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660151

registered interest
date	16/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what guidance NICE has issued on whether it is clinically appropriate to delay surgery for (a) obese patients for 12 months and (b) smokers for 6 months.
tabling member constituency	York Central
tabling member printed	Rachael Maskell
uin	58010
answer	answer is ministerial correction date of answer 23/12/2016 answer text <p>The National Institute for Health and Care Excellence has advised that it has not made any specific recommendations on delaying surgery for obese patients or patients who smoke, and that its guidelines tend to focus on the diagnosis, care and management of health conditions, rather than protocols for the delivery of services.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 23/12/2016 10:20:19 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4471 label Biography information for Rachael Maskell

658724

registered interest
date	14/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many NHS hospital operations have been cancelled since August 2016 because of a shortage of (1) beds, or (2) staff.
tabling member printed	The Marquess of Lothian
uin	HL4142
answer	answer is ministerial correction date of answer 20/12/2016 answer text <p>The information is not available in the format requested.</p> answering member printed Lord Prior of Brampton question first answered 20/12/2016 17:09:06 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	259 label Biography information for The Marquess of Lothian

649497

registered interest
date	01/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department and NHS England plan to take to prevent clinical commissioning groups from rationing treatments by restricting routine surgery for patients who smoke or are clinically obese.
tabling member constituency	North Norfolk
tabling member printed	Norman Lamb
uin	55790
answer	answer is ministerial correction date of answer 06/12/2016 answer text <p>Clinical commissioning groups (CCGs) are responsible for commissioning services to meet the requirements of their population, including obese patients and smokers. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, and are based on the available evidence and take into account national guidelines.</p><p> </p><p>Major surgery poses much higher risks for severely overweight patients and those who smoke. So local general practitioner-led CCGs are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their operation. Reducing obesity and cutting smoking not only benefits patients but saves the National Health Service and taxpayers millions of pounds.</p><p> </p><p>This does not and cannot mean blanket bans on particular patients, such as smokers, getting operations, which would be inconsistent with the NHS Constitution.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 06/12/2016 14:23:43 answering member 4080 label Biography information for David Mowat
tabling member	1439 label Biography information for Norman Lamb

637276

registered interest
date	15/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many centres carry out complex thoracic surgery in NHS England; what is their annual procedure volume; and when they will publish risk normalised outcome data for those centres.
tabling member printed	Lord Freyberg
uin	HL3201
answer	answer is ministerial correction date of answer 24/11/2016 answer text <p>There are 28 centres undertaking complex thoracic procedures.</p><p> </p><p>Complex thoracic surgery involves a range of procedures, and therefore there is no overarching outcomes data set, only procedure-specific data.</p><p> </p><p>The predominant procedure is lung resection. The latest outcomes data for this is available in the <em>National Lung Cancer Audit annual report 2015 (for the audit period 2014)</em>, which is attached.</p> answering member printed Lord Prior of Brampton question first answered 24/11/2016 14:32:50 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name 2015-12-02 National Lung Cancer Report.pdf title National Lung Cancer Report
tabling member	2593 label Biography information for Lord Freyberg

634128

registered interest
date	11/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many elective operations were cancelled in each of the last five years.
tabling member constituency	Leicester South
tabling member printed	Jonathan Ashworth
uin	52570
answer	answer is ministerial correction date of answer 21/11/2016 answer text <p>The number of cancelled operations remains low in the context of the millions of operations performed in the National Health Service each year. Cancelled elective operations in Quarter 1 2016/17 as a percentage of elective admissions were 0.9%. However, hospitals should continue to do everything they can to keep last minute cancellations of operations to an absolute minimum.</p><p> </p><p>NHS England publishes information each quarter on the number of last minute elective operations cancelled for non-clinical reasons. The following table shows this information for the last five years plus the first two quarters of 2016/17. A last minute cancellation is defined as when a patient’s operation is cancelled by the hospital on or after the day of admission, including the day of surgery, for non-clinical reasons.</p><p> </p><p>Number of elective operations cancelled for non-clinical reasons in each of the last five years, 2011/12 to 2015/16 and Quarters 1 and 2 2016/17</p><p> </p><table><tbody><tr><td><p>Year</p></td><td><p>Quarter</p></td><td><p>Number of cancelled elective operations</p></td></tr><tr><td><p>2011/12</p></td><td><p>1</p></td><td><p>12,780</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>12,892</p></td></tr><tr><td><p> </p></td><td><p>3</p></td><td><p>14,696</p></td></tr><tr><td><p> </p></td><td><p>4</p></td><td><p>16,719</p></td></tr><tr><td><p>2012/13</p></td><td><p>1</p></td><td><p>14,113</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>13,155</p></td></tr><tr><td><p> </p></td><td><p>3</p></td><td><p>16,281</p></td></tr><tr><td><p> </p></td><td><p>4</p></td><td><p>19,968</p></td></tr><tr><td><p>2013/14</p></td><td><p>1</p></td><td><p>15,443</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>15,032</p></td></tr><tr><td><p> </p></td><td><p>3</p></td><td><p>15,852</p></td></tr><tr><td><p> </p></td><td><p>4</p></td><td><p>17,868</p></td></tr><tr><td><p>2014/15</p></td><td><p>1</p></td><td><p>15,650</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>15,898</p></td></tr><tr><td><p> </p></td><td><p>3</p></td><td><p>19,470</p></td></tr><tr><td><p> </p></td><td><p>4</p></td><td><p>20,464</p></td></tr><tr><td><p>2015/16</p></td><td><p>1</p></td><td><p>16,099</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>16,414</p></td></tr><tr><td><p> </p></td><td><p>3</p></td><td><p>18,393</p></td></tr><tr><td><p> </p></td><td><p>4</p></td><td><p>23,352</p></td></tr><tr><td><p>2016/17</p></td><td><p>1</p></td><td><p>18,730</p></td></tr><tr><td><p> </p></td><td><p>2</p></td><td><p>19,399</p></td></tr></tbody></table><p> </p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 21/11/2016 17:35:12 answering member 1542 label Biography information for Philip Dunne
tabling member	4244 label Biography information for Jonathan Ashworth

619970

registered interest
date	24/10/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many operations in (a) St Helens North constituency, (b) Merseyside and (c) the UK had to be cancelled due to a lack of hospital beds available in each year since 2010.
tabling member constituency	St Helens North
tabling member printed	Conor McGinn
uin	49942
answer	answer is ministerial correction date of answer 27/10/2016 answer text <p>The information requested is not collected centrally.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 27/10/2016 14:13:52 answering member 1542 label Biography information for Philip Dunne
tabling member	4458 label Biography information for Conor McGinn

598098

registered interest
date	10/10/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what has been the average number of hip and knee replacement operations per one million population performed weekly (1) by the NHS, and (2) privately, during each quarter since October 2015 in the English regions of (a) London, (b) the South, (c) the Midlands and East, and (d) the North.
tabling member printed	Lord Maginnis of Drumglass
uin	HL2127
answer	answer is ministerial correction date of answer 24/10/2016 answer text <p>The information requested is in the table attached.</p><p> </p><p>The data is activity in National Health Service Hospitals in England and NHS funded activity in the independent sector. Information on privately funded activity in the independent sector is not available.</p> answering member printed Lord Prior of Brampton question first answered 24/10/2016 12:34:02 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name HL2127 FORMATTED TABLE.pdf title HL2127 TABLE
tabling member	648 label Biography information for Lord Maginnis of Drumglass

598113

registered interest
date	10/10/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what steps they are taking to prevent the late cancellation of operations.
tabling member printed	Lord Taylor of Warwick
uin	HL2142
answer	answer is ministerial correction date of answer 24/10/2016 answer text <p>The commitment that ‘all patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the patient’s choice’ is included as a pledge in the Handbook to the NHS Constitution. A copy is attached.</p><p> </p><p>Every quarter, NHS England publishes the number of operations cancelled at the ‘last minute’ for non-clinical reasons. A last minute cancellation is defined as ‘when a patient’s operation is cancelled by the hospital on or after the day of admission (including the day of surgery) for non-clinical reasons’. The financial sanction for not meeting the pledge in 2016-17 is non-payment of costs associated with cancellation and non-payment or reimbursement (as applicable) of the re-scheduled episode of care.</p><p> </p><p>Every month, NHS England also publishes data on urgent operations that are cancelled by the trust for non-medical reasons, including those cancelled for a second or subsequent time. This includes all urgent operations cancelled, not just those cancelled at the last minute. Although there is no pledge for cancelled urgent operations, NHS England has set a National Quality Requirement that no urgent operation should be cancelled for a second time, and the NHS Standard Contract provides for a financial sanction of £5,000 per incidence.</p> answering member printed Lord Prior of Brampton question first answered 24/10/2016 12:11:56 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name NHS_Constitution_Handbook_v2.pdf title Handbook to NHS Constitution
tabling member	1796 label Biography information for Lord Taylor of Warwick

576850

registered interest
date	06/09/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
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 potential benefits of mobile surgical health theatres; and whether such centres are included in the Sustainability and Transformation Plans.
tabling member constituency	St Albans
tabling member printed	Mrs Anne Main
uin	45270
answer	answer is ministerial correction date of answer 15/09/2016 answer text <p>Under the Directed Enhanced Services directions to NHS England, there is a Minor Surgery Scheme, the underlying purpose of which is to ensure that a wide range of minor surgical procedures are made available as part of the primary medical services provided throughout England. Minor surgery is also one of the additional services which are set out in the General Medical Services Contract Regulations. It is for local areas to decide whether they include the development of these centres in their Sustainability and Transformation Plan.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 15/09/2016 14:41:24 answering member 4080 label Biography information for David Mowat
tabling member	1568 label Biography information for Mrs Anne Main

420886

registered interest
date	13/10/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Surgery
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 variation in elective surgery rates among the most affluent and least affluent areas of England recorded in the recent survey by the Health Service Journal.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2572
answer	answer is ministerial correction date of answer 26/10/2015 answer text <p>NHS England has advised it is aware of the findings of the survey.</p><br /><p>The NHS Atlas of Variation in Healthcare, published in September 2015 by Public Health England, NHS England and NHS Right Care, aims to identify unwarranted variation, and the causes of variation, in the provision of health services. Linked to this, the NHS Right Care programme will advise local health systems on variation in elective surgery intervention rates and support them to look at reasons for this and identify any changes needed.</p><br /><p>The NHS Atlas of Variation in Healthcare is too large to attach to this reply, but can be found online at the following:</p><br /><p><a href="http://www.rightcare.nhs.uk/atlas/RC_nhsAtlas3_HIGH_150915.pdf" target="_blank">http://www.rightcare.nhs.uk/atlas/RC_nhsAtlas3_HIGH_150915.pdf</a></p><p><strong></strong></p><p><strong></strong></p> answering member printed Lord Prior of Brampton question first answered 26/10/2015 17:50:16 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2024 label Biography information for Lord Hunt of Kings Heath