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516972

	registered interest
	date	03/05/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Olympic Games: Brazil
	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 Prior of Brampton on 11 and 12 February (HL5764 and HL5766) and by Baroness Neville-Rolfe on 11 February (HL5765), and in the light of current information about the increased extent of dangers from the Zika virus affecting up to 20 per cent of all births, whether they intend to issue further advice about, or to reconsider, in consultation with other European governments, the long-term implications of participating in or attending the 2016 Olympic Games in Brazil.
	tabling member printed	Lord Maginnis of Drumglass
	uin	HL8128
	answer	answer is ministerial correction date of answer 11/05/2016 answer text <p>The British Olympic Association (BOA) and British Paralympic Association (BPA) have prepared guidance to consider the health risks, including those posed by Zika, for British athletes and staff travelling to Brazil for the Olympics.</p><p> </p><p>The Department of Health has convened an Olympics health advisory group on behalf of the Department for Culture, Media and Sport to focus on Zika and to support the BOA and BPA to ensure that they can continue to provide the best possible information and advice.</p><p> </p><p>The group will be chaired by the Department’s Chief Scientific Advisor, Professor Chris Whitty, and will bring together experts from the BOA and BPA as well as the London School of Hygiene and Tropical Medicine, University of Liverpool, University of Nottingham, the Royal Free London, Public Health England and across Government.</p><p> </p><p>Revisions of existing guidance or specific further advice will be published if it is deemed necessary.</p><p> </p><p>In the meantime, Public Health England and the National Travel Health Network and Centre (NaTHNaC) have developed and issued more general travel advice online to health professionals that is suitable for people travelling to Zika-affected countries, including pregnant women. A copy of the online advice is attached.</p><p> </p><p>This includes a list of countries where Zika virus transmission is occurring, advice around bite avoidance measures and what and who to speak to if those travelling have concerns. PHE and NaTHNaC continue to monitor the situation very closely and update advice as needed.</p> answering member printed Lord Prior of Brampton question first answered 11/05/2016 16:20:48 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name zika-virus-update-and-advice-for-travellers-including-pregnant-women.pdf title Zika Virus travel advice
	tabling member	648 label Biography information for Lord Maginnis of Drumglass

621149

	registered interest
	date	25/10/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Disability: Employment Schemes
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what assessment they have made of the case for more resources to be made available for specialist support models for people with complex support needs, and who do not benefit from the Work and Health Programme.
	tabling member printed	Baroness Garden of Frognal
	uin	HL2666
	answer	answer is ministerial correction date of answer 08/11/2016 answer text <p>The Government recognises the challenges of helping those with the most complex health conditions move closer to work. The new Personal Support Package announced in <em>Improving Lives: The Work, Health and Disability </em>Green Paper introduces a range of new measures and interventions designed as part of a package of support which can be tailored to people’s individual needs. The offer, which applies to all Employment and Support Allowance claimants (and Universal Credit equivalents), includes personal support from disability trained, accredited work coaches, with a focus on mental health. Work coaches will be supported by an additional 300 Disability Employment Advisers and around 200 new community partners with disability expertise and local knowledge. This will lead to better signposting to other local voluntary and public sector services that may be available. A copy of the Green Paper is attached.</p><p> </p><p>The Government recognises that more needs to be done to help people stay well at work, including those with complex health conditions. The consultation on the Green Paper will help us to consider appropriate new models of support to help more people with disabilities or long term conditions to enter and remain in work.</p> answering member printed Lord Prior of Brampton question first answered 08/11/2016 15:08:55 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name work-and-health-green-paper-print-version.pdf title HL2666 Green Paper
	tabling member	3842 label Biography information for Baroness Garden of Frognal

784707

	registered interest
	date	06/11/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Rickets
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they have any plans to designate a group of health care professionals to be accountable and responsible for the prevention of rickets and its complications.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL2925
	answer	answer is ministerial correction date of answer 20/11/2017 answer text <p>The Government has no plans to designate a group of healthcare professionals focused on the prevention of rickets.</p><p>Rickets can generally be prevented by ensuring that children have a healthy, balanced diet, spend some time outside in the sun and take appropriate supplements containing ten micrograms of vitamin D. There is already a range of resources available to increase awareness of the need for vitamin D supplements, including advice on the NHS Choices website on the importance of vitamin D for bone health, and supplements are readily available over the counter and through the Healthy Start vitamins scheme.</p><p>In August the National Institute for Health and Care Excellence (NICE) updated its public health guidance on increasing vitamin D supplement use among population groups at risk of vitamin D deficiency, in the light of the 2016 Scientific Advisory Committee on Nutrition report on Vitamin D and health. A copy of <em>Vitamin D: supplement use in specific population groups </em>is attached. This guideline includes recommendations on how to: increase access to and availability of vitamin D supplements, including for at-risk groups such as the BAME community, ensure health professionals recommend vitamin D supplements, raise awareness of the importance of these supplements amongst the population, and monitor provision and uptake of vitamin D supplements. Local commissioners will wish to consider how best to take forward these recommendations in respect of local BAME populations.</p><p>The Government has made no formal assessment of the research referred to. Given the widespread availability of vitamin D supplements and clear guidance to health professionals and the public the Government does not believe there is a need for further strategies to prevent rickets.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 20/11/2017 12:33:04 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name vitamin-d-supplement-use-in-specific-population-groups-pdf-1996421765317.pdf title Vitamin D supplement use
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

784708

	registered interest
	date	06/11/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Rickets: Ethnic Groups
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what analysis they have undertaken of the steps necessary to protect members of the BAME community from the risk of rickets and its complications.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL2926
	answer	answer is ministerial correction date of answer 20/11/2017 answer text <p>The Government has no plans to designate a group of healthcare professionals focused on the prevention of rickets.</p><p>Rickets can generally be prevented by ensuring that children have a healthy, balanced diet, spend some time outside in the sun and take appropriate supplements containing ten micrograms of vitamin D. There is already a range of resources available to increase awareness of the need for vitamin D supplements, including advice on the NHS Choices website on the importance of vitamin D for bone health, and supplements are readily available over the counter and through the Healthy Start vitamins scheme.</p><p>In August the National Institute for Health and Care Excellence (NICE) updated its public health guidance on increasing vitamin D supplement use among population groups at risk of vitamin D deficiency, in the light of the 2016 Scientific Advisory Committee on Nutrition report on Vitamin D and health. A copy of <em>Vitamin D: supplement use in specific population groups </em>is attached. This guideline includes recommendations on how to: increase access to and availability of vitamin D supplements, including for at-risk groups such as the BAME community, ensure health professionals recommend vitamin D supplements, raise awareness of the importance of these supplements amongst the population, and monitor provision and uptake of vitamin D supplements. Local commissioners will wish to consider how best to take forward these recommendations in respect of local BAME populations.</p><p>The Government has made no formal assessment of the research referred to. Given the widespread availability of vitamin D supplements and clear guidance to health professionals and the public the Government does not believe there is a need for further strategies to prevent rickets.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 20/11/2017 12:33:25 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name vitamin-d-supplement-use-in-specific-population-groups-pdf-1996421765317.pdf title Vitamin D supplement use
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

784709

	registered interest
	date	06/11/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Rickets
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of research published in Endocrine Connections finding (1) that the UK does not provide information to new parents before discharge on the necessity of infant vitamin D supplementation, and (2) that the vitamin D supplementation programme in infants is not monitored.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL2927
	answer	answer is ministerial correction date of answer 20/11/2017 answer text <p>The Government has no plans to designate a group of healthcare professionals focused on the prevention of rickets.</p><p>Rickets can generally be prevented by ensuring that children have a healthy, balanced diet, spend some time outside in the sun and take appropriate supplements containing ten micrograms of vitamin D. There is already a range of resources available to increase awareness of the need for vitamin D supplements, including advice on the NHS Choices website on the importance of vitamin D for bone health, and supplements are readily available over the counter and through the Healthy Start vitamins scheme.</p><p>In August the National Institute for Health and Care Excellence (NICE) updated its public health guidance on increasing vitamin D supplement use among population groups at risk of vitamin D deficiency, in the light of the 2016 Scientific Advisory Committee on Nutrition report on Vitamin D and health. A copy of <em>Vitamin D: supplement use in specific population groups </em>is attached. This guideline includes recommendations on how to: increase access to and availability of vitamin D supplements, including for at-risk groups such as the BAME community, ensure health professionals recommend vitamin D supplements, raise awareness of the importance of these supplements amongst the population, and monitor provision and uptake of vitamin D supplements. Local commissioners will wish to consider how best to take forward these recommendations in respect of local BAME populations.</p><p>The Government has made no formal assessment of the research referred to. Given the widespread availability of vitamin D supplements and clear guidance to health professionals and the public the Government does not believe there is a need for further strategies to prevent rickets.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 20/11/2017 12:33:44 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name vitamin-d-supplement-use-in-specific-population-groups-pdf-1996421765317.pdf title Vitamin D supplement use
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

386906

	registered interest
	date	01/07/2015
	answering body	Department for Business, Innovation and Skills
	answering dept id	26
	answering dept short name	Business, Innovation and Skills
	answering dept sort name	Business, Innovation and Skills
	hansard heading	Small Businesses: Audit
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what data they used to estimate the savings made from enabling small businesses to decide whether their accounts need to be audited.
	tabling member printed	Lord Mendelsohn
	uin	HL1015
	answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Data on company size and audit fees was sourced from the “FAME” database, Bureau van Dijk. The data was used for both of the final impact assessments approved by the Regulatory Policy Committee in the last Parliament on changes to the law to enable more companies to decide whether or not their accounts need to be audited.</p><p> </p><p>The impact assessment on the audit changes (including for small businesses) in the Companies and Limited Liability Partnerships (Accounts and Audit Exemptions and Change of Accounting Framework) Regulations 2012 is available at: <a href="http://www.legislation.gov.uk/uksi/2012/2301/impacts/2014/286" target="_blank">http://www.legislation.gov.uk/uksi/2012/2301/impacts/2014/286</a></p><p> </p><p>The impact assessment on all the changes in the Companies, Partnerships and Groups (Accounts and Reports) Regulations 2015 is available at: <a href="http://www.legislation.gov.uk/uksi/2015/980/impacts/2014/424" target="_blank">http://www.legislation.gov.uk/uksi/2015/980/impacts/2014/424</a></p><p> </p><p> </p><p> </p> answering member printed Baroness Neville-Rolfe attachment 1 file name ukia_20140286_en.pdf title Audit Changes 2 file name ukia_20140424_en.pdf title Changes in the Companies. Partnerships and groups question first answered 14/07/2015 11:25:06 answering member 4284 label Biography information for Baroness Neville-Rolfe
	tabling member	4286 label Biography information for Lord Mendelsohn

450641

	registered interest
	date	04/02/2016
	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 steps they are taking to develop the model of co-location of urgent and emergency primary care service with accident and emergency departments.
	tabling member printed	Baroness Masham of Ilton
	uin	HL5942
	answer	answer is ministerial correction date of answer 11/02/2016 answer text <p>In August 2015, NHS England published <em>Safer, faster, better: good practice in delivering urgent and emergency care. </em>A copy is attached. This provides guidance to help frontline providers and commissioners re-design urgent and emergency care services, including considering locating urgent care centres in emergency departments.</p><p><em>Safer, faster, better</em> notes that urgent care centres co-located with emergency departments provide an opportunity to stream patients with less serious illnesses and injuries to a service that is resourced to meet their needs, while reducing crowding in emergency departments. It also sets out that to preserve flow, urgent care centre staff and cubicles must wherever possible be entirely separated from the majors/admission stream and that where urgent care centres are co-located with emergency departments, there must be appropriate integration, with shared governance arrangements and clearly defined protocols for the two-way transfer of patients.</p> answering member printed Lord Prior of Brampton question first answered 11/02/2016 12:53:09 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name trans-uec - HL5942.pdf title Safer, Faster, Better
	tabling member	1850 label Biography information for Baroness Masham of Ilton

447470

	registered interest
	date	25/01/2016
	answering body	Department for Culture, Media and Sport
	answering dept id	10
	answering dept short name	Culture, Media and Sport
	answering dept sort name	Culture, Media and Sport
	hansard heading	Employment: Electronic Surveillance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what assessment they have made of the impact of the European Court of Human Rights ruling on 12 January in <i>Barbulescu v Romania</i> on an employer's right to access an employee's private emails in the UK.
	tabling member printed	Lord Chadlington
	uin	HL5372
	answer	answer is ministerial correction date of answer 09/02/2016 answer text <p>The Government has made no assessment of the judgment The case raises the important question of whether the Applicant had a reasonable expectation that his communications would not be monitored; and could reasonably expect privacy when communicating from the Yahoo Messenger account that he had registered at his employer's request, and where there was a strict company policy prohibiting use of work systems for personal purposes. The Applicant alleged interference with his article 8 rights and that the interference was not foreseeable or proportionate. But the Court held that there was nothing to indicate that the domestic authorities failed to strike a fair balance between the applicant’s right to respect for his private life under Article 8 and his employer’s interests, and that there had been no violation of Article 8 of the Convention.</p><p> </p><p>The attached ICO's employment practices code sets out guidance in relation to workplace monitoring. The code is already clear that employers should have policies in place explaining how they expect their IT systems to be used, including setting out the extent to which, if any, the IT system can be used for personal use. Even where no such policy is in place, it is reasonable in certain circumstances for employers to monitor an employee’s use of the IT systems to ensure compliance with any policy or to ensure that employees are not abusing the use of the system. Such monitoring may include accessing non-work communications but this should only be done in exceptional circumstances.</p> answering member printed Baroness Neville-Rolfe question first answered 09/02/2016 14:25:09 answering member 4284 label Biography information for Baroness Neville-Rolfe attachment 1 file name the_employment_practices_code.pdf title ICO Employment Code
	tabling member	3318 label Biography information for Lord Chadlington

421268

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they have taken to help patients with undiagnosed hypothyroidism who present clinical signs and symptoms of that condition, but are refused any treatment as their blood test results remain normal.
	tabling member printed	Lord Pendry
	uin	HL2639
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2640 HL2641 HL2642 question first answered 27/10/2015 17:53:42 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry

421269

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether there are any plans to amend the diagnosis of hypothyroidism, which under current guidance is based solely on a blood test.
	tabling member printed	Lord Pendry
	uin	HL2640
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2639 HL2641 HL2642 question first answered 27/10/2015 17:53:42 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry