Became Member: 10th February 2000
Left House: 23rd June 2022 (Death)
Speeches made during Parliamentary debates are recorded in Hansard. For ease of browsing we have grouped debates into individual, departmental and legislative categories.
These initiatives were driven by Baroness Greengross, and are more likely to reflect personal policy preferences.
Baroness Greengross has not introduced any legislation before Parliament
Baroness Greengross has not co-sponsored any Bills in the current parliamentary sitting
The Senior Deputy Speaker has asked me, as Chairman of the Services Committee, to respond on his behalf.
Clinical waste bins (which are suitable for the disposal of continence products) are currently provided in all accessible toilets in the House of Lords (Palace of Westminster, Millbank House and Old Palace Yard) where space provides, with an additional one situated in the male Peers’ shower / toilet room on the Ground Floor West Front.
Separately, feminine hygiene bins are provided in all female, accessible and unisex toilets in the House of Lords.
Fuel poverty is measured at the household level rather than the individual level. Fuel Poverty is a partially devolved issue, with each separate administration having their own targets and producing their own statistics. Data on Scotland, Wales and Northern Ireland is available from:
Scotland: http://www.scotland.gov.uk/Publications/2013/12/3017
Northern Ireland: http://www.nihe.gov.uk/index/corporate/housing_research/house_condition_survey.htm
The number of fuel poor households in England under the LIHC indicator containing someone over the age of (1)65 and (2)75 is given below:
Age of oldest person in household | Number of households (000's) | Total number of households (000's) | Proportion of fuel poor households (%) | ||
Not fuel poor | Fuel poor | ||||
over 65 | 5,176 | 383 | 5,559 | 16.8 | |
over 75 | 2,328 | 180 | 2,508 | 7.9 | |
The sample size of households from the English Housing Survey with someone aged over 85 is too small to produce accurate data.
The Government believes that improving residential energy efficiency is an important part of its efforts to reduce UK greenhouse gas emissions, combat fuel poverty and enhance the country’s energy security, as well as helping all consumers save money on their energy bills and enjoy warmer, more comfortable homes.
We continue to see progress in the deployment of energy efficiency measures towards our goal of 1 million homes helped by March 2015. We have not set any particular target regarding all homes reaching EPC Band C and do not hold any detailed projections as to when this might be achieved.
The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.
20 January 2021
Dear Baroness Greengross,
As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking when the Office for National Statistics (ONS) removed the upper age limit from the Crime Survey for England and Wales (CSEW); and when the statistics from this survey relating to those aged 75 and older will be published (HL12104).
The CSEW is a face-to-face victimisation survey which asks people aged 16 and over resident in households in England and Wales about their experiences of a range of crimes. Self-completion modules are included on the survey to collect information on topic areas that respondents could feel uncomfortable talking to an interviewer about. The upper age limit for respondents eligible for the self-completion modules of the CSEW was increased from 59 years to 74 years in April 2017. This is different to the main face-to-face part of the survey which has no upper age limit.
In response to the coronavirus (COVID-19) pandemic, it was necessary to move the CSEW from a face-to-face survey to a telephone-only survey (by which it may be referred to differently as the TCSEW, or “Telephone-operated Crime Survey for England and Wales”, in publications). As a result, we are currently not asking questions around any sensitive topics, including domestic abuse and sexual assault, because of ethical and safeguarding concerns with this new mode of delivery.
Once it is possible to return to the face-to-face mode of delivery, we will immediately remove the upper age limit for respondents to the self-completion modules, in the interests of inclusivity. It will then take at least 12 months of data collection to enable us to produce accurate victimisation estimates for adults aged 75 and over.
Yours sincerely,
Professor Sir Ian Diamond
In the Strategy for our Veterans Consultation Response published in January 2020, we committed to exploring how veterans could benefit from initiatives developed and invested in through the cross-Government Tackling Loneliness agenda. The Office for Veterans’ Affairs (OVA) is working with colleagues across Government to develop new initiatives to support veterans of all ages who are facing social isolation.
The Government recognises the important role that the charity sector plays in supporting and connecting with vulnerable and isolated veterans on the ground. In light of COVID-19, the Government awarded £6 million in emergency COVID-19 funding to 100 Service charities, to ensure that they could continue to provide vital services to the Armed Forces community throughout the pandemic. This is in addition to £10 million awarded yearly through the Armed Forces Covenant Fund Trust, which provides specific funding to organisations through grants programmes. This includes a current grant programme to identify and support charities working to tackle loneliness in the Armed Forces community. Previous recipients of grant funding include Veterans Breakfast Clubs, Age UK and a number of other organisations who support older and socially isolated veterans.
The OVA has also commissioned new research looking at the specific impact of COVID-19 on the veteran community, including in terms of isolation and loneliness. This will allow policy makers to understand how the pandemic has affected the veteran community and respond with evidence-based and targeted interventions.
The department does not hold information on the subjects offered by individual schools and colleges. However, the department does publish the number of entries into GCSE Citizenship and A level Citizenship Studies, which can be used as a guide to how many schools and colleges offer these qualifications.
GCSE Citizenship was first introduced as a full course in academic year 2010/11 and the earliest national data held by the department is available for academic year 2011/12. In 2011/12, 10,474 pupils at the end of key stage 4 were entered for GCSE Citizenship and 237 schools entered pupils. In 2018/19, 18,098 pupils at the end of key stage 4 were entered for GCSE Citizenship and 570 schools entered pupils.
A level Citizenship studies became operational in September 2008 and this qualification ended operation in July 2019. There were no pupils aged 16 to 18 who were entered for A level Citizenship studies in academic years 2008/09 or 2018/19. The 2008/09 figure is not published separately but has been included as part of ‘other social studies’ up until and including 2017/18.
The department does not hold information on the subjects offered by individual schools and colleges. However, the department does publish the number of entries into GCSE Citizenship and A level Citizenship Studies, which can be used as a guide to how many schools and colleges offer these qualifications.
GCSE Citizenship was first introduced as a full course in academic year 2010/11 and the earliest national data held by the department is available for academic year 2011/12. In 2011/12, 10,474 pupils at the end of key stage 4 were entered for GCSE Citizenship and 237 schools entered pupils. In 2018/19, 18,098 pupils at the end of key stage 4 were entered for GCSE Citizenship and 570 schools entered pupils.
A level Citizenship studies became operational in September 2008 and this qualification ended operation in July 2019. There were no pupils aged 16 to 18 who were entered for A level Citizenship studies in academic years 2008/09 or 2018/19. The 2008/09 figure is not published separately but has been included as part of ‘other social studies’ up until and including 2017/18.
The Government's response to food vulnerability caused by COVID-19 is built around three categories of vulnerability: Clinically Extremely Vulnerable (CEV), other Non-Shielded Vulnerable (NSV), and the economically vulnerable.
Individuals in the CEV group are those who have a medical condition that is deemed to put them at very high risk of COVID-19 related serious illness. This group has been asked to 'shield' by the Government until at least the end of June, meaning they need to stay at home at all times and minimise all contact with others, including other members of their household.
There are around 2.2. million people in England who fit into this group. The majority will have received a letter from the NHS or been contacted by their GP to inform them of their vulnerable status. The group comprises people of all ages - with extreme respiratory conditions (such as cystic fibrosis), certain types of cancers (such as leukaemia), those who have had organ transplants, as well as a range of other conditions or medical histories.
Many within this group have local family and friends who can get the vital provisions needed. There is a significant subset of the CEV group however who do not. Individuals in this group can register as extremely clinically vulnerable with the Government. Data from these registrations is shared with supermarkets on an ongoing basis, whereby supermarkets provide individuals with access to priority access to booking slots for delivery. The vast majority of supermarkets are engaged in this data-sharing initiative.
Individuals in the NSV group are those who are unable to access food and other essential supplies due to a COVID-19 related change in physical or financial circumstance.
We have been working quickly with local authorities, retailers, food businesses and the voluntary sector to support those who do not necessarily fall into the shielded category, but who may be struggling to access food and essential supplies as a result of the coronavirus pandemic. We have been careful to ensure that the definition of non-shielded food-vulnerable people includes those who are unable to access food due to the impact of COVID-19 on food services and delivery, as well as those who are in temporary isolation or enhanced social distancing. This group would include disabled people whose disabilities make it difficult for them to comply with social distancing requirements in food shops or whose access to food has been compromised by COVID-19. This could be a result of increased delivery demand, or their usual support networks being unable to help due to self-isolation or social distancing.
This group of non-shielded vulnerable people are now able to access food in a variety of ways, including through being paired with volunteers who will shop for them, and through food deliveries from local retailers, wholesalers and food businesses, many of whom will be able to take orders over the phone. We have also been working with retailers to enable these individuals to access priority delivery or click and collect slots.
Over 750,000 people have signed up as NHS Volunteer Responders via the mobile app GoodSam. Verified volunteer responders can receive tasks to help those in their communities, including through shopping for vulnerable people for food and essential supplies. Health and care professionals and a number of approved Voluntary and Community Services organisations are now able to refer vulnerable individuals into the system to receive support from volunteers. It is now also possible for individuals to self-refer for assistance from the programme, if they consider themselves to be vulnerable and in need of support.
Supermarkets have also been working at pace to expand the total number of delivery and click and collect slots. Most supermarkets are offering prioritised delivery or click and collect slots to those they have identified as vulnerable from their customer database (for example by age, shopping habits, previous use of vulnerable customer helplines).
DFID’s approach to non-communicable diseases is focused on improving the provision of basic health services for the poorest by supporting health systems strengthening such as improving health worker capacity and access to essential medicines. This helps to increase coverage, equity, access and quality of health services to address all health problems including non-communicable diseases.
As part of these efforts the UK Government continues to champion universal health coverage (UHC) to ensure access to quality essential services for all. UHC includes ensuring that no one is impoverished through paying for health services and reducing financial barriers for essential services, especially for the poorest and most vulnerable.
The Government currently spends £5.8 billion a year providing some help to 1.43 million people of pension age with the cost of their care needs.
Attendance Allowance provides financial support towards the extra costs faced by those with a severe disability. It is only available to those over State Pension age who require care or supervision as a result of their disability. The support is aimed at those with long term care needs so there is a qualifying period of 6 months. The qualifying period is waived for those with a terminal illness.
Claims for Attendance Allowance can be made by to the Department by telephone on 0800 731 0122 or by obtaining a claim form online at: www.gov.uk and returning to: Freepost DWP Attendance Allowance.
The Department routinely reviews its use of staffing resources to ensure that it meets the needs of our customers. The Department have recently recruited more staff to process Attendance Allowance claims, which will enable us to determine benefit eligibility within a shorter timescale.
The Workplace (Health, Safety and Welfare) Regulations 1992 cover a wide range of basic health, safety and welfare issues and apply to most workplaces. These Regulations require for suitable and sufficient sanitary conveniences to be available at readily accessible places. The attached documents the Workplace Health Safety and Welfare Approved Code of Practice and Guidance (L24) and Welfare at Work – Guidance for employers (INDG293), which are guidance to help dutyholders comply with the regulations, say:
There are no equivalent requirements for men.
These regulations do not apply to non-workplaces; however, the Ministry for Housing, Communities and Local Government’s building regulations are applicable to public buildings and the advice is:
In 2016-17, 1.81m (60 per cent) of eligible state pensioners claimed Pension Credit. Corresponding figures for 2017-18 and 2018-19 are not yet available.
Official statistics on the take-up of income related benefits at Great Britain level, including Pension Credit, can be found in the ‘Income-related benefits: estimates of take-up in 2016 to 2017’ publication on gov.uk.
Historic and forecast benefit expenditure and caseload data relating to DWP benefits at Great Britain level, including Pension Credit, can be found in the ‘Benefit expenditure and caseload tables 2019’ publication on gov.uk.
The information is not available in the format requested.
Findings from the Office of National Statistics (ONS) Wealth and Asset survey show that overall, the average (median) amount of wealth held in pensions not yet in payment was £33,000 in 2010/12. There is no breakdown available to show wealth held in funds created due to Automatic Enrolment.
DWP’s annual official statistics on workplace pension participation found that in 2014, the annual total amount saved in workplace pensions by employees eligible for Automatic Enrolment was £80.3 billion, an increase of £6.6 billion from 2012.
Local authorities in England receive a public health grant to support their statutory duty to improve the health of their population. The public health grant to local authorities in England has increased from £3.279 billion in 2020/21 to £3.324 billion in 2021/22.
The NHS Long Term Plan commits to a range of actions to prevent ill health, including the prevention of up to 150,000 heart attacks, strokes and dementia cases over a 10 year period. Although no formal assessment has yet been made on the effects on investing in preventative healthcare on waiting lists and demand, it is estimated there will be a significant positive impact on National Health Service waiting lists as part of recovery from the pandemic. Preventative interventions can deliver significant health benefits for individuals as well as reducing the burden of preventable illness on the NHS.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The information is not available in the format requested. Data on care home occupancy has not been systematically collected from care homes, whose residents are a mix of publicly and self-funded clients.
The overall supply position of hormone replacement therapy (HRT) products has been improving since the end of February 2020 and will continue to improve in the coming months.
We have been advised that supplies of Brevinor, Norimin and Synphase tablets will be available from late January/early February 2021, with supplies of Yiznell available from early January 2021. Supplies of Eloine and Zoely tablets remain available via the usual routes.
Issues such as regulatory or manufacturing problems, problems accessing supplies of pharmaceutical raw ingredients and commercial decisions to divest certain products can affect the supply of medicines, including HRT and oral contraceptives.
The Local Government and Social Care Ombudsman (LGSCO) took the decision to suspend new complaints in order to protect frontline services. It has now fully reopened and is working through complaints received during the pause. Members of the public will not lose their access to justice because of the pandemic, and complaints regarding the COVID-19 outbreak period are now being considered as are all other complaints. The LGSCO has taken steps to ensure complainants are not penalised on time grounds for not being able to come to the LGSCO during the pause. The LGSCO has also carefully tracked legislation and guidance in operation since the outbreak and developed expertise to consistently investigate complaints made about council and social care provider actions during that period.
We have made arrangements to help ensure that settings providing adult social care services can access personal protection equipment (PPE) where they have a clinical need, in line with published guidance. This includes community retirement settings that have care provision.
We have released millions of items of PPE to wholesalers for onward sale to the adult social care sector for providers to access if they cannot obtain PPE through their business as usual routes. We have also released of millions of items of PPE to Local Resilience Forums to help them respond to urgent local spikes in need across the adult social care sector and some other front-line services, where they are unable to access PPE through their business as usual and designated wholesaler routes. We have also mobilised a National Supply Disruption Response system to respond to emergency PPE requests, including for the adult social care sector if they cannot obtain PPE through other routes.
On access to COVID-19 testing, staff that are experiencing symptoms can be referred for testing by their employer, use the self-referral portal to order a home test kit or visit a regional testing site.
The Care Quality Commission (CQC) is committed to supporting its colleagues who wish to undertake a different role to support the national effort in combatting COVID-19. As of 30 April 2020, the CQC has 101 colleagues with a formal external loan agreement. It has released 18 colleagues to the Department, 16 to NHS Improvement, one to Public Health England and one to Public Health Wales. It has released an additional 65 colleagues under local agreements to organisations including National Health Service trusts, general practitioner practices and pharmacies. In the majority of cases they are undertaking a frontline role. The CQC paused its routine inspection programme on 16 March 2020. This has freed up around 2,300 specialist advisors, who are not the CQC’s employees but can be called upon to support their inspection programme alongside clinical duties, to focus on frontline work.
Putting social care on a sustainable footing, where everyone is treated with dignity and respect, is one of the biggest challenges we face as a society. The Government will bring forward a plan for social care this year. There are complex questions to address, which is why we will seek to build cross-party consensus. We will consider all options available to ensure that every person is treated with dignity and offered the security they deserve, and that nobody needing care is forced to sell their home to pay for it.
The Government remains committed to support informal carers to provide care for those they care for.
While the Department does not provide specific guidance and advice for carers of those they care for with nutritional problems and eating difficulties, the Care Act 2014 requires that where an adult or carer appears to have care and support needs the local authority must carry out a care assessment. It must then decide if the person has eligible needs by considering the outcomes the person wants to achieve, what needs they have, and how these impact on their wellbeing.
Where a person is assessed as having eligible care and support needs, these must be met by their local authority. For those who do not meet the eligibility criteria, local authorities should signpost people to relevant services. This includes guidance and advice for informal carers of patients with nutritional problems.
One of the eligibility determinations in the Care Act 2014 for care and support is managing and maintaining nutrition. In addition, there are other sources of information carers can access, such as advice from healthcare professionals. The nutrition company Nutricia also produces information for carers to help provide better support for them around nutritional problems and eating difficulties. The leaflets are available free online as downloads from Carers UK.
Public Health England has undertaken modelling on the impact of a reduced dose pneumococcal conjugate vaccine (PCV) schedule in the United Kingdom. The Joint Committee on Vaccination and Immunisation (JCVI) reviewed the modelling in October 2017 and after considering all relevant evidence advised a revised schedule for PCV13 vaccine, with vaccination offered at three months and 12 months.
The JCVI is currently undertaking a consultation on their advice, therefore the estimates requested are not yet finalised. The modelling will be submitted for publication in a peer reviewed journal in spring 2018.
The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom immunisation programme. It bases its recommendations on a comprehensive review of a wide range of scientific and other evidence, including from the published literature, and commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness. It can consult with stakeholders on its advice when it deems this necessary.
At its meeting in October 2017, the JCVI advised a change to the UK’s childhood pneumococcal conjugate vaccine (PCV) schedule. It recommended that infants should receive a single dose in infancy followed by a booster at one year of age (a “1+1” schedule). This advice was based on high vaccine uptake and effectiveness of the current PCV programme in the UK which has reduced vaccine-preventable pneumococcal disease.
The JCVI conducted a short focused consultation in January on its proposed advice about the PCV schedule. This concluded on 2 February. It is understood that some stakeholders have requested an extension to this consultation. The JCVI considered this request at its meeting on 7 February and their decision on this will be made public shortly. It is the JCVI rather than the Government that is best placed to carry out consultation about scheduling within the vaccine programme and who to target the consultation at.
The Challenge on Dementia 2020, published in February 2015, made clear that, by 2020, we expect social care providers to provide appropriate training on dementia to all relevant staff. A copy of the Challenge on Dementia 2020 is attached.
The Department estimates that more than 100,000 social care workers have already received dementia awareness training. Newly appointed health care assistants and social care support workers, including those providing care and support to people with dementia and their carers, should undergo training as part of the national implementation of the Care Certificate.
Standard 9 of the Care Certificate concerns awareness of mental health, dementia and learning disabilities. In meeting the standard, each worker must show that he or she understands the needs and experiences of people with mental health conditions, dementia or learning disabilities, the importance of promoting their health and wellbeing, the adjustments which may be necessary in delivering their care, and the importance of early detection. They must also prove that they understand the legal context, including mental capacity considerations.
This standard is based in tier 1 of the Dementia Core Skills Education and Training Framework, which focuses on awareness. This tier of knowledge is applicable across the spectrum of health and adult social care services and so is at an appropriate level to inform the Care Certificate’s content.
The Challenge on Dementia 2020, published in February 2015, made clear that, by 2020, we expect social care providers to provide appropriate training on dementia to all relevant staff. A copy of the Challenge on Dementia 2020 is attached.
The Department estimates that more than 100,000 social care workers have already received dementia awareness training. Newly appointed health care assistants and social care support workers, including those providing care and support to people with dementia and their carers, should undergo training as part of the national implementation of the Care Certificate.
Standard 9 of the Care Certificate concerns awareness of mental health, dementia and learning disabilities. In meeting the standard, each worker must show that he or she understands the needs and experiences of people with mental health conditions, dementia or learning disabilities, the importance of promoting their health and wellbeing, the adjustments which may be necessary in delivering their care, and the importance of early detection. They must also prove that they understand the legal context, including mental capacity considerations.
This standard is based in tier 1 of the Dementia Core Skills Education and Training Framework, which focuses on awareness. This tier of knowledge is applicable across the spectrum of health and adult social care services and so is at an appropriate level to inform the Care Certificate’s content.
The Challenge on Dementia 2020, published in February 2015, made clear that, by 2020, we expect social care providers to provide appropriate training on dementia to all relevant staff. A copy of the Challenge on Dementia 2020 is attached.
The Department estimates that more than 100,000 social care workers have already received dementia awareness training. Newly appointed health care assistants and social care support workers, including those providing care and support to people with dementia and their carers, should undergo training as part of the national implementation of the Care Certificate.
Standard 9 of the Care Certificate concerns awareness of mental health, dementia and learning disabilities. In meeting the standard, each worker must show that he or she understands the needs and experiences of people with mental health conditions, dementia or learning disabilities, the importance of promoting their health and wellbeing, the adjustments which may be necessary in delivering their care, and the importance of early detection. They must also prove that they understand the legal context, including mental capacity considerations.
This standard is based in tier 1 of the Dementia Core Skills Education and Training Framework, which focuses on awareness. This tier of knowledge is applicable across the spectrum of health and adult social care services and so is at an appropriate level to inform the Care Certificate’s content.
The performance indicators included in the 2016-17 S7A public health functions agreement do not reflect every activity which is carried out under the agreement.
As I stated in my answer of 26 April, the provision of pneumococcal vaccination to severely immunocompromised children aged at least five years and adults, as recommended by the Joint Committee on Vaccination and Immunisation in July 2013, is reflected in the relevant service specification for the existing pneumococcal immunisation programme and within the document Immunisation against Infectious Diseases (‘the Green Book’). The Green Book is published on the GOV.UK website in an online only format.
A copy of the service specification on the pneumococcal immunisation programme is attached.
The 2016-17 Section 7A public health functions agreement specifies key deliverables in relation to new or changed programmes that are being introduced within 2016-17.
The provision of pneumococcal vaccination to severely immunocompromised children aged at least five years and adults, as recommended by the Joint Committee on Vaccination and Immunisation in July 2013, is reflected in the relevant service specification for the existing pneumococcal immunisation programme and within the document Immunisation against Infectious Diseases (‘the Green Book’). The Green Book is published on the GOV.UK website in an online only format.
The Section 7A public health functions agreement is updated on an annual basis, at which point any new recommendations from relevant expert committees, including the Joint Committee on Vaccinations and Immunisation (JCVI), are taken into account.
If the JCVI makes a recommendation which is urgent, for example in the case of a public health emergency, the agreement can be amended in-year by agreement between the Department and NHS England.
NHS England has a specific role to commission those public health services set out in the Section 7A public health functions agreement 2016-17, including immunisation programmes and to hold to account providers to ensure that they deliver the contracts that have been agreed. The agreement sets out specific outputs and outcomes to be achieved by NHS England including performance indicators that outline minimum levels of vaccination coverage for different programmes. NHS England publishes national service specifications outlining the minimum levels of vaccinations expected, which in turn are put into contracts with providers at local level.
The Section 7A agreement requires NHS England to at least maintain, or improve, national levels of performance on existing services, while also implementing planned changes. It also includes an ambition to reduce local variation in performance between different geographical areas.
There are no plans to review incentives, however a number are already in place. For example, within primary care general practitioner (GP) settings, some vaccination services such as flu for those with diabetes have quality outcome framework indicators attached, whereby GPs are rewarded for good practice. Also, as part of the contracts given outside of the primary care settings, local teams can develop Commissioning for Quality and Innovation payments that link a proportion of providers' income to the achievement of local quality improvement goals.
Public Health England issues guidance to healthcare professionals on the use of nationally procured vaccine stock through chapter three of its publication, ‘Immunisation against infectious diseases’ titled ‘Storage, distribution and disposal of vaccines’. A copy is attached.
Through the National Health Service public health functions agreement (S7A), NHS England commissions services from a variety of providers across England, and has a national service specification outlining the national standards and expectations. Immunisation programmes are delivered in partnership with Public Health England (PHE) and the Department, who use contracting and commissioning levers to reduce variation in local levels of performance between different geographical areas. In addition, organisations are working together on a number of priority programmes where there is variation, such as measles, mumps, and rubella to put in place effective actions for improvement.
PHE works in partnership with NHS England and Directors of Public Health to ensure that local population needs are understood and addressed by local immunisation services, and with NHS England local teams to provide leadership and coordination to sustain and improve the successful delivery of existing programmes.
PHE constantly monitors cases of vaccine preventable disease and levels of vaccine coverage.
NHS England has a specific role to commission those public health services set out in the Section 7A public health functions agreement 2016-17, including immunisation programmes and to hold to account providers to ensure that they deliver the contracts that have been agreed. The agreement sets out specific outputs and outcomes to be achieved by NHS England including performance indicators that outline minimum levels of vaccination coverage for different programmes. NHS England publishes national service specifications outlining the minimum levels of vaccinations expected, which in turn are put into contracts with providers at local level.
The Section 7A agreement requires NHS England to at least maintain, or improve, national levels of performance on existing services, while also implementing planned changes. It also includes an ambition to reduce local variation in performance between different geographical areas.
There are no plans to review incentives, however a number are already in place. For example, within primary care general practitioner (GP) settings, some vaccination services such as flu for those with diabetes have quality outcome framework indicators attached, whereby GPs are rewarded for good practice. Also, as part of the contracts given outside of the primary care settings, local teams can develop Commissioning for Quality and Innovation payments that link a proportion of providers' income to the achievement of local quality improvement goals.
The legislation under which NHS England and clinical commissioning groups (CCGs) commission services requires them to arrange for the provision of services for which they are responsible, to such extent as they consider necessary to meet all reasonable requirements.
For CCGs, this includes offering continence services as part of their obligation to provide community health. Although CCGs often focus on prevention and treatment, it is expected any standard continence service should include access to products. The criteria for the provisioning of continence products are set by individual CCGs. To support CCGs, NHS England has recently published new guidance to help improve the care and experience of children and adults with continence issues. This encourages much greater collaboration between health and social care.
A copy of the guidance Excellence in continence care is attached.
The Government included in its Mandate to NHS England an objective for them to “make partnership a success”. This includes “championing the Time to Change campaign to raise awareness of mental health issues and reduce stigma, including in the NHS workforce”.
In taking this forward, NHS England recently announced the "A healthy NHS workforce" initiative. This aims to raise staff awareness and understanding of mental health issues, helping to ensure they have access to help, support and treatment when they need it. A copy of the announcement is attached.
“A healthy NHS workforce” includes, for example, line manager trainingand, providing NHS staff rapid access to talking therapies. Thisis currently being tested as part of the Healthy Workforce programme led by NHS England.
In addition, NHS Employers have launched the How are you feeling NHS? toolkit. This has been developed with NHS staff to help bridge a gap in understanding and enable them to: talk openly and regularly about their emotional health; assess the impact emotional wellbeing has on themselves, their colleagues and patients, and help with action planning to enable more good days than bad. The online only resource can be found at:
The number of days lost through the sickness of healthcare workers between 2009 and 2014 were:
England | Full Time Equivalent Days Lost to Sickness Absence (includes non-working days) | Full Time Equivalent Days Available (includes non-working days) | Sickness Absence Rate |
2009-10 | 16,745,315 | 380,199,666 | 4.40% |
2010-11 | 15,947,054 | 383,278,845 | 4.16% |
2011-12 | 15,555,507 | 377,908,880 | 4.12% |
2012-13 | 15,947,518 | 376,187,354 | 4.24% |
2013-14 | 15,385,468 | 378,691,376 | 4.06% |
2014-15 | 16,423,722 | 386,388,483 | 4.25% |
Source: Health and Social Care Information Centre
The Government does not record the cost incurred by the National Health Service due to days lost through the sickness of healthcare workers.
Employers are responsible for reducing the days lost through sickness of their staff. The Department supports the NHS by commissioning NHS Employers to provide trusts with advice, guidance and good practice on improving NHS staff health and wellbeing which is available on an online only resource at:
NHS Employers is also working with NHS England and Public Health England on a £5 million initiative to improve NHS staff health announced in its Five Year Forward View. A copy of the ‘A healthy NHS workforce’ announcement is attached.
The number of days lost through the sickness of healthcare workers between 2009 and 2014 were:
England | Full Time Equivalent Days Lost to Sickness Absence (includes non-working days) | Full Time Equivalent Days Available (includes non-working days) | Sickness Absence Rate |
2009-10 | 16,745,315 | 380,199,666 | 4.40% |
2010-11 | 15,947,054 | 383,278,845 | 4.16% |
2011-12 | 15,555,507 | 377,908,880 | 4.12% |
2012-13 | 15,947,518 | 376,187,354 | 4.24% |
2013-14 | 15,385,468 | 378,691,376 | 4.06% |
2014-15 | 16,423,722 | 386,388,483 | 4.25% |
Source: Health and Social Care Information Centre
The Government does not record the cost incurred by the National Health Service due to days lost through the sickness of healthcare workers.
Employers are responsible for reducing the days lost through sickness of their staff. The Department supports the NHS by commissioning NHS Employers to provide trusts with advice, guidance and good practice on improving NHS staff health and wellbeing which is available on an online only resource at:
NHS Employers is also working with NHS England and Public Health England on a £5 million initiative to improve NHS staff health announced in its Five Year Forward View. A copy of the ‘A healthy NHS workforce’ announcement is attached.
The Government has not assessed how many National Health Service employees have attempted, or committed, suicide in each year between 2009 and 2014. The Department does not collect this information centrally.
However, the Department is not complacent and commissions NHS Employers to support trusts to improve the physical and mental health and wellbeing of their employees, which is the responsibility of employers across the NHS in England.
NHS Employers is working with NHS England and Public Health England on NHS England’s recently announced “A healthy NHS workforce", a commitment in its Five Year Forward View “which includes increasing awareness of and addressing mental health issues affecting NHS staff”. A copy of the announcement is attached.
NHS England’s recent announcement "A healthy NHS workforce", aims to raise staff awareness and understanding of mental health issues and ensure staff have access to help, support and treatment when they need it.
“A healthy NHS workforce” includes, for example, line manager training and, providing NHS staff rapid access to talking therapies. This is currently being tested as part of the Healthy Workforce programme led by NHS England.
NHS Employers is working with NHS England and Public Health England on improving NHS staff health and wellbeing. They offer extensive information and tools for managers to support their employees who are demonstrating signs of mental health problems, or returning to work following periods of sickness absence.
These resources, which are only available online, can be found at the following link:
www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/health-work-and-wellbeing/protecting-staff-and-preventing-ill-health/supporting-line-managers/managers-guide-on-supporting-workplace-mental-health/supporting-staff-who-are-experiencing-mental-health-problems
The Joint Committee on Vaccination and Immunisation concluded a review of the adult pneumococcal vaccination programme in 2012. The Committee started a new review at its meeting on 28 January, taking into account the latest information on the epidemiology, cost-effectiveness and impact of adult pneumococcal vaccination. It is anticipated that the review will take six months to complete, subject to the availability of the necessary evidence.
The Secretary of State has not requested a recommendation about immunisation against pneumococcal disease from the Joint Committee on Vaccination and Immunisation (JCVI) under the terms of the Health Protection (Vaccination) Regulations 2009.
We will consider carefully any advice received from the JCVI about immunisation against pneumococcal disease in due course.
The information requested is shown in the following table.
Recommendation from the Joint Committee on Vaccination and Immunisation | Date of recommendation | Date of implementation |
The use of rotavirus vaccine in the routine infant immunisation programme, if vaccine prices were much less than those at which they are currently being offered, so that such an immunisation programme is cost-effective. | February 2009 | July 2013 |
The use of herpes zoster (shingles) vaccine vaccination programme for adults aged 70 years up to and including 79 years provided that a vaccine is available at a cost effective price. | March 2010 (full statement) | September 20131 |
The use of the Respiratory Syncytial Virus (RSV) prophylactic medicine Palivizumab to prevent serious RSV disease in at risk pre-term infants. | October 2010 | October 20102 |
The annual influenza vaccination programme be extended to include children aged 2 to under 17 years of age. | July 2012 | September 20133 |
Notes
The Secretary of State has not requested a recommendation about immunisation against pneumococcal disease from the Joint Committee on Vaccination and Immunisation (JCVI) under the terms of the Health Protection (Vaccination) Regulations 2009 in the last five years.
Departmental officials requested advice from the JCVI in early 2014 about the use of pneumococcal conjugate vaccine (PCV). At its meeting on 4 June 2014, the minutes of which are available on GOV.UK, the JCVI concluded that PCV13 should remain the pneumococcal conjugate vaccine of choice for infants in the United Kingdom at this time. We have accepted this advice.
One of the underpinning principles of the NHS Outcomes Framework is to ensure that it encourages the promotion of equality in line with the Equality Act 2010.
The Domain 1 premature mortality indicators in the NHS Outcomes Framework and Clinical Commissioning Groups Outcomes Indicator Set are capped at age 75 because the attribution of the cause of death is more vexed for older people, who often have co-morbidities. Therefore, including those aged 75 and above could lead these indicators to become misleading.
However, to ensure all age groups are covered equally, ‘Life Expectancy at 75’ is an overarching indicator in Domain 1 of the NHS Outcomes Framework. This indicator captures ages 75 and over and all conditions.
The above information is contained in the NHS Outcomes Framework 2011-12 Equalities Impact Assessment and the NHS Outcomes Framework 2011-12, both of which have already been placed in the Library.