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1037592

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Hospitals: Nurses
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether there is a legal limit on the ratio of nurses to patients on wards in NHS hospitals in England; and if so, what are those limits.
tabling member printed	Lord Clark of Windermere
uin	HL12650
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>The National Health Service does not have a legal ratio of nurses to patients.</p><p>Appropriate staffing levels are the responsibility of commissioners and trusts. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 include a requirement for the deployment of sufficient numbers of suitably qualified, competent, skilled and experienced persons at all times.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:02:02 answering member 4289 label Biography information for Baroness Manzoor
tabling member	525 label Biography information for Lord Clark of Windermere

1037602

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Adrenaline Auto-injectors
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many adrenaline auto-injectors they estimate will be needed over the next 12 months to ensure that no patient dies as a result of lacking such a device.
tabling member printed	Baroness Finlay of Llandaff
uin	HL12658
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>Based on available data sources (IMS, company supplied figures and NHS Prescription Cost Analysis Data), we estimate that approximately 900,000 adrenaline auto-injectors were issued throughout 2017 across the United Kingdom. Analysis of year on year data suggests an upward trend in the number of devices supplied, so the required volume is likely to exceed 900,000 in 2019.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:01:04 answering member 4289 label Biography information for Baroness Manzoor
tabling member	3609 label Biography information for Baroness Finlay of Llandaff

1037603

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Neurology
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to improve services for people with neurological conditions such as Parkinson’s.
tabling member printed	Baroness Gale
uin	HL12659
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS England established the National Neurology Advisory Group (NNAG) with the Neurological Alliance which led the development of a national collaborative clinical leadership model, bringing together key stakeholders such as Parkinson’s UK, a range of national clinical leaders and patient groups with the aim to seek alignment between programmes in NHS England, arm’s length bodies and system partners and to guide the strategic development of work to improve outcomes for people living with neurological conditions including Parkinson’s.</p><p>Throughout 2018, the NNAG has organised a number of condition specific meetings with the aim of defining what good neurology looks like for patients with neurological conditions including Parkinson’s, and identifying the barriers to achieving that.</p><p>NHS England also supports local transformation through their national programmes, as highlighted in the NHS Long Term Plan. NHS RightCare has published a number of intelligence tools and resources to support reduction in unwarranted variation in neurology services. For 2018/19, 37 of 195 clinical commissioning groups submitted delivery plans that include neurological problems as improvement projects as part of their NHS RightCare programmes. Of these 37, six systems have explicitly referenced Parkinson’s in their delivery plans. Interventions in these plans primarily focus on ensuring that patients are linked into end of life care recording and reviewing effective primary prescribing of Parkinson’s disease drugs.</p><p>NHS England Specialised Commissioning has also recently approved a national review of specialised adult neuroscience services, working alongside and closely with the Getting It Right First Time programme.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:06:58 answering member 4289 label Biography information for Baroness Manzoor
tabling member	2503 label Biography information for Baroness Gale

1037606

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Health Services: Foreign Nationals
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many written submissions they have received as part of the review of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017; how many case studies were submitted to the review where urgent care was withheld; and what assessment they have made of the number of case studies submitted where urgent care was, or may have, been incorrectly withheld.
tabling member printed	Lord Hunt of Kings Heath
uin	HL12662
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>The Department engaged with 79 organisations as part of the process of reviewing of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 and received 57 formal responses. Of these, 22 case studies included instances where individuals were required to make advance payment for treatment that the Department has concluded was arguably, on proper analysis, immediately necessary and/or urgent.</p><p>The common issue in these cases is that clinicians have not fully taken into account the date at which those seeking treatment have been expected to leave the United Kingdom, something that national guidance is clear must be taken into consideration when making a decision as to whether or not treatment is considered urgent. To mitigate this risk and help ensure the regulations are applied as intended the Department has updated its guidance, published on 24 December 2018, and is planning further updates to relevant training material and case studies in early 2019 to ensure all relevant circumstances are considered when deciding if a treatment is to be considered immediately necessary, urgent or non-urgent.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:03:35 answering member 4289 label Biography information for Baroness Manzoor
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1037619

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Nurses: Labour Turnover
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of whether the retention rate for new NHS nurses has increased in the last two years.
tabling member printed	Baroness Redfern
uin	HL12673
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>Data relating to the retention of newly qualified nurses is not held centrally.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:07:17 answering member 4289 label Biography information for Baroness Manzoor
tabling member	4551 label Biography information for Baroness Redfern

1037620

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	NHS: Negligence
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Baroness Manzoor on 7 January (HL12528), how they format clinical negligence claims.
tabling member printed	Lord Storey
uin	HL12674
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.</p><p>NHS Resolution formats its clinical negligence claims using a coding system.</p><p>NHS Resolution has advised that it codes claims under its management to identify whether formal court proceedings have commenced. However, the reasons for this can be multiple and complex, i.e. a dispute on breach of duty, causation, the amount due to be paid in compensation, the imminent expiry of the limitation period, a combination of all four, or alternatively, the need for court approval of a settlement. Given this, and the fact that the claimant’s reasons for commencing court proceedings may not be shared with NHS Resolution, the reasons for commencement are not coded separately.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:18:11 answering member 4289 label Biography information for Baroness Manzoor
tabling member	4238 label Biography information for Lord Storey

1037627

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Cervical Cancer: Screening
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 uptake in cervical smear tests; how they will encourage women to take such tests; and how they will increase the availability of such tests.
tabling member printed	Baroness Tonge
uin	HL12680
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS England has reviewed the data from 2013 showing the gradual national and international decline in the five-year coverage. Assessments for the decline were done in partnership with key stakeholders Public Health England (PHE) and Jo’s Cervical Cancer Trust.</p><p>Following Jo’s Cervical Cancer Trust report published in January 2018, NHS England and PHE have modified the commissioning levers and communication processes, for example through supporting Jo’s Trust in the Time to Screen campaign and the launch of its first national multimedia cervical screening campaign ‘Be Clear on Cancer’ in March 2019 promoting uptake of cervical screening.</p><p>NHS England has supported the Cancer Alliances who bring together local senior clinical and managerial leaders representing the whole cancer patient pathway across a specific geography, and have a general role in improving early diagnosis. In turn they have developed specific plans to improve uptake rates in screening programmes as part of that agenda with cervical screening considered a priority area.</p><p>Cancer Research UK and Macmillan general practitioners (GPs) are also being utilised to provide awareness and training, with work and focus groups to target reducing inequalities among women over 50 and women from Eastern European countries a specific focus in one region.</p><p>Training of GP receptionists is underway to improve ease of access to a screening appointment, while a toolkit has been developed to reduce the inequality in uptake among women with a learning disability. In addition, NHS England recently announced that Professor Sir Mike Richards has been asked to lead a review of cancer screening programmes which will consider ways to increase uptake of cervical screening and the NHS Long Term Plan confirms that using human papillomavirus testing as the primary screen for cervical cancer will be implemented across England by 2020.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:00:29 answering member 4289 label Biography information for Baroness Manzoor
tabling member	200 label Biography information for Baroness Tonge

1037634

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Prescription Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, in relation to the proposed changes to the Human Medicines Regulation 2012, as outlined in the document Further guidance note on the regulation of medicines, medical devices and clinical trials if there’s no Brexit deal, published on 4 January, what assessment they have made of whether allowing pharmacists to lead on medicines substitution and override physicians would (1) reduce the transparency of communication across the health system about medicines supplied, (2) confuse patients and physicians, and (3) affect the quality of care delivered by the NHS; and whether those proposed changes are consistent with the outcome of the public consultation on automatic generic substitution in 2010.
tabling member printed	Lord Warner
uin	HL12686
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>Community pharmacists have an important role in ensuring that patient get the medicines they need. If a serious shortage protocol is in place they can dispense an alternative but only as prescribed in the protocol.</p><p>A protocol would increase the transparency of communication across the health system and reduce confusion amongst patients and prescribers as the protocol will give prescribers clarity about what will happen in the event a prescription only medicine is unavailable.</p><p>A protocol would support the quality of care delivered by the National Health Service. In particular, in a situation with multiple large shortages, serious shortages protocols can have an important role in reducing delays in getting patients their medicines and freeing up general practitioners’ time.</p><p>The serious shortage protocol provisions would enable retail pharmacies to provide a generic medicine when the brand has been prescribed but only if there is a serious shortage of that particular branded medicine and only if the protocol, developed with and signed off by clinicians, allows for the substitution. This is not automatic generic substitution of branded medicines by retail pharmacies which is currently not allowed and the Department has no plans to change this.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 16:05:50 answering member 4289 label Biography information for Baroness Manzoor
tabling member	1732 label Biography information for Lord Warner

1037635

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	NHS: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government why the proposed changes to the Human Medicines Regulation 2012, as outlined in the document Further guidance note on the regulation of medicines, medical devices and clinical trials if there’s no Brexit deal, published on 4 January, will not be subject to the affirmative instrument procedure.
tabling member printed	Lord Warner
uin	HL12687
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>The proposed changes to the Human Medicines Regulation 2012 will be subject to the affirmative resolution procedure in accordance with paragraph 1(1) of Schedule 7 to the European Union (Withdrawal) Act 2018 for it to be exercisable in the United Kingdom. The Statutory Instrument will be laid before Parliament very soon.</p> answering member printed Baroness Manzoor question first answered 22/01/2019 15:57:48 answering member 4289 label Biography information for Baroness Manzoor
tabling member	1732 label Biography information for Lord Warner

1037772

registered interest
date	08/01/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Learning Disabilities Mortality Review Programme
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, with reference to the Learning Disabilities Mortality Review report published by the University of Bristol, whether his Department is taking steps to address the recommendations of that report.
tabling member constituency	Slough
tabling member printed	Mr Tanmanjeet Singh Dhesi
uin	206447
answer	answer is ministerial correction date of answer 16/01/2019 answer text <p>The Government’s response to the Learning Disabilities Mortality Review Programme (LeDeR) report, published on 12 September 2018, identifies actions for the Department, as well as NHS England and other partners, to address the national recommendations in the LeDeR report.</p><p> </p><p>The Department and its partners continue to make progress towards implementing these actions, to improve support for people with learning disabilities across the health and care system, reduce health inequalities and improve health and wellbeing outcomes.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 16/01/2019 12:20:39 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4638 label Biography information for Mr Tanmanjeet Singh Dhesi