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1653013

registered interest
date	13/07/2023
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	Home Care Services: Standards
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what are the Key Performance Indicators for homecare providers; and what is the actual level of performance against those indicators for each homecare provider, for the latest period for which data are available.
tabling member printed	Lord Blencathra
uin	HL9312
answer	answer is ministerial correction date of answer 26/07/2023 answer text <p>Appendix 10 of the 2014 Royal Pharmaceutical Society handbook contains the Key Performance Indicators for Homecare Medicine service providers. A copy is attached.</p><p>Providers of Homecare Medicines services operate in a highly regulated environment with obligations to record and monitor quality metrics, including any trends. To monitor industry trends, providers provide the same data set to the trade association, the National Clinical Homecare Association (NCHA), allowing for the aggregation of all providers metrics. The NCHA report that the delivery performance of providers (delivery to patients on the agreed date) was 99.0% in 2020, 98.6% in 2021 and 98.8% in 2022. Formal complaints and incidents are also monitored and the data shows that the percentage of complaints raised was 1.4% in 2020, 1.6% in 2021 and 1.8% in 2022 of active patients. This refers to complaints opened, not upheld.</p> answering member printed Lord Markham question first answered 26/07/2023 13:33:00 answering member 4948 label Biography information for Lord Markham attachment 1 file name 2014 - RPS Homecare Medicines Hanbook - Appendix 10 KPIs - 20-12-22 (1).xlsx title Attachment
tabling member	497 label Biography information for Lord Blencathra

1653014

registered interest
date	13/07/2023
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	Home Care Services: Prescriptions
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government how many NHS hospitals have issued prescriptions to homecare providers (1) 10 or more days before the delivery is due, (2) between 10 days and the delivery date, and (3) after the delivery was supposed to be made.
tabling member printed	Lord Blencathra
uin	HL9313
answer	answer is ministerial correction date of answer 26/07/2023 answer text <p>This information is not collected centrally by NHS England or the Department. Each individual trust may or may not collect this data depending on the contracted Key Performance Indicators.</p> answering member printed Lord Markham question first answered 26/07/2023 13:33:11 answering member 4948 label Biography information for Lord Markham
tabling member	497 label Biography information for Lord Blencathra

1653015

registered interest
date	13/07/2023
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	Medical Treatments
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government whether Market Authorisation Holders set different (1) Key Performance Indicator measurements, and (2) clinical pathways, for the same therapy.
tabling member printed	Lord Blencathra
uin	HL9314
answer	answer is ministerial correction date of answer 26/07/2023 answer text <p>Marketing Authorisation Holders (MAHs) are encouraged to use the national Key Performance Indicators (KPIs) published in the Royal Pharmaceutical Homecare Services Handbook 2014 in their contracts with homecare providers. MAHs may also use additional or alternative specific KPIs where they consider this necessary. Neither NHS England nor National Health Service trusts are directly party to those contracts between MAHs and homecare providers, and therefore do not have visibility of the KPIs agreed in each case.</p><p>The treatment choice is determined by the clinician in the hospital trust in conversation with the patient, based on the best available evidence and cost-effectiveness aligned to national and local guidance where available. The homecare medicines service provider is contracted to undertake supply and delivery, and administration in some cases. The homecare medicines service provider does not determine the clinical pathway.</p> answering member printed Lord Markham question first answered 26/07/2023 13:33:48 answering member 4948 label Biography information for Lord Markham
tabling member	497 label Biography information for Lord Blencathra

1653018

registered interest
date	13/07/2023
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	Coronavirus: Vaccination
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what assessment they have made of reports that COVID-19 vaccines may cause serious side effects, including death; and what steps they taking to collate all evidence on side effects from COVID-19 vaccinations in order that sufferers may be advised how best to respond to symptoms.
tabling member printed	Lord Framlingham
uin	HL9318
answer	answer is ministerial correction date of answer 20/07/2023 answer text <p>All COVID-19 vaccines deployed in the United Kingdom have been authorised for use following a rigorous review by the independent regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).</p><p>The MHRA continuously monitors a wide range of data regarding the safety of COVID-19 vaccines, including reports of adverse reactions from the UK and internationally. The MHRA’s position remains that the benefits of these vaccines far outweigh any currently known side effects in the majority of patients.</p><p>In the very rare event where an individual may have suffered a severe adverse reaction to a COVID-19 vaccine, care is likely to be best managed by local National Health Service specialist services, augmented as appropriate by national specialist advice.</p> answering member printed Lord Markham question first answered 20/07/2023 15:55:45 answering member 4948 label Biography information for Lord Markham
tabling member	134 label Biography information for Lord Framlingham

1653025

registered interest
date	13/07/2023
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	Brain: Tumours
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what assessment they have made of the Early Access to Medicines Scheme to ensure that brain tumour patients are able to access the most promising treatments.
tabling member printed	Lord Hunt of Kings Heath
uin	HL9326
answer	answer is ministerial correction date of answer 19/07/2023 answer text <p><del class="ministerial">We do not currently have a national mechanism to capture and report incidents of violence and aggression in the National Health Service. Data is held at a local level.</del></p><p> </p><p><del class="ministerial">At a national level, data on self-reported violent incidents is gathered through the NHS Staff Survey. Results from the 2022 NHS Staff Survey indicated that 14.7% of NHS staff have self-reported that they have experienced at least one incident of physical violence from patients, service users, relatives or other members of the public in the last 12 months.</del></p><p> </p><p><del class="ministerial">27.8% of NHS staff who completed the NHS Staff Survey experienced at least one incident of harassment, bullying or abuse in the last 12 months from patients or service users, their relatives or members of the public. This figure is similar to previous years’ NHS Staff Survey data.</del></p><p> </p><p><del class="ministerial">NHS England has commissioned a number of data insight workstreams to better understand the current landscape of statistics, data reporting and associated challenges. This includes a national review of all available data and intelligence sources, an analysis of the costs of violence to the health care system in England and a review of the impact on the safety and wellbeing of NHS staff.</del></p><p> </p><p><del class="ministerial">The Ministry of Justice collects data on prosecution, conviction and sentences for the offence of assault on an emergency worker, although it does not identify the type of emergency worker. This data is available in the Criminal Justice Statistics Quarterly and the Outcomes of Offence Tool and Offence Group Classification: Criminal Justice System Statistics Quarterly: December 2022, a copy of which is attached.</del></p><p><ins class="ministerial">The early access to medicines scheme (EAMS) aims to give patients with life threatening or seriously debilitating conditions access to medicines that do not yet have a marketing authorisation when there is a clear unmet medical need.</ins></p><p><ins class="ministerial">Under the scheme, the Medicines and Healthcare products Regulatory Agency (MHRA) will give a scientific opinion on the benefit/risk balance of the medicine, based on the data available when the EAMS submission was made and the EAMS criteria. The MHRA will make an evaluation of products, including drugs such as for brain tumour treatments, once an application is received.</ins></p><p><ins class="ministerial">If we do receive an application, it is only made public where an EAMS Scientific Opinion (SO) is awarded. All EAMS SOs are published on the EAMS webpage. All drugs that have previously held an EAMS SO are also published on the EAMS webpage.</ins></p> answering member printed Lord Markham question first answered 19/07/2023 16:58:18 question first ministerially corrected 20/07/2023 11:30:24 answering member 4948 label Biography information for Lord Markham previous answer version 88876 answering member printed Lord Markham answering member 4948 label Biography information for Lord Markham attachment 1 file name criminal-justice-statistics-december-2022.pdf title Criminal Justice statistics
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1653026

registered interest
date	13/07/2023
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	Clinical Trials: Rare Cancers
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what discussions they have had with European health ministers regarding working together to capture data from clinical trials for less common cancers, such as brain tumours.
tabling member printed	Lord Hunt of Kings Heath
uin	HL9327
answer	answer is ministerial correction date of answer 02/08/2023 answer text <p>Following the United Kingdom’s departure from the European Union, the Medicines and Healthcare products Regulatory Agency has not had recent discussions with European health ministers regarding collaboration to capture data from clinical trials for less common cancers, such as brain tumours.</p> answering member printed Lord Markham question first answered 02/08/2023 12:11:27 answering member 4948 label Biography information for Lord Markham
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1653027

registered interest
date	13/07/2023
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	Brain: Tumours
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what recent steps they have taken to encourage more medical researchers to enter into brain tumour research.
tabling member printed	Lord Hunt of Kings Heath
uin	HL9328
answer	answer is ministerial correction date of answer 19/07/2023 answer text <p>Brain tumour research remains a challenging scientific area, with a relatively small research community. We are working closely with the Tessa Jowell Brain Cancer Mission (TJBCM) in hosting customised workshops for researchers, and training for clinicians. These actions will grow the capacity for brain cancer research, attracting new researchers, developing the community, and supporting researchers to submit high-quality research funding proposals.</p><p>The TJBCM recently announced two appointments to the inaugural Tessa Jowell Fellowship programme. These 12-month fellowships will support high quality training in neuro-oncology clinical practice and research, to ensure clinicians are equipped with the relevant research skills needed to lead neuro-oncology trials that change practice.</p><p>Additionally, the TJBCM have designated 28 adult Tessa Jowell Centres of Excellence within the National Health Service, which has created a world-class network of brain tumour treatment and research centres to provide the best care and share best practice.</p> answering member printed Lord Markham question first answered 19/07/2023 13:18:44 answering member 4948 label Biography information for Lord Markham
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1653028

registered interest
date	13/07/2023
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	Cancer: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what steps they are taking to ensure that more cancer drugs can transition from a Phase 1 study to Medicines and Healthcare products Regulatory Agency (MHRA) approval.
tabling member printed	Lord Hunt of Kings Heath
uin	HL9329
answer	answer is ministerial correction date of answer 20/07/2023 answer text <p>The Medicines and Healthcare products Regulatory Agency (MHRA) is aware that customers who have submitted initial applications and amendments to our Clinical Investigations and Trials team have experienced extended timeframes in some cases, and understands how this unpredictability may be reducing the number of cancer drugs that can transition from a Phase 1 study to MHRA approval. To help improve the predictability of decision making in applications for clinical trials, the MHRA have implemented several actions.</p><p>The MHRA are looking at novel ways to develop staff capability and expertise. New assessor capacity is being supplemented with an additional fixed-term resource of appropriately experienced and qualified specialists to support the training and supervision of new staff and to help reduce the current backlog. The MHRA has also established links with the Association of the British Pharmaceutical Industry and the BioIndustry Association on clinical trials, to reduce the backlog of delayed applications, which may include applications for cancer drugs. Additionally, they have already reallocated work, and are evaluating queued applications for complexity, to improve the speed of assessment, and are changing processes to take a joined-up risk-proportionate approach.</p><p>The MHRA is committed to reducing these backlogs so that it makes regulatory decisions in accordance with statutory timeframes for all new fully compliant clinical trial applications received from 1 September 2023. This will enable more cancer drugs to progress from Phase 1 studies to MHRA approval where appropriate.</p> answering member printed Lord Markham question first answered 20/07/2023 16:33:27 answering member 4948 label Biography information for Lord Markham
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1653030

registered interest
date	13/07/2023
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	Physician Associates: Employment
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what safeguards are in place to ensure that the increased employment of physician associates (PAs) as part of the NHS Long Term Workforce Plan to tackle staff shortages in the NHS do not compromise patient safety; and what measures are in place to ensure that patients understand when they are being treated by a PA and not by a fully qualified GP.
tabling member printed	The Marquess of Lothian
uin	HL9331
answer	answer is ministerial correction date of answer 19/07/2023 answer text <p>Physician associates (PAs) are medically trained generalist healthcare professionals who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. They should always work with a registered medical supervisor, whether in primary care or a hospital setting, so that they have immediate access to appropriate support and guidance.</p><p>The Government is progressing the required legislation which will the enable the General Medical Council (GMC) to regulate the PA role. We plan to lay legislation before the House at the end of 2023, which will allow the GMC to commence regulation by the end of 2024. Regulation by the GMC will provide a standardised framework of governance and assurance for the clinical practice and professional conduct of PAs.</p><p>PAs, like all other members of the primary care team, are expected to introduce themselves to each patient that they see, and this introduction should include explaining their role in the multi-professional team.</p> answering member printed Lord Markham question first answered 19/07/2023 14:25:53 answering member 4948 label Biography information for Lord Markham
tabling member	259 label Biography information for The Marquess of Lothian

1653047

registered interest
date	13/07/2023
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: Staff
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what steps they are taking to combat the abuse of NHS staff.
tabling member printed	Lord Turnberg
uin	HL9349
answer	answer is ministerial correction date of answer 19/07/2023 answer text <p>Everyone working in the National Health Service had a fundamental right to be safe at work. NHS England’s NHS Violence Reduction Programme aims to prevent and reduce violence and aggression from patients, their families and the public, and mitigate the effects of violence and abuse on NHS staff.</p><p>A key part of this has been the creation of Violence Prevention and Reduction Standards, which help NHS organisations assess their arrangements for managing the risk of violence towards staff. Work is underway with integrated care systems to improve system working and skill mix training in tackling violence, embedding a longer term, preventative approach in line with the World Health Organization and Home Office guidance.</p><p>NHS England has invested £8.4 million into the ambulance service sector to explore the efficacy of body worn cameras in reducing violence and abuse. All ambulance trusts are now trialling the cameras and an independent evaluation is underway with a final report expected at the end of the 2024. In addition, NHS England have been working with the Association of Ambulance Chief Executives, to produce a national communications campaign in response to the rising levels of aggression, verbal and physical assaults against NHS ambulance staff.</p><p>The Government legislated last year through the Police, Crime, Sentencing and Courts Act to double the sentence for assaults on emergency workers to a maximum of two years.</p> answering member printed Lord Markham question first answered 19/07/2023 14:19:46 answering member 4948 label Biography information for Lord Markham
tabling member	2537 label Biography information for Lord Turnberg