The Administration of Estates Act 1925 provides that claims on behalf of the estate of a deceased person may be made by their personal representative, such as the executor of a will and grants of probate provide the legal standing to conduct litigation on behalf of the estate. Claims may also be made by certain dependants of the deceased person either under the Fatal Accidents Act 1976 for damages, loss of income or service dependency, or the Law Reform (Miscellaneous Provisions) Act 1934, also for damages.

The interim NHS People Plan, published on 3 June 2019, puts the workforce at the heart of the National Health Service and will ensure we have the staff needed to deliver high quality care. A final People Plan will be published soon after the conclusion of the 2019 Spending Review.

The Cancer Workforce Plan for England, published in December 2017 by Health Education England (HEE), set out plans to expand capacity and skills in the cancer workforce, including targeting additional training support for seven priority professions which are key to cancer prevention, diagnosis and treatment, such as clinical radiology, histopathology, oncology and diagnostic and therapeutic radiography. HEE will now work with NHS England and NHS Improvement to understand the longer-term workforce implications of further development of cancer services. This work will inform the final People Plan.

The latest year for which data for all European Union countries is published on a comparable basis is 2015. Total health spending as a proportion of Gross Domestic Product for 27 EU countries is published by the EU and is available at the following link:

https://ec.europa.eu/eurostat/statistics-explained/index.php?title=File:Current_healthcare_expenditure,_2015_FP18a.png

Individual National Health Service hospital providers - NHS trusts and foundation trusts – are responsible and accountable for their own purchasing decisions of non-medical and medical equipment and all other supplies. However, the Government has put in place a range of initiatives to help NHS bodies make informed choices about the products and the route through which they are bought and thus deliver improved value for money for the NHS. NHS bodies can use a number of routes for procurement, including:

- Framework agreements negotiated on behalf of all Government bodies by the Crown Commercial Service;

- National framework agreements negotiated on behalf of the NHS by NHS Supply Chain (NHSSC);

- Regional agreements negotiated by, or on behalf of, NHS regional collaborative; and

- Local agreements negotiated by individual NHS bodies.

A new NHSSC model is being introduced, bringing together 11 expert procurement specialist teams to deliver high quality, clinically assured goods at the best possible price. This new operating model aims to increases national leverage of spend which will lead to lower costs and simplification of the number of products used across the NHS. The new NHSSC is aiming for an 80% market share of NHS goods supplied compared to the current 40%.

‘Towards a smokefree generation: A Tobacco Control Plan for England 2017-2022’, published in July 2017, suggests that in 2014/15, smoking cost the National Health Service in England £2.5 billion. The figure quoted includes the cost of treating smokers in primary and secondary care, general practitioner visits, nurse visits, prescriptions, outpatient visits and hospital admissions.

Data on NHS spending on treatment of alcohol related conditions is not collected centrally. However, the costs to the NHS in England associated with alcohol misuse are estimated at £3.5 billion each year.

‘The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006-07 NHS costs’ estimated that overweight and obesity cost the NHS in the United Kingdom £5.1 billion per year. This figure was uplifted to £6.1 billion in 2014/15 to take account of inflation.

This information is not collected.

This information is not collected centrally; however this is an issue which I have asked Departmental officials to consider.

NHS England does not currently routinely commission Selective Dorsal Rhizotomy surgery and published a policy in 2014 based on the clinical evidence available at that time, which did not demonstrate the benefits of surgery over and above other non-surgical treatment options (such as intensive physiotherapy).

However, given the continued clinical and patient interest in the procedure, NHS England invested in a Commissioning through Evaluation (CtE) scheme which has gathered new ‘real world’ evidence from 140 children undergoing surgery in selected centres in England. The interim results of this scheme, independently evaluated by the National Institute for Health and Care Excellence, together with an updated review of the published evidence of clinical effectiveness, have been used to support the drafting of an updated policy proposition which will be considered as part of NHS England’s relative prioritisation process for investments in specialised care in May 2018.

If appropriate, there may also be an opportunity to further review the policy once the full evaluation is available from the CtE scheme in autumn 2018.

Different organisations have a range of responsibilities for training and development. Individual employers have responsibility for supporting staff with courses which are required to fulfil duties to work in their organisation and core employment requirements.

National funding through Health Education England (HEE) has historically been used to support development of the National Health Service workforce. HEE invests up to £300 million per year on supporting individuals in NHS employment achieve registered qualifications and a further £80 million on workforce transformation projects agreed locally, some of which has prioritised training courses for ongoing development.

HEE is considering alternative models for traditional continual professional development funding; for example exploring routes for apprenticeships for post graduate qualifications that previously may have been funded directly at a national level.

NHS Digital publishes workforce statistics and we have defined non-clinical, non-patient facing staff as those working in National Health Service Infrastructure support. As of September 2017 there are 164,584 Full Time Equivalent (FTE) infrastructure support staff working in the NHS in England. This is 2,848 more than in September 2016. As of September 2017 there are 1,285 FTE infrastructure support staff working in NHS trusts and clinical commissioning groups in Gloucestershire. This is 55 more than in September 2016.

The estimated cost of drugs in England, 2010/11 to 2015/16 is given in the table below. A combined and consistent time series is not available prior to 2010/11.

Due to changes to the National Health Service organisational structure, the lowest level of data available from 1 April 2013 is NHS Area Teams. These were superseded from 1 April 2015 by NHS England Regions. However data for 2013/14, 2014/15 and 2015/16 have been shown at the lower NHS Area Team Level for consistency. Regional level data prior to April 2013 are not available on a consistent basis. Data have been provided for the Bath, Gloucestershire and Wiltshire Area Team.

Costs exclude any discounts that may have been negotiated, and exclude payments made by pharmaceutical companies as part of the Pharmaceutical Price Regulation Scheme.

Source: ePACT; IMS HEALTH 2016: Hospital Pharmacy Audit Index

We have had no such discussions. It has long been the Department’s policy to encourage the prescribing of drugs by their generic name, both for reasons of good professional practice and because of the opportunities for more effective use of National Health Service resources. 84.1% of prescriptions dispensed in the community in 2015 were prescribed generically.

Responsibility for prescribing rests with the doctor who has clinical responsibility for that particular aspect of a patient's care. Prescribing can be influenced in a number of ways, but ultimately the decision on what to prescribe is made by the prescriber after an informed discussion with their patient. There is nothing to prevent branded prescribing if a clinician considers it essential for a patient to receive a specific product.

The National Institute for Health and Care Excellence provides guidance on the clinical and cost-effectiveness of drugs, as part of its technology appraisal programme. Non branded drugs (generics) are as effective as their branded equivalents, and usually come at much lower cost, hence are more cost-effective than branded equivalents.

No assessment has been made of the performance of the NHS 111 service.

NHS 111 is locally commissioned and Harmoni is one of a number of providers delivering the service, which will be available to the whole of England by June 2013.

The numbers of qualified nursing, midwifery and health visiting staff and healthcare assistants employed in the national health service from 2007 to 2011 are shown in the following table:

Qualified nursing, midwifery and health visiting staff are registered with the Nursing and Midwifery Council.

Healthcare assistants care for patients, working under the supervision of nurses; midwives and other health professionals. There are other support staff who work with doctors and nursing staff, including nursing auxiliaries and support workers.