Compliance with the Patient Safety Incident Response Framework (PSIRF) is now a contractual requirement for all services commissioned under the NHS Standard Contract. Implementing the PSIRF is an ongoing process and organisations’ approach to patient safety incident response can and should evolve over time. Work is also underway to explore implementation of the PSIRF in wider services within the National Health Service, such as primary care.

The 2024 GP Patient Survey includes a question on long-term conditions, which currently lists 15 such conditions. ‘Speech, Language, and Communication Difficulties’ is not one of the specific options listed in this question in the 2024 survey.

We appreciate that there are many people in England who are living with speech, language, and communication difficulties. We must strike a careful balance between breadth of coverage and the availability of space in the questionnaire. Anyone who is living with a long-term condition which is not listed is able to select ‘Another long-term condition’.

However, we record all questionnaire feedback given to us and take it into account when we review the survey every year.

NHS England published updated policy and guidance on both Care (Education) and Treatment Reviews (C(E)TRs) and Dynamic Support Registers (DSRs) on 25 January 2023, for implementation from 1 May 2023, to help ensure people get the support they need to stay well in their communities. This includes guidance on the timescales for C(E)TRs and on ensuring that actions are taken forward.

NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of C(E)TRs and DSRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.

No such assessment has been made. NHS England wrote to systems and trusts on 25 January 2024 reiterating the need to improve accident and emergency performance for all patients requiring emergency care and emphasised some of the known best practice in emergency department processes to ensure delays to patient care are minimised.

Access to National Health Service care and treatment will always be based on clinical priority.

The number of applicants continues to outstrip the places on offer. Nursing training places are competitive, and lead to an attractive and important career in the National Health Service.

Record numbers of nurses are now working in the NHS, and the first ever NHS Long Term Workforce Plan, backed by over £2.4 billion of funding, will add 24,000 more nurse and midwifery training places by 2031.

Over the last decade, the Government and system partners have delivered major initiatives to advance patient safety in the NHS. This includes implementing the first NHS Patient Safety Strategy, establishing the independent Health Services Safety Investigations Body to address the most serious patient safety incidents, and appointing the first Patient Safety Commissioner to champion the patient voice in relation to the safety of medicines and medical devices.

Getting It Right First Time (GIRFT), in conjunction with the British Geriatrics Society, published Six Steps to Better Care for Older People in Acute Hospitals, which accompanies the GIRFT hospital acute care frailty pathway. A copy of the document is attached.

The acute care pathway recommends that all older patients admitted to hospital as an emergency are assessed for their degree of frailty using a standardised assessment, namely the Clinical Frailty Scale. For patients identified as living with moderate or severe frailty, the pathway recommends a multidomain assessment, namely the Comprehensive Geriatric Assessment, and links this to functional optimisation, which would commonly include physiotherapy assessment supporting recovery or maintenance of mobility.

Ongoing support to patients to prevent hospital-acquired deconditioning should be supported by the whole ward team after physiotherapists have recommended appropriate intervention.

The Six Steps to Better Care guidance makes similar recommendations for older patients admitted to hospital for planned care. As part of GIRFT's ongoing review and support, implementation of these recommendations is reviewed at individual hospital trusts, including the staffing levels of older person multidisciplinary teams, which include physiotherapists.

In addition, GIRFT recommends the development of Advanced Care Practitioners (ACPs) specialising in frailty. Some trusts have development programmes to support training of ACPs, although there is variation in provision.

NHS England is updating its Delivering Same-Sex Accommodation Guidance. A revised version will be published in due course.

It is imperative that National Health Service trusts respect the privacy and dignity of patients. The Government has been clear that patients should not have to share sleeping accommodation with others of the opposite sex and should have access to segregated bathroom and toilet facilities.

As set out by the former Secretary of State for Health and Social Care in October 2023, proposals to protect the privacy, dignity and safety of patients will be brought forward as part of the routine update of the NHS Constitution and its Handbook. Any measures consulted on will be in line with the Equality Act 2010, respecting the rights of all patients in hospital settings.

Following a report of manufacturing error for a medicine called Cabazitaxel, inspectors from the Medicines and Healthcare products Regulatory Agency (MHRA) visited the manufacturing facility to determine the cause of the error and assess the number of patients who were impacted. Inspectors identified that four patients had received the products, and the products had been administered several weeks previously. MHRA’s review of the incident confirmed the company had already instigated measures to contact the clinicians who were responsible for the patients’ care.

MHRA has taken regulatory action by means of an immediate partial suspension of the licence to manufacture held by Sciensus. This action was taken in accordance with Regulation 28 of the 2012 Human Medicines regulations and ensures that the error is prevented from being replicated whilst further long-term corrective actions are taken by Sciensus assure ongoing patient safety.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

In response to feedback from the profession, work is being undertaken to review the current incentive schemes in primary care, with the aim of making them more focussed and streamlined to give clinicians the flexibility to provide care that is aligned with patient needs. We will consult the profession, patients, and the broader system on primary care incentives this year to inform future reform.

NHS England has committed to a review of the Additional Roles Reimbursement Scheme by the end of 2023. This work will cover the performance of the scheme to date and inform the Government’s approach to any future support for additional clinical roles in general practice.

In addition, the Department has funded, via the National Institute for Health and Care Research, a project to look at the impact of non-general practitioner staff in practices on patient care.

The Government is clear that biological sex matters and that there are different health needs between the sexes. We have been clear that removing language around biological sex and women has the potential for unintended adverse health consequences. Language used in healthcare settings, whilst being inclusive, should use clear terms that everyone can understand.

As set out in Women’s Health Strategy, we are working with National Health Service bodies to ensure that women are properly represented in communications and guidance.

We have been clear that biological sex matters and it is important to use appropriate language that recognises the separate health and biological needs of men and women.

No review has taken place on all advice to National Health Service staff, but we continue to work with NHS bodies to ensure that women are properly represented in communications and guidance.

NHS England cannot provide relevant information to these questions without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.

To monitor industry trends, the home care providers association, the National Clinical Homecare Association, aggregates all providers’ KPIs and they have provided written evidence to the House of Lords Public Services Committee as part of their current investigation into the Homecare Medicines service which has been published. This includes data on patient safety incidents and duty of candour reports, of which a copy is attached.

The Homecare Medicines sector has delivered services to an increasing number of patients within the National Health Service in recent years and the demand for convenient ways of accessing medicines is expected to continue.

The National Clinical Homecare Association collates data and estimates approximately 500,000 patients are in receipt of a homecare medicines service in England. However, these figures have not been validated by the NHS.

NHS England collects data for its national framework agreements; however, it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.

NHS England collects data in respect of the first question for its national framework agreements, however it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. No patient level data is collected against each of the framework agreements and admissions data is not linked to homecare systems data. This reason for admission would also need to be coded correctly within the hospital records.

Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.

The National Clinical Homecare Association (NCHA) collates data and estimates approximately 500,000 patients are in receipt of a homecare medicines service in England with an estimated annual value of £3.2 billion. However, these figures have not been validated by the National Health Service.

To monitor industry trends, providers provide the same data set to the NCHA, allowing for the aggregation of all providers metrics. The NCHA reports that delivery performance of providers (delivery to patients on the agreed date) was 99.0% in 2020; 98.6% in 2021; and 98.8% in 2022.

NHS England collects data for its national framework agreements; however, it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.

NHS England cannot provide relevant information to these questions without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.

To monitor industry trends, the home care providers association, the National Clinical Homecare Association, aggregates all providers’ KPIs and they have provided written evidence to the House of Lords Public Services Committee as part of their current investigation into the Homecare Medicines service which has been published. This includes data on patient safety incidents and duty of candour reports, of which a copy is attached.

NHS England cannot provide relevant information to these questions without creation of new data and analysis derived from manual clinical review or other processes. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against the KPIs is part of this project.