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100021

	registered interest
	date	15/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Home Care Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, if he will bring forward proposals to facilitate the portability of home-based care packages between local authorities in different countries in the UK.
	tabling member constituency	Edinburgh East
	tabling member printed	Sheila Gilmore
	uin	905560
	answer	answer is ministerial correction date of answer 21/10/2014 answer text <p>Adults with care and support needs should be able to move between countries within the United Kingdom knowing that their care will continue during the move.</p><p> </p><p> </p><p> </p><p>As the care and support systems in the four countries are different, we are developing principles with the Devolved Administrations to ensure continuity of care for people moving.</p><p> </p><p>These should be published in November.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 21/10/2014 15:45:44 answering member 1439 label Biography information for Norman Lamb
	tabling member	3965 label Biography information for Sheila Gilmore

100024

	registered interest
	date	15/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Community Health Services: Devon
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, if he will increase funding from the Better Care Fund to improve the transition of community services in Devon.
	tabling member constituency	North Devon
	tabling member printed	Sir Nick Harvey
	uin	905558
	answer	answer is ministerial correction date of answer 21/10/2014 answer text <p>The Better Care Fund is a pooled budget of £3.8 billion to be spent on integrating Health and Social care. Local areas will decide how best to use their funding to transform the provision of services to their communities, both improving outcomes for people, and driving efficiencies.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 21/10/2014 15:44:45 answering member 1439 label Biography information for Norman Lamb
	tabling member	231 label Biography information for Sir Nick Harvey

100206

	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	Compulsorily Detained Psychiatric Patients
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, whether any audits have been carried out since April 2012 which consider how many patients may have been detained under the Mental Health Act 1983 because a doctor had been influenced by the fact that doing so might make the provision of a bed for their patient more likely; and what were the findings of those audits.
	tabling member constituency	West Lancashire
	tabling member printed	Rosie Cooper
	uin	211396
	answer	answer is ministerial correction date of answer 24/10/2014 answer text <p>The Care Quality Commission (CQC) is the regulator of the Mental Health Act 1983. In their annual report for 2012-13 <em>Monitoring the Mental Health Act in 2012/13</em>, published in January 2014, the CQC noted concerns raised by the House of Commons Health Committee over whether the Act’s powers of detention were being used improperly to access services. They said they found no direct evidence of unlawful practice.</p><p> </p><p> </p><p> </p><p>On 22 August 2014, the CQC published a series of reports relating to its inspection in May 2014 of services provided by Camden and Islington NHS Foundation Trust. The CQC found that that bed occupancy at the Trust averaged 96.4% between October and December last year, compared to the average of 85.9% across England. CQC inspectors were told that the pressures on beds meant that most new admissions to inpatient beds were people detained under the Act.</p><p> </p><p> </p><p> </p><p>The CQC’s annual report on the Act for 2013-14 is expected to be published early in 2015.</p><p> </p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 24/10/2014 11:27:05 answering member 1439 label Biography information for Norman Lamb
	tabling member	1538 label Biography information for Rosie Cooper

48229

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment his Department has made of the role independent pharmacies play in relieving pressures on other health and welfare services; and what steps he has taken to disseminate best practice.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	uin	196239
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high quality care and support, improving people's health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long term conditions and helping make sure patients and the National Health Service get the best use from medicines.</p><p> </p><p>NHS England's public consultation, <em>Improving care through community pharmacy –</em> <em>a call to action</em>, which closed on 18 March, has provided an important opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:</p><p> </p><p>www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/</p><p> </p><p>In the meantime, NHS England's <em>The earlier, the better</em> campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and reduce pressures on other parts of the NHS.</p><p> </p><p>On 14 April, the Department and NHS England published <em>Transforming Primary Care - Safe, proactive, personalised care for those who need it most</em>. This sets out plans for more proactive, personalised and joined up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196241 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name 196239_and_196241_-_Library_document[1].pdf title Transforming Primary Care document
	tabling member	4006 label Biography information for Dr Matthew Offord

48233

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what estimate has he made of the cost to the economy of untreated mental illness.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196255
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196245 196254 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48237

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what proportion of NHS funding is allocated to (a) mental and (b) physical health care.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196254
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196245 196255 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48241

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he has taken to increase public understanding of the services offered by independent pharmacies.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	uin	196241
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high quality care and support, improving people's health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long term conditions and helping make sure patients and the National Health Service get the best use from medicines.</p><p> </p><p>NHS England's public consultation, <em>Improving care through community pharmacy –</em> <em>a call to action</em>, which closed on 18 March, has provided an important opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:</p><p> </p><p>www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/</p><p> </p><p>In the meantime, NHS England's <em>The earlier, the better</em> campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and reduce pressures on other parts of the NHS.</p><p> </p><p>On 14 April, the Department and NHS England published <em>Transforming Primary Care - Safe, proactive, personalised care for those who need it most</em>. This sets out plans for more proactive, personalised and joined up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196239 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name 196239_and_196241_-_Library_document[1].pdf title Transforming Primary Care document
	tabling member	4006 label Biography information for Dr Matthew Offord

48242

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what criteria his Department use to define illness as mental as opposed to physical.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196245
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196254 196255 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48260

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the reduction of avoidable harm by better medicines reconciliation for hospital patients with Parkinson's.
	tabling member constituency	Bridgend
	tabling member printed	Mrs Madeleine Moon
	uin	196344
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department has made no such assessment.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) and the National Patient Safety Agency (NPSA) issued joint guidance, <em>Technical patient safety solutions for medicines reconciliation on admission of adults to hospital</em> in December 2007, which aims to reduce medication errors, which occur most commonly on transfer between care settings and on admission to hospital. This guidance applies to all patients, including those with Parkinson's disease and is available at:</p><p> </p><p>www.nice.org.uk/nicemedia/live/11897/38560/38560.pdf</p><p> </p><p>The NPSA also issued a Rapid Response Report on <em>Reducing harm from omitted and delayed medicines in hospital </em>in February 2010. This makes reference to medicines where timeliness of administration is crucial, including those for Parkinson's disease. This is available at:</p><p> </p><p>www.nrls.npsa.nhs.uk/alerts/?entryid45=66720</p><p> </p><p>NICE, the NPSA and the Royal Pharmaceutical Society have all identified the key role of pharmacists in medicines reconciliation and the majority of hospitals now have pharmacists on admission wards to help ensure patients' medicines are reconciled promptly.</p><p> </p><p>A strong reporting culture, where safety incidents are reported and monitored is essential to improving safety for all patients, including those with Parkinson's disease. NHS England and the <a title="Medicines and Healthcare products Regulatory Agency (MHRA) website - Opens in a new window" href="http://www.mhra.gov.uk/" target="_blank">Medicines and Healthcare products Regulatory Agency</a> jointly issued two patient safety alerts on 20 March 2014 to help healthcare providers increase incident reporting for <a href="http://www.england.nhs.uk/2014/03/20/med-devices#mederr" target="_blank">medication errors</a> and <a href="http://www.england.nhs.uk/2014/03/20/med-devices#meddev" target="_blank">medical devices</a>. The alerts instruct providers to take specific steps that will improve data reporting quality; and will see the establishment of national networks to maximise learning and provide guidance on minimising harm relating to these incident types.</p><p> </p><p>The measures announced by my Rt Hon Friend, the Secretary of State for Health on 26 March, as part of his invitation to NHS organisations to ‘Sign up to Safety', are also likely to lead to an increase in the number of reported incidents of harm in the National Health Service even though care will be getting safer.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196360 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	1490 label Biography information for Mrs Madeleine Moon

48264

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he is taking to improve reporting of instances in which the medication regimes of hospital patients with Parkinson's are disrupted through delays or errors in medicines reconciliation; and if he will make a statement.
	tabling member constituency	Bridgend
	tabling member printed	Mrs Madeleine Moon
	uin	196360
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department has made no such assessment.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) and the National Patient Safety Agency (NPSA) issued joint guidance, <em>Technical patient safety solutions for medicines reconciliation on admission of adults to hospital</em> in December 2007, which aims to reduce medication errors, which occur most commonly on transfer between care settings and on admission to hospital. This guidance applies to all patients, including those with Parkinson's disease and is available at:</p><p> </p><p>www.nice.org.uk/nicemedia/live/11897/38560/38560.pdf</p><p> </p><p>The NPSA also issued a Rapid Response Report on <em>Reducing harm from omitted and delayed medicines in hospital </em>in February 2010. This makes reference to medicines where timeliness of administration is crucial, including those for Parkinson's disease. This is available at:</p><p> </p><p>www.nrls.npsa.nhs.uk/alerts/?entryid45=66720</p><p> </p><p>NICE, the NPSA and the Royal Pharmaceutical Society have all identified the key role of pharmacists in medicines reconciliation and the majority of hospitals now have pharmacists on admission wards to help ensure patients' medicines are reconciled promptly.</p><p> </p><p>A strong reporting culture, where safety incidents are reported and monitored is essential to improving safety for all patients, including those with Parkinson's disease. NHS England and the <a title="Medicines and Healthcare products Regulatory Agency (MHRA) website - Opens in a new window" href="http://www.mhra.gov.uk/" target="_blank">Medicines and Healthcare products Regulatory Agency</a> jointly issued two patient safety alerts on 20 March 2014 to help healthcare providers increase incident reporting for <a href="http://www.england.nhs.uk/2014/03/20/med-devices#mederr" target="_blank">medication errors</a> and <a href="http://www.england.nhs.uk/2014/03/20/med-devices#meddev" target="_blank">medical devices</a>. The alerts instruct providers to take specific steps that will improve data reporting quality; and will see the establishment of national networks to maximise learning and provide guidance on minimising harm relating to these incident types.</p><p> </p><p>The measures announced by my Rt Hon Friend, the Secretary of State for Health on 26 March, as part of his invitation to NHS organisations to ‘Sign up to Safety', are also likely to lead to an increase in the number of reported incidents of harm in the National Health Service even though care will be getting safer.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196344 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	1490 label Biography information for Mrs Madeleine Moon

48269

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what discussions officials in his Department have had with the National Institute for Health and Care Excellence (NICE) on the development of NICE's highly specialised technologies programme since 1 January 2014; what the content of those discussions was; and if he will make a statement.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196411
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Departmental officials have had no such discussions. Officials may discuss individual highly specialised technology topics with the National Institute for Health and Care Excellence, including at the topic selection stage.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48274

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what estimate his Department has made of the increase in demand for child and adolescent mental health following the launch of the MindEd e-portal; and what steps it is taking to accommodate that increase.
	tabling member constituency	Liverpool, Wavertree
	tabling member printed	Luciana Berger
	uin	196448
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department has not made an estimate of the increase in demand for child and adolescent mental health following the launch of the MindEd e-portal on 25 March 2014.</p><p> </p><p>We know that many schools want to do more to help children who are, or may be, experiencing mental health problems. Many now have their own programmes and mental health support – such as a school-based counsellor, whilst others have whole school approaches to mental and emotional health. We want to ensure that such programmes offer the best support possible, but also that schools are better able to identify mental health problems in their pupils sooner.</p><p> </p><p>The Department funded the MindEd website which will help anyone working with children, including all school staff, to spot the signs of mental health problems in children and help them get the support they need. Spotting the signs of mental health problems early in children and young people is essential to prevent problems from escalating and continuing into adulthood.</p><p> </p><p>The Chief Medical Officer has recommended better data on children and young people's mental health. The Department, with arms lengths bodies (ALBs) and other key partners, is currently looking at the options available for arranging a survey of children and young people to look at prevalence of mental health conditions. We are seeking advice from colleagues in the Department's Health and Social Care Information Centre to consider options for the survey, and what such a survey would be able to tell us.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4036 label Biography information for Luciana Berger

48276

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, pursuant to the Answer of 24 March 2014, Official Report, column 120W, on haemolytic uraemic syndrome, what discussions NHS England has had with the National Institute for Health and Care Excellence (NICE) since 1 January 2014 on NICE's appraisal of eculizumab; and if he will make a statement.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196426
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>We understand that NHS England was formally consulted on the scope of the National Institute for Health and Care Excellence's (NICE) evaluation of eculizumab for atypical haemolytic uraemic syndrome. NHS England was also consulted on the evaluation consultation document, which was published on 27 February.</p><p> </p><p>Following the publication of NICE's draft guidance on eculizumab, NICE sought further advice from NHS England on what considerations relating to the management of its specialised commissioning budget it considers should be taken into account in formulating a recommendation. The response from NHS England will be considered by NICE at the next meeting of the evaluation committee.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48280

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, pursuant to the Answer of 31 March 2014, Official Report, column 491W, on medical treatments, what technology appraisals were conducted by the National Institute for Health and Care Excellence in the last five years; what the most plausible cost per quality adjusted life-year for each such appraisal was; what the estimated eligible patient population was for each appraised indication; on which appraisals end-of-life criteria were applied in each final appraisal determination; and on which date each such appraisal was (a) initiated and (b) concluded.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196429
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>National Institute for Health and Care Excellence (NICE) technology appraisal decisions published between 2000 to end of February 2014 have already been placed in the Library.</p><p> </p><p>NICE has advised that it does hold the most plausible cost per quality adjusted life-year for each technology appraisal, the estimated patient population for each appraised indication, details of appraisals where the end-of-life criteria were applied in each final appraisal determination and the dates each appraisal was initiated and concluded. However, this information could only be provided at disproportionate cost.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48281

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, if he will discuss with the National Institute for Health and Care Excellence (NICE) ensuring that assessments of treatments by NICE conducted through (a) normal technology appraisals and (b) highly specialised technology appraisals is consistent in its (i) engagement with stakeholders and (ii) wider methodological approaches.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196428
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>We have no plans to do so. As an independent body, the National Institute for Health and Care Excellence is responsible for developing its methods and processes and applying them consistently.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48282

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how the National Institute for Health and Care Excellence (NICE) assesses the cost-effectiveness of an intervention when the data available are uncertain; what assessment NICE has made of the average range around the most-plausible cost-per-QALY in its technology appraisals; and if he will make a statement.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196424
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The National Institute for Health and Care Excellence (NICE) follows a rigorous process in the appraisal of technologies to ensure that judgements regarding the cost-effective use of NHS resources are consistently applied. This includes consideration of the uncertainty generated where available data have serious limitations.</p><p> </p><p>When making judgements on cost effectiveness, the NICE appraisal committee will consider a number of factors including the strength of the clinical-effectiveness evidence, the innovative nature of the technology, the robustness and plausibility of the economic models, the degree of certainty around the incremental cost-effectiveness ratio (ICER), the range and plausibility of the ICERs and the likelihood of decision error and its consequences. Full details of how the Committee takes uncertainty into account is contained within sections 5.8, 6.3 and 6.4 of NICE's Guide to the Methods of Technology Appraisal 2013, which is available at:</p><p>http://publications.nice.org.uk/guide-to-the-methods-of-technology-appraisal-2013-pmg9</p><p> </p><p>NICE advises that it has not carried out an assessment of the average range around the most plausible cost-per Quality Adjusted Life Year (QALY) in its technology appraisals. We understand that although NICE usually specifies the most plausible cost-per-QALY for each technology appraisal, it does not normally specify a range for this assessment.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48283

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, pursuant to the Answer of 24 March 2014, Official Report, column 120W, on haemolytic uraemic syndrome, for what reasons it was felt that further advice was needed on the overall cost implications, benefits and affordability of eculizumab; when it was first concluded that such further advice was needed; for what reasons the seeking of that advice was delayed until the National Institute for Health and Care Excellence took on responsibility for assessing highly specialised technologies; and if he will make a statement.
	tabling member constituency	Eddisbury
	tabling member printed	Mr Stephen O'Brien
	uin	196427
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Ministers concluded that further advice was needed on the overall cost implications, benefits and affordability of eculizumab as, while Advisory Group for National Specialised Services (AGNSS) members were convinced of the clinical effectiveness of the drug, they noted the very high costs of the drug and the increasing cost profile for the National Health Service.</p><p> </p><p>AGNSS was informed of this decision on 17 January 2013. On 7 February 2013, the Department conveyed its decision to the National Institute for Health and Care Excellence (NICE) so that NICE could begin preparatory work in advance of taking on formal responsibility for evaluating highly specialised technologies on 1 April 2013.</p><p> </p><p>While NICE carries out its evaluation, the current interim commissioning arrangements by NHS England in line with the ‘Clinical Commissioning Policy Statement: Eculizumab for atypical haemolytic uraemic syndrome' will remain in place. The policy statement is available at:</p><p> </p><p>www.england.nhs.uk/wp-content/uploads/2013/09/e03-hss-a.pdf</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	427 label Biography information for Mr Stephen O'Brien

48539

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many patients have required further operations due to complications with transvaginal mesh implants in each of the last three years; and what the cost of such procedures was.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196743
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department of Health does not hold information on the number of patients who have required further operations due to complications with transvaginal mesh implants in each of the last three years or the costs of these operations.</p><p> </p><p>The Department has had two meetings in which polypropylene transvaginal mesh implants were either discussed or on the agenda.</p><p> </p><p>NHS England manages the National Reporting and Learning System (NRLS) for patient safety incident reports from the NHS. NHS England shares incident reports concerning harms arising from medical devices with the Medicines and Healthcare products Regulatory Agency (MHRA).</p><p> </p><p>Manufacturers of medical devices such as transvaginal mesh implants are legally required to report adverse incidents (ie death, serious injury or potential serious injury) involving their devices to the MHRA. General Medical Guidance published in February 2013 makes it clear that clinicians should report medical device incidents to the MHRA, and make information available to patients about how they can report side effects to the MHRA. The MHRA also encourages voluntary reporting of adverse incidents by healthcare workers, carers, patients and members of the public and participates in monthly telephone meetings with regulators in other European Union member states to share information about medical device safety.</p><p> </p><p>The Department is currently engaged in work to assess the effectiveness of existing arrangements for reporting complications relating to transvaginal mesh implants. NHS England is leading this work, which also involves the MHRA, the Royal College of Obstetricians and Gynaecologists, and the relevant professional societies (the British Society of Urogynaecology and the British Association of Urological Surgeons).</p><p> </p><p>Finished Consultant Episodes for women who have received a primary or secondary operative procedure for the insertion of Transvaginal Mesh, Transobturator Tape, Transvaginal Slings and Transvaginal Tape.</p><p> </p><table><tbody><tr><td><p>Procedure</p></td><td><p>2010-11</p></td><td><p>2011-12</p></td><td><p>2012-13</p></td></tr><tr><td><p>Insertion of Transvaginal Mesh</p></td><td><p>1,636</p></td><td><p>1,524</p></td><td><p>1,310</p></td></tr><tr><td><p>Insertion of Transobturator Tape</p></td><td><p>5,426</p></td><td><p>4,885</p></td><td><p>4,476</p></td></tr><tr><td><p>Insertion of Transvaginal Sling</p></td><td><p>130</p></td><td><p>134</p></td><td><p>135</p></td></tr><tr><td><p>Insertion of Transvaginal Tape</p></td><td><p>8,087</p></td><td><p>8,172</p></td><td><p>7,627</p></td></tr></tbody></table><p> </p><p><em>Source</em>: Hospital Episode Statistics (HES), Health and Social Care Information Centre.</p><p><em>Note</em>: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.</p><p> </p><p> </p><p>Adverse events reported to MHRA by Health Professionals concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>3</p></td><td><p>1</p></td><td><p>0</p></td></tr><tr><td><p>2012</p></td><td><p>23</p></td><td><p>31</p></td><td><p>2</p></td></tr><tr><td><p>2013</p></td><td><p>27</p></td><td><p>20</p></td><td><p>0</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>16</p></td><td><p>7</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p> </p><p>Number of patient safety incidents relating to mesh used in gynaecological procedures reported to the NRLS (Year of occurrence by reported degree of harm)</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>No Harm</p></td><td><p>Low</p></td><td><p>Moderate</p></td><td><p>TOTAL</p></td></tr><tr><td><p>2011</p></td><td><p>0</p></td><td><p>2</p></td><td><p>4</p></td><td><p>6</p></td></tr><tr><td><p>2012</p></td><td><p>7</p></td><td><p>4</p></td><td><p>3</p></td><td><p>14</p></td></tr><tr><td><p>2013</p></td><td><p>4</p></td><td><p>1</p></td><td><p>1</p></td><td><p>6</p></td></tr><tr><td><p>TOTAL</p></td><td><p>11</p></td><td><p>7</p></td><td><p>8</p></td><td><p>26</p></td></tr></tbody></table><p>Search strategy: All incidents from gynaecological specialties in the NRLS were searched on 2 December 2013 for the keyword ‘mesh'</p><p> </p><p> </p><p> </p><p>Adverse events reported to MHRA by patients/members of the public concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>33</p></td><td><p>7</p></td><td><p>3</p></td></tr><tr><td><p>2012</p></td><td><p>26</p></td><td><p>2</p></td><td><p>0</p></td></tr><tr><td><p>2013</p></td><td><p>30</p></td><td><p>10</p></td><td><p>3</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>7</p></td><td><p>0</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p>No incidents relating to transvaginal mesh have been reported to the NRLS by patients.</p><p> </p><p>The Department has answered 11 previous Parliamentary Questions, 27 letters from hon. Members and Peers and 17 letters from members of the public since 1 September 2011. The Chief Executive of the MHRA has replied to six letters from hon. Members since 1 September 2011.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196738 196739 196740 196741 196742 196744 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice

48540

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what criteria his Department uses to decide whether to prescribe Kadcyla using funds from the Cancer Drugs Fund.
	tabling member constituency	Newport West
	tabling member printed	Paul Flynn
	uin	196787
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>NHS England is responsible for administering the Cancer Drugs Fund. Its national Cancer Drugs Fund clinical panel added Kadcyla (trastuzumab emtansine) for the treatment of HER2-positive locally advanced/unresectable or metastatic breast cancer to its national cohort policies list in February 2014. Further information on how the panel made its decision is available at:</p><p> </p><p>www.england.nhs.uk/ourwork/pe/cdf/</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	545 label Biography information for Paul Flynn

48546

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what systems are in place for recording and publication of children's deaths in psychiatric hospitals who had been either forcefully detained or voluntary in-patients; and to which authority such deaths are reported.
	tabling member constituency	Feltham and Heston
	tabling member printed	Seema Malhotra
	uin	196780
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>From 1 April 2008, all Local Safeguarding Children Boards (LSCBs) have had a statutory responsibility to review the deaths of all children from birth (excluding still born babies) up to 18 years, who are normally resident within their area. This is known as the Child Death Review Process. Their responsibilities include setting up a Child Death Overview Panel which reviews child deaths on behalf of the LSCB. This would include deaths in psychiatric in-patient settings. The following link presents data collected from LSCBs in England to the year ending 31 March 2013.</p><p> </p><p>www.gov.uk/government/publications/child-death-reviews-year-ending-31-march-2013</p><p> </p><p>The Care Quality Commission (CQC) is currently developing a system of Intelligent Monitoring for Mental Health services; it is considering which indicators, including those that relate to Serious Untoward Incidents to include in it. This will include children and young people.</p><p> </p><p>The CQC is the official source of information on deaths of patients subject to the Mental Health Act. A link to the CQC's <em>Monitoring the Mental Health Act 2012/13</em> is:</p><p>www.cqc.org.uk/sites/default/files/media/documents/cqc_mentalhealth_2012_13_07_update.pdf</p><p> </p><p>Further information can be obtained from:</p><p> </p><p>The Care Quality Commission (CQC)</p><p> </p><p>public.affairs@cqc.org.uk</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4253 label Biography information for Seema Malhotra

48547

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many (a) meetings, (b) items of written correspondence, (c) phone calls, (d) consultation responses, (e) tenders and (f) other individual communications and contacts his Department has had with (i) Johnson & Johnson, (ii) Ethicon and (iii) BARD.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196778
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Within the last 12 months, the Department has had regular communication with a number of pharmaceutical, device and diagnostic manufacturers, on a wide range of topics. However, the information requested could only be provided at disproportionate cost.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice

48548

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many children of each (a) age and (b) gender have died while in-patients (i) at psychiatric hospitals in total as either forcefully detained or voluntary in-patients and (ii) in each institution in each year since 2000.
	tabling member constituency	Feltham and Heston
	tabling member printed	Seema Malhotra
	uin	196781
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Since April 2008 all Local Safeguarding Children Boards have had a statutory duty to review the death of all children from birth to age 18. Statistics on these Child Death Reviews are collated and published by the Care Quality Commission (CQC) and are available on the CQC's website:</p><p> </p><p>www.gov.uk/government/collections/statistics-child-death-reviews.</p><p> </p><p>Statistics on the location of child deaths are available from 2010 onward and show that in this time, no child has died in an inpatient mental health unit.</p><p> </p><p>According to data from the Mental Health Act Commission, six females and one male under 18 died between 2003 and 2008. Owing to patient confidentiality these figures cannot broken down to each institution.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4253 label Biography information for Seema Malhotra

48549

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what systems and controls are in place for recording, monitoring and oversight of the use of force and restraint against children receiving psychiatric in-patient care.
	tabling member constituency	Feltham and Heston
	tabling member printed	Seema Malhotra
	uin	196782
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department does not currently collect data on restraint.</p><p> </p><p>The Department is planning on categorising physical restraint as a patient safety incident. All incidents of restraint against children receiving psychiatric in-patient care will need to be reported to the National Reporting and Learning System.</p><p> </p><p>Mental Health Commissioners visit patients detained under the Mental Health Act, including children and review all aspects of their care including restraint.</p><p> </p><p>Plans for the monitoring and oversight of restraint in psychiatric in-patient services will form part of the Care Quality Commission's (CQC's) new inspection approach for all hospitals. The CQC is currently consulting on its handbooks for all sectors and has set out its planned approach to assessing services against five questions: Are they safe? Are they effective? Are they caring? Are they responsive? Are they well-led? Restraint will be reviewed in services against the question of whether the service is safe and the CQC is developing guidance for both providers and inspection teams that will draw upon good practice guidance and tools. For children's psychiatric services specifically, this would require specific key lines of enquiry to be used.</p><p> </p><p>The CQC is planning to work with NHS Confederation to look at how the CQC expects providers to implement the guidance as set out in <em>Positive and Safe</em> and how this will be used in our monitoring and oversight approaches. <em>Positive and Safe</em> is a two year programme with the principal aim to radically reduce all restrictive interventions, including ending the deliberate use of face down restraint and – outside the Mental Health Act – seclusion. The work group will be preparing guidance on restraint in the light of <em>Positive and Safe</em> and using this to inform CQC tools and inspection methodology. The CQC always considers providers' approaches to restraint when carrying out comprehensive inspections. Mental Health Act monitoring visits to inpatient units will also look at individual concerns relating to restraint practices. The methodology for all reviews and inspections which the CQC carries out is informed by the available guidance and the Mental Health Act Code of Practice.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4253 label Biography information for Seema Malhotra

48550

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what proportion of places for children and adolescents receiving mental health services are publicly funded; and what proportion of such places are provided by (a) private and (b) public sector healthcare institutions.
	tabling member constituency	Feltham and Heston
	tabling member printed	Seema Malhotra
	uin	196783
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>NHS England holds only information on beds for children and adolescents receiving mental health services that are funded by the National Health Service (ie publicly funded). The NHS commissions 474 beds for children and adolescents receiving mental health services from independent providers and 783 beds from the NHS.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4253 label Biography information for Seema Malhotra

48551

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what data requirements are necessary to precipitate the development of Clinical Commissioning Group Outcome Indicators based on quality statements 1 and 2 of the NICE quality standard on psoriasis.
	tabling member constituency	Chesham and Amersham
	tabling member printed	Mrs Cheryl Gillan
	uin	196784
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>I refer the right hon. Member to the Written Answer I gave her on 9 April 2014, <em>Official Report</em>, column 262-63W.</p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196785 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name Answer of 9 April - Hansard Extract.docx title Answer of 9 April Hansard Extract column 26263W
	tabling member	18 label Biography information for Dame Cheryl Gillan