The information requested is not available centrally. It may be obtained from Heart of England NHS Foundation Trust. We have written to the Rt. Hon. Jacqui Smith, Chair of the Trust, informing her of the hon. Member’s enquiry. She will reply shortly and a copy of the letter will be placed in the Library.

This is a matter for the National Health Service locally.

The majority of paediatric neurology services are specialised and are based in Neurosciences Centres which have the necessary infrastructure in terms of diagnostic services and other specialities, including consultant expertise.

NHS England is responsible for commissioning specialised neurological services, including some services for patients with neuromuscular disorders. NHS England has published two separate service specifications for neurological care, one for adults and one for children, that sets out what providers must have in place to offer evidence-based, safe and effective care for patients with neurological conditions, including neuromuscular disorders.

Both service specifications for neurological care can be found at:

www.england.nhs.uk/wp-content/uploads/2013/06/d04-neurosci-spec-neuro.pdf

www.england.nhs.uk/wp-content/uploads/2013/06/e09-paedi-neurology.pdf

Data for available and occupied paediatric critical care beds, for the week ending 4 December 2016, was published on Friday 9 December as part of the winter weekly sitreps on NHS England’s website.

The data is available at the link below:

https://www.england.nhs.uk/statistics/statistical-work-areas/winter-daily-sitreps/

The information requested is not collected. NHS Digital collects data on the number of neurologists working in the National Health Service in England by grade, but not to the level of specialist or specialist paediatric neuromuscular consultants.

As the national body for education and training, Health Education England (HEE) provides national leadership for and co-ordinates workforce planning and education commissioning activity to ensure that sufficient numbers of skilled workers are available in England for the NHS.

HEE reports that the numbers currently undertaking neurology training are sufficient to ensure the consultant workforce supply continues to grow at current rates over the next five years. Neuromuscular is part of the specialty training for neurologists. HEE does not plan to the level of the sub specialty requested.

The information requested is not collected. NHS Digital collects data on the number of neurologists working in the National Health Service in England by grade, but not to the level of specialist or specialist paediatric neuromuscular consultants.

As the national body for education and training, Health Education England (HEE) provides national leadership for and co-ordinates workforce planning and education commissioning activity to ensure that sufficient numbers of skilled workers are available in England for the NHS.

HEE reports that the numbers currently undertaking neurology training are sufficient to ensure the consultant workforce supply continues to grow at current rates over the next five years. Neuromuscular is part of the specialty training for neurologists. HEE does not plan to the level of the sub specialty requested.

The information requested is not available centrally. It may be obtained from Heart of England NHS Foundation Trust. We have written to the Rt. Hon. Jacqui Smith, Chair of the Trust, informing her of the hon. Member’s enquiry. She will reply shortly and a copy of the letter will be placed in the Library.

The Department has had no formal discussions with NHS England on auditing the effect of its guidance Excellence in Continence Care on the quality of paediatric continence services.

NHS England continues to promote extensively its guidance both through traditional and social media and through engagement with key stakeholders.

The Department of Health, in conjunction with the Department for Education, has published links to the Paediatric Continence Commissioning Guide as part of its support for commissioners, providers and health professionals implementing the new system for Special Educational Need and Disability. Developed by the Paediatric Continence Forum and accredited by the National Institute for Health and Care Excellence this provides a specification for paediatric continence services which puts integration at its heart.

The Department has had no formal discussions with NHS England on auditing the effect of its guidance Excellence in Continence Care on the quality of paediatric continence services.

NHS England continues to promote extensively its guidance both through traditional and social media and through engagement with key stakeholders.

The Department of Health, in conjunction with the Department for Education, has published links to the Paediatric Continence Commissioning Guide as part of its support for commissioners, providers and health professionals implementing the new system for Special Educational Need and Disability. Developed by the Paediatric Continence Forum and accredited by the National Institute for Health and Care Excellence this provides a specification for paediatric continence services which puts integration at its heart.

Data for available and occupied paediatric critical care beds, for the week ending 4 December 2016, will be published as part of the winter weekly sitreps on NHS England’s website on 9 December 2016 at 9.30am.

The data will be available at the link below:

https://www.england.nhs.uk/statistics/statistical-work-areas/winter-daily-sitreps/

The numbers of admissions to the paediatric intensive care unit at the London site of the Royal Brompton and Harefield NHS Foundation Trust, which took place during 2015 – the most recent 12 month period for which figures are available - and the proportion of those admissions that were cardiac cases, are shown in the table below:

Source: Paediatric Intensive Care Audit Network

NHS England has not yet made any decisions following its review of congenital heart disease services. It will run a service change process, including a public consultation, on the proposals for change which it announced in July 2016. In the meantime, NHS England is working with the hospital trusts that may be affected to assess the impact of implementing the proposals.

This will include consideration of the impact on paediatric intensive care unit (PICU) services. Should the proposals proceed to implementation, NHS England would expect those hospitals accepting additional congenital heart disease patients to expand their PICU capacity accordingly. Any wider regional implications for PICU services will be considered by NHS England's paediatric critical care review, which is currently underway.

There are alternative providers of specialist paediatric respiratory services in London. NHS England will work with those providers and the Royal Brompton and Harefield NHS Foundation Trust to consider how those services might be affected and how the potential implementation of changes could best be managed.

The new standards for congenital heart disease services were initially drafted by the Standards Group, which was convened for that purpose, and not by the Clinical Reference Group (CRG). This was because work on the standards started before the formation of NHS England and the CRG system.

The draft standards, prepared by the Standards Group and considered by the Clinical Advisory Panel, listed fewer paediatric specialties in the category that ‘must’ be co-located on the same hospital site with paediatric cardiac services and more in the category that ‘should’ be co-located on the same hospital site than in the final standards as agreed by the NHS England Board.

The Standards Group did not advise the Clinical Advisory Panel that the standards should reflect the existing availability of services. It has always been recognised that the standards should describe how services should ideally be set up rather than how they currently exist.

NHS England does not hold information on which NHS trusts provide both adult and paediatric audiology services.

As of 1 November 2016, NHS trusts with Improving Quality in Physiological Services accreditation of adult audiology services are:

- Aintree University Hospital NHS Foundation Trust

- Bolton NHS Foundation Trust

- Royal Shrewsbury and Telford Hospitals NHS Trust

- University Hospitals Birmingham NHS Foundation Trust

- The Royal Wolverhampton NHS Trust

- Wrightington, Wigan and Leigh NHS Foundation Trust

- North Tees and Hartlepool NHS Foundation Trust

- Barnsley Hospital NHS Foundation Trust

- Western Sussex Hospitals NHS Foundation Trust

- Chesterfield Royal Hospital NHS Foundation Trust

As of 1 November 2016, the following NHS trusts have gained accreditation for paediatric audiology services:

- Berkshire Healthcare NHS Foundation Trust

- Sherwood Forest Hospitals NHS Foundation Trust

- Sandwell and West Birmingham Hospitals NHS Trust

- University Hospitals of Morecambe Bay NHS Foundation Trust

- University Hospitals Coventry and Warwickshire NHS Trust

- Kingston Hospital NHS Foundation Trust

- Pennine Care NHS Foundation Trust

- South Devon Healthcare NHS Foundation Trust

- University Hospitals South Manchester NHS Foundation Trust

- Royal Berkshire NHS Foundation Trust

- Southend University Hospital NHS Foundation Trust

- Norfolk and Norwich University Hospitals NHS Foundation Trust

- The Great Western Hospitals NHS Foundation Trust

- Portsmouth Hospital NHS Trust

- Northern Devon Healthcare NHS Trust

- Sheffield Teaching Hospitals NHS Foundation Trust

- Hounslow and Richmond Community Healthcare NHS Trust

- Hearing Services - Sheffield Children's NHS Foundation Trust

- Royal Cornwall Hospitals NHS Trust

In addition Chime Social Enterprise Community Interest Company, as a significant NHS provider, has gained accreditation for paediatric audiology services.

NHS England does not hold information on which NHS trusts provide both adult and paediatric audiology services.

As of 1 November 2016, NHS trusts with Improving Quality in Physiological Services accreditation of adult audiology services are:

- Aintree University Hospital NHS Foundation Trust

- Bolton NHS Foundation Trust

- Royal Shrewsbury and Telford Hospitals NHS Trust

- University Hospitals Birmingham NHS Foundation Trust

- The Royal Wolverhampton NHS Trust

- Wrightington, Wigan and Leigh NHS Foundation Trust

- North Tees and Hartlepool NHS Foundation Trust

- Barnsley Hospital NHS Foundation Trust

- Western Sussex Hospitals NHS Foundation Trust

- Chesterfield Royal Hospital NHS Foundation Trust

As of 1 November 2016, the following NHS trusts have gained accreditation for paediatric audiology services:

- Berkshire Healthcare NHS Foundation Trust

- Sherwood Forest Hospitals NHS Foundation Trust

- Sandwell and West Birmingham Hospitals NHS Trust

- University Hospitals of Morecambe Bay NHS Foundation Trust

- University Hospitals Coventry and Warwickshire NHS Trust

- Kingston Hospital NHS Foundation Trust

- Pennine Care NHS Foundation Trust

- South Devon Healthcare NHS Foundation Trust

- University Hospitals South Manchester NHS Foundation Trust

- Royal Berkshire NHS Foundation Trust

- Southend University Hospital NHS Foundation Trust

- Norfolk and Norwich University Hospitals NHS Foundation Trust

- The Great Western Hospitals NHS Foundation Trust

- Portsmouth Hospital NHS Trust

- Northern Devon Healthcare NHS Trust

- Sheffield Teaching Hospitals NHS Foundation Trust

- Hounslow and Richmond Community Healthcare NHS Trust

- Hearing Services - Sheffield Children's NHS Foundation Trust

- Royal Cornwall Hospitals NHS Trust

In addition Chime Social Enterprise Community Interest Company, as a significant NHS provider, has gained accreditation for paediatric audiology services.

The information requested is in the table below. NHS England publishes monthly data on critical care bed capacity, including the number of paediatric intensive care beds. The data reports the numbers of beds that are open, as a snapshot, at midnight on the last Thursday of the month.

Number of paediatric intensive care beds in central London and the Royal Brompton and Harefield NHS Foundation Trust open on the last Thursday of the reporting period, September 2016

Source: Critical care bed capacity and urgent operations cancelled, NHS England

The Department does not have a dedicated three to five strategy for supporting the training and development of advanced paediatric and neonatal nurse practitioners.

It is Health Education England’s (HEE) responsibility to ensure that there is sufficient future supply of staff, including those needed in specialist fields such as this, to meet the workforce requirements of the English health system.

As part of its ongoing work HEE continually looks to ensure that staff groups, such as those highlighted, have the correct planned workforce growth, consider whether new roles are required and ensure that existing undergraduate training and education meets the needs of both students and patients.

At a local level, it is the responsibility of National Health Service organisations to ensure that their staff, through Continuing Professional Development, have the ongoing skills required to deliver safe and effective care to patients.

The following figures are produced by the Health Education England Oriel recruitment system and are for England. Oriel has only been in operation for the last three years and the Department does not have access to any comprehensive data collected by local regional teams prior to this.

Source: Oriel

Note: The figures for Paediatrics are for ST1 only (which is general paediatrics). There are other paediatric specialties that are entered into in later years of speciality training.

NHS England’s proposals for change, to ensure that all providers of congenital heart disease services for adults and children comply with new commissioning standards, are based on written evidence provided by the units themselves. The Royal Brompton and Harefield NHS Foundation Trust conducted a self-assessment against the nationally agreed standards which NHS England then considered. No inspection was undertaken as part of this process.

NHS England has met with the Royal Brompton and Harefield NHS Foundation Trust to discuss the impact of their proposals for change. On reviewing the material provided by the Trust, NHS England has asked for further information.

The standards for paediatric co-location are not currently met by the Royal Brompton and Harefield Hospital NHS Foundation Trust, University Hospitals of Leicester NHS Trust and Newcastle Hospitals NHS Foundation Trust. NHS England has informed these trusts of its assessment and whether this may involve further consideration of proposals to cease providing those services.

NHS England has not yet made any commissioning decisions. It will run a service change process, including a public consultation, on its proposals for change.

NHS England’s proposals for change, to ensure that all providers of congenital heart disease services for adults and children comply with new commissioning standards, are based on written evidence provided by the units themselves. The Royal Brompton and Harefield NHS Foundation Trust conducted a self-assessment against the nationally agreed standards which NHS England then considered. No inspection was undertaken as part of this process.

NHS England has met with the Royal Brompton and Harefield NHS Foundation Trust to discuss the impact of their proposals for change. On reviewing the material provided by the Trust, NHS England has asked for further information.

The standards for paediatric co-location are not currently met by the Royal Brompton and Harefield Hospital NHS Foundation Trust, University Hospitals of Leicester NHS Trust and Newcastle Hospitals NHS Foundation Trust. NHS England has informed these trusts of its assessment and whether this may involve further consideration of proposals to cease providing those services.

NHS England has not yet made any commissioning decisions. It will run a service change process, including a public consultation, on its proposals for change.