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967440

	registered interest
	date	04/09/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Community Nurses
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether the number of district nurses in England in community service organisations, such as NHS Community Healthcare Trusts, has reduced since 2010; and, if so, what measures they are taking to address any problems caused by such a reduction.
	tabling member printed	Baroness Cox
	uin	HL9937
	answer	answer is ministerial correction date of answer 18/09/2018 answer text <p>Community health care services are a crucial part of the health and social care system that allows patients to be cared for at the right time in the right place.</p><p>NHS Digital data shows a reduction in the number of full time equivalent district nurses in England from 7,546 in September 2010 to 4,587 in May 2018. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care or in general practitioner surgeries, local authorities or other providers. The number of district nurses in independent healthcare providers increased by 273, from September 2010 to September 2017. As a result of changes made in 2009 to the ways in which community services are provided – i.e. from a range of different types of provider – this does not represent the full picture and there will be a number of district nurses providing National Health Service services in organisations that do not provide a return to the Electronic Staff Records.</p><p>The training of new district nurses is important in maintaining a workforce that can deliver the needs of the population in the community. Health Education England has commissioned and funded the District Nursing Specialist Practice Qualification at a steady state over the last six years. These are based upon the requirements that local providers have informed Health Education England. However, year on year these commissions are not fully taken up and therefore Health Education England is working to better understand the reasons this may be.</p><p>Health Education England is now exploring the capacity and capability required of our community workforce to best meet the future needs of the population. Health Education England is evaluating the skills and knowledge required within the wider community workforce including district nurses. This has involved extensive engagement across England to understand how best to meet to needs of the local population, as well as develop a role that has a more desirable career pathway for prospective healthcare professionals. The Government is also supporting incentives for postgraduates who go on to work in community nursing roles, including ‘golden hellos’.</p><p>Patient safety remains a key priority for the Department and in 2017 we restated our commitment to the NHS being the “safest healthcare system in the world”. The Care Quality Commission (CQC) assesses all registered providers that deliver regulated activities against the Fundamental Standards, below which the standard of care must not fall. Staffing is one of the Standards, and the CQC inspections check that sufficient numbers of suitably qualified, competent, skilled and experienced staff are deployed within service providers. To this effect we would expect providers to continue to ensure patient safety in the community.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL9938 question first answered 18/09/2018 11:36:58 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3364 label Biography information for Baroness Cox

967441

	registered interest
	date	04/09/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Community Nurses
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what measures they are taking to ensure patient safety and wellbeing in the light of the expected reduction in funding for district nurse training in England from September 2019.
	tabling member printed	Baroness Cox
	uin	HL9938
	answer	answer is ministerial correction date of answer 18/09/2018 answer text <p>Community health care services are a crucial part of the health and social care system that allows patients to be cared for at the right time in the right place.</p><p>NHS Digital data shows a reduction in the number of full time equivalent district nurses in England from 7,546 in September 2010 to 4,587 in May 2018. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care or in general practitioner surgeries, local authorities or other providers. The number of district nurses in independent healthcare providers increased by 273, from September 2010 to September 2017. As a result of changes made in 2009 to the ways in which community services are provided – i.e. from a range of different types of provider – this does not represent the full picture and there will be a number of district nurses providing National Health Service services in organisations that do not provide a return to the Electronic Staff Records.</p><p>The training of new district nurses is important in maintaining a workforce that can deliver the needs of the population in the community. Health Education England has commissioned and funded the District Nursing Specialist Practice Qualification at a steady state over the last six years. These are based upon the requirements that local providers have informed Health Education England. However, year on year these commissions are not fully taken up and therefore Health Education England is working to better understand the reasons this may be.</p><p>Health Education England is now exploring the capacity and capability required of our community workforce to best meet the future needs of the population. Health Education England is evaluating the skills and knowledge required within the wider community workforce including district nurses. This has involved extensive engagement across England to understand how best to meet to needs of the local population, as well as develop a role that has a more desirable career pathway for prospective healthcare professionals. The Government is also supporting incentives for postgraduates who go on to work in community nursing roles, including ‘golden hellos’.</p><p>Patient safety remains a key priority for the Department and in 2017 we restated our commitment to the NHS being the “safest healthcare system in the world”. The Care Quality Commission (CQC) assesses all registered providers that deliver regulated activities against the Fundamental Standards, below which the standard of care must not fall. Staffing is one of the Standards, and the CQC inspections check that sufficient numbers of suitably qualified, competent, skilled and experienced staff are deployed within service providers. To this effect we would expect providers to continue to ensure patient safety in the community.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL9937 question first answered 18/09/2018 11:36:58 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3364 label Biography information for Baroness Cox

1127426

	registered interest
	date	20/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Lung Diseases: Medical Equipment
	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 impact of the use of metred dose inflators containing hydrofluorocarbons in releasing greenhouse gases.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL15837
	answer	answer is ministerial correction date of answer 04/06/2019 answer text <p>We have made no such assessment on the proportion of the National Health Service carbon footprint made by hydrofluorocarbon in metred dose inhalers or of the impact of the use of metred dose inhalers containing hydrofluorocarbons in releasing greenhouse gases. However, we are informed by NHS England that the National Atmospheric Emissions Inventory calculated the carbon emissions from inhalers in England as 850,000 tonnes of carbon dioxide equivalents. This is equivalent to approximately 4% of the entire carbon footprint of the NHS in England.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15840 question first answered 04/06/2019 13:46:09 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1127429

	registered interest
	date	20/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Lung Diseases: Medical Equipment
	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 proportion of the NHS carbon footprint made by hydrofluorocarbon in metred dose inflators.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL15840
	answer	answer is ministerial correction date of answer 04/06/2019 answer text <p>We have made no such assessment on the proportion of the National Health Service carbon footprint made by hydrofluorocarbon in metred dose inhalers or of the impact of the use of metred dose inhalers containing hydrofluorocarbons in releasing greenhouse gases. However, we are informed by NHS England that the National Atmospheric Emissions Inventory calculated the carbon emissions from inhalers in England as 850,000 tonnes of carbon dioxide equivalents. This is equivalent to approximately 4% of the entire carbon footprint of the NHS in England.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15837 question first answered 04/06/2019 13:46:09 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1127265

	registered interest
	date	16/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	West Hertfordshire Hospitals NHS Trust: Finance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how much funding they provided to the West Hertfordshire Hospitals NHS Trust in each year from May 2010 to May 2015.
	tabling member printed	Baroness Thornhill
	uin	HL15818
	answer	answer is ministerial correction date of answer 24/05/2019 answer text <p>The Department does not hold the information requested on funding which was changed, cancelled or forfeited in each year from May 2010 to May 2015.</p><p>The following table shows the total amount of income that West Hertfordshire Hospitals NHS Trust received in the financial years 2011-12 to 2014-15.</p><table><tbody><tr><td><p>Year</p></td><td><p>Income £ million</p></td></tr><tr><td><p>2011-12</p></td><td><p>273.7</p></td></tr><tr><td><p>2012-13</p></td><td><p>278.2</p></td></tr><tr><td><p>2013-14</p></td><td><p>291.34</p></td></tr><tr><td><p>2014-15</p></td><td><p>344.97</p></td></tr></tbody></table><p> </p><p>We are not able to divide the income into years from May to April due to how the data is reported, which is by financial year. Additionally, this is total income, so it includes Government funding plus any additional funding that the trust received.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15819 question first answered 24/05/2019 11:48:46 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4558 label Biography information for Baroness Thornhill

1127266

	registered interest
	date	16/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	West Hertfordshire Hospitals NHS Trust: Finance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what funding committed to the West Hertfordshire Hospitals NHS Trust from May 2005 to May 2010 was (1) changed, (2) cancelled, and (3) forfeit, in each year from May 2010 to May 2015.
	tabling member printed	Baroness Thornhill
	uin	HL15819
	answer	answer is ministerial correction date of answer 24/05/2019 answer text <p>The Department does not hold the information requested on funding which was changed, cancelled or forfeited in each year from May 2010 to May 2015.</p><p>The following table shows the total amount of income that West Hertfordshire Hospitals NHS Trust received in the financial years 2011-12 to 2014-15.</p><table><tbody><tr><td><p>Year</p></td><td><p>Income £ million</p></td></tr><tr><td><p>2011-12</p></td><td><p>273.7</p></td></tr><tr><td><p>2012-13</p></td><td><p>278.2</p></td></tr><tr><td><p>2013-14</p></td><td><p>291.34</p></td></tr><tr><td><p>2014-15</p></td><td><p>344.97</p></td></tr></tbody></table><p> </p><p>We are not able to divide the income into years from May to April due to how the data is reported, which is by financial year. Additionally, this is total income, so it includes Government funding plus any additional funding that the trust received.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15818 question first answered 24/05/2019 11:48:46 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4558 label Biography information for Baroness Thornhill

1126307

	registered interest
	date	13/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Civil Proceedings
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how much money the NHS spent as part of legal settlements in each year from 2009 to 2018; and how much of each year's spend relates to legal fees.
	tabling member printed	Baroness Hodgson of Abinger
	uin	HL15667
	answer	answer is ministerial correction date of answer 24/05/2019 answer text <p>NHS Resolution has provided the following information:</p><p>NHS Resolution has provided tables which cover:</p><p>- total expenditure for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes from 2009 to 2018;</p><p>- the total legal costs per financial year; and</p><p>- the draft budget for legal fees/damages 2019 for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes.</p><p>The data is attached due to the size of the data.</p><p>National Health Service spend on legal fees for matters other than clinical/non-clinical negligence settlements since 2009 has been interpreted as spend relating to NHS providers and commissioners.</p><p>This includes NHS trusts, NHS foundation trusts and NHS England and clinical commissioning groups. NHS spend on legal fees for non-negligence matters is shown in the following table.</p><table><tbody><tr><td><p>Year</p></td><td><p>Total legal fees (£000s)</p></td></tr><tr><td><p>2013-14</p></td><td><p>110,747</p></td></tr><tr><td><p>2014-15</p></td><td><p>171,806</p></td></tr><tr><td><p>2015-16</p></td><td><p>162,273</p></td></tr><tr><td><p>2016-17</p></td><td><p>172,135</p></td></tr><tr><td><p>2017-18</p></td><td><p>160,140</p></td></tr></tbody></table><p>Prior to 2013-14, expenditure on legal fees was not separately classified by primary care trusts and strategic health authorities who both carried out NHS commissioning and NHS trusts. Therefore, comparable information pre 2013-14 is unavailable.</p><p>There is no specific category of expenditure that isolates spend relating to legal settlements in the NHS.</p><p>We have interpreted the request for data for the amounts set aside in 2019 as the value of said provisions as at the end of the financial year, 31 March 2019. This data is still subject to audit and will not be available until after publication of the Annual Report and Accounts in July 2019.</p><p>The budget totals for legal fees relating to NHS spend in 2019 is not available.</p><p> </p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15668 question first answered 24/05/2019 11:47:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name HL15667 & HL15668 Data.docx title HL15667_HL15668_data
	tabling member	4301 label Biography information for Baroness Hodgson of Abinger

1126308

	registered interest
	date	13/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Civil Proceedings
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how much money the NHS has set aside for potential legal settlements in 2019; and how much they have budgeted for legal fees.
	tabling member printed	Baroness Hodgson of Abinger
	uin	HL15668
	answer	answer is ministerial correction date of answer 24/05/2019 answer text <p>NHS Resolution has provided the following information:</p><p>NHS Resolution has provided tables which cover:</p><p>- total expenditure for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes from 2009 to 2018;</p><p>- the total legal costs per financial year; and</p><p>- the draft budget for legal fees/damages 2019 for NHS Resolution Clinical Negligence Schemes and NHS Resolution non-clinical negligence schemes.</p><p>The data is attached due to the size of the data.</p><p>National Health Service spend on legal fees for matters other than clinical/non-clinical negligence settlements since 2009 has been interpreted as spend relating to NHS providers and commissioners.</p><p>This includes NHS trusts, NHS foundation trusts and NHS England and clinical commissioning groups. NHS spend on legal fees for non-negligence matters is shown in the following table.</p><table><tbody><tr><td><p>Year</p></td><td><p>Total legal fees (£000s)</p></td></tr><tr><td><p>2013-14</p></td><td><p>110,747</p></td></tr><tr><td><p>2014-15</p></td><td><p>171,806</p></td></tr><tr><td><p>2015-16</p></td><td><p>162,273</p></td></tr><tr><td><p>2016-17</p></td><td><p>172,135</p></td></tr><tr><td><p>2017-18</p></td><td><p>160,140</p></td></tr></tbody></table><p>Prior to 2013-14, expenditure on legal fees was not separately classified by primary care trusts and strategic health authorities who both carried out NHS commissioning and NHS trusts. Therefore, comparable information pre 2013-14 is unavailable.</p><p>There is no specific category of expenditure that isolates spend relating to legal settlements in the NHS.</p><p>We have interpreted the request for data for the amounts set aside in 2019 as the value of said provisions as at the end of the financial year, 31 March 2019. This data is still subject to audit and will not be available until after publication of the Annual Report and Accounts in July 2019.</p><p>The budget totals for legal fees relating to NHS spend in 2019 is not available.</p><p> </p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15667 question first answered 24/05/2019 11:47:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name HL15667 & HL15668 Data.docx title HL15667_HL15668_data
	tabling member	4301 label Biography information for Baroness Hodgson of Abinger

1125504

	registered interest
	date	08/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Pneumococcal Diseases: Vaccination
	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 recommendations by the Joint Committee on Vaccination and Immunisation to reduce the infant pneumococcal vaccination schedule from three doses to two.
	tabling member printed	Baroness Masham of Ilton
	uin	HL15599
	answer	answer is ministerial correction date of answer 22/05/2019 answer text <p>The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom’s immunisation programme. As an independent committee, it is well placed to ensure the latest and most appropriate evidence has been considered on potential changes to scheduling within the vaccine programme. It bases its advice on review of a wide range of scientific and other evidence, including from the published literature, commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness.</p><p>The JCVI advised that a two-dose schedule for the infant pneumococcal conjugate vaccine (PCV) Prevenar13 is appropriate for the UK. Its advice takes into account the public health aspects of any potential change to the vaccination schedule, such as the potential impact on cases of infectious disease. The JCVI consulted relevant stakeholders on its proposed advice, between January and April 2018, to ensure that its advice reflects all the evidence.</p><p>The JCVI’s advice on the infant pneumococcal programme was given full consideration, including the potential public health implications, before a decision was made to implement it. The UK frequently adopts innovative immunisation schedules and we regularly change the vaccine schedule following the advice of our independent expert committee, as we are doing in this case.</p><p>The decision is based on the excellent effectiveness of the vaccine and years of high uptake, which has helped to provide protection to the rest of the population and has successfully controlled many types of pneumococcal disease in this country. The evidence shows that two doses will sustain the excellent results we have already seen. We are confident that the world-class disease surveillance system we have in this country means our expert committee can closely monitor the impact of this change. This is set out in the JCVI’s minutes which are attached.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15600 question first answered 22/05/2019 14:50:14 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name JCVI Minute 2015 10 Attached to HL16000 and 15999.pdf title JCVI Minute 2015
	tabling member	1850 label Biography information for Baroness Masham of Ilton

1125505

	registered interest
	date	08/05/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Pneumococcal Diseases: Vaccination
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what analyses they have conducted of the risks and benefits of reducing the infant pneumococcal vaccination schedule from 2+1 to 1+1; and whether they will publish the results any such analyses.
	tabling member printed	Baroness Masham of Ilton
	uin	HL15600
	answer	answer is ministerial correction date of answer 22/05/2019 answer text <p>The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom’s immunisation programme. As an independent committee, it is well placed to ensure the latest and most appropriate evidence has been considered on potential changes to scheduling within the vaccine programme. It bases its advice on review of a wide range of scientific and other evidence, including from the published literature, commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness.</p><p>The JCVI advised that a two-dose schedule for the infant pneumococcal conjugate vaccine (PCV) Prevenar13 is appropriate for the UK. Its advice takes into account the public health aspects of any potential change to the vaccination schedule, such as the potential impact on cases of infectious disease. The JCVI consulted relevant stakeholders on its proposed advice, between January and April 2018, to ensure that its advice reflects all the evidence.</p><p>The JCVI’s advice on the infant pneumococcal programme was given full consideration, including the potential public health implications, before a decision was made to implement it. The UK frequently adopts innovative immunisation schedules and we regularly change the vaccine schedule following the advice of our independent expert committee, as we are doing in this case.</p><p>The decision is based on the excellent effectiveness of the vaccine and years of high uptake, which has helped to provide protection to the rest of the population and has successfully controlled many types of pneumococcal disease in this country. The evidence shows that two doses will sustain the excellent results we have already seen. We are confident that the world-class disease surveillance system we have in this country means our expert committee can closely monitor the impact of this change. This is set out in the JCVI’s minutes which are attached.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL15599 question first answered 22/05/2019 14:50:14 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name JCVI Minute 2015 10 Attached to HL16000 and 15999.pdf title JCVI Minute 2015
	tabling member	1850 label Biography information for Baroness Masham of Ilton