NHS Kernow - Disclosure Log Freedom of Information Requests August 2017

Transcription

1 NHS Kernow - Disclosure Log Freedom of Information Requests August 2017

2 Contents Clinical Management... 3 FOI Access to Treatment... 3 FOI Bariatric Surgery... 3 Continuing Healthcare... 4 FOI CHC Approvals and Staffing... 4 Contracts... 4 FOI Non Emergency Transport... 4 Finance and Budgets... 5 FOI Payments from Private Companies... 5 FOI Contract Spend... 7 Individual funding requests... 7 FOI Requests made during 2015/16 and 2016/ Long Term Conditions FOI Secondary Elective Spinal Care FOI Continuous Glucose Monitoring Mental Health and Learning Disabilities FOI Spend on Mental Health Learning Disabilities and Dementia Organisation FOI Ransomware Attacks FOI GP Forward View FOI Management Consultant Fees FOI Staff Car Parking FOI STP Staff Secondment Patient Safety and Experience FOI High Quality VTE Prevention Prescribing and Pharmacies FOI Gainshare Agreements FOI Prescribing Decision Support Systems FOI Blood Glucose Formularies FOI Toric Intraocular Lenses Properties and Estates FOI Strategic Estates Plan Referral management FOI Orthopaedic Referrals Urgent Care

3 FOI Cardiology FOI Heart Failure The information supplied to you continues to be protected by the Copyright, Designs and Patents Act You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting. Any other re-use, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by NHS Kernow Clinical Commissioning Group will have been produced by local officials and will be our copyright. Information you receive which is not subject to our copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party information. All appendices for this disclosure log are available upon request by ing with the appropriate FOI reference below. Clinical Management FOI Access to Treatment 1. With the exception of IVF, do you have any commissioning policies which delay access to surgery based on alcohol consumption? A. NHS Kernow do not have any policies which delay access to surgery based on alcohol consumption. 2. If so, please provide a copy of these policies. A. Not applicable FOI Bariatric Surgery 1) What criteria, if any, has been stipulated by your CCG in relation to the provision of bariatric surgery? (e.g surgery restricted to BMI over 45 and/or other co-morbidities, surgery only for those with BMI over 50) A. NHS Kernow took over the specialised commissioning of bariatric Surgery from NHS England in April No Criteria has been applied by NHS Kernow since then. 2) When was the criteria introduced? A. N/A 3) How many patients have been refused bariatric surgery since the criteria was introduced? A. N/A 3

4 4) How many patients have received bariatric surgery since the criteria was introduced and how much has this cost the CCG? A. N/A Continuing Healthcare FOI CHC Approvals and Staffing Question 1 Does your CCG have a system in place or auditing the use of the Fast Track Pathway tool for Continuing Healthcare? A. Yes, NHS Kernow does have an audit system in place Question 2 - How many packages of Continuing Healthcare did you approve in the financial year 2016/17 (including fast track packages) A Question 3 -How many Fast Track Pathway packages of Continuing Healthcare did you fund in the financial year 2016/17? A For both Q4 and Q5 the number of staff in full/whole time equivalents would be ideal, and we would like to know how many administrative and clinical staff are on the team. Question 4 - How many people are there in your Continuing Healthcare team? A. There are a total of whole time equivalent (WTE) of which 11.8 WTE are administrative and WTE are clinical. Question 5 - How many people are there in your Continuing Healthcare team dedicated to processing Fast Track Pathway packages of care? A. There are a total of 9.2 (WTE) of which 5.2WTE are administrative and 4 WTE are clinical. Contracts FOI Non Emergency Transport 1. Please could you confirm whether non-emergency patient transport services (including secure transport) for the NHS trusts within your geography are procured by the CCG, or if each hospital trust procures their own services? A: NHS Kernow procures non-emergency ambulance transport for all its residents registered with a GP in Cornwall and the Isles of Scilly. Royal Cornwall Hospital Transport (RCHT) procures all other non-emergency patient transport for these residents. 2. If the services are procured by the CCG, please could you confirm the name of the person/s responsible for the procurement of these services? A: Gordon Frame, Director of Integrated Care, Community. 4

5 3. Please could you confirm the name of the provider/s currently delivering non-emergency patient transport within the geography of your CCG? A: E-Zec Medical provide non-emergency ambulance transport. Royal Cornwall Hospital Trust and Plymouth Hospital Trust may also rely other transport providers as well. Should you require a list please contact the hospitals directly. 4. Please could you confirm the start date/s of the non-emergency patient transport contract/s operating in the geography of your CCG? A: The non-emergency patient transport contract started on 01/010/2013 and was originally awarded to NSL Care Services. The contract was novated to E-Zec Medical Services on 28/05/2016, when NSL Care Services exited the patient transport market. As with (3), please contact the hospitals directly if you require a list of any other non-emergency transport providers they use. 5. Please could you confirm the end date/s of the non-emergency patient transport contract/s operating in the geography of your CCG? A: The E-Zec medical contract is due to end on 30/09/ Please could you confirm the value/s of the non-emergency patient transport contract/s operating in the geography of your CCG? A: The Expected Annual Contract Value for E-Zec for the 2017/18 financial year is 3,257, If you are using an e-procurement portal for suppliers to access opportunities for non-emergency patient transport services within the geography of your CCG, please could you provide the name of the portal and a hyperlink to access the webpage or webpage address? A: Home page: Supplier Registration page: Finance and Budgets FOI Payments from Private Companies 5

6 1. Please confirm or deny that the clinical commissioning group received financial payments or benefits in kind from private sector companies or charities in A. NHS Kernow can confirm that it did receive payments from private sector companies in 2015/16. As is common practice among Clinical Commissioning Groups, these payments help us to drive down costs associated with prescribing certain medication. 2. If the clinical commissioning group received any financial payments or benefits in kind from private sector companies or charities in 2015/16, please state: Reason for payment Amount (all VAT exempt) Transaction Period Private sector Company Prescribing rebate 5, Apr-15 SANOFI Prescribing rebate 5, Jul-15 SANOFI Prescribing rebate 58, Aug-15 BAYER PLC Prescribing rebate 6, Oct-15 SANOFI Prescribing rebate 377,033 Nov-15 FRESENIUS KABI LTD Prescribing rebate 159, Feb-16 BAYER PLC Prescribing rebate 6, Feb-16 SANOFI Prescribing rebate 98, Mar-16 FRESENIUS KABI LTD Prescribing rebate 98, Mar Please confirm or deny that the clinical commissioning group received financial payments or benefits in kind from private sector companies or charities in BOEHRINGER- INGELHEIM A. NHS Kernow can confirm that it did receive payments from private sector companies or charities in 2016/17. As is common practice among Clinical Commissioning Groups, these payments help us to drive down costs associated with prescribing certain medication. 4. If the CCG received any financial payments or benefits in kind from private sector companies in 2016, please state: Reason for payment Amount Transaction Private sector (all VAT Period Company exempt) Prescribing rebate 8,867 Dec-16 AGAMATRIX EUROPE Prescribing rebate 9,017 Dec-16 AGAMATRIX EUROPE Prescribing rebate 9,365 Mar-17 AGAMATRIX EUROPE Prescribing rebate 2,262 Dec-16 DB ASHBOURNE LTD Prescribing rebate 8,620 Dec-16 DB ASHBOURNE LTD Prescribing rebate 1,319 Mar-17 ETHYPHARM UK LTD Prescribing rebate 63,612 Jul-16 FRESENIUS KABI LTD Prescribing rebate 60,565 Nov-16 FRESENIUS KABI LTD Prescribing rebate 2,738 Jan-17 FRESENIUS KABI LTD 6

7 Prescribing rebate 57,577 Feb-17 FRESENIUS KABI LTD Prescribing rebate 4,651 Mar-17 GLUCORX LTD Prescribing rebate 21,967 Mar-17 GSK Prescribing rebate 5,009 Sep-16 NOVO NORDISK LTD Prescribing rebate 5,533 Oct-16 SANOFI Prescribing rebate 12,028 Jan-17 SANOFI FOI Contract Spend Q: Please complete the table below to show the total spend by your CCG in each of the categories listed for the financial years. Covers Acute, primary care, community, mental health, CHC, ambulance, running costs, all other for 15/16, 16/17 and 17/18. If you do not have the data to complete the table fully, please fill it in as far as your data allow. Table 1 Spending Programme 2017/ / /16 m m m Acute Primary Care Community Mental Health Continuing Care Ambulance Running Costs All Other Total CCG Funding NHS Kernow operates a publication scheme, which includes the publication of all governing body papers and annual accounts. The information you have requested can be found as follows: We therefore exempt the release of this information under section 21 of the Freedom of Information Act as information accessible by other means. Individual funding requests FOI Requests made during 2015/16 and 2016/17 7

8 1. A list of individual funding request applications made during the 2015/16 and 2016/17 financial years. Please break each record down by: a) the procedure requested (e.g. tattoo removal) b) the outcome of the decision c) financial year Financial year 2015/2016 Intervention Total Approved Declined Abdominoplasty 8 8 Adalimumab Less than 5 Apronectomy Less than 5 Assisted Conception Avastin (Bevacizumab) Less than 5 Baxter elastomeric device Less than 5 Blepharoplasty Less than 5 Brachioplasty Less than 5 Breast asymmetry correction Less than 5 Breast augmentation 9 9 Breast implant removal Less than 5 Breast implant replacement 8 * * Breast reduction Cataract surgery Less than 5 Chondrolaryngoplasty Less than 5 Computer assisted endoscopic sinus surgery Less than 5 Continuous glucose monitoring system Less than 5 cosmetic ear surgery Less than 5 Cryopreservation of gametes or embryos Less than 5 cryopreservation of ovarian tissue Less than 5 Deferasirox Less than 5 Egg donation Less than 5 Facial fat graft Less than 5 facial reanimation Less than 5 Gammacore Less than 5 Ganglion - removal of (wrist and hand) Less than 5 Gastric electrical stimulator Less than 5 Gracilis muscle transfer surgery Less than 5 Homeopathy treatment referral to secondary care Less than 5 8

9 Hypnotherapy Less than 5 Immunotherapy Less than 5 In ear hearing aids Less than 5 Intra-vitreal Iluvien implants Less than 5 IOL-AMD lenses Less than 5 Labiaplasty 8 8 Laser hair removal Less than 5 Laser treatment Less than 5 LINX surgery Less than 5 Lycra body suit Less than 5 Lycra socks Less than 5 nerve stimulation Less than 5 Orthotic Less than 5 Ovarian re-siting Less than 5 Ozurdex Less than 5 Pegylated interferon (PEG-IFN) Less than 5 Penile Prosthesis Less than 5 Percutaneous intraperitoneal catheter Less than 5 Photodynamic therapy Less than 5 Physiotherapy Less than 5 Pinnaplasty 5 5 Referral to Exeter Headache Clinic Less than 5 Rehab - facial burns Less than 5 Rehabilitation Less than 5 Removal of skin lesion Reversal of sterilisation Less than 5 Rhinoplasty Less than 5 SAFO Less than 5 Scar revision Less than 5 Sodium Oxybate (Xyrem) Less than 5 Specialist assessment Less than 5 Specialist bed Less than 5 Specialist wheelchair Less than 5 Surgical correction of inverted nipple Less than 5 Sympathectomy Less than 5 Tattoo removal Less than 5 Tonsillectomy Less than 5 transcranial magnetic stimulation Less than 5 Urolift Less than 5 Varicose vein procedures 8 * * Wheelchair power pack Less than 5 Wheelchair riser Less than 5 Financial year 2016/17 9

10 Intervention Total Approved Declined Awaiting decision Abdominoplasty Acupuncture Less than 5 Apronectomy Less than 5 Assisted Conception 12 * * Body contouring 6 6 Breast asymmetry correction 6 * * Breast augmentation Less than 5 Breast implant replacement 5 5 Breast reduction 15 * * Continuous glucose monitoring system Less than 5 Contracture correction devices Less than 5 Cryopreservation of gametes or embryos 5 * * Ear lobe repair Less than 5 Egg donation Less than 5 Endoscopic brow lift Less than 5 Etanercept Less than 5 Gammacore Less than 5 Gynaecomastia surgery Less than 5 Helmet Less than 5 Labiaplasty 6 6 Laser hair removal Less than 5 Laser treatment Less than 5 Lycra body suit Less than 5 Lycra socks Less than 5 Lycra socks Less than 5 Mastopexy Less than 5 MDT opinion Less than 5 Pinnaplasty Less than 5 Pressure garments Less than 5 Psychotherapy Less than 5 Rehabilitation Less than 5 Removal of skin lesion Residential placement Less than 5 Reversal of sterilisation Less than 5 SAFO Less than 5 Scar revision Less than 5 Surgery for pectus excavatum Less than 5 Surgery for rhinophyma Less than 5 Surgery for Bell's palsy Less than 5 Surgery for varification of recti Less than 5 SYMPATHECTOMY Less than 5 Tocilizumab Less than 5 10

11 Tonsillectomy Less than 5 transcranial magnetic stimulation Less than 5 Trophic electrical stimulation Less than 5 Varicose vein procedures 6 6 Please note that if the number is very low (less than 5) the information cannot be disclosed as it could potentially identify the individuals involved, especially if combined with other data, and this would constitute a breach of the Data Protection Act Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information. Where * please note that one of the figures for approved or declined is less than 5 and to disclose either figure may allow for the identification of an individual as explained above. Long Term Conditions FOI Secondary Elective Spinal Care 1. The recent annual number of patients referred from NHS primary to secondary care (whether secondary care be from NHS or private providers). A patients were referred to secondary elective spinal care from primary care within NHS Kernow Clinical Commissioning Group. 2. The current secondary care providers for patients with elective spinal referrals from within Kernow CCG and the allocation of patients to these (e.g. the Duchy hospital in Truro, the Royal Devon and Exeter Hospital, Salisbury Hospital etc). A. NHS Kernow took over the commissioning of routine spinal activity in April 2017 and does not have full year data. NHS England were previous commissioners and may have the information you are requesting england.contactus@nhs.net 3. If known the current approximate annual cost for secondary care spinal referrals to Kernow CCG. A. Please see response to Q2. FOI Continuous Glucose Monitoring 1. How many people are living with type 1 diabetes in your CCG? A. Approximately 2,949 adults and children 11

12 2. How many type 1 diabetic patients in your CCG currently use continuous glucose monitoring (CGM)? A. Less than 5. If the number is very low (less than 5) the information cannot be disclosed as it could potentially identify the individuals involved, especially if combined with other data, and this would constitute a breach of the Data Protection Act Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information. 3. Does your CCG have a policy on the use and funding of CGM? A. No 4. How is CGM currently funded within your CCG? (e.g. routinely commissioned/ routinely commissioned within the scope of the NICE guidance/ Individual Funding Request/patient self-funded/ Hospital funded etc.) A. CGM is currently funded through Individual Funding Request 5. Does your CCG specify specific CGM systems? A. No 6. Does your CCG differentiate between CGM and flash glucose monitoring (FGM)? A. Yes, in our IFR process. 7. How many IFR applications were received between 1st April 2016 and 31st March 2017 for CGM? A. Less than 5 8. How many IFR applications were received between 1st April 2016 and 31st March 2017 for FGM? (Total number) A. No IFR applications were received for this time period. Mental Health and Learning Disabilities FOI Spend on Mental Health Learning Disabilities and Dementia 12

13 Q1 What was your total spend on all mental health, learning disability and dementia services in 2016/17? A. Our finance team are currently working on producing programme budgeting data which will be published later in the year. We therefore exempt the release of this information under section 22 of the Freedom of Information Act 2000, Intended for Future Publication. Q2 What is your total planned spend on all mental health, learning disability and dementia services in 2017/18? A. NHS Kernow s Current plan shows 126,035k, this includes expenditure on Continuing Healthcare and prescribing. Q3 Please breakdown the total spend figures in Q1 and Q2 as follows: A. As per our response in Q1, our finance team are currently working on producing programme budgeting data which will be published later in the year. We therefore exempt the release of this information under section 22 of the Freedom of Information Act 2000, Intended for Future Publication. We are able to provide the following breakdown for the 2017/18 planned spend: Mental Health Spend by Category 2017/18 Plan k Children & Young People's Mental Health (excluding LD) 6,143 Children & Young People's Eating Disorders 550 Perinatal Mental Health (Community) 449 Improved access to psychological therapies (adult) 5,190 A and E and Ward Liaison mental health services (adult) 867 Learning Disabilities 31,485 Dementia 90 Other adult mental health 76,081 Primary care prescribing on mental health drugs 5,180 TOTAL 126,035 Q4 Has your Clinical Commissioning Group signed agreements with its local Mental Health Trusts that meets the mental health investment standard for each of the years 2017/18, 2018/19 and 2019/20? A. At present NHS Kernow has not signed agreements with Cornwall Partnership Foundation Trust in order that all partners can review all health delivery in Cornwall and Isles of Scilly in light of Shaping our Future. Organisation 13

14 FOI Ransomware Attacks 1. How many GP practices in NHS Kernow CCG s area had to shut down any IT systems in response to the ransomware attack, known as WannaCry, on or after 12 May, 2017? A How many computers/servers/devices in GP practices were infected in the ransomware attack, known as WannaCry, on 12 May, 2017? A How many planned appointments and did the GP practices have to cancel/postpone/reschedule as a result, either direct or indirect, of the WannaCry ransomware attack? A How many patients had to be recalled for tests by GP practices, as a result, either direct or indirect of the WannaCry ransomware attack? A. 0 FOI GP Forward View 1. Please send me the rating (of either red/amber/green) received from NHS England for NHS Kernow CCG s phase 1 GPFV delivery plan submitted to NHS England in December A. NHS Kernow received an overall rating of amber. 2. Please send me the rating (of either red/amber/green) received from NHS England for NHS Kernow CCG s phase 2 GPFV delivery plan which was submitted in February A. NHS Kernow has consulted NHS England and there was no request for an updated delivery plan in February Please send me a copy of the phase 1 and phase 2 delivery plans submitted to NHS England. A. Please find attached a copy of the draft delivery plan which was submitted in December This is draft, pending on-going input from public, patients and practitioners as part of our Shaping our Future programme. FOI Management Consultant Fees 1. Any data you have on the amount spent by NHS Kernow CCG on management consultancy broken down by year from 2012/ / /13 A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating to the former primary care trust (2012 to 2013). Please contact the Department of 14

15 Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk 2013/14 Management consultancy spend was 271k 2014/15 and 2015/16 NHS Kernow has recently responded to a similar request in March 2017, please see our disclosure log We therefore exempt the release of this information under section 21 of the Freedom of Information act 2000, information accessible by other means. 2016/17 Finalised accounts for 2016/17 can be found here: Consultancy is explicitly disclosed in Note 5 of the annual accounts. We therefore exempt the release of this information under section 21 of the Freedom of Information act 2000, information accessible by other means. 2. Any planned expenditure on management consultancy fees for A. The current planned expenditure for management consultancy fees for is 33,000. FOI Staff Car Parking 1. Please can you provide me with a copy of the current statement of car parking charges for staff? If such a document doesn t exists, please can you tell me how much you charge (hourly rate) for staff working at your hospital(s) A. NHS Kernow is a commissioning service, not a hospital. It does not charge staff for car parking. 2. What are the wages and job titles of your five highest paid members of staff? A. NHS Kernow publishes this information on its website, to obtain this information please see: We therefore exempt the release of this information under the Freedom of information act section 21, information accessible by other means. 3. How much money has the trust spent on public relations and marketing (including staff costs) in the past two financial years (15/16 and 16/17). (If this information is easy to obtain please include if this will take my combined request over the cost/time limit, please do not process this part of the request) A. Whilst NHS Kernow have staff employed in public and stakeholder engagement this forms part of their wider job role and we therefore are unable to provide you with the amount spent on this as we do not require staff to complete timesheets. 15

16 FOI STP Staff Secondment 1. The total number of staff that have been seconded over to your local STP programme since December Please provide the name of your STP and data both in total number and Full Time Equivalent if staff have only been partially seconded. 2. The total pay bill of these staff seconded to the STP footprint area and the time period this covers. 3. Your organisation's total spend on outsourced consultancy related to drafting and implementing the STP programme, if possible broken down by contracted company 4. The total value of any further financial contributions or benefits in kind to the STP programme from your organisation with a brief description of what it constituted. Q1-4: A. NHS Kernow has previously responded to similar requests, please see our disclosure log. We therefore exempt this information under section 21 of the Freedom of information act, information accessible by other means. Patient Safety and Experience FOI High Quality VTE Prevention 1. Please complete and return the attached FOI request into commissioning services that deliver high quality VTE prevention A. Please see completed response attached. Prescribing and Pharmacies FOI Gainshare Agreements 1. Are there any gainshare agreements in place between you the CCG and a provider (e.g. hospital trust)? A. Yes If Yes, then please provide the following details: Agreement Disease Area Provider included in Name of specific the gainshare drugs involved agreement 1 Rheumatology Royal Infliximab 50:50 16 Savings apportioned between CCG and the provider

17 Dermatology Gastroenterology Endocrine Neurology Urology GI surgery Oral/Facial Surgery Stroke Medicine Orthopaedics Cornwall Hospitals Trust Adalimumab Etanercept Certolizumab Golimumab Ustekimumab Rituximab Abatacept Tocilizumab Omalizumab Botulinum Somatropin Riluzole Alitretinoin Eltrombopag Romiplostim Teriparatide Osteogenic Protein Abatacept Anakinra Apremilast Secukinumab Ustekinumab Vedolizumab 2. Do you have any other agreements with a provider to switch from branded to biosimilar products? A. No 3. Are there any other agreements between you the CCG and a provider, not included in the above, for the following services? A. No FOI Prescribing Decision Support Systems 1) Do your member practices use prescribing decision support systems? A. Yes 2) If yes, how many practices (or what % of practices) use the following systems: Script Switch - none. DXS - Unknown Eclipse- this is being used widely (number unknown), however this is not a decision support system. Optimise RX - 57 of 62 practices 17

18 3) Request for Re-use Please can you confirm whether we are permitted to reuse any information provided under the Open Government Licence? We (QuintilesIMS) request permission to re-use as a part of an independent analysis into the use of prescribing decision support software, which has been commissioned by one of our clients. The contents of the report will not be made available publically, but may be used by other QuintilesIMS Health Group entities and service suppliers. The information in the report will be presented in a factual manner with all publication details staying true to the publisher. We acknowledge that information provided may be protected by copyright and will include a copyright statement to this effect at the end of any information we publish if requested by you. A. NHS Kernow agrees that the information included in this response may be used as you describe. FOI Blood Glucose Formularies 1. Does the CCG have a formulary for Blood Glucose Test Strips and Insulin Pen Needles. If so please can provide the formulary/s or link to the formulary/s. If you cannot provide a link can you advise which products are included under what guidance. A. The guidance you have requested can be found on our formulary at We therefore exempt the release of this information under section 21 of the Freedom of Information Act 2000; information accessible by other means. 2. Are there any Area Prescribing Committee guidelines or other regional guidance consulted when forming the above formularies for BGTS and PNs A. No, however we have a robust internal process approved through our Medicines Optimisation Programme Board. 3. Please advise the responsible Medicines Optimisation contact for the above formularies and their contact details A. NHS Kernow does not provide contact names and details below director level, the director with responsibility for this area of work is Andrew Abbott Please advise the date when the above Formularies are set for next review A. Date to be confirmed but will be sometime in

19 FOI Toric Intraocular Lenses 1. Does NHS Kernow CCG fund toric intraocular lenses for NHS patients with astigmatism undergoing cataract surgery? A. Yes 2. If yes to Qu1, please list the criteria under which toric intraocular lenses are available to patients, and please send us (electronic) copies of any policy documentation. A. No criteria is currently applied. Properties and Estates FOI Strategic Estates Plan 1. Please can I have a copy of the NHS Kernow document known as the Local Strategic Estates Plan," as described in the recent NHS England CCG Annual Assessment. NHS England say the Local Strategic Estates Plan is "now in place." A. The Local Strategic Estates Plan is currently in draft form and has not been agreed locally. Additionally the plan has been superseded by the development of an estates plan as part of Shaping Our Future. Any document which may result in changes to the operation of health estates will require extensive consultation and will be published once finalised. NHS Kernow therefore exempt the release of this document under section 22 of the Freedom of Information Act, information intended for future publication. Referral management FOI Orthopaedic Referrals 1. Please state the total number of orthopaedic referrals from primary care in A) 2015/16 Referrals from all sources received for Orthopaedics were 13,518. GP referrals to Orthopaedics, in 2015/16 resulted in 9,336 appointments being booked. B) 2016/17 Referrals from all sources received for Orthopaedics were 13,456. GP referrals to Orthopaedics in 2016/17 resulted in 9,759 appointments being booked. NB: GP Referrals across Cornwall and the Isles of Scilly go through one of two referral management centres, Referral management Service (Kernow RMS) and Devon Referral Support Services (DRSS). The above figures exclude where the 19

20 referral was made by a consultant. However it is only in the RMS data that the Referral_Made_By field is populated, so the above may still contain non-primary Care referrals from DRSS. 2. Please state the total number of referrals from primary care for cataract treatment in A) 2015/16 = 12,954 B) 2016/17 = 13, A) What are the current eligibility guidelines/criteria for referrals for orthopaedic procedures? Please cut and paste any relevant information or provide a link (and page number if relevant) to the relevant website/document. NHS Kernow publishes referral criteria, the information you request can be found here: We therefore exempt the release of this information under the Freedom of Information Act 2000, information accessible by other means. B) When were these current guidelines introduced? The dates of introduction are not currently recorded. We are in the process of adding dates when new guidelines are introduced or amendments are made. 4. A) What are the current eligibility guidelines/criteria for referrals for cataract treatment? Please cut and paste any relevant information or provide a link (and page number if relevant) to the relevant website/document. NHS Kernow publishes referral criteria, the information you request can be found here: _clinical_referral_criteria/opthamology/cataract We therefore exempt the release of this information under the Freedom of Information Act 2000, information accessible by other means. B) When were these current guidelines introduced? The dates of introduction are not currently recorded. We are in the process of adding dates when new guidelines are introduced or amendments are made. Urgent Care FOI Cardiology Would you be so kind to please send me information regarding several aspects of cardiology investigations? 20

21 The cardiac investigation tests are: a) 24-Hour Holter Monitor (also known as 24-Hour ECG) b) 48-Hour Holter Monitor c) 72-Hour Holter Monitor d) 7-day Holter Monitor e) Echocardiogram (also known as Cardiac Ultrasound ) f) 24-hour Blood Pressure Monitor g) Exercise Tolerance test For each of the tests stated above, please may you provide the following information from years 2014-present (financial years acceptable): 1) Cost of each individual test 2) Number of tests requested 3) Average waiting time for each test i.e. from request to examination. 4) Breach time (if any) for each test 5) Cost of breaching on each said test Procedure codes Total outpatient spend for patients having this procedure Total number of outpatient tests performed 2014/ / / / / /17 U , , , U193 3,570 2,093 5, Hour Holter Monitor (also known as 24- Hour ECG) 48-Hour Holter Monitor 72-Hour Holter Monitor 7-day Holter Monitor Echocardiogram (also known as Cardiac Ultrasound ) 24-hour Blood Pressure Monitor Exercise Tolerance test Not available Not available U201- U205 & U208- U209 U332 U333 Not available 347, , , ,412 *Less than 5 *Less than 5 55 If the number is very low (less than 5) the information cannot be disclosed as it could potentially identify the individuals involved, especially if combined with other data, and this would constitute a breach of the Data Protection Act Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information. NHS Kernow do not hold information on the following: 3) Average waiting time for each test i.e. from request to examination. 4) Breach time (if any) for each test 5) Cost of breaching on each said test. Royal Cornwall hospitals Trust may hold the information you have requested. Please contact rch-tr.foi@nhs.net 21

22 FOI Heart Failure Q1 Number of inpatients with heart failure in the last 5 years, with heart failure being any part of the diagnosis A Q2 Number of inpatients with heart failure in the last 5 years, with heart failure being the primary diagnosis A Q3 Number of inpatients, regardless of condition, were treated with Furosemide (tablets or intravenous injection) in the last 5 years Q4 Number of inpatients that were treated with Furosemide in the last 5 years had heart failure as any part of the diagnosis Q5 Number of inpatients that were treated with Furosemide in the last 5 years had heart failure as the primary diagnosis Q3 Q5: NHS Kernow does not hold the information you request and would suggest contacting the following organisations: Royal Cornwall Hospitals Trust rch-tr.foi@nhs.net Cornwall Partnership Foundation Trust cpn-tr.freedomofinformation@nhs.net Plymouth Hospitals Trust plh-tr.foi-requests@nhs.net 22