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347943

	registered interest
	date	02/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Human Papillomavirus: Vaccination
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, to date, how many adverse reactions to (1) Cervarix, (2) Gardasil and (3) generic human papilloma virus vaccines have been reported to the Medicines and Healthcare products Regulatory Agency; for each category, how many of those reports are of serious adverse reactions; and what age-specific rate those figures represent.
	tabling member printed	The Countess of Mar
	uin	HL229
	answer	answer is ministerial correction date of answer 16/06/2015 answer text <p>A total of 8,243 suspected adverse drug reaction (ADR) reports with human papilloma virus (HPV) vaccines have been reported to the Medicines and Healthcare products Regulatory Agency (MHRA), via the Yellow Card Scheme, up to 3 June 2015.</p><p> </p><p> </p><p> </p><p>To date, more than 8 million doses of HPV vaccine have been given across the United Kingdom as part of the routine immunisation programme. The MHRA does not hold data on age-specific vaccine usage, and therefore age-specific reporting rates cannot be calculated.</p><p> </p><p> </p><p> </p><p>It is important to note that a Yellow Card report is not proof of a side effect occurring, but a suspicion by the reporter that the vaccine may have been the cause. Yellow Card data cannot be used as a reliable indicator of the frequency of suspected ADRs to vaccines or medicines. The level of ADR reporting may fluctuate between given years due to a variety of reasons such as a medicine being new (reporting rates are generally higher when a product is first introduced), stimulated interest/publicity and variations in exposure to the medicine.</p><p> </p><p> </p><p> </p><p>The possible known side effects, and the frequency, are listed in the product information which is provided with the vaccines. The vast majority of the 8,243 ADRs relate to the known risks of vaccination that are well-described in the available product information. The proportion of suspected ADRs for HPV vaccines that were reported as serious (32%) is less than the proportion reported as serious for other routinely used vaccines (68% overall) during the same time period. The expected benefits in protecting against HPV-related mortality and disease outweigh the known side effects of HPV vaccine.</p><p> </p><p> </p><p> </p><p>The following table provides a breakdown of UK suspected spontaneous ADRs received via the Yellow Card Scheme in association with the HPV vaccine. The MHRA does not hold data on age-specific vaccine usage, and therefore age-specific reporting rates cannot be calculated.</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Vaccine Brand</p></td><td><p>Total number of reports</p></td><td><p>Number of serious reports (% of total)</p></td><td><p>Reporting rate per 1000 doses (serious reporting rates per 1000)</p></td></tr><tr><td><p>Cervarix</p></td><td><p>6,266</p></td><td><p>1,768 (28%)</p></td><td><p><ins class="ministerial">n/a **</ins><del class="ministerial">0.78 (0.22)</del></p></td></tr><tr><td><p>Gardasil</p></td><td><p>1,471</p></td><td><p>504 (34%)</p></td><td><p><ins class="ministerial">n/a **</ins><del class="ministerial">0.18 (0.06)</del></p></td></tr><tr><td><p>HPV Brand unspecified</p></td><td><p>507</p></td><td><p>326 (64%)</p></td><td><p><ins class="ministerial">n/a ** </ins><del class="ministerial">0.06 (0.04)</del></p></td></tr><tr><td><p>Total for Human Papilloma virus vaccines</p></td><td><p>*8,244</p></td><td><p>2,598 (32%)</p></td><td><p>1.03 (0.32)</p></td></tr></tbody></table><p> </p><p><em>Source:</em> MHRA sentinel database for adverse reactions.</p><p> </p><p>* It should be noted that the total number of reports received will not be equal to the totals in the table above as some reports of suspected adverse reactions may have included more than one vaccine.</p><p><ins class="ministerial">**Updated UK-wide brand-specific usage data are not available to MHRA at the time of writing based on a minimum of 8 million combined doses of Cervarix and Gardasil administered across the UK to date.</ins></p><p> </p><p><ins class="ministerial"> <p> </p><p> </p><p> </p></ins></p><p> </p><p> </p><p> </p><p> </p><p> </p><p>The seriousness criteria for ADR reporting were determined by a working group of the Council for International Organizations of Medical Sciences (CIOMS) and are defined as 6 possible categories which are explained on the Yellow Card. The MHRA asks reporters to select one of the following criteria by ticking the appropriate box on the Yellow Card: (1) patient died due to reaction; (2) life threatening; (3) resulted in hospitalisation or prolonged inpatient hospitalisation; (4) congenital abnormality; and (5) involved persistent or significant disability or incapacity; or (6) if the reaction was deemed medically significant. In addition to this, seriousness of reaction terms has also been defined by the MHRA in its medical dictionary. Therefore an ADR report can be serious because the reporter considers the reaction to be serious or because the reaction term itself is considered serious in the MHRA medical dictionary.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 16/06/2015 14:35:02 question first ministerially corrected 03/07/2015 14:01:13 answering member 127 label Biography information for Lord Prior of Brampton previous answer version 5462 answering member printed Lord Prior of Brampton answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	1861 label Biography information for The Countess of Mar

348423

	registered interest
	date	03/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	General Practitioners
	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 results of a survey on behalf of Monitor, which found that one in ten people are dissatisfied with their general practitioner surgery.
	tabling member printed	Lord Taylor of Warwick
	uin	HL235
	answer	answer is ministerial correction date of answer 17/06/2015 answer text <p>On 1 June 2015, Monitor published <em>Improving GP Services: Commissioners and Patient Choice</em>, which included the findings of a nationally representative survey conducted by Ipsos Mori.</p><p> </p><p> </p><p> </p><p>The report noted a high level of satisfaction with general practice overall. It found that 81% of patients were satisfied with their general practitioner (GP) practice, while only 10% were dissatisfied.</p><p> </p><p> </p><p> </p><p>Monitor’s report found that, after location, patients most value the ease of getting an appointment when choosing a GP practice. In order to improve access for patients, the Government has invested £175 million over two years through the Prime Minister’s GP Access Fund. This is testing improved and innovative access to GP services through longer opening hours, such as at evenings and weekends, but also different ways of accessing services, for example the use of Skype consultations. Altogether, there are now 57 schemes covering over 2,500 practices, meaning that over 18 million patients are expected to benefit from improved access and transformational change at local level by March 2016.</p><p>Additionally, the Primary Care Infrastructure Fund is investing £1 billion<ins class="ministerial">, including</ins> <del class="ministerial">and</del> £25 million as part of the Prime Minister’s GP Access Fund, over four years to improve premises and information technology, which will also improve access.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 17/06/2015 13:19:17 question first ministerially corrected 19/06/2015 11:00:07 answering member 127 label Biography information for Lord Prior of Brampton previous answer version 5697 answering member printed Lord Prior of Brampton answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	1796 label Biography information for Lord Taylor of Warwick

164499

	registered interest
	date	24/11/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	NHS: Negligence
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government by how much the provision for clinical negligence claims against the National Health Service has grown in the last year; why it has grown; and what strategy is in place for reducing that amount.
	tabling member printed	Lord Sharkey
	uin	HL3092
	answer	answer is ministerial correction date of answer 04/12/2014 answer text <p>As at 31 March 2014, the National Health Service Litigation Authority (NHS LA) estimates that it has potential liabilities of £26.1 billion, of which £25.7 billion relates to clinical negligence. This is an increase of £3.1 billion from 31 March 201<del class="ministerial">4<ins class="ministerial">3</ins></del>, which can mainly be attributed to a continual rise in clinical negligence claims over recent years. There are a number of factors driving this increase, including the rise in the number of patients cared for and in the complexity of their care; and the general rise in litigation across a number of sectors including the NHS, driven in part by ‘no win, no fee’ agreements. It is anticipated that the effect of the latter is likely to diminish as a result of the Government’s Legal Aid Sentencing and Punishment of Offenders Act of 2012.</p><p> </p><p>The Department believes the best way to reduce negligence claims is to improve patient care and safety. In March 2014, the Secretary of State for Health issued a call to action to make the NHS the safest healthcare system in the world and achieve a three-year goal to halve avoidable harm and save 6,000 lives. The Sign up to Safety campaign embodies the ambition of the NHS to build a culture of safety, bringing together individuals and organisations with a contribution to make towards the patient safety goal. Elements of this campaign will focus on a reduction in avoidable harm that can lead to compensation claims. Organisations that sign up are setting out what they will do to strengthen patient safety, including a safety improvement plan which shows how their organisation intends to save lives and reduce harm for patients over the next three years. The NHS Litigation Authority, which already provides a “safety and learning service” to trusts<strong>,</strong> will support those organisations which have patient safety improvement plans that show a likely reduction in their higher volume, higher value claims.</p><p> </p> answering member printed Earl Howe question first answered 04/12/2014 16:04:05 question first ministerially corrected 13/01/2015 14:37:59 answering member 2000 label Biography information for Earl Howe previous answer version 31769 answering member printed Earl Howe answering member 2000 label Biography information for Earl Howe
	tabling member	4196 label Biography information for Lord Sharkey

177981

	registered interest
	date	04/02/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Passive Smoking
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what is their estimate of the number of people who died as a result of passive smoking in each of the last five years.
	tabling member printed	Lord Laird
	uin	HL4692
	answer	answer is ministerial correction date of answer 17/02/2015 answer text <p>Exposure to secondhand smoke is a serious health hazard. More than 50 carcinogens have been identified in secondhand smoke.</p><p> </p><p> </p><p> </p><p>The report of the United States Surgeon General titled “<em>The health consequences of involuntary exposure to tobacco smoke”</em> concluded that secondhand smoke causes premature death and disease in children and adults who do not smoke. The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in children. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. Legislation to stop smoking in vehicles carrying children will come into force in England on 1 October 2015.</p><p> </p><p><br /> The report of the Royal College of <ins class="ministerial">Physicians </ins><del class="ministerial">Surgeons</del> titled “<em>Going smoke-free: The medical case for clean air in the home, at work and in public places”</em> included estimates that secondhand smoke exposure caused approximately 12<del class="ministerial">2</del>,200 deaths in the United Kingdom in 2003, and that the majority of these deaths occurred as a result of exposure to secondhand smoke in the home. These estimates were made prior to the introduction of smokefree legislation in England in 2007. Over the past decade, the proportion of smokers who say that they do not smoke in the home has increased.</p><p> </p><p> </p><p> </p><p>The evidence is clear that smokefree legislation in England has had beneficial effects on health, as set out in the report “<em>The Impact of smokefree legislation in England: evidence review”</em> which was published alongside the Government’s <em>“Tobacco Control Plan for England”</em> in March 2011.</p><p> </p><p> </p><p> </p><p>The reports referred to have been placed in the Library.</p><p> </p> answering member printed Earl Howe question first answered 17/02/2015 16:08:25 question first ministerially corrected 12/03/2015 12:34:25 answering member 2000 label Biography information for Earl Howe previous answer version 45462 answering member printed Earl Howe answering member 2000 label Biography information for Earl Howe
	tabling member	2479 label Biography information for Lord Laird

385301

	registered interest
	date	24/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government why the national waiting time criterion for referral to hepatitis C treatment is 18 weeks whereas the national waiting time criterion for referral to specialist services for HIV treatment is two weeks.
	tabling member printed	Baroness Masham of Ilton
	uin	HL784
	answer	answer is ministerial correction date of answer 08/07/2015 answer text <p><del class="ministerial">NHS England and Public Health England (PHE) are working alongside a coalition of other organisations and patient groups to draft a framework for hepatitis C improvement. This hepatitis C improvement framework will set high level aims for the public health system towards elimination of hepatitis C related liver disease as a significant public health concern.</del></p><p> </p><p> </p><p> </p><p><del class="ministerial">The hepatitis C improvement framework will be referred to in PHE’s liver disease framework.</del></p><p> </p><p><ins class="ministerial">Timing for access to care or treatments for all NHS England service specifications or policies is based on an assessment of the evidence for clinical effectiveness, cost effectiveness and affordability.</ins></p><p> </p><p> </p> answering member printed Lord Prior of Brampton question first answered 08/07/2015 13:53:15 question first ministerially corrected 08/07/2015 14:59:37 answering member 127 label Biography information for Lord Prior of Brampton previous answer version 12907 answering member printed Lord Prior of Brampton answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	1850 label Biography information for Baroness Masham of Ilton

176781

	registered interest
	date	29/01/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Health Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, whether joint committees of NHS England and clinical commissioning groups are permitted to deviate from national service specifications for specialised services.
	tabling member constituency	Walsall South
	tabling member printed	Valerie Vaz
	uin	222695
	answer	answer is ministerial correction date of answer 03/02/2015 answer text <p>NHS England is the accountable commissioner and budget holder for all specialised services as set out in The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, with the Manual for prescribed specialised services providing further detail.</p><p> </p><p> </p><p> </p><p>NHS England has achieved significant progress in developing a set of nationally consistent service standards and commissioning policies, which ensure equity of access to high quality services across the board. Those standards and policies will continue to apply for those specialised services which are to be collaboratively commissioned by NHS England and clinical commissioning groups.</p><p> </p><p> </p><p> </p><p>NHS England is currently in the process of agreeing the guidance on the collaborative commissioning arrangements which will be in place from 1 April 2015.</p><p> </p><p> </p><p> </p><p>NHS England has clarified that where there are collaboratively commissioned services, NHS England will retain the full financial risk for these services for 2015/16. NHS England has advised us that there will be further work conducted over the next year to advise on the range of specialised services for which NHS England should remain the accountable commissioner and budget holder for 2016/17 and future years.</p><p> </p><p> </p><p> </p><p>Copies of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 and the Manual for prescribed specialised services are attached.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison attachment 1 file name nhs-england-and-ccg-regulations.pdf title Regulations NHS Commissioning Board & CCGs 2 file name pss-manual.pdf title Manual prescribed specialised services question first answered 03/02/2015 15:09:14 question first ministerially corrected 03/02/2015 15:20:37 answering member 3918 label Biography information for Jane Ellison previous answer version 42619 answering member constituency Battersea answering member printed Jane Ellison answering member 3918 label Biography information for Jane Ellison
	tabling member	4076 label Biography information for Valerie Vaz

176783

	registered interest
	date	29/01/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Health Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, when NHS England will publish details of the co-commissioning of specialised services.
	tabling member constituency	Walsall South
	tabling member printed	Valerie Vaz
	uin	222693
	answer	answer is ministerial correction date of answer 03/02/2015 answer text <p>NHS England is the accountable commissioner and budget holder for all specialised services as set out in The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, with the Manual for prescribed specialised services providing further detail.</p><p> </p><p> </p><p> </p><p>NHS England has achieved significant progress in developing a set of nationally consistent service standards and commissioning policies, which ensure equity of access to high quality services across the board. Those standards and policies will continue to apply for those specialised services which are to be collaboratively commissioned by NHS England and clinical commissioning groups.</p><p> </p><p> </p><p> </p><p>NHS England is currently in the process of agreeing the guidance on the collaborative commissioning arrangements which will be in place from 1 April 2015.</p><p> </p><p> </p><p> </p><p>NHS England has clarified that where there are collaboratively commissioned services, NHS England will retain the full financial risk for these services for 2015/16. NHS England has advised us that there will be further work conducted over the next year to advise on the range of specialised services for which NHS England should remain the accountable commissioner and budget holder for 2016/17 and future years.</p><p> </p><p> </p><p> </p><p>Copies of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 and the Manual for prescribed specialised services are attached.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison attachment 1 file name nhs-england-and-ccg-regulations.pdf title Regulations NHS Commissioning Board & CCGs 2 file name pss-manual.pdf title Manual prescribed specialised services question first answered 03/02/2015 15:09:14 question first ministerially corrected 03/02/2015 15:21:10 answering member 3918 label Biography information for Jane Ellison previous answer version 42620 answering member constituency Battersea answering member printed Jane Ellison answering member 3918 label Biography information for Jane Ellison
	tabling member	4076 label Biography information for Valerie Vaz

176784

	registered interest
	date	29/01/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Health Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, whether NHS England will remain the sole budget-holder and accountable commissioner for all specialised services.
	tabling member constituency	Walsall South
	tabling member printed	Valerie Vaz
	uin	222694
	answer	answer is ministerial correction date of answer 03/02/2015 answer text <p>NHS England is the accountable commissioner and budget holder for all specialised services as set out in The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, with the Manual for prescribed specialised services providing further detail.</p><p> </p><p> </p><p> </p><p>NHS England has achieved significant progress in developing a set of nationally consistent service standards and commissioning policies, which ensure equity of access to high quality services across the board. Those standards and policies will continue to apply for those specialised services which are to be collaboratively commissioned by NHS England and clinical commissioning groups.</p><p> </p><p> </p><p> </p><p>NHS England is currently in the process of agreeing the guidance on the collaborative commissioning arrangements which will be in place from 1 April 2015.</p><p> </p><p> </p><p> </p><p>NHS England has clarified that where there are collaboratively commissioned services, NHS England will retain the full financial risk for these services for 2015/16. NHS England has advised us that there will be further work conducted over the next year to advise on the range of specialised services for which NHS England should remain the accountable commissioner and budget holder for 2016/17 and future years.</p><p> </p><p> </p><p> </p><p>Copies of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 and the Manual for prescribed specialised services are attached.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison attachment 1 file name nhs-england-and-ccg-regulations.pdf title Regulations NHS Commissioning Board & CCGs 2 file name pss-manual.pdf title Manual prescribed specialised services question first answered 03/02/2015 15:09:14 question first ministerially corrected 03/02/2015 15:23:29 answering member 3918 label Biography information for Jane Ellison previous answer version 42621 answering member constituency Battersea answering member printed Jane Ellison answering member 3918 label Biography information for Jane Ellison
	tabling member	4076 label Biography information for Valerie Vaz

178160

	registered interest
	date	05/02/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Heart Diseases
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many admissions to hospital with a (a) primary and (b) secondary diagnosis of coronary heart disease per head of population there were in (i) each clinical commissioning group and its predecessor organisation and (ii) England in each of the last 10 years.
	tabling member constituency	Sutton and Cheam
	tabling member printed	Paul Burstow
	uin	223598
	answer	answer is ministerial correction date of answer 12/02/2015 answer text <p>The following tables show the number of admissions to hospital with a primary and secondary diagnosis of coronary heart disease by primary care trust of treatment for the years 2004/05 to 2012/13; by clinical commissioning group of treatment for 2013/14 and for England as a whole.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 12/02/2015 15:52:16 question first ministerially corrected 12/02/2015 16:09:16 answering member 3918 label Biography information for Jane Ellison attachment 1 file name Hospital Admissions data.xlsx title No. of adnissions - CHD previous answer version 45133 answering member constituency Battersea answering member printed Jane Ellison answering member 3918 label Biography information for Jane Ellison
	tabling member	204 label Biography information for Paul Burstow

167080

	registered interest
	date	01/12/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Sickle Cell Diseases
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how much the NHS spends on sickle cell anaemia; and what proportion this is of the total NHS budget.
	tabling member constituency	Wolverhampton South East
	tabling member printed	Mr Pat McFadden
	uin	216527
	answer	answer is ministerial correction date of answer 08/12/2014 answer text <p>There are an estimated 250,000 people with <ins class="ministerial">the</ins> sickle cell <ins class="ministerial">trait</ins> <del class="ministerial">anaemia</del> in the United Kingdom. The Department has made no estimation of the annual cost of treating sickle cell anaemia in the National Health Service nor does it hold information on the total NHS spend on sickle cell anaemia.</p><p> </p><p> </p><p> </p><p>The Department does hold estimated costs for admitted patient care episodes as reported by Healthcare Resource Groups. In 2013-14 the total estimated figure for sickle anaemia was £23.8 million; in 2012-13 it was £21.9 million. This figure does not include other costs such as primary and social care.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 08/12/2014 15:12:22 question first ministerially corrected 10/12/2014 16:29:44 answering member 3918 label Biography information for Jane Ellison previous answer version 32239 answering member constituency Battersea answering member printed Jane Ellison answering member 3918 label Biography information for Jane Ellison
	tabling member	1587 label Biography information for Pat McFadden