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To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to support increases in auscultation using a stethoscope in primary and community care settings to detect heart murmurs characteristic of heart valve disease.
To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to support increases in auscultation using a stethoscope in primary and community care settings to detect heart murmurs characteristic of heart valve disease.
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
To ask the Secretary of State for Health and Social Care, what services breathlessness clinics will provide to support the early detection of heart valve disease; and whether those clinics will refer patients for auscultation using a stethoscope in primary care or community diagnostic centres.
To ask the Secretary of State for Health and Social Care, what services breathlessness clinics will provide to support the early detection of heart valve disease; and whether those clinics will refer patients for auscultation using a stethoscope in primary care or community diagnostic centres.
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
To ask the Secretary of State for Health and Social Care, if he will take steps to support the increased use of stethoscopes in (a) primary care settings and (b) CDCs for the detection of heart valve disease.
To ask the Secretary of State for Health and Social Care, if he will take steps to support the increased use of stethoscopes in (a) primary care settings and (b) CDCs for the detection of heart valve disease.
NHS England has assessed that clinical auscultation using a stethoscope is insufficiently sensitive to identify the presence and clinical significance of heart valve disease. Clinicians are expected to consider the history of the patient and undertake an examination to ensure the appropriate test is requested, which would normally include auscultation of the heart, with other assessments such as blood pressure. While some community diagnostic centres may have facilities to examine patients, its aims are to provide diagnostics tests such as echocardiograms.
With an ageing population, I, too, welcome the aim of integrating health and social care and developing population-based planning, as we have done in Scotland with health and social care partnerships, but the outsourcing of health service contracts to private providers in NHS England has led to more fragmentation rather than integration. Will the Secretary of State agree that we need to repeal section 75 of the Health and Social Care Act 2012 so that local commissioners can develop patient-centred services and not fear litigation if they do not put them out to tender?
With an ageing population, I, too, welcome the aim of integrating health and social care and developing population-based planning, as we have done in Scotland with health and social care partnerships, but the outsourcing of health service contracts to private providers in NHS England has led to more fragmentation rather than integration. Will the Secretary of State agree that we need to repeal section 75 of the Health and Social Care Act 2012 so that local commissioners can develop patient-centred services and not fear litigation if they do not put them out to tender?
We want to encourage the NHS to move towards more integrated services, and part of that is about contractual structures, but part of it is about funding, and I gently point out to the hon. Lady that 8% of the NHS budget in England goes to general practice and only 6.6% in Scotland, which is why there is an even bigger problem with GP surgeries closing in Scotland.
The many and varied new integrated care structures developing in NHS England have no statutory basis, yet in the future will control the entire health budget for a population. Does the Secretary of State accept that with another major NHS reorganisation we need debate and legislation in this place to get the structure and governance right?
The many and varied new integrated care structures developing in NHS England have no statutory basis, yet in the future will control the entire health budget for a population. Does the Secretary of State accept that with another major NHS reorganisation we need debate and legislation in this place to get the structure and governance right?
In my first few years as Health Secretary, the message I heard loud and clear from the NHS was that it did not want a huge structural reorganisation, so we are very cautious about changing statutory structures. We want to encourage integration, but in time, if the NHS says it would like the statutory structure changed, we will of course listen.