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887313

	registered interest
	date	19/04/2018
	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	Medical Records: Data Protection
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government from when a national data opt-out expressed directly to NHS Digital will apply to data shared for secondary uses by a GP practice and be visible to GP practices.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7110
	answer	answer is ministerial correction date of answer 03/05/2018 answer text <p>In line with the implementation plan set out in the Government response to the National Data Guardian’s Review of Data Security, Consent and Opt-Outs, <em>Your Data: Better Security, Better Choice, Better Care</em>, general practitioner (GP) practices will be required to apply national data opt-outs, expressed to NHS Digital, by March 2020. By this date national data opt-outs must be applied by all health and care organisations in line with the national data opt-out policy when confidential patient information is being shared for purposes beyond the patient’s individual care (also referred to as secondary uses). NHS Digital has commissioned the GP system suppliers to develop solutions for their GP systems which will enable GP practices to uphold national data opt-outs. We will publish further details as these solutions become available.</p> answering member printed Lord O'Shaughnessy question first answered 03/05/2018 10:58:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

897319

	registered interest
	date	03/05/2018
	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	Abortion
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many specialist centres are available in the NHS to provide specialist care for women with complex medical needs seeking an abortion.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7550
	answer	answer is ministerial correction date of answer 15/05/2018 answer text <p>Information on the number of centres in the National Health Service that provide specialist care for women with complex medical needs seeking an abortion is not collected centrally.</p><p>The timing of publication of the tariff structure for specialist care for women with complex medical needs requiring abortion will be announced in due course.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL7551 question first answered 15/05/2018 16:13:02 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

857581

	registered interest
	date	07/03/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many withdrawal centres and aftercare facilities for prescribed drugs dependency to benzodiazepines, Z-drugs, SSRIs and opiate painkillers have been opened within the last ten years.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL6153
	answer	answer is ministerial correction date of answer 21/03/2018 answer text <p>Public Health England does not centrally hold information on the numbers of drug treatment centres or aftercare facilities for prescribed drugs dependency to benzodiazepines, Z-drugs, selective serotonin reuptake inhibitors and opiate painkillers which have been opened in the past 10 years.</p><p>Plans to develop treatment for any problem with prescribed medicines are the responsibility of local authorities (LAs) and the National Health Service in each area. LAs assess their local need and commission services and interventions to meet that need.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL6158 question first answered 21/03/2018 15:26:50 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825283

	registered interest
	date	17/01/2018
	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	Prescription Drugs: Misuse
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what actions they are taking to discourage the use of dependence-forming medicines prescribed in primary care.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL4816
	answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government is concerned about the impact of long term use of benzodiazepines by National Health Service patients and other dependence forming medicines prescribed in primary care. The National Centre for Social Research recently published <em>Prescribing Patterns in Dependence Forming Medicines, </em>which reviewed data for 50,000 NHS patients in England and looked at those who had been prescribed at least one of four types of potentially addictive drugs - known as Dependence Forming Medicines - between 2000 and 2015. The data shows that potentially dependence forming medicines are widely prescribed in primary care.</p><p> </p><p>The report highlights that a balance needs to be struck between avoiding prescribing that might lead to dependence or other harms and ensuring proper access to medicines to relieve suffering and treat disorders with. The report notes that clinical guidance recommending more cautious and time limited prescribing of benzodiazepines may well have been effective in changing practice, with reductions in the extent and length of benzodiazepine prescribing. It also suggests close and ongoing monitoring of opioid prescribing is needed. This independent research was commissioned and funded by the National Institute for Health Research Policy Research Programme. A copy of the report is attached.</p><p> </p><p>In the light of this research, the Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence.</p><p>The review will bring together the best available evidence on prevalence and prescribing; the nature and likely causes of dependence or withdrawal among some people who continue to take these medicines; and effective prevention and treatment responses for each indication.</p><p>The recently-updated National Clinical Guidelines for Drug Misuse and Dependence, <em>Drug misuse and dependence: UK guidelines on clinical management</em>, have specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are attached.</p><p>There is relevant National Institute for Health and Care Excellence guidance available for primary care prescribers for example on benzodiazepine and z-drug withdrawal.</p><p> </p> answering member printed Lord O'Shaughnessy attachment 1 file name clinical_guidelines_2017.pd.pdf title Drug Misuse and Dependence Clinical Guideline 2 file name PHRC_014_Final_Report.pdf title Prescribing Patterns in Dependence Forming Meds grouped question UIN HL4814 HL4815 HL4818 question first answered 25/01/2018 16:24:46 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

892406

	registered interest
	date	26/04/2018
	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	Surgical Mesh Implants
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what action they are taking to prevent mesh from being offered routinely to patients as a first intervention.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7313
	answer	answer is ministerial correction date of answer 09/05/2018 answer text <p>The National Institute for Health and Care Excellence (NICE) has published eight pieces of interventional procedures guidance that make a number of different recommendations about the safety and efficacy of various procedures using mesh to treat stress urinary incontinence or pelvic organ prolapse. They also emphasise the importance of informed consent and data collection, along with the requirement to report adverse events and the need for special training to undertake these procedures.</p><p>The most recent update was an update of its <em>Transvaginal mesh repair of anterior or posterior vaginal wall prolapse</em> interventional procedures guidance published on 15 December 2017. NICE recommends that this procedure should only be used in the context of research. The updated NICE recommendation does not constitute a “ban”, but specifies that research should include details of patient selection, long-term outcomes including complications, type of mesh used and method of fixation, and quality of life. A copy of the guidance is attached.</p><p>Additionally, NICE is extending its clinical guideline on the management of urinary incontinence in women to also include pelvic organ prolapse. The final guideline is expected to be published in 2019.</p> answering member printed Lord O'Shaughnessy question first answered 09/05/2018 11:34:22 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name transvaginal-mesh-repair-of-anterior-or-posterior-vaginal-wall-prolapse-pdf.pdf title NICE guidance transvaginal mesh repair
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

897083

	registered interest
	date	02/05/2018
	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	Abortion
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what action they plan to take in response to the British Pregnancy Advisory Service report Medically Complex Women and Abortion Care, published in March.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7507
	answer	answer is ministerial correction date of answer 15/05/2018 answer text <p>The British Pregnancy Advisory Service’s report, <em>Medically Complex Women and Abortion Care</em>, found that women in the United Kingdom with medical conditions including epilepsy, heart problems, and cancer can struggle to obtain abortion care. The Department recognises that some women with complex medical needs face challenges in accessing timely abortion care and is working with NHS England to ensure there are sufficient facilities in the National Health Service to provide abortions for women who have medical conditions and cannot be treated in standalone abortion clinics.</p><p>Currently clinical commissioning groups are responsible for commissioning NHS-funded termination of pregnancy services in England. Ministers have agreed that in 2018/19 NHS England will become the responsible commissioner for a small number of terminations, estimated at between 2,500 and 3,000, where the woman has significant comorbidities, which require critical care and/or medical support that would only be available in co-located NHS facilities. A national service specification will be developed to formally commission this service.</p><p>The Department has not made an estimate of the number of women who are currently unable to access appropriate specialist care.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL7508 HL7510 HL7512 question first answered 15/05/2018 16:18:55 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

832881

	registered interest
	date	29/01/2018
	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	Liothyronine
	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 degree to which the analysis contained in the NHS England document Items which should not be routinely prescribed in primary care: Guidance for CCGs justifies the advice given that prescribers in primary care should not prescribe liothyronine (T3) for any new patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL5203
	answer	answer is ministerial correction date of answer 07/02/2018 answer text <p>In November 2017 NHS England published commissioning guidance for clinical commissioning groups, entitled <em>Items which should not be routinely prescribed in primary care: A Consultation on guidance for CCGs, </em>following a three month consultation. A joint clinical working group comprised of clinical representatives reviewed the consultation findings and made evidence-based recommendations for consideration by the NHS England Board. Liothyronine attracted a significant number of responses and following detailed review, significant amendments to the original proposals were made before being published in the finalised guidance. NHS England’s recommendations are that National Health Service consultant endocrinologists may still initiate and recommend liothyronine for new patients, following audited individual trial periods of use, as recommended by the British Thyroid Association.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 07/02/2018 12:11:38 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

833604

	registered interest
	date	30/01/2018
	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	Thyroid Diseases: Drugs
	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 extent to which the NHS England document Items which should not be routinely prescribed in primary care: Guidance for CCGs reflects the most recent view of the British Thyroid Association.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL5225
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>We understand that the British Thyroid Association (BTA) advises that a small proportion of patients treated with the most commonly used drug, levothyroxine, continue to suffer with symptoms despite adequate biochemical correction. In these circumstances, where levothyroxine has failed and in line with BTA guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months’ duration of liothyronine.</p><p>NHS England’s recommendations to clinical commissioning groups (CCGs) take account of those of the BTA and are to:</p><p>- Advise CCGs that prescribers in primary care should not initiate liothyronine for any new patient;</p><p> </p><p>- Advise CCGs that individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine where clinically appropriate; and</p><p> </p><p>- Advise CCGs that a local decision, involving the Area Prescribing Committee (or equivalent) informed by national guidance (e.g. from the National Institute for Health and Care Excellence or the Regional Medicines Optimisation Committee), should be made regarding arrangements for on-going prescribing of liothyronine. This should be for individuals who, in exceptional circumstances, have an on-going need for liothyronine as confirmed by a consultant National Health Service endocrinologist.</p><p>A number of CCGs had already created local policies on the prescribing of liothryronine before the national consultation started in July 2017.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5228 question first answered 08/02/2018 15:03:07 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

905302

	registered interest
	date	15/05/2018
	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	Community Nurses
	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 decline in the number of district nurses from 7,716 in 2010 to 4,400 in 2016, reported by NHS Digital, on the treatment of wound care.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7893
	answer	answer is ministerial correction date of answer 30/05/2018 answer text <p>Community health services plays a crucial role in keeping people living healthier for longer through proactively managing health in a setting where patients feel most comfortable. Having the right workforce is fundamental to ensure this can happen and the Government acknowledges the challenge of meeting increased demand for care from community nurses</p><p>Work by the NHS Benchmarking Network found that 39% of district nursing clinical time is spent on wound care and so wound care is a key service within the remit of community health services. There are a number of activities currently taking place to address the issues around wound care including the National ‘Stop the Pressure’ programme by NHS Improvement and the Leading Change, Adding Value: Improving Wound Care Project by NHS England.</p><p>District nurses will have completed a Specialist Practitioner Programme, approved by the Nursing and Midwifery Council, to practice. NHS Digital’s data shows a drop in the number of full-time equivalent practicing district nurses. This has been reported by various interested parties, including the King’s Fund and the Queen’s Nursing Institute. As a result of changes, made in 2009, to the way that community health services are commissioned – i.e. to a range of different types of provider – there will be a number of district nurses providing National Health Service funded services in organisations that do not provide a return to the Electronic Staff Record and therefore this data does not represent the full picture.</p><p>However we are not complacent, which is why Health Education England is exploring the capacity and capability requirement of our community workforce to best meet the future needs of the population. This will be set out in their workforce strategy later this year. In order to meet the growing need to increase the future supply of registered nurses including mental health, additional clinical placement funding was announced by the Department in August and October 2017. This will enable around 5,000 more nursing students to enter training each year from September 2018; a historic increase.</p><p>On 9 May, the Minister of State for Health (Stephen Barclay), also announced that postgraduate students who go on to work in mental health and learning disability fields, as well as those postgraduates who go on to work in community nursing roles, will receive £10,000 'golden hellos’. The Government announced £10 million to support this and we are currently considering how this is best delivered on the ground.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL7894 HL7895 HL7896 HL7897 HL7970 HL7971 question first answered 30/05/2018 12:19:39 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

906457

	registered interest
	date	17/05/2018
	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	Community Nurses
	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 reasons for the decline in the number of district nurses with a Nursing and Midwifery Council-recordable qualification employed in the NHS.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL7970
	answer	answer is ministerial correction date of answer 30/05/2018 answer text <p>Community health services plays a crucial role in keeping people living healthier for longer through proactively managing health in a setting where patients feel most comfortable. Having the right workforce is fundamental to ensure this can happen and the Government acknowledges the challenge of meeting increased demand for care from community nurses</p><p>Work by the NHS Benchmarking Network found that 39% of district nursing clinical time is spent on wound care and so wound care is a key service within the remit of community health services. There are a number of activities currently taking place to address the issues around wound care including the National ‘Stop the Pressure’ programme by NHS Improvement and the Leading Change, Adding Value: Improving Wound Care Project by NHS England.</p><p>District nurses will have completed a Specialist Practitioner Programme, approved by the Nursing and Midwifery Council, to practice. NHS Digital’s data shows a drop in the number of full-time equivalent practicing district nurses. This has been reported by various interested parties, including the King’s Fund and the Queen’s Nursing Institute. As a result of changes, made in 2009, to the way that community health services are commissioned – i.e. to a range of different types of provider – there will be a number of district nurses providing National Health Service funded services in organisations that do not provide a return to the Electronic Staff Record and therefore this data does not represent the full picture.</p><p>However we are not complacent, which is why Health Education England is exploring the capacity and capability requirement of our community workforce to best meet the future needs of the population. This will be set out in their workforce strategy later this year. In order to meet the growing need to increase the future supply of registered nurses including mental health, additional clinical placement funding was announced by the Department in August and October 2017. This will enable around 5,000 more nursing students to enter training each year from September 2018; a historic increase.</p><p>On 9 May, the Minister of State for Health (Stephen Barclay), also announced that postgraduate students who go on to work in mental health and learning disability fields, as well as those postgraduates who go on to work in community nursing roles, will receive £10,000 'golden hellos’. The Government announced £10 million to support this and we are currently considering how this is best delivered on the ground.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL7893 HL7894 HL7895 HL7896 HL7897 HL7971 question first answered 30/05/2018 12:19:39 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath