are no licensing requirements to open a private dispensing appliance contractor business. NHS England is responsible for determining whether a dispensing appliance contractor should be granted the right to provide National Health Service pharmaceutical services. Such determinations can generally be appealed to the Family Health Services Appeal Unit of the NHS Litigation Authority.

The Department keeps the operation of the relevant NHS regulations governing the right to provide NHS pharmaceutical services under regular review with NHS England, the NHS Litigation Authority and contractors’ representatives, as appropriate. We are not aware of any significant issues regarding the impact of these arrangements on small and medium-sized businesses offering continence products nor on the adoption of innovation in the NHS.

The introduction of the Friends and Family Test (FFT) was announced in May 2012. Implementation began in April 2013 and is due to be completed by end March 2015. NHS England is responsible for implementing the FFT.

NHS service providers are responsible for funding their own implementation of the FFT as a requirement of their National Health Service contract. Information about these costs is not available centrally. NHS England has a national programme that co-ordinates implementation of the FFT. During 2013/14 and, to date, during 2014/15 the programme has spent £5,499,915. This includes work directly with NHS service providers to support and advise on implementation.

The FFT has a number of strengths against which costs need to be considered.

We have made no such assessment and are not aware of reported delays in patients obtaining the appliances prescribed for them, including continence and ostomy products. There are no licensing requirements to open a private dispensing appliance contractor business. NHS England is responsible for determining whether a dispensing appliance contractor should be granted the right to provide National Health Service pharmaceutical services. Such determinations can generally be appealed to the Family Health Services Appeal Unit of the NHS Litigation Authority.

The Department keeps the operation of the relevant NHS regulations governing the right to provide NHS pharmaceutical services under regular review with NHS England, the NHS Litigation Authority and contractors’ representatives as appropriate.

The National Institute for Health Research (NIHR) Clinical Research Network (CRN) makes it possible for patients to participate in relevant research. The CRN supports the set-up and timely delivery of commercial and non-commercial trials and studies in the National Health Service in England. The number of CRN-hosted studies in stroke as main specialty, and recruitment to these studies, has increased substantially since 2008/09.

Data on the number of CRN trials (phases I to IV) and other well-designed studies open in each year in stroke, and recruitment to these trials and studies is shown in the following table.

Recruitment to stroke studies was lower in 2013/14 than in 2012/13 as several large multi-centre studies with high recruitment targets closed. In addition, there has been change in the overall composition of the stroke study portfolio, with an increased number of single-centre and earlier phase studies with smaller recruitment targets.

It is for local commissioners and providers to make decisions on making new technologies available to their patients, taking the evidence of their clinical and cost-effectiveness into account.

NHS England has set out its ambition to accelerate useful health innovation in its Five Year Forward View and the National Information Board has recently outlined how the National Health Service will respond to digital transformations in Personalised Health and Care 2020 – Using Data and Technology to Transform Outcomes for Patients and Citizens.

Patient experience surveys are a valuable source of evidence and the results are used in a range of ways, including the assessment of National Health Service performance as well as in regulatory activities such as registration, monitoring ongoing compliance and reviews. The Care Quality Commission has developed a new Intelligent Monitoring tool to give inspectors a clear picture of the areas of care that need to be followed up within an NHS acute trust or a specialist NHS trust. The system is built on a set of indicators that look at a range of information including patient experience, staff experience and performance.

In addition to the patient experience surveys hospital boards and other providers and commissioners of services can also consider the results of the Friends and Family Test (FFT) to consider the implications for quality and safety. While not a traditional survey, the FFT provides near real-time feedback to identify both good and poor quality patient experience. A NHS England review of the FFT found that it is performing well as a service improvement tool, with 85% of trusts reporting that it is being used to improve patient experience, and 78% saying that FFT has increased the emphasis placed on patient experience in their trusts.