NHS England surveys capture the experiences of people with a wide range of conditions including diabetes but, with the exception of the cancer patient experience survey, they are not condition specific. As part of a forthcoming review of patient experience surveys, NHS England will consider whether it is best to collect information as it does currently or by specific conditions.

Professor Jonathan Valabhji, the National Clinical Director, has reported that last year’s Patient Experience of Diabetes Services pilot survey, which collected information from people with diabetes about their care, received very positive feedback.

As of 31 January 2015 the number of people in England who hold a valid medical exemption certificate is 1,769,872. This is based on the number of certificates issued by the NHS Business Services Authority within the previous five years.

No estimate has been made of the number of people in England who meet the underlying eligibility criteria for a medical exemption certificate.

As of 31 January 2015 the number of people in England who hold a valid medical exemption certificate is 1,769,872. This is based on the number of certificates issued by the NHS Business Services Authority within the previous five years.

No estimate has been made of the number of people in England who meet the underlying eligibility criteria for a medical exemption certificate.

Commissioners and providers should make insulin pumps available for those people with Type 1 diabetes who meet the criteria in the National Institute for Health and Care Excellence’s technology appraisal guidance on continuous subcutaneous insulin infusion for the treatment of diabetes mellitus (TA151) as well as ensuring that relevant structured patient education is provided to support people newly diagnosed with diabetes and at appropriate points in their life as their condition progresses.

Information on the number of people using insulin pumps is not collected centrally.

The United Kingdom Insulin Pump Audit, published in May 2013, collected data from across the United Kingdom. The audit demonstrated that 6% of adults with Type 1 diabetes and 19% of children with Type 1 diabetes were being treated with insulin pumps. The audit’s findings are available at:

www.diabetes.org.uk/Documents/News/The_United_Kingdom_Insulin_Pump_Audit_May_2013.pdf

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.

A copy of the information requested has been attached.

The CQC has advised that the attached dataset contains the breakdown (at National Health Service acute provider and clinical commissioning group (CCG) level) of bespoke analysis carried out by the CQC as part of the 'Thematic data review of diabetes care pathways: secondary care analysis comparing people with and without diabetes' that was published alongside the CQC's 2013/14 State of Care report on 16 October 2014.

The analysis compares the outcomes within each provider or CCG for people with diabetes against a reference group of similar people without diabetes. It is not a comparison of performance between providers or CCGs and it would be inappropriate to use the data in this way. The analysis at provider and CCG level should be treated as experimental and the measures should not be considered as judgements of providers or CCGs.

We have made a commitment to ban the testing of household products on animals. Although superficially straightforward, this issue has not been easy to resolve. The key issue is around ingredients. We are currently engaging with
stakeholders to develop a solution that is workable, but does not have a chain of unforeseen circumstances.

Any solution has to be legally viable since we cannot ban testing which may be required under UK or EU law. The solution we develop must not preclude research that is a lawful requirement nor that which has significant benefits to people, the environment or animals. Nor should it drive research overseas.

There is, at present, no authoritative definition of household products in the United Kingdom or European legislation. Through stakeholder engagement we are seeking to develop an agreed definition.

The Home Office does not collect data on the number of animals used in scientific procedures for testing (a) finished household products or (b) household product ingredients. It does however collect data on the number of
animals used in procedures undertaken for the testing of substances used in the household, in Great Britain.

In 2010 there were 24 animals used in procedures for the testing of substances used in the household. In 2009, 2011, 2012 and 2013 there were no animals used in procedures for the testing of substances used in the household.

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. The CQC has provided the following information.

A copy of the information requested has been attached.

The report ‘The State of health and adult social care in England 2013/14 – Technical annex: Thematic data review of diabetes care pathways’ was published on the CQC’s website on 16 October.

The CQC undertook two separate pieces of bespoke analysis, which were summarised in the 13/14 State of Care (technical annex): Thematic Data Review of Diabetes Care Pathways. Neither of these documents were published on the CQC’s website. Drafts of both have been previously circulated to the CQC’s external advisory group. These two separate pieces of analysis have been attached to this response.

The attached table shows finished admission episodes (FAEs) with a primary diagnosis of hypoglycaemia and diabetic ketoacidosis by primary care trust (PCT) of residence for ages (i) 0 to 17, (ii) 18 to 64 and (iii) 65 and over from 2003-04 to 2012-13. PCT of residence has been used as this data is available for the 10 year period requested.

The data we have provided should not be considered a count of people as the same person may have been admitted on more than one occasion.

Reference should be made to the footnotes when interpreting the data.

The national Commissioning for Quality and Innovation (CQUIN) scheme for 2014-15 includes national indicators relating to the NHS Safety Thermometer, the Friends and Family Test (FFT), diagnosis and onward referral of patients with dementia or delirium, and assessment of physical health risk factors and provision of appropriate interventions for mental health inpatients. The FFT indicator incentivises providers to implement the FFT scheme and to achieve good response rates; the dementia indicator requires providers to undertake a carer survey; and the mental health indicator involves a specific process of national clinical audit, facilitated by the Royal College of Psychiatrists.

CQUIN applies to all providers who operate under the NHS Standard Contract. The Contract, which is used for all providers of National Health Service-funded care other than primary care, already includes as core standards for all providers requirements to:

- put in place an ongoing proportionate programme of clinical audit;

- participate in relevant national clinical audits under the National Clinical Audit and Patient Outcomes Programme; and

- undertake patient, carer and staff surveys, including FFT.

NHS England is reviewing both CQUIN and the NHS Standard Contract and will be publishing updated versions of both for 2015-16 shortly.

The Patient Experience of Diabetes Services survey is commissioned by the Healthcare Quality Improvement Partnership, on behalf of NHS England, and delivered by the Health and Social Care Information Centre, working in collaboration with Diabetes UK and Public Health England (PHE). It will therefore be a matter for PHE and NHS England to decide on future plans for this survey.

There has been no decision made about the future of the Patient Experience of Diabetes Survey. NHS England is currently reviewing the whole National Clinical Audit and Patient Outcomes Programme collectively, including the pilots that have reported. The first of these meetings was on 11 November.

My Rt. hon. Friend, The Secretary of State meets with NHS England on a weekly basis and discusses a wide range of healthcare issues.

However, there have been no specific discussions between the Secretary of State for Health and NHS England on the future funding of the Patient Experience of Diabetes Survey or between Ministers and officials of the Department and NHS England on plans to roll out the diabetes patient experience survey across all NHS services in England.

The Patient Experience of Diabetes Services survey is commissioned by the Healthcare Quality Improvement Partnership, on behalf of NHS England, and delivered by the Health and Social Care Information Centre, working in collaboration with Diabetes UK and Public Health England (PHE). It will therefore be a matter for PHE and NHS England to decide on future plans for this survey.

There has been no decision made about the future of the Patient Experience of Diabetes Survey. NHS England is currently reviewing the whole National Clinical Audit and Patient Outcomes Programme collectively, including the pilots that have reported. The first of these meetings was on 11 November.

My Rt. hon. Friend, The Secretary of State meets with NHS England on a weekly basis and discusses a wide range of healthcare issues.

However, there have been no specific discussions between the Secretary of State for Health and NHS England on the future funding of the Patient Experience of Diabetes Survey or between Ministers and officials of the Department and NHS England on plans to roll out the diabetes patient experience survey across all NHS services in England.

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

We do not hold information on the number of adult patients on insulin therapy who have been offered an Insulin Passport in each NHS commissioning area in each of the last five years.

This information is not available in the format requested.

Information concerning the number of finished admission episodes and a rate per 100,000 of the population where the method of admission was an emergency by primary care trust of residence for the years 2008-09 to 2012-13 is attached.

It should be noted that this is not a count of people as the same person may have had more than one admission episode within the same time period.

This information is not collected in the format requested.

The attached table shows both Hospital Episode Statistics (HES) for finished consultant episodes with a primary diagnosis of diabetes and a primary or secondary procedure of amputation of the foot or toe, as well as National Diabetes Audit (NDA) figures for the number of diabetes patients in the audit having major or minor amputations the following year. The NDA figures are only available for 2009-10 and 2010-11.

Reference should be made to the notes provided with the table when interpreting these figures.