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1142432

	registered interest
	date	25/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Pensions
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have, if any, to compensate senior NHS staff who have inadvertently exceeded the tapered annual pensions allowance.
	tabling member printed	Baroness Altmann
	uin	HL17506
	answer	answer is ministerial correction date of answer 06/08/2019 answer text <p>For the majority of people, their pension contributions are tax-free. This makes pensions tax relief one of the most expensive reliefs in the personal tax system. The reforms to the lifetime and annual allowance made in the previous two parliaments are expected to save over £6 billion per year and are necessary to deliver a fair system and protect public finances. Less than 1% of pension savers will have to reduce their saving or face an annual allowance charge as a result of the tapered annual allowance.</p><p>While there are no plans to compensate senior National Health Service staff who exceed their tax-free pension savings allowances, the Scheme Pays facility is there to assist NHS Pension Scheme members who breach the annual allowance, and allows them to settle their lifetime and annual allowance charges without making an upfront payment. The Scheme Pays facility was recently extended to cover tax charges of any amount and those arising from the tapered annual allowance.</p><p>The Government has launched a full public consultation setting out proposals to make the NHS Pension Scheme more flexible for clinicians, to give them more control over their pension growth and tax liabilities.</p> answering member printed Baroness Blackwood of North Oxford question first answered 06/08/2019 15:06:30 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4533 label Biography information for Baroness Altmann

1141919

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Bacterial Diseases
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 9 July (HL16592), what is their view of the proportion of each of the resulting illness, deaths and costs that could be prevented by new efforts to prevent transmission; and what are the costs of new measures introduced in 2019 to prevent transmission of carbapenem-resistant Enterobacteriaceae.
	tabling member printed	Baroness Gardner of Parkes
	uin	HL17463
	answer	answer is ministerial correction date of answer 06/08/2019 answer text <p>Public Health England (PHE) has prioritised collecting the necessary data across the National Health Service to enable estimation and monitoring of the proportion of cases, deaths and costs attributable to carbapenemase-resistant Enterobacteriaceae.</p><p>In May 2015 PHE implemented an enhanced surveillance system of all carbapenemase-producing Gram negative bacteria, which was modified in 2019 to maximise efficiency. The health burden of cases, estimated from these data, will be published in the <em>English Surveillance Programme for Antimicrobial Utilisation Report</em> in November 2019.</p><p>The few published reports of outbreaks have estimated costs of at least £1 million, and up to £5 million, all indicating multi-model control measures are required, as outlined in the PHE toolkit for prevention and control of carbapenemase-producing Enterobacteriaceae which is currently being updated.</p><p>Using national surveillance and patient administration data to develop mathematical models, work is ongoing to estimate the reduction in levels of illness and death when specified detection and control measures are applied by 2020. Developed models will enable associated costs incurred to be estimated and the cost-effectiveness of control measures to be established by 2021.</p><p> </p> answering member printed Baroness Blackwood of North Oxford question first answered 06/08/2019 15:07:02 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3596 label Biography information for Baroness Gardner of Parkes

1141940

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Gambling: Rehabilitation
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, further to the Written Answers by Baroness Blackwood of North Oxford on 17 July (HL16963 and HL16964), what was the budget of Leeds and York Partnership NHS Trust for funding the NHS Northern Gambling Clinic; and what is the projected cost of that clinic in (1) 2020, (2) 2021, and (3) 2022.
	tabling member printed	The Lord Bishop of St Albans
	uin	HL17484
	answer	answer is ministerial correction date of answer 06/08/2019 answer text <p>NHS England and NHS Improvement have allocated £600,000 to Central and North West London NHS Foundation Trust and £370,000 to Leeds and York Partnership NHS Foundation Trust for gambling harm services provision in 2019/20, which includes funding for these clinics.</p><p> </p><p>GambleAware, an independent charity, is providing additional funding for these clinics. Information on this funding is not held centrally.</p><p> </p><p>Future years’ funding is not yet available.</p><p> </p><p> </p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17485 question first answered 06/08/2019 14:58:10 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4308 label Biography information for The Lord Bishop of St Albans

1141941

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	National Problem Gambling Clinic
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, further to the Written Answers by Baroness Blackwood of North Oxford on 17 July (HL16963 and HL16964), what was the budget of the Central and North West London NHS Foundation Trust for funding the National Problem Gambling Clinic; and what is the projected cost of that clinic in (1) 2020, (2) 2021, and (3) 2022.
	tabling member printed	The Lord Bishop of St Albans
	uin	HL17485
	answer	answer is ministerial correction date of answer 06/08/2019 answer text <p>NHS England and NHS Improvement have allocated £600,000 to Central and North West London NHS Foundation Trust and £370,000 to Leeds and York Partnership NHS Foundation Trust for gambling harm services provision in 2019/20, which includes funding for these clinics.</p><p> </p><p>GambleAware, an independent charity, is providing additional funding for these clinics. Information on this funding is not held centrally.</p><p> </p><p>Future years’ funding is not yet available.</p><p> </p><p> </p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17484 question first answered 06/08/2019 14:58:10 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4308 label Biography information for The Lord Bishop of St Albans

1141957

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Breast Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what are the drugs approved by NICE to treat HER2+ breast cancer; and what assessment they have made of the efficacy of such drugs.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL17501
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is the independent body responsible for making recommendations for the National Health Service on whether drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE has recommended the following drugs for the treatment of HER2-positive breast cancer: trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab (Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta) for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta) for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners are legally required to fund drugs recommended in NICE technology appraisal guidance. It is for clinicians to decide on the most appropriate treatment for an individual patient based on their clinical judgement and in discussion with the patient.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17502 question first answered 25/07/2019 16:45:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4151 label Biography information for Lord Willis of Knaresborough

1141958

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Pertuzumab
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what advice they provide to clinicians for the use of Pertuzumab rather than Herceptin for the treatment of HER2+ breast cancer.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL17502
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is the independent body responsible for making recommendations for the National Health Service on whether drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE has recommended the following drugs for the treatment of HER2-positive breast cancer: trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab (Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta) for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta) for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners are legally required to fund drugs recommended in NICE technology appraisal guidance. It is for clinicians to decide on the most appropriate treatment for an individual patient based on their clinical judgement and in discussion with the patient.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17501 question first answered 25/07/2019 16:45:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4151 label Biography information for Lord Willis of Knaresborough

1141176

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Eating Disorders: Hospital Beds
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many inpatient beds are available to the NHS for eating disorder patients in (1) England, (2) the North of England, (3) the Midlands and East of England, (4) London, and (5) the South of England; and, for each of those categories, how many are available for (a) children and young people, and (b) adults.
	tabling member printed	Baroness Parminter
	uin	HL17359
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The following table provides data on the number of inpatient beds for eating disorders for children and young people and adults.</p><table><tbody><tr><td><p>Type of inpatient bed</p></td><td><p>North of England</p></td><td><p>South of England</p></td><td><p>Midlands and East of England</p></td><td><p>London</p></td><td><p>England</p></td></tr><tr><td><p>Children and adolescent mental health service eating disorder<sup>1</sup></p></td><td><p>40</p></td><td><p>45</p></td><td><p>108</p></td><td><p>56</p></td><td><p>249</p></td></tr><tr><td><p>Adult eating disorder</p></td><td><p>110</p></td><td><p>67</p></td><td><p>103</p></td><td><p>120</p></td><td><p>400</p></td></tr></tbody></table><p> </p><p><em>Source:</em> NHS England</p><p><em> </em></p><p><em>Note:</em></p><p><sup>1</sup>Some children and young people with eating disorders are treated in general child and adolescent mental health services.</p><p><strong> </strong></p><p> </p><p> </p> answering member printed Baroness Blackwood of North Oxford question first answered 25/07/2019 16:46:32 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4178 label Biography information for Baroness Parminter

1140456

	registered interest
	date	18/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Food: Hygiene
	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 number of online food outlets that do not display their food hygiene ratings.
	tabling member printed	Baroness Doocey
	uin	HL17289
	answer	answer is ministerial correction date of answer 31/07/2019 answer text <p>The Food Hygiene Rating Scheme is operated by the Food Standards Agency (FSA) in partnership with local authorities across England, Wales and Northern Ireland.</p><p>For businesses offering online ordering of food, legislation requiring provision of the rating at the point of choice is expected to be introduced in Northern Ireland once the Assembly is back in operation and Wales are exploring the introduction of a similar legislative requirement.</p><p>The case for extending mandatory display to England is being finalised by the FSA for ministerial consideration and ultimately cross-Government approval. As increasing numbers of food businesses provide online ordering services for consumers, for England, provision of food hygiene ratings online will be considered in the case being finalised for ministers.</p><p>To date the FSA has not undertaken any research to assess the proportion of online food businesses that display ratings, but work is underway to develop methodology to monitor this.</p> answering member printed Baroness Blackwood of North Oxford question first answered 31/07/2019 15:43:19 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4197 label Biography information for Baroness Doocey

1140465

	registered interest
	date	18/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Organs: Donors
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have, if any, to introduce legislation to require evidence of the consent of an organ donor before any transplant can take place.
	tabling member printed	Lord Hylton
	uin	HL17298
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The Human Tissue Act 2004, as amended, sets out the requirements for consent to organ donation.</p><p>The Human Tissue Authority is currently consulting on a revised Code of Practice F: Donation of solid organs and tissue for transplantation, to reflect amendments to the Human Tissue Act 2004 from the Organ Donation (Deemed Consent) Act 2019.</p><p>The revised code will provide clinical advice and guidance for organ and tissue transplant professionals in England on how the new law will affect their practice from spring 2020. It also provides guidance in situations where someone’s consent to donate their organs is not clear or when clinical decisions are complex. This consultation asks professionals working in the field of organ donation and transplantation for their views on the draft version, and will run for 12 weeks, closing on 26 September 2019.</p> answering member printed Baroness Blackwood of North Oxford question first answered 25/07/2019 16:26:21 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2018 label Biography information for Lord Hylton

1140466

	registered interest
	date	18/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Psychiatric Hospitals: Children and Young People
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether the Care Quality Commission has published a specific inspection framework for Child and Adolescent Mental Health (CAMHS) Tier 4 inpatient services; what is the maximum time allowed between inspections of CAMHS inpatient services; and in what ways the views and experiences of child patients and their parents are elicited.
	tabling member printed	Baroness Jolly
	uin	HL17299
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Tier 4 inspections are covered as part of the child and adolescent mental health wards core service. The definition for this core service is as follows:</p><p>Child and adolescent mental health services may assess and treat children and young people as an inpatient in hospital. This may be when community-based services cannot meet their needs safely and effectively because of their level of risk and/or complexity and where they need 24-hour nursing and medical care.</p><p>If providers are registering with the CQC as a new provider, the CQC will normally aim to inspect within 12 months of registration. For services that are rated, providers will receive their initial rating at this inspection. The CQC use this initial rating to determine when next to inspect the service.</p><p>For both National Health Service trusts and independent providers, the following principles apply regarding re-inspection (for NHS trusts since June 2017 and for independent providers since April 2018):</p><p>- Inadequate – Normally within 12 months of publishing the last comprehensive inspection report;</p><p> </p><p>- Requires improvement - Normally within two years of publishing the last comprehensive inspection report;</p><p> </p><p>- Good - Normally within three and a half years of publishing the last comprehensive inspection report; and</p><p> </p><p>- Outstanding - Normally within five years of publishing the last comprehensive inspection report.</p><p> </p><p>These are maximum inspection intervals, therefore the CQC may inspect more frequently, particularly if there is a risk.</p><p>The CQC encourages people to share their experience to ensure it is acted upon, including through the national Tell Us About Your Care partner charities.</p><p>The CQC aim to speak to children and young people and their families/carers during the inspection (depending on their availability) and have specific inspection tools to enable this.</p><p>This information is published as part of the inspection framework for NHS acute hospitals.</p> answering member printed Baroness Blackwood of North Oxford question first answered 25/07/2019 16:46:46 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4203 label Biography information for Baroness Jolly