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418706

	registered interest
	date	14/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	NHS: Temporary Employment
	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 cost to the public purse of employing agency staff to cover staff shortages within the NHS in the last three years for which figures are available.
	tabling member constituency	Sheffield, Heeley
	tabling member printed	Louise Haigh
	uin	10136
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>The information on the cost to the public purse of employing agency staff to cover staff shortages within the National Health Service in the last three years is not held centrally.</p><p> </p> answering member constituency North East Bedfordshire answering member printed Alistair Burt question first answered 22/09/2015 10:03:30 answering member 1201 label Biography information for Alistair Burt
	tabling member	4473 label Biography information for Louise Haigh

418703

	registered interest
	date	14/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Department of Health: Freedom of Information
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many hours his Department spent on processing freedom of information requests in each of the last 24 months.
	tabling member constituency	Aberdeen North
	tabling member printed	Kirsty Blackman
	uin	10225
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>Staff throughout the Department consider requests made under the Freedom of Information Act as part of their duties, and time spent is not accounted for separately. A central team of five full-time staff manages the caseload and gives advice on Freedom of Information Act requests.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 22/09/2015 09:51:10 answering member 3918 label Biography information for Jane Ellison
	tabling member	4357 label Biography information for Kirsty Blackman

418176

	registered interest
	date	10/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Warfarin
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many patients on long-term Warfarin prescriptions now have access to self-monitoring technology; and whether Clinical Commissioning Groups support moves towards further patient self-management.
	tabling member printed	Baroness Gardner of Parkes
	uin	HL2147
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>Information on the number of patients on long-term Warfarin prescriptions who have access to self-monitoring technology is not collected centrally.</p><p> </p><p> </p><p> </p><p>NHS England and clinical commissioning groups (CCGs) have responsibility for commissioned services for patients who receive anticoagulation treatments. It is for individual CCGs to commission treatment and services for patients on anticoagulation treatment or other medications which require monitoring, as they are best placed to identify what is needed in their local areas.</p><p> </p><p> </p><p> </p><p>There is guidance in place to support CCGs in planning services for patients who receive anticoagulation treatments. Under its Diagnostics Assessment Programme, the National Institute for Health and Care Excellence (NICE) has published guidance on self-monitoring of anticoagulation treatments which is attached and also available at:</p><p> </p><p> </p><p> </p><p><a href="http://www.nice.org.uk/guidance/dg14" target="_blank">http://www.nice.org.uk/guidance/dg14</a></p><p> </p><p> </p><p> </p><p>NICE has also published quality standards on the management and treatment of atrial fibrillation which set out that self-monitoring should be offered as an option to appropriate patients. The guidance is also attached and available at:</p><p> </p><p> </p><p> </p><p><a href="http://www.nice.org.uk/guidance/qs93/chapter/Quality-statement-6-developmental-Selfmonitoring-of-anticoagulation" target="_blank">http://www.nice.org.uk/guidance/qs93/chapter/Quality-statement-6-developmental-Selfmonitoring-of-anticoagulation</a></p><p> </p> answering member printed Lord Prior of Brampton attachment 1 file name guidance-atrial-fibrillation-treatment-and-management-pdf.pdf title Atrial Fibrillation Guidance 2 file name NICE CoaguChek XS.pdf title Self monitoring Anticoagulation treatments question first answered 22/09/2015 10:18:58 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	3596 label Biography information for Baroness Gardner of Parkes

418385

	registered interest
	date	11/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Breast Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what assessment they have made of the number of lives that might be saved per annum from licensing bisphosphonates for the treatment of early post-menopausal breast cancer.
	tabling member printed	Lord MacKenzie of Culkein
	uin	HL2179
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>Neither the Department nor NHS England have made an assessment of the number of lives that might be saved per annum from licensing bisphosphonates for the treatment of early post-menopausal breast cancer.</p><p> </p><p> </p><p> </p><p>Doctors can already prescribe a drug outside its licensed indications where they judge it to be the most clinically appropriate treatment for an individual patient.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL2180 question first answered 22/09/2015 10:19:17 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	2507 label Biography information for Lord MacKenzie of Culkein

418386

	registered interest
	date	11/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Breast Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether doctors are free to prescribe bisphosphonates in the treatment of early stage breast cancer despite the fact that it is not presently licensed for that purpose.
	tabling member printed	Lord MacKenzie of Culkein
	uin	HL2180
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>Neither the Department nor NHS England have made an assessment of the number of lives that might be saved per annum from licensing bisphosphonates for the treatment of early post-menopausal breast cancer.</p><p> </p><p> </p><p> </p><p>Doctors can already prescribe a drug outside its licensed indications where they judge it to be the most clinically appropriate treatment for an individual patient.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL2179 question first answered 22/09/2015 10:19:18 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	2507 label Biography information for Lord MacKenzie of Culkein

418387

	registered interest
	date	11/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Breast Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what is the cost to the National Health Service of bisphosphonates and whether they will take steps to encourage the National Institute for Health and Care Excellence to consider the evidence base for the prescription of these drugs in treatment of early stage breast cancer.
	tabling member printed	Lord MacKenzie of Culkein
	uin	HL2181
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>The net ingredient cost of prescription items dispensed in the community in England for bisphosphonates<sup>1</sup> in 2014, was £16.813 million<sup>2</sup>.</p><p> </p><p> </p><p> </p><p>In secondary care, the cost in 2014 was £35.841 million<sup>3</sup>.</p><p> </p><p> </p><p> </p><p>The National Institute for Health and Care Excellence (NICE) has published clinical guidelines on early and locally advanced breast cancer and advanced breast cancer, published in February 2009, and familial breast cancer published in June 2013. NICE periodically reviews its guidance to take account of new and emerging evidence.</p><p> </p><p> </p><p> </p><p>A copy of these clinical guidelines are attached.</p><p> </p><p><em> </em></p><p> </p><p><sup>1 </sup>Bisphosphonates are defined as those included in paragraph 6.6.2 (Bisphosphonates and other drugs affecting bone metabolism) of the British National Formulary (BNF) but excluding denosumab and strontium ranelate.</p><p> </p><p><sup>2 </sup>Source: Prescription Cost Analysis (PCA) provided by the Health and Social Care Information Centre</p><p> </p><p><sup>3 </sup>Source: Hospital Pharmacy Audit Index (HPAI) provided by IMS Health</p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton attachment 1 file name HL2181 Cost ofbisphosphonates to the NHS.doc attachment 1.pdf title Early and locally advanced breast cancer guideline 2 file name HL2181 Cost ofbisphosphonates to the NHS.doc attachment 2.pdf title Advanced breast cancer guidelines 3 file name HL2181 Cost ofbisphosphonates to the NHS.doc attachment 3.pdf title Familial breast cancer guidelines question first answered 22/09/2015 10:20:06 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	2507 label Biography information for Lord MacKenzie of Culkein

418802

	registered interest
	date	15/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	NHS: Fees and Charges
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government when they will introduce National Health Service numbers that differentiate between those who are entitled to the full facilities of the National Health Service without charge and those for whom such services are available on payment.
	tabling member printed	Lord Marlesford
	uin	HL2237
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>National Health Services numbers are a patient safety measure, and do not indicate either entitlement to free NHS care or chargeable status. Changes to the NHS record are being made to enable the NHS to supplement that record with information that will support a decision about whether a patient is chargeable or not when they present for NHS care.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 22/09/2015 10:20:22 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	1854 label Biography information for Lord Marlesford

418803

	registered interest
	date	15/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	National Insurance and NHS Numbers
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many (1) National Health Service numbers, and (2) National Insurance numbers, are currently live; and whether the General Register Office reports deaths to the Department of Health and the Department for Work and Pensions.
	tabling member printed	Lord Marlesford
	uin	HL2238
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>The total number of live National Health Service numbers is approximately 72 million (England and Wales). The latest available figures (August 2015) show that there are approximately 67.6 Million National Insurance records on the Department for Work and Pensions (DWP) Customer Information System.</p><p> </p><p> </p><p> </p><p>The Health &amp; Social Care Information Centre (HSCIC), on behalf of the Department of Health, receives a weekly feed of death notifications from the General Register Office (GRO). These are applied to the Personal Demographics Service on the Spine, with any non-automatic matches dealt with by the PDS National Back Office within HSCIC.</p><p> </p><p><strong> </strong></p><p> </p><p>Upon the death of an individual DWP receives automatic updates from the three GROs. These are sent for England, Wales and Scotland on a daily basis, and for Northern Ireland on a weekly basis.</p><p> </p><p><strong> </strong></p><p> </p> answering member printed Lord Prior of Brampton question first answered 22/09/2015 10:20:41 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	1854 label Biography information for Lord Marlesford

419208

	registered interest
	date	16/09/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pharmaceutical Price Regulation Scheme
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what rebate payments have been paid by the pharmaceutical industry in each quarter since the commencement of the current Pharmaceutical Price Regulation Scheme; and what proportion of those payments has been reinvested in innovative medicines.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL2281
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>The following table includes information on aggregate payments received by the Department since the beginning of the Pharmaceutical Scheme 2014. The Department publishes quarterly information on the Pharmaceutical Price Regulation Scheme (PPRS) sales and payments on the Government’s website at:</p><p> </p><p> </p><p> </p><p>https://www.gov.uk/government/publications/pprs-quarterly-net-sales-and-payment-information</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Year and Quarter (Q)</p></td><td><p>Aggregate Payments Received by the Department of Health</p></td></tr><tr><td><p>2014 Q1</p></td><td><p>£74 million</p></td></tr><tr><td><p>2014 Q2</p></td><td><p>£76 million</p></td></tr><tr><td><p>2014 Q3</p></td><td><p>£79 million</p></td></tr><tr><td><p>2014 Q4</p></td><td><p>£81 million</p></td></tr><tr><td><p>2015 Q1</p></td><td><p>£208 million</p></td></tr><tr><td><p>2015 Q2</p></td><td><p>£209 million</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p>The Department ensures that all the income it receives from PPRS payments in England is reinvested in the National Health Service for patients’ benefit. The Department includes the expected PPRS payments in setting the NHS England allocations in advance of each year.</p><p> </p><p> </p><p> </p><p>As a statutory organisation, it is for NHS England to ensure that its actions are in line with its statutory duties. NHS England is responsible for allocating its overall budget (which includes expected income from PPRS payments in England) across commissioning areas, including specialised commissioning and clinical commissioning groups. Following normal Government accounting rules, there is no separately identified or ring-fenced funding stream associated with the PPRS payments.</p><p> </p><p> </p><p> </p><p>The Government believes that NHS commissioners and providers are best placed to decide how to allocate their budgets to deliver improvements in the outcomes for patients. The PPRS includes a number of commitments for improving patient outcomes by improving access to clinically and cost effective medicines.</p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL2282 question first answered 22/09/2015 10:32:21 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	4151 label Biography information for Lord Willis of Knaresborough

419209

	registered interest
	date	16/09/2015
	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	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, in the light of comments by the NHS National Clinical Director for Specialised Services in July stating that the NHS was unlikely to be able to afford increasing costs for specialised drugs, whether they plan to investigate why NHS England Specialised Services have not received any additional funding to spend on new products through the Pharmaceutical Price Regulation Scheme, and where those available funds have been spent within NHS England.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL2282
	answer	answer is ministerial correction date of answer 22/09/2015 answer text <p>The following table includes information on aggregate payments received by the Department since the beginning of the Pharmaceutical Scheme 2014. The Department publishes quarterly information on the Pharmaceutical Price Regulation Scheme (PPRS) sales and payments on the Government’s website at:</p><p> </p><p> </p><p> </p><p>https://www.gov.uk/government/publications/pprs-quarterly-net-sales-and-payment-information</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Year and Quarter (Q)</p></td><td><p>Aggregate Payments Received by the Department of Health</p></td></tr><tr><td><p>2014 Q1</p></td><td><p>£74 million</p></td></tr><tr><td><p>2014 Q2</p></td><td><p>£76 million</p></td></tr><tr><td><p>2014 Q3</p></td><td><p>£79 million</p></td></tr><tr><td><p>2014 Q4</p></td><td><p>£81 million</p></td></tr><tr><td><p>2015 Q1</p></td><td><p>£208 million</p></td></tr><tr><td><p>2015 Q2</p></td><td><p>£209 million</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p>The Department ensures that all the income it receives from PPRS payments in England is reinvested in the National Health Service for patients’ benefit. The Department includes the expected PPRS payments in setting the NHS England allocations in advance of each year.</p><p> </p><p> </p><p> </p><p>As a statutory organisation, it is for NHS England to ensure that its actions are in line with its statutory duties. NHS England is responsible for allocating its overall budget (which includes expected income from PPRS payments in England) across commissioning areas, including specialised commissioning and clinical commissioning groups. Following normal Government accounting rules, there is no separately identified or ring-fenced funding stream associated with the PPRS payments.</p><p> </p><p> </p><p> </p><p>The Government believes that NHS commissioners and providers are best placed to decide how to allocate their budgets to deliver improvements in the outcomes for patients. The PPRS includes a number of commitments for improving patient outcomes by improving access to clinically and cost effective medicines.</p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL2281 question first answered 22/09/2015 10:32:21 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	4151 label Biography information for Lord Willis of Knaresborough