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62470

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps they are taking to ensure that people with diabetes are able to access innovative medicines.
tabling member printed	Baroness Masham of Ilton
uin	HL399
answer	answer is ministerial correction date of answer 25/06/2014 answer text <p>We want to ensure that patients, including those with diabetes, have access to new and effective treatments on terms that represent value to the National Health Service and the taxpayer.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) has recommended a number of medicines for diabetes. National Health Service commissioners are legally required by regulations to fund those medicines recommended by NICE in its technology appraisal guidance.</p> answering member printed Earl Howe question first answered 25/06/2014 12:55:05 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

62471

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how they plan to review NHS England's progress in implementing the Action for Diabetes plan.
tabling member printed	Baroness Masham of Ilton
uin	HL400
answer	answer is ministerial correction date of answer 30/06/2014 answer text <p>Action for Diabetes sets out the broad vision and direction for how NHS England will support improvements in outcomes for people with and at risk of diabetes in the coming years, as a direct commissioner of services and supporting clinical commissioning groups (CCGs) in their commissioning role.</p><p> </p><p>Outcomes for people with diabetes will continue to be measured through the NHS Outcomes Framework and the CCG Outcomes Indicator Set, which are both updated and published annually. Outcomes for people with diabetes will also be assessed through the National Diabetes Audit, which includes the core audit, the national inpatient diabetes audit, the national diabetes pregnancy audit, the national patient experience of diabetes services survey and the national diabetes foot audit. The latter of these is due to be launched this summer.</p> answering member printed Earl Howe question first answered 30/06/2014 10:55:27 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

62472

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps are being taken to ensure that people with diabetes receive the care processes recommended by the National Institute for Health and Care Excellence.
tabling member printed	Baroness Masham of Ilton
uin	HL401
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>The management of people with diabetes is measured and reported on through the Quality and Outcomes Framework (QOF), the CCG Outcomes Indicator Set (OIS) and National Diabetes Audit. These publications and data are used by local commissioners, providers and healthcare professionals to assess the quality of the services provided and to drive improvements.</p><p> </p><p>General practitioners (GPs) are incentivised to ensure completion of the care processes recommended by The National Institute for Health and Care Excellence (NICE) through the QOF. The latest available data (2011-12) shows a 60.5% completion rate of all the eight measurable NICE-recommended care processes for diabetes. However, it is for individual GP practices, working with the CCGs in their area, to assess their own performance on completion of the care processes, and take action where improvement is necessary.</p><p> </p><p>CCGs can use the information reported from the OIS indicator on completion of the care processes for people with diabetes to assess progress in improvement in their area and against their peers. Where completion rates are low, CCGs can then take action jointly with other practices in their area to make improvements.</p><p> </p><p>To support local commissioning, NHS England has also developed a non-mandatory service specification for diabetes, based on the diabetes NICE Quality Standard, which is currently being piloted with some CCGs. The pilot will be evaluated to assess how useful the specification has been to commissioners, and this will inform decisions about its future development.</p><p> </p><p>The Patient Experience of Diabetes Services survey, part of the National Diabetes Audit, is measuring the healthcare experiences of people with diabetes in England and Wales. The survey pilot tested an online-only approach to measure patient experience in GP and specialist diabetes services. Any diabetes service in England and Wales should be able to use the survey to get feedback from their patients. The survey can help to raise standards and drive out variation, and also empower services to understand at a local level how satisfied their patients are with the service being provided.</p> answering member printed Earl Howe grouped question UIN HL402 question first answered 01/07/2014 11:37:32 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

62473

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps are being taken to ensure that the treatment targets for people with diabetes recommended by the National Institute for Health and Care Excellence are being met.
tabling member printed	Baroness Masham of Ilton
uin	HL402
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>The management of people with diabetes is measured and reported on through the Quality and Outcomes Framework (QOF), the CCG Outcomes Indicator Set (OIS) and National Diabetes Audit. These publications and data are used by local commissioners, providers and healthcare professionals to assess the quality of the services provided and to drive improvements.</p><p> </p><p>General practitioners (GPs) are incentivised to ensure completion of the care processes recommended by The National Institute for Health and Care Excellence (NICE) through the QOF. The latest available data (2011-12) shows a 60.5% completion rate of all the eight measurable NICE-recommended care processes for diabetes. However, it is for individual GP practices, working with the CCGs in their area, to assess their own performance on completion of the care processes, and take action where improvement is necessary.</p><p> </p><p>CCGs can use the information reported from the OIS indicator on completion of the care processes for people with diabetes to assess progress in improvement in their area and against their peers. Where completion rates are low, CCGs can then take action jointly with other practices in their area to make improvements.</p><p> </p><p>To support local commissioning, NHS England has also developed a non-mandatory service specification for diabetes, based on the diabetes NICE Quality Standard, which is currently being piloted with some CCGs. The pilot will be evaluated to assess how useful the specification has been to commissioners, and this will inform decisions about its future development.</p><p> </p><p>The Patient Experience of Diabetes Services survey, part of the National Diabetes Audit, is measuring the healthcare experiences of people with diabetes in England and Wales. The survey pilot tested an online-only approach to measure patient experience in GP and specialist diabetes services. Any diabetes service in England and Wales should be able to use the survey to get feedback from their patients. The survey can help to raise standards and drive out variation, and also empower services to understand at a local level how satisfied their patients are with the service being provided.</p> answering member printed Earl Howe grouped question UIN HL401 question first answered 01/07/2014 11:37:33 answering member 2000 label Biography information for Earl Howe
tabling member	1850 label Biography information for Baroness Masham of Ilton

62487

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Alcoholic Drinks and Drugs
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 number of people currently damaged by alcohol and drug abuse in the United Kingdom.
tabling member printed	The Earl of Dundee
uin	HL416
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>The United Kingdom Drug Policy Commission collect data on the numbers affected by drug addiction and publish their findings in their report <em>Supporting the Supporters: families of drug misusers 2009.</em> The findings estimate that nearly 1.5 million people are affected by drug addiction in their families, mostly in poor communities.</p><p> </p><p>Estimates in the Office of National Statistics report ‘Deaths Related to Drug Poisoning in England and Wales, 2012 and Alcohol-related deaths in the UK, registered in 2012' showed that there were 1,496 drug misuse deaths in England.</p><p> </p><p>In England, data on the number of adults who report some signs of drug or alcohol dependence is published by theHealth and Social Care Information Centre, in the <em>Adult Psychiatric Morbidity in England, 2007 report</em>. The report includes information on rates of dependency and access to treatments. This data will be updated in 2014 and will be available in 2017.</p><p> </p><p>The Centre for Public Health, Liverpool John Moores University, published on 25 March, ‘Updating England-specific Alcohol-attributable Fractions', with revised estimates for England showing that over 21,000 people died in 2010 and that over 900,000 people were admitted to hospital in 2010-11 for alcohol-related causes.</p><p> </p><p>Public health prevention, treatment and care in Scotland, Wales and Northern Ireland is a matter for those Devolved Administrations. Each country maintains its own information. For example:</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>- In 2012-13 there were 5,683 drug related discharges from a general acute hospital in Scotland (a European age-sex-standardised rate (EASR) of 107 discharges per 100,000 population). The National Records of Scotland reported that there were 581 drug related deaths in 2012 in Scotland.</p><p> </p><p>- In 2012-13 there were 35,926 alcohol related discharges from a general acute hospital in Scotland (a European age-sex-standardised rate (EASR) of 693 discharges per 100,000 population).</p><p> </p><p>- There were 25,000 referrals for drug and alcohol misuse recorded in 2012 -13 on the Welsh National Database for Substance Misuse.</p><p> </p><p>- Data on the number of drug - related deaths in Northern Ireland is collected by the General Register Office and published in their annual report. The most recent estimates show that there were 110 drug related deaths in 2012.</p><p> </p><p>- Data on the number of drug and alcohol – related hospital admissions is collected by the Hospital Inpatient System in Northern Ireland. The most recent estimates show that there were 15,701 drug and alcohol admissions to hospitals in Northern Ireland.</p><p> </p><p>Data may not be comparable across the UK in all cases.</p> answering member printed Earl Howe question first answered 01/07/2014 11:39:40 answering member 2000 label Biography information for Earl Howe
tabling member	2735 label Biography information for The Earl of Dundee

62488

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Alcoholic Drinks and Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what is their current level of funding of charities and institutions that seek to reduce alcohol and drug abuse in the United Kingdom.
tabling member printed	The Earl of Dundee
uin	HL417
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>The Innovation Excellence &amp; Strategic Development Fund (IESD) provides funding from one to three years to support proposals in the health and care field.</p><p> </p><p>A total of £658,902 has been awarded by the Department's IESD Fund in 2014-15 to organisations seeking to reduce alcohol and/or drug misuse. This amount is in respect of seven separate projects. The scope of the activity of these projects and the IESD Fund in general is within England only. The main responsibility for funding of services reducing alcohol and drug misuse is for local authorities. The Department does not hold detailed information on local funding.</p><p> </p><p>A significant proportion of alcohol and drug treatment services is provided by charities and voluntary organisations and is funded by local authorities though the public health grant.</p> answering member printed Earl Howe question first answered 01/07/2014 11:40:48 answering member 2000 label Biography information for Earl Howe
tabling member	2735 label Biography information for The Earl of Dundee

62490

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Alcoholic Drinks and Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps they are taking to co-operate with institutions and other governments to reduce alcohol and drug abuse internationally.
tabling member printed	The Earl of Dundee
uin	HL419
answer	answer is ministerial correction date of answer 01/07/2014 answer text <p>We recognise the importance of international cooperation in preventing alcohol and drug misuse effectively.</p><p> </p><p>We continue to work with international partners, the United Nations, the European Union and through the British-Irish Council to promote the lessons the United Kingdom has learnt from its effective drugs strategy, and the benefits of a balanced, evidence based response within the international drug control conventions.</p><p> </p><p>The Treaty on the Functioning of the European Union recognises that Member States have the prime responsibility for public health, including preventing and reducing harm from alcohol, while the EU has a role to support Member States in this function. Discussions are currently taking place with Member States and the European Commission to develop:</p><p> </p><p>- A new EU Alcohol Action Plan on youth drinking and binge drinking to run from 2014 to 2016 within the current EU Alcohol Strategy; and</p><p>- ideas for a new EU Alcohol Strategy.</p><p> </p><p>The World Health Organization (WHO) has a leading role in further building the evidence base, the development of policy tools and the establishment and maintenance of a global information system on alcohol and health as set out in the WHO global alcohol strategy.</p><p> </p><p>The WHO UK Alcohol Focal Point which represents the UK, including the Devolved Administrations, is chair of the 53 European Alcohol Focal Points and sits on the WHO Global Co-ordinating Council for delivery of the global alcohol strategy.</p> answering member printed Earl Howe question first answered 01/07/2014 11:42:20 answering member 2000 label Biography information for Earl Howe
tabling member	2735 label Biography information for The Earl of Dundee

62491

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Autism
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many adults with autism in England currently receive support because they have been identified by a local authority as being at risk of abuse or neglect.
tabling member printed	Lord Touhig
uin	HL420
answer	answer is ministerial correction date of answer 30/06/2014 answer text <p>This information is not kept centrally.</p> answering member printed Earl Howe question first answered 30/06/2014 12:33:44 answering member 2000 label Biography information for Earl Howe
tabling member	542 label Biography information for Lord Touhig

62492

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Care Act 2014
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government why staying safe from abuse or neglect has been omitted from the list of specified care outcomes in the new draft eligibility criteria for the Care Act 2014 Part 1 regulations; and whether there are any plans to address the issue elsewhere in the regulations.
tabling member printed	Lord Touhig
uin	HL421
answer	answer is ministerial correction date of answer 02/07/2014 answer text <p>The Care Act for the first time will put adult safeguarding on a legal basis. The new measures require local authorities to carry out a safeguarding enquiry where they suspect a person is at risk of abuse or neglect and consider what if any actions are needed, and who should carry these out.</p><p> </p><p>The safeguarding duties are triggered on the basis of suspecting that an adult with care and support needs may be at risk of abuse or neglect. This rightly does not have an eligibility threshold, or require a particular level of need before the duty to carry out an enquiry is required. If we were to treat the risk of abuse and neglect separately in the eligibility criteria, then a person's level of risk would have to meet the eligibility threshold before they became eligible for the local authority to meet their need.</p><p> </p><p>The Act is clear that safeguarding responsibilities sit alongside the other elements of the care and support system, including assessment of needs. The draft guidance clarifies that where a local authority has started a safeguarding enquiry, it should continue the needs assessment for care and support in parallel, and determine whether the person has eligible needs which it must meet.</p><p> </p><p>This approach will ensure that the local authority identifies both risks of, and responses to, abuse or neglect, as well as identifying the person's eligible needs which must be met through care and support.</p><p> </p><p>The draft regulations and guidance which support implementation are subject to public consultation until 15 August 2014.</p><p> </p> answering member printed Earl Howe question first answered 02/07/2014 12:53:24 answering member 2000 label Biography information for Earl Howe
tabling member	542 label Biography information for Lord Touhig

62511

registered interest
date	18/06/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	National Institute for Health and Care Excellence
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what representations they have made to National Institute for Health and Care Excellence (NICE) to ensure that charities representing patients are consulted by NICE when drawing up treatment guidelines; and whether they have asked NICE to take evidence from the Multiple Sclerosis Society over the guidance being prepared on the management of multiple sclerosis.
tabling member printed	Baroness Finlay of Llandaff
uin	HL440
answer	answer is ministerial correction date of answer 25/06/2014 answer text <p>We have made no representations and have not asked the National Institute for Health and Care Excellence (NICE) to take evidence from the Multiple Sclerosis Society.</p><p> </p><p>Charities representing patients are able to register as stakeholders and we understand that the Multiple Sclerosis Society is a stakeholder in the development of NICE's updated clinical guideline on multiple sclerosis. In developing guidance, NICE consults with its registered stakeholders and takes their comments fully into account. We understand the Society has responded to NICE's recent consultation on its draft guideline in detail.</p> answering member printed Earl Howe question first answered 25/06/2014 15:49:39 answering member 2000 label Biography information for Earl Howe
tabling member	3609 label Biography information for Baroness Finlay of Llandaff