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889843

	registered interest
	date	23/04/2018
	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	Health Services: Reciprocal Arrangements
	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 possible increases in travel insurance for UK citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.
	tabling member printed	Baroness Quin
	uin	HL7175
	answer	answer is ministerial correction date of answer 08/05/2018 answer text <p>The Department has not made a formal assessment of the possible increases in travel insurance for United Kingdom citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.</p><p> </p><p>However, the Department engages regularly with the Association of British Insurers and industry to discuss matters relating to reciprocal healthcare and this will continue.</p> answering member printed Lord O'Shaughnessy question first answered 08/05/2018 14:02:52 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	518 label Biography information for Baroness Quin

850569

	registered interest
	date	27/02/2018
	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	Vitamin D
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, in the light of proposals to restrict access to prescription-based vitamin D maintenance, whether they will undertake a study into how such proposals might affect at-risk groups, as set out in NICE Guidelines 56-2, and in particular those in the at-risk groups on low or fixed incomes.
	tabling member printed	Baroness Quin
	uin	HL5913
	answer	answer is ministerial correction date of answer 12/03/2018 answer text <p>NHS England undertook a study into how the proposals in the consultation <em>Conditions for which over the counter items should not routinely be prescribed in primary care: A Consultation on guidance for CCGs </em>might affect at-risk groups by accompanying the consultation with a full Equality and Health Inequalities Impact Assessment. The Impact Assessment, <em>Equality and Health Inequalities – Full Analysis Form – Conditions for which over the counter items should not routinely be prescribed in primary care</em> sets out how the proposals may affect groups protected by the Equality Act 2010 and those people on low income and ethnic minorities, including those at-risk groups, as set out in National Institute for Health and Care Excellence guidelines. Copies of the consultation and Impact Assessment are attached.</p><p>In the summer months most people should be able to get all the vitamin D they need from sunlight on the skin. It is also found in some foods – oily fish, red meat, liver, egg yolks and fortified foods – such as most fat spreads and some breakfast cereals.</p><p>The Advisory Committee on Borderline Substances states that vitamins and minerals should be prescribed only in the management of actual or potential vitamin or mineral deficiency, and are not to be prescribed as dietary supplements. We understand that NHS England’s current consultation is in line with this. Prescribing vitamin D for maintenance would be classed as a treatment for prevention or as a dietary supplement.</p> answering member printed Lord O'Shaughnessy attachment 1 file name 2018 03 02 otc-guidance-2 nhse consultation.pdf title NHS England consultation on guidance for CCGs 2 file name Equality and Health Inequalities Impact Assessment.pdf title Equality Impact Assessment question first answered 12/03/2018 16:30:44 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	518 label Biography information for Baroness Quin

800465

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Fractures
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to ensure that all NHS users over 50 years old have access to Fracture Liaison Services to identify the link between any fracture and the bone health of the patient.
	tabling member printed	Baroness Quin
	uin	HL3852
	answer	answer is ministerial correction date of answer 14/12/2017 answer text <p>Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) evidence based guideline <em>Osteoporosis: assessing the risk of fragility fracture</em>, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.</p><p> </p><p>Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.</p><p> </p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL3853 question first answered 14/12/2017 15:01:14 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name osteoporosis-assessing-the-risk-of-fragility-fracture-pdf-35109574194373.pdf title Osteoporosis
	tabling member	518 label Biography information for Baroness Quin

800466

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Osteoporosis
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to ensure that women over 60 years old are routinely offered bone density scans to ascertain bone health.
	tabling member printed	Baroness Quin
	uin	HL3853
	answer	answer is ministerial correction date of answer 14/12/2017 answer text <p>Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) evidence based guideline <em>Osteoporosis: assessing the risk of fragility fracture</em>, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.</p><p> </p><p>Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.</p><p> </p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL3852 question first answered 14/12/2017 15:01:14 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name osteoporosis-assessing-the-risk-of-fragility-fracture-pdf-35109574194373.pdf title Osteoporosis
	tabling member	518 label Biography information for Baroness Quin