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927364

	registered interest
	date	19/06/2018
	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	Public Health and Social Services: Finance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what increases, in constant prices and on present funding plans, will be provided for (1) Public Health England, (2) local authority public health services, and (3) adult social care services, over each of the next five years; and what are the planned annual percentage increases for each of those service areas over that period.
	tabling member printed	Lord Warner
	uin	HL8805
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>The available figures are provided in the following table.</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>2019-20 budget</p></td><td><p>2020-21 budget</p></td></tr><tr><td><p>Public Health England: operating expenditure £ million</p></td><td><p><ins class="ministerial">287 </ins><del class="ministerial">237</del></p></td><td><p><ins class="ministerial">287 </ins><del class="ministerial">237</del></p></td></tr><tr><td><p>Increase (£)</p></td><td><p>-</p></td><td><p>£0</p></td></tr><tr><td><p>Increase (%)</p></td><td><p>-</p></td><td><p>0%</p></td></tr></tbody></table><p> </p><table><tbody><tr><td><p> </p></td><td><p>2019-20 planned</p></td><td><p>2020-21 planned</p></td></tr><tr><td><p>Public health funding for local authorities £ billion</p></td><td><p>3.13</p></td><td><p>3.13</p></td></tr><tr><td><p>Increase (£)</p></td><td><p>-</p></td><td><p>£0</p></td></tr><tr><td><p>Increase (%)</p></td><td><p>-</p></td><td><p>0%</p></td></tr></tbody></table><p> </p><p>Budgets for both Public Health England and local authorities beyond these years will be agreed as part of the next Spending Review settlement.</p><p> </p><p>Spending decisions on social care, including annual increases, are a matter for local government which know their local areas best. Overall, the Government has given access to £9.4 billion additional funding for social care between 2017-18 and 2019-20. Funding allocations for local government beyond 2019-20 are subject to the Spending Review.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:11:53 question first ministerially corrected 20/07/2018 10:43:05 answering member 4545 label Biography information for Lord O'Shaughnessy previous answer version 67072 answering member printed Lord O'Shaughnessy answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1732 label Biography information for Lord Warner

927357

	registered interest
	date	19/06/2018
	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	Mental Health Services
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how they assess the providers of mental health contracts commissioned by NHS England; and what criteria they use to evaluate the standard of services provided.
	tabling member printed	Baroness Uddin
	uin	HL8799
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>All providers of National Health Service funded care (NHS and independent sector providers) for specialised mental health services are contracted using the same standard NHS national contract. These contracts set out the standard terms of business relating to the provider and commissioner relationship.</p><p>The monitoring of performance is undertaken by NHS England centrally and through the contracting hubs. Performance management includes:</p><p>- Performance against operational standards within the NHS Contract;</p><p>- Reporting against Key Performance Indicators undertaken quarterly and reviewed as part of contract management meetings between commissioner and provider;</p><p>- Regular performance review meetings with the provider;</p><p>- Measurement against local quality standards developed by individual hubs;</p><p>- Measurement of service specification compliance;</p><p>- NHS England Hub ward visits;</p><p>- The patient satisfaction survey and implementation of service improvements informed by patient feedback; and</p><p>- Triangulation with Care Quality Commission inspections.</p><p>The Quality Assurance and Improvement Framework sets out the quality assurance and improvement activity undertaken in relation to all specialised commissioned services.</p><p>The outcome of the annual assessment has two features:</p><p>- Identification of levels of surveillance for the following year; and</p><p>- Assessment of compliance and non-compliance and if non-compliant, whether provider action or commissioner action is required.</p><p>A framework has been introduced which requires those reviewing and assessing the information on quality, to categorise services into one of three categories to determine levels of surveillance for the following year:</p><p>- Routine surveillance – services that have been scored at 100% with no risks identified and those services that have not scored 100% but regional teams have determined that the issue is not material;</p><p> </p><p>- Enhanced surveillance – services in this category will require further discussions between provider organisations and relevant commissioning teams to determine whether formal provider action or commissioner action is required, or whether after further discussion the service is deemed to be compliant; and</p><p> </p><p>- Peer review visit – services considered for peer review should be discussed with the provider and commissioner to confirm that the factors leading to this proposed option are relevant and proportionate for the action. Based on the level of risk agreed at hub or regional meetings, the service may also be subject to a provider or commissioner action.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:09:45 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1827 label Biography information for Baroness Uddin

927341

	registered interest
	date	19/06/2018
	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	Leuprorelin
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how much Lupron they estimate to have been legally prescribed in England and Wales last year.
	tabling member printed	Lord Moonie
	uin	HL8785
	answer	answer is ministerial correction date of answer 02/07/2018 answer text <p>No such estimate has been made.</p><p>The following table shows the number of prescription items of leuprorelin acetate written in the United Kingdom and dispensed in the community in England, 2017. We do not hold data for Wales. Lupron is the brand name, used in the United States of America, for the chemical leuprorelin acetate. In the United Kingdom and Ireland, leuprorelin is marketed under the brand names Lutrate and Prostap.</p><table><tbody><tr><td><p>Chemical Name</p></td><td><p>Brand</p></td><td><p>Presentation</p></td><td><p>Items</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Lutrate</p></td><td><p>Lutrate_1 month Depot Inj 3.75mg Vl+Dil</p></td><td><p>182</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Lutrate</p></td><td><p>Lutrate_3 month Depot Inj 22.5mg Vl+Dil</p></td><td><p>611</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Prostap</p></td><td><p>Prostap 3_DCS Inj 11.25mg Dil + Pfs</p></td><td><p>150,586</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Prostap</p></td><td><p>Prostap 3_Depot Inj 11.25mg Vl + Dil Pfs</p></td><td><p>59</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Prostap</p></td><td><p>Prostap SR_DCS Inj 3.75mg Dil + Pfs</p></td><td><p>41,771</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Prostap</p></td><td><p>Prostap SR_Inj 3.75mg Vl + Dil Pfs</p></td><td><p>38</p></td></tr><tr><td><p>Leuprorelin Acetate</p></td><td><p>Total</p></td><td><p>Total</p></td><td><p>193,247</p></td></tr></tbody></table><p><em>Source</em>: Prescription Cost Analysis</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 02/07/2018 15:47:04 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	621 label Biography information for Lord Moonie

927340

	registered interest
	date	19/06/2018
	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	Leuprorelin
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many seizures of illegal Lupron have been made in the last 12 months in England and Wales; and what measures, if any, they plan to take to prevent its purchase and import via the internet.
	tabling member printed	Lord Moonie
	uin	HL8784
	answer	answer is ministerial correction date of answer 02/07/2018 answer text <p>Lupron is not an authorised medicine in the United Kingdom. The Active Pharmaceutical Ingredient in Lupron is Leuprorelin which is classed as a prescription only medicine and is present in Prostap 3 which is licensed in the UK.</p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) has regulatory responsibility for medicines and medical devices. The MHRA has no recorded seizures of Lupron, Leuprolin or Prostap 3.</p><p>There is provision in medicines regulations for the import of unauthorised medicines for specific use by named patients. In the last five years, there have been 25 notifications of the import of leuprolide/leuprorelin.</p><p>Additionally, there are no formal restrictions on an individual importing medicines into the UK provided they are strictly for use by that person or a member of their immediate family. Legal controls on the retail sale, supply and advertising of medicines are set out in the Human Medicines Regulations 2012. These apply without distinction to medicines advertised, sold or supplied through the internet.</p><p>Websites offering to supply unauthorised medicines to UK citizens are breaching UK legal requirements. The MHRA investigates reports of illegal activity taking place on a website and, where appropriate, takes enforcement action against suppliers who operate outside the legal requirements. However, considerable illegal activity takes place outside of UK jurisdiction and illegally trading websites identified overseas are referred to the relevant country for appropriate action.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 02/07/2018 15:49:07 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	621 label Biography information for Lord Moonie

927339

	registered interest
	date	19/06/2018
	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	Food: Safety
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what action they have taken following the recommendation of the Elliott Review into the integrity and assurance of food supply networks that they should “work in partnership with Public Health England and local authorities with their own laboratories to consider appropriate options for an integrated shared scientific service around food standards”; and whether there has been any public scrutiny of this project as was requested in that Review.
	tabling member printed	The Countess of Mar
	uin	HL8783
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>In response to the recommendations of the Elliott Review, the following actions that have been undertaken to address the integrity and assurance of the food supply networks include:</p><p> </p><p>- Creation of a United Kingdom Virtual Food Authenticity Network to bring together centres of scientific expertise on food standards; and</p><p> </p><p>- Supporting sharing analytical best practice on food standards across laboratories via a new coordinated knowledge transfer programme to upskill laboratories in the application of analytical methods and support food law enforcement; and supporting the Mastership in Chemical Analysis (MChemA).</p><p> </p><p>The <em>Government response to the Elliott review of the integrity and assurance of food supply networks</em> was published in September 2014. A copy is attached. This document provides the details of the Government’s actions and commitments to address the recommendations of the Elliott Review and was open to the public for further enquiries and comments.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:07:34 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name elliott-review-gov-response-sept-2014.pdf title Government response to the Elliott review
	tabling member	1861 label Biography information for The Countess of Mar

927338

	registered interest
	date	19/06/2018
	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	Food: Safety
	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 review of the official control laboratories agreed at the Food Standards Agency board meeting on 6 December 2017 will address the anomalous funding position of the Public Analyst laboratories when compared with other laboratories with roles in official controls.
	tabling member printed	The Countess of Mar
	uin	HL8782
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>The Food Standards Agency’s Board proposed in December 2017 that investigating official laboratories in a systematic review was an important priority. The first phase of the review will address the availability of services to Government departments to ensure official controls can be carried out effectively. A report of this review is expected by March 2019.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:12:47 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

927336

	registered interest
	date	19/06/2018
	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	Food: Safety
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many competent authorities with responsibility for food standards consulted (1) a public analyst, and (2) a food examiner employed by those authorities when preparing food sampling policies and programmes for 2016–17.
	tabling member printed	The Countess of Mar
	uin	HL8781
	answer	answer is ministerial correction date of answer 02/07/2018 answer text <p>The Food Standards Agency does not routinely capture information on the number of competent authorities that have consulted a public analyst and/or a food examiner when preparing their food sampling policies and programmes. However, the Agency requires local authorities to have a food sampling policy and linked sampling programme and that these should be prepared in consultation with the food examiner and/or the public analyst. This consultation may take place on a local or regional basis.</p> answering member printed Lord O'Shaughnessy question first answered 02/07/2018 15:47:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

927335

	registered interest
	date	19/06/2018
	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	Food: Safety
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many competent authorities with responsibilities for food standards did not have a sampling programme in place for 2016–17; and how many local authority Chief Executives the Food Standards Agency has written to since January 2018 regarding lack of compliance with legal obligations regarding the delivery of the official controls in relation to (1) food standards, and (2) food safety.
	tabling member printed	The Countess of Mar
	uin	HL8780
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>Data submitted to the Food Standards Agency for local authority activity in 2016-17 indicates that there were 13 authorities responsible for food standards that reported no sampling activity for food standards. However, all 13 of these were unitary authorities, with responsibility for safety and standards, and reported sampling activity in relation to food safety.</p><p> </p><p>The Food Standards Agency has written to 14 local authorities, either to the Chief Executive or the Head of Service, since January 2018 in relation to concerns about compliance with legal obligations. Of these, one was in relation to food standards, eight were in relation to food safety and five related to both food safety and food standards.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:08:59 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

927334

	registered interest
	date	19/06/2018
	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	Food: Safety
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what action they have taken, if any, to ensure that the 14 District Councils and two London boroughs that did not carry out any food safety sampling during 2016–17 now have a sampling programme in place.
	tabling member printed	The Countess of Mar
	uin	HL8779
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>Food Standards Agency officials contacted all 14 district councils that reported no food safety sampling in 2016/17 to investigate why no sampling had been carried out. As a result, nine of the 14 councils carried out sampling in 2017/18. Further follow up work will be carried out with the remaining five councils. Analysis of the 2016-17 local authority monitoring data indicates that all of the London boroughs reported sampling for food safety.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:08:23 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

927315

	registered interest
	date	19/06/2018
	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	Out-patients: Attendance
	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 19 March (HL6008), why the information surrounding the cost of missed appointments at hospital out-patient services is not collected centrally.
	tabling member printed	Lord Dobbs
	uin	HL8763
	answer	answer is ministerial correction date of answer 03/07/2018 answer text <p>There is no national performance standard for missed appointments and, as stated in my answer of 19 March, the information is not collected centrally. However, this is an issue which the Minister of State for Health (Stephen Barclay) has asked Departmental officials to consider.</p><p>Costs associated with hospital appointments are determined by a range of locally determined factors including appointment duration, the workforce requirement and the clinical complexity of each appointment. This ensures out-patient services meet the needs of patients and these will differ across the country.</p><p>National Health Service staff are able to use time resulting from missed appointments productively, however. This may include undertaking a variety of additional tasks including support to other patients, or spending time on personal development and training.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2018 11:12:28 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4192 label Biography information for Lord Dobbs