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381050

	registered interest
	date	15/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Multiple Births
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether the Care Quality Commission’s new maternity inspection framework and NHS England’s new maternity commissioning guidance will explicitly refer to the need to demonstrate how providers are actively working to reduce the much higher risks of still birth, neonatal death and clinical negligence claims among multiple pregnancies.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL498
	answer	answer is ministerial correction date of answer 25/06/2015 answer text <p>The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England and has supplied the following information:</p><p> </p><p> </p><p> </p><p>The current version of CQC’s core service framework does not refer explicitly to multiple births. CQC is currently reviewing the framework and they are working with organisations such as the Twins and Multiple Births Association to determine how best to ensure their new framework takes account of the risks associated with multiple births. As part of the existing inspection framework CQC expects maternity services to have due regard to existing advice and guidance, such as NICE Quality Standard 46 which refers specifically to multiple births and risk assessments. Going forward the CQC will expect trusts to provide evidence of their compliance with these recommendations.</p><p> </p><p> </p><p> </p><p>NHS England has informed us that its new maternity commissioning guidance will explicitly refer to the need to demonstrate how providers are actively working to reduce the much higher risks of still birth, neonatal death and clinical negligence claims among multiple pregnancies and how it will achieve this.</p><p> </p><p> </p><p> </p><p>The Department together with the parent’s support and campaigning organisation Stillbirth and Neonatal Death Charity (Sands) and a number of key organisations including NHS England, Public Health England, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists are working on an on-going stillbirth prevention work programme. This work identifies key messages which can be used to raise awareness among both pregnant women and health professionals of the risk factors for stillbirths and the actions that can be taken to minimise these risks.</p><p> </p><p> </p><p> </p><p>The new maternity commissioning guidance will make reference to stillbirth prevention work and will focus on identifying the evidence based interventions which impact on reducing stillbirths and early neonatal death.</p><p> </p><p> </p><p> </p><p>NHS England has been working with many stakeholders on collating a package of interventions and best practice models to reduce stillbirths which will result in recommendations for clinical practice and are likely to be included in future commissioning specifications for maternity. The NHS England – led “Saving Babies’ Lives” Care Bundle brings together a number of elements likely to impact on still birth rates including:</p><p> </p><p> </p><p> </p><p>- reducing smoking in pregnancy by carrying out Carbon Monoxide test at antenatal booking appointment to identify smokers (or those exposed to tobacco smoke) and referring to stop smoking service/specialist as appropriate;</p><p> </p><p>- identification and surveillance of pregnancies with fetal growth restriction;</p><p> </p><p>- raising awareness amongst pregnant women of the importance of detecting and reporting reduced fetal movement; and</p><p> </p><p>- effective fetal monitoring during labour.</p><p> </p><p> </p><p> </p><p>The commissioning guidance will refer to sufficient provision of resource to support appropriate levels of these types of surveillance within the clinical practice environment.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 25/06/2015 13:26:22 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	248 label Biography information for Lord Jones of Cheltenham

381051

	registered interest
	date	15/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Multiple Births
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether the National Health Service's Sign up to Safety Campaign will aim to reduce the higher-than-average proportion of multiple pregnancies that result in a still birth, neonatal death or clinical negligence claim.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL499
	answer	answer is ministerial correction date of answer 29/06/2015 answer text <p>The NHS Litigation Authority (NHS LA) has supported the campaign by managing incentive scheme bids to reduce harm and subsequent claims. Whilst there are no bids received specific to multiple pregnancies the NHS LA has awarded over £8 million across 25 successful maternity bids. This funding is aimed at supporting the reduction of claims relating to stillbirth and birth injury for all pregnancies and will include multiple births.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 29/06/2015 14:44:26 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	248 label Biography information for Lord Jones of Cheltenham

381052

	registered interest
	date	15/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Multiple Births
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether they plan to issue advice to commissioners, regulators and providers about tackling the disproportionately high rates of still birth and neonatal death in multiple pregnancies.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL500
	answer	answer is ministerial correction date of answer 29/06/2015 answer text <p>We have made reducing stillbirth an improvement area for the National Health Service in the NHS Outcomes Framework. The Department is working with key partners, including NHS England, Public Health England, The Royal College of Obstetricians and Gynaecologists, The Royal College of Midwives and the stillbirth and neonatal death charity Sands, to identify and drive forward the actions required to help reduce further the stillbirth and neonatal mortality rate in England.</p><p> </p><p> </p><p> </p><p>Evidence based advice on the care of women with multiple pregnancies is set out in the National Institute for Health and Care Excellence (NICE) Clinical Guidelines ‘Multiple Pregnancies – The management of twin and triplet pregnancies in the antenatal period’ which is attached. In line with these guidelines, we would expect clinical care for women with twin and triplet pregnancies to be provided by a nominated multidisciplinary team consisting of a core team, including named specialist obstetricians, who have experience and knowledge of managing twin and triplet pregnancies. The Department has not undertaken an assessment of the effectiveness of the implementation of the NICE guidelines. It is for local maternity care providers to determine how best to deliver services for women with multiple pregnancies in their area. In doing so we would expect them to give due regard to NICE guidance.</p><p> </p><p> </p><p> </p><p>NHS England is undertaking a major review of the commissioning of NHS maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies. This review is expected to report by the end of the year.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 29/06/2015 14:48:58 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name NICE - Multiple pregnancy.pdf title NICE - Multiple Pregancies
	tabling member	248 label Biography information for Lord Jones of Cheltenham

386101

	registered interest
	date	29/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Infectious Diseases
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what research is being supported by Public Health England and the Animal and Plant Health Agency into the global health and economic security threats posed by pandemics caused by emerging zoönoses and coronaviruses.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL900
	answer	answer is ministerial correction date of answer 13/07/2015 answer text <p>The United Kingdom has robust systems in place to detect, assess and respond to infectious disease threats of both natural and deliberate origin. This was tested during the assessment of the application of the Global Health Security Agenda Assessment Tool and was considered to be an exemplar of good practice. These systems are particularly strong across Public Health England (PHE) and the Animal and Plant Health Agency (APHA) for emerging zoonotic threats, and the UK has been seen as one of the world leaders in putting One Health into action. Zoonotic diseases are included within the Government’s National Risk Register as high risk and needing cross Government action to reduce the threat, mitigate the risk and respond to cases/outbreaks.</p><p> </p><p> </p><p> </p><p>PHE undertakes a varied programme of research into infectious agents and medical tools required to detect, diagnose, recognise, and respond to outbreaks of infectious disease. PHE collaborates with academia on modelling threats posed by emerging zoonoses and assess the roles of cross-immunity and seasonal influenza vaccination on the emergence of pandemic strains. During the recent Ebola virus outbreak in West Africa, PHE conducted research on the design and assessment of containment equipment for safe diagnostics in West Africa; improving diagnosis, understanding pathogenesis, and assessing treatment/prevention approaches for Ebola virus disease in animal models and human clinical trials. This capability is and can be applied to all pathogens, including those which are zoonotic.</p><p> </p><p> </p><p> </p><p>APHA is engaged in a number of research projects on the subject of zoonotic pathogens with pandemic potential. This includes: the rapid detection of coronaviruses, studies into the ability of H5N1 avian influenza viruses to infect, adapt and become transmissible in mammalian species and research into risks and pathways for the introduction of Chinese-origin H7N9 avian influenza virus into United Kingdom and European poultry. APHA is also engaged in various research projects with international and external collaborators, including European consortiums assessing new and emerging diseases.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 13/07/2015 14:27:46 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	248 label Biography information for Lord Jones of Cheltenham

388447

	registered interest
	date	08/07/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pregnancy
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many (1) singleton, and (2) multiple, pregnancies were dealt with in each (a) hospital trust, and (b) region, in each of the last 10 years.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL1222
	answer	answer is ministerial correction date of answer 21/07/2015 answer text <p>As the information requested is over a 10 year period, it has been provided in the attached tables.</p><p> </p><p>We have provided a count of delivery episodes involving:</p><p> </p><p>(a) a singleton birth;</p><p> </p><p>(b) multiple births; or</p><p> </p><p>(c) an unknown number of babies born at the end of a single delivery episode.</p><p> </p><p>The information is provided by hospital provider and government office region of treatment for the years 2004-05 to 2013-14.</p><p> </p><p>Data should not be described as a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p>The footnotes should be referred to when interpreting the data.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 21/07/2015 16:14:15 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Copy of HL1222 - Excel spreadsheet of figures.xlsx title Tables
	tabling member	248 label Biography information for Lord Jones of Cheltenham

388448

	registered interest
	date	08/07/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Childbirth
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many cases there were involving the stillbirth, neonatal death or disability of a baby, or the disability of the mother or maternal death, in a singleton pregnancy by (1) hospital trust and (2) region, in each of the last 10 years; and what was the total cost of settling claims dealt with by the NHS arising from these cases.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL1223
	answer	answer is ministerial correction date of answer 21/07/2015 answer text <p>The information requested has been provided by the NHS Litigation Authority (NHS LA). As the information is over a 10 year period it has been put into the attached spreadsheets, entitled:</p><p> </p><p> </p><p> </p><p>1) Single pregnancy by Trust - will show the number of obstetrics claims involving a single birth pregnancy received by hospital trust for NHS LA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>2) Single pregnancy by Region - will show the number of obstetrics claims involving a single birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>3) Multiple pregnancy by Region - will show the number of obstetrics claims involving a multiple birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>4) Multiple pregnancy by Cause - will show the number of obstetrics claims involving a multiple birth pregnancy received by cause for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>5) Multiple pregnancy by Trust - will show the number of obstetrics claims involving a multiple birth pregnancy received by hospital trust for NHSLA Notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p> </p><p> </p><p>It should be noted that where there are less than five claims in a cohort against a trust, an asterisk has been used in the spreadsheets, as the disclosure of such information could breach an individual’s confidentiality.</p><p> </p><p> </p> answering member printed Lord Prior of Brampton question first answered 21/07/2015 16:16:37 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Copy of Workbook_HL122312241225.xlsx title Spreadsheets workbook
	tabling member	248 label Biography information for Lord Jones of Cheltenham

388449

	registered interest
	date	08/07/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Childbirth
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government how many cases there were involving the stillbirth, neonatal death or disability of a baby, or the disability of the mother or maternal death, in a multiple pregnancy by (1) hospital trust, and (2) region, in each of the last 10 years; and what was the total cost of settling claims dealt with by the NHS arising from these cases.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL1224
	answer	answer is ministerial correction date of answer 21/07/2015 answer text <p>The information requested has been provided by the NHS Litigation Authority (NHS LA). As the information is over a 10 year period it has been put into the attached spreadsheets, entitled:</p><p> </p><p>1) Single pregnancy by Trust - will show the number of obstetrics claims involving a single birth pregnancy received by hospital trust for NHS LA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>2) Single pregnancy by Region - will show the number of obstetrics claims involving a single birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>3) Multiple pregnancy by Region - will show the number of obstetrics claims involving a multiple birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>4) Multiple pregnancy by Cause - will show the number of obstetrics claims involving a multiple birth pregnancy received by cause for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>5) Multiple pregnancy by Trust - will show the number of obstetrics claims involving a multiple birth pregnancy received by hospital trust for NHSLA Notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p> </p><p> </p><p>It should be noted that where there are less than five claims in a cohort against a trust, an asterisk has been used in the spreadsheets, as the disclosure of such information could breach an individual’s confidentiality.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1225 question first answered 21/07/2015 16:22:32 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Copy of Workbook_HL122312241225.xlsx title Spreadsheets workbook
	tabling member	248 label Biography information for Lord Jones of Cheltenham

388450

	registered interest
	date	08/07/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Maternity Services
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what were the causes of those maternity-related claims settled by the NHS in each of the last 10 years.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL1225
	answer	answer is ministerial correction date of answer 21/07/2015 answer text <p>The information requested has been provided by the NHS Litigation Authority (NHS LA). As the information is over a 10 year period it has been put into the attached spreadsheets, entitled:</p><p> </p><p>1) Single pregnancy by Trust - will show the number of obstetrics claims involving a single birth pregnancy received by hospital trust for NHS LA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>2) Single pregnancy by Region - will show the number of obstetrics claims involving a single birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>3) Multiple pregnancy by Region - will show the number of obstetrics claims involving a multiple birth pregnancy received by region for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>4) Multiple pregnancy by Cause - will show the number of obstetrics claims involving a multiple birth pregnancy received by cause for NHSLA notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p>5) Multiple pregnancy by Trust - will show the number of obstetrics claims involving a multiple birth pregnancy received by hospital trust for NHSLA Notification years 04/05 to 13/14, as at 31/03/2014</p><p> </p><p> </p><p> </p><p>It should be noted that where there are less than five claims in a cohort against a trust, an asterisk has been used in the spreadsheets, as the disclosure of such information could breach an individual’s confidentiality.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1224 question first answered 21/07/2015 16:22:32 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Copy of Workbook_HL122312241225.xlsx title Spreadsheets workbook
	tabling member	248 label Biography information for Lord Jones of Cheltenham

423160

	registered interest
	date	22/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Cancer Drugs Fund
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government which medicines will be delisted following their planned changes to the Cancer Drugs Fund.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL2910
	answer	answer is ministerial correction date of answer 29/10/2015 answer text <p><strong></strong></p><p>NHS England has advised that decisions on which drugs will be removed from the national Cancer Drugs Fund list are still subject to change. A revised list will be published on NHS England’s website in due course.</p> answering member printed Lord Prior of Brampton question first answered 29/10/2015 18:00:32 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	248 label Biography information for Lord Jones of Cheltenham

423161

	registered interest
	date	22/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Cancer Drugs Fund
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what NHS pathways will be available to patients newly diagnosed as suffering from (1) multiple myeloma, and (2) rarer cancers, when changes are made to the Cancer Drugs Fund.
	tabling member printed	Lord Jones of Cheltenham
	uin	HL2911
	answer	answer is ministerial correction date of answer 30/10/2015 answer text <p>NHS England has advised that a draft treatment pathway for patients with multiple myeloma is currently in the process of being finalised and is likely to be published early in 2016. This has been the subject of public consultation and is being revised to take into account the comments received.</p><br /><p>Work on the treatment pathways for patients with rarer cancers is planned for development and consultation in 2016.</p> answering member printed Lord Prior of Brampton question first answered 30/10/2015 08:49:18 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	248 label Biography information for Lord Jones of Cheltenham