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731070

registered interest
date	21/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government when they intend to introduce legislation to reform professional healthcare regulation as proposed by the Law Commission in their report Regulation of Health and Social Care Professionals published in April 2014.
tabling member printed	Lord Warner
uin	HL78
answer	answer is ministerial correction date of answer 03/07/2017 answer text <p>The Government is considering options on how to take forward the reform and rationalisation of professional regulation.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2017 16:45:36 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

731071

registered interest
date	21/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether they still intend to produce consultation proposals for the reform of social care by the end of 2017.
tabling member printed	Lord Warner
uin	HL79
answer	answer is ministerial correction date of answer 03/07/2017 answer text <p>The Government will work to address the challenges of social care for our ageing population, bringing forward proposals for consultation to build widespread support. We are committed to listening to people’s views on how to reform the social care system, to ensure it is sustainable for current and future generations and that the quality of care improves.</p><p> </p><p>As part of the overall package of reform, we will consult on detailed proposals which will include a capital floor and an absolute limit on the amount people can be asked to pay.</p><p> </p><p>We will provide further details on the next steps on social care in due course.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL80 question first answered 03/07/2017 16:45:15 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

731072

registered interest
date	21/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether they will implement the provisions in the Care Act 2014 to cap individual liability for adult social care costs on or before April 2020.
tabling member printed	Lord Warner
uin	HL80
answer	answer is ministerial correction date of answer 03/07/2017 answer text <p>The Government will work to address the challenges of social care for our ageing population, bringing forward proposals for consultation to build widespread support. We are committed to listening to people’s views on how to reform the social care system, to ensure it is sustainable for current and future generations and that the quality of care improves.</p><p> </p><p>As part of the overall package of reform, we will consult on detailed proposals which will include a capital floor and an absolute limit on the amount people can be asked to pay.</p><p> </p><p>We will provide further details on the next steps on social care in due course.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL79 question first answered 03/07/2017 16:45:15 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

717829

registered interest
date	04/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 28 March (HL6071), how much of the 20 per cent increase in NHS expenditure on medicines between 2010–11 and 2015–16 related to the introduction of medicines approved by NICE.
tabling member printed	Lord Warner
uin	HL6638
answer	answer is ministerial correction date of answer 20/04/2017 answer text <p>The information requested is not available.</p><p> </p><p>NHS Digital has advised that estimated National Health Service spend on medicines recommended in National Institute of Health and Care Excellence (NICE) technology appraisals increased by £758.9 million between 2014/15 and 2015/16, which compares to an overall increase in estimated NHS medicines spend of £1,247.1 million over the same period. Information on NHS spend on medicines recommended in NICE technology appraisals is not available for 2010/11 to 2013/14.</p><p> </p><p>This represents the cost of the medicines at NHS list price and not necessarily the price paid. It does not take account of discounts, dispensing costs, fees or prescription charges income.</p> answering member printed Lord O'Shaughnessy question first answered 20/04/2017 14:37:08 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

717830

registered interest
date	04/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 28 March (HL6071), whether it is the responsibility of NICE to take the decision to extend the implementation period of a new drug technology under the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013; and to what extent representations are entertained by (1) the Secretary of State for Health, and (2) NHS England in respect of such decisions.
tabling member printed	Lord Warner
uin	HL6639
answer	answer is ministerial correction date of answer 20/04/2017 answer text <p>National Health Service commissioners are legally required to fund drugs and treatments recommended in National Institute for Health and Care Excellence (NICE) technology appraisal guidance. NICE is responsible for specifying the period within which NHS commissioners are required to make funding available for a NICE recommended treatment, and the regulations provide that the funding period will normally be three months from the point of final guidance.</p><p> </p><p>The regulations make provision for NICE to specify a longer funding period where there are significant barriers to implementation of a NICE-recommended technology within three months. In such cases, NICE must consult the Secretary of State, NHS England and other relevant bodies about the appropriate funding period.</p> answering member printed Lord O'Shaughnessy question first answered 20/04/2017 15:04:17 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

713132

registered interest
date	21/03/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Social Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of the number of providers of publicly funded (1) home care, and (2) residential and nursing home care services, who have handed back contracts to local authorities in England; what representations they have received from local authorities and others about this issue; and what assessment they have made of the impact of such actions on the performance of the NHS.
tabling member printed	Lord Warner
uin	HL6252
answer	answer is ministerial correction date of answer 28/03/2017 answer text <p>Information on the number of providers of publicly funded home care and residential and nursing home care services who have handed back contracts is not held centrally. Ministers have received representations from a number of local authorities (LAs) about market fragility which have touched on the risk of and alluded to actual handing back of contracts.</p><p><strong> </strong></p><p>Following the Chancellor’s announcement in the Budget, LAs in England will receive an additional £2 billion for social care over the next three years.</p><p> </p><p>The additional resources will help LAs commission care services that are sustainable, diverse and offer sufficient high quality care and support for people in their areas.</p><p> </p><p>There is a complex relationship between social care and NHS services. NHS England is working with the Department to identify a fuller understanding of the linkages between health and social care services. It is aiming to undertake some detailed work at local level to exploit linked data where it is available to analyse more fully how changes and variation in the provision of social care impacts on health care services.</p><p> </p><p>The results of the best available academic study indicate that for each additional £1 spent on social care, there is a saving to the National Health Service of £0.35. Also, £1 additional NHS spend corresponds to just over £0.35 reduction on social care.</p> answering member printed Lord O'Shaughnessy question first answered 28/03/2017 13:15:52 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

713133

registered interest
date	21/03/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Care Homes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether NHS hospital trusts are permitted to purchase residential or nursing home beds for patients who no longer need to occupy an acute hospital bed but cannot be discharged to a social care placement.
tabling member printed	Lord Warner
uin	HL6253
answer	answer is ministerial correction date of answer 04/04/2017 answer text <p>National Health Service trusts are able to purchase residential and nursing care but we would expect them to do this in a planned way with their local clinical commissioning group and local authority.</p> answering member printed Lord O'Shaughnessy question first answered 04/04/2017 13:12:20 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

711183

registered interest
date	14/03/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what plans they have to restrict patient access to new NICE-approved treatments for a period of time in excess of one year if the cost of introducing such treatments exceeds a given financial threshold in their early years; and whether any such plans to restrict patient access could be implemented without legislation.
tabling member printed	Lord Warner
uin	HL6071
answer	answer is ministerial correction date of answer 28/03/2017 answer text <p>From 1 April, a ‘budget impact test’ will be introduced for products assessed through the National Institute for Health and Care Excellence (NICE) technology appraisal and highly specialised technologies programmes. The budget impact test has been developed within the existing legislative framework for the funding requirement. The National Health Service spent over £15 billion on medicines in 2015/16, a 20% increase since 2010/11, and the purpose of the budget impact test is to help to manage the introduction of high budget impact products into the NHS, and to ensure that their introduction does not distort the NHS’s ability to fund other priorities.</p><p> </p><p>Where the budget impact of a technology being evaluated by NICE is expected to have a net budget impact that is £20 million or greater in any of the first three years, NHS England will seek to have a commercial discussion with the company in order to manage the introduction of the high budget impact product into the NHS. In circumstances where a commercial arrangement is unable to be reached, NHS England may make a case to NICE for a longer implementation period, normally up to a maximum of three years, during which the product would have a phased introduction. It should be noted that £20 million is not the maximum amount that the NHS would commit to funding a new technology in any one financial year.</p> answering member printed Lord O'Shaughnessy question first answered 28/03/2017 15:39:37 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

686779

registered interest
date	08/02/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Social Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many Care Quality Commission de-registrations have taken place in each of the last three years for which figures are available, of (1) nursing homes, (2) residential care homes, and (3) domiciliary care services; and how many beds were involved in relation to categories (1) and (2).
tabling member printed	Lord Warner
uin	HL5363
answer	answer is ministerial correction date of answer 20/02/2017 answer text <p>The Care Quality Commission (CQC) has provided the following information:</p><p> </p><table><tbody><tr><td rowspan="2"><p>The total number of nursing homes, residential homes and domiciliary care service locations<sup>1</sup> active as at 31 December 2014, 31 December 2015 and 31 December 2016 is as follows:</p></td></tr></tbody></table><p> </p><table><tbody><tr><td colspan="2"><p> </p></td><td colspan="2"><p>Nursing Home</p></td><td colspan="2"><p>Residential Home</p></td><td><p>Domiciliary care service</p></td></tr><tr><td colspan="2"><p>Date</p></td><td><p>Number of Locations</p></td><td><p>Number of Beds</p></td><td><p>Number of Locations</p></td><td><p>Number of Beds</p></td><td><p>Number of Locations</p></td></tr><tr><td colspan="2"><p>31 December 2014</p></td><td><p>4,609</p></td><td><p>221,899</p></td><td><p>12,563</p></td><td><p>246,371</p></td><td><p>7,737</p></td></tr><tr><td colspan="2"><p>31 December 2015</p></td><td><p>4,550</p></td><td><p>220,412</p></td><td><p>12,280</p></td><td><p>242,885</p></td><td><p>8,036</p></td></tr><tr><td colspan="2"><p>31 December 2016</p></td><td><p>4,518</p></td><td><p>221,523</p></td><td><p>11,978</p></td><td><p>239,503</p></td><td><p>8,189</p></td></tr><tr><td colspan="10"><p><em>Note:</em> Service types and bed numbers can change over time. Numbers presented here use the service types/bed numbers applicable in the database at 10 February 2017. <sup>1</sup> A location can have multiple service types and so some locations could be counted in both the care home (nursing or residential) and domiciliary care service columns.</p></td></tr><tr><td colspan="10"><p>Care homes with both the 'Care home services with nursing' and 'Care home services without nursing' service types have been categorised as a 'Nursing home'; those with only the 'Care home service without nursing' as 'Residential home'.</p></td></tr><tr><td><p> </p></td><td colspan="10" rowspan="2"><p>Number of nursing homes, residential homes and domiciliary care service locations<sup>2</sup> that have de-registered per year from 1 January 2014 to 31 December 2016 and number of beds in the homes:</p></td><td colspan="4"><p> </p></td></tr><tr><td><p> </p></td><td colspan="4"><p> </p></td></tr></tbody></table><p> </p><table><tbody><tr><td><p> </p></td><td colspan="2"><p>Nursing home</p></td><td colspan="2"><p>Residential home</p></td><td><p>Domiciliary care service</p></td></tr><tr><td><p>Year of De-registration</p></td><td><p>Number of Locations</p></td><td><p>Number of beds</p></td><td><p>Number of Locations</p></td><td><p>Number of beds</p></td><td><p>Number of Locations</p></td></tr><tr><td><p>2014</p></td><td><p>232</p></td><td><p>8,992</p></td><td><p>995</p></td><td><p>14,742</p></td><td><p>1,437</p></td></tr><tr><td><p>2015</p></td><td><p>307</p></td><td><p>14,478</p></td><td><p>938</p></td><td><p>17,356</p></td><td><p>1,594</p></td></tr><tr><td><p>2016</p></td><td><p>370</p></td><td><p>17,451</p></td><td><p>1,011</p></td><td><p>17,757</p></td><td><p>1,812</p></td></tr><tr><td><p>Total</p></td><td><p>909</p></td><td><p>40,921</p></td><td><p>2,944</p></td><td><p>49,855</p></td><td><p>4,843</p></td></tr></tbody></table><p> </p><p><em>Source:</em> CQC database as at 9 February 2017.</p><p> </p><p>The majority of de-registrations are initiated by the service providers and are not due to CQC enforcement activity. The figures provided represent the number of locations that have been de-registered. In some cases, these will be true closures where the location is no longer open or operating. In others however, it may be that the location has appeared to close when in fact the service continues, but under new registration due to a legal entity change or a change in the provider. This means that the number of de-registrations should not be used as an indication of the total number of locations.</p><p> </p><p><sup>2</sup>A location can have multiple service types and so some locations could be counted in both the care home (nursing or residential) and domiciliary care service columns.</p><p>Care homes with both the 'Care home services with nursing' and 'Care home services without nursing' service types have been categorised as a 'Nursing home'; those with only the 'Care home service without nursing' as 'Residential home'.</p> answering member printed Lord O'Shaughnessy question first answered 20/02/2017 15:24:07 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner

686780

registered interest
date	08/02/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Social Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, for the year to 31 December 2016, how many contracts for (1) nursing home places, (2) residential care home places, and (3) domiciliary care services, were handed back to local authorities in England with responsibility for adult social care; and in which local authorities that happened.
tabling member printed	Lord Warner
uin	HL5364
answer	answer is ministerial correction date of answer 20/02/2017 answer text <p>The Department does not collect detailed information about local contracting.</p><p> </p><p>Commissioning high quality social care is the responsibility of local government which is best placed to understand the needs of local people and communities, and how best to meet them.</p><p> </p><p>Local authorities have legal duties to facilitate effective local markets, supporting people to have choice. The Department supports local authorities in meeting their market shaping duties when commissioning services and provides further support and guidance through sector-led improvement programmes.</p><p> </p><p>The Department has worked with the <em>Association of Directors of Adult Social Services</em><strong>,</strong> the Local Government Association, the care sector and other partners to produce a wide range of guidance and support about market shaping and commissioning. We have brought this together in an online hub called Adult Social Care Market Shaping, which is an online only resource, widely available to people and organisations, including local authorities, service users, and care providers.</p><p> </p><p>Where a care provider ‘hands back’ a contract to a local authority, the authority remains responsible for meeting the needs of people who previously had services provided under the contract and for arranging replacement services. Where a care provider fails financially and services cease, potentially abruptly, the local authority has duties under the Care Act 2014 to step in and ensure people’s needs continue to be met, regardless of who pays.</p> answering member printed Lord O'Shaughnessy question first answered 20/02/2017 16:59:52 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1732 label Biography information for Lord Warner