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825264

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	Health
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they plan to take further action to encourage NHS users to accept greater responsibility for their health.
tabling member printed	Lord Brooke of Alverthorpe
uin	HL4797
answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>The Government wants everyone to be able to make healthier choices, regardless of their circumstances, and to minimise the risk and impact of illness. We have given local government the freedom to innovate and develop their own ways of improving public health in their area. In addition, Public Health England supports local innovation, helps to provide disease control and protection and spreads information on the latest innovations from around the world.</p><p> </p><p>Progress is being made. Since 2000, both life expectancy and healthy life expectancy have increased in England; the population is now living longer and spending more years in good health. There has been a significant reduction in the prevalence of smoking going from almost 46% in 1974 to 15.5% in 2016 and alcohol consumption is also falling.</p><p> </p><p>However there is more to do and a range of initiatives are underway to build upon these improvements:</p><p> </p><p>- Change4Life, Public Health England’s flagship behaviour change social marketing campaign, encourages families across England to ‘eat well and move more’;</p><p>- the Tobacco Control Plan for England 2017-2022 lays down bold ambitions to reduce further smoking prevalence in England, en-route towards creating a smoke free generation; and</p><p>- the 2016 UK Chief Medical Officers’ low risk drinking guidelines provide the public with the most up to date scientific information to help people make informed decisions about their own drinking.</p><p> </p><p>Additionally, the NHS Constitution sets out responsibilities patients have that will safeguard their and their family’s health and wellbeing. The handbook that is published alongside the Constitution provides further detail on what steps patients can take. We will update the handbook in 2018 and will take this opportunity to look at how the wording on patient responsibilities can be strengthened further.</p> answering member printed Lord O'Shaughnessy question first answered 25/01/2018 16:31:31 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

825266

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	Agency Nurses
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the answer by Lord O'Shaughnessy on 10 January (HL Deb, col 182), how many of the 10,000 extra nurses on wards are agency nurses.
tabling member printed	Lord Clark of Windermere
uin	HL4799
answer	answer is ministerial correction date of answer 29/01/2018 answer text <p>NHS Digital publishes workforce statistics for substantive staff employed by the National Health Service trusts and clinical commissioning groups. Nurses on our wards are coded on the Electronic Staff Record as Acute, Elderly and General Nurses and are a subset of all nurses and health visitors. As at September, NHS Digital data shows there were 14,185 full time equivalent more nurses on our wards than in May 2010. All of these nurses are professionally qualified clinical nurses. As such, none are agency nurses.</p><p>Figures are provided as full time equivalent as this is the most accurate measure of service capacity.</p> answering member printed Baroness Chisholm of Owlpen grouped question UIN HL4800 question first answered 29/01/2018 17:47:11 answering member 4330 label Biography information for Baroness Chisholm of Owlpen
tabling member	525 label Biography information for Lord Clark of Windermere

825267

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	Nurses
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the answer by Lord O'Shaughnessy on 10 January (HL Deb, col 182), how many of the 10,000 extra nurses on wards are qualified, registered nurses.
tabling member printed	Lord Clark of Windermere
uin	HL4800
answer	answer is ministerial correction date of answer 29/01/2018 answer text <p>NHS Digital publishes workforce statistics for substantive staff employed by the National Health Service trusts and clinical commissioning groups. Nurses on our wards are coded on the Electronic Staff Record as Acute, Elderly and General Nurses and are a subset of all nurses and health visitors. As at September, NHS Digital data shows there were 14,185 full time equivalent more nurses on our wards than in May 2010. All of these nurses are professionally qualified clinical nurses. As such, none are agency nurses.</p><p>Figures are provided as full time equivalent as this is the most accurate measure of service capacity.</p> answering member printed Baroness Chisholm of Owlpen grouped question UIN HL4799 question first answered 29/01/2018 17:47:11 answering member 4330 label Biography information for Baroness Chisholm of Owlpen
tabling member	525 label Biography information for Lord Clark of Windermere

825281

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	Benzodiazepines
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they have assessed the impact on patients of the long-term use of benzodiazepines by NHS patients.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4814
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 HL4815 HL4816 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

825282

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 assessment they have made of trends in the use of dependence-forming medicines prescribed in primary care.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4815
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 HL4816 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

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

825284

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 whether they intend to establish a national helpline for people affected by dependence on prescribed drugs.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4817
answer	answer is ministerial correction date of answer 29/01/2018 answer text <p>The Government has no plans to introduce a national helpline specifically to support people affected by prescribed drug dependence. People who feel that they might be dependent on either prescribed or over the counter medicines should seek help from a health professional in the first instance, such as a general practitioner (GP) or pharmacist. Help and advice is also available from the 111 helpline or the online NHS Choices service. People who have developed problems with benzodiazepines, antidepressants, painkillers and other medicines should seek help from their GP in the first instance. Specialist advice for GPs and support for patients with complex and severe problems is available from substance misuse services which are available in each local authority across the country.</p><p> </p><p>The Department has commissioned Public Health England to undertake an evidence review to better understand the scope of the problem of prescribed drug dependence. 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> </p><p> </p> answering member printed Baroness Chisholm of Owlpen question first answered 29/01/2018 17:46:05 answering member 4330 label Biography information for Baroness Chisholm of Owlpen
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825285

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 whether they intend to commission specific guidelines for the NHS that cover withdrawal from prescription drugs.
tabling member printed	Lord Hunt of Kings Heath
uin	HL4818
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 HL4816 question first answered 25/01/2018 16:24:47 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

825292

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	Hospital Beds
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many beds there were in English hospitals in each of the last five years.
tabling member printed	Baroness Jolly
uin	HL4825
answer	answer is ministerial correction date of answer 29/01/2018 answer text <p>Information is not available in the format requested. Data is not collected on total number of beds. NHS England collects quarterly data from all National Health Service organisations on available overnight and day only beds and the total number of occupied bed days by consultant led specialty, excluding critical care beds.</p><p> </p><p>There has been a long-term reduction in the number of general and acute beds open overnight because hospitals are dealing with patients more efficiently. The NHS now performs more day cases, length of stay is decreasing and more people are treated in community settings.</p><p> </p><p>A table showing the numbers of these NHS hospital beds is attached owing to the size of the data.</p><p> </p><p>NHS England statistics show that the bed occupancy rate has remained stable, between 84% and 89% (all beds) since 2000. Bed availability does fluctuate but the NHS has practice and experience in managing capacity to cope with both routine and emergency care.</p><p>The majority of patients are discharged quickly, with average lengths of stay falling from just over six days in 2006-07 to just under five days in 2016-17.</p><p> </p><p> </p> answering member printed Baroness Chisholm of Owlpen question first answered 29/01/2018 17:50:10 answering member 4330 label Biography information for Baroness Chisholm of Owlpen attachment 1 file name HL4825 tables formatted.docx title NHS Hospital beds data
tabling member	4203 label Biography information for Baroness Jolly

825298

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	Medical Records
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what remedy there is when a hospital trust persistently refuses to release full medical records to a patient or a GP for the patient under the Access to Medical Records Act 1990 and the Data Protection Act 1998 and may have destroyed some of those records despite their being protected on police advice.
tabling member printed	The Countess of Mar
uin	HL4831
answer	answer is ministerial correction date of answer 25/01/2018 answer text <p>Patients have a legal right to apply for access to their medical records. A request for medical records should be made directly to the healthcare provider that provides the treatment. However, information can be exempt from disclosure if it “would be likely to cause serious harm to the physical or mental health or condition of the data subject or any other person”.</p><p> </p><p>An individual can complain to the Information Commissioner (ICO) about the data controller if they disagree with the decision to withhold records, or that this was not done in accordance with the legislation. Similarly, if records that should have been retained have been destroyed or deleted, this can be raised as part of a complaint to the ICO.</p><p> </p><p>From an Information Governance perspective, there are provisions with the current Data Protection Act 1998 and under discussion in the Data Protection Bill that allow the data subject (patient) to seek redress.</p> answering member printed Lord O'Shaughnessy question first answered 25/01/2018 16:26:42 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar