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177981
star this property registered interest false more like this
star this property date less than 2015-02-04more like thismore than 2015-02-04
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Passive Smoking more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property 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. more like this
star this property tabling member printed
Lord Laird more like this
star this property uin HL4692 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-02-17more like thismore than 2015-02-17
star this property 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>
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2015-02-17T16:08:25.233Zmore like thismore than 2015-02-17T16:08:25.233Z
star this property question first ministerially corrected
less than 2015-03-12T12:34:25.527Zmore like thismore than 2015-03-12T12:34:25.527Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property previous answer version
45462
star this property answering member printed Earl Howe more like this
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
2479
star this property label Biography information for Lord Laird more like this
347943
star this property registered interest false more like this
star this property date less than 2015-06-02more like thismore than 2015-06-02
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Human Papillomavirus: Vaccination more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property 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. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL229 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-06-16more like thismore than 2015-06-16
star this property 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>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-06-16T14:35:02.313Zmore like thismore than 2015-06-16T14:35:02.313Z
star this property question first ministerially corrected
less than 2015-07-03T14:01:13.16Zmore like thismore than 2015-07-03T14:01:13.16Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
5462
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
348423
star this property registered interest false more like this
star this property date less than 2015-06-03more like thismore than 2015-06-03
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading General Practitioners more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property 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. more like this
star this property tabling member printed
Lord Taylor of Warwick more like this
star this property uin HL235 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-06-17more like thismore than 2015-06-17
star this property 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>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-06-17T13:19:17.147Zmore like thismore than 2015-06-17T13:19:17.147Z
star this property question first ministerially corrected
less than 2015-06-19T11:00:07.59Zmore like thismore than 2015-06-19T11:00:07.59Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
5697
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1796
star this property label Biography information for Lord Taylor of Warwick more like this
385301
star this property registered interest false more like this
star this property date less than 2015-06-24more like thismore than 2015-06-24
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Hepatitis more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property 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. more like this
star this property tabling member printed
Baroness Masham of Ilton more like this
star this property uin HL784 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-07-08more like thismore than 2015-07-08
star this property 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> more like this
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-07-08T13:53:15.517Zmore like thismore than 2015-07-08T13:53:15.517Z
star this property question first ministerially corrected
less than 2015-07-08T14:59:37.913Zmore like thismore than 2015-07-08T14:59:37.913Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
12907
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1850
star this property label Biography information for Baroness Masham of Ilton more like this
390599
star this property registered interest false more like this
star this property date less than 2015-07-16more like thismore than 2015-07-16
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Anaemia more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what action they are taking to address the problems associated with the late diagnosis of pernicious anaemia, in the light of the results of the survey published in the <i>British Nursing Journal</i> in April 2014. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1539 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-07-24more like thismore than 2015-07-24
star this property answer text <p>It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.</p><p>To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,</em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient’s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.</p><p><br /> The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document <del class="ministerial">has already been placed in the Library and</del> is attached.</p><p><br /> More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.</p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-07-24T13:21:19.45Zmore like thismore than 2015-07-24T13:21:19.45Z
star this property question first ministerially corrected
less than 2015-10-14T11:21:08.233Zmore like thismore than 2015-10-14T11:21:08.233Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BCSH Guidelines pernicious anaemia more like this
star this property previous answer version
17459
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BCSH Guidelines pernicious anaemia more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
390600
star this property registered interest false more like this
star this property date less than 2015-07-16more like thismore than 2015-07-16
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Anaemia more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government how they propose to alert medical practitioners to the severe and irreversible nerve damage that can occur when pernicious anaemia is misdiagnosed. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1540 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-07-24more like thismore than 2015-07-24
star this property answer text <p>It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.</p><p>To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,</em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient’s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.</p><p><br /> The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document <del class="ministerial">has already been placed in the Library and</del> is attached.</p><p><br /> More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.</p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-07-24T13:21:19.357Zmore like thismore than 2015-07-24T13:21:19.357Z
star this property question first ministerially corrected
less than 2015-10-14T11:21:19.847Zmore like thismore than 2015-10-14T11:21:19.847Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BCSH Guidelines pernicious anaemia more like this
star this property previous answer version
17460
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BCSH Guidelines pernicious anaemia more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
432082
star this property registered interest false more like this
star this property date less than 2015-11-24more like thismore than 2015-11-24
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Atrial Fibrillation: Screening more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what action they are taking to promote opportunistic screening for atrial fibrillation. more like this
star this property tabling member printed
Baroness Masham of Ilton more like this
star this property uin HL3855 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-12-08more like thismore than 2015-12-08
star this property answer text <br /><p>NHS England is encouraging clinical commissioning groups to work with local practices to target people at risk of atrial fibrillation (AF). Innovative approaches such as pulse testing at flu clinics and by some dentists are being used to identify AF in older people. The NHS Health Check programme’s best practice guidance also recommends a pulse check is carried out as part of the process of taking a blood pressure reading. People found to have an irregular pulse rhythm should be referred to the general practitioner for further investigation.</p><br /><p>The National Institute for Health and Care Excellence (NICE) published an updated guideline on AF in June 2014. This offers evidence-based advice on the care and treatment of people with AF and includes recommendations on diagnosis. In July 2015 NICE also published a quality standard on AF.</p><br /><p>In addition to its clinical guideline on AF, NICE has published technology appraisal guidance on a number of new oral anticoagulants (NOACs), approving them for certain patients.</p><br /><p>There is a legal requirement on commissioners to provide funding for treatments and drugs recommended in NICE technology appraisal guidance within three months of the guidance being published.This is enshrined in the NHS Constitution as a right to NICE-approved drugs.</p><br /><p>A <a href="https://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> by the <a href="https://www.nice.org.uk/News/Article/new-collaborative-aims-to-increase-nice-guidance-uptake" target="_blank">NICE Implementation Collaborative</a> was published alongside NICE’s updated guideline in June 2014. This addresses some of the barriers to implementing NICE’s recommendations on prescribing NOACs.</p><br /><p>The need to reduce variation and strengthen compliance of the uptake of NICE technology appraisals was identified in <em>Innovation Health and Wealth</em>, published in December 2011. In response, NHS England and the Health and Social Care Information Centre now publishes on a quarterly basis an Innovation Scorecard to enable commissioners to benchmark their own position and increase transparency to patients and the public. This assists the NHS in the identification of variation and the adoption of treatments such as NOACs that are recommended in NICE technology appraisals. In addition, NHS England advises that it expects practitioners to consider anticoagulant treatments in line with NICE guidelines.</p><p>Some progress is being made. The uptake of NOACs across England has doubled in recent years from 45,708 per 100,000 of the resident population in 2013-14 to 126,845 in 2014-15.</p><br /><p><del class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</del></p><br /><p><del class="ministerial">Copies of the guidance referred to have been placed in the Library.</del></p><p><ins class="ministerial"></ins></p><p><ins class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</ins></p><p><ins class="ministerial"></ins></p><p><ins class="ministerial">Copies of the guidance referred to, excluding GRASP-AF have been placed in the Library.</ins></p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-12-08T12:43:31.24Zmore like thismore than 2015-12-08T12:43:31.24Z
star this property question first ministerially corrected
less than 2015-12-09T13:42:42.943Zmore like thismore than 2015-12-09T13:42:42.943Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
34227
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1850
star this property label Biography information for Baroness Masham of Ilton more like this
432083
star this property registered interest false more like this
star this property date less than 2015-11-24more like thismore than 2015-11-24
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Atrial Fibrillation: Diagnosis more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what action they are taking to improve the diagnosis of atrial fibrillation. more like this
star this property tabling member printed
Baroness Masham of Ilton more like this
star this property uin HL3856 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-12-08more like thismore than 2015-12-08
star this property answer text <p>NHS England is encouraging clinical commissioning groups to work with local practices to target people at risk of atrial fibrillation (AF). Innovative approaches such as pulse testing at flu clinics and by some dentists are being used to identify AF in older people. The NHS Health Check programme’s best practice guidance also recommends a pulse check is carried out as part of the process of taking a blood pressure reading. People found to have an irregular pulse rhythm should be referred to the general practitioner for further investigation.</p><br /><p>The National Institute for Health and Care Excellence (NICE) published an updated guideline on AF in June 2014. This offers evidence-based advice on the care and treatment of people with AF and includes recommendations on diagnosis. In July 2015 NICE also published a quality standard on AF.</p><br /><p>In addition to its clinical guideline on AF, NICE has published technology appraisal guidance on a number of new oral anticoagulants (NOACs), approving them for certain patients.</p><br /><p>There is a legal requirement on commissioners to provide funding for treatments and drugs recommended in NICE technology appraisal guidance within three months of the guidance being published.This is enshrined in the NHS Constitution as a right to NICE-approved drugs.</p><br /><p>A <a href="https://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> by the <a href="https://www.nice.org.uk/News/Article/new-collaborative-aims-to-increase-nice-guidance-uptake" target="_blank">NICE Implementation Collaborative</a> was published alongside NICE’s updated guideline in June 2014. This addresses some of the barriers to implementing NICE’s recommendations on prescribing NOACs.</p><br /><p>The need to reduce variation and strengthen compliance of the uptake of NICE technology appraisals was identified in <em>Innovation Health and Wealth</em>, published in December 2011. In response, NHS England and the Health and Social Care Information Centre now publishes on a quarterly basis an Innovation Scorecard to enable commissioners to benchmark their own position and increase transparency to patients and the public. This assists the NHS in the identification of variation and the adoption of treatments such as NOACs that are recommended in NICE technology appraisals. In addition, NHS England advises that it expects practitioners to consider anticoagulant treatments in line with NICE guidelines.</p><p>Some progress is being made. The uptake of NOACs across England has doubled in recent years from 45,708 per 100,000 of the resident population in 2013-14 to 126,845 in 2014-15.</p><br /><p><del class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</del></p><br /><p><del class="ministerial">Copies of the guidance referred to have been placed in the Library.</del></p><p><ins class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</ins></p><p><ins class="ministerial"></ins></p><p><ins class="ministerial">Copies of the guidance referred to, excluding GRASP-AF have been placed in the Library.</ins></p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-12-08T12:43:31.287Zmore like thismore than 2015-12-08T12:43:31.287Z
star this property question first ministerially corrected
less than 2015-12-09T13:43:14.663Zmore like thismore than 2015-12-09T13:43:14.663Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
34228
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1850
star this property label Biography information for Baroness Masham of Ilton more like this
432084
star this property registered interest false more like this
star this property date less than 2015-11-24more like thismore than 2015-11-24
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Atrial Fibrillation: Strokes more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what assessment they have made of how many strokes related to atrial fibrillation could be prevented each year through the roll-out of GRASP-AF in primary care. more like this
star this property tabling member printed
Baroness Masham of Ilton more like this
star this property uin HL3857 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-12-08more like thismore than 2015-12-08
star this property answer text <p>NHS England is encouraging clinical commissioning groups to work with local practices to target people at risk of atrial fibrillation (AF). Innovative approaches such as pulse testing at flu clinics and by some dentists are being used to identify AF in older people. The NHS Health Check programme’s best practice guidance also recommends a pulse check is carried out as part of the process of taking a blood pressure reading. People found to have an irregular pulse rhythm should be referred to the general practitioner for further investigation.</p><br /><p>The National Institute for Health and Care Excellence (NICE) published an updated guideline on AF in June 2014. This offers evidence-based advice on the care and treatment of people with AF and includes recommendations on diagnosis. In July 2015 NICE also published a quality standard on AF.</p><br /><p>In addition to its clinical guideline on AF, NICE has published technology appraisal guidance on a number of new oral anticoagulants (NOACs), approving them for certain patients.</p><br /><p>There is a legal requirement on commissioners to provide funding for treatments and drugs recommended in NICE technology appraisal guidance within three months of the guidance being published.This is enshrined in the NHS Constitution as a right to NICE-approved drugs.</p><br /><p>A <a href="https://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> by the <a href="https://www.nice.org.uk/News/Article/new-collaborative-aims-to-increase-nice-guidance-uptake" target="_blank">NICE Implementation Collaborative</a> was published alongside NICE’s updated guideline in June 2014. This addresses some of the barriers to implementing NICE’s recommendations on prescribing NOACs.</p><br /><p>The need to reduce variation and strengthen compliance of the uptake of NICE technology appraisals was identified in <em>Innovation Health and Wealth</em>, published in December 2011. In response, NHS England and the Health and Social Care Information Centre now publishes on a quarterly basis an Innovation Scorecard to enable commissioners to benchmark their own position and increase transparency to patients and the public. This assists the NHS in the identification of variation and the adoption of treatments such as NOACs that are recommended in NICE technology appraisals. In addition, NHS England advises that it expects practitioners to consider anticoagulant treatments in line with NICE guidelines.</p><p>Some progress is being made. The uptake of NOACs across England has doubled in recent years from 45,708 per 100,000 of the resident population in 2013-14 to 126,845 in 2014-15.</p><br /><p><del class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</del></p><br /><p><del class="ministerial">Copies of the guidance referred to have been placed in the Library.</del></p><p><ins class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</ins></p><p><ins class="ministerial"></ins></p><p><ins class="ministerial">Copies of the guidance referred to, excluding GRASP-AF have been placed in the Library.</ins></p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-12-08T12:43:31.333Zmore like thismore than 2015-12-08T12:43:31.333Z
star this property question first ministerially corrected
less than 2015-12-09T13:43:28.1Zmore like thismore than 2015-12-09T13:43:28.1Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
34229
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1850
star this property label Biography information for Baroness Masham of Ilton more like this
432085
star this property registered interest false more like this
star this property date less than 2015-11-24more like thismore than 2015-11-24
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health remove filter
star this property answering dept sort name Health more like this
star this property hansard heading Atrial Fibrillation: Strokes more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what action they are taking to promote the implementation of NICE guidance on prescribing anticoagulants for the prevention of strokes related to atrial fibrillation. more like this
star this property tabling member printed
Baroness Masham of Ilton more like this
star this property uin HL3858 more like this
star this property answer
answer
unstar this property is ministerial correction true remove filter
star this property date of answer less than 2015-12-08more like thismore than 2015-12-08
star this property answer text <p>NHS England is encouraging clinical commissioning groups to work with local practices to target people at risk of atrial fibrillation (AF). Innovative approaches such as pulse testing at flu clinics and by some dentists are being used to identify AF in older people. The NHS Health Check programme’s best practice guidance also recommends a pulse check is carried out as part of the process of taking a blood pressure reading. People found to have an irregular pulse rhythm should be referred to the general practitioner for further investigation.</p><br /><p>The National Institute for Health and Care Excellence (NICE) published an updated guideline on AF in June 2014. This offers evidence-based advice on the care and treatment of people with AF and includes recommendations on diagnosis. In July 2015 NICE also published a quality standard on AF.</p><br /><p>In addition to its clinical guideline on AF, NICE has published technology appraisal guidance on a number of new oral anticoagulants (NOACs), approving them for certain patients.</p><br /><p>There is a legal requirement on commissioners to provide funding for treatments and drugs recommended in NICE technology appraisal guidance within three months of the guidance being published.This is enshrined in the NHS Constitution as a right to NICE-approved drugs.</p><br /><p>A <a href="https://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> by the <a href="https://www.nice.org.uk/News/Article/new-collaborative-aims-to-increase-nice-guidance-uptake" target="_blank">NICE Implementation Collaborative</a> was published alongside NICE’s updated guideline in June 2014. This addresses some of the barriers to implementing NICE’s recommendations on prescribing NOACs.</p><br /><p>The need to reduce variation and strengthen compliance of the uptake of NICE technology appraisals was identified in <em>Innovation Health and Wealth</em>, published in December 2011. In response, NHS England and the Health and Social Care Information Centre now publishes on a quarterly basis an Innovation Scorecard to enable commissioners to benchmark their own position and increase transparency to patients and the public. This assists the NHS in the identification of variation and the adoption of treatments such as NOACs that are recommended in NICE technology appraisals. In addition, NHS England advises that it expects practitioners to consider anticoagulant treatments in line with NICE guidelines.</p><p>Some progress is being made. The uptake of NOACs across England has doubled in recent years from 45,708 per 100,000 of the resident population in 2013-14 to 126,845 in 2014-15.</p><br /><p><del class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</del></p><br /><p><del class="ministerial">Copies of the guidance referred to have been placed in the Library.</del></p><p><ins class="ministerial">No assessment has been made of the number of strokes related to AF could be prevented each year through the roll-out of Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) in primary care. However, in 2014, an economic analysis estimated that if all eligible patients at high risk were managed according to the NICE AF guidelines, an additional 11,600 AF related strokes per year could be avoided.</ins></p><p><ins class="ministerial"></ins></p><p><ins class="ministerial">Copies of the guidance referred to, excluding GRASP-AF have been placed in the Library.</ins></p>
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-12-08T12:43:31.4Zmore like thismore than 2015-12-08T12:43:31.4Z
star this property question first ministerially corrected
less than 2015-12-09T13:43:51.933Zmore like thismore than 2015-12-09T13:43:51.933Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property previous answer version
34230
star this property answering member printed Lord Prior of Brampton more like this
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
1850
star this property label Biography information for Baroness Masham of Ilton more like this