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1109422

	registered interest
	date	03/04/2019
	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	Dementia: Care Homes
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of the number of high quality dementia care homes available in England and Wales.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	240525
	answer	answer is ministerial correction date of answer 08/04/2019 answer text <p>Commissioning social care is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Care Act 2014 placed duties on local authorities to shape their local markets so that there is an adequate supply of provision. This includes ensuring sufficient dementia care provision is available and that individuals have a choice of high quality services.</p><p> </p><p>There are 7,341 care homes in England that provide dementia care as of 1 April 2019. Of those that have a Care Quality Commission (CQC) rating, 76% are rated Good or Outstanding.</p><p> </p><p>There are 144 care homes in Staffordshire local authority that provide dementia care as of 1 April 2019. Of those that have a CQC rating, 59% are rated Good or Outstanding.</p><p> </p><p>The Green Paper, to be published at the earliest opportunity, will set out our proposals for a sustainable system in the long term and address issues related to the quality of care and variation in practice.</p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 240526 question first answered 08/04/2019 15:31:12 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1436 label Biography information for Paul Farrelly

1109423

	registered interest
	date	03/04/2019
	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	Dementia: Care Homes
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of high quality dementia care homes available in North Staffordshire.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	240526
	answer	answer is ministerial correction date of answer 08/04/2019 answer text <p>Commissioning social care is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Care Act 2014 placed duties on local authorities to shape their local markets so that there is an adequate supply of provision. This includes ensuring sufficient dementia care provision is available and that individuals have a choice of high quality services.</p><p> </p><p>There are 7,341 care homes in England that provide dementia care as of 1 April 2019. Of those that have a Care Quality Commission (CQC) rating, 76% are rated Good or Outstanding.</p><p> </p><p>There are 144 care homes in Staffordshire local authority that provide dementia care as of 1 April 2019. Of those that have a CQC rating, 59% are rated Good or Outstanding.</p><p> </p><p>The Green Paper, to be published at the earliest opportunity, will set out our proposals for a sustainable system in the long term and address issues related to the quality of care and variation in practice.</p> answering member constituency Gosport answering member printed Caroline Dinenage grouped question UIN 240525 question first answered 08/04/2019 15:31:12 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1436 label Biography information for Paul Farrelly

1091017

	registered interest
	date	18/03/2019
	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	Dialysis Machines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the equity of access to home-based dialysis services in England; and if he will make a statement.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	233465
	answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>NHS England commissions dialysis services at a national level as a specialised service, setting out what providers should have in place to deliver dialysis care, including at home, as part of its remit to deliver specialised services. National Commissioning supports equity of access to high quality dialysis care. The service delivery contract sets out that the principle should be that home haemodialysis should always be an option for patients and that solutions should be sought to overcoming barriers that might prevent this. Decisions should be made on an individual basis but in general, patients suitable for home haemodialysis will be those who:</p><p>- have the ability and motivation to learn to carry out the process and the commitment to maintain treatment;</p><p>- are stable on dialysis;</p><p>- are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe;</p><p>- have good functioning vascular access;</p><p>- have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own; and</p><p>- have suitable space and facilities or an area that could be adapted within their home environment.</p><p><strong> </strong></p><p>NHS England’s renal services specifications can be found at the following link:</p><p> </p><p><a href="http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/" target="_blank">www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/</a></p><p> </p><p>NHS England Specialised Services use the Renal Registry Annual Report and data to support work with local dialysis services so they are aware where variation exists so this can be considered and addressed.</p><p> </p><p>The Atlas of variation, published by Public Health England in 2015, showed that for clinical commissioning groups (CCGs) in England, the percentage of dialysis patients who were receiving dialysis in the home (home haemodialysis and peritoneal dialysis combined) ranged from 4.1% to 44.0% (10.6-fold variation). When the seven CCGs with the highest percentages and the seven CCGs with the lowest percentages are excluded, the range is 7.6–33.7%, and the variation is 4.4-fold. Variation by parliamentary constituency is not available.</p><p> </p><p>Reasons for the degree of variation observed include differences in:</p><p> </p><p>- access to, and timely assessment by, a specialist kidney unit – working with patients to help them decide between treatments takes time, but in some areas 30% of patients are not known to their kidney team for even 90 days before they start renal replacement therapy;</p><p>- access to a multi-professional team, including staff who regularly support patients undertaking home dialysis; and</p><p>- levels of support for people undertaking home dialysis to help them maintain their independence, including access to respite in-centre dialysis.</p><p> </p><p>The Atlas can be found at the following link:</p><p> </p><p><a href="https://fingertips.phe.org.uk/profile/atlas-of-variation" target="_blank">https://fingertips.phe.org.uk/profile/atlas-of-variation</a></p><p><strong> </strong></p><p>According to the latest data from the UK Renal Registry (UKRR), there were 1,195 patients receiving home dialysis in the United Kingdom in 2014, 1,175 patients in 2015; and 1,256 patients in 2016. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres. Participation is mandated in England, via the national services specification published by NHS England.</p><p> </p><p>The latest report from the UK Renal Registry can be found at the following link:</p><p> </p><p><a href="http://www.renalreg.org/publications-reports/" target="_blank">www.renalreg.org/publications-reports/</a></p><p><strong> </strong></p><p>No specific assessment of the cost to the National Health Service of the provision of dialysis services in a patient’s home compared to a clinical setting has been undertaken. In its assessment of the evidence regarding cost, the National Institute for Health and Care Excellence (NICE) set out in its guideline, ‘Renal Replacement Therapy and Conservative Management’, published in October 2018, that there is uncertainty in current UK dialysis costs, but they may be lower at home. The committee acknowledged that these treatments can have very different effects on lifestyle and recommended patient choice. The NICE guideline can be found at the following link:</p><p><strong> </strong></p><p><a href="http://www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301" target="_blank">www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301</a></p><p><strong> </strong></p><p>Regarding the benefits of home dialysis, there is good evidence that home dialysis therapies offer advantages for suitable patients. The limitations of thrice weekly standard in-centre haemodialysis have been recognised in recent years. However, it is very difficult to separate the effect of different case mix, the most up to date and comprehensive data does not show a survival difference between patients who received more frequent versus thrice weekly (standard regimen) haemodialysis.</p><p> </p><p>The advantage of self-care haemodialysis includes not only those related to control and convenience but also the opportunity to conduct more frequent or longer sessions to optimise health prospects. The introduction of smaller more portable haemodialysis machines also provides opportunity for travel for employment or holidays. Furthermore, these therapies are cost effective in the UK when compared with hospital treatments and have been demonstrated to be safe. Information regarding a reduction in travel times and reliance on other medicines is not available.</p><p> </p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 233478 233479 233480 233481 question first answered 21/03/2019 16:14:41 answering member 4067 label Biography information for Steve Brine
	tabling member	1436 label Biography information for Paul Farrelly

1091042

	registered interest
	date	18/03/2019
	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	Dialysis Machines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the availability of home-based dialysis services across each (a) Clinical Commissioning Group area and (b) Parliamentary constituency.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	233478
	answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>NHS England commissions dialysis services at a national level as a specialised service, setting out what providers should have in place to deliver dialysis care, including at home, as part of its remit to deliver specialised services. National Commissioning supports equity of access to high quality dialysis care. The service delivery contract sets out that the principle should be that home haemodialysis should always be an option for patients and that solutions should be sought to overcoming barriers that might prevent this. Decisions should be made on an individual basis but in general, patients suitable for home haemodialysis will be those who:</p><p>- have the ability and motivation to learn to carry out the process and the commitment to maintain treatment;</p><p>- are stable on dialysis;</p><p>- are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe;</p><p>- have good functioning vascular access;</p><p>- have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own; and</p><p>- have suitable space and facilities or an area that could be adapted within their home environment.</p><p><strong> </strong></p><p>NHS England’s renal services specifications can be found at the following link:</p><p> </p><p><a href="http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/" target="_blank">www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/</a></p><p> </p><p>NHS England Specialised Services use the Renal Registry Annual Report and data to support work with local dialysis services so they are aware where variation exists so this can be considered and addressed.</p><p> </p><p>The Atlas of variation, published by Public Health England in 2015, showed that for clinical commissioning groups (CCGs) in England, the percentage of dialysis patients who were receiving dialysis in the home (home haemodialysis and peritoneal dialysis combined) ranged from 4.1% to 44.0% (10.6-fold variation). When the seven CCGs with the highest percentages and the seven CCGs with the lowest percentages are excluded, the range is 7.6–33.7%, and the variation is 4.4-fold. Variation by parliamentary constituency is not available.</p><p> </p><p>Reasons for the degree of variation observed include differences in:</p><p> </p><p>- access to, and timely assessment by, a specialist kidney unit – working with patients to help them decide between treatments takes time, but in some areas 30% of patients are not known to their kidney team for even 90 days before they start renal replacement therapy;</p><p>- access to a multi-professional team, including staff who regularly support patients undertaking home dialysis; and</p><p>- levels of support for people undertaking home dialysis to help them maintain their independence, including access to respite in-centre dialysis.</p><p> </p><p>The Atlas can be found at the following link:</p><p> </p><p><a href="https://fingertips.phe.org.uk/profile/atlas-of-variation" target="_blank">https://fingertips.phe.org.uk/profile/atlas-of-variation</a></p><p><strong> </strong></p><p>According to the latest data from the UK Renal Registry (UKRR), there were 1,195 patients receiving home dialysis in the United Kingdom in 2014, 1,175 patients in 2015; and 1,256 patients in 2016. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres. Participation is mandated in England, via the national services specification published by NHS England.</p><p> </p><p>The latest report from the UK Renal Registry can be found at the following link:</p><p> </p><p><a href="http://www.renalreg.org/publications-reports/" target="_blank">www.renalreg.org/publications-reports/</a></p><p><strong> </strong></p><p>No specific assessment of the cost to the National Health Service of the provision of dialysis services in a patient’s home compared to a clinical setting has been undertaken. In its assessment of the evidence regarding cost, the National Institute for Health and Care Excellence (NICE) set out in its guideline, ‘Renal Replacement Therapy and Conservative Management’, published in October 2018, that there is uncertainty in current UK dialysis costs, but they may be lower at home. The committee acknowledged that these treatments can have very different effects on lifestyle and recommended patient choice. The NICE guideline can be found at the following link:</p><p><strong> </strong></p><p><a href="http://www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301" target="_blank">www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301</a></p><p><strong> </strong></p><p>Regarding the benefits of home dialysis, there is good evidence that home dialysis therapies offer advantages for suitable patients. The limitations of thrice weekly standard in-centre haemodialysis have been recognised in recent years. However, it is very difficult to separate the effect of different case mix, the most up to date and comprehensive data does not show a survival difference between patients who received more frequent versus thrice weekly (standard regimen) haemodialysis.</p><p> </p><p>The advantage of self-care haemodialysis includes not only those related to control and convenience but also the opportunity to conduct more frequent or longer sessions to optimise health prospects. The introduction of smaller more portable haemodialysis machines also provides opportunity for travel for employment or holidays. Furthermore, these therapies are cost effective in the UK when compared with hospital treatments and have been demonstrated to be safe. Information regarding a reduction in travel times and reliance on other medicines is not available.</p><p> </p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 233465 233479 233480 233481 question first answered 21/03/2019 16:14:41 answering member 4067 label Biography information for Steve Brine
	tabling member	1436 label Biography information for Paul Farrelly

1091047

	registered interest
	date	18/03/2019
	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	Dialysis Machines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of patients receiving home-based dialysis in place of hospital-based dialysis in each of the past three years.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	233479
	answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>NHS England commissions dialysis services at a national level as a specialised service, setting out what providers should have in place to deliver dialysis care, including at home, as part of its remit to deliver specialised services. National Commissioning supports equity of access to high quality dialysis care. The service delivery contract sets out that the principle should be that home haemodialysis should always be an option for patients and that solutions should be sought to overcoming barriers that might prevent this. Decisions should be made on an individual basis but in general, patients suitable for home haemodialysis will be those who:</p><p>- have the ability and motivation to learn to carry out the process and the commitment to maintain treatment;</p><p>- are stable on dialysis;</p><p>- are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe;</p><p>- have good functioning vascular access;</p><p>- have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own; and</p><p>- have suitable space and facilities or an area that could be adapted within their home environment.</p><p><strong> </strong></p><p>NHS England’s renal services specifications can be found at the following link:</p><p> </p><p><a href="http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/" target="_blank">www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/</a></p><p> </p><p>NHS England Specialised Services use the Renal Registry Annual Report and data to support work with local dialysis services so they are aware where variation exists so this can be considered and addressed.</p><p> </p><p>The Atlas of variation, published by Public Health England in 2015, showed that for clinical commissioning groups (CCGs) in England, the percentage of dialysis patients who were receiving dialysis in the home (home haemodialysis and peritoneal dialysis combined) ranged from 4.1% to 44.0% (10.6-fold variation). When the seven CCGs with the highest percentages and the seven CCGs with the lowest percentages are excluded, the range is 7.6–33.7%, and the variation is 4.4-fold. Variation by parliamentary constituency is not available.</p><p> </p><p>Reasons for the degree of variation observed include differences in:</p><p> </p><p>- access to, and timely assessment by, a specialist kidney unit – working with patients to help them decide between treatments takes time, but in some areas 30% of patients are not known to their kidney team for even 90 days before they start renal replacement therapy;</p><p>- access to a multi-professional team, including staff who regularly support patients undertaking home dialysis; and</p><p>- levels of support for people undertaking home dialysis to help them maintain their independence, including access to respite in-centre dialysis.</p><p> </p><p>The Atlas can be found at the following link:</p><p> </p><p><a href="https://fingertips.phe.org.uk/profile/atlas-of-variation" target="_blank">https://fingertips.phe.org.uk/profile/atlas-of-variation</a></p><p><strong> </strong></p><p>According to the latest data from the UK Renal Registry (UKRR), there were 1,195 patients receiving home dialysis in the United Kingdom in 2014, 1,175 patients in 2015; and 1,256 patients in 2016. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres. Participation is mandated in England, via the national services specification published by NHS England.</p><p> </p><p>The latest report from the UK Renal Registry can be found at the following link:</p><p> </p><p><a href="http://www.renalreg.org/publications-reports/" target="_blank">www.renalreg.org/publications-reports/</a></p><p><strong> </strong></p><p>No specific assessment of the cost to the National Health Service of the provision of dialysis services in a patient’s home compared to a clinical setting has been undertaken. In its assessment of the evidence regarding cost, the National Institute for Health and Care Excellence (NICE) set out in its guideline, ‘Renal Replacement Therapy and Conservative Management’, published in October 2018, that there is uncertainty in current UK dialysis costs, but they may be lower at home. The committee acknowledged that these treatments can have very different effects on lifestyle and recommended patient choice. The NICE guideline can be found at the following link:</p><p><strong> </strong></p><p><a href="http://www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301" target="_blank">www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301</a></p><p><strong> </strong></p><p>Regarding the benefits of home dialysis, there is good evidence that home dialysis therapies offer advantages for suitable patients. The limitations of thrice weekly standard in-centre haemodialysis have been recognised in recent years. However, it is very difficult to separate the effect of different case mix, the most up to date and comprehensive data does not show a survival difference between patients who received more frequent versus thrice weekly (standard regimen) haemodialysis.</p><p> </p><p>The advantage of self-care haemodialysis includes not only those related to control and convenience but also the opportunity to conduct more frequent or longer sessions to optimise health prospects. The introduction of smaller more portable haemodialysis machines also provides opportunity for travel for employment or holidays. Furthermore, these therapies are cost effective in the UK when compared with hospital treatments and have been demonstrated to be safe. Information regarding a reduction in travel times and reliance on other medicines is not available.</p><p> </p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 233465 233478 233480 233481 question first answered 21/03/2019 16:14:41 answering member 4067 label Biography information for Steve Brine
	tabling member	1436 label Biography information for Paul Farrelly

1091048

	registered interest
	date	18/03/2019
	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	Dialysis Machines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the cost benefit to the NHS of the provision of dialysis services in a patient’s home compared to a clinical setting.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	233480
	answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>NHS England commissions dialysis services at a national level as a specialised service, setting out what providers should have in place to deliver dialysis care, including at home, as part of its remit to deliver specialised services. National Commissioning supports equity of access to high quality dialysis care. The service delivery contract sets out that the principle should be that home haemodialysis should always be an option for patients and that solutions should be sought to overcoming barriers that might prevent this. Decisions should be made on an individual basis but in general, patients suitable for home haemodialysis will be those who:</p><p>- have the ability and motivation to learn to carry out the process and the commitment to maintain treatment;</p><p>- are stable on dialysis;</p><p>- are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe;</p><p>- have good functioning vascular access;</p><p>- have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own; and</p><p>- have suitable space and facilities or an area that could be adapted within their home environment.</p><p><strong> </strong></p><p>NHS England’s renal services specifications can be found at the following link:</p><p> </p><p><a href="http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/" target="_blank">www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/</a></p><p> </p><p>NHS England Specialised Services use the Renal Registry Annual Report and data to support work with local dialysis services so they are aware where variation exists so this can be considered and addressed.</p><p> </p><p>The Atlas of variation, published by Public Health England in 2015, showed that for clinical commissioning groups (CCGs) in England, the percentage of dialysis patients who were receiving dialysis in the home (home haemodialysis and peritoneal dialysis combined) ranged from 4.1% to 44.0% (10.6-fold variation). When the seven CCGs with the highest percentages and the seven CCGs with the lowest percentages are excluded, the range is 7.6–33.7%, and the variation is 4.4-fold. Variation by parliamentary constituency is not available.</p><p> </p><p>Reasons for the degree of variation observed include differences in:</p><p> </p><p>- access to, and timely assessment by, a specialist kidney unit – working with patients to help them decide between treatments takes time, but in some areas 30% of patients are not known to their kidney team for even 90 days before they start renal replacement therapy;</p><p>- access to a multi-professional team, including staff who regularly support patients undertaking home dialysis; and</p><p>- levels of support for people undertaking home dialysis to help them maintain their independence, including access to respite in-centre dialysis.</p><p> </p><p>The Atlas can be found at the following link:</p><p> </p><p><a href="https://fingertips.phe.org.uk/profile/atlas-of-variation" target="_blank">https://fingertips.phe.org.uk/profile/atlas-of-variation</a></p><p><strong> </strong></p><p>According to the latest data from the UK Renal Registry (UKRR), there were 1,195 patients receiving home dialysis in the United Kingdom in 2014, 1,175 patients in 2015; and 1,256 patients in 2016. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres. Participation is mandated in England, via the national services specification published by NHS England.</p><p> </p><p>The latest report from the UK Renal Registry can be found at the following link:</p><p> </p><p><a href="http://www.renalreg.org/publications-reports/" target="_blank">www.renalreg.org/publications-reports/</a></p><p><strong> </strong></p><p>No specific assessment of the cost to the National Health Service of the provision of dialysis services in a patient’s home compared to a clinical setting has been undertaken. In its assessment of the evidence regarding cost, the National Institute for Health and Care Excellence (NICE) set out in its guideline, ‘Renal Replacement Therapy and Conservative Management’, published in October 2018, that there is uncertainty in current UK dialysis costs, but they may be lower at home. The committee acknowledged that these treatments can have very different effects on lifestyle and recommended patient choice. The NICE guideline can be found at the following link:</p><p><strong> </strong></p><p><a href="http://www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301" target="_blank">www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301</a></p><p><strong> </strong></p><p>Regarding the benefits of home dialysis, there is good evidence that home dialysis therapies offer advantages for suitable patients. The limitations of thrice weekly standard in-centre haemodialysis have been recognised in recent years. However, it is very difficult to separate the effect of different case mix, the most up to date and comprehensive data does not show a survival difference between patients who received more frequent versus thrice weekly (standard regimen) haemodialysis.</p><p> </p><p>The advantage of self-care haemodialysis includes not only those related to control and convenience but also the opportunity to conduct more frequent or longer sessions to optimise health prospects. The introduction of smaller more portable haemodialysis machines also provides opportunity for travel for employment or holidays. Furthermore, these therapies are cost effective in the UK when compared with hospital treatments and have been demonstrated to be safe. Information regarding a reduction in travel times and reliance on other medicines is not available.</p><p> </p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 233465 233478 233479 233481 question first answered 21/03/2019 16:14:41 answering member 4067 label Biography information for Steve Brine
	tabling member	1436 label Biography information for Paul Farrelly

1091049

	registered interest
	date	18/03/2019
	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	Dialysis Machines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of reductions in (a) travel times for patients, (b) recovery times, (c) reliance on additional medicines and (d) risk of death amongst patients with access to home dialysis provision.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	233481
	answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>NHS England commissions dialysis services at a national level as a specialised service, setting out what providers should have in place to deliver dialysis care, including at home, as part of its remit to deliver specialised services. National Commissioning supports equity of access to high quality dialysis care. The service delivery contract sets out that the principle should be that home haemodialysis should always be an option for patients and that solutions should be sought to overcoming barriers that might prevent this. Decisions should be made on an individual basis but in general, patients suitable for home haemodialysis will be those who:</p><p>- have the ability and motivation to learn to carry out the process and the commitment to maintain treatment;</p><p>- are stable on dialysis;</p><p>- are free of complications and significant concomitant disease that would render home haemodialysis unsuitable or unsafe;</p><p>- have good functioning vascular access;</p><p>- have a carer who has (or carers who have) also made an informed decision to assist with the haemodialysis unless the individual is able to manage on his or her own; and</p><p>- have suitable space and facilities or an area that could be adapted within their home environment.</p><p><strong> </strong></p><p>NHS England’s renal services specifications can be found at the following link:</p><p> </p><p><a href="http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/" target="_blank">www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a06/</a></p><p> </p><p>NHS England Specialised Services use the Renal Registry Annual Report and data to support work with local dialysis services so they are aware where variation exists so this can be considered and addressed.</p><p> </p><p>The Atlas of variation, published by Public Health England in 2015, showed that for clinical commissioning groups (CCGs) in England, the percentage of dialysis patients who were receiving dialysis in the home (home haemodialysis and peritoneal dialysis combined) ranged from 4.1% to 44.0% (10.6-fold variation). When the seven CCGs with the highest percentages and the seven CCGs with the lowest percentages are excluded, the range is 7.6–33.7%, and the variation is 4.4-fold. Variation by parliamentary constituency is not available.</p><p> </p><p>Reasons for the degree of variation observed include differences in:</p><p> </p><p>- access to, and timely assessment by, a specialist kidney unit – working with patients to help them decide between treatments takes time, but in some areas 30% of patients are not known to their kidney team for even 90 days before they start renal replacement therapy;</p><p>- access to a multi-professional team, including staff who regularly support patients undertaking home dialysis; and</p><p>- levels of support for people undertaking home dialysis to help them maintain their independence, including access to respite in-centre dialysis.</p><p> </p><p>The Atlas can be found at the following link:</p><p> </p><p><a href="https://fingertips.phe.org.uk/profile/atlas-of-variation" target="_blank">https://fingertips.phe.org.uk/profile/atlas-of-variation</a></p><p><strong> </strong></p><p>According to the latest data from the UK Renal Registry (UKRR), there were 1,195 patients receiving home dialysis in the United Kingdom in 2014, 1,175 patients in 2015; and 1,256 patients in 2016. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres. Participation is mandated in England, via the national services specification published by NHS England.</p><p> </p><p>The latest report from the UK Renal Registry can be found at the following link:</p><p> </p><p><a href="http://www.renalreg.org/publications-reports/" target="_blank">www.renalreg.org/publications-reports/</a></p><p><strong> </strong></p><p>No specific assessment of the cost to the National Health Service of the provision of dialysis services in a patient’s home compared to a clinical setting has been undertaken. In its assessment of the evidence regarding cost, the National Institute for Health and Care Excellence (NICE) set out in its guideline, ‘Renal Replacement Therapy and Conservative Management’, published in October 2018, that there is uncertainty in current UK dialysis costs, but they may be lower at home. The committee acknowledged that these treatments can have very different effects on lifestyle and recommended patient choice. The NICE guideline can be found at the following link:</p><p><strong> </strong></p><p><a href="http://www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301" target="_blank">www.nice.org.uk/guidance/ng107/resources/renal-replacement-therapy-and-conservative-management-pdf-66141542991301</a></p><p><strong> </strong></p><p>Regarding the benefits of home dialysis, there is good evidence that home dialysis therapies offer advantages for suitable patients. The limitations of thrice weekly standard in-centre haemodialysis have been recognised in recent years. However, it is very difficult to separate the effect of different case mix, the most up to date and comprehensive data does not show a survival difference between patients who received more frequent versus thrice weekly (standard regimen) haemodialysis.</p><p> </p><p>The advantage of self-care haemodialysis includes not only those related to control and convenience but also the opportunity to conduct more frequent or longer sessions to optimise health prospects. The introduction of smaller more portable haemodialysis machines also provides opportunity for travel for employment or holidays. Furthermore, these therapies are cost effective in the UK when compared with hospital treatments and have been demonstrated to be safe. Information regarding a reduction in travel times and reliance on other medicines is not available.</p><p> </p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 233465 233478 233479 233480 question first answered 21/03/2019 16:14:41 answering member 4067 label Biography information for Steve Brine
	tabling member	1436 label Biography information for Paul Farrelly

1077535

	registered interest
	date	26/02/2019
	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	Eating Disorders: Mental Health Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, when NHS England plans to answer the Freedom of Information request submitted by the hon. Member for Newcastle-under-Lyme on 21 January 2019 on specialist in-patient eating disorder services.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	226067
	answer	answer is ministerial correction date of answer 04/03/2019 answer text <p>NHS England has confirmed that the Freedom of Information (FOI) request was received on 21 January 2019 but the statutory deadline was not met. A response to the FOI was issued on 28 February 2019.</p><p> </p><p>The investigation of instances when the statutory deadline for FOI cases are missed by NHS England is a matter for the Information Commissioner.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 226068 question first answered 04/03/2019 17:41:51 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1436 label Biography information for Paul Farrelly

1077536

	registered interest
	date	26/02/2019
	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	Eating Disorders: Mental Health Services
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, if he will undertake an investigation into the reasons NHS England has not replied within the statutory timeframe to the Freedom of Information request of 21 January 2019 from the hon. Member for Newcastle-under-Lyme on specialist in-patient eating disorder services.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	226068
	answer	answer is ministerial correction date of answer 04/03/2019 answer text <p>NHS England has confirmed that the Freedom of Information (FOI) request was received on 21 January 2019 but the statutory deadline was not met. A response to the FOI was issued on 28 February 2019.</p><p> </p><p>The investigation of instances when the statutory deadline for FOI cases are missed by NHS England is a matter for the Information Commissioner.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 226067 question first answered 04/03/2019 17:41:51 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1436 label Biography information for Paul Farrelly

1020404

	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	Medicines and Healthcare products Regulatory Agency
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 03 December 2018 to Question 196736 on Medicines and Healthcare Products Regulatory Agency (MHRA), and with reference to the transition period set out in the Agreement on the Withdrawal of the United Kingdom of Great Britain and Northern Ireland from the European Union, if the MHRA will be recognised as an EU competent authority under the EU (a) Medical Devices Directive, (b) in-vitro diagnostic medical devices, and (c) Medical Devices Regulation during the period covered by the Agreement.
	tabling member constituency	Newcastle-under-Lyme
	tabling member printed	Paul Farrelly
	uin	199325
	answer	answer is ministerial correction date of answer 10/12/2018 answer text <p>The agreement of an implementation period will mean that the Medicines and Healthcare products Regulatory Agency (MHRA) will continue to be recognised as a European Union competent authority designated under the EU Directives for medical devices, in vitro diagnostic medical devices and active implantable medical devices, during this period.</p><p> </p><p>This is also the case for the new EU Regulations for medical devices and in vitro diagnostic medical devices, which both entered into force in May 2017.</p><p> </p><p>It is possible for a single organisation to have individual notified bodies designated in more than one Member State. The authority within each Member State is responsible for notified bodies based in its own country.</p><p> </p><p>The MHRA is responsible for the designation and monitoring of notified bodies in the United Kingdom, which the response to Question 196736 refers to.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 199327 question first answered 10/12/2018 14:12:25 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1436 label Biography information for Paul Farrelly