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1148085

registered interest
date	02/10/2019
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: Construction
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what is the estimated total cost of the 40 hospital building projects announced on 29 September.
tabling member printed	Lord Roberts of Llandudno
uin	HL18013
answer	answer is ministerial correction date of answer 08/10/2019 answer text <p>On Sunday 29 September, the Secretary of State for Health and Social Care formally announced the next stage in our strategic investment in the National Health Service, with the Health Infrastructure Plan (HIP) to ensure that our health infrastructure is fit-for-purpose for decades to come. On Wednesday 2 October, the Prime Minister then set out his plan that “in the next ten years we will build 40 new hospitals in the biggest investment in hospital infrastructure for a generation.” As a step towards this, we have committed funding for six new hospitals as well as seed funding to support the initial stage of a further 34 building projects.</p><p>The package of funding includes:</p><p>- £2.7 billion for six new hospital projects to be delivered in our first phase of major hospital rebuilds (HIP1);</p><p>- £100 million to support for 21 major projects (£5 million each) comprising 34 hospital sites go to the next stage of developing their plans to be delivered in the second phase of major hospital rebuilds, subject to business case development and future spending reviews. Other projects will be able to bid into this and other future waves too. (HIP2); and</p><p>- £200 million investment for state-of-the-art MRI, CT and breast cancer screening machines, to update or replace our most out of date diagnostic equipment, across over 80 trusts.</p><p>The Health Infrastructure Plan also outlines our plans for a new system for ensuring funding reaches the frontline when and where it is needed, with national infrastructure to support this, and clear accountability for how it is spent. These plans include proposals for assisting trusts, including allowing some access to early funding and streamlining the business case process.</p><p>As part of our rolling investment programme, we have confirmed that there will be future phases of the Health Infrastructure Plan, with opportunities for the NHS to put forward further new hospital projects for the next phases of the programme. We also recognise that there may some more schemes suitable for investments that are not currently part of HIP1 and HIP2. These should continue developing their plans and priorities for local NHS infrastructure, and where exceptionally strong schemes come to light before HIP3, we will consider these in the context of available funding.</p> answering member printed Baroness Blackwood of North Oxford question first answered 08/10/2019 16:45:16 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3691 label Biography information for Lord Roberts of Llandudno

1122909

registered interest
date	24/04/2019
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	British Nationals Abroad: EU Countries
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what guarantees, if any, they have made of the healthcare benefits available to British citizens residing in EU countries post-Brexit.
tabling member printed	Lord Roberts of Llandudno
uin	HL15300
answer	answer is ministerial correction date of answer 09/05/2019 answer text <p>Subject to Parliament ratifying the Withdrawal Agreement, in a deal scenario current reciprocal healthcare rights will continue during the implementation period until 31 December 2020. The Withdrawal Agreement and European Free Trade Area (EFTA) Agreements also give longer-term reciprocal healthcare rights to those who are living in or previously worked in the other country on exit day.</p><p>Further to this, on 19 March 2019 I laid a written statement (HLWS1396) outlining the Department’s plans for the continuity of reciprocal healthcare arrangements in the event we exit the European Union without a deal. This statement includes specific guidance for United Kingdom nationals residing in EU countries post-exit.</p><p>The UK has proposed to EU Member States and EFTA states that we should maintain the existing healthcare arrangements, in the event of the UK leaving the EU without a deal up until 31 December 2020.</p><p>As well as seeking an extension of the current arrangements, we have made a guarantee to EU member states that we will reimburse Member States for treatments that were ongoing on exit day, for up to one year where this is necessary.</p><p>This guarantee requires reciprocity from the EU or individual Member States and cannot be implemented unilaterally. The UK Government is seeking agreements with Member States, so that no individual, including UK nationals living in other EU Member States, will face sudden changes to their healthcare cover. These discussions are ongoing.</p><p>The Government has brought forward legislation to enable us to implement new reciprocal healthcare arrangements. The Healthcare (European Economic Area and Switzerland Arrangements) Act received Royal Assent on 26 March 2019 and will provide us with the power to fund and implement comprehensive reciprocal healthcare arrangements after we leave the EU. We have also laid three Statutory Instruments which will give us the specific legal basis to implement our proposal.</p><p>General information is available online on the GOV.UK website and country-specific advice can be found under the relevant sections of NHS.UK.</p> answering member printed Baroness Blackwood of North Oxford question first answered 09/05/2019 13:10:09 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3691 label Biography information for Lord Roberts of Llandudno

1050831

registered interest
date	29/01/2019
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	Diabetes: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what commitments they will make to ensure that the UK's 3.7 million diagnosed diabetics will have access to sufficient stockpiles of medication to avoid potential deaths from diabetic ketoacidosis in the event of a no-deal Brexit.
tabling member printed	Lord Roberts of Llandudno
uin	HL13252
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department understand that diabetes medicines and medical radiopharmaceuticals are vitally important to many people in this country. Our ‘no deal’ contingency plans include mitigations for medicines that come to the United Kingdom from or via the European Union or European Economic Area (EEA), including precautionary stockpiling by suppliers and securing alternative shipping routes to ensure the flow of medicines, to ensure that the supply of diabetes medicines, medical radioisotopes and other essential medicines to patients is not disrupted.</p><p>In August 2018, the Department wrote to all pharmaceutical companies that supply prescription-only and pharmacy medicines to the UK that come from, or via, the EU/EEA asking them to ensure a minimum of six weeks’ additional supply in the UK, over and above existing business-as-usual buffer stocks, by 29 March 2019.</p><p>We recognise that certain medicines with short shelf lives, including medical radiopharmaceuticals or medical radioisotopes, cannot be reasonably stockpiled. Where these medicines are imported from the EU or EEA, we have asked that suppliers ensure that they have plans in place in advance plans to air freight these medicines from the EU in the event of a ‘no deal’ exit.</p><p> </p><p>While the stockpiling medicines and alternative air freight remains a critical part of our ‘no deal’ medicine supply contingency plans, we are also supplementing these with additional actions.</p><p>We are working towards ensuring we have sufficient roll-on, roll-off freight capacity on alternative routes to enable these vital products to continue to move freely in to the UK. Medicines and medical products, including diabetes medicines, will be prioritised on these routes to ensure that the flow of all these products will continue unimpeded after 29 March 2019.</p><p>Throughout enacting our plans, we have received very good engagement from industry who share our aims of ensuring that the continuity of supply of medicines and medical products for patients is maintained and able to cope with any potential delays at the border that may arise in the short term in the event of a ‘no deal’ EU exit.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13253 HL13254 question first answered 11/02/2019 17:57:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3691 label Biography information for Lord Roberts of Llandudno

1050833

registered interest
date	29/01/2019
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	Radioisotopes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how they will ensure the supply of radiopharmaceuticals in the event of a no-deal Brexit; and what steps they will take to prevent delays in the treatment of patients with serious conditions.
tabling member printed	Lord Roberts of Llandudno
uin	HL13253
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department understand that diabetes medicines and medical radiopharmaceuticals are vitally important to many people in this country. Our ‘no deal’ contingency plans include mitigations for medicines that come to the United Kingdom from or via the European Union or European Economic Area (EEA), including precautionary stockpiling by suppliers and securing alternative shipping routes to ensure the flow of medicines, to ensure that the supply of diabetes medicines, medical radioisotopes and other essential medicines to patients is not disrupted.</p><p>In August 2018, the Department wrote to all pharmaceutical companies that supply prescription-only and pharmacy medicines to the UK that come from, or via, the EU/EEA asking them to ensure a minimum of six weeks’ additional supply in the UK, over and above existing business-as-usual buffer stocks, by 29 March 2019.</p><p>We recognise that certain medicines with short shelf lives, including medical radiopharmaceuticals or medical radioisotopes, cannot be reasonably stockpiled. Where these medicines are imported from the EU or EEA, we have asked that suppliers ensure that they have plans in place in advance plans to air freight these medicines from the EU in the event of a ‘no deal’ exit.</p><p> </p><p>While the stockpiling medicines and alternative air freight remains a critical part of our ‘no deal’ medicine supply contingency plans, we are also supplementing these with additional actions.</p><p>We are working towards ensuring we have sufficient roll-on, roll-off freight capacity on alternative routes to enable these vital products to continue to move freely in to the UK. Medicines and medical products, including diabetes medicines, will be prioritised on these routes to ensure that the flow of all these products will continue unimpeded after 29 March 2019.</p><p>Throughout enacting our plans, we have received very good engagement from industry who share our aims of ensuring that the continuity of supply of medicines and medical products for patients is maintained and able to cope with any potential delays at the border that may arise in the short term in the event of a ‘no deal’ EU exit.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13252 HL13254 question first answered 11/02/2019 17:57:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3691 label Biography information for Lord Roberts of Llandudno

1050834

registered interest
date	29/01/2019
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 what steps they will take to ensure that every prescription for medication can still be redeemed in the event of a no-deal Brexit.
tabling member printed	Lord Roberts of Llandudno
uin	HL13254
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department understand that diabetes medicines and medical radiopharmaceuticals are vitally important to many people in this country. Our ‘no deal’ contingency plans include mitigations for medicines that come to the United Kingdom from or via the European Union or European Economic Area (EEA), including precautionary stockpiling by suppliers and securing alternative shipping routes to ensure the flow of medicines, to ensure that the supply of diabetes medicines, medical radioisotopes and other essential medicines to patients is not disrupted.</p><p>In August 2018, the Department wrote to all pharmaceutical companies that supply prescription-only and pharmacy medicines to the UK that come from, or via, the EU/EEA asking them to ensure a minimum of six weeks’ additional supply in the UK, over and above existing business-as-usual buffer stocks, by 29 March 2019.</p><p>We recognise that certain medicines with short shelf lives, including medical radiopharmaceuticals or medical radioisotopes, cannot be reasonably stockpiled. Where these medicines are imported from the EU or EEA, we have asked that suppliers ensure that they have plans in place in advance plans to air freight these medicines from the EU in the event of a ‘no deal’ exit.</p><p> </p><p>While the stockpiling medicines and alternative air freight remains a critical part of our ‘no deal’ medicine supply contingency plans, we are also supplementing these with additional actions.</p><p>We are working towards ensuring we have sufficient roll-on, roll-off freight capacity on alternative routes to enable these vital products to continue to move freely in to the UK. Medicines and medical products, including diabetes medicines, will be prioritised on these routes to ensure that the flow of all these products will continue unimpeded after 29 March 2019.</p><p>Throughout enacting our plans, we have received very good engagement from industry who share our aims of ensuring that the continuity of supply of medicines and medical products for patients is maintained and able to cope with any potential delays at the border that may arise in the short term in the event of a ‘no deal’ EU exit.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13252 HL13253 question first answered 11/02/2019 17:57:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3691 label Biography information for Lord Roberts of Llandudno

1036910

registered interest
date	07/01/2019
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 what steps they are taking to ensure that the supply of medicines into the UK will not be disrupted as a result of Brexit; and what is the cost of any such steps.
tabling member printed	Lord Roberts of Llandudno
uin	HL12552
answer	answer is ministerial correction date of answer 21/01/2019 answer text <p>The Government has now agreed the Withdrawal Agreement with the European Commission, which includes an implementation period that will run from March 2019 until December 2020. During this time, the supply of medicines will remain unchanged. As a responsible Government, however, we continue to prepare proportionately for all scenarios, including ‘no deal’.</p><p>On 23 August 2018, the Department wrote to all pharmaceutical companies that supply prescription only medicines and pharmacy medicines to the United Kingdom that come from, or via, the European Union or European Economic Area (EEA) asking them to ensure a minimum of six weeks’ additional supply in the UK, over and above existing business-as-usual buffer stocks, by 29 March 2019.</p><p>We have received very good engagement from industry who share our aims of ensuring continuity of medicines supply for patients is maintained and able to cope with any potential delays at the border that may arise in the short term in the event of a ‘no deal’ EU exit. In the light of this engagement, the Department is currently considering how best it may support those companies taking part in the contingency planning.</p><p>Additionally, a tender process to procure additional warehouse space for stockpiled medicines, including ambient, refrigerated and controlled drug storage, was undertaken in October 2018. Contract agreements for storage have recently been signed or are imminent. This is expected to cost the Government in the low tens of millions of pounds.</p><p>Whilst the six-week stockpiling activity remains a critical part of our contingency plans, this has been supplemented with additional actions. The Government recognises the importance of medicines and is working to ensure that there is sufficient roll-on, roll-off freight capacity to enable these vital products to continue to move freely in to the UK from 29 March in a ‘no deal’ scenario. The Department is working closely with the Department for Transport to ensure all medicines and medical products are prioritised on these alternative routes to ensure that the flow of all these products will continue unimpeded after 29 March 2019.</p><p>On 7 December 2018, the Department wrote to pharmaceutical companies that supply licensed medicines to the UK from or via the EU/EEA, and/or manufacture medicines in the UK, informing them of the updated reasonable worst-case scenario border planning assumptions and asking them about their current transportation routes and their ability to re-route their supply chains if they currently rely on Dover and/or Folkestone. Since then we have been working closely with those companies to better understand their supply chains and the potential for rerouting in a ‘no deal’ scenario.</p><p> </p> answering member printed Baroness Manzoor question first answered 21/01/2019 16:25:51 answering member 4289 label Biography information for Baroness Manzoor
tabling member	3691 label Biography information for Lord Roberts of Llandudno

930930

registered interest
date	25/06/2018
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	Medicine: Research
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how they will protect joint projects with EU member states into disabilities and diseases if the UK leaves the EU.
tabling member printed	Lord Roberts of Llandudno
uin	HL8930
answer	answer is ministerial correction date of answer 09/07/2018 answer text <p>We want to continue to cooperate closely with our European partners to the benefit of all citizens and patients in the United Kingdom and across the European Union. As part of this, we are determined to continue working closely with health ministers across the EU and the European Commission and Parliament on a wide variety of issues including disabilities and diseases. Whilst we cannot pre-empt the negotiations, nor can we disadvantage the UK’s position in these negotiations by giving inappropriate guarantees at this time, the Government will continue to seek the best possible deal for the UK.</p> answering member printed Lord O'Shaughnessy question first answered 09/07/2018 10:43:10 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3691 label Biography information for Lord Roberts of Llandudno

930931

registered interest
date	25/06/2018
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	Fibromyalgia
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps they are taking to progress the diagnosis and treatment of fibromyalgia.
tabling member printed	Lord Roberts of Llandudno
uin	HL8931
answer	answer is ministerial correction date of answer 09/07/2018 answer text <p>Diagnosing fibromyalgia can be difficult as there is no specific diagnostic test that can be used, and the symptoms can vary from person to person. Diagnosis is usually made by taking a medical history, checking symptoms and carrying out a physical examination. Blood tests, x-rays and other scans may be used to rule out medical conditions with similar symptoms to fibromyalgia.</p><p>The Royal College of General Practitioners (RCGP) curriculum includes training in musculoskeletal conditions, and as such, GP training can include fibromyalgia. A key component of a trainee GP’s final assessment, alongside the Clinical Skills Assessment and Workplace Based Assessment, is the applied knowledge test (AKT). The AKT is a summative assessment of the knowledge base that underpins independent general practice in the United Kingdom within the context of the NHS. The content guide for the RCGP, which serves to prepare trainees for the test, includes a specific reference to a required knowledge of fibromyalgia. <em>The Applied Knowledge Test Content Guide</em> is attached.</p><p>A range of support exists to help GPs identify the signs and symptoms of fibromyalgia in primary care. This includes an e-learning course developed by the RCGP and Arthritis Research UK on musculoskeletal care, including fibromyalgia, and a medical guide on diagnosis and treatment developed by the Fibromyalgia Association UK (FMUK) for health professionals. Information for the public can be found on the NHS Choices website and is also available in an online patient information guide produced by FMUK. The <em>Fibromyalgia Guidance for Health Professionals</em> is attached.</p><p>Although there is no cure for fibromyalgia, some treatments can ease symptoms and support improved quality of life for patients. The treatments offered will depend on the severity of a patient’s condition, but may include: pharmacological pain relief; physiotherapy; dietary and exercise advice; counselling or cognitive behavioural therapy; and self-management programmes which aim to give patients the skills and confidence to manage their conditions more effectively. There are also a number of National Health Service trusts that offer specialist fibromyalgia clinics, such as the Royal National Hospital for Rheumatic Diseases in Bath, which patients can access on referral from the clinician responsible for their care.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy attachment 1 file name Medical Pack.pdf title Fibromyalgia Guidance for Health Professionals 2 file name Content Guide August 2014.pdf title Applied Knowledge Test Content Guide question first answered 09/07/2018 14:17:12 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3691 label Biography information for Lord Roberts of Llandudno

908916

registered interest
date	21/05/2018
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	Diabetes: Health Education
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 16 April (HL6830), how many people accessed diabetes education programmes in (1) each Clinical Commissioning Group, and (2) across the country, in the most recent year for which data are available.
tabling member printed	Lord Roberts of Llandudno
uin	HL8078
answer	answer is ministerial correction date of answer 05/06/2018 answer text <p>The most recent National Diabetes Audit publication reports the number of people with diabetes who were offered a diabetes structured education programme within 12 months of diagnosis and the number who attended a programme within 12 months of diagnosis, by diabetes type.</p><p>Information showing the number of people newly diagnosed with type 1 diabetes and type 2 and other diabetes who were offered/attended a structured education programme within 12 months of diagnosis in each clinical commissioning group in the year 2015 is attached, due to the size of the data.</p><p>Data in the following table shows the total number of people newly diagnosed with type 1 diabetes and type 2 and other diabetes who were offered/attended a structured education programme within 12 months of diagnosis in England and Wales.</p><p>Type 1 diabetes</p><table><tbody><tr><td><p>Calendar Year</p></td><td><p>Organisation</p></td><td><p>Newly diagnosed</p></td><td><p>Offered within 12 months of diagnosis</p></td><td><p>Attended within 12 months of diagnosis</p></td></tr><tr><td><p>2015</p></td><td><p>England</p></td><td><p>7,345</p></td><td><p>3,030</p></td><td><p>245</p></td></tr><tr><td><p>2015</p></td><td><p>Wales</p></td><td><p>435</p></td><td><p>170</p></td><td><p>5</p></td></tr></tbody></table><p> </p><p>Type 2 and other diabetes</p><table><tbody><tr><td><p>Calendar Year</p></td><td><p>Organisation</p></td><td><p>Newly diagnosed</p></td><td><p>Offered within 12 months of diagnosis</p></td><td><p>Attended within 12 months of diagnosis</p></td></tr><tr><td><p>2015</p></td><td><p>England</p></td><td><p>194,640</p></td><td><p>150,440</p></td><td><p>14,495</p></td></tr><tr><td><p>2015</p></td><td><p>Wales</p></td><td><p>12,190</p></td><td><p>8,780</p></td><td><p>160</p></td></tr></tbody></table><p> </p><p><em>Source</em>: National Diabetes Audit 2016-17</p><p>NHS Digital has advised that caution should be taken when using programme attendance figures, as it is believed that poor recording within primary care systems means that the apparently low rates of attendance at structured education programmes are an underestimate.</p> answering member printed Lord O'Shaughnessy question first answered 05/06/2018 15:54:21 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name HL8078 data formatted.docx title HL8078 data formatted
tabling member	3691 label Biography information for Lord Roberts of Llandudno

908917

registered interest
date	21/05/2018
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	Diabetes: Health Education
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 16 April (HL6830), what consideration they have given to utilising technology, including apps, better to deliver diabetes education.
tabling member printed	Lord Roberts of Llandudno
uin	HL8079
answer	answer is ministerial correction date of answer 05/06/2018 answer text <p>£1.5 million is being made available by NHS England in 2018/19 and 2019/20 through the NHS Test Bed Programme to implement and evaluate digital delivery models for self-management support and education for people living with type 2 diabetes. Further, NHS England will be investing £10.5 million in 2018/19 to improve provision and uptake of structured education through the Transformation Fund bidding process. Up to 25% of these funds can be used to commission digital approaches, subject to the receipt of appropriate plans.</p><p>A new website on NHS.UK will be launched in July which is aimed at people living with type 1 diabetes. This will focus on empowering people to self-manage their condition. Individuals visiting the site will be able to access remote personalised digital education content from Diabetes UK and an on-line education programme developed by Bournemouth Diabetes Centre.</p> answering member printed Lord O'Shaughnessy question first answered 05/06/2018 15:56:14 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3691 label Biography information for Lord Roberts of Llandudno