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NHS: Finance

Volume 465: debated on Wednesday 24 October 2007

To ask the Secretary of State for Health (1) what assessment he has made of the reduction in NHS expenditure arising from the two-year price freeze on products in part IX of the drug tariff; (160451)

(2) what assessment he has made of the impact of his Department’s proposals for Part IX of the drug tariff on the workloads of specialist nurses;

(3) if he will publish an impact assessment on the proposed changes to storma and incontinence appliances in Part IX of the drug tariff.

[holding answer 23 October 2007]: The review of the arrangements under Part IX of the Drug Tariff for the provision of stoma and incontinence appliances—and related services—in primary care is ongoing. A further consultation, “Arrangements under Part IX of the Drug Tariff for the provision of stoma and incontinence appliances—and related services—to Primary Care. Revised Proposals”, was published on 6 September 2007 and closes on 28 December 2007. Copies of the consultation have been placed in the Library and it is also available on the Department’s website at:

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_078135

A partial regulatory impact assessment was published with the previous consultation that was published in November 2006. A copy has been placed in the Library.

An impact assessment will be produced as part of the Department’s final recommendation.

Some dispensing contractors employ specialist nurses who visit patients. The most recent consultation, “Arrangements under Part IX of the Drug Tariff for the provision of stoma and incontinence appliances—and related services—to Primary Care. Revised Proposals”, proposes that these dispensing contractors should be remunerated for providing this service. This is in keeping with one of the Department’s stated objectives: maintain, and where applicable improve, the current quality of care to patients and provide a consistent level of care.

In meeting this objective, the Department does not anticipate any impact on the workload of the specialist nurses employed directly by the national health service.

The current spend on stoma and incontinence appliances by the NHS is about £200 million a year. Reimbursement prices for Part IX items are usually subject to an annual increase.

The Department froze the levels of reimbursement in April 2006. The value of this 18-month freeze is estimated to be £7-8 million. However, it should be noted that this cost avoidance has been offset by the additional cost of an increased number of Part IX prescription items dispensed in the same period.

To ask the Secretary of State for Health what the average (a) income per patient, (b) nurse to patient ratio and (c) doctor to patient ratio was for each (i) primary care trust and (ii) hospital trust in England at the latest date for which figures are available. (156441)

The average income per primary care trust and NHS Trust has been placed in the Library.

PCTs recognise a combination of funding and miscellaneous income in their accounts. We have supplied both as normally we do not just add these together, as funding is cash based and income is based on accruals accounting. PCTs with large amounts of income will commonly be commissioning on behalf of other PCTs or have pooled budgets with local authorities.

Information on the average doctor to patient ratio and nurse to patient ratio for each PCT and hospital trust is not collected centrally.