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79517

registered interest
date	22/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Cardiovascular Diseases: Health Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what progress has been made against each of the actions in their Cardiovascular Disease Outcomes Strategy.
tabling member printed	Lord Black of Brentwood
uin	HL1416
answer	answer is ministerial correction date of answer 11/08/2014 answer text <p>It is for NHS England, working with Public Health England (PHE) and other stakeholders, to implement the actions set out in the Cardiovascular Disease (CVD) Outcomes Strategy. NHS England has established a working group with PHE which meets quarterly to discuss progress on the strategy and is taking action on all the recommendations, some it has prioritised over others.</p><p> </p><p>For example, on making benchmarked data on CVD risk factors available, PHE has established a CVD National Cardiovascular Intelligence Network and a Partnership Board. These bring together a variety of stakeholders which hold or have an interest in this type of data, including the leads of the existing clinical audits covering cardiovascular disease.</p><p> </p><p>PHE also continues to raise awareness of the signs and symptoms of CVD by running campaigns such as Act FAST. This has been the Department’s and PHE’s most successful campaign and continues to help people experiencing the signs and symptoms of a stroke get to hospital quicker. The campaign will be run again during 2014-15.</p><p> </p><p>NHS England’s National Clinical Director for Cardiac Disease established a Familial Hypercholesterolaemia (FH) advisory group which has identified some of the barriers to identifying more families with FH and will continue to develop and spread good practice in this field.</p><p> </p><p>At a local level, clinical commissioning groups (CCGs) are being encouraged to implement the Strategy with the support of the twelve Strategic Clinical Networks. These networks are working with CCGs and other partners in the health and care system to identify local and regional priorities for cardiac and renal disease, diabetes and stroke.</p><p> </p><p>All 152 local authorities are offering the NHS Health Check programme, which aims to present heart disease, stroke, diabetes and kidney disease. Local authorities have a legal duty to deliver the programme to all of their eligible population once every five years. In 2013-14 a total of 2.8 million people (18.5%) of the five years eligible population were offered an NHS Health Check while just fewer than 1.4 million received an NHS Health Check, equating to 49% of those offered. This is the greatest number of NHS Health Checks offerred and received in one year since the programme began.</p><p> </p> answering member printed Earl Howe question first answered 11/08/2014 12:24:22 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

64118

registered interest
date	25/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Heart Diseases
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what action they are taking to improve the diagnosis of atrial fibrillation.
tabling member printed	Lord Black of Brentwood
uin	HL622
answer	answer is ministerial correction date of answer 08/07/2014 answer text <p>NHS England is taking a number of actions to improve the care and management of people with atrial fibrillation (AF). It has published <em>Our Ambition to Reduce Premature Mortality: A resource to support commissioners in setting a level of ambition</em>, which identifies improved management of AF as a priority for reducing premature mortality. The resource can be found at:</p><p> </p><p>www.england.nhs.uk/ourwork/sop/red-prem-mort/</p><p> </p><p>National Health Service Improving Quality's <em>Living Longer Lives</em> programme includes promoting the use of a simple but effective audit tool called Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) which simplifies the process of identifying patients with AF who are not receiving the right treatment. NHS Improving Quality is currently collaborating with partner organisations, including charities, to support the nationwide roll-out of GRASP-AF.</p><p> </p><p>This work will be supported by the publication of an economic analysis commissioned by NHS Improving Quality using GRASP data which demonstrates both the current and potential impact of atrial fibrillation management on the number of AF related strokes.</p><p><em> </em></p><p>Discussions are also underway to consider whether opportunistic testing for atrial fibrillation (AF) should be encouraged nationally as part of the NHS Health Check programme.</p><p> </p> answering member printed Earl Howe grouped question UIN HL623 question first answered 08/07/2014 15:27:07 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

64119

registered interest
date	25/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Heart Diseases
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, in the light of the publication of the National Institute for Health and Care Excellence clinical guideline 180, what action they are taking to ensure appropriate risk stratification and uptake of anti-thrombotic therapy among patients with atrial fibrillation.
tabling member printed	Lord Black of Brentwood
uin	HL623
answer	answer is ministerial correction date of answer 08/07/2014 answer text <p>NHS England is taking a number of actions to improve the care and management of people with atrial fibrillation (AF). It has published <em>Our Ambition to Reduce Premature Mortality: A resource to support commissioners in setting a level of ambition</em>, which identifies improved management of AF as a priority for reducing premature mortality. The resource can be found at:</p><p> </p><p>www.england.nhs.uk/ourwork/sop/red-prem-mort/</p><p> </p><p>National Health Service Improving Quality's <em>Living Longer Lives</em> programme includes promoting the use of a simple but effective audit tool called Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) which simplifies the process of identifying patients with AF who are not receiving the right treatment. NHS Improving Quality is currently collaborating with partner organisations, including charities, to support the nationwide roll-out of GRASP-AF.</p><p> </p><p>This work will be supported by the publication of an economic analysis commissioned by NHS Improving Quality using GRASP data which demonstrates both the current and potential impact of atrial fibrillation management on the number of AF related strokes.</p><p><em> </em></p><p>Discussions are also underway to consider whether opportunistic testing for atrial fibrillation (AF) should be encouraged nationally as part of the NHS Health Check programme.</p><p> </p> answering member printed Earl Howe grouped question UIN HL622 question first answered 08/07/2014 15:27:07 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

64120

registered interest
date	25/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anticoagulants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many people in England are treated with (1) warfarin, and (2) novel oral anticoagulants each year.
tabling member printed	Lord Black of Brentwood
uin	HL624
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>Information is not held centrally on the number of people treated with warfarin or novel oral anticoagulants. The following table provides information on the number of prescription items written in England and dispensed in the community in the United Kingdom, for the latest calendar year, for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium.</p><p> </p><table><tbody><tr><td colspan="2"><p>Prescription items written in England and dispensed in the community in the United Kingdom for 2013 <sup>1</sup></p></td></tr><tr><td><p>Medicine <sup>2</sup></p></td><td><p>Items (000s)</p></td></tr><tr><td><p>Apixaban</p></td><td><p>14.4</p></td></tr><tr><td><p>Dabigatran etexilate</p></td><td><p>174.0</p></td></tr><tr><td><p>Rivaroxaban</p></td><td><p>190.0</p></td></tr><tr><td><p>Warfarin sodium <sup>3</sup></p></td><td><p>11,022.8</p></td></tr><tr><td><p>Total for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium</p></td><td><p>11,401.2</p></td></tr><tr><td><p>Percentage of warfarin sodium compared to the total for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium</p></td><td><p>96.7%</p></td></tr></tbody></table><p><em> </em></p><p><em>Source:</em> ePACT and Hospital ePACT, NHS Prescription Services, part of the NHS Business Services Authority</p><p><em> </em></p><p><em>Notes:</em></p><p><sup>1. </sup>The figures include prescriptions written in a hospital in England but dispensed in the community in the United Kingdom.</p><p><sup>2. </sup>These medicines are also used in secondary care, however no equivalent measure to a prescription item is available for secondary care data.</p><p>Some patients treated with warfarin may receive prescription items for two or three different strengths of warfarin to allow the dose to be altered in response to monitoring of INR. (NB: warfarin is available as 0.5mg, 1mg, 3mg and 5mg tablets).</p> answering member printed Earl Howe grouped question UIN HL625 question first answered 01/07/2014 11:46:45 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

64121

registered interest
date	25/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anticoagulants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what percentage of the total number of prescriptive items for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium in England were for warfarin sodium in the last year for which figures are available.
tabling member printed	Lord Black of Brentwood
uin	HL625
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>Information is not held centrally on the number of people treated with warfarin or novel oral anticoagulants. The following table provides information on the number of prescription items written in England and dispensed in the community in the United Kingdom, for the latest calendar year, for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium.</p><p> </p><table><tbody><tr><td colspan="2"><p>Prescription items written in England and dispensed in the community in the United Kingdom for 2013 <sup>1</sup></p></td></tr><tr><td><p>Medicine <sup>2</sup></p></td><td><p>Items (000s)</p></td></tr><tr><td><p>Apixaban</p></td><td><p>14.4</p></td></tr><tr><td><p>Dabigatran etexilate</p></td><td><p>174.0</p></td></tr><tr><td><p>Rivaroxaban</p></td><td><p>190.0</p></td></tr><tr><td><p>Warfarin sodium <sup>3</sup></p></td><td><p>11,022.8</p></td></tr><tr><td><p>Total for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium</p></td><td><p>11,401.2</p></td></tr><tr><td><p>Percentage of warfarin sodium compared to the total for apixaban, dabigatran etexilate, rivaroxaban, and warfarin sodium</p></td><td><p>96.7%</p></td></tr></tbody></table><p><em> </em></p><p><em>Source:</em> ePACT and Hospital ePACT, NHS Prescription Services, part of the NHS Business Services Authority</p><p><em> </em></p><p><em>Notes:</em></p><p><sup>1. </sup>The figures include prescriptions written in a hospital in England but dispensed in the community in the United Kingdom.</p><p><sup>2. </sup>These medicines are also used in secondary care, however no equivalent measure to a prescription item is available for secondary care data.</p><p>Some patients treated with warfarin may receive prescription items for two or three different strengths of warfarin to allow the dose to be altered in response to monitoring of INR. (NB: warfarin is available as 0.5mg, 1mg, 3mg and 5mg tablets).</p> answering member printed Earl Howe grouped question UIN HL624 question first answered 01/07/2014 11:46:44 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

64122

registered interest
date	25/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anticoagulants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what action they are taking to increase the uptake of novel oral anticoagulants in the management of atrial fibrillation.
tabling member printed	Lord Black of Brentwood
uin	HL626
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>Decisions on the prescribing of medicines are a matter for clinicians in discussion with their patients.</p><p> </p><p>National Health Service commissioners are legally required by regulations to fund those anticoagulant treatments recommended by the National Institute for Health and Care Excellence(NICE) in its technology appraisal guidance.</p><p> </p><p>The NICE Implementation Collaborative published a consensus statement on supporting the use of novel oral anticoagulants in non-valvular atrial fibrillation on 18 June 2014. This is available at:</p><p> </p><p>www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64</p><p> </p><p>NICE published its updated clinical guideline on the management of atrial fibrillation on 25 June 2014 which recommends that novel oral anticoagulants should be offered where appropriate.</p><p> </p><p>The latest data from the Innovation Scorecard show that uptake of new anticoagulants across England is increasing. Further information is available at:</p><p> </p><p>www.hscic.gov.uk/catalogue/PUB13669</p><p> </p> answering member printed Earl Howe question first answered 01/07/2014 11:47:28 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood

61516

registered interest
date	11/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Homosexuality
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Earl Howe on 6 May (WA 358), whether they are considering introducing legislation to prevent the practice of reparative or conversion therapy on homosexual men and women.
tabling member printed	Lord Black of Brentwood
uin	HL294
answer	answer is ministerial correction date of answer 25/06/2014 answer text <p>This Government does not believe that being lesbian, gay or bisexual is an illness to be treated or cured. We have no current plans to ban or restrict conversion therapy via legislation as we do not feel this would be an effective preventive measure.</p><p> </p><p>We do, however, fully recognise the importance of this issue. Therefore, the Minister of State for Care and Support, Norman Lamb, convened a roundtable with professional bodies and charities in February of this year to discuss collaborative measures to help prevent the use of such therapies. The Department continues to work with these organisations.</p><p> </p> answering member printed Earl Howe question first answered 25/06/2014 16:32:04 answering member 2000 label Biography information for Earl Howe
tabling member	4171 label Biography information for Lord Black of Brentwood