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824572

	registered interest
	date	17/01/2018
	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	Pharmacy: Disclosure of Information
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many Freedom to Speak up Guardians have been nominated in community pharmacies; and whether his Department holds information on names of those Guardians.
	tabling member constituency	Rother Valley
	tabling member printed	Sir Kevin Barron
	uin	123373
	answer	answer is ministerial correction date of answer 22/01/2018 answer text <p>The Department does not hold information on the number or names of Freedom to Speak up Guardians in community pharmacies.</p><p> </p><p>NHS England is responsible for issuing the guidance on Freedom to Speak Up in primary care and has provided the following response:</p><p> </p><p>The number and names of Freedom to Speak Up Guardians in community pharmacies is not held centrally. Guidance for primary care providers was published in November 2016 on the NHS England website and a number of models for Freedom to Speak Up are detailed within that guidance, including having a named Guardian who is independent of the line management chain and not a direct employee. NHS England is working with the National Guardian's Office to assess the support that primary care providers, including community pharmacies, may need to comply with this guidance.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 22/01/2018 17:23:23 answering member 4067 label Biography information for Steve Brine
	tabling member	392 label Biography information for Sir Kevin Barron

825327

	registered interest
	date	17/01/2018
	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 what assessment, if any, they have made of the Safe Haven Projects, as operated by the Frimley Health Foundation Trust.
	tabling member printed	Baroness Taylor of Bolton
	uin	HL4860
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>We are informed by Surrey and Borders Partnership NHS Foundation Trust that five Safe Haven services are currently operating within Surrey and North East Hampshire, providing out of hours support to people who may be in a mental health crisis. The Foundation Trust has informed us that more than 500 people use these services each month, often as an alternative to attending accident and emergency (A&amp;E).</p><p> </p><p>An Independent Evaluation of the Aldershot Safe Haven, <em>Independent Evaluation of the North East Hampshire and Farnham Vanguard: Aldershot Safe Haven Service</em>, conducted by the Wessex Academic Health Science Network, and published October 2017, found that the Safe Haven may have contributed to a reduction in acute psychiatric inpatient admissions by 16% between August 2016 and July 2017 and that for a tracked cohort of people there was a reduction in A&amp;E attendances by 45% for the year after their first attendance at a Safe Haven. A copy of the evaluation is attached.</p><p> </p><p>The Prime Minister visited the Aldershot Safe Haven on 9 January 2017 where she announced funding for mental health crisis cafes and community clinics. The Government has pledged to provide up to £15 million investment from 2018 to 2020 to provide and promote such services.</p> answering member printed Lord O'Shaughnessy question first answered 25/01/2018 16:14:40 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name Safe Haven Evaluation_FINAL_October 2017.pdf title Safe Haven Independent Evaluation
	tabling member	407 label Biography information for Baroness Taylor of Bolton

825281

	registered interest
	date	17/01/2018
	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	Benzodiazepines
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they have assessed the impact on patients of the long-term use of benzodiazepines by NHS patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4814
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government is concerned about the impact of long term use of benzodiazepines by National Health Service patients and other dependence forming medicines prescribed in primary care. The National Centre for Social Research recently published <em>Prescribing Patterns in Dependence Forming Medicines, </em>which reviewed data for 50,000 NHS patients in England and looked at those who had been prescribed at least one of four types of potentially addictive drugs - known as Dependence Forming Medicines - between 2000 and 2015. The data shows that potentially dependence forming medicines are widely prescribed in primary care.</p><p> </p><p>The report highlights that a balance needs to be struck between avoiding prescribing that might lead to dependence or other harms and ensuring proper access to medicines to relieve suffering and treat disorders with. The report notes that clinical guidance recommending more cautious and time limited prescribing of benzodiazepines may well have been effective in changing practice, with reductions in the extent and length of benzodiazepine prescribing. It also suggests close and ongoing monitoring of opioid prescribing is needed. This independent research was commissioned and funded by the National Institute for Health Research Policy Research Programme. A copy of the report is attached.</p><p> </p><p>In the light of this research, the Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence.</p><p>The review will bring together the best available evidence on prevalence and prescribing; the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines; and effective prevention and treatment responses for each indication.</p><p>The recently-updated National Clinical Guidelines for Drug Misuse and Dependence, <em>Drug misuse and dependence: UK guidelines on clinical management</em>, have specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are attached.</p><p>There is relevant National Institute for Health and Care Excellence guidance available for primary care prescribers for example on benzodiazepine and z-drug withdrawal.</p><p> </p> answering member printed Lord O'Shaughnessy attachment 1 file name clinical_guidelines_2017.pd.pdf title Drug Misuse and Dependence Clinical Guideline 2 file name PHRC_014_Final_Report.pdf title Prescribing Patterns in Dependence Forming Meds grouped question UIN HL4815 HL4816 HL4818 question first answered 25/01/2018 16:24:46 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825282

	registered interest
	date	17/01/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of trends in the use of dependence-forming medicines prescribed in primary care.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4815
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government is concerned about the impact of long term use of benzodiazepines by National Health Service patients and other dependence forming medicines prescribed in primary care. The National Centre for Social Research recently published <em>Prescribing Patterns in Dependence Forming Medicines, </em>which reviewed data for 50,000 NHS patients in England and looked at those who had been prescribed at least one of four types of potentially addictive drugs - known as Dependence Forming Medicines - between 2000 and 2015. The data shows that potentially dependence forming medicines are widely prescribed in primary care.</p><p> </p><p>The report highlights that a balance needs to be struck between avoiding prescribing that might lead to dependence or other harms and ensuring proper access to medicines to relieve suffering and treat disorders with. The report notes that clinical guidance recommending more cautious and time limited prescribing of benzodiazepines may well have been effective in changing practice, with reductions in the extent and length of benzodiazepine prescribing. It also suggests close and ongoing monitoring of opioid prescribing is needed. This independent research was commissioned and funded by the National Institute for Health Research Policy Research Programme. A copy of the report is attached.</p><p> </p><p>In the light of this research, the Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence.</p><p>The review will bring together the best available evidence on prevalence and prescribing; the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines; and effective prevention and treatment responses for each indication.</p><p>The recently-updated National Clinical Guidelines for Drug Misuse and Dependence, <em>Drug misuse and dependence: UK guidelines on clinical management</em>, have specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are attached.</p><p>There is relevant National Institute for Health and Care Excellence guidance available for primary care prescribers for example on benzodiazepine and z-drug withdrawal.</p><p> </p> answering member printed Lord O'Shaughnessy attachment 1 file name clinical_guidelines_2017.pd.pdf title Drug Misuse and Dependence Clinical Guideline 2 file name PHRC_014_Final_Report.pdf title Prescribing Patterns in Dependence Forming Meds grouped question UIN HL4814 HL4816 HL4818 question first answered 25/01/2018 16:24:46 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825283

	registered interest
	date	17/01/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what actions they are taking to discourage the use of dependence-forming medicines prescribed in primary care.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4816
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government is concerned about the impact of long term use of benzodiazepines by National Health Service patients and other dependence forming medicines prescribed in primary care. The National Centre for Social Research recently published <em>Prescribing Patterns in Dependence Forming Medicines, </em>which reviewed data for 50,000 NHS patients in England and looked at those who had been prescribed at least one of four types of potentially addictive drugs - known as Dependence Forming Medicines - between 2000 and 2015. The data shows that potentially dependence forming medicines are widely prescribed in primary care.</p><p> </p><p>The report highlights that a balance needs to be struck between avoiding prescribing that might lead to dependence or other harms and ensuring proper access to medicines to relieve suffering and treat disorders with. The report notes that clinical guidance recommending more cautious and time limited prescribing of benzodiazepines may well have been effective in changing practice, with reductions in the extent and length of benzodiazepine prescribing. It also suggests close and ongoing monitoring of opioid prescribing is needed. This independent research was commissioned and funded by the National Institute for Health Research Policy Research Programme. A copy of the report is attached.</p><p> </p><p>In the light of this research, the Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence.</p><p>The review will bring together the best available evidence on prevalence and prescribing; the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines; and effective prevention and treatment responses for each indication.</p><p>The recently-updated National Clinical Guidelines for Drug Misuse and Dependence, <em>Drug misuse and dependence: UK guidelines on clinical management</em>, have specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are attached.</p><p>There is relevant National Institute for Health and Care Excellence guidance available for primary care prescribers for example on benzodiazepine and z-drug withdrawal.</p><p> </p> answering member printed Lord O'Shaughnessy attachment 1 file name clinical_guidelines_2017.pd.pdf title Drug Misuse and Dependence Clinical Guideline 2 file name PHRC_014_Final_Report.pdf title Prescribing Patterns in Dependence Forming Meds grouped question UIN HL4814 HL4815 HL4818 question first answered 25/01/2018 16:24:46 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825285

	registered interest
	date	17/01/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to commission specific guidelines for the NHS that cover withdrawal from prescription drugs.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4818
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government is concerned about the impact of long term use of benzodiazepines by National Health Service patients and other dependence forming medicines prescribed in primary care. The National Centre for Social Research recently published <em>Prescribing Patterns in Dependence Forming Medicines, </em>which reviewed data for 50,000 NHS patients in England and looked at those who had been prescribed at least one of four types of potentially addictive drugs - known as Dependence Forming Medicines - between 2000 and 2015. The data shows that potentially dependence forming medicines are widely prescribed in primary care.</p><p> </p><p>The report highlights that a balance needs to be struck between avoiding prescribing that might lead to dependence or other harms and ensuring proper access to medicines to relieve suffering and treat disorders with. The report notes that clinical guidance recommending more cautious and time limited prescribing of benzodiazepines may well have been effective in changing practice, with reductions in the extent and length of benzodiazepine prescribing. It also suggests close and ongoing monitoring of opioid prescribing is needed. This independent research was commissioned and funded by the National Institute for Health Research Policy Research Programme. A copy of the report is attached.</p><p> </p><p>In the light of this research, the Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence.</p><p>The review will bring together the best available evidence on prevalence and prescribing; the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines; and effective prevention and treatment responses for each indication.</p><p>The recently-updated National Clinical Guidelines for Drug Misuse and Dependence, <em>Drug misuse and dependence: UK guidelines on clinical management</em>, have specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are attached.</p><p>There is relevant National Institute for Health and Care Excellence guidance available for primary care prescribers for example on benzodiazepine and z-drug withdrawal.</p><p> </p> answering member printed Lord O'Shaughnessy attachment 1 file name clinical_guidelines_2017.pd.pdf title Drug Misuse and Dependence Clinical Guideline 2 file name PHRC_014_Final_Report.pdf title Prescribing Patterns in Dependence Forming Meds grouped question UIN HL4814 HL4815 HL4816 question first answered 25/01/2018 16:24:47 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825298

	registered interest
	date	17/01/2018
	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	Medical Records
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what remedy there is when a hospital trust persistently refuses to release full medical records to a patient or a GP for the patient under the Access to Medical Records Act 1990 and the Data Protection Act 1998 and may have destroyed some of those records despite their being protected on police advice.
	tabling member printed	The Countess of Mar
	uin	HL4831
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>Patients have a legal right to apply for access to their medical records. A request for medical records should be made directly to the healthcare provider that provides the treatment. However, information can be exempt from disclosure if it “would be likely to cause serious harm to the physical or mental health or condition of the data subject or any other person”.</p><p> </p><p>An individual can complain to the Information Commissioner (ICO) about the data controller if they disagree with the decision to withhold records, or that this was not done in accordance with the legislation. Similarly, if records that should have been retained have been destroyed or deleted, this can be raised as part of a complaint to the ICO.</p><p> </p><p>From an Information Governance perspective, there are provisions with the current Data Protection Act 1998 and under discussion in the Data Protection Bill that allow the data subject (patient) to seek redress.</p> answering member printed Lord O'Shaughnessy question first answered 25/01/2018 16:26:42 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

825264

	registered interest
	date	17/01/2018
	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	Health
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they plan to take further action to encourage NHS users to accept greater responsibility for their health.
	tabling member printed	Lord Brooke of Alverthorpe
	uin	HL4797
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government wants everyone to be able to make healthier choices, regardless of their circumstances, and to minimise the risk and impact of illness. We have given local government the freedom to innovate and develop their own ways of improving public health in their area. In addition, Public Health England supports local innovation, helps to provide disease control and protection and spreads information on the latest innovations from around the world.</p><p> </p><p>Progress is being made. Since 2000, both life expectancy and healthy life expectancy have increased in England; the population is now living longer and spending more years in good health. There has been a significant reduction in the prevalence of smoking going from almost 46% in 1974 to 15.5% in 2016 and alcohol consumption is also falling.</p><p> </p><p>However there is more to do and a range of initiatives are underway to build upon these improvements:</p><p> </p><p>- Change4Life, Public Health England’s flagship behaviour change social marketing campaign, encourages families across England to ‘eat well and move more’;</p><p>- the Tobacco Control Plan for England 2017-2022 lays down bold ambitions to reduce further smoking prevalence in England, en-route towards creating a smoke free generation; and</p><p>- the 2016 UK Chief Medical Officers’ low risk drinking guidelines provide the public with the most up to date scientific information to help people make informed decisions about their own drinking.</p><p> </p><p>Additionally, the NHS Constitution sets out responsibilities patients have that will safeguard their and their family’s health and wellbeing. The handbook that is published alongside the Constitution provides further detail on what steps patients can take. We will update the handbook in 2018 and will take this opportunity to look at how the wording on patient responsibilities can be strengthened further.</p> answering member printed Lord O'Shaughnessy question first answered 25/01/2018 16:31:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

825326

	registered interest
	date	17/01/2018
	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	Health Services: Asylum
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how they intend to recover the cost of NHS treatment from failed asylum seekers.
	tabling member printed	Baroness Taylor of Bolton
	uin	HL4859
	answer	answer is ministerial correction date of answer 26/01/2018 answer text <p>Some groups of failed asylum seekers are exempt from charge for National Health Service secondary care under the NHS (Charges to Overseas Visitors) Regulations 2015, as amended.</p><p>In situations where charges do apply to overseas visitors for NHS secondary care, including where the person is a failed asylum seeker, providers of that care must make and recover charges from the person liable where this is possible.</p><p>Where a clinician considers the need of the overseas visitor to be non-urgent in that treatment can safely wait until the person returns to their home country, payment must be received in advance of the provision of the treatment.</p><p>Immediately necessary treatment or urgent treatment, which clinicians assess as being unable to wait the person’s return to their home country, will not be withheld pending payment. It is a matter for the provider of NHS secondary care services what measures it takes to recover costs from overseas visitors that have received services to which they are not entitled free of charge, which might include agreeing a repayment plan with the patient or writing the debt off as unrecoverable.</p> answering member printed Lord O'Shaughnessy question first answered 26/01/2018 13:49:50 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	407 label Biography information for Baroness Taylor of Bolton

825284

	registered interest
	date	17/01/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to establish a national helpline for people affected by dependence on prescribed drugs.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4817
	answer	answer is ministerial correction date of answer 29/01/2018 answer text <p>The Government has no plans to introduce a national helpline specifically to support people affected by prescribed drug dependence. People who feel that they might be dependent on either prescribed or over the counter medicines should seek help from a health professional in the first instance, such as a general practitioner (GP) or pharmacist. Help and advice is also available from the 111 helpline or the online NHS Choices service. People who have developed problems with benzodiazepines, antidepressants, painkillers and other medicines should seek help from their GP in the first instance. Specialist advice for GPs and support for patients with complex and severe problems is available from substance misuse services which are available in each local authority across the country.</p><p> </p><p>The Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence. The review will bring together the best available evidence on prevalence and prescribing, the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines and effective prevention and treatment responses for each indication.</p><p> </p><p> </p> answering member printed Baroness Chisholm of Owlpen question first answered 29/01/2018 17:46:05 answering member 4330 label Biography information for Baroness Chisholm of Owlpen
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath