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114826

registered interest
date	05/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Drugs
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many times he has exercised his powers under the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013 to refer an unlicensed indication of a drug for a NICE technology appraisal.
tabling member constituency	Cambridge
tabling member printed	Dr Julian Huppert
uin	213574
answer	answer is ministerial correction date of answer 10/11/2014 answer text <p>Since the ‘National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013’ came into force on 1 April 2013, the Department has not asked the National Institute for Health and Care Excellence (NICE) to develop under Regulation 7 any technology appraisal guidance on the use of an unlicensed drug. The Department has, however, under Regulation 5, asked NICE to develop guidance and recommendations on the use of a combination therapy for use in the treatment of ovarian cancer outside the terms of its marketing authorisation.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 10/11/2014 12:01:27 answering member 4020 label Biography information for George Freeman
tabling member	3931 label Biography information for Dr Julian Huppert

114829

registered interest
date	05/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Drugs: Licensing
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what discussions he has had with (a) charities and (b) clinicians who support the Off-patent Drugs Bill.
tabling member constituency	Cambridge
tabling member printed	Dr Julian Huppert
uin	213575
answer	answer is ministerial correction date of answer 10/11/2014 answer text <p>Departmental Ministers have met with the hon. Member for Cardiff North (Jonathan Evans), with regard to his Off-Patent Drugs Bill and officials have also had discussions with Breast Cancer Campaign to understand their concerns around the prescribing of off-patent drugs and the implications for patients.</p><p> </p><p><br> We are in the process of setting up a round-table discussion with key stakeholders, NHS England and the National Institute for Health and Care Excellence to review the evidence and develop a strategy to better support use of off-label medicines in areas where the evidence suggests that they can deliver patient benefit.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 10/11/2014 17:01:24 answering member 4020 label Biography information for George Freeman
tabling member	3931 label Biography information for Dr Julian Huppert

106311

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Medical Equipment
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what recent discussions his Department has had with NHS England on the criteria of assessment for awarding dispensing appliance contractor licences.
tabling member constituency	North Durham
tabling member printed	Mr Kevan Jones
uin	213273
answer	answer is ministerial correction date of answer 11/11/2014 answer text <p>There are no licensing requirements to open a private dispensing appliance contractor business. NHS England is responsible for determining whether a dispensing appliance contractor should be granted the right to provide National Health Service pharmaceutical services. Such determinations can generally be appealed to the Family Health Services Appeal Unit of the NHS Litigation Authority.</p><p> </p><p> </p><p> </p><p>The Department keeps the operation of the relevant NHS regulations governing the right to provide NHS pharmaceutical services under regular review with NHS England, the NHS Litigation Authority and contractors’ representatives as appropriate.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 11/11/2014 11:47:48 answering member 4020 label Biography information for George Freeman
tabling member	1438 label Biography information for Mr Kevan Jones

106313

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescriptions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what recent steps his Department has taken at regional and local level to reduce prescribing errors.
tabling member constituency	Scunthorpe
tabling member printed	Nic Dakin
uin	213306
answer	answer is ministerial correction date of answer 11/11/2014 answer text <p>NHS England is involved in a range of initiatives to improve all aspects of medication safety, including prescribing error. These include setting up a network of dedicated Medication Safety Officers (MSOs) in organisations providing National Health Service-funded care. Over 345 MSOs are now in place and have responsibility for medication safety reporting and learning from errors, including prescription errors.</p><p> </p><p> </p><p> </p><p>NHS England and the Medicines and Healthcare products Regulatory Agency issued a Patient Safety Alert <em><a href="http://www.england.nhs.uk/wp-content/uploads/2014/03/psa-med-error.pdf" target="_blank">Improving medication error incident reporting and learning</a></em> in March 2014, and potential Patient Safety Alerts are under development that will aim to improve the safe prescribing of glucose test strips, naloxone and low molecular weight heparin.</p><p> </p><p> </p><p> </p><p>NHS England has commissioned the development of a new Medication Safety Thermometer, which is a ‘point prevalence’ survey tool available for providers to help them measure the prevalence of certain medication incidents in their care and so facilitate quality improvement projects to tackle leading causes of harm. Details of the Medication Safety Thermometer are available at:</p><p> </p><p> </p><p> </p><p><a href="http://www.safetythermometer.nhs.uk/" target="_blank">http://www.safetythermometer.nhs.uk/</a></p><p> </p><p> </p><p> </p><p>NHS England is also involved in an initiative led by the Royal College of Paediatrics and Child Health to develop interventions to reduce prescribing errors, as part of their Paediatric Care Online programme.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 11/11/2014 11:46:35 answering member 4020 label Biography information for George Freeman
tabling member	4056 label Biography information for Nic Dakin

106314

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescriptions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what estimate he has made of the (a) number of lives saved and (b) cost savings that could be made through a reduction in prescribing errors.
tabling member constituency	Scunthorpe
tabling member printed	Nic Dakin
uin	213307
answer	answer is ministerial correction date of answer 07/11/2014 answer text <p>NHS England published a Patient Safety Alert on 20 March 2014 on improving medication error incident reporting and learning. This cited research on medication error rates in medicine, including prescribing error rates of:</p><p> </p><p>- 7% of prescription items in hospitals; and</p><p> </p><p>- 5% of prescriptions in general practice of which 0.18% were severe errors.</p><p> </p><p> </p><p> </p><p>There is limited research to quantify actual harm arising from prescribing errors, many of which are picked up by pharmacists at the dispensing stage.</p><p> </p><p> </p><p> </p><p>Significant investment has been made by the Department, Health Education England and NHS Education for Scotland over the last four years in the development of a National Prescribing Safety Assessment. This is a joint initiative by the Medical Schools Council and the British Pharmacological Society involving the United Kingdom’s leading experts in prescribing, clinical pharmacology and medical assessment. It is intended to enhance patient safety by ensuring that all new graduates entering the first year of Foundation training have achieved a basic standard of practice.</p><p> </p><p> </p><p> </p><p>It is the Nursing and Midwifery Council’s (NMC) role to ensure that nurse and midwife prescribers provide an appropriate level of treatment and care for their patients. The NMC does this by setting standards to ensure that nurses and midwives are competent to prescribe drugs, and by making sure that their knowledge and skills in prescribing remain up-to-date.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman grouped question UIN 213430 question first answered 07/11/2014 14:48:22 answering member 4020 label Biography information for George Freeman
tabling member	4056 label Biography information for Nic Dakin

106315

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Cholesterol
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, when NHS England will take up responsibility for the commissioning of specialised services for the treatment and care of people with Homozygous Familial Hypercholesterolemia (HoFH) once the definitions have been standardised; what steps he is taking to improve care and treatment for people in England with HoFH; and if he will make a statement.
tabling member constituency	North Durham
tabling member printed	Mr Kevan Jones
uin	213285
answer	answer is ministerial correction date of answer 11/11/2014 answer text <p>We understand that NHS England will take responsibility for the commissioning of services for homozygous familial hypercholesterolemia patients from 1 April 2015. The national commissioning of this service will clearly define what NHS England expects to be in place for providers to offer evidence-based, safe and effective services. This should ensure equity of access to a nationally consistent, high quality service for patients.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 11/11/2014 11:49:04 answering member 4020 label Biography information for George Freeman
tabling member	1438 label Biography information for Mr Kevan Jones

106317

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Cancer Drugs Fund
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, with reference to NHS England's consultation document Proposal for a sustainable Cancer Drug Fund, page 9, Points 24 and 25, what NHS England's overspend of the Cancer Drug Fund (CDF) was during its first year in charge of the CDF; whether the CDF was in budget each year prior to 1 April 2013; how much was taken from the radiotherapy budget to underwrite the overspend; from which disease area money was taken to underwrite the CDF overspend; and how much funding was taken in such a fashion to underwrite the overspend.
tabling member constituency	Wells
tabling member printed	Tessa Munt
uin	213358
answer	answer is ministerial correction date of answer 07/11/2014 answer text <p><strong> </strong></p><p> </p><p>Prior to April 2013, the Cancer Drugs Fund was administered through clinical panels based in each strategic health authority. There were no overspends through the Fund during this period.</p><p> </p><p> </p><p> </p><p>NHS England has had oversight of the Cancer Drugs Fund since April 2013 and publishes information on spend and patient numbers routinely on its website at:</p><p> </p><p> </p><p> </p><p><a href="http://www.england.nhs.uk/ourwork/pe/cdf/" target="_blank">www.england.nhs.uk/ourwork/pe/cdf/</a></p><p> </p><p> </p><p> </p><p>NHS England has published a summary financial report for the Cancer Drugs Fund which states that the Fund was overspent by £30,539,000 in 2013-14. We understand from NHS England that this overspend was not funded from funding for radiotherapy services but from underspends in other parts of NHS England’s budget.</p><p> </p><p> </p><p> </p><p>Since October 2010, over 55,000 patients in England have benefitted from the Cancer Drugs Fund.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 07/11/2014 14:49:39 answering member 4020 label Biography information for George Freeman
tabling member	4089 label Biography information for Tessa Munt

106323

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Idiopathic Pulmonary Fibrosis
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department has taken to act upon the research by the National Institute for Health Research into idiopathic pulmonary fibrosis.
tabling member constituency	East Londonderry
tabling member printed	Mr Gregory Campbell
uin	213429
answer	answer is ministerial correction date of answer 07/11/2014 answer text <p>The Department’s National Institute for Health Research (NIHR) is funding a systematic review of evidence on the benefits, harms and costs of treatments for idiopathic pulmonary fibrosis (IPF). The report is expected to be published in the journal <em>Health Technology Assessment</em> in January 2015.</p><p> </p><p><strong> </strong></p><p> </p><p>The NIHR Clinical Research Network (CRN) provides support to help the life sciences industry set up and deliver large multi-centre clinical trials in the National Health Service, across a wide range of disease and therapeutic areas. The CRN is currently hosting trials assessing the efficacy and safety of lebrikizumab and simtuzumab in patients with IPF. The CRN is also recruiting patients to a pilot study seeking to test whether omeprazole can reduce cough in patients with IPF.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 07/11/2014 12:09:02 answering member 4020 label Biography information for George Freeman
tabling member	1409 label Biography information for Mr Gregory Campbell

106324

registered interest
date	04/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescriptions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether his Department has any plans to strengthen the training of (a) clinicians and (b) nurses to reduce prescribing errors.
tabling member constituency	Scunthorpe
tabling member printed	Nic Dakin
uin	213430
answer	answer is ministerial correction date of answer 07/11/2014 answer text <p>NHS England published a Patient Safety Alert on 20 March 2014 on improving medication error incident reporting and learning. This cited research on medication error rates in medicine, including prescribing error rates of:</p><p> </p><p>- 7% of prescription items in hospitals; and</p><p> </p><p>- 5% of prescriptions in general practice of which 0.18% were severe errors.</p><p> </p><p> </p><p> </p><p>There is limited research to quantify actual harm arising from prescribing errors, many of which are picked up by pharmacists at the dispensing stage.</p><p> </p><p> </p><p> </p><p>Significant investment has been made by the Department, Health Education England and NHS Education for Scotland over the last four years in the development of a National Prescribing Safety Assessment. This is a joint initiative by the Medical Schools Council and the British Pharmacological Society involving the United Kingdom’s leading experts in prescribing, clinical pharmacology and medical assessment. It is intended to enhance patient safety by ensuring that all new graduates entering the first year of Foundation training have achieved a basic standard of practice.</p><p> </p><p> </p><p> </p><p>It is the Nursing and Midwifery Council’s (NMC) role to ensure that nurse and midwife prescribers provide an appropriate level of treatment and care for their patients. The NMC does this by setting standards to ensure that nurses and midwives are competent to prescribe drugs, and by making sure that their knowledge and skills in prescribing remain up-to-date.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman grouped question UIN 213307 question first answered 07/11/2014 14:48:22 answering member 4020 label Biography information for George Freeman
tabling member	4056 label Biography information for Nic Dakin

105984

registered interest
date	03/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pneumococcal Disease
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what proportion of people have records contained in the General Practice Research Database; how many patients whose records are in the Database have at least one record of pneumococcal disease (a) in total and (b) in the last year for which figures are available; and if he will make a statement.
tabling member constituency	Coventry South
tabling member printed	Mr Jim Cunningham
uin	213015
answer	answer is ministerial correction date of answer 06/11/2014 answer text <p>The main primary care database held by the Clinical Practice Research Datalink (CPRD) is known as CPRD GOLD (formerly known as the General Practice Research Database, or GPRD). CPRD GOLD contains the anonymised, longitudinal medical records of patients registered with contributing primary care practices across the United Kingdom.</p><p> </p><p> </p><p> </p><p>The CPRD GOLD database covers approximately 8.8% of the UK population, including practices in England, Northern Ireland, Scotland and Wales. As of September 2014 there were 684 general practitioner (GP) practices and 13.58 million acceptable (research quality) patients in GOLD, of which 5.69 million are active (still alive and registered with the GP practice). Data has been collected from GP practices since 1987.</p><p> </p><p> </p><p> </p><p>A review of the CPRD GOLD database has identified the a total of 15,248 acceptable (research quality) patients with at least one record of pneumococcal disease in CPRD GOLD over the period 1 January 1987 to 30 September 2014 during their up-to-standard registration period. Of these patients, 14,150 had at least one record of pneumococcal pneumonia and 491 patients had at least one record of pneumococcal meningitis.</p><p> </p><p> </p><p> </p><p>Over the period 1 October 2013 to 30 September 2014, there were a total of 473 acceptable (research quality) patients with at least one record of pneumococcal disease during their up-to-standard registration period. Of these patients; 445 had a record of pneumococcal pneumonia and 14 had at least one record of pneumococcal meningitis.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 06/11/2014 13:15:07 answering member 4020 label Biography information for George Freeman
tabling member	308 label Biography information for Mr Jim Cunningham