Policies and Procedures

Can you supply me with details of:

• Your protocol for patients making the transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS)

• How many young people in Derby City PCT, have been
 a) Referred from CAMHS to AMHS in the periods 2005-2006, 2006-2007, 2007-2008, 2008-2009, 2009-2010
 b) Been offered treatment by AMHS following referral from (CAMHS) and assessment?

The request concerns the PCT's Policies towards:
1. Cryotherapy as a primary treatment for prostate cancer
2. Salvage Cryotherapy for recurrent prostate cancer
3. High-intensity focused ultrasound for prostate cancer

For each of the 3 procedures listed above please supply the following information:
1. A copy of the current PCT Guidance / Policy Document on the Procedure (electronic copies)
2. Details of when the guidance / policy was last reviewed
3. Details of when the guidance / policy is due for review
4. Details of the number of applications for treatment that have been received in each of the last 3 financial years
5. Details of the number of applications for treatment that were approved in each of the last 3 financial years

Please confirm the name and email address of the Director for the Cancer Network that covers your PCT area.

Please provide an electronic version of any other Policy / Procedure that the Trust applies to the funding of new technologies / procedures.

Please confirm the population base for the PCT area.

A. Oncology Funding
A1 - In the last 12 months, how many business cases were submitted from Oncologists requesting funding for patients with advanced renal cell carcinoma
A2 - If the case was successful what was the number of patients involved in the business cases in A1
A3 - In the last 12 months, the number of individual funding requests submitted by your oncologists requesting funding for the treatment of patients with advanced renal cell carcinoma
A4 - The number of those individual funding requests that were approved

B. Haematology Funding
B1 - In the last 12 months, how many business cases were submitted from Haematologists requesting funding for patients with Idiopathic (immune) thrombocytopenic purpura (ITP)
B2 - IF the case was successful what was the number of patients involved in the business cases in B1
B3 - In the last 12 months, the number of individual funding requests submitted by your Haematologists requesting funding for the treatment of patients with Idiopathic (immune) thrombocytopenic purpura (ITP)
B4 - The number of those individual funding requests that were approved

1. What are your clinical guidelines or criteria for body contouring (plastic / reconstructive or skin reduction surgery including abdominoplasty) following bariatric surgery or other massive weight loss, specifically:
- BMI criteria
- Length of time following weight loss
- Weight lost
- Quality of life

2. What reconstructive surgery is available to your patients following massive weight loss?

3. What is the process for accessing reconstructive surgery and body contouring (plastic / reconstructive or skin reduction surgery including abdominoplasty) following massive weight loss? E.g.
- Exceptional circumstance request
- Normal referral to plastic surgeon

1. How many children and young adults (aged between 2 & 15 years) with sickle cell anaemia (Hb SS) are being treated within your NHS Trust?

2. How many children and young adults (aged between 2 & 15 years) have received TCD scans in line with TCD Scanning for Children with Sickle Cell Disease standards and guidance during: a) 2008/09 b)2009/10

3. What has the local NHS Trust done to implement the TCD Scanning standards and guidance by providing parents with both a verbal and written explanation of TCD scanning process?
a) Are information leaflets about TCD scanning available for parents?
b) Aside from leaflets, how is information about TCD scanning delivered to service users?

4. What has the local NHS Trust done to ensure all operators performing TCD or TCDi scanning on children must have had appropriate training in the technique as per the TCD Scanning standards and guidance?
a) How many operators have attended a training day on the theory of TCD scanning, protocol and equipment?
b) How many operators have attended a day’s secondment at a centre of excellence to receive hands on training?

- How are weight management services for those of a BMI of over 30 (and over 18 years of age) delivered in your PCT?

- What does the PCT consider as a 'success' for your weight management services?

- Are there any PCT policies or strategies for weight management?

- What is the e-mail address of your weight management services commissioner?

- What is the annual expenditure on such services?

- Are any non-NHS companies employed to deliver them?

A.  Reference your policy(ies) for dealing with exceptional and individual funding requests. Please would you either:
• Give me the url were they can be found, or
• Send me electronic copy(ies) of the document(s)

B.  Referring to each the following neuromodulation interventions:

B1. Spinal Cord Stimulation for the treatment of Neuropathic pain
• Do you have a local policy for its provision/commissioning
• Do you have a Service Level agreement with your local provider for its provision
• If not how are the needs of your local population met
• In the last year, how many requests for this services were managed via the individual/exceptional funding route
• How many of these requests were successful

B2. Intra Thecal Bacolofen drug delivery
• Do you have a local policy for its provision/commissioning
• Do you have a Service Level agreement with your local provider for its provision
• If not how are the needs of your local population met
• In the last year, how many requests for this services were managed via the individual/exceptional funding route
• How many of these requests were successful

B3. Sacral Nerve Stimulation for the management of urinary & Faecal incontinence
• Do you have a local policy for its provision/commissioning
• Do you have a Service Level agreement with your local provider for its provision
• If not how are the needs of your local population met
• In the last year, how many requests for this services were managed via the individual/exceptional funding route
• How many of these requests were successful

B4. Deep brain Stimulation for licensed and NICE guided indications
• Do you have a local policy for its provision/commissioning
• Do you have a Service Level agreement with your local provider for its provision
• If not how are the needs of your local population met
• In the last year, how many requests for this services were managed via the individual/exceptional funding route
• How many of these requests were successful

2.    Would you please specify any HIV-specific QIPP projects you have in your local health economy?

3.    In your local health economy what is the HIV patient journey and how is this mapped?

4.    Who is responsible for commissioning HIV services?

5.    When are HIV tenders published?

6.    What are the Key Performance Indicators that commissioners apply to HIV service providers?

7.    What are your local HIV prevention policies?

8.    What strategies do you have in place relative to HIV to diagnose the undiagnosed?

9.    Do you have any local HIV networks - please give contact details?

10.  Are there HIV local prescribing guidelines - please send electronic copies?

11.  Which  prescribing groups that influence HIV treatment?

12.  What are the main driver for these groups and who influences them?

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Please could you supply the following documents:
• Dementia Strategies
• Patient Care Pathways for Dementia
• Treatment Protocols for Dementia

Please could you also advise who fulfills the following roles for your organisation:
• Dementia Commissioning Lead 
• Older People’s Mental Health Commissioning Lead
• Mental Health Commissioning Lead 
• GPwSI in Elderly Care

Copies of the written specifications for all Locally Enhanced Services (LES) commissioned from general practitioners by Derby City PCT that were in operation on November 30 2010.

By ‘specification’ is meant the document or documents that describe what general practices participation in a LES are expected to do, the timeline over which the LES would operate, the conditions for payment and the rates of remuneration.

Where a written speciation is supplemented by a separate contract document, this request should be taken to include a copy of that template contract in addition to the specification.

Where a LES has been packaged into another contractual device or document, this request should be taken to include a copy of that document

A list of general practice names with postcode or other definitive identifier that were signed up to each of the LES operation on November 30 2010.

a)   Has NHS Derby City issued written guidance to GPs about managing the number of referrals for elective surgery, since June 2010?

b)   Has NHS Derby City issued any guidance to GPs since June 2010 asking them to stop referring patients for elective surgery and, if so when was this guidance issued and for which types of surgery?

c)   Has NHS Derby City asked GPs to stop referrals for low priority procedures and if so, could it be stated which low priority procedures have been identified?

a) Has NHS Derby City introduced any caps or limits on the number of referrals to elective surgery procedures since June 2010? If so, which types of elective surgery have been capped?

b) The reasons for any caps and limits on the number of referrals to elective surgery procedures since June 2010.

c) Has NHS Derby City stopped any types of elective surgery procedures, since June 2010? And if so, which types of elective surgery have been stopped?

1: What policy do you (NHS Derby City) have in place to determine eligibility for cataract surgery? Please provide a copy of this policy together with a written statement of the reasons for this policy.

2: Have you made any changes to your policy since January 2009, or are you planning to make changes to your policy, for instance, are plans being submitted to the PCT management board to approve changes for the coming financial year?

I would be grateful if you could send me, the current commissioning policy document used by your PCT for approval of this treatment.

1. Confirm in writing/by email that you hold the information listed below; and

2. Supply us with the information

The information is:

a) Confirmation of how the decision to commence a Consultation on the NHS Derby City Review of Direct Access Services was made;

b) All materials available to and relied on by the individuals(s) who took the decision to undertake the consultation:

c) Confirmation of the process by which the decision of which options will be pursued once the responses to the consultation are received;

d) Confirmation of at what stage the PCT is intending refer the possible closure of a health centre to the Local Authority Health Overview and Scrutiny Committee (“OSC”) as required by law;

e) Details of the “existing commitment” to provide health provision at the former Derby Royal Infirmary site following the relocation of A&E;

f) Confirmation of the basis upon which the PCT asserts in the Review that “the need for a GP service (such as DOAC) in addition to existing GP practices has reduced”;

g) What surveys, as referred to in the Review have “demonstrated that patients greatly values their own GP and that this should generally be their first option for treatment during normal practice hours”. Please provide copies of the surveys relied on by the PCT; and

h) Details of the how the economics of the respective contracts for Walk in Centre and open access centre present a lower “financial risk” the PCT in Contracting with the Walk in Centre.

In our request we asked you to confirm in writing or by email whether you held the information listed and to provide this.

In particular, matters A, F, G and H as originally set out in our letter of 28 February 2011 and repeated in your letter 28 March 2011 have neither been answered nor provided by reference to the materials supplied.

As originally requested, please confirm whether you hold the information as listed and supply us with that information.

With regards to matter A you have supplied various document from the period after 20 October 2010. No information has been provided on how the decision to commence a consultation was undertaken. You have provided the Walk in Centre and Open Access Centre Report dated 20 October 2010. This sets out that “the PCT need to review its provision of Walk-in and Direct Access Services”. No information concerning for the inception, generation, development (or terms of reference for the author) have been provided.

Original Questions:
A - Confirmation of how the decision to commence a Consultation on the NHS Derby City Review of Direct Access Services was made;
F - Confirmation of the basis upon which the PCT asserts in the Review that “the need for a GP service (such as DOAC) in addition to existing GP practices has reduced”;
G - What surveys, as referred to in the Review have “demonstrated that patients greatly values their own GP and that this should generally be their first option for treatment during normal practice hours”. Please provide copies of the surveys relied on by the PCT; and
H - Details of the how the economics of the respective contracts for Walk in Centre and open access centre present a lower “financial risk” the PCT in Contracting with the Walk in Centre.

The measures the PCT will be taking in the next financial year (2011/12) to avoid patients with long-term conditions being admitted to hospital.
The PCT will be undertaking this work currently, in accordance with instructions issued by the Department of Health as part of the long term conditions and urgent and emergency care work stream of its Quality, Innovation, Productivity and Prevention (QIPP) agenda.

1. Have you been working with any pathfinder GP consortia, or private companies, to develop new models of care to enable GPs to prevent patients with long term conditions making unscheduled use of urgent or emergency care? If so please give details.

2. Will you launch any new primary care initiatives to help GPs prevent unnecessary admissions to or attendance at secondary care in 2011/12? If so please give details.

3. If so, have you made any estimates of how much the PCT could save in 2011/12 by implementing the new initiatives? If so please give details.

4. Have you identified what level of reduction could be achieved in each of the following areas: a) unscheduled hospital admissions b) attendance at accident and emergency c) reductions in length of stay? If so, please give details and identify when you expect the reductions to be achieved by.

I write to submit a freedom of information request regarding the availability of infertility treatment on the NHS, made available by your PCT, in the last quarter that figures are available.

Please can you outline and detail how many requests for fertility treatment have been submitted by women over the age of 40 years old in the most recent quarter for which figures are available; how many women over the age of 40 years old have received infertility treatment free on the NHS in the most recent quarter for which figures are available; and what the subsequent cost and impact on health budgets has been.

Please give some indication of whether current rates and costs are increasing or decreasing.

• Does your PCT recognise Binge Eating Disorder as a treatable eating disorder?

• Is there a specific BMI/weight an overweight person must be to receive treatment for an eating disorder? Is there a limit to how high their BMI/weight is before they are refused treatment for an eating disorder? What are the reasons behind these limits?

• At what point (i.e. a certain BMI?) is help offered to overweight people?

• What measures of help do you offer overweight people, and do these come in a certain order dependent on weight/BMI?

• How much of your funding goes towards the primary problems of obesity each year? (Excluding secondary effects such as diabetes - just funding for treatments for weight management such as gastric surgery, counselling, dieticians and weight loss tablets). What percentage is this of your entire budget?
 
Could you tell me the answers to these in relation to the 08/09 and 09/10 financial years please?

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1. In 2008-09, 2009-10 and so far in 2010-11, how many individual funding requests for medicines or procedures not normally funded by the PCT were (i) received and (ii) accepted?

2. Can you confirm or deny whether the PCT has kept any record of whether the drafting of such requests was supported in any way by patient groups of healthcare professionals (for instance, were standard forms used)? If the PCT kept any such record, could you provide further details of the proportion of requests that were supported in this way?

3. In 2008-09, 2009-10 and so far in 2010-11, how many complaints did the PCT receive from patients about NICE-approved therapies not provided by the PCT? How many of these complaints led to patients receiving the therapy about which they had complained?

Original Question –
“In 2008-09, 2009-10 and so far in 2010-11, how many individual funding requests for medicines or procedures not normally funded by the PCT were (i) received and (ii) accepted?”

 You clarified –
“By ‘accepted’ I mean what you call ‘approved’.”

1) A list of types of elective surgery that the PCT has decided not to commission/provide (or is proposing not to commission/provide in future) under any circumstance;

2) A list of types of elective surgery that the PCT has decided to restrict access to (or is proposing to restrict access to in future), for example where the type of surgery will only be approved ‘in exceptional circumstances’, or will be denied to patients with certain characteristics such as obesity.

1. Have the medicines management, pharmacy, commissioning or public health teams had any discussions with the local pharmaceutical committee or internally since September 2010 on halting (or not extending, where a contract has come to an end) any community pharmacy enhanced services. 

2. Where such a discussion has been held, could you confirm:
• The date of the meeting
• Which service was discussed
• Whether a decision has been made on discontinuing the service
• The (brief) reasons for that decision and when the service will be stopped.

3. If any minutes or notes are available from these meetings, please could I see a copy of these.

• A copy of the latest Assisted Conception Policy (even if it's under review)

• Your PCT, Cluster or Specialist Group confirm as to whether you are still currently providing funding, currently reviewing funding, suspended funding or stopped funding entirely as of Mar/April 2011? 

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I would like to know what criteria exist that is used within your PCT for listing patients for cataract surgery.

What scoring system (if any) is used and what is the threshold?

What is the policy for patients who do not fulfil such criteria and how are they managed?

Is there variation within your trust for listing patients for cataracts?

What are the guidelines/criteria based on?

I would be most grateful if you could answer these questions as accurately as possible and if feasible to please send me any supporting documentation regarding your policy.

Q1 Name of Primary Care Trust

Q2 Contact details:

Q3 Has the PCT worked with the relevant local authority to agree policies, plans and budgets to support carers for 2011/12?

Q4 Have you pooled any budgets with the relevant local authority to provide services specifically for carers in 2011/12?

Q5 Have you worked with local carers and/or carers’ organisations to agree policies, plans and budgets to provide services that specifically support carers in 2011/12? If possible, please list local carers’ organisation (s)

Q6 Have you published and made these policies, plans and budgets available to local people? Expected publication date?

1. What is the waiting time for group CBT therapy for treatment of mild to moderate depression?

2. What is the waiting time for individual CBT therapy for treatment of mild to moderate depression?

3. What is the waiting time for computerised CBT for treatment of mild to moderate depression?

4. What is the waiting time for outpatient counselling for treatment of mild to moderate depression?

5. Is there a waiting time for a self-help programme for the treatment of mild to moderate depression? If so, what is it?

6. Is there a waiting time for group exercise therapy for the treatment of mild to moderate depression? If so, what is it?

7. Which, if any, of the following treatments are available to patients with a diagnosis of mild to moderate depression? If they are available, what is the waiting time?
 a) Interpersonal therapy
 b) Behavioural activation
 c) Behavioural couples therapy
 d) Psychodynamic psychotherapy

8. How many prescriptions for anti-depressants were issued in each of the past five years?

1. Does the PCT have a policy that restricts the funding of surgical or interventional procedures?

2. If yes, what is the total number of procedures for which funding restriction exist under this policy

3. For the following operation, does the PCT have a policy that restricts funding?
If yes, then how long has this policy been in operation?
a) Inguinal hernia surgery
b) Varicose vain surgery
c) Hip arthroplasty (replacement) surgery
d) Knee arthroplasty (replacement) surgery
e) Cataract surgery

Please also send me the policy that sets out these criteria

Please could you supply the following information:

• Patient Care Pathways relating to Stroke Prevention and/or Atrial Fibrillation (SPAF);

• Treatment Protocols relating to Stroke Prevention and/or Atrial Fibrillation (SPAF);

• Clinical Guidelines relating to Stroke Prevention and/or Atrial Fibrillation (SPAF).

- Who is eligible for IVF treatment?

- Who isn't eligible for IVF treatment?

- How many cycles of treatment are funded by the PCT

- Has the eligibility criteria OR number of cycles funded changed in the last 12 months

- Are there any plans to change eligibility criteria OR the number of cycles funded by the PCT in the next 12 months

Also I would appreciate it if you could tell me...

- How many rounds of IVF treatment has the PCT funded in the last five years

- How many cases put forward for funding have been refused by the PCT

Emergency contraception provision in schools:

1.  Does the Trust offer emergency contraception/the morning after pill/emergency hormonal contraception to pupils on school premises, either through its own staff, a service arranged through the trust, a partnership of multi-agency arrangement, or similar?

If so….
2. In how many schools does it currently provide this service?
3.  A list of the schools in which the service is currently provided
4a. For each school in which emergency contraception has been provided, the total doses of emergency contraception given to pupils (so far) in the 2010/11 school year.
4b. For each school that records age distinction, the number of recipients from Year 11 or below.
5a. For each school in which emergency contraception has been provided, the total doses of emergency contraception given to pupils in the 2009/10 school year.
5b. For each school that records age distinction, the number of recipients from Year 11 or below.
6a. For each school in which emergency contraception has been provided, the total doses of emergency contraception given to pupils in the 2008/9 school year.
6b. For each school that records age distinction, the number of recipients from Year 11 or below.

Please note this information has been repeatedly provided by trusts in previous FOI responses where held. Any refusal will be appealed. The only age distinction I am asking for is under 16s.

Consistent with Department of Health and NHS responses concerning abortions and similar, for any number of 5 doses or fewer please feel free to suppress to state only that it was between one and five.

Bariatric Surgery leads to significant weight loss which in turn results in patients having loose skin folds. Some of these patients need plastic surgery to correct this disfigurement. We are conducting a survey to find out the guidelines that are used and the different practices followed by the different Primary Care Trusts (PCT) to make referrals for plastic/aesthetic surgery for these patients.

Please help us to find out the current practice in your PCT by filling out a form which we have attached. Please return the form by the 11th of July by the email or via post on the address provided below.

1. How many women were diagnosed with perinatal mental health conditions over the past three years in your Primary Care Trust?

2. What proportion of those women developed perinatal:
a. Mild depression?
b. Moderate depression?
c. Severe depression?

3. What services are currently available for women who develop mild or moderate depression during pregnancy or the postnatal period?

4. What services are current available for women who suffer a moderate depressive episode and have a history of depression, or have a severe depressive episode, during their pregnancy or the postnatal period?

5. Which courses of treatment were delivered to the women identified in question 1, and with what frequency were these treatments administered?

6. What is the average waiting time from their initial assessment for pregnant women and women in the postnatal period who require psychological treatment?

7. How many places are there available in specialist mother and baby units for women who are pregnant, or in the postnatal period, and who need inpatient care for a mental disorder? What has the occupancy rate of these places been over the past 24 months?

8. How many of these mother and baby mental health units:
a. provide facilities specifically for mothers and infants?
b. are staffed by specialist perinatal mental health staff?
c. are staffed to provide appropriate care for infants?
d. have effective liaison with general medical and mental health services?
e. have available the full range of therapeutic services?
f. are closely integrated with community-based mental health services to ensure continuity of care and minimum length of stay?

1. Do you have a standard DNR form, and if so when was it introduced? If not, do you have plans to introduce one?

2. How many patients have requested that they should not be resuscitated, via DNR forms or other written statements, in each of the following years: 2008/9, 2009/10 and 2010/11

3. What criteria do you use for determining whether it is appropriate to issue a DNR form to a patient (eg terminal illness, resident of nursing or care home, patients over a certain age),

4. Which of the following healthcare professionals are on occasions expected to discuss DNR forms or equivalent paperwork with patients in your area? Please indicate all that apply. [List redacted]

1. What guidance do you have in place for NHS treatment of asylum seekers and other non-UK residents, and when did you introduce it?

2. What criteria do you use for deciding whether an asylum seeker or other non-UK resident is eligible for NHS care, and specifically for primary care?

3. How much money have you spent on provision of all NHS care, and specifically primary care, to asylum seekers and other non-UK residents in 2009/9, 2009/10 and 2010/11.

4. What action do you take against GP practices who choose to provide care to asylum seekers and other non-residents who should not qualify for NHS care under your criteria?

Clarify your PCT's stance on the commissioning of EVLT and open varicose vein surgery.  Has your PCT either:

1) decided not to commission EVLT and/or open varicose vein surgery (or is currently proposing not to commission EVLT in future) under any circumstance

2) decided to restrict access to EVLT and/or open varicose vein surgery (or is proposing to restrict access to in future.  If so, what exceptional circumstances are required to permit commissioning of these services?

If you have time, please would you indicate how many elective EVLT and open varicose vein procedures your PCT commissioned in 2008-09, 2009-10 and 2010-11.

Clarify your PCT's stance on the commissioning of EVLT and open varicose vein surgery.  Has your PCT either:

1) decided not to commission EVLT and/or open varicose vein surgery (or is currently proposing not to commission EVLT in future) under any circumstance

2) decided to restrict access to EVLT and/or open varicose vein surgery (or is proposing to restrict access to in future.  If so, what exceptional circumstances are required to permit commissioning of these services?

If you have time, please would you indicate how many elective EVLT and open varicose vein procedures your PCT commissioned in 2008-09, 2009-10 and 2010-11.

1) Does Derby City PCT have a policy in place for procuring domestically produced food for catering operations within establishments, which is served to patients, staff etc?

2) If so, please can you provide a brief outline of the policy?
 
3) What percentage out of the total food procured was produced in Britain in financial years 2009-2010 and 2010-2011?

4) In total how much was spent on food procurement in financial years 2009-2010 and 2010-2011?

We would be very grateful if you could provide the following information regarding your current provision of bariatric surgery, and what you feel may happen to the provision within the next two years:

-How many adults receive health care within your PCT?

-Currently what is the BMI cut-off for bariatric surgery?

-Is there an age cut-off for bariatric surgery within your PCT?

-Do you require people to lose weight before they are allowed to have bariatric surgery?  If so, how much weight and over what time period?

-Do you require people to attend a weight management programme before they are considered for bariatric surgery? If so how long is this programme?

-How many applications for bariatric surgery were there in the financial years 2009/10 and 2010/11?

-How many procedures were funded in the financial years

-Could you provide demographic information on the population in your PCT including age, sex and overall deprivation score?

-What are the demographics for those received funding in the financial years 2009/10 and 2010/11? (age, sex and deprivation scores)

-Over the next two years do you think that there will be a change in the funding for bariatric surgery? Could you give us your views as to how you foresee these changes (ie. expected same number of operations/ fewer operations/ more operations and by what percentage).

-If possible, could you send us a copy of your referral pathway for bariatric services?

1) Do you currently fund penile prosthesis?

2) What are your criteria for funding?

3) How many have you funded in the last 12 months?

4) How many requests have you had in the last 12 months?

5) Do you have any plans for changing your current funding criteria?

I request full details of NHS-funded IVF treatment offered and denied by the PCT in each year since 2005.

I would like the response to include, for each year during the period, the number of NHS-funded cycles offered and completed, the number of applications refused, and the reasons given - eg age, obesity, existing children.

Request 1: Please confirm whether your primary care trust offers specialist rheumatology physiotherapy services to patients with RA after admission to hospital following a) surgery or b) ‘flare-ups’ or c) on an ongoing basis to support self-management, as part of a specialist consultant-led multidisciplinary team.

Request 2: Please confirm whether your PCT provides general, non-specialist hospital-based physiotherapy services to patients with RA after admission to hospital following a) surgery or b) following ‘flare-ups’ or c) on an ongoing basis to support self-management.

Request 3: Please confirm whether your PCT provides generalist community-based physiotherapy services to patients with RA following a) surgery or b) following ‘flare-ups’ or c) on an ongoing basis to support self-management.

Request 4: Please provide details of the amount of money spent by your PCT on RA-related physiotherapy services for the last full financial year.

Request 5: Please provide details of the total number of physiotherapists employed by the PCT which are involved in the treatment of people with RA, during the last full financial year.

Request 6: Please provide details of any a) redundancies and b) vacant posts that your PCT has made in relation to physiotherapists involved in the treatment of people with RA, during the last full financial year.

Request 7: Please provide details of any reductions to physiotherapy services in your PCT that involve the treatment of people with RA, during the last full financial year.

Request 8: Please provide details of how physiotherapists employed by the PCT, involved in the treatment of people with RA, receive specialist training about RA.

Request 9: Please provide details of the a) average and b) maximum waiting time for a person with RA to see a physiotherapist for treatment.

Request 10: Please provide details of any plans to introduce an Any Qualified Provider (AQP) model for the provision of physiotherapy services for RA.

Can you please advise me where I can find the following documents for NHS Derby City

- Annual Report 2010/11
- Annual Accounts 2010/11
- Joint Strategic Needs Assessment 2011
- Operating Plan 2011/12

1. Please state the definitions that you use for different forms of palliative and end of life services

2. Please confirm whether end of life care was included in your most recent joint strategic needs assessment
a. If yes, please provide a copy of your joint strategic needs assessment

3. Please confirm or deny whether you hold records of the number of people with motor neurone disease in your PCT
a. If yes, please provide details of the number of people with motor neurone disease in your PCT

4. Please confirm or deny whether you hold records of the number of people requiring (i) specialist palliative and (ii) end of life care in your PCT
a. If yes, please supply details on the number of people requiring (i) specialist palliative and (ii) end of life care in your PCT

5. Please confirm or deny whether you hold details on expenditure on (i) specialist palliative and (ii) end of life care services for (a) 2007/08 (b) 2008/09 (c) 2009/10 (d) 2010/11 in your PCT
a. If yes, please supply details of this expenditure

6. Please confirm or deny whether you hold details of expenditure on motor neurone disease for (a) 2007/08 (b) 2008/09 (c) 2009/10 (d) 2010/11
a. If yes, please supply details

7. Please confirm or deny whether you hold contracts with providers of (i) specialist palliative and (ii) end of life care
a. If yes, please supply a) the names of organisations with whom a contract is held b) the value of each contract and c) the specification of each contract

8. Please confirm or deny whether you hold data on GP practices in your PCT that have established an end of life care register
a. If yes, please supply details of the proportion of practices that have established an end of life care register
 
9. Please confirm or deny whether your organisation has developed any local tariffs for a) specialist palliative or b) end of life care
a. If yes, please supply details

10. Please confirm or deny whether your organisation has agreed CQUIN schemes with providers of palliative or end of life care services

11. Please confirm or deny whether your organisation holds information on performance against CQUIN indicators on (i) specialist palliative or (ii) end of life care
a. If yes, please supply details of (a) indicator thresholds and (b) if thresholds were met

12. Please confirm or deny whether your organisation has made payment on CQUIN indicators relating to (i) specialist palliative or (ii) end of life care
a. If yes, please supply details on payments made

13. Please confirm or deny whether your organisation publishes data on (i) specialist palliative or (ii) end of life care services in your area
a. If yes, please supply details
        
14. Please confirm or deny whether your organisation provides written information for patients on (i) specialist palliative or (ii) end of life care services in your area
a. If yes, please supply details
 
15. Please confirm or deny whether your organisation provides guidance to GP practices in your area on (i) specialist palliative or (ii) end of life care services
a. If yes, please supply details of this guidance
 
16. Please confirm or deny whether your organisation has in place agreed pathways of care for (i) specialist palliative or (ii) end of life care services
a. If yes, please supply details

17. Please confirm or deny whether contracts your organisation has in place for out of hours services contain standards relating to (i) specialist palliative or (ii) end of life care services  
a. If yes, please supply details

What is the name of your Primary Care Trust? 
What is the population of your area?  
Do you commission specialist secondary care ME/CFS services for ME/CFS patients?
If yes are these patients referred to local specialist service providers or to specialist service providers out of your area
Do you commission domiciliary services for ME/CFS patients?
For how many of these patients each year?

For each of the years 2008/09, 2009/10, 2010/11, how many referrals were made to the specialist ME/CFS services (a) for adults and (b) for children, living in your area?

What is the budgeted funding for ME/CFS services (a) for adults and
(b) for children in 2011/12?
What amount was spent on ME/CFS services
(a) for adults and (b) for children, for each of the years 2008/09, 2009/10, 2010/11?
Do you plan to maintain the levels of funding for these services in the longer term or to increase/decrease financial provision?
For each of the years 2008/09, 2009/10, 2010/11, how many referrals were made to Multiple sclerosis services (a) for adults and (b) for children living in your area?
What amount was spent on Multiple Sclerosis services (a) for adults and (b) for children for each of the years 2008/09, 2009/10, 2010/11?
For each of the years 2008/09, 2009/10, 2010/11, how many referrals were made to Ataxia services (a) for adults and (b) for children living in your area?

What amount was spent on Ataxia services (a) for adults and (b) for children for each of the years 2008/09, 2009/10, 2010/11?

What is the budgeted funding for Ataxia services (a) for adults and (b) for children in 2011/12?
For each of the years 2008/09, 2009/10, 2010/11, how many referrals were made to Parkinson’s services (a) for adults and (b) for children living in your area?
What amount was spent on Parkinson’s (a) for adults and (b) for children for each of the years 2008/09, 2009/10, 2010/11?

What is the budgeted funding for Parkinson’s services (a) for adults and (b) for children 2011/12?
What is your best estimate in your area of the prevalence of ME/CFS (a) for adults and (b) for children?
What is your best estimate in your area of the prevalence of Multiple Sclerosis (a) for adults and (b) for children?
What is your best estimate in your area of the prevalence of Parkinson’s (a) for adults and (b) for children?
What is your best estimate in your area of the prevalence of Ataxia (a) for adults and (b) for children?
In addition could you please provide a copy of the care pathway for ME/CFS patients in your area?

•Referral Pathways / Care Pathways / Prescribing Guidelines for Anaphylaxis
•Referral Pathways / Care Pathways / Prescribing Guidelines  for Allergic Rhinitis

I would also like to request:

•Diabetes Service Specifications / Service Level Agreements (SLAs)

Please can you email me a copy of your ICT/IM&T strategy?

a. The URL for the webpages showing the DED for the PCT’s Diabetic Retinopathy Monitoring Service.  

b. The Specific Equality Duty which replaced your 2006-2009 scheme.

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Click for Diabetic Retinopathy Uptake Report

Click for Strategy

1)   A list of treatments refused funding by your PCT in 2011 and reasons why they were refused.

2)   A list of treatments refused funding by your PCT in 2010 and reasons why they were refused.

3)   A list of treatments funded by your PCT in 2011.

4)   A list of treatments funded by your PCT in 2010.

Click for response

Click for spreadsheet 1) - refused 2010

Click for spreadsheet 2) - refused 2011

Click for spreadsheet 3) - approved 2010

Click for spreadsheet 4) - approved 2011

Ref 46 / Request 1:  Please confirm or deny whether the PCT holds a definition of ‘specialist open access contraceptive services’
a)  If confirmed please supply the definition of ‘specialist open access contraceptive services’

Ref 47 / Request 2:  Please confirm or deny whether the PCT has any policy or commissioning contract in place that restricts access to specialist contraceptive services (not supplied by general practice) to women on the basis of i) age, ii) place of residence, or iii) type of contraceptive method
a) If confirmed please supply the PCT’s policy or commissioning contract on restricting access to contraceptive services
b) If confirmed please supply any assessment the PCT has carried out on the impact of its policy or commissioning contract on restricting access to contraceptive services

Ref 48 / Request 3:  Please confirm or deny whether the PCT has put any restrictions in place on the prescribing or availability through general practice or other commissioned contraceptive services of any i) methods of emergency contraception, ii) long-acting reversible contraceptive methods or iii) other contraceptive methods/formulations during the financial year 2011/12, including within commissioned abortion services
a) If confirmed please supply details
b) If confirmed please supply any assessment the PCT has carried out on the impact of these restrictions

Ref 49 / Request 4:  Please confirm or deny whether the PCT has any plans to place restrictions on the prescribing or availability through general practice or other commissioned contraceptive services of any i) methods of emergency contraception, ii) long-acting reversible contraceptive methods or  iii) other contraceptive methods/formulations  during the financial year 2012/13, including within commissioned abortion services
a) If confirmed please supply details
b) If confirmed please supply any assessment the PCT has carried out on the potential impact of these planned restrictions

Ref 50 / Request 5:  Please confirm or deny whether the PCT provides any policy or guidance on the prescribing of i) emergency contraception methods, ii) long-acting reversible contraception methods and iii) other contraceptive methods/formulations
a) If confirmed please supply the PCT’s policy or guidance on the prescribing of i) emergency contraception methods, ii) long-acting reversible contraception methods and iii) other contraceptive methods/formulations

Ref 51 / Request 6:  Please confirm or deny whether contraceptive methods/formulations including, but not limited to, all methods of emergency contraception are currently included on the PCT’s i) red lists or ii) black lists of prescription items 

Ref 52 / Request 7:  Please confirm or deny whether the PCT has a formal strategy in place to reduce i) the rate of unintended pregnancy, ii) the level of abortions, and/or iii) the level of repeat abortions

Ref 53 / Request 8:  Please confirm or deny whether the PCT has undertaken a review of abortion services since 2007
a) If confirmed please supply details
b) If confirmed please supply details where services have been changed to improve i) service access, ii) access to all methods of contraception as part of the episode of care, and iii) choice of provider 

Ref 54 / Request 9:  Please confirm or deny whether the PCT commissions, as part of its abortion services, the provision of methods of contraception
a) If confirmed please supply details of this provision
b) If confirmed please supply detail of any policy or commissioning contract on restricting access to methods/formulations of contraception

Ref 55 / Request 10:  Please confirm or deny whether the PCT has any standards of competence for healthcare professionals fitting long-acting reversible contraception (subdermal implants and intrauterine contraceptive methods) in any healthcare setting
a) If confirmed please supply details

Ref 56 / Request 11:  Please confirm or deny whether the PCT has an agreement in place for Enhanced Service delivery of i) subdermal implants and/or ii) intrauterine contraceptive methods
a) If confirmed please provide details
b) If confirmed please confirm what percentage of general practices are signed-up to this Enhanced Service in each of the last 3 financial years

Ref 57 / Request 12:  Please confirm or deny whether the PCT intends to have an agreement in place for Enhanced Service delivery for methods of i) subdermal implants and/or ii) intrauterine contraceptive methods during the financial year 2012/13
a) If confirmed please provide details

Ref 58 / Request 13:  Please provide any service specification issued by the PCT to potential sexual health service providers in the last 3 years

Ref 59 / Request 14:  Please confirm or deny whether the PCT has, within the past 2 years, conducted an assessment of the local need for additional contraceptive training to provide subdermal implants and intrauterine contraceptive methods
a) If confirmed please supply details of how many healthcare professionals in general practitioners are currently trained to fit i) subdermal implants and ii) intrauterine contraceptive methods
b) If confirmed please supply details of how many healthcare professionals in community settings are currently trained to fit i) subdermal implants and ii) intrauterine contraceptive methods

Ref 60 / Request 15:  Please confirm or deny whether the PCT has any plans in place to increase capacity for fitting subdermal implants and intrauterine contraceptive methods
a) If confirmed please supply details

I am writing to convey the concerns of the Spinal Injuries Association (SIA), the leading national charity for people with Spinal Cord Injuries, at the inconsistencies in determinations of eligibility/ineligibility on NHS Continuing Healthcare (CHC) experienced by our tetraplegic members.

In a number of PCTs, we are aware of eligibility criteria for CHC being used which are not Coughlan-compliant; indeed it is our view that Ms Coughlan would not be deemed eligible for NHS Continuing Healthcare (CHC) funded under them.   Yet, Ms Coughlan, a C5/6 (complete) tetraplegic and SIA member whose health care needs are well-understood by us, is eligible for CHC: indeed in its (1999) judgement (R v North and East Devon Health Authority, ex parte Coughlan) the Court of Appeal held that her needs were of a “wholly different category”.   As you will appreciate the National Framework for NHS Continuing Healthcare & NHS Funded Nursing Care 2009 (The “National Framework guidance) is predicated on this judgement (as it must be, since guidance must follow the law).

Given our concerns about these inconsistencies, please treat this letter as a request under the Freedom of Information Act 2000, that you provide me with a copy of the eligibility criteria for CHC and the CHC Policy which you utilise in your PCT (please note that I am not referring to the “National Framework” guidance) and a copy of the Disability Impact Assessment (required by s49A Disability Discrimination Act 1995 and s149 Equality Act 2010) as to the impact of the Policy.

You will I trust appreciate that people with a spinal cord injury resulting in health care needs comparable to or greater than Ms Coughlan, a C5/6 (complete) tetraplegic, (whose needs remain to this day as described by ADASS/LGA Advice on Continuing Care October in Annex F, 2007) would similarly be expected to be eligible for CHC as indicated by and in accordance with guidance contained in the National Framework 2009 para. 79.  Please note that I am not referring to diagnosis of tetraplegia per se, but to the consequential and predictable health care needs emanating there from.

To this end, may I draw your attention to the attached “Statement on Tetraplegia” which has been endorsed by both BASCIS (the British Association of Spinal Cord Injury Specialists) and MASCIP (the Multidisciplinary Association of Spinal Cord Injury Professionals), and which is strongly supported by the SIA. CHC funding is important to the care packages for tetraplegic patients in order to appropriately manage the risk of serious complications associated with this left of spinal cord injury and to reduce the financial impact to the NHS of not doing so.  We would ask you, therefore, to make both CHC nurse assessors and the eligibility-determining Panels aware of this document and the importance of heeding it.

We have considerable experience of assisting our members and would be pleased to work with you to improve understanding of spinal cord injury within the NHS with regard to the application of CHC eligibility.   Please do not hesitate to contact me or Mr Brian O’Shea, our CHC Advisor, in this regard if you feel this would be helpful.
 
I look forward to hearing from you.

Please could we obtain the following information?

On Age Related Macular Degeneration (AMD):
Your policy on the treatment of wet AMD. In particular, the use of Avastin (bevacizumab) and Lucentis (ranibizumab) for this condition.
Minutes and papers relating to any board meetings where this policy was discussed / approved.
The information you give to patients to explain your policy on treating wAMD, in particular the treatment options including Avastin and Lucentis.

On cataract: 
Your current policy on cataract surgery. In particular the criteria used to decide:
when a patient is eligible for surgery
whether the patient can have surgery in both eyes if they have a cataract in both

On glaucoma:
What proportion of your glaucoma follow-up appointments are delayed or cancelled?

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Click for Wet AMD Service Specification

Click for PLCV Policy

1. Between April 2010 and February 2012, please indicate whether your trust has brought in any new policies or modified any existing policies for referring for secondary care treatment that specifically restrict access to treatment for:
a) Smokers
b) Patients with alcohol problems
c) Obese patients

2. For each new/modified policy, please state
a) what the policy is
b) how it has changed from the previous position
c) the date it was introduced

1. Does your PCT currently offer NHS funded embryo screening?

2. Does your PCT currently offer NHS funded fertility treatment?

3. How many cycles of fertility treatments are you authorised to fund per patient in your PCT? If you have any limits on the kind of procedures provided can you list this as well i.e. funding IVF but not ICIS for example. 
a. Have you made any changes to this policy in the last three years?
i. If so can you describe the changes to this policy, i.e. when it changed, what number of cycles was funded over the old policy

4. Please provide the number of cycles the PCT provided during 1) the first six months of the year ended April 2011, 2) the second six months of the year ended April 2011, 3) the first six months of the year ended April 2012, and your most recent numbers for second six months of the year ended April 2012

a. Embryo screening i.e. pre-implantation genetic diagnosis

b. Fertility treatment, this would include such things as IVF and non-IVF cycles 

5. Please provide the monetary total spent by the PCT in 1) the first six months of the year ended April 2011, 2) the second six months of the year ended April 2011, 3) the first six months of the year ended April 2012, and your most recent numbers for second six months of the year ended April 2012

a. Embryo screening i.e. pre-implantation genetic diagnosis

b. Fertility treatment, this would include such things as IVF and non-IVF cycles

1. Does your PCT Cluster have a commissioning policy for the overall management of Hereditary Angioedema?  If so please supply a copy of your policy.  If policies vary within your cluster, please state which PCTs do/do not have a policy for the management of Hereditary Angioedema, and attach each individual policy.

2. Does your PCT Cluster have an overall commissioning policy for any of the following drugs: C1 Esteraise Inhibitor, Icatibant?  If policies vary within your cluster, please state which PCTs do/do not have a policy, and attach each individual policy.

3. Does your PCT Cluster have an overall policy for home use of the above named drugs?  If so, please supply a copy of your policy.  If policies vary within your cluster, please state which PCTs do/do not have a policy for this, and please attach individual policies.

4. How many requests for funding of the above named drugs for Hereditary Angioedema or Acquired Angioedema has your PCT Cluster received over the past two years.  Please provide details of the indication and the drug concerned, together with the particular PCT receiving the request.

5. How many requests for each drug were approved and how many were refused.  Please indicate the particular PCT involved in each instance.

1) Please can you list the third sector services and/or projects across all departments that your PCT commissions, awards grants and/or provides contracts for, that are targeted at or primarily used by women?
 
2) Please can you list the third sector services and/or projects across all departments that your PCT commissions, awards grants and/or provides contracts for, that are targeted at or primarily used by men?
 
3) Please can you list the amount of funding provided across all departments by your PCT over each of the last five financial years, or the nearest dates possible, to each of the commissioned, grant-awarded and / or contracted third sector services and/or projects that are targeted at or primarily used by women?

4) Please can you list the amount of funding provided across all departments by your PCT over each of the last five financial years, or the nearest dates possible, to each of the commissioned, grant-awarded and / or contracted third sector services and/or projects that are targeted at or primarily used by men?
 
5) If this break down is not possible, please could you provide me with the total amount of funding provided by your PCT over each of the last five financial years, or the nearest dates possible, to commissioned, grant-awarded and / or contracted third sector services and/or projects that are targeted at or primarily used by men and women respectively?
 
6) Please can you tell me, of those third sector services and/or projects that are used by both men and women, for each service what percentage or numbers of users are men and what percentage or numbers of users are women?

7) Please can you provide me with a full list of the names of all the third sector organisations commissioned, grant-awarded and / or contracted across all departments by your PCT over each of the last five financial years, or the nearest dates possible?
 
8) Does your PCT have a dedicated men’s health worker or officer, or equivalent and how much are they paid?

9) Does your PCT have a dedicated women’s health worker or officer, or equivalent and how much are they paid?

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Click for County List

Click for City List

Please could you supply the following information:

• Referral Pathways / Care Pathways for Rheumatoid Arthritis;
• Prescribing Guidelines for Rheumatoid Arthritis;
• Treatment protocols for Rheumatoid Arthritis;
• Disease Strategies/Long-Term Disease Strategies for Rheumatoid Arthritis.

1. Has the PCT undertaken any active measures to increase capacity in endoscopy services since April 2011? Please give details of any action taken, or the reasons why action has not been taken.

2. How much has the PCT spent in 2011/12 on the action set out in answer to Q1? How much has it budgeted to spend in 2012/13 on expanding endoscopy access? (Note: if actual figures are not available, please provide best estimates).

1) Which departments in Derby City Primary Care Trust and Derbyshire County PCT received the highest number of formal complaints in the following years:
a. January 1st to December 31st 2008
b. January 1st to December 31st 2009
c. January 1st to December 31st 2010
d. January 1st to December 31st 2011

2) Which department in Derby City Primary Care Trust and Derbyshire County PCT received the highest number of formal compliments in the following years:
a. January 1st to December 31st 2008
b. January 1st to December 31st 2009
c. January 1st to December 31st 2010
d. January 1st to December 31st 2011

3) Please can you send me the performance records of the surgeons in the departments given as answers to questions 1 a-d and 2 a-d?

Click for response

Click for City report 2008/09

Click for City report 2009/10

Click for City report 2010/11

Click for County report 2009/10

Click for County report 2010/11

I wish to make a request under the Freedom of Information Act to find the number of times in which electro-convulsive therapy was used, as stipulated by the Mental Health Act 1983, by Derby County PCT between 1st April 2010 and 31st March 2011. I would also like to know how many times each method of consent outlined in the Mental Health Act was used – how many times consent was granted by the patient, how many times the emergency powers under Section 62 of the Act were employed and how many times a second opinion was given instead of patient consent under Section 58(A), Subsection 5, of the Act.

I would also like to request that the number of times ECT was used on patients under the age of 18 years be included in the data, and how many times each of the forms of consent outlined above was used in the case of patients under the age of 18. Further to this request, I remind you that approximate age groups have been included in similar public data, most notably in the Department of Health’s survey of electro-convulsive therapy between January and March 2011.

You asked us to provide the following information.

185 - Request #1 Please confirm or deny whether there is a lead for hepatitis C in the PCT.

186 - Request #2 Please confirm or deny whether the PCT has a strategy in place for managing hepatitis C in its area.

187 - Request #3 Please confirm or deny whether the PCT has arrangements with the relevant local authorities to ensure coordination of hepatitis C commissioning in its area.

188 - Request #4 Please confirm or deny whether the PCT has a hepatitis C clinical network in place.

189 - Request #5 Please confirm or deny whether the PCT has undertaken an assessment of the current and future health needs of its population in relation to hepatitis C.

190 - Request #6 Please confirm or deny whether the PCT has developed an estimate of the overall prevalence of hepatitis C in its area.

191 - Request #7 Please confirm or deny whether the PCT has developed an estimate of the number of people diagnosed with hepatitis each year in its area.

192 - Request #8 Please confirm or deny whether the PCT has any data on the number of people tested for hepatitis C in its area.

193 - Request #9 Please confirm or deny whether the PCT has an estimate of the number of patients with hepatitis C accessing NHS services in its area. 

194 - Request #10 Please confirm or deny whether the PCT has an estimate of the number of patients with hepatitis C that were initiated with treatment for hepatitis C in the last year in its area.

195 - Request #11 Please confirm or deny whether the PCT has an estimate of the amount spent on drugs for the treatment of hepatitis C in its area.

196 - Request #12 Please confirm or deny whether the PCT has details on the number of exceptional case requests that were made for hepatitis C treatment in (a) 2009-10, (b) 2010-11 in its area.

197 - Request #13 Please confirm or deny whether the PCT has details on the number of exceptional case requests that were approved for hepatitis C treatment in (a) 2009-10, (b) 2010-11 in its area.

198 - Request #14 Please confirm or deny whether the PCT has an estimate of the number of patients with hepatitis C that achieved sustained virological clearance following hepatitis C treatment in its area.

199 - Request #15 Please confirm or deny whether the PCT has measures to encourage hepatitis C testing in local GP practices.

200 - Request #16 Please confirm or deny whether the PCT has measures to increase treatment of patients with hepatitis C in its area. 

201 - Request #17 Please confirm or deny whether the PCT has communicated with local providers on how clinical outcomes for hepatitis C patients can be improved.

202 - Request #18 Please confirm or deny whether the PCT has undertaken an audit of the quality of hepatitis C services in its area. 

203 - Request #19 Please confirm or deny whether the PCT commissions prison services.

Request #19a If confirmed, please provide details on the prevalence of hepatitis C in each prison in its area.

Request #19b If confirmed, please confirm or deny whether the PCT commissions a blood borne virus service in its prison(s).

Request #19c If confirmed, please confirm or deny whether the PCT commissions a blood borne virus specialist nurse in its prison(s).

Request #19d If confirmed, please provide details on (a) the number of offenders tested for hepatitis C, (b) the number of hepatitis C diagnoses amongst offenders and (c) the number of offenders undergoing active hepatitis C treatment in its prison(s) in 2010-11.

1. Please list all services or treatments that were previously commissioned by the PCT for residents in your area and have now been decommissioned or restricted, in the financial years 2010/11 or 11/12.

2. If a service has been decommissioned or restricted:
a. Please provide the date from when the decision was applied.
b. Please specify whether the decision to decommission or restrict this service relates to new clinical guidelines.

3. Please give details of any plans to decommission or restrict services or treatments in the 2012/13 financial year.

NHS Derbyshire Cluster Commissioning Policy for Procedures of Limited Clinical Value:
• Version 1
• Version 2.1
• Version 2.2

East Midlands Commissioning Policy for Cosmetic Procedures (Region-wide):
• Commissioning Policy relating to non-urgent cosmetics procedures (Revised Nov 2005)
• Revised Commissioning Policy relating to non-urgent cosmetics procedures (Revised Nov 2005)
• East Midlands Adult Cosmetic Procedures Policy (Issued 01 June 2010, Review Date 30 April 2012)
• East Midlands Cosmetic Procedures Policy (All ages) (Issued 25 March 2011, Review Date 01 April 2012)

1) Is treatment of myopic choroidal neovascularisation ("mCNV") with anti-vascular endothelial growth factors ("anti-VEGFs") routinely funded by your organisation?

2) If mCNV treatment with anti-VEGFs is not routinely funded, please provide the total number of individual funding requests, in each of the calendar years 2008, 2009, 2010, 2011 and 2012, that requested this treatment which were (a) received and b) approved, disaggregated by drug product requested and approved.

3) If a written policy regarding mCNV treatment with anti-VEGFs exists within your organisation, please provide a copy.

Please break this down by the following wherever possible
a. Mothers having a their first child
b. Mothers aged under 20
c. Mothers who were Black or from an Ethnic Minority Community
d. Mothers on benefits
e. Mothers known to social services
f. Mothers with English as an additional language
g. Mothers living in social housing
h. Mothers with a diagnosed mental health problem
i. Mothers who are known to have suffered from domestic abuse
j. Mothers who are registered as disabled

7. How much was spent on these classes by your organisation?  Wherever possible please breakdown by
a. Programme
b. Group within each programme

8. Were any classes provided specifically for parents with the following additional needs?

a. Teenage parents
b. Substance misusing parents
c. Single mothers
d. Asylum seekers or refugees
e. English as an additional language
f. Learning difficulties
g. Victims of domestic abuse
h. Gypsies or travellers
i. Offenders
j. Mental health problems

9. If possible, please tell us the following information about each of these specialist programmes:
a.  the number of groups run;
b.  the number of the parents who attended these groups;
c. the name of the provider, and
d. the programme offered.

10. Please send any documents detailing criteria used to commission antenatal provision.

1. Did the PCT commission or fund any services involving homeopathy in (i) 2010/11 and (ii) 2011/12?

2. Did the PCT agree to fund any individual requests for funding of services involving homeopathy in (i) 2010/11 and (ii) 2011/12?

3. How much does the PCT estimate it spent on services involving homeopathy in (i) 2010/11 and (ii) 2011/12?

4. When did the PCT last review its policy on funding of services involving homeopathy? If this review led to any change in policy, what was the reason for this?

1) Please could you tell me the budget for Child and Adolescent Mental Health Services (CAMHS) for each of the following years a) 2010-2011, b) 2011-2012 and c) 2012-2013?

2) Please could you also tell me whether, between April 2010 and the date of this request

a) the criteria for being accepted for assessment and/ or treatment within the CAMH service has changed
b) there are now groups of clients/ types of problems for which you do not accept referrals
c) the criteria for which agencies/ people are allowed to refer into CAMH services has changed
d) there have been any local limits (formal or informal) placed on the number of sessions that can be offered to clients for assessment and/ or treatment

3) I would be grateful if you could provide me with a copy of any existing referral criteria or guidance on offering assessment and any previous criteria/ guidance issued after April 2010.

• Since 2009, how many corneal grafts has your PCT performed?
• Since 2009, how many people have been on your waiting list for a corneal graft? (please give figures for each year since 2009).
• How many people are on your current waiting list for a corneal graft?
• Since 2009, what has been the wait for each corneal graft?

• Are people placed on the waiting list for graft after diagnosis for a corneal graft or when graft material becomes available?

• Further to confirmation of the need for corneal graft, what is the time gap between request for graft material and arrival of graft material?

• How many surgeons in total have you had performing corneal graft surgery in 2009, 2010, 2011 and 2012?

1. If your organisation provides a Musculoskeletal Community Assessment Triage [MCAT] service, please indicate the location of these services [eg name of local Hospital Trust or other treatment centre]

2. If you provide a MCAT service, how many extended scope practitioners do you have within the service, please name where possible

3. Do primary care GP practices have direct access to MRI scanners?

4. How many physiotherapists are employed by your organisation – please state by their work location?

If you commission physiotherapy to an AQP or other body, please state their name

1. What services do you intend to provide within the next two years to support patients to reduce their alcohol intake, or their consumption of illegal drugs
a. Which, if any, of these services do you intend to utilize a ‘whole family’ approach to reducing drug or alcohol consumption?
b. Which, if any, of these programmes will be open to self-referral?

2. Do you intend to provide any services designed to reduce alcohol or drug consumption in expecting parents or those who have a child under 2 years old?

3. Are there any alcohol/drug reduction programmes currently being run by Primary Care Trusts in your area which you do not intend to provide from April 2013?

4. Are there any alcohol/drug reduction programmes currently being run by Primary Care Trusts in your area which you intend to outsource within the next two years?

We would like to understand how NHS Derbyshire County deals with the treatment of Multiple Sclerosis and therefore we would like to request any documents that are used to cover this treatment area. In particular, we would like:

• Treatment protocols
• Patient Care-pathways
• Disease Strategies
• Prescribing Guidelines

NHS Derbyshire Cluster adopt and implement East Midlands Specialised Commissioning Group (EMSCG) policies regarding Multiple Sclerosis.

EMSCG policies can be found here:

Click for North Derbyshire Response

Click for North Derbyshire DVT draft

Click for Southern Derbyshire Response

Please can you let me know how Derbyshire NHS are meeting the mental health needs of BME communities in Derby City and Derby County?

Who have Derbyshire NHS commissioned both voluntary, statutory and private sector to address these needs?

Since DRE how have the recommendations been implemented as we have witnessed a further death of a Pakistani young male in 2010? I have been engaged with the family and there were clear issues around communication and lack of advocacy and carer support. 

As lead commissioner I am also concerned that the recommendations of the research report in 2007 have not been implemented so resulting in further lack of equitable services for BME communities which I have given a copy to Anita Thomas - Equality Lead.
 
I would like to organise a number of meetings for BME communities to talk about mental health needs and services in Derby City  as there are visible gaps in commissioned services for Service users, carers and community and faith organisations so can you advise who will be the best person to attend from Derbyshire NHS ?
 
I have had a number of meetings with Derbyshire Healthcare Foundation Trust, to seek a partnership approached to addressing the BME CQUIN targets which to date has not led to any successful outcomes for Derby REC to be commissioned to deliver and work in partnership so please can you let me have further information on the actual targets that Derbyshire Healthcare Foundation Trust have to deliver on and also any other providers specific to BME communities or equality.

Can you tell me if you participated in the NHS lone worker framework agreement?

If you did take part in the framework agreement, can you please tell me when?

If you do not take part in the framework, can you please tell me the reasons why?

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Please can I request a copy of the most recent QiPP Plan and Process for NHS Derby County PCT &/or NHS Derbyshire Cluster and copies of the most recent QiPP Performance Finance Review Report and / or indicate if any of these documents are available to access on the PCT website or within the most recent PCT Operating Plan.

I would also like to request the Re-use of these documents under Public Sector Information Regulations 2005. The documents will be re-used on a Business Intelligence Online Service.

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Ref. 411
1. Please confirm or deny whether your PCT holds guidance or policies concerning programmes for outreach in the community for Hepatitis C diagnosis

a. If confirmed, please provide details of guidance or policies concerning outreach in the community for Hepatitis C diagnosis being used by your PCT

b. If confirmed, please provide details of Hepatitis C diagnosis community outreach programmes that your PCT has commissioned in 2011-12  and 2010-11

Ref. 412
2. Please confirm or deny whether your PCT commissions epidermal growth factor receptor (EGFR) testing for patients diagnosed with non-squamous non-small cell lung cancer (NSCLC)

a. If confirmed, please confirm how many EGFR tests were commissioned by your PCT in 2011-12 and 2010-11

b. If confirmed, please confirm for what proportion of patients diagnosed with non-squamous non-small cell lung cancer were EGFR tests commissioned by your PCT in 2011-12 and 2010-11

c. If confirmed, please provide details at what stage in the treatment pathway for patients diagnosed with non-squamous non-small cell lung cancer your PCT will pay for EGFR testing

Ref. 413
3. Please confirm or deny whether your PCT holds its own policies or guidance for the commissioning of sequential therapy for the treatment of glioma in addition to NICE guidance

a. If confirmed, please provide details of policies or guidance used within your PCT concerning the commissioning of sequential therapy for the treatment of glioma

Ref. 414
4. Please confirm or deny whether your PCT has had any communications with its cancer network concerning policies or guidance for the commissioning of sequential therapy for the treatment of glioma

a. If confirmed, please provide details

Ref. 415
5. Please confirm or deny whether your PCT holds its own policies or guidance for the commissioning of anti-tumour necrosis factor alpha (anti-TNF) therapy for patients with rheumatoid arthritis in addition to NICE clinical guideline 79 (The management of rheumatoid arthritis in adults)

a. If confirmed, please provide details

Ref. 416
6. Please confirm or deny whether your PCT monitors compliance with NICE clinical guideline 79 (The management of rheumatoid arthritis in adults) in respect of the commissioning of anti-tumour necrosis factor alpha (anti-TNF) therapy for patients with rheumatoid arthritis

a. If confirmed, please provide details of any policies of guidance used by your PCT concerning the initiation of patients onto anti-TNF therapies for the treatment of rheumatoid arthritis

b. If confirmed, please provide details of any policies of guidance used by your PCT concerning the cessation of anti-TNF therapies for the treatment of patients with rheumatoid arthritis

c. If confirmed, please provide details of any policies of guidance used by your PCT concerning the cycling of patients through anti-TNF therapies for the treatment of rheumatoid arthritis

Ref. 417
7. Please confirm or deny whether your PCT holds its own policies or guidance for the commissioning of dual x-ray absorptiometry (DXA) for diagnosis of osteoporosis

a. If confirmed, please provide details of policies or guidance used within your PCT concerning the commissioning of dual x-ray absorptiometry (DXA) for diagnosis of osteoporosis

b. If confirmed, please provide details of policies or guidance used within your PCT concerning the ability of GPs to commissioning directly dual x-ray absorptiometry (DXA) for diagnosis of osteoporosis

a) If yes please give details of which specialties/pathways have been involved and any readily available detail of what has been put in place (eg copies of protocols, pathway guidance, GP management advice etc).

2) Has the PCT/Cluster and/or associated CCGs developed any protocols, pathways, referral triage arrangements or similar frameworks for optimising the use of internal referrals, inc consultant to consultant?

a) If yes please give details of which specialties/pathways have been involved and any readily available detail of what has been put in place for both intra- and inter-specialty referrals (eg copies of protocols etc)

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What steps have been taken by the PCT to ensure that clinicians undertake shared decision-making when determining treatment options for patients for Chronic Myeloid Leukaemia (CML) patients? 

What steps have been taken by the PCT to support clinicians to undertake shared-decision making when determining treatment options, regardless of condition? 

1. What was the highest amount paid out in redundancy payment to a member of staff in the current financial year 2012/13 - and what was the highest in 2011/12 and in 2010/11? Please note I am asking about the PCT cluster and its predecessor organisations.

2. How many requests to fund Cyberknife or Gammaknife treatment have you had since May 2010 (please indicate which cancers were involved in each case, whether the request was for Cyberknife or Gammaknife, and which centres were requested)?

3. Of these, how many have been funded by the PCT/cluster(please indicate which cancers were involved, was the treatment Cyberknife or Gammaknife, and where treatment took place)?

Question 1: What policy do you have in place to determine eligibility for cataract surgery? Please provide a copy of this policy together with a written statement of the reasons for this policy.

Question 2: Have you made any changes to your policy during or after 2006/07 financial year? If yes, please outline what policies have been in place between the 2006/07 financial year to the current date; as well as the exact dates that they were in operation. Please list the policies in date order and explain any gaps.

Question 3: Are you planning to make changes to your policy? For example, are plans being submitted to the PCT / Clinical Commissioning Group Board to approve ahead of the coming financial year? If you are intending to make changes to your current policy - which will come into force in the financial year 2013/14 or 2014/15 - please provide details of the proposed or agreed new policy to RNIB.

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Click for policy - September 2011

1. Please list the specialist services in your area that exist to assess older people to see whether they have dementia. This should include any memory clinics or older people’s mental health teams, and not include primary healthcare (i.e. GPs). Please state which local authority each service listed operates in (at county rather than district council level where appropriate). (Responses would look like, for example, Memory Clinic, Oxfordshire County Council or Older people’s CMHT, LB Barnet).
 
2. For each service listed, please state whether or not social workers are employed within the service.

3. For each service listed whose primary function is to assess older people for dementia (i.e. memory services but not older people’s CMHTs): if social workers are employed in this service, please attach a job description for that post. If there are several social work posts different grades, please attach all relevant job descriptions.

How many patients have been granted personal health budgets by your PCT (whether or not they have actually received funding to date)?

How many requests to spend personal health budget funding on healthcare interventions has your PCT received?

How many of these requests were rejected and why?

Please give details of types of services patients have used personal health budgets to pay for.

Please give details of total funding allocated via personal health budgets by your PCT in the 2012/13 financial year.

Please give details of the smallest and largest amount allocated to any one patient via personal health budgets in your PCT area, and the average amount across all patients.

1. How many people live in the PCTs catchment area?

2. How many people participated in an Expert Patient Programme provided or commissioned by the PCT in the years 2010, 2011, and 2012?
 
3.     Does the PCT commission or provide any disease-specific patient education or self-management programmes? For example, a cardiac rehabilitation programme for patients who have survived a heart attack.
a.     If so, please specify for which diseases and the number of participants in each programme for 2010, 2011 and 2012
b.     If these programmes are commissioned by the PCT, but provided by a third party, please give details of the provider.

4.     If the PCT commissions and/or provides any patient education or self-management programmes specifically for patients with osteoarthritis or other musculoskeletal problems, please provide details of the programmes, for example:
a.     The number of patients who have participated (if not already specified in answer to 3 above)
b.     Number of times it has been run in the last 12 months
c.      Who it is lead by (e.g. physiotherapists, lay experts)
d.     The venues it is delivered in
e.     The number of sessions delivered each time the programme runs, and the time interval between each session (for example, six sessions delivered on a weekly basis)
f.      The times at which these sessions are run (for example, from 09:00 to 11:00 on Mondays)
g.     Details of the provider(s) if not the PCT.