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1012115

registered interest
date	21/11/2018
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	Prosthetics
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many amputee sockets the NHS fitted in (1) 2013, (2) 2014, (3) 2015, (4) 2016, and (5) 2017; and in each year, what was the cost of casting and fitting these.
tabling member printed	Baroness Hodgson of Abinger
uin	HL11642
answer	answer is ministerial correction date of answer 29/11/2018 answer text <p>This information is not collected centrally.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL11643 HL11644 HL11645 HL11646 HL11647 question first answered 29/11/2018 17:13:01 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

990146

registered interest
date	17/10/2018
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	Multiple Births
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they plan to update the guidance by NHS England Saving Babies’ Lives Care Bundle to include advice on how to reduce poor outcomes in multiple pregnancies; and if not, why not.
tabling member printed	Baroness Hodgson of Abinger
uin	HL10768
answer	answer is ministerial correction date of answer 29/10/2018 answer text <p>The Saving Babies’ Lives Care Bundle is undergoing review by an oversight group consisting of nationally recognised experts, including representatives of the Royal College of Obstetricians and Gynaecologists and the British Maternal and Fetal Medicine Society. Upon completion of the review, and subject to necessary approvals, NHS England aims to publish an updated version of the Care Bundle.</p><p>There are no plans to include a new, specific element relating to multiple pregnancies in the updated version of the Care Bundle. Guidance relating to the management of multiple pregnancies is currently available from the National Institute for Health and Care Excellence (NICE). The Twins and Multiple Births Association has promoted the widespread adoption of this guidance. The oversight group concluded that inclusion of an additional element specifically focusing on multiple pregnancies would and add little benefit beyond compliance with NICE guidance.</p> answering member printed Lord O'Shaughnessy question first answered 29/10/2018 14:53:33 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

990147

registered interest
date	17/10/2018
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	Multiple Births
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they plan to support a randomised control trial of the different growth charts used across England to monitor twin pregnancies in order to understand better how effective they are in preventing poor outcomes.
tabling member printed	Baroness Hodgson of Abinger
uin	HL10769
answer	answer is ministerial correction date of answer 29/10/2018 answer text <p>The Department is aware of the Twins and Multiple Births Association’s launch in July last year of growth charts specifically designed to monitor twin pregnancies.</p><p>The Department’s National Institute for Health Research welcomes funding applications for research into any aspect of human health, including pregnancy. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.</p> answering member printed Lord O'Shaughnessy question first answered 29/10/2018 14:55:46 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

990148

registered interest
date	17/10/2018
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	Multiple Births
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether the Avoiding Term Admissions Into Neonatal units programme has been successful in reducing neonatal admissions in twin pregnancies.
tabling member printed	Baroness Hodgson of Abinger
uin	HL10770
answer	answer is ministerial correction date of answer 29/10/2018 answer text <p>NHS England collects neonatal unit admission data. However, this data cannot be disaggregated to identify admissions of twins.</p> answering member printed Lord O'Shaughnessy question first answered 29/10/2018 14:56:04 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

990150

registered interest
date	17/10/2018
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: Negligence
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how much they spent in each of the last five years on clinical negligence pay-outs; and what proportion of the NHS budget this equates to.
tabling member printed	Baroness Hodgson of Abinger
uin	HL10772
answer	answer is ministerial correction date of answer 29/10/2018 answer text <p>The following table shows total Government spending on clinical negligence pay-outs managed through the Clinical Negligence Scheme for Trusts (CNST) and NHS England total funding for the past five financial years. Government spending on clinical negligence pay-outs for CNST in the last five financial years has accounted for between 1.1% and 1.9% of the total funding provided to NHS England during the same period.</p><p>The rising costs of clinical negligence are a major concern and something the Government is committed to tackling, given that National Health Service resources used on clinical negligence are not available for front-line care. Building on the National Audit Office (NAO) report <em>Managing the costs of clinical negligence in trusts</em>, published in September 2017, we have been working intensively across Government and expect to set out more detail on the way forward in due course. The NAO report set out key recommendations for NHS Resolution to promote better and more consistent data, develop greater insight on the causes of clinical negligence claims and work more closely with legal services regulators. A copy of the report is attached.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Financial Year</p></td><td><p>Government spending on CNST clinical negligence pay-outs (£ billion)</p></td><td><p>NHS England total funding (cash) (£ billion)</p></td><td><p>Government spending on CNST clinical negligence pay-outs as a proportion of NHS England total funding</p></td></tr><tr><td><p>2013-14</p></td><td><p>1.1</p></td><td><p>93.9</p></td><td><p>1.2%</p></td></tr><tr><td><p>2014-15</p></td><td><p>1.1</p></td><td><p>97.3</p></td><td><p>1.1%</p></td></tr><tr><td><p>2015-16</p></td><td><p>1.4</p></td><td><p>100.5</p></td><td><p>1.4%</p></td></tr><tr><td><p>2016-17</p></td><td><p>1.6</p></td><td><p>106.0</p></td><td><p>1.5%</p></td></tr><tr><td><p>2017-18</p></td><td><p>2.1</p></td><td><p>109.8</p></td><td><p>1.9%</p></td></tr></tbody></table><p> </p><p>Notes:</p><ol><li>The NHS England total funding figures represent the total amount of funding provided to NHS England through the mandate each year.</li><li>The Government spending figures only cover spending specifically attributed to clinical negligence, principally pay-outs pertaining to CNST as managed by NHS Resolution plus associated administration costs. They do not include any unrecorded costs, for example staff employed by trusts to deal with claims. The figures do not include the cost of clinical negligence claims in primary care as primary care funding includes an unspecified element for indemnity premia.</li><li>The Government spending figure for 2017-18 includes the cost of additional funding to cover the change to the Personal Injury Discount Rate in February 2017 from 2.5% to -0.75%.</li><li>The figures do not include clinical negligence pay-outs relating to Department-funded indemnity schemes in respect of legacy bodies such as primary care trusts and Regional Health Authorities.</li></ol> answering member printed Lord O'Shaughnessy question first answered 29/10/2018 15:28:04 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name NAO 11531-001 Clinical negligence report as published.pdf title Managing the costs of clinical negligence
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

990151

registered interest
date	17/10/2018
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: Negligence
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether any funds are ring-fenced within the NHS budget to pay for clinical negligence; and if so, what amount is allocated for such funding.
tabling member printed	Baroness Hodgson of Abinger
uin	HL10773
answer	answer is ministerial correction date of answer 29/10/2018 answer text <p>Clinical negligence costs for the National Health Service are funded in the vast majority of cases through contributions to NHS Resolution from NHS bodies that are members of its risk pooling schemes. A small number of historical claims relating to incidents before 1995 and claims against former NHS bodies receive central funding from the Department. Neither the risk pooling schemes nor the Department’s coverage of historical claims are subject to ring-fencing. NHS Resolution is collecting £1,984 million from NHS bodies in 2018/19 for settling and administering claims for the Clinical Negligence Scheme for Trusts, the largest of NHS Resolution’s risk pooling schemes.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 29/10/2018 14:56:52 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

967468

registered interest
date	04/09/2018
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	Postnatal Depression
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 23 July (HL9378), what steps they intend to take to address the under-diagnosis of maternal mental illness and, in particular, to ensure that those suffering from post-natal depression are diagnosed and able to access treatment.
tabling member printed	Baroness Hodgson of Abinger
uin	HL9962
answer	answer is ministerial correction date of answer 17/09/2018 answer text <p>This Government is committed to improving perinatal mental health services for women during pregnancy and in the first postnatal year, so that women are able to access the right care at the right time and close to home. The Department is investing £365 million from 2015/16 to 2020/21 in perinatal mental health services and NHS England is leading a transformation programme to ensure that, by 2020/21, at least 30,000 more women each year are able to access evidence-based specialist mental health care during the perinatal period.</p><p>A key aim of this transformation programme is to take a preventative approach wherever possible, including: earlier diagnosis and intervention; support for recovery; and reducing avoidable harm.</p><p>To drive forward change, NHS England is also investing in multidisciplinary perinatal mental health clinical networks across the country, which includes general practitioners as part of the networks. These clinical networks focus on collaborative working to develop local, integrated pathways and to support early identification of those at risk of mental illness in the perinatal period, to enable better outcomes for women in all communities.</p><p>Looking ahead, we are continuing to work with the National Health Service to develop a 10 year plan for the future of the health service, underpinned by a five-year funding offer which will see the NHS budget grow by over £20 billion a year in real terms by 2023-24. The NHS will work closely with Government to produce the plan, which will set out how the money will be used to deliver our vision for the health service and to ensure every penny is well spent.</p><p>The plan will be published later this year. Better access to mental health services is one of the priorities to help achieve the Government’s commitment for parity of esteem between mental and physical health. This will be a significant step forward towards improving, and continuing to deliver, high-quality mental health support services.</p> answering member printed Lord O'Shaughnessy question first answered 17/09/2018 13:51:53 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

967469

registered interest
date	04/09/2018
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	Health Visitors
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many visits from a health visitor a new mother in England should receive in the three months after giving birth; what is the length of each visit; and how these visits are monitored.
tabling member printed	Baroness Hodgson of Abinger
uin	HL9963
answer	answer is ministerial correction date of answer 17/09/2018 answer text <p>Health visitors undertake five mandated visits between the ages of zero to five. Three of these mandated visits occur during the first three months after birth which are the antenatal health visit, new baby review and six to eight-week assessment. The length of each visit will be entirely dependent on the individual needs of the mother and baby. Some families will require additional visits and support, the health visitor will use their professional judgement and public health expertise to determine need and support. Local authorities are responsible for commissioning health visiting services, local monitoring of service delivery and commissioning compliance should be undertaken locally as part of contract management.</p> answering member printed Lord O'Shaughnessy question first answered 17/09/2018 13:56:16 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

967470

registered interest
date	04/09/2018
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	Health Visitors
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what training health visitors receive to enable them to identify incipient and actual cases of ante-natal depression, post-natal depression, and other maternal mental health issues.
tabling member printed	Baroness Hodgson of Abinger
uin	HL9964
answer	answer is ministerial correction date of answer 17/09/2018 answer text <p>Health visitors are part of the nursing profession and regulated by the Nursing and Midwifery Council (NMC). Health visitors are qualified and registered nurses or midwives who have undertaken an approved training programme in Specialist Community Public Health Nursing - Health Visiting.</p><p>The NMC has the general function of promoting high standards of education and coordinating all stages of education to ensure that health visitors are equipped with the knowledge, skills and attitudes essential for professional practice, including continuous professional development (CPD). The NMC set the standards of education and training for the nursing profession expected at undergraduate and postgraduate level and approve curricula set by individual higher education institutes. In so doing, they set out the knowledge, skills and behaviours that both postgraduate and undergraduate nurses must be able to demonstrate.</p><p>CPD is a term used to describe a number of different training and development activities which may be required for the purposes of professional practice in the National Health Service. The NMC requires 35 hours of CPD relevant to scope of practice in the three year period since registration was last renewed, or joining the register.</p><p>The NMC are in the process of rewriting their standards. For example, in the new pre-registration nursing standards the NMC specify that registrants must have proficiencies in identifying risk and vulnerability, in all settings and across the lifespan and would expect post-natal depression to be included in the curriculum.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL9965 question first answered 17/09/2018 13:50:13 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger

967472

registered interest
date	04/09/2018
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	Health Visitors
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what continuous professional development health visitors are required to undertake to enable them to identify incipient and actual cases of ante-natal depression, post-natal depression, and other maternal mental health issues.
tabling member printed	Baroness Hodgson of Abinger
uin	HL9965
answer	answer is ministerial correction date of answer 17/09/2018 answer text <p>Health visitors are part of the nursing profession and regulated by the Nursing and Midwifery Council (NMC). Health visitors are qualified and registered nurses or midwives who have undertaken an approved training programme in Specialist Community Public Health Nursing - Health Visiting.</p><p>The NMC has the general function of promoting high standards of education and coordinating all stages of education to ensure that health visitors are equipped with the knowledge, skills and attitudes essential for professional practice, including continuous professional development (CPD). The NMC set the standards of education and training for the nursing profession expected at undergraduate and postgraduate level and approve curricula set by individual higher education institutes. In so doing, they set out the knowledge, skills and behaviours that both postgraduate and undergraduate nurses must be able to demonstrate.</p><p>CPD is a term used to describe a number of different training and development activities which may be required for the purposes of professional practice in the National Health Service. The NMC requires 35 hours of CPD relevant to scope of practice in the three year period since registration was last renewed, or joining the register.</p><p>The NMC are in the process of rewriting their standards. For example, in the new pre-registration nursing standards the NMC specify that registrants must have proficiencies in identifying risk and vulnerability, in all settings and across the lifespan and would expect post-natal depression to be included in the curriculum.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL9964 question first answered 17/09/2018 13:50:13 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4301 label Biography information for Baroness Hodgson of Abinger