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93738

registered interest
date	16/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Standards
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what steps they will take to make the National Health Service more efficient and to reduce mistakes in practice.
tabling member printed	Lord Taylor of Warwick
uin	HL2162
answer	answer is ministerial correction date of answer 21/10/2014 answer text <p>National Health Service funding has risen in each year of this parliament and is £12.7 billion higher in cash terms in 2014-15 than in 2010-11. The NHS is on track to make up to £20 billion efficiency savings this parliament to reinvest into frontline care. We are confident that it will continue to make the efficiency improvements necessary to meet rising demand and protect the quality of the services delivered.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>In a recent report commissioned by the Department, Frontier Economics has estimated that poor care could be costing the NHS up to £2.5 billion every year. In order to focus attention on the harms contributing to these costs and the savings that could be reinvested, a poster and leaflet will go out to all NHS hospitals to display this vital information to their staff.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>We have introduced a wide range of measures, including the Sign Up to Safety Campaign, Patient Safety Collaboratives, a new tougher inspection regime for providers and a reformed National Patient Safety Alert System to reduce mistakes in practice. In order to promote a culture of openness and transparency, that will enable organisations to learn from their mistakes, there will be the duty of candour in the event of serious harm. We are also publishing information on hospital performance, including staffing levels, as part of the new MyNHS website.</p><p> </p> answering member printed Earl Howe question first answered 21/10/2014 11:10:41 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

78955

registered interest
date	18/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Statins
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they consider that offering statins to more people will discourage the adoption of long-term healthy lifestyles.
tabling member printed	Lord Taylor of Warwick
uin	HL1272
answer	answer is ministerial correction date of answer 29/07/2014 answer text <p>Earlier this month, the National Institute for Health and Care Excellence (NICE) published guidance on the modification of blood lipids (cholesterol) for the primary and secondary prevention of cardiovascular disease (CVD).</p><p> </p><p>The guidance recognises the place of statins in the primary prevention of CVD. However, it does not propose that statins should be used instead of the lifestyle adjustments that people at risk of CVD need to make — such as stopping smoking, being more active, drinking less alcohol, eating more healthily and losing weight.</p><p> </p><p>The guidance encourages general practitioners to fully explore with their patients the ways in which people can reduce their risk of CVD, presenting all the options promoted by NICE’s guidance, including lifestyle changes, and to allow patients to make their own decisions.</p><p> </p> answering member printed Earl Howe question first answered 29/07/2014 11:49:51 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

78956

registered interest
date	18/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Accident and Emergency Departments
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they intend to take action to improve accident and emergency unit waiting times, in the light of reported missed targets over the last year.
tabling member printed	Lord Taylor of Warwick
uin	HL1273
answer	answer is ministerial correction date of answer 22/07/2014 answer text <p>National Health Service accident and emergency (A&amp;E) departments are measured against a standard that at least 95% of patients should be admitted, transferred or discharged within four hours of arrival. The standard applies to all types of (A&amp;E) departments, including major (A&amp;E) departments, minor injury units, and walk-in centres.</p><p> </p><p>This standard was met in all four quarters and for the whole of 2013-14, with performance at 95.7% for the year. It has been met for the first quarter (April to June) of 2014-15, with performance at 95.1%.</p><p> </p><p>There were 21.8 million attendances at (A&amp;E) departments in 2013-14 compared to 20.5 million in 2009-10, and in the face of rising demand not all patients are receiving care within the standard. NHS England, the NHS Trust Development Authority and Monitor are working with the most challenged providers and commissioners. £400 million has been made available this year to ensure local urgent and emergency care services are sustainable and prepared for winter.</p><p> </p> answering member printed Earl Howe question first answered 22/07/2014 16:29:07 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

78957

registered interest
date	18/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Hospitals: Standards
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how effective they consider the process of special measures to have been for failing hospitals.
tabling member printed	Lord Taylor of Warwick
uin	HL1274
answer	answer is ministerial correction date of answer 28/07/2014 answer text <p>Progress is being made in nearly every trust and the Chief Inspector of Hospitals has recommended that five of the initial 11 placed in special measures a year ago should come out. As a result the Department and its arm’s length bodies are finally turning around performance in failing hospitals.</p><p> </p><p>The Government will no longer tolerate services which persistently fail to reach an acceptable standard. It is therefore introducing a special measures regime from 1 April 2015 for all adult social care providers registered with and inspected by the Care Quality Commission (CQC).</p><p> </p><p>Providers that are rated as inadequate by the CQC under its new inspection regime will be given a clear timescale within which they will be expected to improve, or face actions which could lead to their closing down. This clarity on timing will provide an incentive for providers to improve quickly and help local authorities and others plan for alternative provision should services have to close. It will also give the public confidence that poor care will be tackled more quickly.</p><p> </p><p>During the autumn, the Department will work with the CQC, social care providers and people using services, their families and carers on the details of the regime, including what support can be given to failing providers to help them improve their services.</p> answering member printed Earl Howe grouped question UIN HL1275 question first answered 28/07/2014 11:41:13 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

78958

registered interest
date	18/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Care Homes: Standards
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how effective they expect the extension of the special measures process to failing care homes to be.
tabling member printed	Lord Taylor of Warwick
uin	HL1275
answer	answer is ministerial correction date of answer 28/07/2014 answer text <p>Progress is being made in nearly every trust and the Chief Inspector of Hospitals has recommended that five of the initial 11 placed in special measures a year ago should come out. As a result the Department and its arm’s length bodies are finally turning around performance in failing hospitals.</p><p> </p><p>The Government will no longer tolerate services which persistently fail to reach an acceptable standard. It is therefore introducing a special measures regime from 1 April 2015 for all adult social care providers registered with and inspected by the Care Quality Commission (CQC).</p><p> </p><p>Providers that are rated as inadequate by the CQC under its new inspection regime will be given a clear timescale within which they will be expected to improve, or face actions which could lead to their closing down. This clarity on timing will provide an incentive for providers to improve quickly and help local authorities and others plan for alternative provision should services have to close. It will also give the public confidence that poor care will be tackled more quickly.</p><p> </p><p>During the autumn, the Department will work with the CQC, social care providers and people using services, their families and carers on the details of the regime, including what support can be given to failing providers to help them improve their services.</p> answering member printed Earl Howe grouped question UIN HL1274 question first answered 28/07/2014 11:41:13 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

77786

registered interest
date	14/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Osteoarthritis
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of the advice given by healthcare practitioners to patients with knee osteoarthritis.
tabling member printed	Lord Taylor of Warwick
uin	HL1083
answer	answer is ministerial correction date of answer 24/07/2014 answer text <p>No assessment has been made of the advice given by healthcare practitioners to patients with knee osteoarthritis. In 2008, the National Institute for Health and Care Excellence (NICE) published ‘<em>Osteoarthritis: the care and management in adults’,</em> which sets out best practice on the diagnosis treatment, care and support of patients with this condition, including patients suffering from osteoarthritis of the knee.</p><p> </p><p>Healthcare practitioners in the National Health Service are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not replace the knowledge and expertise of practitioners, who should make decisions on a case by case basis, taking into account the individual circumstances of each patient.</p><p> </p><p>The NICE Osteoarthritis clinical guideline was updated and replaced in February 2014 and can be found on the NICE website at the following link:</p><p> </p><p>www.nice.org.uk/guidance/cg177/resources/guidance-osteoarthritis-pdf.</p> answering member printed Earl Howe question first answered 24/07/2014 14:19:51 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

77787

registered interest
date	14/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Obesity
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many obese (1) men, and (2) women, between the ages of (a) 30–35, (b) 35–40, and (c) 40–45, have required knee replacement surgery in the past four years.
tabling member printed	Lord Taylor of Warwick
uin	HL1084
answer	answer is ministerial correction date of answer 22/07/2014 answer text <p>The Health and Social Care Information Centre has provided a count of finished consultant episodes1 with a main or secondary procedure2 for knee replacement surgery (a) where there is a main or secondary diagnosis of obesity3 and (b) for all diagnosis, by gender and patients aged 30-34, 35-39, 40-44 and 45-49, 2009-10 to 2012-134. This information is provided in the following tables:</p><p> </p><table><tbody><tr><td colspan="13"><p>(a) main or secondary diagnosis of obesity</p></td></tr><tr><td> </td><td colspan="12"><p>Gender and age group</p></td></tr><tr><td> </td><td colspan="4"><p>Male</p></td><td colspan="4"><p>Female</p></td><td colspan="4"><p>Unknown</p></td></tr><tr><td><p>Year</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td></tr><tr><td><p>2009-10</p></td><td><p>3</p></td><td><p>2</p></td><td><p>17</p></td><td><p>39</p></td><td><p>-</p></td><td><p>5</p></td><td><p>23</p></td><td><p>67</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td></tr><tr><td><p>2010-11</p></td><td><p>-</p></td><td><p>6</p></td><td><p>22</p></td><td><p>77</p></td><td><p>1</p></td><td><p>5</p></td><td><p>45</p></td><td><p>126</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td></tr><tr><td><p>2011-12</p></td><td><p>2</p></td><td><p>4</p></td><td><p>31</p></td><td><p>83</p></td><td><p>8</p></td><td><p>13</p></td><td><p>50</p></td><td><p>159</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td></tr><tr><td><p>2012-13</p></td><td><p>3</p></td><td><p>3</p></td><td><p>31</p></td><td><p>99</p></td><td><p>6</p></td><td><p>9</p></td><td><p>61</p></td><td><p>162</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td></tr><tr><td colspan="13"><p> </p><p>(b) all diagnoses</p></td></tr><tr><td> </td><td colspan="12"><p>Gender and age group</p></td></tr><tr><td> </td><td colspan="4"><p>Male</p></td><td colspan="4"><p>Female</p></td><td colspan="4"><p>Unknown</p></td></tr><tr><td><p>Year</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td><td><p>30-34</p></td><td><p>35-39</p></td><td><p>40-44</p></td><td><p>45-49</p></td></tr><tr><td><p>2009-10</p></td><td><p>20</p></td><td><p>69</p></td><td><p>232</p></td><td><p>612</p></td><td><p>39</p></td><td><p>92</p></td><td><p>294</p></td><td><p>805</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>3</p></td></tr><tr><td><p>2010-11</p></td><td><p>21</p></td><td><p>55</p></td><td><p>210</p></td><td><p>619</p></td><td><p>29</p></td><td><p>73</p></td><td><p>329</p></td><td><p>861</p></td><td><p>-</p></td><td><p>-</p></td><td><p>1</p></td><td><p>-</p></td></tr><tr><td><p>2011-12</p></td><td><p>29</p></td><td><p>55</p></td><td><p>241</p></td><td><p>697</p></td><td><p>39</p></td><td><p>85</p></td><td><p>313</p></td><td><p>966</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>1</p></td></tr><tr><td><p>2012-13</p></td><td><p>28</p></td><td><p>43</p></td><td><p>261</p></td><td><p>723</p></td><td><p>45</p></td><td><p>82</p></td><td><p>361</p></td><td><p>975</p></td><td><p>-</p></td><td><p>-</p></td><td><p>-</p></td><td><p>3</p></td></tr></tbody></table><p> </p><p><em>Notes:</em></p><p> </p><p><sup>1. </sup>A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.</p><p><sup>2. </sup>The number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and 4 prior to 2002-03) procedure fields in a Hospital Episode Statistics (HES) record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a ‘cataract operation’ would tend to have at least two procedures – removal of the faulty lens and the fitting of a new one – counted in a single episode.</p><p><sup>3. </sup>The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.</p><p><sup>4. </sup>HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, changes in activity may be due to changes in the provision of care.</p><p> </p> answering member printed Earl Howe question first answered 22/07/2014 16:24:17 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

77788

registered interest
date	14/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Obesity
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether the proposed expansion of weight loss surgery in England is a long-term strategy for public health; and what effect they predict its implementation will have.
tabling member printed	Lord Taylor of Warwick
uin	HL1085
answer	answer is ministerial correction date of answer 28/07/2014 answer text <p>The National Institute for Health and Care Excellence (NICE) published its draft updated clinical guideline on the prevention, identification, assessment and management of overweight and obesity in adults and children on 11 July, proposing the expansion of weight loss surgery. The guideline is out for consultation until the 8 August and NICE will take stakeholders’ comments into account in developing the final guideline, which is scheduled for publication later in the year.</p><p> </p><p>We have a well-developed and wide ranging programme of actions to reduce levels of obesity. These include working with a wide range of partners including Public Health England, NHS England, government departments including the Department for Transport through the Public Health Responsibility Deal.</p> answering member printed Earl Howe question first answered 28/07/2014 15:19:10 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

77789

registered interest
date	14/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Maternity Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of the rate of maternity unit closures; and what steps they intend to take in respect of such closures.
tabling member printed	Lord Taylor of Warwick
uin	HL1086
answer	answer is ministerial correction date of answer 22/07/2014 answer text <p>To drive improvements to maternity care nationally we have invested £35 million to improve services at over 160 maternity units across the country, targeting those areas with the largest increases in birth rates. There are over 1,700 more midwives than in 2010, with 6,000 more in training, and the number of midwifery-led units has increased from 82 in 2007 to 155 units in 2013.</p><p> </p><p>The Department does not collect data on, or assess the rate of, maternity unit closures centrally. The National Audit Office report, Maternity Services in England, published in November 2013, found that 28% of maternity units reported that they closed for half a day or more between April and September 2012.</p><p> </p><p>There are occasions when a maternity unit cannot safely accept more women into their care and may need to close temporarily. Any decisions to redirect women are always made by clinicians as part of a carefully managed process.</p><p> </p><p>Clinical commissioning groups (CCGs) are responsible for commissioning maternity services in line with NHS England commissioning guidance. As part of the commissioning process, CCGs take into account the views of local maternity services users and factors such as demography, geography and the balance between choice and safety to determine the level of provision appropriate locally. NHS England has established strategic clinical networks to research, develop and disseminate best practice to support this guidance.</p><p> </p> answering member printed Earl Howe question first answered 22/07/2014 16:20:00 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

77303

registered interest
date	10/07/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Fees and Charges
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what is their assessment of the survey by the Nuffield Trust suggesting that almost half of National Health Service managers believe that patients will be forced to pay for some services within 10 years.
tabling member printed	Lord Taylor of Warwick
uin	HL1037
answer	answer is ministerial correction date of answer 17/07/2014 answer text <p>The principles underpinning the National Health Service, enshrined in the NHS Constitution, include that it provides a comprehensive service available to all based on clinical need and that NHS services are free of charge, except in limited circumstances sanctioned by Parliament.</p><p> </p><p>Rising demands and continued fiscal constraint means that the NHS faces challenges in ensuring that it remains financially sustainable in the future. The Government believes that the answer to these challenges lies in changing the way services are delivered and keeping people well and independent for longer, not in altering the fundamental principles that underpin the NHS.</p> answering member printed Earl Howe question first answered 17/07/2014 12:00:18 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick