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388431

registered interest
date	08/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS England
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what specific role NHS England has in supporting Clinical Commissioning Groups; and what plans, if any, they have to change this role.
tabling member printed	Lord Morris of Aberavon
uin	HL1206
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Clinical commissioning groups (CCGs) commission the majority of NHS services in England. As such, NHS England is responsible for ensuring that every CCG can access excellent affordable commissioning support services. Its principal vehicles for delivering this are through the Lead Provider Framework for commissioning support which enables CCGs to draw down a range of support services from nine high quality providers and through the oversight of NHS Commissioning Support Units, which NHS England hosts.</p><p> </p><p><strong> </strong></p><p> </p><p>NHS England also has a statutory duty to produce commissioning guidance, which CCGs must have regard to, and continues to promote good commissioning through its CCG assurance framework.</p><p> </p><p> </p><p> </p><p>NHS England continues to review its support of CCGs to ensure they are well supported organisations. There are no immediate plans to change this offer.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 14/07/2015 15:29:44 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	565 label Biography information for Lord Morris of Aberavon

387717

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Monitor: Employment Agencies
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many agency staff Monitor has used since 2010; and at what cost.
tabling member printed	Lord Hunt of Kings Heath
uin	HL1094
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Monitor use agency staff to temporarily fill administrative and clerical roles according to the business needs of the organisation, providing cover for vacancy, holiday and sickness.</p><p> </p><p> </p><p> </p><p>The table below shows Monitor’s approximate average headcount for agency staff between 2010-11 and 2014-15. The total cost over this period was £1.564 million including VAT.</p><p> </p><p> </p><p> </p><p>To note, there is some discrepancy in the data as collection methodology changed in 2011, when it started to be collected monthly.</p><p> </p><p> </p><p> </p><p>Figures for headcount and spend on agency staff:</p><p> </p><p> </p><p> </p><table><tbody><tr><td> </td><td><p>Average Headcount</p></td><td><p>Cost, £000 incl VAT</p></td></tr><tr><td><p>2010-11</p></td><td><p>5.5</p></td><td><p>160**</p></td></tr><tr><td><p>2011-12</p></td><td><p>8</p></td><td><p>235**</p></td></tr><tr><td><p>2012-13</p></td><td><p>13</p></td><td><p>385*</p></td></tr><tr><td><p>2013-14</p></td><td><p>12.5</p></td><td><p>418</p></td></tr><tr><td><p>2014-15</p></td><td><p>10.5</p></td><td><p>366</p></td></tr><tr><td> </td><td> </td><td> </td></tr><tr><td><p>Sum</p></td><td><p>50</p></td><td><p>1,564</p></td></tr><tr><td><p>Average</p></td><td><p>10</p></td><td><p>313</p></td></tr></tbody></table><p> </p><p>* Extrapolation of full year position from incomplete data</p><p> </p><p>** Extrapolation based on trends</p><p> </p> answering member printed Lord Prior of Brampton question first answered 14/07/2015 15:28:39 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

387206

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Vitamin B12
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they plan to replace the current test for human vitamin B12 status with the Active B12 (holotranscobalamin) test; and if not, why not.
tabling member printed	The Countess of Mar
uin	HL1042
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1032 HL1033 HL1034 HL1035 HL1036 question first answered 14/07/2015 15:00:42 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BSCH Guidance
tabling member	1861 label Biography information for The Countess of Mar

387208

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Congenital Abnormalities
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government when they expect the population of England to be covered by the National Congenital Anomaly and Rare Disease Registration Service.
tabling member printed	Lord Rooker
uin	HL1044
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The current plan for expansion of the Congenital Anomalies and Rare Disease Registration Service aims to achieve national coverage by April 2016, subject to review in the context of the forthcoming spending review.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 14/07/2015 15:30:01 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

387225

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mental Health Services: Ethnic Groups
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 level of mental health resources and support currently available to young people from Black, Asian and Minority Ethnic backgrounds.
tabling member printed	Baroness Lawrence of Clarendon
uin	HL1061
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The Department has not made an assessment of the level of mental health resources and support currently available to young people from Black, Asian and Minority Ethnic backgrounds. Commissioners and providers of NHS services are required to ensure that the services they commission or provide operate in such a way to meet the needs of diverse groups, including people from Black and Minority Ethnic communities.</p><p> </p><p> </p><p> </p><p>The Children and Young People’s Mental Health and Wellbeing Taskforce considered the mental health needs of all children and young people. As part of this work, a specific group was set up to look at the needs of vulnerable groups and inequalities. A report from this group was published alongside the <em>Future in mind</em> report.</p><p> </p><p> </p><p> </p><p>The Department is commissioning a new prevalence survey for children and young people’s mental health. We anticipate that the new survey will report on ethnicity, which would provide us with more up-to-date information on the mental health needs of children and young people from Black and Minority Ethnic groups.</p><p> </p><p> </p><p> </p><p>Difficulties may arise preventing access to mental health services by members of some communities due to the stigma attached to mental illness among those communities. We believe that Time to Change, a joint anti-stigma campaign led by Mind and Rethink, is addressing this issue and we are considering how best to help.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1064 question first answered 14/07/2015 15:22:56 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	4290 label Biography information for Baroness Lawrence of Clarendon

387226

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mental Health Services: Ethnic Groups
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they intend to make additional resources available to mental health services in Black, Asian and Minority Ethnic communities, and if so, what resources they will make available.
tabling member printed	Baroness Lawrence of Clarendon
uin	HL1062
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Everyone should be able to access mental health services according to need. However, we know that there are inequalities in the access to mental health services. For example, older adults, men, Black, Asian and Minority Ethnic (BAME) communities and those who are Deaf are not accessing services in the numbers predicted by prevalence studies. The National Health Service is leading on work on equality of access. We are listening to people with experience of mental health within BAME communities and continuing to make the changes needed to ensure equality throughout mental health services.</p><p> </p><p> </p><p> </p><p>There are no plans to make additional resources available for mental health services in BAME communities. However, planning requirements for 2015-2016 require clinical commissioning groups to invest additionally in mental health in line with the growth in their overall funding allocation, which should benefit all communities.</p><p> </p><p> </p><p> </p><p>In July 2014, the Joint Commissioning Panel for Mental Health published guidance for commissioners of mental health services for those from black and minority ethnic communities which is attached and can be found at the following link:</p><p> </p><p> </p><p> </p><p><a href="http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf" target="_blank">http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf</a></p><p> </p><p> </p><p> </p><p>The Department has been working with NHS England and commissioners to disseminate this guidance which describes what ‘good’ mental health services for people from BAME communities look like.</p><p> </p><p> </p><p> </p><p>One of the key priorities of the work in updating the <em>Mental Health Act 1983 Code of Practice</em>, which was published in January 2015, was to eliminate discrimination, including for people from BAME communities. The Department’s published Equality Analysis <em>Equality for all: Mental Health Act 1983: Code of Practice</em> sets out a range of additional guidance that has been included aiming to address concerns raised by BAME stakeholders and others.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1063 HL1065 question first answered 14/07/2015 15:27:38 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Joint Commissioning Panel for Mental Health BME Guidance.pdf title Joint Commissioning Panel - Mental Health guidance
tabling member	4290 label Biography information for Baroness Lawrence of Clarendon

387227

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mental Health Services: Ethnic Groups
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of early intervention and preventative mental health services and the extent to which these are used by Black, Asian and Minority Ethnic communities.
tabling member printed	Baroness Lawrence of Clarendon
uin	HL1063
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Everyone should be able to access mental health services according to need. However, we know that there are inequalities in the access to mental health services. For example, older adults, men, Black, Asian and Minority Ethnic (BAME) communities and those who are Deaf are not accessing services in the numbers predicted by prevalence studies. The National Health Service is leading on work on equality of access. We are listening to people with experience of mental health within BAME communities and continuing to make the changes needed to ensure equality throughout mental health services.</p><p> </p><p> </p><p> </p><p>There are no plans to make additional resources available for mental health services in BAME communities. However, planning requirements for 2015-2016 require clinical commissioning groups to invest additionally in mental health in line with the growth in their overall funding allocation, which should benefit all communities.</p><p> </p><p> </p><p> </p><p>In July 2014, the Joint Commissioning Panel for Mental Health published guidance for commissioners of mental health services for those from black and minority ethnic communities which is attached and can be found at the following link:</p><p> </p><p> </p><p> </p><p><a href="http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf" target="_blank">http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf</a></p><p> </p><p> </p><p> </p><p>The Department has been working with NHS England and commissioners to disseminate this guidance which describes what ‘good’ mental health services for people from BAME communities look like.</p><p> </p><p> </p><p> </p><p>One of the key priorities of the work in updating the <em>Mental Health Act 1983 Code of Practice</em>, which was published in January 2015, was to eliminate discrimination, including for people from BAME communities. The Department’s published Equality Analysis <em>Equality for all: Mental Health Act 1983: Code of Practice</em> sets out a range of additional guidance that has been included aiming to address concerns raised by BAME stakeholders and others.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1062 HL1065 question first answered 14/07/2015 15:27:38 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Joint Commissioning Panel for Mental Health BME Guidance.pdf title Joint Commissioning Panel - Mental Health guidance
tabling member	4290 label Biography information for Baroness Lawrence of Clarendon

387228

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mental Health Services: Ethnic Groups
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what efforts they are making to address the lack of access to mental health services for young people from Black, Asian and Minority Ethnic communities.
tabling member printed	Baroness Lawrence of Clarendon
uin	HL1064
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The Department has not made an assessment of the level of mental health resources and support currently available to young people from Black, Asian and Minority Ethnic backgrounds. Commissioners and providers of NHS services are required to ensure that the services they commission or provide operate in such a way to meet the needs of diverse groups, including people from Black and Minority Ethnic communities.</p><p> </p><p> </p><p> </p><p>The Children and Young People’s Mental Health and Wellbeing Taskforce considered the mental health needs of all children and young people. As part of this work, a specific group was set up to look at the needs of vulnerable groups and inequalities. A report from this group was published alongside the <em>Future in mind</em> report.</p><p> </p><p> </p><p> </p><p>The Department is commissioning a new prevalence survey for children and young people’s mental health. We anticipate that the new survey will report on ethnicity, which would provide us with more up-to-date information on the mental health needs of children and young people from Black and Minority Ethnic groups.</p><p> </p><p> </p><p> </p><p>Difficulties may arise preventing access to mental health services by members of some communities due to the stigma attached to mental illness among those communities. We believe that Time to Change, a joint anti-stigma campaign led by Mind and Rethink, is addressing this issue and we are considering how best to help.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1061 question first answered 14/07/2015 15:22:56 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	4290 label Biography information for Baroness Lawrence of Clarendon

387229

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mental Health Services: Ethnic Groups
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, following the Ethnic Inequality and Mental Health Consultation by Lankelly Chase Foundation, what efforts they are making to address the dissatisfaction felt within the Black, Asian and Minority Ethnic mental health sector with the Government's lack of commitment to address ethnic inequalities in mental health.
tabling member printed	Baroness Lawrence of Clarendon
uin	HL1065
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Everyone should be able to access mental health services according to need. However, we know that there are inequalities in the access to mental health services. For example, older adults, men, Black, Asian and Minority Ethnic (BAME) communities and those who are Deaf are not accessing services in the numbers predicted by prevalence studies. The National Health Service is leading on work on equality of access. We are listening to people with experience of mental health within BAME communities and continuing to make the changes needed to ensure equality throughout mental health services.</p><p> </p><p> </p><p> </p><p>There are no plans to make additional resources available for mental health services in BAME communities. However, planning requirements for 2015-2016 require clinical commissioning groups to invest additionally in mental health in line with the growth in their overall funding allocation, which should benefit all communities.</p><p> </p><p> </p><p> </p><p>In July 2014, the Joint Commissioning Panel for Mental Health published guidance for commissioners of mental health services for those from black and minority ethnic communities which is attached and can be found at the following link:</p><p> </p><p> </p><p> </p><p><a href="http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf" target="_blank">http://www.jcpmh.info/wp-content/uploads/jcpmh-bme-guide.pdf</a></p><p> </p><p> </p><p> </p><p>The Department has been working with NHS England and commissioners to disseminate this guidance which describes what ‘good’ mental health services for people from BAME communities look like.</p><p> </p><p> </p><p> </p><p>One of the key priorities of the work in updating the <em>Mental Health Act 1983 Code of Practice</em>, which was published in January 2015, was to eliminate discrimination, including for people from BAME communities. The Department’s published Equality Analysis <em>Equality for all: Mental Health Act 1983: Code of Practice</em> sets out a range of additional guidance that has been included aiming to address concerns raised by BAME stakeholders and others.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1062 HL1063 question first answered 14/07/2015 15:27:38 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Joint Commissioning Panel for Mental Health BME Guidance.pdf title Joint Commissioning Panel - Mental Health guidance
tabling member	4290 label Biography information for Baroness Lawrence of Clarendon

386886

registered interest
date	01/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Amyloidosis and Multiple Myeloma
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they will place in the Library of the House any publications resulting from the phase 3 clinical trials approved for the potential treatment of systemic amyloidosis or multiple myeloma; and what is the National Institute of Health Research’s assessment of progress in these areas.
tabling member printed	Lord Willis of Knaresborough
uin	HL995
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>There are four trials for systemic amyloidosis that are designated as ‘ongoing’ in the United Kingdom. These are being conducted by two commercial sponsors, Millennium Pharmaceuticals Inc and A.T. Development Switzerland Sarl (two studies), and one non-commercial sponsor, European Myeloma Network.</p><p> </p><p> </p><p> </p><p>Clinical trial sponsors are required to publish a summary of their trial results to the EU Clinical Trials Register within one year of their trial completing. At that point, these results will become publically available on the EU Clinical Trials Register</p><p> </p><p> </p><p> </p><p>The Department of Health, which funds the National Institute for Health Research (NIHR), is a member of the National Cancer Research Institute (NCRI). NCRI Clinical Studies Groups (CSGs) bring together clinicians, scientists, statisticians and lay representatives to coordinate development of a strategic portfolio of trials within their field. All CSGs interact with clinical research networks, funders (including NIHR) and researchers to develop studies aimed at improving outcomes for patients. The Haematological Oncology CSG has a Myeloma Subgroup and its 2013-14 annual report that includes an assessment of progress in these areas is attached and available on the NCRI website at:</p><p> </p><p><a href="http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf" target="_blank">http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf</a>.</p><p> </p><p> </p><p> </p><p>We cannot comment on commercial considerations. When the results are known, the commercial potential of these trial’s products will be a matter for the respective trial sponsors.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL996 HL997 question first answered 14/07/2015 15:34:29 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf title 2013-14 Annual Report
tabling member	4151 label Biography information for Lord Willis of Knaresborough