Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans are in place to ensure the continued delivery of psychiatric medication to pharmacies in England in the event of a no-deal Brexit.
Answered by Baroness Blackwood of North Oxford
We understand that psychiatric medicines are vitally important to many people in this country. Our contingency plans aim to ensure that the supply of psychiatric medicine and other essential medicines to patients is not disrupted in all European Union exit scenarios, including in the event we exit the EU without a deal.
We are confident that, if everyone does what they need to do, the supply of medicines will be uninterrupted in the event of exiting the EU without a deal.
The Department is working closely with trade bodies, product suppliers, the health and care system in England, the devolved administrations and Crown Dependencies, to make detailed plans to ensure the continuation of the supply of medicines to the whole of the United Kingdom in the event of a ‘no deal’ EU exit.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they have taken to ensure that media allegations of incompetent brain and other surgery at Coventry and Warwickshire NHS Trust have been investigated.
Answered by Lord O'Shaughnessy
Patient safety is a critical priority, and a culture that seeks out opportunities for learning and improvement is vital for making care safer for patients.
NHS Improvement is in regular contact with University Hospitals Coventry and Warwickshire NHS Trust and has received assurances from the Trust that the allegations relating to neurological surgery are subject to independent review, either through the Royal College of Surgeons or through ongoing coroner’s cases. NHS Improvement is confident that all media allegations have been fully investigated.
NHS Improvement has also taken robust steps in line with their whistleblowing policy to ensure that these matters are looked into thoroughly.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of (1) patient safety in the Coventry and Warwickshire NHS Trust, and (2) the procedures to ensure that whistle-blowers are protected and that any medical negligence is exposed.
Answered by Lord O'Shaughnessy
The Care Quality Commission (CQC) has advised us that it conducted a comprehensive inspection of the Trust in March 2015, a focused inspection in September 2016, and these were followed by the CQC issuing requirement notices regarding breaches of regulations.
The CQC carried out an unannounced inspection of eight core services and two additional services in April 2018 at University Hospital, Coventry, and three core services at Hospital St Cross, Rugby in May 2018, as well as further unannounced inspections in May 2018. The CQC is compiling its report findings with a view to publishing the inspection report in August or September 2018.
The Government supports the right of staff working in the National Health Service to raise concerns and expects all NHS organisations to support staff that wish to do so. All NHS trusts and foundation trusts are required to have Freedom to Speak up Guardians to whom employees can raise concerns about patient safety in confidence.
In May 2018, the Government introduced legislation to further protect prospective employees into the NHS from discrimination if the individual is perceived to have been a whistleblower. This legislation was a recommendation from Sir Robert Francis’ Freedom to Speak Up review, published in February 2015.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment, if any, they have made of the estimate, produced by Mencap, that the Employment Appeal Tribunal decision to backdate pay for sleep-in carers will lead to a funding shortfall of £400 million for care organisations.
Answered by Lord O'Shaughnessy
The Government recognises the pressure that sleep-in back pay liabilities are placing on providers of social care, and is exploring options to minimise any impact on the sector. Any intervention to support the sector would need to be proportionate and necessary.
The Government commissioned market analysis to assess the impact of sleep-ins back pay liabilities across the social care sector. This work forms part of the evidence base that is being used to assess options and is subject to further analysis and refinement. The Department has committed to sharing a summary of the analysis at the appropriate time.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of any potential threat to the viability of social care providers caused by the Employment Appeal Tribunal ruling on backdating sleep-in pay.
Answered by Lord O'Shaughnessy
The Government recognises the pressure that sleep-in back pay liabilities are placing on providers of social care, and is exploring options to minimise any impact on the sector. Any intervention to support the sector would need to be proportionate and necessary.
The Government commissioned market analysis to assess the impact of sleep-ins back pay liabilities across the social care sector. This work forms part of the evidence base that is being used to assess options and is subject to further analysis and refinement. The Department has committed to sharing a summary of the analysis at the appropriate time.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of research published in the Lancet showing that the estimated health benefits of minimum unit pricing of alcohol would benefit those from the lowest socioeconomic group.
Answered by Lord O'Shaughnessy
Public Health England (PHE) published an evidence review The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An evidence review in December 2016. A copy of the evidence review is attached. The research Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study published in the Lancet in 2014 was considered as part of this review. The PHE review concluded that reducing the affordability of alcohol is the most effective way of reducing alcohol harm, including hospital admissions and deaths, and targeted pricing measures are particularly effective at reducing harm in those groups most at risk. The review also found that targeting price increases at the cheapest alcohol is very effective and cost-effective and is able to substantially reduce harm in heavy drinkers without affecting moderate drinkers or the price of alcohol sold in pubs and bars.
Minimum Unit Pricing and its effects will continue to remain under review pending the impact of its implementation in Scotland, which will give us the opportunity to see whether the beneficial impacts predicted by modelling are realised in practice.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking to reduce health inequalities amongst older people.
Answered by Lord O'Shaughnessy
Public Health England’s (PHE) older people and dementia work programme uses a range of approaches to help reduce inequalities amongst older people. These include: influencing and commissioning research evidence, publishing resources and tools to support improved commissioning by local authorities and the National Health Service, pilot programmes, collaborating with a range of third sector organisations who are working in the field, and advising the Department.
The NHS Health Check programme aims to target the major causes of premature death, ill health and inequalities in England. Since April 2013, almost five million people aged 40-74 have benefitted from this service. Evidence suggests that the greatest uptake is seen in more deprived communities and older adults.
PHE works closely with local areas to tackle health inequalities. For example, PHE is supporting local authorities to respond to the needs of older drug and alcohol users, particularly an ageing group who are experiencing poor physical and mental health and are more susceptible to alcohol or drug related death.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the findings of the report by the British Medical Association <i>Growing Older in the UK</i>.
Answered by Lord O'Shaughnessy
The Government welcomes the British Medical Association’s report Growing Older in the UK. Supporting people to continue to play an active role in society as they grow older is a priority for Government and the report’s findings will be taken into account in relevant policy development work.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what estimate they have made, or are planning to make, of the cost to the health service of poverty-related ill health.
Answered by Lord Prior of Brampton
The Department has not made, and is not planning to make, an estimate of the cost to the health service of poverty related ill health. However, in 2008 the Department commissioned Professor Michael Marmot of University College London to chair an independent strategic review of health inequalities in England from 2010. The Review, Fair Society, Healthy Lives, estimated that, in 2010, direct NHS healthcare costs in England associated with treating the consequences of inequality amounted to £5.5 billion per year for treating acute illness, mental illness and prescriptions. This estimate does not cover all health service activity, including primary care costs.
The review also estimated the wider costs of health inequalities, with £31-33 billion worth of productivity losses resulting from inequalities in illness, and between £20-32 billion in lost taxes and higher welfare payments. A copy of the review has been placed in the Library.
Asked by: Baroness Hollins (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what safeguards are in place to ensure that the transfer of commissioning responsibility for Tier 4 obesity services from NHS England to Clinical Commissioning Groups does not have a negative impact on patient services or clinical standards, and how they will ensure that patients receive high quality, safe and effective care should that transfer proceed in April 2016.
Answered by Lord Prior of Brampton
Specialised commissioning teams at NHS England are in contact with clinical commissioning groups (CCGs) and a formal process has been agreed to transfer the technical and service aspects of the commissioning responsibility.
This process includes NHS England leading on the contract negotiation for 2016/17 on behalf of CCGs based on the current service provision. Although the transfer is effective from April 2016 in terms of the contract values, the timing of the handover will be agreed between local specialised commissioning teams and CCGs, in line with their preparedness.
NHS England will continue to work with CCGs to provide support as appropriate.
NHS England does not expect the services patients receive to be affected following the transfer of obesity surgery commissioning responsibilities to CCGs from April 2016, as the change is primarily to commissioning responsibilities.
No service changes are included as part of the transfer process. The transfer process will include providing information to CCGs on pathways, provider performance and any quality issues relating to this service.
The transfer should support better integration between Tier 3 and Tier 4 services (which include obesity services) which in turn should improve access for eligible patient and streamline pathways. Clinical teams remain responsible for the quality of their services.
NHS England through its clinical reference group has finalised clinical guidance to support commissioners and clinical teams. We would also look to leadership from royal colleges and professional groups to promote best practice in this area. CCGs already have mechanisms in place to monitor provider performance and quality through the existing quality assurance processes.