To ask the Secretary of State for Health what guidelines his Department has issued on patient access to treatment by extended choice network providers; and what recent assessment he has made of the range of conditions for which patients are being treated by extended choice network providers. (304108)

All approved extended choice networks (ECN) providers must agree to the ECN rules and sign up to a membership agreement prior to service commencement.

ECN providers undertake adult elective procedures. The range of procedures is listed in the ECN rules.

As at 30 September 2009, more than 105,000 patients have been treated under the extended choice and free choice networks.

To ask the Secretary of State for Health how many patients were refused a referral to an extended choice network provider by such a provider in each of the last three years. (304109)

The Department does not hold this information as extended choice network providers are not required to submit data on refused patient referrals to the Department. Patient referral issues will be monitored locally by the appropriate primary care trust.

To ask the Secretary of State for Health which psychiatric disorders are included in the list of conditions in relation to which providers in the extended choice network may refuse a patient referral. (304111)

To help safeguard patient safety, Extended Choice Network rules state that a facility providing elective care should not treat a patient who has a current and significantly unstable psychiatric disorder where it cannot reasonably be expected to accommodate the patient’s needs.

To ask the Secretary of State for Health on what criteria providers in the extended choice network are permitted to refuse referrals relating to (a) patients with psychiatric disorders and (b) other patients. (304112)

National health service patients are assessed to ensure that they are treated in a clinically appropriate setting.

The Extended Choice Network rules list the patient and procedure exclusions.

The listed exclusions are:

Patient:

any person under the age of 18-years-old;

any patient with an American Society of Anaesthesiologists (ASA) score of three (who is unstable), unless the appropriate critical care facilities that meet the “Levels of Critical Care for Adult Patients” Standards and Guidelines (Intensive Care Society 2002) are available;

any patient with an ASA score higher than three (whether stable or unstable), unless the appropriate critical care facilities that meet the “Levels of Critical Care for Adult Patients” Standards and Guidelines (Intensive Care Society 2002) are available; and

a patient who has a current and significantly unstable psychiatric disorder where the approved facility cannot reasonably be expected to accommodate the patient’s needs.

Procedure:

clinically urgent procedures (being patients that require surgery within 10 days for a clinical reason);

procedures related to maternity services;

termination of pregnancy;

surgery indicated to be for cosmetic reasons;

any procedure that is likely to require critical care, unless the appropriate critical care facilities that meet the “Levels of Critical Care for Adult Patients” Standards and Guidelines (Intensive Care Society 2002) are available; and

in vitro fertilisation treatment for a patient that exceeds the number of procedures that would in the same circumstances be offered to that patient in his/her local NHS area or which is not in compliance with the licensing regulations laid down by the Human Fertilisation and Embryology Authority.