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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

1024246

	registered interest
	date	12/12/2018
	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	Social Services: Pay
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what guidance they provide to local authorities about the payment of sleep-in shifts; and whether any such guidance has been updated following the ruling by the Court of Appeal in Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad [2018] EWCA Civ 1641.
	tabling member printed	Baroness Jolly
	uin	HL12243
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>Updated Government guidance National Minimum Wage and National Living Wage: Calculating the minimum wage was published on 8 November setting out the implications for paying workers for sleep-in shifts following the ruling by the Court of Appeal in Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad. The Government sent advance notice of the publication to local government representatives. A copy of the guidance is attached.</p><p>The Government is sending a clear message that the judgment should not be used as an opportunity to make ad-hoc changes to the fees paid to providers. Commissioners and providers should be working together to determine a fair rate of pay for sleep-in shifts to fit their local labour market conditions.</p><p>The Government has given councils access to up to £3.6 billion more, dedicated for adult social care in 2018-19 and up to £3.9 billion for 2019-20. Overall, councils are able to increase spending on adult social care by 9% in real terms from 2015/16 to 2019/20. The Government encourages employers to pay more than the minimum wage wherever possible but recognises that employers’ ability to do so will depend on a range of factors.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12244 question first answered 20/12/2018 12:32:51 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name Calculating_the_minimum_wage_guidance_dec_2018.pdf title HL12243,HL12244 attached document
	tabling member	4203 label Biography information for Baroness Jolly

1024247

	registered interest
	date	12/12/2018
	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	Social Services: Pay
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they are taking to ensure that social care providers and staff are not penalised financially if local authorities decide to reduce the fees at which they commission future sleep-in shifts.
	tabling member printed	Baroness Jolly
	uin	HL12244
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>Updated Government guidance National Minimum Wage and National Living Wage: Calculating the minimum wage was published on 8 November setting out the implications for paying workers for sleep-in shifts following the ruling by the Court of Appeal in Royal Mencap Society v Tomlinson-Blake and Shannon v Rampersad. The Government sent advance notice of the publication to local government representatives. A copy of the guidance is attached.</p><p>The Government is sending a clear message that the judgment should not be used as an opportunity to make ad-hoc changes to the fees paid to providers. Commissioners and providers should be working together to determine a fair rate of pay for sleep-in shifts to fit their local labour market conditions.</p><p>The Government has given councils access to up to £3.6 billion more, dedicated for adult social care in 2018-19 and up to £3.9 billion for 2019-20. Overall, councils are able to increase spending on adult social care by 9% in real terms from 2015/16 to 2019/20. The Government encourages employers to pay more than the minimum wage wherever possible but recognises that employers’ ability to do so will depend on a range of factors.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12243 question first answered 20/12/2018 12:32:51 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name Calculating_the_minimum_wage_guidance_dec_2018.pdf title HL12243,HL12244 attached document
	tabling member	4203 label Biography information for Baroness Jolly

1023660

	registered interest
	date	11/12/2018
	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	Genito-urinary Medicine: Finance
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what estimate they have made of the number of councils that have reduced or plan to reduce their budgets for sexual and reproductive health services; and what assessment they have made of the impact of any such reductions on women of reproductive age living in affected areas.
	tabling member printed	Baroness Tonge
	uin	HL12212
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>Data collected on sexual health expenditure by local authority as part of the Ministry of Housing, Communities and Local Government General Fund Revenue Account Outturn data on Social Care and Public Health service spend show that 94 of the 152 local authorities spent less on sexual health services in 2017-18 than in 2016-17.</p><p>Returns from the Sexual and Reproductive Health Activity Dataset (SRHAD) data show that in 2017-18, there was a reduced number of services in 49 local authority areas compared to 2016-17. Other services may provide contraception but not complete a SRHAD return. Ongoing reconfiguration of individual sexual and reproductive health services can vary which means that reduction in number of services need not necessarily equate to reduction in overall provision. Contraception is also widely available free of charge through general practice. No assessment has been made on the impact of these changes.</p><p>The Government has mandated local authorities in England to commission comprehensive open access sexual health services, including advice on, and reasonable access to, a broad range of contraceptive substances and appliances. It is for local authorities to assess and understand local needs, including assessing the impact locally of reductions due to service reconfiguration, and determine how funding is spent to deliver services that meet those needs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12213 question first answered 20/12/2018 12:34:04 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	200 label Biography information for Baroness Tonge

1023661

	registered interest
	date	11/12/2018
	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	Contraceptives
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what estimate they have made of the number of local councils that have reduced the number of sites commissioned to deliver contraceptive services; and what assessment they have made of the impact of any such reductions.
	tabling member printed	Baroness Tonge
	uin	HL12213
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>Data collected on sexual health expenditure by local authority as part of the Ministry of Housing, Communities and Local Government General Fund Revenue Account Outturn data on Social Care and Public Health service spend show that 94 of the 152 local authorities spent less on sexual health services in 2017-18 than in 2016-17.</p><p>Returns from the Sexual and Reproductive Health Activity Dataset (SRHAD) data show that in 2017-18, there was a reduced number of services in 49 local authority areas compared to 2016-17. Other services may provide contraception but not complete a SRHAD return. Ongoing reconfiguration of individual sexual and reproductive health services can vary which means that reduction in number of services need not necessarily equate to reduction in overall provision. Contraception is also widely available free of charge through general practice. No assessment has been made on the impact of these changes.</p><p>The Government has mandated local authorities in England to commission comprehensive open access sexual health services, including advice on, and reasonable access to, a broad range of contraceptive substances and appliances. It is for local authorities to assess and understand local needs, including assessing the impact locally of reductions due to service reconfiguration, and determine how funding is spent to deliver services that meet those needs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12212 question first answered 20/12/2018 12:34:05 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	200 label Biography information for Baroness Tonge

1022880

	registered interest
	date	10/12/2018
	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	Alcoholic Drinks: Consumption
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they are taking to increase awareness of the Chief Medical Officers' low-risk drinking guidelines following the findings in the report by the Alcohol Health Alliance, How we drink, what we think: Public views on alcohol and alcohol policies in the UK, published on 4 December, that only 19 per cent of people know the guidelines.
	tabling member printed	Baroness Hayter of Kentish Town
	uin	HL12145
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>In March 2017, the Department issued guidance to the alcohol industry setting out how the guidelines can best be communicated on the labels of alcoholic drinks. The Department agreed a transitional period with the industry until 1 September 2019 to reflect the new guidelines on labelling.</p><p>The Government currently has no plans to include a commitment in the Alcohol Strategy to issue cancer warnings on alcohol labels. The UK Chief Medical Officers’ Low Risk Drinking Guidelines highlight that the risk of developing a range of health problems, including cancer, increases the more you drink on a regular basis. Information on the low risk guidelines is also available online.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12146 question first answered 20/12/2018 12:39:28 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4159 label Biography information for Baroness Hayter of Kentish Town

1022881

	registered interest
	date	10/12/2018
	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	Alcoholic Drinks: Labelling
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether their forthcoming Alcohol Strategy will include a commitment to require cancer warnings on alcohol labels, following the findings in the report by the Alcohol Health Alliance, How we drink, what we think: Public views on alcohol and alcohol policies in the UK, published on 4 December, that the majority of people support such a requirement.
	tabling member printed	Baroness Hayter of Kentish Town
	uin	HL12146
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>In March 2017, the Department issued guidance to the alcohol industry setting out how the guidelines can best be communicated on the labels of alcoholic drinks. The Department agreed a transitional period with the industry until 1 September 2019 to reflect the new guidelines on labelling.</p><p>The Government currently has no plans to include a commitment in the Alcohol Strategy to issue cancer warnings on alcohol labels. The UK Chief Medical Officers’ Low Risk Drinking Guidelines highlight that the risk of developing a range of health problems, including cancer, increases the more you drink on a regular basis. Information on the low risk guidelines is also available online.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12145 question first answered 20/12/2018 12:39:28 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4159 label Biography information for Baroness Hayter of Kentish Town

1020282

	registered interest
	date	05/12/2018
	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	Nutrition (Amendment) (EU Exit) Regulations 2018
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what factors they took into consideration when deciding that 11 days was an appropriate consultation period for the Nutrition (Amendment) (EU Exit) Regulations 2018.
	tabling member printed	Baroness Jolly
	uin	HL12072
	answer	answer is ministerial correction date of answer 13/12/2018 answer text <p>Proposals addressed by the Nutrition (Amendment) (EU Exit) Regulations 2018 public consultation are predominantly technical in nature, simply changing European Union-specific references so that relevant legislation remains effective when the United Kingdom is no longer a member state.</p><p>Plans outlined in the consultation would therefore provide continuity and assurance for business and consumers, as they seek to mirror existing European systems domestically as far as is practically possible.</p><p>As the duration of a consultation is informed by the nature and impact of the proposals we consider a relatively short consultation period appropriate, and therefore have no plans to extend its length.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12073 question first answered 13/12/2018 14:59:45 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4203 label Biography information for Baroness Jolly

1020283

	registered interest
	date	05/12/2018
	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	Nutrition (Amendment) (EU Exit) Regulations 2018
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to consider extending the consultation period on proposed amendments to the Nutrition (Amendment) (EU Exit) Regulations 2018 to allow sufficient time for stakeholders to provide meaningful feedback.
	tabling member printed	Baroness Jolly
	uin	HL12073
	answer	answer is ministerial correction date of answer 13/12/2018 answer text <p>Proposals addressed by the Nutrition (Amendment) (EU Exit) Regulations 2018 public consultation are predominantly technical in nature, simply changing European Union-specific references so that relevant legislation remains effective when the United Kingdom is no longer a member state.</p><p>Plans outlined in the consultation would therefore provide continuity and assurance for business and consumers, as they seek to mirror existing European systems domestically as far as is practically possible.</p><p>As the duration of a consultation is informed by the nature and impact of the proposals we consider a relatively short consultation period appropriate, and therefore have no plans to extend its length.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL12072 question first answered 13/12/2018 14:59:46 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4203 label Biography information for Baroness Jolly