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1056454

registered interest
date	06/02/2019
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	NHS: Buildings
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 awareness amongst NHS Estates Managers of their obligations under the Construction, Design and Management Regulations 2015 and the application of those Regulations to facilities maintenance operations.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13510
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13511 HL13512 HL13513 HL13514 HL13515 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1056455

registered interest
date	06/02/2019
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	NHS: Buildings
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to increase awareness of the Construction, Design and Management Regulations 2015 relating to the NHS Estate and the application of those Regulations to the facilities maintenance operations amongst NHS Estates Managers.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13511
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13510 HL13512 HL13513 HL13514 HL13515 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1056456

registered interest
date	06/02/2019
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	NHS: Buildings
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how the application of the Construction, Design and Management Regulations 2015 is monitored across the NHS Estate, specifically in relation to the facilities maintenance operations.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13512
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13510 HL13511 HL13513 HL13514 HL13515 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1056457

registered interest
date	06/02/2019
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	NHS: Buildings
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 NHS Estates Managers receive appropriate training in respect of their obligations under the Construction, Design and Management Regulations 2015, specifically in relation to facilities maintenance operations.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13513
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13510 HL13511 HL13512 HL13514 HL13515 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1056459

registered interest
date	06/02/2019
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	NHS: Buildings
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what discussions they have had with the Health and Safety Executive about the observance of the Construction, Design and Management Regulations 2015 and the application of those Regulations across the NHS Estate, specifically in relation to facilities maintenance operations.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13514
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13510 HL13511 HL13512 HL13513 HL13515 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1056460

registered interest
date	06/02/2019
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	NHS: Buildings
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of whether NHS Estates Managers are sufficiently aware of the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016 and the application of those Guidelines following a breach of the Construction, Design and Management Regulations 2015 and other Health and Safety legislation.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13515
answer	answer is ministerial correction date of answer 20/02/2019 answer text <p>The Construction, Design and Management Regulations 2015 apply to all National Health Service construction and design work and as such are implemented across all capital investment, including the responsibilities of specific professionals employed. The business case approval process for capital funding implemented by NHS England and NHS Improvement assures appropriate elements of these regulations which are used to review business cases for capital received from the NHS. Staff with estates and facilities services responsibilities across the NHS receive training that should include awareness of their duties and obligations under these regulations, in line with individuals roles and responsibilities, including potential penalties for non-compliance in line with the Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Sentencing Guidelines 2016. NHS Improvement and the Department have not discussed these regulations with the Health and Safety Executive recently.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13510 HL13511 HL13512 HL13513 HL13514 question first answered 20/02/2019 14:07:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1049579

registered interest
date	28/01/2019
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	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what discussions they have had, or intend to have, with NHS England on ensuring Liothyronine (T3) is prescribed in accordance with NICE guidelines.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13166
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department has had no such discussions with NHS England on ensuring liothyronine is prescribed in accordance with the National Institute for Health and Care Excellence guidelines, nor does the Department intend to conduct such an assessment.</p><p>The Regional Medicines Optimising Committee published its latest guidance on the prescribing of liothyronine in November and we can confirm NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13167 question first answered 11/02/2019 17:39:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1049580

registered interest
date	28/01/2019
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	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they intend to conduct an assessment of the impact of the withdrawal of Liothyronine (T3) on patients as a result of Clinical Commissioning Groups misinterpreting or failing to follow NHS England's guidance on the prescription of that drug.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13167
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department has had no such discussions with NHS England on ensuring liothyronine is prescribed in accordance with the National Institute for Health and Care Excellence guidelines, nor does the Department intend to conduct such an assessment.</p><p>The Regional Medicines Optimising Committee published its latest guidance on the prescribing of liothyronine in November and we can confirm NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13166 question first answered 11/02/2019 17:39:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1049581

registered interest
date	28/01/2019
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	Liothyronine
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 Liothyronine (T3) is purchased at a cost in line with other EU countries.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13168
answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>All United Kingdom marketing authorisation holders of liothyronine are obliged to ensure that the product complies with the minimum standard as specified in the updated British Pharmacopoeia monograph for liothyronine tablets. Liothyronine on the market in other European Union Member States may not comply with the updated British Pharmacopoeia monograph and therefore would not be considered therapeutically equivalent.</p><p>Liothyronine is an unbranded generic medicine. The Department encourages competition between suppliers of unbranded generic medicines to keep prices down. This generally works well and has led to some of the lowest prices in Europe. Concerns about anti-competitive behaviour are a matter for the Competition and Markets Authority (CMA) to investigate.</p><p>Liothyronine, marketed by Advanz Pharma (formerly Concordia), is currently the subject of an investigation by the CMA. The CMA has provisionally found that the company abused its dominant position to overcharge the National Health Service by millions of pounds for liothyronine tablets. A provisional decision does not necessarily lead to an infringement decision. Where companies have breached competition law, the Department will seek damages and invest that money back into the NHS.</p> answering member printed Baroness Blackwood of North Oxford question first answered 11/02/2019 13:48:58 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1041209

registered interest
date	14/01/2019
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	University Hospitals Bristol NHS Foundation Trust: Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what action they plan to take to lift the ban on the prescription of liothyronine (T3) by University Hospital Bristol in contradiction of the advice given by NHS England.
tabling member printed	Lord Hunt of Kings Heath
uin	HL12791
answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care. The Department has not had specific discussions with NHS England or made an assessment on these issues.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs. CCGs set the policy which governs what hospitals and trusts implement, therefore the prescription of liothyronine at University Hospital Bristol and Musgrove Park Hospital in Taunton is a matter for those CCGs.</p><p>This guidance for CCGs on items which should not be routinely prescribed in primary care includes recommendations on the use of liothyronine in line with the British Thyroid Association, who advise that a small proportion of patients treated with levothyroxine continue to suffer with symptoms despite adequate biochemical correction. In these circumstances,</p><p>where levothyroxine has failed and in line with this guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months duration of the drug.</p><p>Further guidance on the prescribing of liothyronine has been published by the Regional Medicines Optimisation Committee. The aim of the guidance is to make best practice on the prescribing of liothyronine clearer. A copy of <em>Guidance – Prescribing of Liothyronine</em> is attached.</p> answering member printed Baroness Manzoor grouped question UIN HL12792 HL12793 HL12794 question first answered 22/01/2019 16:17:24 answering member 4289 label Biography information for Baroness Manzoor attachment 1 file name RMOC-Liothyronine-Guidance-v2.0-final-1.pdf title RMOC liothyronine guidance
tabling member	2024 label Biography information for Lord Hunt of Kings Heath