Sutton Borough Liberal Democrats

Offenders are entitled to expect, and receive, the same quality of treatments and services from the national health service as anyone else. All prisons have access to on-site health care teams, which can treat most mental health problems and issue prescriptions required by prisoners.

From 2013, the National Health Service Commissioning Board (NHSCB) will be responsible for commissioning of health services for those in custody. The NHSCB will assume commissioning responsibilities for mental health services for those in prison and other detained settings.

The National Institute for Health and Clinical Excellence updated its schizophrenia guidelines in 2009. They cover the care, treatment and support that adults, aged 18 and older, with schizophrenia should be offered. The guidelines recommended Cognitive Behavioural Therapy be offered, in an acute episode of schizophrenia. These guidelines apply to all adults, including prisoners.

The NHS is responsible for commissioning health care in prisons where prisoners are entitled to receive the same level of care as people in the community. The services provided are based on a health needs assessment undertaken by the NHS commissioner and the prison, but all prisons have access to mental health care delivered by primary care and specialist mental health services.

The information requested about schizophrenia services and morbidity is not collected centrally. However, a survey by the Office for National Statistics in 1997 estimated that around 90% of adult prisoners had at least one of the five disorders considered in the survey (personality disorder, psychosis, neurosis, alcohol misuse and drug dependence). This is an aggregate figure so the data will include adult prisoners with schizophrenia but the exact proportion of prisoners with schizophrenia is not known.

The Department is currently setting up an audit of the mental health needs of offenders, both in prison and where possible in community settings. A feasibility study for this work is due to start later this year and a fuller research study is expected to be commissioned in 2013.

We do not collect the information requested centrally. However, in 2009-10, the Department commissioned the National Health Service Information Centre to undertake a survey of carers in households as part of its Carers' Strategy programme. Over 2,000 carers were interviewed and were asked a question to establish why the people they cared for needed their help, including their health needs. 13% of the responses indicated that the cared for person required help 'for a mental health problem'.

The cross-Government mental health outcomes strategy No Health Without Mental Health, published in February 2011, sets out the Government's commitment to improving mental health and mental health services. The strategy implementation framework focuses on improving outcomes, quality and value for money, and on ensuring that people who use mental health services, their families and carers, are fully involved in all aspects of services.

We have made no estimate of the number of cancer patients in each primary care trust area in England who have to travel for more than 45 minutes in order to access their nearest radiotherapy treatment centre.

The National Radiotherapy Advisory Group (NRAG) report 'Radiotherapy: developing a world class service for England', published in 2007, provided clear guidance to support commissioners in the provision of radiotherapy services. The NRAG report recommended that, where possible, patients should not travel more than 45 minutes for radiotherapy treatment. A copy of this report has already been placed in the Library.

Since the publication of the NRAG report, the National Cancer Action Team has continued to provide advice to commissioners and providers to help them assess travel times for their patients and plan the location of new services.

Decisions regarding renewal of radiotherapy machines are taken locally and need to be assessed against local priorities. It is the responsibility of each individual organisation to ensure that it adopts good asset management and financial planning. However, national teams such as the National Cancer Action Team and NHS Improvement provide support to help providers plan for their equipment needs.

The Department has recently worked with NHS Supply Chain to launch a new procurement scheme that allows trusts to access high-value medical equipment at significantly discounted prices. The scheme allows NHS Supply Chain to purchase equipment up front through use of a central capital fund, and then pass on discounts to trusts. The scheme does not limit choice or supplier.

Within the Cancer Peer Review programme; the radiotherapy measures require local organisations to agree an equipment replacement programme with their cancer network. The outcome of the Peer Review programme is shared with commissioners.

We are committed to improving outcomes for all cancer patients, including those with pancreatic cancer. Achieving earlier diagnosis of cancer is key to our ambition to save an additional 5,000 lives a year from cancer by 2014-15 and we have provided more than £450 million over the spending review period to improve general practitioner (GP) access to key diagnostic tests; support campaigns to raise public awareness of the signs and symptoms of cancer and to encourage people to visit their GP when they have persistent symptoms; and to pay for more treatment and testing in secondary care.

We know that some types of cancer can be difficult diagnose, often because their symptoms are shared with more common, benign conditions. To better understand the barriers to early diagnosis and to discuss possible solutions, departmental officials met with a range of cancer charities during spring and summer 2011, including two pancreatic cancer charities. This work has been fed into the National Awareness and Early Diagnosis Initiative. I also met with Pancreatic Cancer UK on 17 December 2011 to hear their concerns in more detail and I will be attending the charity's early diagnosis workshop in June2012.

To further address the need to improve awareness of rarer cancers, such as pancreatic cancer, consideration also is being given to piloting a symptom-based approach awareness campaign covering multiple cancers. A final decision on campaign work in 2011-12 will be subject to funding and Efficiency and Reform Group approval.

We recognise the need to ensure that the care people receive at the end of life is compassionate, appropriate and supports the exercise of choice by care users. Improved access to social care and better integrated palliative care will be central to delivering improved choice, and this is an important part of the work we are doing to implement the Department's End of Life Care Strategy.

One of the recommendations of the independent Palliative Care Funding Review was that, once a patient reaches the end of life stage, and is put on the end of life care locality register, all health and social care should be funded by the state and be free at the point of delivery. We are testing all the recommendations of the review through the eight Palliative Care Funding pilots we have set up, which will inform the development of a new funding system for palliative care from 2015.

We have committed to publishing a social care White Paper shortly, alongside a progress report on funding reform. The Department jointly led the "Caring for our future" engagement last year, together with the care and support sector, which sought the views of people who use care and support services, carers, local councils, care providers and the voluntary sector, about the priorities for improving care and support. The White Paper will set out the Government's plans for transforming the care and support system.

With support from the National End of Life Care Programme, the Department piloted Electronic Palliative Care Co-ordination Systems (EPaCCS), formerly known as End of Life Care Locality Registers, in eight localities. Ipsos MORI was commissioned to undertake an evaluation of these pilots. Their report, "End of Life Locality Registers Evaluation: Final Report (June, 2011)" identified the key challenges to developing such a system and how these were addressed via a range of approaches and solutions. The evaluation report is available at:

www.endoflifecareforadults.nhs.uk/publications/localities-registers-report

When this report was published, only the Weston Area Health Trust and NHS South West pilot had outcomes data on the impact of the register. These early findings showed that, in tandem with other end of life care initiatives, particularly providing training in advance care planning, use of the register could significantly reduce deaths in hospital and enable many more people to die in their preferred place. Since then, the experiences of other EPaCCS implementers have reinforced these findings. The National End of Life Care Programme is currently collating outcomes data from all implementers, and will make these available to health and social care commissioners and providers to inform future service development.

The National End of Life Care Programme, with support from the Department, has been taking forward a range of other work to support the wider uptake of EPaCCS. It has led on the development of an End of Life Care Co-ordination: Core Content Information Standard, which was approved by the Information Standards Board on 20 March 2012. The standard will underpin the development and use of EPaCCS, and details are available at:

www.endoflifecareforadults.nhs.uk/strategy/strategy/coordination-of-care/end-of-life-care-information-standard

The National Programme is also working through the Quality, Innovation, Productivity and Prevention (QIPP) end of life care workstream, which identifies the importance of EPaCCS as a tool to support identification of people approaching the end of life and planning for their care, including advance care planning. In tandem with the Department's QIPP digital team, a series of events have been run around the country to share learning about EPaCCS, and to seek feedback on the technical work that can be undertaken nationally to support wider implementation.

Doctors are required to start with the immediate, direct cause of death and then go back through the sequence of events or conditions that led to death, until they reach the one that started the fatal sequence. This initiating condition will usually be selected as the underlying cause of death, according to the International Classification of Diseases coding rules.

People with multiple sclerosis do not die directly from the condition, but if they are severely affected the risk of dying from a multiple sclerosis related complication (like an infection) is greater. Research suggests that, on average, life expectancy of people with multiple sclerosis is around 10 years lower than that of the general population.

Offender Health has worked with Professor Martin Lombard, National Clinical Director for Liver Disease, to survey hepatitis C services in prisons in England. The aims of the survey were: to map existing service provision for prisoners in relation to hepatitis C testing and treatment; to develop a national database of services providing hepatitis C treatment for prisoners; and, to use the survey to develop a national hepatitis C prison network to share good practice across England and help to develop a model for the diagnosis and treatment of hepatitis C in prison.

A survey report is due to be published soon and is expected to demonstrate that prisons in England are providing access to screening and treatment for hepatitis C.

Information is not collected centrally about the number of people living with hepatitis C in England and is therefore not available in respect of prisoners in England with hepatitis C, or being screened for hepatitis C upon entering prison or for prisoners with hepatitis C who are undergoing treatment.

Offender Health have begun to collect quarterly data on the total number of tests carried out in prisons in England for Hepatitis C for the Prison Health Quality and Performance Indicators dataset. Data is available from April 2010 only and the number of tests performed per quarter in reporting prisons and the percentage of total new receptions to those prisons this figure represents is shown in the following table.

However, this data may not reflect the total number of tests performed on people in prison as testing may also be carried out in sexual health services for example, which is not captured in this dataset.

This information is not collected centrally.

The information is shown in the following table.

We are developing an outcomes strategy for long-term conditions. A companion document will be published on diabetes alongside this strategy by the end of 2012. We are also developing a cardiovascular outcome strategy, and that will set out the important links between cardiovascular disease and diabetes and this will also be published before the end of 2012.

Data published by the Health and Social Care Information Centre for 2010-11 show a total of 13,372 patients with a diagnosis of depression on registers within NHS Bexley under the Quality and Outcomes Framework for general practitioner practices.

There were no meetings before the take-over. Departmental officials met with representatives of Terra Firma on 1 May, after the announcement of the take-over, to discuss the company's plans and intentions.

The Department welcomes any development that will help give security to the residents and employees of Four Seasons' care homes. This has always been the Government's priority.

The Department has not made an assessment of the effect of not increasing the means test capital limit for residential care on businesses, charities and voluntary bodies in the sector.

The decision in the spending review 2010 not to increase capital limits was taken in order to help local authorities, at a time of financial stringency, to maintain the level of services they provide. The spending review 2010 covers Government spending up to April 2015. However, the capital limits are being kept under review in order to monitor the impact of not increasing them.

The responsibility for providing or arranging residential care rests with local authorities, which have specific duties of care to their populations under section 21(a) of the National Assistance Act 1948 and Section 47(5) of the National Health Service and Community Care Act 1990.

The NHS and Community Care Act 1990 gives local authorities the powers to provide or arrange care services for anyone in urgent need. Were a care home to fail, no resident-whether publicly or self-funded-would be left homeless or without care. In an emergency, a local authority could provide residential accommodation to anyone-publicly or self-funded-who had an urgent need for it. A local authority would continue to provide care for any self-funding resident who was unable to find or arrange care for themselves.

As commissioners and providers of care services, local authorities have a responsibility to manage the care sector in their areas in order to ensure there is a suitable range of provision available to meet local need.

Social care is a devolved matter; different oversight and regulatory mechanisms are in place across the United Kingdom. The Care Quality Commission (CQC) has responsibility for the regulation of adult social care in England. As such, it contributes to ensuring the safety and wellbeing of people who use social care services. All providers of regulated activities in England must be registered with the CQC and meet the registration requirements, which are set out in regulations made under the Health and Social Care Act 2008.

The regulations include a requirement to take all reasonable steps to carry on the regulated activity in such a manner as to ensure the financial viability of the carrying on of that activity. This requirement does not apply to local authorities or NHS bodies. The CQC can take enforcement action, including cancellation of registration, if the registration requirements are not met.

In October 2011, the Department published a discussion paper, "Oversight of the Social Care Market", which outlined the issues facing the social care market and possible options for strengthening oversight of the largest and most complex providers. A copy has already been placed in the Library. This has provided a valuable opportunity for us to hear views on this area and reflect on the best approach.

We have considered the responses to the consultation paper, arid intend to address the issue of market oversight in the forthcoming White Paper on Care and Support.

The amounts included in the Strategic Health Authority (SHA) bundle for cancer networks for 2009-10, 2010-11, 2011-12 and 20012-13 can be found in the following table:

These allocations are based on estimates of the funding required to deliver cancer networks. However, it is for each SHA to determine how the total amount they receive in the SHA bundle is allocated to specific services, such as cancer networks, taking into account the needs of local populations.

Local national health service breast cancer screening programmes in England are replacing their current analogue (film) systems with digital systems (direct digital mammography-DDM). As at May 2012, 74 (92.5%) local programmes have at least one direct digital x-ray set and 53 (66%) are fully digital.

Local programmes have been advised to implement direct digital as quickly as possible as the independent Advisory Committee on Breast Cancer Screening has said that running both film and digital systems together is inefficient. Six programmes (7.5%) are still to implement digital mammography.

Departmental officials have been in regular contact with officials from the Devolved Administrations and will continue to work closely with them on this issue.

The Thalidomide Grant is a three-year pilot, running from April 2010 until March 2013, to explore how the health needs of Thalidomide survivors can best be met in the longer term and how such a scheme might be applied to other small groups of geographically dispersed patients with specialised needs.

Officials met with members of the National Advisory Council to the Thalidomide Trust in June 2010, to discuss their evaluation of the first year. The Government expects to receive the evaluation of the second year of the pilot study shortly, and will look to meet with the National Advisory Council to discuss that report. We will consider the future of the grant further into the pilot.

The Department does not collect data on the prevalence of multiple sclerosis, or the number of deaths associated with it.