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100031

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Liver Diseases
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they are taking to reverse the rise in liver deaths in England between 2001 and 2012 shown by Public Health England’s report <i>Liver Disease Profiles</i>.
	tabling member printed	Lord Avebury
	uin	HL2237
	answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>Public Health England (PHE) has a comprehensive range of action aimed at reducing the incidence and mortality from liver disease. It monitors the incidence, mortality and outcomes of treatment for liver disease and the risk factors: alcohol obesity and Hepatitis B and C. PHE has a wide range of action to tackle unhealthy alcohol consumption, obesity and viral hepatitis through strengthening local action, promoting healthy choices, and giving appropriate information to support healthier lives. <br> <br> In response to the All Party Parliamentary Hepatology Group report PHE has committed to producing a PHE Liver Disease Framework. This will focus on public health action to tackle risk factors for liver disease and inequalities in relation to liver disease. Work has already begun to bring together expertise within PHE on the major risk factors for liver disease (alcohol, hepatitis B and C and obesity), data on liver disease and its risk factors and on death and dying from liver disease. Many of the actions to tackle the major risk factors require a coordinated approach between PHE and NHS England.</p><p> </p><p><br> NHS England is responsible for delivering improvements in outcomes against the NHS Mandate and in line with the NHS Outcomes Framework. NHS England are adopting a broad strategy for delivering improvements in relation to premature mortality, working with commissioners and PHE to support clinical commissioning groups in understanding where local challenges lie and in identifying the evidence in relation to the priorities for reducing mortality at a national level.</p><p> </p> answering member printed Earl Howe question first answered 03/11/2014 11:52:44 answering member 2000 label Biography information for Earl Howe
	tabling member	1665 label Biography information for Lord Avebury

100036

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Accident and Emergency Departments
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what has been the impact since 2009 of the closure of accident and emergency departments on neighbouring hospitals.
	tabling member printed	Baroness McDonagh
	uin	HL2242
	answer	answer is ministerial correction date of answer 27/10/2014 answer text <p>The reconfiguration of local health services is a matter for the local National Health Service. All service changes should be led by clinicians and be in the best interests of patients, not driven from the top down.</p><p> </p><p> </p><p> </p><p>It is for NHS commissioners and providers to work together, with local authorities, patients and the public, in bringing forward proposals that will improve the quality, safety and sustainability of healthcare services.</p><p> </p><p> </p><p> </p><p>Any changes must be supported by the Government’s four tests for service change, namely:</p><p> </p><p> </p><p> </p><p>- support from general practitioner commissioners;</p><p> </p><p>- clarity on the clinical evidence base;</p><p> </p><p>- robust patient and public engagement; and</p><p> </p><p>- support for patient choice.</p><p> </p><p> </p><p> </p><p>Once a decision on a local case for change has been made, it is up to the NHS to ensure its local services meet the needs of its population.</p><p> </p><p> </p><p> </p><p>More generally, we would expect any local plans for changes to acute services to take full account of the impact on neighbouring hospitals.</p><p> </p> answering member printed Earl Howe question first answered 27/10/2014 12:41:26 answering member 2000 label Biography information for Earl Howe
	tabling member	3701 label Biography information for Baroness McDonagh

100037

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	General Practitioners: Dismissal
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many general practitioners have been dismissed by primary care trusts, or by the Care Quality Commission, in each year since 2005.
	tabling member printed	Baroness McDonagh
	uin	HL2243
	answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>The information requested is not centrally collected. Departmental officials are aware that the General Medical Council does collect some demographic data about doctors and this is published in its annual report ‘The state of medical education and practice in the UK’.</p><p> </p><p> </p><p> </p><p>The Care Quality Commission (CQC), the independent regulator of health and adult social care in England, has registered all general practitioner (GP) practices since April 2012. The CQC’s role is to inspect and regulate GP practices, including those practices run by single-handed GPs. The CQC regulates at a provider level and may remove a practice’s registration where care is not meeting the required standard. Actions taken against an individual GP would be the responsibility of NHS England for contractual issues and the General Medical Council for professional issues.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:18:49 answering member 2000 label Biography information for Earl Howe
	tabling member	3701 label Biography information for Baroness McDonagh

100044

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Tobacco: Packaging
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government why they notified the European Commission of the draft regulations for possible standardised packaging for tobacco products without waiting for the results of the recent consultation that closed on 7 August.
	tabling member printed	Lord Palmer
	uin	HL2250
	answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>The consultation on introducing regulations for standardised packaging of tobacco ran between 26 June and 7 August 2014. All substantive responses were then considered before the regulations were notified in draft to the European Commission as technical standards under the procedures of Directive 98/34/EC. They were notified to the Commission on 29 August 2014.</p><p> </p><p><strong> </strong></p><p> </p> answering member printed Earl Howe question first answered 03/11/2014 11:54:12 answering member 2000 label Biography information for Earl Howe
	tabling member	3192 label Biography information for Lord Palmer

100045

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Tobacco: Packaging
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government when they will publish a revised impact assessment on standardised packaging of tobacco products following the comments of the Regulatory Policy Committee.
	tabling member printed	Lord Palmer
	uin	HL2251
	answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>The consultation-stage impact assessment on standardised packaging of tobacco products is being updated following the public consultation, which ran between 26 June and 7 August 2014. The updated Impact Assessment takes into account previous comments from the Regulatory Policy Committee (RPC) and will be re-submitted to the RPC for their consideration before it is published.</p><p> </p> answering member printed Earl Howe question first answered 03/11/2014 11:55:04 answering member 2000 label Biography information for Earl Howe
	tabling member	3192 label Biography information for Lord Palmer

100057

	registered interest
	date	21/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Health Services and Social Services
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what response they have given to the Care Quality Commission’s annual State of Care report.
	tabling member printed	Lord Taylor of Warwick
	uin	HL2263
	answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>The Secretary of State for Health has said “The Care Quality Commission’s (CQC) State of Health and Adult Social Care in England 2013-14 report highlights examples of excellent care but it also exposes unacceptable levels of variation. It also confirms that the NHS has seen a period of “hard realities and rapid change” following the scandal at Mid Staffordshire NHS Foundation Trust. We need to keep building on this to ensure greater cultural change, continuing transparency and a focus on safety to drive up standards of care across the country.”</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:20:34 answering member 2000 label Biography information for Earl Howe
	tabling member	1796 label Biography information for Lord Taylor of Warwick

100550

	registered interest
	date	22/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	IVF
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, further to the Written Answers by Lord Darzi of Denham on 22 July 2008 (HL4926 and HL4927) and by Earl Howe on 9 July 2012 (HL1211), of how many cycles the Human Fertilisation and Embryology Authority are aware in which fresh embryo transfers took place after 15 or more eggs were collected over each of the past ten years.
	tabling member printed	Lord Alton of Liverpool
	uin	HL2287
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The number of treatment cycles in which fresh embryo transfers took place after 15 or more eggs were collected, in each of the last 10 years, is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Years</p></td><td><p>Cycles in which fresh embryo transfers took place after 15 or more eggs were collected</p></td></tr><tr><td><p>2004</p></td><td><p>5602</p></td></tr><tr><td><p>2005</p></td><td><p>5737</p></td></tr><tr><td><p>2006</p></td><td><p>5843</p></td></tr><tr><td><p>2007</p></td><td><p>6345</p></td></tr><tr><td><p>2008</p></td><td><p>6589</p></td></tr><tr><td><p>2009</p></td><td><p>7344</p></td></tr><tr><td><p>2010</p></td><td><p>7801</p></td></tr><tr><td><p>2011</p></td><td><p>8195</p></td></tr><tr><td><p>2012</p></td><td><p>8200</p></td></tr><tr><td><p>2013(1)</p></td><td><p>8128</p></td></tr></tbody></table><p> </p><p>Source: The Human Fertilisation and Embryology Authority</p><p> </p><p> </p><p> </p><p>(1) 2013 is the most recent year for which information is available.</p><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:25:39 answering member 2000 label Biography information for Earl Howe
	tabling member	738 label Biography information for Lord Alton of Liverpool

100552

	registered interest
	date	22/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Dementia
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what plans they have to help care for dementia patients in the community.
	tabling member printed	Lord Taylor of Warwick
	uin	HL2289
	answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>Dementia is a key priority for this Government and we are committed to ensuring people with dementia and their carers receive the best possible care in all care settings. That is why in 2012 we launched the first ever Prime Minister’s Challenge on dementia to increase diagnosis rates, raise awareness and understanding and double funding for research in dementia by 2015.</p><p> </p><p> </p><p> </p><p>A number of steps have been taken to help care for dementia patients in the community:</p><p> </p><p> </p><p> </p><p>- On 1 April 2014 we put in place a new Dementia Directed Enhanced Service, which has had over 80% take up by general practitioners to reward practices for facilitating timely diagnosis and support for people with dementia.</p><p> </p><p> </p><p> </p><p>- In the hospital setting, through the Dementia Commissioning for Quality and Innovation reward (introduced from April 2012), with around 4,000 referrals a month, it is clear that more people with dementia in hospitals are being identified and assessed.</p><p> </p><p> </p><p> </p><p>- The Dementia Care &amp; Support Compact, the care sector’s own response to the Prime Minister’s Challenge on Dementia, sets out a commitment to support the delivery of the challenge and improve care and support for people with dementia, their carers and families.</p><p> </p><p> </p><p> </p><p>- Health Education England, Skills for Care and Skills for Health launched pilots for the new Care Certificate on 28 April 2014. Taking place across a range of health and social care settings, the pilots are testing a set of standards designed to help employers to assess not only workers’ skills, but also the knowledge, behaviours and values that are required to deliver compassionate and quality care. The pilots are nearing completion. Subject to evaluation, we plan to introduce the Care Certificate by 1 April 2015.</p><p> </p><p> </p><p> </p><p>- The Government’s refreshed Mandate to Health Education England, published on 1 May 2014, builds on the existing ambition to have 100,000 National Health Service staff receive Tier 1 training on dementia by setting an ambition for a further 250,000 NHS staff to receive Tier 1 training on dementia by March 2015, with the tools and training opportunities being made available to all staff by the end of 2018.</p><p> </p><p> </p><p> </p><p>- 70 communities across England have signed up to the national Dementia Friendly Communities recognition process, with an increased ambition to reach 75 by March 2015.</p><p> </p><p> </p><p> </p><p>- On 7 May 2014 Public Health England and the Alzheimer’s Society launched a major new campaign with the aim of securing one million people to become dementia friends by March 2015. The campaign is aimed at improving understanding and attitudes about dementia and towards people with the condition. There are currently over 520,000 Dementia Friends.</p><p> </p><p> </p><p> </p><p>- We have made available £50 million capital funding for 2013-14 for the NHS and local authorities to work with providers to create better care environments to help people with dementia live well with the condition. The projects are now in the process of being evaluated and we will disseminate the key recommendations by the end of the year.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:22:09 answering member 2000 label Biography information for Earl Howe
	tabling member	1796 label Biography information for Lord Taylor of Warwick

100591

	registered interest
	date	22/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Orthopaedics
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government in how many Clinical Commissioning Groups rates of (1) major, and (2) minor, amputations are more than 33 per cent above the national average; and how the national average compares with other European Union member states.
	tabling member printed	Lord Harrison
	uin	HL2328
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>It is not possible to distinguish in Hospital Episode Statistics between 'major' and 'minor' amputations.</p><p> </p><p>The Health and Social Care Information Centre (HSCIC) has calculated the England average rate of amputation per 100,000 population and highlighted the clinical commissioning groups (CCGs) of residence having rates more than 33% higher than the national average. There are 25 such CCGs.</p><p> </p><p>This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p><table><tbody><tr><td><p>Clinical Commissioning Group of residence</p></td><td><p>Count of finished consultant episodes</p></td><td><p>Population</p></td><td><p>Rate per 100,000 population</p></td></tr><tr><td><p>NHS SCARBOROUGH AND RYEDALE CCG</p></td><td><p>68</p></td><td><p>110,488</p></td><td><p>61.5</p></td></tr><tr><td><p>NHS EAST RIDING OF YORKSHIRE CCG</p></td><td><p>169</p></td><td><p>314,504</p></td><td><p>53.7</p></td></tr><tr><td><p>NHS DONCASTER CCG</p></td><td><p>159</p></td><td><p>302,739</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS MANSFIELD AND ASHFIELD CCG</p></td><td><p>101</p></td><td><p>192,539</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS BLACKPOOL CCG</p></td><td><p>72</p></td><td><p>141,976</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS KNOWSLEY CCG</p></td><td><p>74</p></td><td><p>145,936</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG</p></td><td><p>138</p></td><td><p>273,043</p></td><td><p>50.5</p></td></tr><tr><td><p>NHS KERNOW CCG</p></td><td><p>272</p></td><td><p>540,178</p></td><td><p>50.4</p></td></tr><tr><td><p>NHS FAREHAM AND GOSPORT CCG</p></td><td><p>98</p></td><td><p>196,078</p></td><td><p>50.0</p></td></tr><tr><td><p>NHS LANCASHIRE NORTH CCG</p></td><td><p>78</p></td><td><p>158,528</p></td><td><p>49.2</p></td></tr><tr><td><p>NHS NORTHERN, EASTERN AND WESTERN DEVON CCG</p></td><td><p>421</p></td><td><p>869,408</p></td><td><p>48.4</p></td></tr><tr><td><p>NHS STOKE ON TRENT CCG</p></td><td><p>124</p></td><td><p>258,114</p></td><td><p>48.0</p></td></tr><tr><td><p>NHS TELFORD AND WREKIN CCG</p></td><td><p>80</p></td><td><p>167,682</p></td><td><p>47.7</p></td></tr><tr><td><p>NHS HEREFORDSHIRE CCG</p></td><td><p>88</p></td><td><p>184,932</p></td><td><p>47.6</p></td></tr><tr><td><p>NHS HULL CCG</p></td><td><p>122</p></td><td><p>257,204</p></td><td><p>47.4</p></td></tr><tr><td><p>NHS NORTH KIRKLEES CCG</p></td><td><p>88</p></td><td><p>186,706</p></td><td><p>47.1</p></td></tr><tr><td><p>NHS BOLTON CCG</p></td><td><p>131</p></td><td><p>278,984</p></td><td><p>47.0</p></td></tr><tr><td><p>NHS EAST STAFFORDSHIRE CCG</p></td><td><p>58</p></td><td><p>123,945</p></td><td><p>46.8</p></td></tr><tr><td><p>NHS COASTAL WEST SUSSEX CCG</p></td><td><p>222</p></td><td><p>476,677</p></td><td><p>46.6</p></td></tr><tr><td><p>NHS LINCOLNSHIRE EAST CCG</p></td><td><p>106</p></td><td><p>228,111</p></td><td><p>46.5</p></td></tr><tr><td><p>NHS HALTON CCG</p></td><td><p>58</p></td><td><p>125,692</p></td><td><p>46.1</p></td></tr><tr><td><p>NHS NEWARK &amp; SHERWOOD CCG</p></td><td><p>53</p></td><td><p>115,897</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS THANET CCG</p></td><td><p>62</p></td><td><p>135,661</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS SOMERSET CCG</p></td><td><p>243</p></td><td><p>534,950</p></td><td><p>45.4</p></td></tr><tr><td><p>NHS BRADFORD CITY CCG</p></td><td><p>37</p></td><td><p>82,319</p></td><td><p>44.9</p></td></tr></tbody></table><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:26:37 answering member 2000 label Biography information for Earl Howe
	tabling member	2488 label Biography information for Lord Harrison

100592

	registered interest
	date	22/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	GP Practice Lists: Immigration
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government (1) what is the average length of a general practitioner practice list; (2) what has been the level of net immigration since 2000; and (3) what is the number of additional general practitioners they estimate to have been required because of that immigration change since 2000.
	tabling member printed	Lord Blencathra
	uin	HL2329
	answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>Figures for 30 September 2013, the latest date for which published figures are available, showed the average number of patients per general practitioner practice was 7,034.</p><p> </p><p> </p><p> </p><p>Information on the level of net immigration for 2000 to 2012 is published by the Office of National Statistics at:</p><p> </p><p> </p><p> </p><p>http://www.ons.gov.uk/ons/rel/migration1/long-term-international-migration/2012/table-2-01a.xls</p><p> </p><p> </p><p> </p><p>Final data, for 2013, will be released on 27 November 2014.</p><p> </p><p> </p><p> </p><p>No estimates are made of the number of additional general practitioners needed specifically related to immigration changes.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:23:07 answering member 2000 label Biography information for Earl Howe
	tabling member	497 label Biography information for Lord Blencathra