I refer the hon. Member to the answer I gave on 7 May 2019 to Question 249197.

Whilst there are no plans for a specific ‘paediatric Workforce Implementation Plan’, the NHS People Plan will include those working with children and young people. A final Plan will be published following the 2019 Spending Review.

The provision of paediatric and perinatal pathology services in Northern Ireland is a devolved matter. It has been necessary for the Northern Ireland Department of Health to put in place, as a temporary measure, arrangements for the provision of hospital perinatal and paediatric pathology post mortems to take place at Alder Hey hospital.

In the meantime, as well as the temporary measures with Alder Hey, NI Department of Health officials will continue to work closely with the relevant Royal Colleges and training organisations to encourage training in this speciality in order to support the restoration of paediatric and perinatal pathology services for the long-term.

This situation once again underlines the need to restore the Northern Ireland Executive.

NHS Digital publishes Hospital and Community Health Services (HCHS) workforce statistics. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in in general practitioner surgeries, local authorities or other providers.

The following table shows the full time equivalent figures for the number of doctors in the paediatric speciality group as at 30 September each year since 2009 and the latest data available.

Source: NHS HCHS monthly workforce statistics, NHS Digital

I refer the hon. Member to the answer I gave on 1 November 2018 to Question 184442.

The information requested can be found in the following link in Annex A under ‘Prices for admitted patient care and outpatient procedures for 2018/19 (APC & OPROC 18.19)’ in row 254 and 255.

https://improvement.nhs.uk/resources/national-tariff-1719/

The Department does not hold data related to the training of audiologists that specialise in paediatrics.

Data on local National Health Service plans covering the number of audiologists specialising in paediatrics that will be needed up to 2020 is not collected centrally. Responsibility for assessing and managing staffing levels, including specialty staff, rests with individual NHS trusts and their boards who are best placed to decide how many staff they need to provide a given service.

There is not a distinct paediatric audiology outpatient price. However national tariffs are available for daycase, elective and non elective care for Audiometry or Hearing Assessments, between five and 18 year olds and Audiometry or Hearing Assessment for four year olds and under.

Paediatric services are covered by the Referral to Treatment (RTT) waiting times standard that requires commissioners to make arrangements to ensure that at least 92% of patients referred to see a consultant-led team should start their treatment within 18 weeks. Part of the £1.6 billion additional funding that the National Health Service will receive in 2018/19 will be used to deliver the actions set out in the NHS planning guidance for 2018-19 as key steps towards recovering performance on core access standards, including RTT.

I can give my hon. Friend the reassurance that he is asking for. He is right that we are supporting the NHS in Boston and Skegness. Any decision taken by the trust about the services available will of course be made to ensure that the provision of services is safe for patients. The trust is continuing to try to recruit paediatricians to support the service. It wants to continue to provide paediatric services at Boston, and every effort will be made to ensure that that can continue.

Q14

.

Matt Warman (Boston and Skegness) (Con):

With a rising budget and a new medical school for Lincolnshire, this Government have very clearly demonstrated their commitment to the NHS in Boston and Skegness, but there are short-term challenges in recruiting paediatric staff to the paediatric ward. Can my right hon. Friend reassure parents in my constituency that the decision to make a temporary closure has not yet been made, and that she will work with me to leave no stone unturned so that the trust, NHS England and NHS Improvement can work together to make sure that we recruit the doctors we need and that this Government are investing in?

Diagnosing autism in children can involve a range of observations over time and a number of different professionals. The time taken to formulate a diagnosis will not be the same in all cases.

There are concerns in some local areas that the length of time some children have had to wait for an assessment for autism to begin is longer than the three months recommended by the National Institute for Care and Health Excellence (NICE) guidelines from a referral to a first appointment. Whilst local clinical commissioning groups have been working to bring down the waits in line with the NICE guidelines, to date there has been no national collection of waiting times data.

The Government is taking steps to rectify this and NHS Digital have confirmed they will be collecting and recording waiting times from referral for suspected autism to a first appointment within the Mental Health Services Data Set from April 2018. This will mean that each area can be held to account in real time and action can be taken to support them when waiting times are increasing.

An indicative timeline for the development of care pathways was set out in the Five Year Forward View for Mental Health. The precise timetable for the establishment of a care pathway for autism will be confirmed by NHS England in due course.

This is a matter for NHS England. No decision has been made to close the Congenital Heart Disease (CHD) service at the Royal Brompton and Harefield NHS Foundation Trust.

NHS England has advised that they have performed impact assessments for all centres which would be impacted by its CHD service change proposals if implemented. We have been informed by NHS England that these initial assessments acknowledged that there would be an impact on paediatric respiratory and cystic fibrosis services at the Royal Brompton, if NHS England’s proposals were implemented.

NHS England has advised that a panel including respiratory clinicians and representatives from respiratory and cystic fibrosis patient and public groups has been created to assess the potential impact of its CHD service change proposals on the Royal Brompton’s paediatric respiratory services. This panel has arranged to visit the Royal Brompton in August and has requested to meet patients as a part of this.

This information is not held centrally. The Care Quality Commission looks at a wide range of services when inspecting hospitals.

NHS England has produced the following service specifications for audiology services that it commissions, which apply to all ages and sit in the Trauma Programme of Care (Specialised Ear and Ophthalmology Services):

- Specialised Ear Surgery: Cochlear Implants (All Ages); and

- Implantable Hearing Aids for Microtia, Bone Anchored Hearing Aids and Middle Ear Implants (All Ages).

Copies of these service specifications are attached.

NHS England has no plans to publish further service specifications for specialist audiology services used by children.

NHS England has also published commissioning policies for the following services that are available for children:

- Auditory brainstem implant with congential abnomalities of the auditory nerves of cochleae;

- Bone Anchored Hearing Aids; and

- Bone conducting hearing implants for hearing loss (all ages).

The Improving Quality in Physiological Services (IQIPS) accreditation scheme is run by the United Kingdom Accreditation Service (UKAS). The process of accreditation provides an independent assessment that a service meets the accreditation standards.

It is the responsibility of the service to ensure that they conform to the standard before application to UKAS for accreditation. There is a pre-registration process within the scheme that enables all services to be able to do an effective gap analysis so that they should be at a point of conforming to the standard on making an application to UKAS. If during an assessment mandatory findings are raised which show non-conformity to any part of the standard then the service agrees appropriate improvement actions with the UKAS team to rectify these and prevent re-occurrence.

The UKAS team base their recommendation for accreditation on the findings raised relating to the conformity to the standard, risk and whether the agreed improvement actions are appropriate and can be achieved within a three month close-out period. Therefore any findings raised must be cleared by the organisation if a positive recommendation for accreditation is to be granted.

In Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups, published in July 2016, NHS England strongly encourages clinical commissioning groups to expect providers to have completed the IQIPS self-assessment tool and applied for accreditation with UKAS, and achieve accreditation within the duration of their contract.

UKAS are supporting the NHS England business objective to increase the use of accreditation, and information about those services which have achieved accreditation is not held by the Department or NHS England, but is publicly available on the UKAS website.

Information on clinical contracts is not held centrally by NHS England.

The Improving Quality in Physiological Services (IQIPS) accreditation scheme is run by the United Kingdom Accreditation Service (UKAS). The process of accreditation provides an independent assessment that a service meets the accreditation standards.

It is the responsibility of the service to ensure that they conform to the standard before application to UKAS for accreditation. There is a pre-registration process within the scheme that enables all services to be able to do an effective gap analysis so that they should be at a point of conforming to the standard on making an application to UKAS. If during an assessment mandatory findings are raised which show non-conformity to any part of the standard then the service agrees appropriate improvement actions with the UKAS team to rectify these and prevent re-occurrence.

The UKAS team base their recommendation for accreditation on the findings raised relating to the conformity to the standard, risk and whether the agreed improvement actions are appropriate and can be achieved within a three month close-out period. Therefore any findings raised must be cleared by the organisation if a positive recommendation for accreditation is to be granted.

In Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups, published in July 2016, NHS England strongly encourages clinical commissioning groups to expect providers to have completed the IQIPS self-assessment tool and applied for accreditation with UKAS, and achieve accreditation within the duration of their contract.

UKAS are supporting the NHS England business objective to increase the use of accreditation, and information about those services which have achieved accreditation is not held by the Department or NHS England, but is publicly available on the UKAS website.

Information on clinical contracts is not held centrally by NHS England.

The Improving Quality in Physiological Services (IQIPS) accreditation scheme is run by the United Kingdom Accreditation Service (UKAS). The process of accreditation provides an independent assessment that a service meets the accreditation standards.

It is the responsibility of the service to ensure that they conform to the standard before application to UKAS for accreditation. There is a pre-registration process within the scheme that enables all services to be able to do an effective gap analysis so that they should be at a point of conforming to the standard on making an application to UKAS. If during an assessment mandatory findings are raised which show non-conformity to any part of the standard then the service agrees appropriate improvement actions with the UKAS team to rectify these and prevent re-occurrence.

The UKAS team base their recommendation for accreditation on the findings raised relating to the conformity to the standard, risk and whether the agreed improvement actions are appropriate and can be achieved within a three month close-out period. Therefore any findings raised must be cleared by the organisation if a positive recommendation for accreditation is to be granted.

In Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups, published in July 2016, NHS England strongly encourages clinical commissioning groups to expect providers to have completed the IQIPS self-assessment tool and applied for accreditation with UKAS, and achieve accreditation within the duration of their contract.

UKAS are supporting the NHS England business objective to increase the use of accreditation, and information about those services which have achieved accreditation is not held by the Department or NHS England, but is publicly available on the UKAS website.

Information on clinical contracts is not held centrally by NHS England.

The Improving Quality in Physiological Services (IQIPS) accreditation scheme is run by the United Kingdom Accreditation Service (UKAS). The process of accreditation provides an independent assessment that a service meets the accreditation standards.

It is the responsibility of the service to ensure that they conform to the standard before application to UKAS for accreditation. There is a pre-registration process within the scheme that enables all services to be able to do an effective gap analysis so that they should be at a point of conforming to the standard on making an application to UKAS. If during an assessment mandatory findings are raised which show non-conformity to any part of the standard then the service agrees appropriate improvement actions with the UKAS team to rectify these and prevent re-occurrence.

The UKAS team base their recommendation for accreditation on the findings raised relating to the conformity to the standard, risk and whether the agreed improvement actions are appropriate and can be achieved within a three month close-out period. Therefore any findings raised must be cleared by the organisation if a positive recommendation for accreditation is to be granted.

In Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups, published in July 2016, NHS England strongly encourages clinical commissioning groups to expect providers to have completed the IQIPS self-assessment tool and applied for accreditation with UKAS, and achieve accreditation within the duration of their contract.

UKAS are supporting the NHS England business objective to increase the use of accreditation, and information about those services which have achieved accreditation is not held by the Department or NHS England, but is publicly available on the UKAS website.

Information on clinical contracts is not held centrally by NHS England.