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173563

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Lyme Disease
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 rate and extent of the spread of Lyme disease in (1) the United Kingdom, (2) other parts of the European Union, and (3) other parts of the world.
tabling member printed	Lord Greaves
uin	HL4123
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>Public Health England monitors laboratory-confirmed Lyme disease (also known as Lyme borreliosis) in England and Wales, devolved administrations of Scotland and Northern Ireland have separate local arrangements in place.</p><p> </p><p> </p><p> </p><p>The rate of laboratory-confirmed Lyme borreliosis and its regional distribution in England and Wales has not changed significantly in recent years, data for 2013 will be published shortly.</p><p> </p><p> </p><p> </p><p>Assessment of Lyme borreliosis in other European Union (EU) countries is co-ordinated by the European Centre for Disease Prevention and Control (ECDC). Reporting systems and criteria are not standardised throughout EU countries and this data is not routinely collected by ECDC. Therefore as an assessment of Lyme borreliosis using routinely collected data across the EU is not available.</p><p> </p><p> </p><p> </p><p>Reporting of Lyme borreliosis worldwide is co-ordinated by the World Health Organization (WHO) based on the heterogeneous reporting systems and criteria adopted by individual countries.</p><p> </p> answering member printed Earl Howe question first answered 26/01/2015 13:01:20 answering member 2000 label Biography information for Earl Howe
tabling member	2569 label Biography information for Lord Greaves

173564

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Lyme Disease
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what is the recorded number of occurrences of Lyme disease in the United Kingdom in each of the past 10 years; whether they have estimated the extent of under-reporting; and what assessment they have made of the number of cases of Lyme disease in (1) the United States, and (2) other member countries of the European Union, in the latest year for which they have information.
tabling member printed	Lord Greaves
uin	HL4124
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>The recorded number of occurrences of Lyme disease in the United Kingdom from 2004-2012 is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Year of report</p></td><td><p>2004</p></td><td><p>2005</p></td><td><p>2006</p></td><td><p>2007</p></td><td><p>2008</p></td><td><p>2009</p></td><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td></tr><tr><td><p> </p><p>Lyme disease cases in UK</p><p> </p></td><td><p>586</p></td><td><p>693</p></td><td><p>940</p></td><td><p>1,027</p></td><td><p>1,098</p></td><td><p>1,093</p></td><td><p>1,213</p></td><td><p>1,189</p></td><td><p>1,163</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p>Data from 2013 is not currently available.</p><p> </p><p> </p><p> </p><p>It is estimated that between 1,000 and 2,000 additional cases of Lyme disease may occur each year in England and Wales.</p><p> </p><p> </p><p> </p><p>The recorded number of occurrences of Lyme disease in the United States in each of the past 10 years is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p> </p></td><td><p>2004</p></td><td><p>2005</p></td><td><p>2006</p></td><td><p>2007</p></td><td><p>2008</p></td><td><p>2009</p></td><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td><td><p>2013</p></td></tr><tr><td><p>TOTAL USA</p></td><td><p>19,804</p></td><td><p>23,305</p></td><td><p>19,931</p></td><td><p>27,444</p></td><td><p>28,921</p></td><td><p>29,959</p></td><td><p>22,561</p></td><td><p>24,364</p></td><td><p>22,014</p></td><td><p>27,203</p></td></tr></tbody></table><p> </p><p><em>Source:</em> CDC <a href="http://www.cdc.gov/lyme/stats/index.html" target="_blank">http://www.cdc.gov/lyme/stats/index.html</a></p><p> </p><p> </p><p> </p><p><em>Notes:</em></p><p> </p><p>The recorded number of occurrences of Lyme disease are not systematically reported. A paper in 2009 provided an estimate of 65,000 cases (Hubalek 2009 <a href="http://www.ncbi.nlm.nih.gov/pubmed/19367096" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/19367096</a>)</p><p> </p><p> </p><p> </p><p>Data on the number of occurrences of Lyme disease in other European Union member states is not held.</p><p> </p> answering member printed Earl Howe question first answered 26/01/2015 15:02:12 answering member 2000 label Biography information for Earl Howe
tabling member	2569 label Biography information for Lord Greaves

173565

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Lyme Disease
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what information, advice and training is provided to doctors and nurses on the symptoms and treatment of Lyme disease; what advice is provided to general practitioners on the reference to specialists of patients exhibiting symptoms of Lyme disease; and which centres provide specialist treatment for that disease.
tabling member printed	Lord Greaves
uin	HL4125
answer	answer is ministerial correction date of answer 28/01/2015 answer text <p>Public Health England (PHE) and the National Health Service have detailed information on the recognition, diagnosis, treatment and management of Lyme disease. PHE has also written a guide on how to refer patients for specialist advice, which is attached. The National Institute for Health and Care Excellence also has an online guide for general practitioners (GP) and other health professionals.</p><p> </p><p> </p><p> </p><p>PHE issues a letter to all GPs on an annual basis at the beginning of the tick season describing Lyme disease and highlighting the need to be aware and to recognise the condition. The majority of cases are managed by GPs without reference to specialists, but problem cases can be referred to neurology, rheumatology, cardiology and infectious disease clinics depending on the local provision and of services and patient’s symptoms. In addition to the attached guidance, <em>Suggested referral pathway for patients with symptoms related to Lyme disease</em>, PHE offers a telephone helpline for GPs and consultants to discuss particular cases. PHE works closely with the patient group Lyme Disease Action, who will also represent individuals who have trouble obtaining specialist advice, and can thus help in suggesting potential routes of referral.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> answering member printed Baroness Jolly question first answered 28/01/2015 14:04:57 answering member 4203 label Biography information for Baroness Jolly attachment 1 file name Lyme disease referral pathway Jan 2015.pdf title Lyme Disease Referral Pathway
tabling member	2569 label Biography information for Lord Greaves

173566

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Lyme Disease
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 quality and availability of tests for Lyme disease and related diseases in (1) the United Kingdom, (2) the rest of the European Union, and (3) North America.
tabling member printed	Lord Greaves
uin	HL4126
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>Public Health England (PHE) actively reviews test methodologies for Lyme disease based on peer reviewed reports and on evaluation of possible alternative test kits within the laboratory. As part of this work, staff from the Rare and Imported Pathogens Laboratory (RIPL) have attended international conferences, including those organised by pressure groups proposing alternative testing systems to those used in state laboratories, and met with private and state laboratory service providers in Europe and the United States.</p><p> </p><p> </p><p> </p><p>RIPL offers a telephone advice line to clinicians with problem cases, and also works with the patient charity Lyme Disease Action to address the needs of individual patients. RIPL also participates in a European external quality assessment programme, and cross-compares results with Raigmore Hospital in Scotland.</p><p> </p><p> </p><p> </p><p>All diagnostic tests for infectious diseases are less sensitive in the very early stages of disease, and the results of a laboratory test have to be interpreted in this light and in conjunction with the patient’s presentation. Whilst the current tests are not perfect, none of the alternatives have yet proven superior to accepted methodologies. Any novel methods to test for Lyme disease are kept under review.</p><p> </p> answering member printed Earl Howe question first answered 26/01/2015 15:07:51 answering member 2000 label Biography information for Earl Howe
tabling member	2569 label Biography information for Lord Greaves

173583

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Podiatry
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what plans they have to ensure that the National Health Service is able to meet any increased need for podiatry services, in the light of the numbers of elderly people and the incidence of diabetes.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4143
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>Foot care services are commissioned locally by clinical commissioning groups (CCGs), working with local partners and are based on the need of the local population, resources available and evidence based practice. These commissioning decisions are informed by the Joint Strategic Needs Assessment and the local Health and Wellbeing Strategy.</p><p> </p><p> </p><p> </p><p>Within NHS England, the National Clinical Director for Rehabilitation and Recovery in the Community and the Chief Allied Health Professions Officer are leading work to improve adult rehabilitation services including collection and dissemination of best practice.</p><p> </p><p> </p><p> </p><p><em>Footcare services for older people</em>, published by the Department in 2009, highlighted five potential models of safe and effective foot care service provision. This includes working in partnership across the health and social care spectrum and may involve training others e.g. within nursing homes or home care agencies to carry out simple foot care. Other models help empower patients to self-care where it is possible and safe to do so.</p><p> </p><p> </p><p> </p><p>National Institute for Health and Care Excellence Clinical Guidelines 119 (on inpatient management of diabetic foot problems) and 10 (on Type 2 diabetes foot problems) offer guidance on best practice for foot care management in diabetes. These guidelines are being updated as one document – <em>Diabetic Foot Problems</em>, which is currently out to consultation.</p><p> </p><p> </p><p> </p><p>It is not possible to distinguish in Hospital Episode Statistics between “major” and “minor” amputations.</p><p> </p><p> </p><p> </p><p>The Health and Social Care Information Centre has calculated the England average rate of amputation per 100,000 population and highlighted the CCGs of residence having rates more than 33% higher than the national average. There are 25 such CCGs which are identified in the attached table. This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p> </p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p> answering member printed Earl Howe grouped question UIN HL4144 HL4145 question first answered 26/01/2015 16:01:01 answering member 2000 label Biography information for Earl Howe attachment 1 file name Counts of Finished Consultant Episodes.xlsx title Counts of Finished Consultant Episodes
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

173584

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Orthopaedics
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government in how many Clinical Commissioning Groups are (1) major, and (2) minor, amputation rates more than 33 per cent above the national average.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4144
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>Foot care services are commissioned locally by clinical commissioning groups (CCGs), working with local partners and are based on the need of the local population, resources available and evidence based practice. These commissioning decisions are informed by the Joint Strategic Needs Assessment and the local Health and Wellbeing Strategy.</p><p> </p><p> </p><p> </p><p>Within NHS England, the National Clinical Director for Rehabilitation and Recovery in the Community and the Chief Allied Health Professions Officer are leading work to improve adult rehabilitation services including collection and dissemination of best practice.</p><p> </p><p> </p><p> </p><p><em>Footcare services for older people</em>, published by the Department in 2009, highlighted five potential models of safe and effective foot care service provision. This includes working in partnership across the health and social care spectrum and may involve training others e.g. within nursing homes or home care agencies to carry out simple foot care. Other models help empower patients to self-care where it is possible and safe to do so.</p><p> </p><p> </p><p> </p><p>National Institute for Health and Care Excellence Clinical Guidelines 119 (on inpatient management of diabetic foot problems) and 10 (on Type 2 diabetes foot problems) offer guidance on best practice for foot care management in diabetes. These guidelines are being updated as one document – <em>Diabetic Foot Problems</em>, which is currently out to consultation.</p><p> </p><p> </p><p> </p><p>It is not possible to distinguish in Hospital Episode Statistics between “major” and “minor” amputations.</p><p> </p><p> </p><p> </p><p>The Health and Social Care Information Centre has calculated the England average rate of amputation per 100,000 population and highlighted the CCGs of residence having rates more than 33% higher than the national average. There are 25 such CCGs which are identified in the attached table. This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p> </p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p> answering member printed Earl Howe grouped question UIN HL4143 HL4145 question first answered 26/01/2015 16:01:01 answering member 2000 label Biography information for Earl Howe attachment 1 file name Counts of Finished Consultant Episodes.xlsx title Counts of Finished Consultant Episodes
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

173585

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Podiatry
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they will issue guidance to the National Health Service on best practice for footcare management.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4145
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>Foot care services are commissioned locally by clinical commissioning groups (CCGs), working with local partners and are based on the need of the local population, resources available and evidence based practice. These commissioning decisions are informed by the Joint Strategic Needs Assessment and the local Health and Wellbeing Strategy.</p><p> </p><p> </p><p> </p><p>Within NHS England, the National Clinical Director for Rehabilitation and Recovery in the Community and the Chief Allied Health Professions Officer are leading work to improve adult rehabilitation services including collection and dissemination of best practice.</p><p> </p><p> </p><p> </p><p><em>Footcare services for older people</em>, published by the Department in 2009, highlighted five potential models of safe and effective foot care service provision. This includes working in partnership across the health and social care spectrum and may involve training others e.g. within nursing homes or home care agencies to carry out simple foot care. Other models help empower patients to self-care where it is possible and safe to do so.</p><p> </p><p> </p><p> </p><p>National Institute for Health and Care Excellence Clinical Guidelines 119 (on inpatient management of diabetic foot problems) and 10 (on Type 2 diabetes foot problems) offer guidance on best practice for foot care management in diabetes. These guidelines are being updated as one document – <em>Diabetic Foot Problems</em>, which is currently out to consultation.</p><p> </p><p> </p><p> </p><p>It is not possible to distinguish in Hospital Episode Statistics between “major” and “minor” amputations.</p><p> </p><p> </p><p> </p><p>The Health and Social Care Information Centre has calculated the England average rate of amputation per 100,000 population and highlighted the CCGs of residence having rates more than 33% higher than the national average. There are 25 such CCGs which are identified in the attached table. This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p> </p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p> answering member printed Earl Howe grouped question UIN HL4143 HL4144 question first answered 26/01/2015 16:01:01 answering member 2000 label Biography information for Earl Howe attachment 1 file name Counts of Finished Consultant Episodes.xlsx title Counts of Finished Consultant Episodes
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

173610

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Heroin and Morphine: Death
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 reasons for the 32 per cent rise in the number of deaths from heroin or morphine abuse between 2012 and 2013; and how many of the 765 people who died as a result of heroin or morphine abuse in 2013 had left drug treatment in the month that preceded their death.
tabling member printed	Lord Patel of Bradford
uin	HL4170
answer	answer is ministerial correction date of answer 26/01/2015 answer text <p>At this stage it is not possible to draw any definitive conclusions about a longer-term trend in deaths from one year’s data. Public Health England is currently analysing the data to better understand the reasons for the increase.</p><p> </p> answering member printed Earl Howe question first answered 26/01/2015 15:27:25 answering member 2000 label Biography information for Earl Howe
tabling member	3798 label Biography information for Lord Patel of Bradford

173671

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Medical Records: Databases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, pursuant to the Answer of 2 January 2015 to Question 219648, who the members of the care.data Programme Board are; and (a) by whom and (b) by what process those board members were appointed.
tabling member constituency	Birmingham, Hall Green
tabling member printed	Mr Roger Godsiff
uin	220819
answer	answer is ministerial correction date of answer 19/01/2015 answer text <p>The Programme Board was reconstituted in June 2014 following a Project Validation Review carried out by the Major Project Authority. Programme Board members were formally invited to join by the Senior Responsible Owner, Tim Kelsey, based upon the requirement for a balance of representation from the Department of Health, those arm’s length bodies with involvement in the programme and representation from those involved in the delivery of the programme at a local level.</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>care.data Programme Board member</p></td><td><p>Organisation</p></td></tr><tr><td><p>Eve Roodhouse</p></td><td><p>Health and Social Care Information Centre</p></td></tr><tr><td><p>Andy Williams</p></td><td><p>Health and Social Care Information Centre</p></td></tr><tr><td><p>Tim Kelsey</p></td><td><p>NHS England</p></td></tr><tr><td><p>Dr Geraint Lewis</p></td><td><p>NHS England, Patients and Information</p></td></tr><tr><td><p>Prof John Newton</p></td><td><p>Public Health England</p></td></tr><tr><td><p>Simon Denegri</p></td><td><p>National Institute for Health Research</p></td></tr><tr><td><p>Peter Knight</p></td><td><p>Department of Health</p></td></tr><tr><td><p>Mark Davies</p></td><td><p>Department of Health</p></td></tr><tr><td><p>David Knight</p></td><td><p>Department of Health</p></td></tr><tr><td><p>Tom Ward</p></td><td><p>Care Quality Commission</p></td></tr><tr><td><p>Dr Ian Hudson</p></td><td><p>Medicines and Healthcare products Regulatory Agency</p></td></tr><tr><td><p>Neil Stutchbury</p></td><td><p>Monitor</p></td></tr><tr><td><p>Sir Bruce Keogh</p></td><td><p>NHS England</p></td></tr><tr><td><p>Dr Sarah Schofield</p></td><td><p>West Hampshire clinical commissioning groups</p></td></tr><tr><td><p>Donna Braisby (Secretariat)</p></td><td><p>Health and Social Care Information Centre</p></td></tr></tbody></table><p> </p><p><strong> </strong></p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 19/01/2015 15:24:17 answering member 3932 label Biography information for Dr Dan Poulter
tabling member	304 label Biography information for Mr Roger Godsiff

173673

registered interest
date	14/01/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Medical Records: Databases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, pursuant to the Answer of 2 January 2015 to Question 219648, what criteria will be used by the National Data Guardian to evaluate whether it is right and safe to collect care.data information from GP practices.
tabling member constituency	Birmingham, Hall Green
tabling member printed	Mr Roger Godsiff
uin	220820
answer	answer is ministerial correction date of answer 19/01/2015 answer text <p>In November 2014, my Rt. hon. Friend the Secretary of State announced the establishment of a new National Data Guardian to be the patient’s champion when it comes to the security of personal medical information. Dame Fiona Caldicott will be the first National Guardian and she has agreed that it will be her responsibility to raise concerns publicly about improper data use.</p><p> </p><p> </p><p> </p><p>Dame Fiona Caldicott’s Independent Information Governance Oversight Panel’s report to the care.data Programme was published on 18 December 2014 and is available at:</p><p> </p><p> </p><p> </p><p><a href="https://www.gov.uk/government/publications/iigop-report-on-caredata" target="_blank">https://www.gov.uk/government/publications/iigop-report-on-caredata</a></p><p> </p><p> </p><p> </p><p>The report outlined the evidence of readiness of the Pathfinder stage Dame Fiona would want to see before she would advise on the next stage of Pathfinder stage of the care.data programme.</p><p> </p><p><strong> </strong></p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 19/01/2015 15:36:14 answering member 3932 label Biography information for Dr Dan Poulter
tabling member	304 label Biography information for Mr Roger Godsiff