Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to address health inequalities on the basis of gender, race, and economic class; what their key priorities are in doing so; and what steps they will take to measure success.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is dedicated to building a fairer, more equal society by addressing the structural inequalities that drive poor health outcomes, especially for disadvantaged groups.
Our Health Mission in England will focus on addressing the social determinants of health, with the goal of halving the gap in healthy life expectancy between the richest and poorest regions.
We are committed to prioritising women’s health as we build a National Health Service fit for the future. We are also taking action on the range of conditions that particularly affect men, including heart disease, liver disease, and cancer.
The Government is also committed to closing the black and Asian maternal mortality gap. Recognising the need for health inequalities to be central to all policy making, our health inequalities work has a renewed focus to bring together policy experts to reduce racial inequalities across health.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many incidents of patient records or personal data being accessed without due cause have been recorded in the most recent year for which figures are available.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Health and care organisations are required to submit data breach reports within 72 hours of an incident. Data breach incidents are reported to the Information Commissioners Office (ICO), who then investigate and decide what action to take. Notifiable breaches are those that are likely to result in a high risk to the rights and freedoms of the individual, referred to as the data subject. NHS England publishes the number of incidents reported through the Data Security and Protection Toolkit on its website. In 2023, 996 incidents were reported to the ICO, but not all of these would have involved patient details being accessed without due cause. The ICO publishes details on its website of incidents where it takes enforcement action.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to ensure that patient records and personal data are only accessible to those who need to view them, and to ensure connections between software systems in health facilities include suitable control measures for this risk.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
National IT systems must ensure that users can be identified correctly, and are given appropriate access. This is achieved using identity verification capabilities, including creating a national digital identity for each authorised user.
Each local National Health Service organisation which requires access to the national IT systems is required to set up its own local Registration Authority (RA) which consists of people and processes who are trained to create identities and grant access for their staff to the national IT systems. NHS England has published the RA Policy requirements with which every local NHS organisation that has an RA must comply. This reflects current best practice for identity and access management as informed by the National Cyber Security Centre (NCSC) guidance.
The RA Policy also allows non-NHS health and care organisations providing direct care to run their own RA service. RA hosting is subject to meeting requirements and assessment criteria, which are soon to be published.
The RA process includes the use of RA codes, assigned to professional users’ smartcards to give them access to the correct information within national IT systems.
The RA codes which are assigned for a specific user will allow that user to create and process referrals appropriately depending on their job role.
Local organisations which have an RA function are required to have an RA audit policy and conduct annual audits on NHS Smartcard usage as part of their RA governance. RA Managers (those responsible for administering the RA function within an organisation) must implement a process to run the RA reports on a regular basis.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the extent of racism and discrimination within the NHS; what steps NHS England are taking to collate data on this issue; and how they disseminate best practice to improve working culture within the NHS.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The National Health Service is one of the most diverse organisations in this country. As of September 2023, 27.3% of hospital and community health service staff reported an ethnic minority background. However, data shows that disabled staff, staff from ethnic minority background, and staff with other protected characteristics face a worse experience of working in the NHS when it comes to abuse, bullying and harassment, and career progression.
Since 2016, NHS England has published an annual Workforce Race Equality Standard (WRES) report. Implementation of the WRES is a requirement for NHS commissioners and NHS healthcare providers, including independent organisations through the NHS standard contract. The WRES enables NHS organisations to better understand how they are performing against nine indicators covering issues such as board representation, career progression, and bullying and harassment. They are required to develop action plans to progress and improve against the indicators.
In June 2023, NHS England published the Equality, Diversity and Inclusion Improvement Plan that sets out targeted actions to address prejudice and discrimination in the NHS workforce. NHS England has also provided guidance to assist trusts and integrated care boards in adopting an improvement approach to the implementation of this plan. It is supported by a repository of good practice and a dashboard, to enable organisations to measure progress.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the overall budget of NHS England, how many staff it has, and how it measures its own performance in driving the delivery of services in primary and secondary care.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The overall budget for NHS England in 2023/24 is £172.1 billion. NHS England publishes quarterly data on the number of staff working in National Health Service Support Organisations and Central Bodies. The latest data for June 2023 shows there are 16,328 full time equivalent staff employed by NHS England.
In May 2023, NHS England published a delivery plan for primary care. Integrated care boards (ICBs) will lead the change for their local health systems as commissioners of primary care. The plan sets out how ICBs are expected to report progress, including though their public board reporting, with national and regional support being offered to any ICBs that are falling behind. A copy of the plan is attached.
On elective care, the NHS published a delivery plan in January 2022 setting out a clear vision for how the NHS will recover and expand elective services over three years. This includes targets to reduce maximum waiting times, so that waits of longer than a year for elective care are eliminated by March 2025, prioritising diagnosis and treatment so that 95% of patients needing a diagnostic test will receive it within six weeks by March 2025 and transforming the way the NHS provides elective care. A copy of the plan is attached.
On urgent and emergency care, performance measures include meeting the ambitions set out in our Delivery plan for recovering urgent and emergency care services, published in January 2023, including improving accident and emergency and ambulance performance to 76% of patients being admitted, transferred or discharged within four hours by March 2024, and improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023 to 2024, with further improvement against both of these measures towards pre-pandemic levels in 2024 to 2025. A copy of the plan is attached.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the health inequalities that have arisen as a result of the COVID-19 pandemic, particularly in cardiovascular diseases; and what steps they are taking to rectify this issue.
Answered by Lord Bethell
The Government has made no assessment of the health inequalities from the COVID-19 pandemic for cardiovascular diseases. However, NHS England is collating audits data and feedback from NHS services. The NHS has made clear that a central part of responding to COVID-19 and restoring services must be to increase the scale and pace of system-wide action to tackle inequalities, with a particular focus on the issues exacerbated by the COVID-19 pandemic.
The most recent NHS England and NHS Improvement planning guidance outlined the health inequalities delivery strategy from a national and local perspective which prioritised eight key urgent actions to address inequalities in NHS provision and outcomes. Action four emphasises the need to accelerate preventative programmes which proactively engages those at greatest risk of poor health outcomes, which includes prioritising and addressing cardiovascular disease.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking, if any, to change the self-isolation period before 16 August for key workers who have received two COVID-19 vaccines so that they do not have to self-isolate if contacted by Test and Trace; and whether they will list those professions which fall under the key worker category.
Answered by Lord Bethell
To protect the delivery of public services before the self-isolation rules change on 16 August, a very limited number of named critical workers will be informed that they are considered to have a reasonable excuse to leave self-isolation to attend work if they are contacts. This will only apply to workers who are fully vaccinated (defined as someone who is 14 days post-second dose) and is solely for the purpose of going to work. To mitigate the risk of increased transmission, certain conditions must be followed. This is a short-term and highly focused measure intended to apply only in exceptional circumstances with the core purpose of preventing significant harm to public welfare as a result of disruption to critical services.
The list of sectors that are currently eligible for consideration are as follows: Border Control; Clinical Consumable Supplies; Digital Infrastructure; Emergency Services; Energy (including Civil and Nuclear); Essential Chemicals; Essential Defence; Essential Transport; Food Production and Supply; Health and Social Care; Local Government; Medicine; Medical Devices; Waste; Water & Veterinary Medicine.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how long the immunity resulting from the COVID-19 vaccines lasts for in different (1) age, and (2) ethnic, groups.
Answered by Lord Bethell
It is currently too early to say how long the immunity resulting from COVID-19 vaccines will last. More data will be published as the programme progresses through to second doses.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what information they had about the impact of the COVID-19 vaccines on people with pre-existing health conditions prior to authorising the use of those vaccines.
Answered by Lord Bethell
Prior to the recent authorisation, the efficacy of COVID-19 mRNA Vaccine BNT162b2 was evaluated in two clinical studies. The first study excluded co-morbidities or pre-existing health conditions. The second study allowed enrolment of subjects with pre-existing stable disease, defined as disease not requiring significant change in therapy or hospitalisation for worsening disease during the six weeks before enrolment. Also enrolled were subjects with known stable infection with HIV, hepatitis C or hepatitis B. There were no meaningful clinical differences in overall vaccine efficacy in participants who were at risk of severe COVID-19 disease including those with one or more comorbidities that increase the risk of severe COVID-19 disease.
Evaluation of data for other vaccines is ongoing but will include a robust review of all quality, safety and efficacy data, including in those with pre-existing health conditions if they were included in clinical trials.
Asked by: Baroness Manzoor (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what research they have undertaken on the impact of the COVID-19 (1) virus, and (2) vaccines, on the development of embryos in the (a) first, (b) second, and (c) third, trimesters of pregnancy.
Answered by Lord Bethell
The Department, through the National Institute for Health Research (NIHR) has funded various studies into the impact of COVID-19 on pregnancy, through the urgent public health COVID-19 call and the Maternal and Neonatal Health & Care Policy Research Unit. UK Research and Innovation and the NIHR jointly launched the Rapid Response Rolling Call to fund research that aimed to understand, prevent, or manage COVID-19. Two studies were funded that aim to understand the impact of the COVID-19 virus on pregnancy. The NIHR is not currently funding research into the impact of COVID-19 vaccines on the development of embryos but welcomes funding applications for research into any aspect of human health.