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1088233

registered interest
date	13/03/2019
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	Community Hospitals: Social Services
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 potential merits of increasing the proportion of specialised social care provided by community hospitals.
tabling member constituency	Newcastle-under-Lyme
tabling member printed	Paul Farrelly
uin	231928
answer	answer is ministerial correction date of answer 19/03/2019 answer text <p>No assessment has been made of the potential merits of increasing the proportion of specialised social care in community hospitals.</p><p> </p><p>Local authorities have duties under the Care Act 2014 to meet the eligible needs of the people in their local area, subject to a financial assessment. Local authorities should ensure that they commission appropriate and effective services for people with eligible care and support needs.</p><p> </p><p>Integrated Care Systems (ICSs) bring together local organisations to redesign care and improve population health, creating shared leadership and action. They are a pragmatic and practical way of delivering the ‘triple integration’ of primary and acute care, physical and mental health services, and health with social care. ICSs will have a key role in working with local authorities at ‘place’ level and through ICSs, the National Health Service and local government will work together to design services and improve population health. The NHS Long Term Plan set out a vision for ICSs to cover the whole country by April 2021.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 19/03/2019 11:09:06 answering member 4008 label Biography information for Dame Caroline Dinenage previous answer version 108485 answering member constituency Gosport answering member printed Caroline Dinenage answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	1436 label Biography information for Paul Farrelly

1088234

registered interest
date	13/03/2019
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	Health Services: Reciprocal Arrangements
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 26 February 2019 to Question 224304 on Health Services: Reciprocal Arrangements, how many European Health Insurance Cards have been issued to people over the age of 70 in each of the nations and regions of the UK.
tabling member constituency	West Bromwich East
tabling member printed	Tom Watson
uin	231936
answer	answer is ministerial correction date of answer 18/03/2019 answer text <p>The number of active European Health Insurance Cards issued to people over 70 is as follows:</p><table><tbody><tr><td><p>Northern Ireland</p></td><td><p>60,132</p></td></tr><tr><td><p>England</p></td><td><p>2,391,876</p></td></tr><tr><td><p>Scotland</p></td><td><p>219,675</p></td></tr><tr><td><p>Wales</p></td><td><p>140,439</p></td></tr></tbody></table><p><br> The data by region is not available.</p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 18/03/2019 11:28:47 answering member 1585 label Biography information for Stephen Hammond
tabling member	1463 label Biography information for Lord Watson of Wyre Forest

1088242

registered interest
date	13/03/2019
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	Eating Disorders
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, whether he plans to ensure that on medicine courses the effect of eating disorders on mental health is given parity of esteem with their effect on physical health; and if he will make a statement.
tabling member constituency	Newcastle-under-Lyme
tabling member printed	Paul Farrelly
uin	231929
answer	answer is ministerial correction date of answer 18/03/2019 answer text <p>Undergraduate medical schools determine the content of their own curricula but are required to integrate the General Medical Council’s ‘Outcomes for Graduates’. These Outcomes include the knowledge, skills and behaviour that graduates must be able to demonstrate before gaining a licence to practise medicine.</p><p>The Outcomes were updated in 2018, with the integration of mental and social health care and caring for people with multiple morbidities, including mental health conditions, being key drivers for the update.</p><p>The new Outcomes specify that newly qualified doctors must explain and illustrate by professional experience the principles for the identification, safe management and referral of patients with mental health conditions. They must also take action in response to factors suggesting patient vulnerability, including assessing the needs of, and support required, for people with mental health conditions. Newly qualified doctors must be able to explain the relationship between psychological and medical conditions and how psychological factors impact on risk and treatment outcome. Finally the Outcomes take into account multi-professional working, noting that newly qualified doctors must work effectively within a multi-professional and multi-disciplinary team and across multiple care settings.</p><p>Medical schools have to design their curricula and assessments in order for their students to be able to meet all of the Outcomes by the time they complete their course. Schools have until summer 2020 to make sure their curriculum meets the new outcomes.</p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 18/03/2019 11:30:33 answering member 1585 label Biography information for Stephen Hammond
tabling member	1436 label Biography information for Paul Farrelly

1088268

registered interest
date	13/03/2019
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	Cervical Cancer: Screening
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 28 February 2019 to Question 223982 on Cervical Cancer: Screening, if he will make it his policy to (a) require CCGs to monitor and report to him on the availability of cervical screening appointments at GP surgeries and (b) request the information necessary to allow him to monitor regularly the rates of attendance for cervical screening appointments.
tabling member constituency	Brighton, Pavilion
tabling member printed	Caroline Lucas
uin	231979
answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>Public Health England publishes cervical screening coverage by clinical commissioning group (CCG), which shows coverage by practice for the current period and the previous screening interval period of 3.5 years or 5.5 years. The information is available at the following link:</p><p> </p><p><a href="https://www.gov.uk/government/publications/cervical-screening-coverage-and-data" target="_blank">https://www.gov.uk/government/publications/cervical-screening-coverage-and-data</a></p><p> </p><p>NHS England commissioners oversee services so that performance and trends can be monitored locally.</p><p> </p><p>NHS England is accountable to the Secretary of State for Health and Social Care for how well it performs its responsibilities under the Public Health Functions Agreement including to commission high quality public health services, with efficient use of resources, seeking to achieve positive health outcomes and to promote equality and reduce health inequalities. Quarterly assurance reports, produced jointly by NHS England and Public Health England, include a performance indicator on cervical screening coverage rates.</p><p> </p><p>In addition, a range of national statistics and other data on cervical screening including coverage rates at primary care and CCG levels is published by NHS Digital and is available at the following link:</p><p> </p><p><a href="https://digital.nhs.uk/data-and-information/publications/statistical/cervical-screening-programme" target="_blank">https://digital.nhs.uk/data-and-information/publications/statistical/cervical-screening-programme</a></p><p> </p><p>As part of the delivery of the General Practitioner Five Year Forward View, the National Health Service is investing more than £258 million to improve access to general practice. Patients are now benefitting from improved access to all routine appointments (including cervical screening), at evening and/or weekends.</p><p> </p><p>The NHS Cervical Cancer screening programme saves an estimated 5,000 lives a year by detecting abnormalities of the cervix early and referring women for effective treatment.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 21/03/2019 16:22:48 answering member 4067 label Biography information for Steve Brine
tabling member	3930 label Biography information for Caroline Lucas

1088277

registered interest
date	13/03/2019
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	Migrants: Detainees
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps are taken to ensure that people in immigration removal centres have uninterrupted access to prescribed medication.
tabling member constituency	Sheffield, Brightside and Hillsborough
tabling member printed	Gill Furniss
uin	232076
answer	answer is ministerial correction date of answer 18/03/2019 answer text <p>NHS England’s focus on improving the physical needs of this patient population have resulted in the development of a dedicated medicine improvement programme for those in an immigration removal centre (IRC).</p><p> </p><p>The programme aims to improve the optimisation of medicines for people in immigration removal centres and has been underpinned by specific professional medicines optimisation standards published in partnership with the Royal Pharmaceutical Society (2017).</p><p> </p><p>The programme aims to improve the optimisation of medicines for people in IRCs to deliver:</p><p> </p><p>- A clear understanding of current provision of pharmacy services, including on-site services, and medicines handling and use in IRCs;</p><p>- An audit of the medicines standards in all IRCs to support quality improvement in pharmacy services and medicines optimisation;</p><p>- Identification of key improvement priorities for each IRC based on the gap analysis between provision and expected standards;</p><p>- Introduction by providers of policies and an IT-based risk assessment tools to enable as many detainees as possible to self-administer their medicines;</p><p>- Provide medicines in an environment where people can maintain confidentiality and access support from pharmacy staff about their medicines; and</p><p>- Improve continuity of medicines on admission through more effective electronic recording during their period of detention in IRCs as well as on their release and transfer or deportation.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 18/03/2019 14:19:34 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4571 label Biography information for Gill Furniss

1088329

registered interest
date	13/03/2019
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	Health: Students
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps the Government is taking to reduce the prevelance of (a) stress, (b) loneliness, (c) anxiety, and (d) substance misuse among undergraduate students.
tabling member constituency	Vale of Clwyd
tabling member printed	Chris Ruane
uin	231917
answer	answer is ministerial correction date of answer 18/03/2019 answer text <p>The Department of Health and Social Care is working closely with the Department for Education to improve the mental health of undergraduate students. Our joint document, ‘Transforming children and young people’s mental health provision: a green paper’, includes a commitment to build a new national strategic partnership with key stakeholders to improve the mental health of 16 to 25 year olds in schools, colleges and universities, by facilitating coordinated action, experimentation and robust evaluation on leadership, prevention and improved data collection.</p><p>To support this, the NHS Long Term Plan commits to a comprehensive expansion of mental health services, including a new approach to mental health services for people aged 18-25, supporting transitions to college and to adulthood, with services being adapted to create a comprehensive offer for 0-25-year olds.</p><p>NHS England is working closely with Universities UK through the Mental Health in Higher Education programme to build the capability and capacity of universities to improve student welfare services and improve access to mental health services for the student population, including focusing on suicide reduction, and improving access to psychological therapies to support treat students suffering from stress and anxiety.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 18/03/2019 14:21:04 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	534 label Biography information for Chris Ruane

1088345

registered interest
date	13/03/2019
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	Cancer: 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, what recent estimate his Department has made of the number of NHS trusts in England that have outsourced cancer treatment services, in part or in whole, to private sector providers.
tabling member constituency	Coventry South
tabling member printed	Mr Jim Cunningham
uin	231900
answer	answer is ministerial correction date of answer 18/03/2019 answer text <p>NHS England does not hold information on the number of National Health Service trusts in England that have outsourced cancer treatment services.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 18/03/2019 16:25:54 answering member 4067 label Biography information for Steve Brine
tabling member	308 label Biography information for Mr Jim Cunningham

1088401

registered interest
date	13/03/2019
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	Pregnancy: Sodium Valproate
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 effectiveness of the valproate pregnancy prevention programme in reducing the number of children born with birth defects and persistent developmental disorders.
tabling member constituency	Lancaster and Fleetwood
tabling member printed	Cat Smith
uin	232043
answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>In April 2018, strengthened regulatory measures for valproate were introduced following a European-wide review of the latest evidence on harms from valproate exposure during pregnancy, including congenital anomalies and neurodevelopmental disorders including autism in children. These measures include the valproate Pregnancy Prevention Programme, the goal of which is to rapidly reduce and eventually eliminate pregnancies exposed to valproate.</p><p> </p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) is monitoring the impact of, and adherence to, the strengthened regulatory recommendations for valproate including the Pregnancy Prevention Programme, using research studies and routinely collected healthcare data. These include data from the Clinical Practice Research Datalink, national databases in England (NHS Business Services Authority and NHS Digital), Scotland (Information Services Division), and Northern Ireland (Health and Social Care Northern Ireland) linking community drug dispensing and maternity services data where these are available. The MHRA is also accessing data on valproate from clinical audits run by healthcare professional organisations, and information on patients’ experience of introduction of the strengthened regulatory measures via surveys conducted by charitable organisations and patient groups.</p><p> </p><p>Monitoring of prescribing of valproate has shown a slow, continued decline in women of childbearing age. Data show variability in levels of prescribing of valproate to women of childbearing age across different clinical commissioning groups in England. The current monitoring methods used by the MHRA do not enable comprehensive monitoring of compliance at the prescriber or patient level. It is therefore not possible to estimate the number of healthcare professionals who are not complying with all aspects of the Pregnancy Prevention Programme. Surveys of patient experiences have shown some evidence of non-compliance amongst healthcare professionals with the valproate Pregnancy Prevention Programme. Actions are being taken by the relevant professional regulators to follow up and address this.</p><p> </p><p>The recent European review of valproate in pregnancy considered a possible association between birth defects and persistent developmental disorders associated with paternal valproate treatment at the time of conception. The review concluded that there was insufficient evidence at present to establish such a link. A retrospective observational study is to be undertaken to further investigate this issue for which a study protocol is currently being agreed by the European Medicines Agency.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 232044 232045 question first answered 21/03/2019 12:14:16 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4436 label Biography information for Cat Smith

1088402

registered interest
date	13/03/2019
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	Pregnancy: Sodium Valproate
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 on the number of healthcare professionals that are not complying with the requirements of the valproate pregnancy prevention programme.
tabling member constituency	Lancaster and Fleetwood
tabling member printed	Cat Smith
uin	232044
answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>In April 2018, strengthened regulatory measures for valproate were introduced following a European-wide review of the latest evidence on harms from valproate exposure during pregnancy, including congenital anomalies and neurodevelopmental disorders including autism in children. These measures include the valproate Pregnancy Prevention Programme, the goal of which is to rapidly reduce and eventually eliminate pregnancies exposed to valproate.</p><p> </p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) is monitoring the impact of, and adherence to, the strengthened regulatory recommendations for valproate including the Pregnancy Prevention Programme, using research studies and routinely collected healthcare data. These include data from the Clinical Practice Research Datalink, national databases in England (NHS Business Services Authority and NHS Digital), Scotland (Information Services Division), and Northern Ireland (Health and Social Care Northern Ireland) linking community drug dispensing and maternity services data where these are available. The MHRA is also accessing data on valproate from clinical audits run by healthcare professional organisations, and information on patients’ experience of introduction of the strengthened regulatory measures via surveys conducted by charitable organisations and patient groups.</p><p> </p><p>Monitoring of prescribing of valproate has shown a slow, continued decline in women of childbearing age. Data show variability in levels of prescribing of valproate to women of childbearing age across different clinical commissioning groups in England. The current monitoring methods used by the MHRA do not enable comprehensive monitoring of compliance at the prescriber or patient level. It is therefore not possible to estimate the number of healthcare professionals who are not complying with all aspects of the Pregnancy Prevention Programme. Surveys of patient experiences have shown some evidence of non-compliance amongst healthcare professionals with the valproate Pregnancy Prevention Programme. Actions are being taken by the relevant professional regulators to follow up and address this.</p><p> </p><p>The recent European review of valproate in pregnancy considered a possible association between birth defects and persistent developmental disorders associated with paternal valproate treatment at the time of conception. The review concluded that there was insufficient evidence at present to establish such a link. A retrospective observational study is to be undertaken to further investigate this issue for which a study protocol is currently being agreed by the European Medicines Agency.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 232043 232045 question first answered 21/03/2019 12:14:16 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4436 label Biography information for Cat Smith

1088403

registered interest
date	13/03/2019
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	Pregnancy: Sodium Valproate
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 link between birth defects and persistent developmental disorders and fathers taking valproate at the time of conception.
tabling member constituency	Lancaster and Fleetwood
tabling member printed	Cat Smith
uin	232045
answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>In April 2018, strengthened regulatory measures for valproate were introduced following a European-wide review of the latest evidence on harms from valproate exposure during pregnancy, including congenital anomalies and neurodevelopmental disorders including autism in children. These measures include the valproate Pregnancy Prevention Programme, the goal of which is to rapidly reduce and eventually eliminate pregnancies exposed to valproate.</p><p> </p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) is monitoring the impact of, and adherence to, the strengthened regulatory recommendations for valproate including the Pregnancy Prevention Programme, using research studies and routinely collected healthcare data. These include data from the Clinical Practice Research Datalink, national databases in England (NHS Business Services Authority and NHS Digital), Scotland (Information Services Division), and Northern Ireland (Health and Social Care Northern Ireland) linking community drug dispensing and maternity services data where these are available. The MHRA is also accessing data on valproate from clinical audits run by healthcare professional organisations, and information on patients’ experience of introduction of the strengthened regulatory measures via surveys conducted by charitable organisations and patient groups.</p><p> </p><p>Monitoring of prescribing of valproate has shown a slow, continued decline in women of childbearing age. Data show variability in levels of prescribing of valproate to women of childbearing age across different clinical commissioning groups in England. The current monitoring methods used by the MHRA do not enable comprehensive monitoring of compliance at the prescriber or patient level. It is therefore not possible to estimate the number of healthcare professionals who are not complying with all aspects of the Pregnancy Prevention Programme. Surveys of patient experiences have shown some evidence of non-compliance amongst healthcare professionals with the valproate Pregnancy Prevention Programme. Actions are being taken by the relevant professional regulators to follow up and address this.</p><p> </p><p>The recent European review of valproate in pregnancy considered a possible association between birth defects and persistent developmental disorders associated with paternal valproate treatment at the time of conception. The review concluded that there was insufficient evidence at present to establish such a link. A retrospective observational study is to be undertaken to further investigate this issue for which a study protocol is currently being agreed by the European Medicines Agency.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 232043 232044 question first answered 21/03/2019 12:14:16 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4436 label Biography information for Cat Smith