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930930

	registered interest
	date	25/06/2018
	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	Medicine: Research
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how they will protect joint projects with EU member states into disabilities and diseases if the UK leaves the EU.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL8930
	answer	answer is ministerial correction date of answer 09/07/2018 answer text <p>We want to continue to cooperate closely with our European partners to the benefit of all citizens and patients in the United Kingdom and across the European Union. As part of this, we are determined to continue working closely with health ministers across the EU and the European Commission and Parliament on a wide variety of issues including disabilities and diseases. Whilst we cannot pre-empt the negotiations, nor can we disadvantage the UK’s position in these negotiations by giving inappropriate guarantees at this time, the Government will continue to seek the best possible deal for the UK.</p> answering member printed Lord O'Shaughnessy question first answered 09/07/2018 10:43:10 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

850572

	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	Diabetes: 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 why flash glucose monitors are available to patients in some parts of England and not in others.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL5916
	answer	answer is ministerial correction date of answer 13/03/2018 answer text <p>Freestyle Libre, the flash glucose monitoring system was included in Part IX of the England and Wales Drug Tariff from November 2017. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free National Health Service prescriptions if they hold a valid medical exemption certificate. However, patients will need to discuss the ongoing management of their condition with their healthcare professional and consider what is most suitable for them.</p><p>Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for clinical commissioning groups (CCGs), who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines.</p><p>Reducing variation in the management and care of people with diabetes by 2020 is an objective included in the NHS England mandate. The NHS RightCare diabetes pathway shows the core components of an optimal diabetes service, as well as evidence of the opportunity to reduce variation. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free NHS prescriptions if they hold a valid medical exemption certificate.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5914 HL5915 question first answered 13/03/2018 15:47:25 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

908918

	registered interest
	date	21/05/2018
	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	Diabetes: Medical Equipment
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what measures are in place to ensure equitable access to (1) insulin pumps, and (2) other diabetes technologies, across England.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL8080
	answer	answer is ministerial correction date of answer 05/06/2018 answer text <p>Clinical commissioning groups (CCGs) are responsible for commissioning diabetes services to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines. This should include consideration of access to insulin pumps and other diabetes technologies for people with diabetes who might benefit from them.</p> answering member printed Lord O'Shaughnessy question first answered 05/06/2018 15:55:33 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

874611

	registered interest
	date	29/03/2018
	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	Diabetes
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have for the long-term approach to diabetes.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL6831
	answer	answer is ministerial correction date of answer 16/04/2018 answer text <p>The long-term approach to diabetes involves both seeking to reduce the increase in the prevalence of diabetes and, for those with diabetes, seeking to reduce the likelihood of developing complications and improving overall levels of treatment and care.</p><p>Work to reduce the increase in future prevalence of type 2 diabetes is being delivered through the NHS Diabetes Prevention Programme. By 2020, the programme will support up to 100,000 people at high risk of type 2 diabetes each year across England. Those referred will get tailored, personalised support over at least nine months to achieve a healthy weight, improve nutrition and increase levels of physical activity in order to reduce risks of developing type 2 diabetes.</p><p>Work on reducing the likelihood of those with diabetes developing complications is through the diabetes treatment and care programme. This focuses on four key interventions:</p><p>- Increasing attendance at structured education by both those newly diagnosed with diabetes and those who have had the condition for a longer period;</p><p>- Increasing achievement of the diabetes treatment targets and reducing variation in achievement of these targets between clinical commissioning groups and between general practitioner practices;</p><p>- Reducing the levels of amputations by increasing the availability of multidisciplinary footcare teams; and</p><p>- Reducing lengths of inpatient stay for people with diabetes by increasing the availability of diabetes inpatient specialist nurses.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 16/04/2018 14:02:32 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

850571

	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	Diabetes: Medical Equipment
	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 all Clinical Commissioning Groups are adequately funded to supply flash glucose monitors to all patients with type 1 diabetes.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL5915
	answer	answer is ministerial correction date of answer 13/03/2018 answer text <p>Freestyle Libre, the flash glucose monitoring system was included in Part IX of the England and Wales Drug Tariff from November 2017. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free National Health Service prescriptions if they hold a valid medical exemption certificate. However, patients will need to discuss the ongoing management of their condition with their healthcare professional and consider what is most suitable for them.</p><p>Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for clinical commissioning groups (CCGs), who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines.</p><p>Reducing variation in the management and care of people with diabetes by 2020 is an objective included in the NHS England mandate. The NHS RightCare diabetes pathway shows the core components of an optimal diabetes service, as well as evidence of the opportunity to reduce variation. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free NHS prescriptions if they hold a valid medical exemption certificate.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5914 HL5916 question first answered 13/03/2018 15:47:25 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

850570

	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	Diabetes: Medical Equipment
	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 all patients with type 1 diabetes in England have access to flash glucose monitors.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL5914
	answer	answer is ministerial correction date of answer 13/03/2018 answer text <p>Freestyle Libre, the flash glucose monitoring system was included in Part IX of the England and Wales Drug Tariff from November 2017. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free National Health Service prescriptions if they hold a valid medical exemption certificate. However, patients will need to discuss the ongoing management of their condition with their healthcare professional and consider what is most suitable for them.</p><p>Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for clinical commissioning groups (CCGs), who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines.</p><p>Reducing variation in the management and care of people with diabetes by 2020 is an objective included in the NHS England mandate. The NHS RightCare diabetes pathway shows the core components of an optimal diabetes service, as well as evidence of the opportunity to reduce variation. People with diabetes insipidus or diabetes mellitus (except where treatment is by diet alone) - which includes type 1 and type 2 diabetes - are eligible for free NHS prescriptions if they hold a valid medical exemption certificate.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5915 HL5916 question first answered 13/03/2018 15:47:24 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

873034

	registered interest
	date	27/03/2018
	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	Medical Treatments: Innovation
	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 the benefits of medical advances are available on the NHS in all areas of England.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL6714
	answer	answer is ministerial correction date of answer 09/04/2018 answer text <p>From April 2018 we are introducing a new Accelerated Access Pathway to streamline regulatory and market access decisions, getting products that we believe will be truly transformative to patients more quickly. The Pathway will be delivered by the Accelerated Access Collaborative, who will help unlock system barriers and disseminate learning. The Government is also working with key partners to expand the National Health Service Innovation Scorecard so that it covers a greater range of innovative products and is used more widely to identify unwarranted variation in uptake and improve patient outcomes.</p><p>In addition to this, we have also provided £39 million to improve local adoption and uptake of innovative medical technologies through the 15 Academic Health and Science Networks (AHSNs). The AHSNs will provide a ‘front door’ for innovators to access the support that they need and increase local knowledge sharing. Finally, the Government will help the NHS to adopt and integrate new technologies into everyday practice through the £6 million Pathway Transformation Fund.</p> answering member printed Lord O'Shaughnessy question first answered 09/04/2018 13:50:49 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

873033

	registered interest
	date	27/03/2018
	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	Medical Treatments: Innovation
	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, in respect of medical advances which have been funded and developed in the UK, the benefits are realised within the UK and made available to the NHS.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL6713
	answer	answer is ministerial correction date of answer 09/04/2018 answer text <p>The Government has multiple measures to allow the National Health Service to benefit from home grown innovations. For example, providing £41 million to support United Kingdom small and medium-sized enterprises creating world leading digital and medtech products to develop the evidence base to launch their products in the NHS; the NHS Clinical Entrepreneur Programme, which has supported the creation of over 50 clinical led start-ups, providing £39 million to improve local adoption and uptake of innovative medical technologies through the 15 Academic Health and Science Networks; and £6 million through the Pathway Transformation Fund to help the NHS to adopt and integrate new technologies into everyday practice.</p> answering member printed Lord O'Shaughnessy question first answered 09/04/2018 13:56:56 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

930931

	registered interest
	date	25/06/2018
	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	Fibromyalgia
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they are taking to progress the diagnosis and treatment of fibromyalgia.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL8931
	answer	answer is ministerial correction date of answer 09/07/2018 answer text <p>Diagnosing fibromyalgia can be difficult as there is no specific diagnostic test that can be used, and the symptoms can vary from person to person. Diagnosis is usually made by taking a medical history, checking symptoms and carrying out a physical examination. Blood tests, x-rays and other scans may be used to rule out medical conditions with similar symptoms to fibromyalgia.</p><p>The Royal College of General Practitioners (RCGP) curriculum includes training in musculoskeletal conditions, and as such, GP training can include fibromyalgia. A key component of a trainee GP’s final assessment, alongside the Clinical Skills Assessment and Workplace Based Assessment, is the applied knowledge test (AKT). The AKT is a summative assessment of the knowledge base that underpins independent general practice in the United Kingdom within the context of the NHS. The content guide for the RCGP, which serves to prepare trainees for the test, includes a specific reference to a required knowledge of fibromyalgia. <em>The Applied Knowledge Test Content Guide</em> is attached.</p><p>A range of support exists to help GPs identify the signs and symptoms of fibromyalgia in primary care. This includes an e-learning course developed by the RCGP and Arthritis Research UK on musculoskeletal care, including fibromyalgia, and a medical guide on diagnosis and treatment developed by the Fibromyalgia Association UK (FMUK) for health professionals. Information for the public can be found on the NHS Choices website and is also available in an online patient information guide produced by FMUK. The <em>Fibromyalgia Guidance for Health Professionals</em> is attached.</p><p>Although there is no cure for fibromyalgia, some treatments can ease symptoms and support improved quality of life for patients. The treatments offered will depend on the severity of a patient’s condition, but may include: pharmacological pain relief; physiotherapy; dietary and exercise advice; counselling or cognitive behavioural therapy; and self-management programmes which aim to give patients the skills and confidence to manage their conditions more effectively. There are also a number of National Health Service trusts that offer specialist fibromyalgia clinics, such as the Royal National Hospital for Rheumatic Diseases in Bath, which patients can access on referral from the clinician responsible for their care.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy attachment 1 file name Medical Pack.pdf title Fibromyalgia Guidance for Health Professionals 2 file name Content Guide August 2014.pdf title Applied Knowledge Test Content Guide question first answered 09/07/2018 14:17:12 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno

874610

	registered interest
	date	29/03/2018
	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	Diabetes: Health Education
	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 there is adequate education for newly diagnosed Type 1 diabetics.
	tabling member printed	Lord Roberts of Llandudno
	uin	HL6830
	answer	answer is ministerial correction date of answer 16/04/2018 answer text <p>The Diabetes Transformation Fund is supporting 137 clinical commissioning groups (CCGs), in partnership with local providers, to expand the numbers of structured education places for patients with type 1 or type 2 diabetes. £10.2 million is being made available to support this in 2018/19. Evidence has also been highlighted to CCGs setting out how investment in structured education should both improve outcomes and result in re-investable savings over the medium term.</p><p>The National Diabetes Audit, carried out by NHS Digital with funding from NHS England, supports CCGs and providers to understand local levels of referral to, and attendance at type 1 structured education and how these compare to other CCGs.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 16/04/2018 13:54:49 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	3691 label Biography information for Lord Roberts of Llandudno