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798644

registered interest
date	01/12/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS Trusts
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps is he taking to ensure that NHS Trusts provide value for money.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	117038
answer	answer is ministerial correction date of answer 08/12/2017 answer text <p>One of the seven key principles in the NHS Constitution is the commitment to providing the most effective, fair and sustainable use of finite resources. NHS Improvement’s Single Oversight Framework (SOF) sets out how NHS Improvement oversee National Health Service trusts and NHS foundation trusts. The framework helps determine where providers may benefit from, or require, improvement support if they are to meet the standards expected of them in a safe and sustainable way. Under the SOF, NHS Improvement oversee and support providers in improving financial sustainability, efficiency and value for money. NHS Improvement also consider how efficiently a provider uses its resources more broadly, and how financially sustainable it is over the longer term.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 08/12/2017 11:06:33 answering member 1542 label Biography information for Philip Dunne
tabling member	4478 label Biography information for Royston Smith

798645

registered interest
date	01/12/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS Trusts
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps he has taken to ensure that NHS Trusts are not over-charged by private sector contractors and suppliers.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	117039
answer	answer is ministerial correction date of answer 08/12/2017 answer text <p>The Department has taken a number of steps to ensure National Health Service trusts are not over-charged by private sector contractors and suppliers. The Department maintains standard NHS Terms and Conditions for NHS trusts to use when procuring goods and services. They are published on the GOV.UK website:</p><p><a href="https://www.gov.uk/government/publications/nhs-standard-terms-and-conditions-of-contract-for-the-purchase-of-goods-and-supply-of-services" target="_blank">https://www.gov.uk/government/publications/nhs-standard-terms-and-conditions-of-contract-for-the-purchase-of-goods-and-supply-of-services</a></p><p>In addition, the Department has developed a full suite of tools and templates, including Invitation to Tender (ITT) documentation for NHS trusts to use when entering into contracts with suppliers. The Commercial Schedule within the ITT documentation includes a pricing model and connected questions, which enable NHS trusts to understand supplier pricing.</p><p> </p><p>The tools and templates are underpinned by an NHS Guide to Procurement. This provides guidance on drafting an effective specification, setting evaluation criteria in line with the principle of ‘most economical advantageous tender’, and devising a robust pricing model (for use when the template provided is not appropriate for the procurement).</p><p> </p><p>By using the standard NHS Terms and Conditions, the NHS Guide to Procurement and the suite of tools and templates, NHS trusts can ensure suppliers submit competitive tenders. Additionally, NHS trusts are also encouraged to use frameworks, such as those procured on behalf of Government by the Crown Commercial Service, enabling them to benefit from consolidated buying arrangements.</p><p> </p><p>The NHS Terms and Conditions guidance document accompanies the NHS Terms and Conditions. Through this guidance document, the Department advises NHS trusts to include in the specification, general requirements as well as key areas such as key performance indicators and conducting periodic contract review meetings to review contractor performance.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 117040 question first answered 08/12/2017 11:04:34 answering member 1542 label Biography information for Philip Dunne
tabling member	4478 label Biography information for Royston Smith

798646

registered interest
date	01/12/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS Trusts: Procurement
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether NHS Trusts are required to review their procurement contracts with independent providers at periodic intervals.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	117040
answer	answer is ministerial correction date of answer 08/12/2017 answer text <p>The Department has taken a number of steps to ensure National Health Service trusts are not over-charged by private sector contractors and suppliers. The Department maintains standard NHS Terms and Conditions for NHS trusts to use when procuring goods and services. They are published on the GOV.UK website:</p><p><a href="https://www.gov.uk/government/publications/nhs-standard-terms-and-conditions-of-contract-for-the-purchase-of-goods-and-supply-of-services" target="_blank">https://www.gov.uk/government/publications/nhs-standard-terms-and-conditions-of-contract-for-the-purchase-of-goods-and-supply-of-services</a></p><p>In addition, the Department has developed a full suite of tools and templates, including Invitation to Tender (ITT) documentation for NHS trusts to use when entering into contracts with suppliers. The Commercial Schedule within the ITT documentation includes a pricing model and connected questions, which enable NHS trusts to understand supplier pricing.</p><p> </p><p>The tools and templates are underpinned by an NHS Guide to Procurement. This provides guidance on drafting an effective specification, setting evaluation criteria in line with the principle of ‘most economical advantageous tender’, and devising a robust pricing model (for use when the template provided is not appropriate for the procurement).</p><p> </p><p>By using the standard NHS Terms and Conditions, the NHS Guide to Procurement and the suite of tools and templates, NHS trusts can ensure suppliers submit competitive tenders. Additionally, NHS trusts are also encouraged to use frameworks, such as those procured on behalf of Government by the Crown Commercial Service, enabling them to benefit from consolidated buying arrangements.</p><p> </p><p>The NHS Terms and Conditions guidance document accompanies the NHS Terms and Conditions. Through this guidance document, the Department advises NHS trusts to include in the specification, general requirements as well as key areas such as key performance indicators and conducting periodic contract review meetings to review contractor performance.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 117039 question first answered 08/12/2017 11:04:34 answering member 1542 label Biography information for Philip Dunne
tabling member	4478 label Biography information for Royston Smith

797507

registered interest
date	29/11/2017
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure value for money on pharmaceutical procurement.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	116470
answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>For unbranded generics the Government relies on completion to keep prices down which generally works well and has led to low prices of these medicines. We alert the Competition and Markets Authority (CMA) when we believe that competition does not work. In the case of liothyronine, the CMA is currently investigating Concordia’s potential abuse of its dominant position to overcharge the National Health Service for liothyronine.</p><p> </p><p>In primary care community pharmacies are incentivised to source products at the lowest possible cost by allowing them to retain the medicines margin (the difference between what the NHS reimburses a pharmacy for a product and how much the pharmacy purchases it for) up to £800 million in England. In secondary care, competitive tenders ensure value-for-money to the NHS.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 116474 116477 116481 116482 question first answered 07/12/2017 15:27:25 answering member 4067 label Biography information for Steve Brine
tabling member	4478 label Biography information for Royston Smith

797511

registered interest
date	29/11/2017
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure that the NHS is not charged a premium price for pharmaceutical products, especially Liothyronine by (a) Concordia, (b) Morningside and (c) Teva.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	116474
answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>For unbranded generics the Government relies on completion to keep prices down which generally works well and has led to low prices of these medicines. We alert the Competition and Markets Authority (CMA) when we believe that competition does not work. In the case of liothyronine, the CMA is currently investigating Concordia’s potential abuse of its dominant position to overcharge the National Health Service for liothyronine.</p><p> </p><p>In primary care community pharmacies are incentivised to source products at the lowest possible cost by allowing them to retain the medicines margin (the difference between what the NHS reimburses a pharmacy for a product and how much the pharmacy purchases it for) up to £800 million in England. In secondary care, competitive tenders ensure value-for-money to the NHS.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 116470 116477 116481 116482 question first answered 07/12/2017 15:27:25 answering member 4067 label Biography information for Steve Brine
tabling member	4478 label Biography information for Royston Smith

797514

registered interest
date	29/11/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Thyroid Gland: Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what medicines NHS England has approved for patients with thyroid conditions
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	116477
answer	answer is ministerial correction date of answer 07/12/2017 answer text <p><del class="ministerial">For unbranded generics the Government relies on completion to keep prices down which generally works well and has led to low prices of these medicines. We alert the Competition and Markets Authority (CMA) when we believe that competition does not work. In the case of liothyronine, the CMA is currently investigating Concordia’s potential abuse of its dominant position to overcharge the National Health Service for liothyronine.</del></p><p> </p><p><del class="ministerial">In primary care community pharmacies are incentivised to source products at the lowest possible cost by allowing them to retain the medicines margin (the difference between what the NHS reimburses a pharmacy for a product and how much the pharmacy purchases it for) up to £800 million in England. In secondary care, competitive tenders ensure value-for-money to the NHS.</del></p><p><ins class="ministerial"> <p><ins class="ministerial">NHS England is not responsible for approving medicines. The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines and medical devices work and are acceptably safe. The National Institute for Health and Care Excellence makes recommendations for the National Health Service on whether medicines and other treatments represent a clinically and cost effective use of NHS resources.</ins></p><p><ins class="ministerial"><strong> </strong></ins></p><p><ins class="ministerial">A list of medicines licensed by the MHRA for the treatment of thyroid conditions is attached. The list is split into two sections because thyroid conditions can be split into either those associated with an overactive thyroid (hyperthyroidism), or an underactive thyroid (hypothyroidism). The list contains only those medicines licensed for overactive and underactive thyroid. It should be noted that not all of the medicines listed will be available on the market at any one time. </ins></p></ins></p> answering member constituency Winchester answering member printed Steve Brine question first answered 07/12/2017 15:27:25 question first ministerially corrected 07/12/2017 18:20:31 answering member 4067 label Biography information for Steve Brine attachment 1 file name 2017 12 06 Thyroid medicines formatted.xls title List of thyroid medicines previous answer version 27995 answering member constituency Winchester answering member printed Steve Brine answering member 4067 label Biography information for Steve Brine
tabling member	4478 label Biography information for Royston Smith

797518

registered interest
date	29/11/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liothyronine
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure that liothyronine will remain available on the NHS.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	116481
answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>For unbranded generics the Government relies on completion to keep prices down which generally works well and has led to low prices of these medicines. We alert the Competition and Markets Authority (CMA) when we believe that competition does not work. In the case of liothyronine, the CMA is currently investigating Concordia’s potential abuse of its dominant position to overcharge the National Health Service for liothyronine.</p><p> </p><p>In primary care community pharmacies are incentivised to source products at the lowest possible cost by allowing them to retain the medicines margin (the difference between what the NHS reimburses a pharmacy for a product and how much the pharmacy purchases it for) up to £800 million in England. In secondary care, competitive tenders ensure value-for-money to the NHS.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 116470 116474 116477 116482 question first answered 07/12/2017 15:27:25 answering member 4067 label Biography information for Steve Brine
tabling member	4478 label Biography information for Royston Smith

797519

registered interest
date	29/11/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liothyronine
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure liothyronine is competitively priced and provides value for money.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	116482
answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>For unbranded generics the Government relies on completion to keep prices down which generally works well and has led to low prices of these medicines. We alert the Competition and Markets Authority (CMA) when we believe that competition does not work. In the case of liothyronine, the CMA is currently investigating Concordia’s potential abuse of its dominant position to overcharge the National Health Service for liothyronine.</p><p> </p><p>In primary care community pharmacies are incentivised to source products at the lowest possible cost by allowing them to retain the medicines margin (the difference between what the NHS reimburses a pharmacy for a product and how much the pharmacy purchases it for) up to £800 million in England. In secondary care, competitive tenders ensure value-for-money to the NHS.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 116470 116474 116477 116481 question first answered 07/12/2017 15:27:25 answering member 4067 label Biography information for Steve Brine
tabling member	4478 label Biography information for Royston Smith

790982

registered interest
date	16/11/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Carers: Finance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what financial and other support his Department makes available to recently bereaved carers.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	113509
answer	answer is ministerial correction date of answer 24/11/2017 answer text <p>Bereavement care is a key part of the provision of good end of life care. In July 2016, the Government set out its commitment to everyone at the end of life in the Government response to the independent Review of Choice in End of Life Care. ‘Our Commitment to you for end of life care’ set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality and personalisation a reality for all and to end variation in end of life care across the health system by 2020.</p><p> </p><p>Bereaved families and carers should have access to information and support as set out in the commitment, including bereavement care, appropriate to their circumstances. This information may also be included in their carer’s assessment where there is an appearance of need as stated under the Care Act 2014.</p><p> </p><p>In addition, for those claiming Carer’s Allowance, entitlement can continue for up to eight weeks following the death of the disabled person who was being cared for. This eight-week run-on helps carers who have recently been bereaved by giving them some time to adapt to their new circumstances and make plans for their future.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 24/11/2017 12:41:27 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4478 label Biography information for Royston Smith

789074

registered interest
date	14/11/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Palliative Care
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what recent assessment he has made of the extent of palliative care available in England; and what change in that level he estimates will occur by 2020.
tabling member constituency	Southampton, Itchen
tabling member printed	Royston Smith
uin	112969
answer	answer is ministerial correction date of answer 22/11/2017 answer text <p>The Department has made no specific assessment of local palliative services care in England. As system leader, NHS England is responsible for securing the provision of high quality care for patients at the end of life, and as with the vast majority of NHS services, the commissioning of palliative and end of life care is a local matter, over which individual clinical commissioning groups (CCGs) have responsibility.</p><p> </p><p>CCGs are best placed to understand the needs of local populations and commission services to meet those needs accordingly, and as such, decisions to increase palliative care service provision are for the local, not the national, National Health Service. NHS England works to support local commissioners in improving the services they provide, including palliative care, and has recently collaborated with Public Health England and the Care Quality Commission to provide bespoke end of life care support to Sustainability and Transformation Partnerships, include Hampshire and Isle of Wight. A copy of the support pack is attached.</p><p> </p><p>Much of the palliative care patients receive will be provided either in outpatient or community settings, by nurses, community teams or general practitioners as part of general NHS services provision, rather than as an identified palliative care service. In such services, data are either not available or does not identify palliative treatment. In addition, social and voluntary sector organisations can provide additional support to patients and the end of life. Therefore, figures for the average cost and average time for treating a terminally ill person and figures for the number of patients offered end of life care in the home are not available.</p><p> </p><p>On 5 July 2016 we published ‘Our Commitment to you’ for end of life care, which set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality, personalised care a reality for everyone. This includes measures to enable personalisation, measures to improve care quality and education and training in end of life care and measures to encourage the spread of innovative models of care. The commitment sets out that by 2020 we want to significantly improve patient choice, including ensuring an increase in the number of people able to die in the place of their choice, including at home. A progress report on delivery of the commitment was published on 21 September 2017.</p><p> </p><p>A key tool in measuring choice and quality in end of life care is the National Survey of Bereaved People (VOICES) survey, which collects the views of bereaved family and friends about the care received by the person they were caring for at the end of life. The survey does provide some information about preferences for care at the end of life, including place of death. The Government Choice Commitment; progress report on the Choice Commitment; and latest VOICES survey report can be found at the following links:</p><p><a href="http://www.gov.uk/government/publications/choice-in-end-of-life-care-government-response" target="_blank">www.gov.uk/government/publications/choice-in-end-of-life-care-government-response</a></p><p><a href="http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/645631/Government_response_choice_in_end_of_life_care.pdf" target="_blank">www.gov.uk/government/uploads/system/uploads/attachment_data/file/645631/Government_response_choice_in_end_of_life_care.pdf</a></p><p><a href="http://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/nationalsurveyofbereavedpeoplevoices/england2015/pdf" target="_blank">www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/nationalsurveyofbereavedpeoplevoices/england2015/pdf</a></p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 112968 112971 112972 112975 112976 question first answered 22/11/2017 14:01:42 answering member 4065 label Biography information for Dame Jackie Doyle-Price attachment 1 file name NHS STP Publication (Hampshire).pdf title PQ112969 attached documnent
tabling member	4478 label Biography information for Royston Smith