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755128

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Parkinson's Disease
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government what steps they are taking to improve access to timely and appropriate support for people with Parkinson's disease who are experiencing anxiety or depression.
	tabling member printed	Baroness Gale
	uin	HL1136
	answer	answer is ministerial correction date of answer 02/08/2017 answer text <p>As set out in <em>Implementing the Five Year Forward View for Mental Health</em> the expansion of Improving Access to Psychological Therapies services will focus on people with long term conditions, including neurological conditions such as Parkinson’s, and/or medically unexplained symptoms. New psychological therapy provision will see physical and mental health care provision co-located. Therapy will be integrated into existing medical pathways and services – either primary care, or secondary care services including neurology.</p><p>Although the majority of people with Parkinson’s can be cared for through routine access to primary and secondary care, NHS England commissions the specialised elements of Parkinson’s care that patients may receive from 24 specialised neurological treatment centres across England. Within these centres neurological multidisciplinary teams ensure patients can access a range of health professionals, including neurologists, neurosurgeons, clinical nurse specialists, psychologists, and that they can receive specialised treatment and support, according to their needs.</p><p>The Neurology Advisory Group will ensure that there is system alignment and a national approach when considering the recommendations, which will be of benefit to patients.</p><p>NHS England is also working with the Neurological Alliance, following the publication on 5 July 2017 of their report on mental health and neurological conditions, <em>Parity of esteem for people affected by neurological conditions: meeting the emotional, cognitive &amp; mental health needs of neurology patients</em>.</p><p>A copy of the report is attached.</p> answering member printed Lord O'Shaughnessy question first answered 02/08/2017 15:07:06 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name HL1136 Parity-of-esteem-for-people-affected-by-neuro-conditions-2017.pdf title Mental health and neurological conditions
	tabling member	2503 label Biography information for Baroness Gale

772990

	registered interest
	date	18/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Clinical Audit
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government (1) how many National Clinical Audits and Patient Outcome Audits there are currently in NHS England under the Healthcare Quality Improvement Partnership; (2) what percentage of care costs and English disability adjusted life years these audits cover; and (3) which diseases currently have patient reported outcomes, and which will have by next year.
	tabling member printed	Lord Freyberg
	uin	HL2191
	answer	answer is ministerial correction date of answer 31/10/2017 answer text <p>NHS England has advised that there are 38 projects currently within the National Clinical Audit and Patient Outcomes Programme (NCAPOP) Portfolio, which are at different stages of the commissioning cycle and comprise of 30 National Clinical Audits (NCA) and six Clinical Outcome Review Programmes or Mortality Review Programmes.</p><p> </p><p>The audits’ primary focus is not care costs or disability adjusted life years. The audits are predominately based upon National Institute for Health and Care Excellence (NICE) evidence-based guidelines, technology appraisals and quality standards. NICE takes into account both clinical and cost effectiveness (mainly Quality Adjusted Life Years) where appropriate, and the clinical evidence exists to enable this. The audits commissioned by NCAPOP use the NICE evidence-based outputs as a foundation for the metrics collected so that where possible the audits are based upon a sound pre-existing evidence base. The exception where care costs are investigated is health economic work undertaken by the Sentinel Stroke National Audit Programme.</p><p> </p><p>The following NCAs include patient reported outcomes (PROMS):</p><p> </p><p>- the National Audit of Psychosis, awarded in March 2017, will collect PROMs in year two of its contract (2018-19) and will likely report these at the end of 2019 as part of the annual report;</p><p>- the National Rheumatoid and Early Inflammatory Arthritis Audit, which ran from 2013 to 2016, collected data on PROMS (capturing disease activity and impact of disease). This audit has been recommissioned (contract commenced October 2017) and will once again incorporate PROMs. It is due to report in year two of its contract (2018-19);</p><p>- the National Ophthalmology Audit is undertaking a study to examine the feasibility of collecting cataract PROMs data. This will likely be published in 2018-19;</p><p>- the National Bowel Cancer Audit has undertaken a study to examine the feasibility of reporting PROMs. This is expected to be published later in 2017; and</p><p>- the National Prostate Cancer Audit has collected PROMs data, which is likely to be reported in 2018. The project is being recommissioned and there is currently provision for a national collection of PROMs and patient reported experience measure data within year three of the new contract (2020-21).</p> answering member printed Lord O'Shaughnessy question first answered 31/10/2017 15:04:08 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

803021

	registered interest
	date	08/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Flour: Folic Acid
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government following the joint letter from the Scottish Government’s Minister for Public Health and Sport and the Welsh Government’s Cabinet Secretary for Health and Social Services to the Secretary of State for Health on 1 December, whether they have any plans to introduce mandatory fortification of flour with folic acid on a UK-wide basis to help reduce neural tube defects in unborn babies.
	tabling member printed	Lord Balfe
	uin	HL3986
	answer	answer is ministerial correction date of answer 20/12/2017 answer text <p>The Scientific Advisory Committee on Nutrition (SACN) recently updated the evidence on folic acid in response to a request from Food Standards Scotland and reiterated its support for mandatory folic acid fortification of United Kingdom flour, provided that this is introduced alongside restrictions on voluntary fortification of foods with folic acid. Ministers are currently considering SACN’s recommendations on mandatory fortification.</p><p> </p><p>Neural tube defects (NTDs) are a serious issue. To help those who may have inadequate folate levels through their diet, the Department provides general advice and health education messages in a range of settings targeted at women of childbearing age to encourage the use of folic acid supplements both pre- and post-conception. Information is also available online via NHS Choices including advice on seeing a healthcare professional as early in pregnancy as possible and that women should take 400 micrograms of folic acid every day prior to conception, and in the first 12 weeks of pregnancy, to help prevent NTDs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL3984 HL3985 question first answered 20/12/2017 13:50:02 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4302 label Biography information for Lord Balfe

773016

	registered interest
	date	18/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Human Papillomavirus: Vaccination
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government for how long the three vaccination regime for human papilloma virus, in the form of Gardasil, Gardasil 9 or Cervarix, maintains protection against infection.
	tabling member printed	The Countess of Mar
	uin	HL2217
	answer	answer is ministerial correction date of answer 31/10/2017 answer text <p>Current evidence from clinical trials has demonstrated that protection against targeted human papilloma virus types following vaccination using Cervarix lasts for at least nine years and at least eight years for Gardasil. The immunological evidence supports expectations that these vaccines will protect for much longer.</p><p> </p><p>The duration of protection for Gardasil 9 is not yet known.</p> answering member printed Lord O'Shaughnessy question first answered 31/10/2017 12:35:08 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1861 label Biography information for The Countess of Mar

776804

	registered interest
	date	24/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government further to the Written Answer by Lord O'Shaughnessy on 17 July (HL530), what support they are giving to Operational Delivery Networks which did not achieve their run rates in the period 2016–17 to meet those targets in the future.
	tabling member printed	Baroness Randerson
	uin	HL2468
	answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>In 2016-17, Operational Delivery Networks achieved 94% of the planned treatment run rate of 10,000 patients, with all but two treating over 90% of their run rate. NHS England has a Commissioning for Quality and Innovation scheme in place for hepatitis C virus (HCV), which provides a substantial opportunity for hospitals to earn additional income available to invest in their contribution to the sustainable rollout of HCV treatments. NHS England also invested £1 million in fibroscanning equipment to identify patients at the highest unmet clinical need. Clinical and commissioning support is provided at regional and national level to share best practice.</p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 15:48:47 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson

792388

	registered interest
	date	20/11/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	HIV Infection: Health Services
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how (1) Public Health England, and (2) the Department of Health, plan to monitor progress made against the Framework for Sexual Health in England, particularly with regard to HIV services.
	tabling member printed	Baroness Barker
	uin	HL3341
	answer	answer is ministerial correction date of answer 29/11/2017 answer text <p>The number and gender of individuals recruited to take part in the NHS England funded HIV pre-exposure prophylaxis (PrEP) Impact trial is being captured in the trial dataset but will not be available until 2018.</p><p> </p><p>No assessment on whether members of the Black African community are less likely to attend sexual and reproductive health services than other citizens has been carried out in relation to sexually transmitted infections and HIV.</p><p> </p><p>The purpose of the trial is to assess under real world conditions the impact of PrEP and to inform service commissioners about how to support clinical and cost effective PrEP access in the future for men who have sex with men (MSM) and non MSM, including those in the Black African community. Places are being reserved for groups at high HIV risk other than men who have sex with men.</p><p> </p><p>Public Health England (PHE) regularly publishes a variety of data sources and reports to monitor the sexual health of the nation. This includes key sexual health indicators in the PHE public health profiles and the annual HIV report. Departmental officials meet regularly with PHE to discuss progress on sexual health, including the ambitions in the Framework for Sexual Health in England.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL3337 HL3338 HL3339 question first answered 29/11/2017 17:47:22 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2501 label Biography information for Baroness Barker

778044

	registered interest
	date	26/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Antimicrobials: Drug Resistance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how cures and treatments in the NHS are being developed to reduce the danger in hospitals of anti-microbial resistance.
	tabling member printed	Lord Hunt of Chesterton
	uin	HL2590
	answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>The UK Antimicrobial Resistance (AMR) Strategy published in 2013 set out the key actions needed to tackle AMR: preventing infections, making appropriate use of the treatments available, and promoting the development of new treatments. In 2016 the government announced ambitions to halve healthcare-associated Gram-negative bloodstream infections and inappropriate prescribing of antimicrobials by 2020-2021. To promote the development of new drugs, diagnostics and alternative treatments we have established unprecedented levels of research collaboration, together with increased investment, including the £50 million Global AMR Innovation Fund. The Government is committed to working with the global finance and health community to develop a global system that rewards companies that develop new, successful antibiotics and make them available to all who need them.</p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 16:14:16 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2543 label Biography information for Lord Hunt of Chesterton

792383

	registered interest
	date	20/11/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	HIV Infection: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many (1) cis women, and (2) trans and non-binary people, have been recruited to take part in NHS England’s HIV Pre-exposure Prophylaxis impact trial.
	tabling member printed	Baroness Barker
	uin	HL3337
	answer	answer is ministerial correction date of answer 29/11/2017 answer text <p>The number and gender of individuals recruited to take part in the NHS England funded HIV pre-exposure prophylaxis (PrEP) Impact trial is being captured in the trial dataset but will not be available until 2018.</p><p> </p><p>No assessment on whether members of the Black African community are less likely to attend sexual and reproductive health services than other citizens has been carried out in relation to sexually transmitted infections and HIV.</p><p> </p><p>The purpose of the trial is to assess under real world conditions the impact of PrEP and to inform service commissioners about how to support clinical and cost effective PrEP access in the future for men who have sex with men (MSM) and non MSM, including those in the Black African community. Places are being reserved for groups at high HIV risk other than men who have sex with men.</p><p> </p><p>Public Health England (PHE) regularly publishes a variety of data sources and reports to monitor the sexual health of the nation. This includes key sexual health indicators in the PHE public health profiles and the annual HIV report. Departmental officials meet regularly with PHE to discuss progress on sexual health, including the ambitions in the Framework for Sexual Health in England.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL3338 HL3339 HL3341 question first answered 29/11/2017 17:47:22 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2501 label Biography information for Baroness Barker

772977

	registered interest
	date	18/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Mental Illness: Research
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many EU nationals engaged in mental health research have left the UK since 23 June 2016, and how this number compares with the same time period before 23 June 2016.
	tabling member printed	Lord Brooke of Alverthorpe
	uin	HL2178
	answer	answer is ministerial correction date of answer 01/11/2017 answer text <p>The Government does not hold information on how many European Union nationals involved in mental health research have left the United Kingdom in either of the time periods specified.</p> answering member printed Lord O'Shaughnessy question first answered 01/11/2017 16:03:09 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

778053

	registered interest
	date	26/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Methadone
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many English patients were on the methadone treatment programme in (1) 2005, (2) 2010, and (3) 2015; in each of those years (a) what was the cost of the programme, (b) how many deaths from methadone abuse, whether of those on the programme or not, were recorded, and (c) how many patients on the programme ceased injecting behaviour and the use of other illicit drugs.
	tabling member printed	Lord Brooke of Alverthorpe
	uin	HL2599
	answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>Data on the number of English patients on the methadone treatment programme is not collected in the format requested.</p><p> </p><p>Information on the cost of local drug treatment programmes is not collected centrally.</p><p> </p><p>Deaths where methadone was among the substances mentioned on the death certificate are published by Office for National Statistics for residents of England and Wales for each calendar year, based on deaths registered in the year. These were 220 in 2005, 355 in 2010,and 434 in 2015.</p><p> </p><p>The <em>Adult substance misuse statistics from the National Drug Treatment Monitoring System</em> <em>(NDTMS) 2015-16</em> report shows that 39% of opiate users who were reviewed after six months of treatment had not used opiates in the previous four weeks. Of those who reported that they were injecting at the start of treatment, 55% reported not injecting in the previous four weeks when reviewed after six months. This data is not available in a comparable form for previous years. A copy of the report is attached.</p><p> </p><p>It should be noted that these are not outcomes for every opiate user in treatment, but specifically for those reviewed at six months within that year, and that not all opiate users are injecting.</p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 16:09:50 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name Adult substance misuse statistics from the National Drug Treatment Monitoring System (NDTMS) 2015-16.pdf title Adult substance misuse statistics
	tabling member	3335 label Biography information for Lord Brooke of Alverthorpe