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61540

registered interest
date	12/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Hospital Beds
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many hospital beds per head of the population there were in (1) England, (2) London and (3) Lewisham, in each year from 2008–09 to 2013–14.
tabling member printed	Lord Kennedy of Southwark
uin	HL309
answer	answer is ministerial correction date of answer 23/06/2014 answer text <p>Hospital beds data per head of population are not collected centrally.</p><p> </p><p>Hospital beds data are collected for each National Health Service trust and NHS foundation trust.</p><p> </p><p>Population estimates and projections are available for local NHS commissioning bodies; primary care trusts (PCTs) up to 2011 and clinical commissioning groups (CCGs) from 2012. These data can be aggregated up to larger areas such as strategic health authorities (SHAs) up to 2011 and local area teams from 2012.</p><p> </p><p>A table has been placed in the Library which shows the estimated hospital beds per 1,000 population in England and London each year from 2008-09 to 2013-14.</p><p> </p><p>It is not possible to show the hospital beds per head of population in a local commissioning body such as Lewisham, because this would be based on the assumptions that the beds in a trust are available only for the population of the local commissioning body and that this population only uses these beds. These assumptions will not reflect reality as trusts serve populations from outside their commissioning areas and patients will access services in hospitals outside their local commissioning area.</p> answering member printed Earl Howe question first answered 23/06/2014 15:56:31 answering member 2000 label Biography information for Earl Howe attachment 1 file name HL309 - Lib Doc Table.xlsx title Table:Estimated hospital beds per 1,000, 2008-2014
tabling member	4153 label Biography information for Lord Kennedy of Southwark

61553

registered interest
date	12/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Learning Disability: Health Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to ensure that people with learning disabilities are not excluded from NHS England's five-year strategic plan for National Health Service commissioners to improve quality of and access to health care, outlined in Everyone Counts: Planning for Patients 2014/15–2018/19.
tabling member printed	Baroness Hollins
uin	HL322
answer	answer is ministerial correction date of answer 26/06/2014 answer text <p>The Government's Mandate to NHS England, sets out our ambitions for the health service, which include an objective that NHS England ensures clinical commissioning groups work with local authorities to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care. NHS England sets out how it will achieve the objectives in the Mandate in its 2014-15 – 2016-17 business plan. The Government will hold NHS England to account for its achievement.</p><p> </p><p><em>Everyone Counts: Planning for Patients 2014/15 to 2018/19</em>sets out a framework within which commissioners will need to work with providers and partners in local government to develop five year plans to secure the continuity of sustainable high quality care for all. Building on <em>Everyone Counts</em>, NHS England is beginning a programme of work to consider how to improve quality of and access to health care for people with learning disabilities. Within the framework there is specific reference to <em>Transforming Care: A national response to Winterbourne View Hospital. </em>This is a non-negotiable item that NHS England expects to be part of every relationship between commissioners and providers. As part of this, clinical commissioning groups, local authorities and specialised commissioners should work together to implement the core specification which describes the core principles that must be present in all education, health and social care services for children, young people, adults and older people with learning disabilities and/or autism who either display, or are at risk of displaying, behaviour that challenges.</p><p> </p><p>NHS England is committed to work to reduce premature mortality amongst people with learning disability, including actions in response to the Confidential Inquiry into Premature Deaths of People with Learning Disabilities.</p><p> </p> answering member printed Earl Howe question first answered 26/06/2014 14:01:36 question first ministerially corrected 26/06/2014 15:34:49 answering member 2000 label Biography information for Earl Howe previous answer version 6304 answering member printed Earl Baldwin of Bewdley answering member 3446
tabling member	4190 label Biography information for Baroness Hollins

61478

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	Tobacco: Packaging
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 444), whether they will place in the Library of the House correspondence between the Intellectual Property Office and the Department of Health regarding the proposed introduction of standardised tobacco packaging.
tabling member printed	Lord Palmer
uin	HL256
answer	answer is ministerial correction date of answer 24/06/2014 answer text <p>The Department has no current plans to publish information on the development and formulation of Government policy on standardised packaging of tobacco products</p> answering member printed Earl Howe question first answered 24/06/2014 12:15:36 answering member 2000 label Biography information for Earl Howe
tabling member	3192 label Biography information for Lord Palmer

61479

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	Tobacco: Packaging
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the statement by Earl Howe on 3 April (HL Deb, col 1121–2), whether in preparing for the publication of the draft regulations on standardised packaging for tobacco products they are considering the scope of the types of tobacco products to be included, such as drawing a distinction between cigars and pipe tobaccos and mainstream tobacco products.
tabling member printed	Lord Palmer
uin	HL257
answer	answer is ministerial correction date of answer 24/06/2014 answer text <p>The Government continues to carefully consider all issues relevant to the introduction of standardised packaging of tobacco products, including the scope of the types of tobacco products covered by the policy.</p> answering member printed Earl Howe question first answered 24/06/2014 12:14:47 answering member 2000 label Biography information for Earl Howe
tabling member	3192 label Biography information for Lord Palmer

61482

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	HIV Infection
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what was their total spending in 2013–14 on treatments for HIV infection in the United Kingdom.
tabling member printed	Lord Lexden
uin	HL260
answer	answer is ministerial correction date of answer 24/06/2014 answer text <p>Data for 2013-14 is not available at present. Primary care trusts' aggregate spend for 2012–13 (latest figures available) on HIV/AIDS was £630 million.</p> answering member printed Earl Howe question first answered 24/06/2014 12:15:17 answering member 2000 label Biography information for Earl Howe
tabling member	4202 label Biography information for Lord Lexden

61489

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	Pregnancy: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how the Department of Health plans to cover the cost of the number of children requiring specialised healthcare due to the effects of fetal valproate syndrome.
tabling member printed	Baroness Masham of Ilton
uin	HL267
answer	answer is ministerial correction date of answer 18/06/2014 answer text <p>The health and care needs of children with fetal valproate syndrome will be met by a range of services and in the majority of cases the local clinical commissioning group (CCG) will decide on the level of provision of services, taking into account the needs of the population it serves. The CCG's decisions are underpinned by clinical insight and knowledge of local healthcare needs.</p> answering member printed Earl Howe question first answered 18/06/2014 11:52:59 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

61490

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	Pregnancy: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether there are any plans to implement a system to ensure that female patients prescribed valproate or any other anti-convulsant medication are given information relating to potential problems in pregnancy.
tabling member printed	Baroness Masham of Ilton
uin	HL268
answer	answer is ministerial correction date of answer 19/06/2014 answer text <p>All doctors, during undergraduate and postgraduate training, are made aware of all of the current evidence when prescribing in pregnancy. This is especially so when prescribing drugs that are potentially teratogenic such as anticonvulsants.</p><p> </p><p>The core curriculum for trainee obstetricians which is overseen by the Royal College of Gynaecologists contains a detailed module on epilepsy in pregnancy including sodium valproate which all trainees are required to complete.</p><p> </p><p>The Royal College of Physicians has a similar core learning module on drugs in pregnancy for physicians in training. It is recommended that women with epilepsy attend for pre pregnancy counselling so that management of their epilepsy in any future pregnancy can be discussed as well as any risks and benefits of medication they are taking.</p><p> </p><p>NHS England expects all clinicians prescribing these drugs to follow the National Institute for Health and Care Excellence (NICE) guidance. This is a very powerful tool to improve commissioning. The NICE guidance issued in January 2012 recommends that epilepsy nurse specialists should be an integral part of the network of care of children, young people and adults with epilepsy (para 1.8.3). One of their roles is to educate, inform and support the patient and their family with specific training about the management of epilepsy.</p> answering member printed Earl Howe question first answered 19/06/2014 11:55:04 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

61491

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	Pregnancy: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what information is currently given to female patients concerning the potential problems of taking valproate in pregnancy; and how that information reflects the guidelines established by the National Institute for Health and Care Excellence on those issues.
tabling member printed	Baroness Masham of Ilton
uin	HL269
answer	answer is ministerial correction date of answer 18/06/2014 answer text <p>The Patient Information Leaflet (PIL) that accompanies the medicine is intended to supplement the information provided by the prescriber. The PIL for Epilim (a brand of valproate for the treatment of epilepsy) states that women who are pregnant or of childbearing age should not take valproate unless explicitly advised by their doctor and provides information on birth defects, impaired development and other problems which may occur in babies born to mothers who take valproate during pregnancy. The PILs for other brands of valproate used in the treatment of epilepsy and to control mania in bipolar disorder contain similar warnings. The warnings in the information for healthcare professionals, the Summary of Product Characteristics (SPC) and the PIL are currently the subject of a Europe–wide review which was prompted by new data on the risk of developmental disorders in children born to mothers who took valproate during pregnancy.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) clinical guideline on epilepsy made the following recommendation as a key priority for implementation: &quot;Women and girls with epilepsy and their partners, as appropriate, must be given accurate information and counselling about contraception, conception, pregnancy, caring for children, breastfeeding and menopause.&quot; NICE's clinical guideline on bipolar disorder recommends that valproate should not routinely be prescribed to pregnant women with bipolar disorder.</p> answering member printed Earl Howe question first answered 18/06/2014 11:52:30 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

61492

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	Pregnancy: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what practical steps are being taken to ensure that the experiences and interests of children with fetal valproate syndrome and their families are represented as an integral part of patient involvement at every level of the reformed National Health Service.
tabling member printed	Baroness Masham of Ilton
uin	HL270
answer	answer is ministerial correction date of answer 19/06/2014 answer text <p>NHS England has developed a delivery model which sets out a systematic approach to the way that it works. Each aspect of its work is underpinned by a commitment to increase patient experience, engagement and participation. This is reflected in their business plan 2014-15 to 2016-17.</p><p> </p><p>In September 2013, it launched a package of measures designed to ensure that the voices of patients, their carers and the public are at the centre of healthcare services.</p><p> </p><p>‘Transforming Participation in Health and Care – The NHS belongs to us all' has been developed by NHS England with a wide range of stakeholders and partners. Its purpose is to support commissioners to improve individual and public participation and to better understand and respond to the needs of the communities they serve.</p><p> </p><p>It supports two legal duties requiring clinical commissioning groups (CCGs) and commissioners in NHS England to enable:</p><p> </p><p>- patients and carers to participate in planning, managing and making decisions about their care and treatment, through the services they commission; and</p><p> </p><p>- the effective participation of the public in the commissioning process itself, so that services provided reflect the needs of local people.</p><p> </p><p>The guidance highlights a range of ways in which National Health Service commissioners can fulfil their statutory responsibilities and seize the opportunity to deliver personalised and responsive care to all. It includes a wide range of tools, resources and case studies that commissioners will find useful when developing their own responses.</p><p> </p><p>The guidance is a starting point and NHS England will be working with partners to develop further resources to support commissioners to develop their approaches to both individual and public participation.</p><p> </p><p>The reforms to the health and social care system set out in the Health and Social Care Act have also emphasised the need for integration. Central to these reforms is the establishment of statutory health and wellbeing boards to encourage local authorities to take a more strategic approach to providing integrated health and local government services. The boards are intended to bring together bodies from the NHS, public and local government, including Healthwatch as the patient's voice, jointly to plan how best to meet local health and care needs, and to commission services accordingly.</p> answering member printed Earl Howe question first answered 19/06/2014 11:54:29 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

61493

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	Pregnancy: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans are being made to improve the collection of information about children and adults affected by anti-convulsant drugs during pregnancy.
tabling member printed	Baroness Masham of Ilton
uin	HL271
answer	answer is ministerial correction date of answer 19/06/2014 answer text <p>The Department and The Medicines and Healthcare Products Regulatory Agency have met representatives of Independent Fetal Anti Convuslant Trust (In-FACT) to discuss issues relating the prescribing of anti-epileptic drugs to women of child bearing age. We are considering what action might be taken. This includes looking at our current data collection systems to see how information on the incidence of fetal anti convulsant syndrome can be improved.</p> answering member printed Earl Howe question first answered 19/06/2014 11:53:22 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton