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1134679

	registered interest
	date	25/06/2019
	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	Self-harm: Children
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what specific measures they are taking to prevent self-harming in very young children.
	tabling member printed	Baroness D'Souza
	uin	HL16646
	answer	answer is ministerial correction date of answer 05/07/2019 answer text <p>The Government is committed to preventing self-harm among children and young people of all ages. In 2017 Public Health England introduced the Rise Above programme that offers advice to young people on dealing with difficult emotions and situations that can lead to problems such as stress, bullying and self-harm.</p><p>The current Healthy Child Programme (from 0-5 years old) aims to support early identification of problems with an emphasis on support for mothers and fathers or partners to provide sensitive and attuned parenting.</p><p>On 17 June 2019, it was announced that tailored advice will be provided to parents on supporting their children’s mental health and well-being by 2020 through the ‘Every Mind Matters’ campaign. This will include information on subjects such as stress, screen time, online bullying, body image and self-harm.</p><p>Ministers wrote to social media and internet providers on 26 January to express concern about suicide and self-harm content. The companies have committed to increasing their efforts by establishing and funding a strategic partnership with the Samaritans to tackle this content and support vulnerable users of their platforms.</p> answering member printed Baroness Blackwood of North Oxford question first answered 05/07/2019 10:55:15 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3709 label Biography information for Baroness D'Souza

1140008

	registered interest
	date	17/07/2019
	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 consideration they have given to mandating the display of food hygiene ratings on online food delivery services.
	tabling member printed	Baroness Doocey
	uin	HL17243
	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>Food businesses covered by the scheme are provided with stickers showing their rating. Those in Wales and Northern Ireland are already required by law to display the stickers at their premises, while those in England are encouraged to do so.</p><p>The case for extending mandatory display to England is being finalised by the FSA for ministerial consideration and ultimately cross-Government approval.</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.</p><p>In Wales, the FSA and Welsh Government are working to address a FSA recommendation to the National Assembly for Wales to explore the introduction of a similar requirement for businesses in Wales that use online food ordering platforms. Proposals will be presented to Welsh Ministers in due course.</p><p>For England, provision of food hygiene ratings online will be considered in the case being finalised for ministers.</p> answering member printed Baroness Blackwood of North Oxford question first answered 31/07/2019 15:39:33 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4197 label Biography information for Baroness Doocey

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

1130604

	registered interest
	date	06/06/2019
	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	Shingles: Vaccination
	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 encouraging people who are 60 years old and above who have not been vaccinated against shingles to receive a vaccination; and what steps they are taking to encourage the take-up of that vaccine amongst that cohort.
	tabling member printed	Baroness Featherstone
	uin	HL16148
	answer	answer is ministerial correction date of answer 18/06/2019 answer text <p>The National Shingles Vaccination Programme, implemented in September 2013 is provided by general practices. The Joint Committee on Vaccination and Immunisation recommends the shingles vaccine for adults routinely at age 70 years with a phased catch up for those aged 71-79 years. The eligibility criteria change means that patients become eligible for the vaccine from their 70th and 78th birthdays, if not previously vaccinated, and can be offered the vaccine opportunistically all year round.</p><p>In support of this change, Public Health England (PHE) has updated the communication materials for both patients and healthcare professionals to better identify those who are eligible and emphasise the benefits to patients from the shingles vaccination. This includes guidance for those individuals who have missed the opportunity to receive the vaccine previously but who remain eligible, up to their 80th birthday.</p> answering member printed Baroness Blackwood of North Oxford question first answered 18/06/2019 12:29:15 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	1531 label Biography information for Baroness Featherstone

1138555

	registered interest
	date	11/07/2019
	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	Shingles: Vaccination
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have to require GP surgeries in England to put in place a call and recall procedure to require them to follow up patients in the shingles vaccination cohort who have not yet availed themselves of the vaccine.
	tabling member printed	Baroness Featherstone
	uin	HL17113
	answer	answer is ministerial correction date of answer 23/07/2019 answer text <p>As outlined in both the NHS Long Term Plan and <em>Investment and Evolution: a five-year framework for GP contract reform to implement The NHS Long Term Plan</em>, NHS England and NHS Improvement are currently undertaking a review of vaccinations and immunisations. The Department would not wish to pre-empt the outcome of this review. Investment and Evolution states that the purpose of the review as being to:</p><p>- Ensure the system incentivises achievement of appropriate uptake rates for immunisations in line with national public health uptake rates;</p><p>- Reduce the administrative burden on general practices by simplifying the system if possible;</p><p>- Clarify what is expected on call/recall for immunisations delivered through the GP contract;</p><p>- Address anomalies in the system that directly incentivise some vaccines but not others;</p><p>- Look at how we deal with outbreaks and catch-up programmes; and</p><p>- Consider whether we extend the list of chargeable travel vaccines.</p><p>A copy of <em>Investment and Evolution: a five-year framework for GP contract reform to implement The NHS Long Term Plan</em> is attached.</p><p> </p> answering member printed Baroness Blackwood of North Oxford question first answered 23/07/2019 11:30:02 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name Investment and Evolution - a five year framework for GP contract.pdf title Five-year framework for GP contract reform
	tabling member	1531 label Biography information for Baroness Featherstone

1133041

	registered interest
	date	18/06/2019
	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	Yellow Card Scheme
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they are taking to (1) encourage pharmacists and clinicians to make full use of the Yellow Card Scheme to report adverse drug reaction to the Medicines and Healthcare products Regulatory Agency, and (2) improve direct patient access to the scheme and to seek patients views on it.
	tabling member printed	Baroness Finlay of Llandaff
	uin	HL16459
	answer	answer is ministerial correction date of answer 27/06/2019 answer text <p>The Medicines and Healthcare products Regulatory Agency (MHRA) has a strategy to improve engagement with the Yellow Card Scheme as well as to increase access through a wide variety or reporting mechanisms, for both healthcare professionals as well as for patients.</p><p>The MHRA has expanded the mechanisms through which reports of side effects can be made. Most recently a new mobile reporting application was delivered, which also includes helpful information about medicines. The MHRA is also continuing to integrate with clinical systems within primary and secondary care to make reporting faster and more accessible to healthcare professionals which has already driven reporting rates up and will continue to do so with the inclusion of more clinical systems.</p><p>The MHRA actively promote the Scheme through regular awareness campaigns (both locally and internationally), attendance at conferences and patient groups, satellite Yellow Card centres that promote locally and the MHRA also provides a range of educational materials to support understanding of the Scheme and the work that the MHRA does.</p><p>An important mechanism to maximise use of the Scheme by healthcare professionals and increase its impact is the National Medication Safety Network, which consists of approximately 450 Medication Safety Officers (MSOs), who raise awareness for reporting of side effects due to medication errors. MSOs are mostly pharmacists based within hospital trusts who encourage local and national learning as well as improve reporting.</p><p>The MHRA regularly communicates safety information through a monthly electronic newsletter called Drug Safety Update which informs healthcare professionals about the latest medicines safety issues and is always coupled with messages to report suspected adverse drug reactions to the Yellow Card Scheme.</p><p>To improve accessibility and transparency, the MHRA has publicly available online interactive Drug Analysis Profiles (iDAPs). The iDAPs are provided for all licensed drugs for which the MHRA have received reports of suspected adverse reactions through the Yellow Card Scheme.</p><p>The MHRA encourages online feedback from both healthcare professionals and patients and proactively engages with patients on a regular basis. Feedback from patients is used to make improvements to the Scheme and to the ways in which patients can report suspected side effects.</p> answering member printed Baroness Blackwood of North Oxford question first answered 27/06/2019 13:36:32 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3609 label Biography information for Baroness Finlay of Llandaff

1133042

	registered interest
	date	18/06/2019
	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	Flour: Folic Acid
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether their consultation on the proposal to add folic acid to flour will include evidence from health economists on the costs to society and the NHS of spina bifida.
	tabling member printed	Baroness Finlay of Llandaff
	uin	HL16460
	answer	answer is ministerial correction date of answer 02/07/2019 answer text <p>The Department is working closely with economists and analysts to estimate costs to society and the National Health Service of spina bifida and other neural tube defects. We are keen to gather further evidence through the consultation and we welcome responses from all interested parties.</p><p>The impact assessment will be revised in light of the consultation and published after the consultation closes.</p> answering member printed Baroness Blackwood of North Oxford question first answered 02/07/2019 14:12:57 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3609 label Biography information for Baroness Finlay of Llandaff

1127421

	registered interest
	date	20/05/2019
	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 14 May (HL15384), what assessment they have made of the number of people, with or without resistant blood stream infections, who have Carbapenem resistant E. coli-like bacteria present in their bodies; and what (1) proposed, and (2) current, initiatives there are to control the transmission of such bacteria.
	tabling member printed	Baroness Gardner of Parkes
	uin	HL15832
	answer	answer is ministerial correction date of answer 04/06/2019 answer text <p>The 2018 English surveillance programme for antimicrobial utilisation and resistance report contains information on carbapenem-resistant Escherichia coli (E. coli) causing bloodstream infections in England. In 2017 there were 18 cases. The number of people with other infections and carriage of E. coli resistant to carbapenems is harder to ascertain as surveillance is not as uniform.</p><p>Public Health England (PHE) publishes guidance on the prevention and control of carbapenemase-producing Enterobacteriaceae (including E. coli); guidance is available for both acute and non-acute settings, copies of the <em>Toolkit for managing carbapenemase-producing Enterobacteriaceae in non-acute and community settings</em> and <em>Acute trust toolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae</em> are attached. PHE is supporting actions outlined in the United Kingdom’s Tackling Antimicrobial Resistance National Action Plan that aim to prevent and control the transmission of carbapenem-resistant bacteria, which includes reducing the number of specific drug-resistant infections in people by 10% by 2025; reducing UK antimicrobial use in humans by 15% by 2024; and adding carbapenem-resistant Gram-negative infections to the list of notifiable diseases in existing laboratory reporting systems.</p> answering member printed Baroness Blackwood of North Oxford attachment 1 file name Acute_trust_toolkit_for_the_early_detection.pdf title Acute trust toolkit 2 file name CPE-Non-AcuteToolkit_CORE.pdf title CPE Non Acute toolkit question first answered 04/06/2019 13:45:10 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3596 label Biography information for Baroness Gardner of Parkes

1135065

	registered interest
	date	26/06/2019
	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 4 June (HL15832), what assessment they have made of (1) the future costs to the NHS as a result of the spread of carbapenem-resistant Enterobacteriaceae, (2) the costs of new measures introduced in 2019 specifically to prevent the transmission of such Enterobacteriaceae, and (3) the views of infection control nurses on investment to prevent the transmission of such Enterobacteriaceae.
	tabling member printed	Baroness Gardner of Parkes
	uin	HL16692
	answer	answer is ministerial correction date of answer 09/07/2019 answer text <p>Public Health England (PHE) has predicted future spread and the health and cost impact to the National Health Service of the Enterobacteriaceae Escherichia coli and a national outbreak of a highly-resistant organism, reflecting carbapenem-resistant Enterobacteriaceae. The models used in this assessment are published in the paper <em>A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study</em>. A copy of the paper is attached.</p><p>Such predictions are highly uncertain. There remain unknowns regarding transmission, efficacy of interventions and the additional hospital stay for infected patients (constituting a large part of the cost to the NHS).</p><p>PHE has worked with NHS colleagues, estimating the cost of controlling a carbapenemase-producing Enterobacteriaceae (CPE) outbreak in five London hospitals to be over £1 million. Monitoring costs alongside implementation of PHE’s upcoming update of the CPE toolkit for health and social care is an important component of enabling cost-effectiveness evaluation.</p><p>Staff interviewed about the challenges of implementing the existing CPE toolkit highlighted maintaining awareness and training as key challenges, alongside infection prevention resourcing. An analysis of the responses was published in the paper <em>An evaluation of a toolkit for the early detection, management, and control of carbapenemase-producing Enterobacteriaceae: a survey of acute hospital trusts in England</em>. A copy is attached.</p> answering member printed Baroness Blackwood of North Oxford attachment 1 file name A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK.pdf title Risk Assessment of Antibiotic Pan Drug Resistance 2 file name An evaluation of a toolkit for the early detection management and control of carbapenemase-producing Enterobacteriaceae. A survey of acute hospital .pdf title An evaluation of a toolkit question first answered 09/07/2019 13:34:21 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	3596 label Biography information for Baroness Gardner of Parkes

1126307

	registered interest
	date	13/05/2019
	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: Civil Proceedings
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how much money the NHS spent as part of legal settlements in each year from 2009 to 2018; and how much of each year's spend relates to legal fees.
	tabling member printed	Baroness Hodgson of Abinger
	uin	HL15667
	answer	answer is ministerial correction date of answer 24/05/2019 answer text <p>NHS Resolution has provided the following information:</p><p>NHS Resolution has provided tables which cover:</p><p>- total expenditure for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes from 2009 to 2018;</p><p>- the total legal costs per financial year; and</p><p>- the draft budget for legal fees/damages 2019 for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes.</p><p>The data is attached due to the size of the data.</p><p>National Health Service spend on legal fees for matters other than clinical/non-clinical negligence settlements since 2009 has been interpreted as spend relating to NHS providers and commissioners.</p><p>This includes NHS trusts, NHS foundation trusts and NHS England and clinical commissioning groups. NHS spend on legal fees for non-negligence matters is shown in the following table.</p><table><tbody><tr><td><p>Year</p></td><td><p>Total legal fees (£000s)</p></td></tr><tr><td><p>2013-14</p></td><td><p>110,747</p></td></tr><tr><td><p>2014-15</p></td><td><p>171,806</p></td></tr><tr><td><p>2015-16</p></td><td><p>162,273</p></td></tr><tr><td><p>2016-17</p></td><td><p>172,135</p></td></tr><tr><td><p>2017-18</p></td><td><p>160,140</p></td></tr></tbody></table><p>Prior to 2013-14, expenditure on legal fees was not separately classified by primary care trusts and strategic health authorities who both carried out NHS commissioning and NHS trusts. Therefore, comparable information pre 2013-14 is unavailable.</p><p>There is no specific category of expenditure that isolates spend relating to legal settlements in the NHS.</p><p>We have interpreted the request for data for the amounts set aside in 2019 as the value of said provisions as at the end of the financial year, 31 March 2019. This data is still subject to audit and will not be available until after publication of the Annual Report and Accounts in July 2019.</p><p>The budget totals for legal fees relating to NHS spend in 2019 is not available.</p><p> </p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15668 question first answered 24/05/2019 11:47:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name HL15667 & HL15668 Data.docx title HL15667_HL15668_data
	tabling member	4301 label Biography information for Baroness Hodgson of Abinger