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521604

registered interest
date	25/05/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assessment he has made of the (a) efficiency of existing diagnostic tests and (b) effectiveness of current treatments for Lyme disease.
tabling member constituency	Coventry North East
tabling member printed	Colleen Fletcher
uin	38421
answer	answer is ministerial correction date of answer 06/06/2016 answer text <p>Lyme disease is a complex infection where challenges in understanding of disease progression, and consequently diagnosis and treatment, remain.</p><p> </p><p>The National Health Service and Public Health England (PHE) use well established validated diagnostic tests for Lyme disease that are highly reproducible between laboratories. International External Quality Assurance schemes are in place to ensure consistency between different test centres. Commercial manufacturers and international academic groups have research programmes into improved tests and PHE continuously reviews new Lyme serology tests and will validate and implement new tests if appropriate.</p><p> </p><p>All treatment for Lyme disease within the NHS should be evidence based, and targeted at the disease mechanisms underlying those symptoms. Most cases are diagnosed in primary care and PHE has published a referral pathway for general practitioners to follow to ensure problem cases are seen by an appropriate NHS specialist.</p><p> </p><p>To further strengthen the evidence base we have commissioned the National Institute for Health and Care Excellence to develop a new clinical guideline on Lyme disease, for both primary and secondary care, for publication in 2018. The Department is also commissioning three Systematic Reviews by independent academic groups to cover</p><p> </p><p>― diagnosis and diagnostic tests;</p><p>― treatment; and</p><p>― epidemiology/transmission routes.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 06/06/2016 14:00:30 answering member 3918 label Biography information for Jane Ellison
tabling member	4378 label Biography information for Colleen Fletcher

520843

registered interest
date	23/05/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to raise awareness of Lyme disease amongst medical professionals.
tabling member constituency	Erith and Thamesmead
tabling member printed	Teresa Pearce
uin	38038
answer	answer is ministerial correction date of answer 26/05/2016 answer text <p>The existing National Institute for Health and Care Excellence (NICE) guidance supports primary care doctors in managing Lyme disease but to further strengthen the evidence base we have commissioned NICE to develop guidelines for the recognition and treatment of Lyme disease; this is expected in June 2018.</p><p> </p><p>Public Health England (PHE) provides information on Lyme disease and tick awareness to the medical profession and the public, holds regular medical training days, and works with Lyme Disease Action to support the needs and interests of patients.</p><p> </p><p>NHS Choices also publishes information on its website to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection.</p><p> </p><p>The number of human cases can be reduced by raising public awareness of how to avoid tick bites, and by environmental measures in public places to reduce the long grass and scrub which harbor ticks. PHE works with interested local authorities to raise tick awareness, and has produced joint public information with local authorities in areas such as the New Forest with a significant incidence of Lyme disease.</p><p> </p><p>The number of laboratory confirmed cases of Lyme disease in England and Wales varies annually, in 2013 there were 878 and in 2014 there were 730, but the majority of diagnoses are made clinically by general practitioners and those figures are not recorded.</p><p> </p><p>Patients with late or complicated Lyme disease may be diagnosed in a variety of specialist clinics, and the numbers are not recorded. Based on the clinical information supplied with the laboratory request, only a small proportion of the annual number of cases fall into this category.</p><p> </p><p>There is no clear definition for chronic Lyme disease, and no general acceptance of what the term means, so no data is available.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 38039 38055 question first answered 26/05/2016 16:24:22 answering member 3918 label Biography information for Jane Ellison
tabling member	4003 label Biography information for Teresa Pearce

520844

registered interest
date	23/05/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to raise public awareness of Lyme disease and of the measures that can be taken to reduce the risk of infection.
tabling member constituency	Erith and Thamesmead
tabling member printed	Teresa Pearce
uin	38039
answer	answer is ministerial correction date of answer 26/05/2016 answer text <p>The existing National Institute for Health and Care Excellence (NICE) guidance supports primary care doctors in managing Lyme disease but to further strengthen the evidence base we have commissioned NICE to develop guidelines for the recognition and treatment of Lyme disease; this is expected in June 2018.</p><p> </p><p>Public Health England (PHE) provides information on Lyme disease and tick awareness to the medical profession and the public, holds regular medical training days, and works with Lyme Disease Action to support the needs and interests of patients.</p><p> </p><p>NHS Choices also publishes information on its website to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection.</p><p> </p><p>The number of human cases can be reduced by raising public awareness of how to avoid tick bites, and by environmental measures in public places to reduce the long grass and scrub which harbor ticks. PHE works with interested local authorities to raise tick awareness, and has produced joint public information with local authorities in areas such as the New Forest with a significant incidence of Lyme disease.</p><p> </p><p>The number of laboratory confirmed cases of Lyme disease in England and Wales varies annually, in 2013 there were 878 and in 2014 there were 730, but the majority of diagnoses are made clinically by general practitioners and those figures are not recorded.</p><p> </p><p>Patients with late or complicated Lyme disease may be diagnosed in a variety of specialist clinics, and the numbers are not recorded. Based on the clinical information supplied with the laboratory request, only a small proportion of the annual number of cases fall into this category.</p><p> </p><p>There is no clear definition for chronic Lyme disease, and no general acceptance of what the term means, so no data is available.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 38038 38055 question first answered 26/05/2016 16:24:22 answering member 3918 label Biography information for Jane Ellison
tabling member	4003 label Biography information for Teresa Pearce

519728

registered interest
date	19/05/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether he has had discussions with his German counterpart on improving the diagnosis and treatment of Lyme disease by the NHS.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	37543
answer	answer is ministerial correction date of answer 25/05/2016 answer text <p>No specific discussions have been held but the National Health Service, Public Health England and national laboratories across Europe use well established, standardised, tests and international External Quality Assurance schemes are in place to ensure consistency across Europe.</p><p>However, Lyme disease is a complex infection and we recognise that challenges in diagnosis and treatment remain. In light of this, the Department is commissioning three reviews on the diagnosis, treatment and transmission of Lyme disease to inform future decision making.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 25/05/2016 12:57:41 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

512603

registered interest
date	13/04/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure that new guidelines on the recognition and treatment of Lyme disease are made available by July 2018.
tabling member constituency	Pendle
tabling member printed	Andrew Stephenson
uin	33894
answer	answer is ministerial correction date of answer 22/04/2016 answer text <p>As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.</p><p> </p><p>Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.</p><p> </p><p>There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 33884 33892 33893 33895 33896 question first answered 22/04/2016 13:03:57 answering member 3918 label Biography information for Jane Ellison
tabling member	4044 label Biography information for Andrew Stephenson

512615

registered interest
date	13/04/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what targets his Department has set to increase early diagnosis and treatment of Lyme disease.
tabling member constituency	Pendle
tabling member printed	Andrew Stephenson
uin	33896
answer	answer is ministerial correction date of answer 22/04/2016 answer text <p>As services for the treatment of Lyme disease are commissioned locally information on the costs associated with laboratory testing and treatment of late stage Lyme disease is not collected centrally. Nor is information collected centrally on the average time to diagnose cases of Lyme disease.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) is developing a clinical guideline on Lyme disease and reports progress on its website. NICE recently consulted on a draft scope for the guideline, and expects to publish final guidance in July 2018.</p><p> </p><p>Public Health England and NHS Choices publish information on their websites to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection. Given the need to maintain public awareness these or similar mechanisms are expected to continue beyond 2018. Increased awareness is likely to encourage early consultation but no information on the time taken to seek medical advice is available.</p><p> </p><p>There are no plans to set targets for diagnosis and treatment as most cases of Lyme disease are diagnosed empirically by general practitioners using their clinical judgement rather than relying on a laboratory test, thus treatment can start immediately. Diagnosis of patients with late or complicated Lyme disease can be difficult and the National Health Service will continue to provide care taking account of the existing evidence base.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 33884 33892 33893 33894 33895 question first answered 22/04/2016 13:03:57 answering member 3918 label Biography information for Jane Ellison
tabling member	4044 label Biography information for Andrew Stephenson

479635

registered interest
date	17/03/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps he is taking to improve the treatment on the NHS for people with Lyme disease.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	31522
answer	answer is ministerial correction date of answer 22/03/2016 answer text <p>The National Health Service already provides medical care following existing guidance but to strengthen the evidence base we have commissioned the National Institute for Health and Care Excellence to develop guidelines for the recognition and treatment of Lyme disease; this is expected in June 2018.</p><p>New diagnostic tests for Lyme disease are regularly reviewed by Public Health England (PHE) who also participates in a Europe wide Quality Assurance programme to ensure that the most suitable tests available are used.</p><p>In addition, PHE provides information on Lyme disease and tick awareness to the medical profession and the public, hold regular medical training days, and work with Lyme Disease Action to support the needs and interests of patients.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 22/03/2016 11:52:05 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

479636

registered interest
date	17/03/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what discussions he has had with the International Lyme and Associated Diseases Society on use of results from the European Accredited Laboratory Assay related to Lyme disease to inform the provision of treatment on the NHS for that disease.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	31523
answer	answer is ministerial correction date of answer 22/03/2016 answer text <p>My Rt. hon. Friend the Secretary of State for Health has had no discussions with the International Lyme and Associated Diseases Society.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 22/03/2016 11:08:10 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

454205

registered interest
date	23/02/2016
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	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to ensure that (a) more cases of chronic lyme disease are correctly diagnosed and (b) more people with chronic lyme disease receive the appropriate treatment.
tabling member constituency	Greenwich and Woolwich
tabling member printed	Matthew Pennycook
uin	27987
answer	answer is ministerial correction date of answer 02/03/2016 answer text <p>Our aim is to ensure that cases of Lyme disease at all its stages and manifestations are recognised and treated appropriately. The National Health Service provides medical care following international guidance and most cases are dealt with by general practitioners (GPs). To help ensure people receive the appropriate treatment Public Health England has published a referral pathway for GPs to follow. Where additional investigation is required, specialist referral may be necessary and a small number of NHS clinics will see complicated cases. The National Institute for Health and Care Excellence has been commissioned to develop guidelines for the recognition and treatment of Lyme disease; this is expected in June 2018.</p><p> </p><p>Public Health England PHE) regularly review new tests for Lyme disease and participate in a Europe wide Quality Assurance programme to ensure that the most suitable tests available are used.</p><p>In addition, PHE provide information on Lyme disease and tick awareness to the medical profession and the public, and holds regular medical training days, and works with Lyme Disease Action to support the needs and interests of patients.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 02/03/2016 16:03:26 answering member 3918 label Biography information for Jane Ellison
tabling member	4520 label Biography information for Matthew Pennycook

452163

registered interest
date	10/02/2016
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 how many NHS and Public Health England laboratories that carry out Lyme borreliosis testing (1) are, and (2) are not, ISO 15189 accredited; and when they expect the Rare and Imported Pathogens Laboratory to be so accredited.
tabling member printed	The Countess of Mar
uin	HL6110
answer	answer is ministerial correction date of answer 24/02/2016 answer text <p>The Department of Health, Public Health England (PHE) or NHS England do not hold information about which laboratories are and are not International Organization for Standardization (ISO) 15189 accredited. A list of accredited laboratories is held on the United Kingdom Accreditation Service (UKAS) website and is the definitive list of accredited laboratories to which the Department, PHE and the NHS refer. Accreditation is covered by the Clinical Pathology Accreditation (CPA) company until recently, and is now part of the UKAS scheme.</p><p> </p><p>There is no intention to transfer the Lyme disease testing service from the Rare &amp; Imported Pathogens Laboratory (RIPL) to another laboratory. RIPL as a department will move from the Porton site as part of the PHE relocation scheduled to commence in 2018 but no decision on the exact date has been made. RIPL is scheduled to transfer to ISO 15189 in late summer 2016, when the ISO inspection team review the tests offered by the laboratory under ISO 15189. Until that time, the laboratory is operating under CPA in accordance with the transition process laid down by ISO.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL6109 HL6111 question first answered 24/02/2016 13:10:52 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	1861 label Biography information for The Countess of Mar