Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what contractual commitments Avanti gave them for the supply of food in its first-class rail service.
Answered by Baroness Vere of Norbiton - Parliamentary Secretary (HM Treasury)
Following a temporary waiver during 2020/2021 due to COVID, Avanti West Coast resumed its contractual obligation from June 2021 to provide a complimentary catering service for First Class passengers which is available 7 days a week. This provision of First Class catering will continue in the National Rail Contract set to commence on 15 October 2023.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what steps they will take to ensure that teachers who assist a pupil under the age of 18 with changing their gender, without parental information or consent, are prosecuted for child abuse.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
The department is working with the Minister for Women and Equalities to develop non statutory guidance to support schools in relation to children who are questioning their gender. It is the department’s intention that the guidance will cover a comprehensive set of relevant topics to provide clarity to schools and teachers on how to respond to children who are questioning their gender. This work is based upon the principle of protecting children and ensuring their safety and as such it will reflect the existing laws and duties placed on schools.
These decisions must not be taken lightly or in haste, and so it is vital that the guidance published by the department gives clarity for schools and colleges and reassurance for parents. Therefore, it is important that the department is able to consider a wide range of views in order to get the guidance right, so it has committed to holding a full public consultation on the draft guidance prior to publication, at the earliest opportunity.
In the meantime, schools and colleges should proceed with extreme caution. They should always involve parents in decisions relating to their child and should not agree to any changes that they are not absolutely confident are in the best interests of that child and their peers. They should prioritise safeguarding by meeting their existing legal duties to protect single sex spaces and maintain safety and fairness in single sex sport.
The Department’s statutory guidance ‘Working Together’ and ‘Keeping Children Safe in Education’, which can both be found attached, already sets out the legal responsibilities and duties placed on professionals and schools in relation to safeguarding and promoting the welfare of children. These are sensitive cases which require professional judgement that takes account of the factors in each particular case.
Asked by: Lord Blencathra (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 current and future demand for homecare medicines services; how many patients have accessed homecare medicines services in each of the last five years, both in total and broken down by (1) region of England, and (2) type of condition; how many of these were classed as active patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Homecare Medicines sector has delivered services to an increasing number of patients within the National Health Service in recent years and the demand for convenient ways of accessing medicines is expected to continue.
The National Clinical Homecare Association collates data and estimates approximately 500,000 patients are in receipt of a homecare medicines service in England. However, these figures have not been validated by the NHS.
NHS England collects data for its national framework agreements; however, it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many medicines deliveries have been made through homecare medicines services in each of the last five years; and how many of these deliveries included a visit from a healthcare professional.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Homecare Medicines sector has delivered services to an increasing number of patients within the National Health Service in recent years and the demand for convenient ways of accessing medicines is expected to continue.
The National Clinical Homecare Association collates data and estimates approximately 500,000 patients are in receipt of a homecare medicines service in England. However, these figures have not been validated by the NHS.
NHS England collects data for its national framework agreements; however, it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.
Asked by: Lord Blencathra (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 impact of the NHS Long Term Workforce Plan, published on 30 June, on the staffing and provision of homecare pharmacy teams.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The assessment of demand for staff in the underpinning modelling for the NHS Long term Workforce Plan takes account of the service plans to deliver more care out of hospitals, in line with the ambitions set out in the NHS Long Term Plan. We will continue to develop the workforce modelling, publishing a refreshed projection every two years.
The Plan includes the expansion of training pathways for pharmacists and technicians which will, in time, increase the pool of staff from which trust homecare teams are recruiting, subject to agreeing appropriate funding from commissioners to recruit.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many times homecare medicines were not delivered on the initial date agreed by the clinician in the last year for which figures are available; how many patients required further medical treatment, including hospitalisation, due to delays in the supply of homecare medicines in that period; and how many patients required surgery due to delays in the delivery of medicines for (1) Crohn's disease, and (2) Colitis.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England collects data in respect of the first question for its national framework agreements, however it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. No patient level data is collected against each of the framework agreements and admissions data is not linked to homecare systems data. This reason for admission would also need to be coded correctly within the hospital records.
Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of NHS procurement processes for homecare medicines services in each of the last five years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is undertaking a piece of work to understand the issues in Homecare Medicines Service to inform any future improvement actions.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many patients are currently in receipt of homecare medicines services; what is the total cost to the NHS of homecare medicines services for the latest year for which figures are available; and what is the total number of (1) late deliveries, (2) incorrect deliveries, and (3) deliveries without the required attendance of a healthcare professional.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Clinical Homecare Association (NCHA) collates data and estimates approximately 500,000 patients are in receipt of a homecare medicines service in England with an estimated annual value of £3.2 billion. However, these figures have not been validated by the National Health Service.
To monitor industry trends, providers provide the same data set to the NCHA, allowing for the aggregation of all providers metrics. The NCHA reports that delivery performance of providers (delivery to patients on the agreed date) was 99.0% in 2020; 98.6% in 2021; and 98.8% in 2022.
NHS England collects data for its national framework agreements; however, it is not in a readily accessible form for analysis and would require significant manual review and analysis to provide. Arrangements for future reporting are being worked on and NHS England is undertaking a piece of work to understand the issues in homecare, so as to inform future improvement actions. A project by the National Homecare Medicines Committee to review the national Key Performance Indicators (KPIs) set is already underway with consultation due later this summer and final documents expected for approval in December 2023. Publication of performance against these KPIs is part of this project.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the review by Mark Hackett Homecare Medicines: Towards a Vision for the Future, published on 30 November 2011, when they will implement the recommendation contained in that review which states that "the NHS should pursue an immediate unbundling of homecare medical dispensing, delivery and associated service costs. The NHS should define these costs and reduce them from their current prices".
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
For the four national frameworks for homecare medicines and services agreements which NHS England’s Commercial Medicines Unit (CMU) manages on behalf of the National Health Service’s referring centres, all elements are unbundled for transparency of cost.
Regional homecare frameworks do not secure pricing for licensed medicines, instead they require homecare providers to supply medicines at the CMU contracted price for generic and branded medicines. In this way, all NHS-funded services routed through regional frameworks are 'unbundled', with competition applied during tenders to the service on both a technical and commercial basis.
Following the Hackett recommendations, the CMU and other local regional procurement teams have for some years now requested separate pricing from manufacturers for pharma-funded homecare medicines services during their branded medicines tendering process to secure ‘unbundled’ pricing, although manufacturers often submit the same price both for supply to hospital and supply to patient homes.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to implement the recommendations of the review conducted by Mark Hackett, 'Homecare Medicines: Towards a Vision for the Future', published in 2011; and what assessment they have made of the progress towards full implementation.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The recommendations of the 2011 Hackett review were implemented with the publications of the Royal Pharmaceutical Society’s ‘Professional Standards for Homecare Services in England’ in 2013 and in 2014 with the Royal Pharmaceutical Society’s ‘Handbook for Homecare Services in England’ to aid implementation of the 2013 standards.
Homecare medicines services deliver ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to the patient’s home with their consent. Homecare medicines services offer many benefits to patients and the National Health Service including patients receiving their medicines at home, reducing the need to visit secondary care services for example, hospital outpatient settings and improving access to new medicines for patients.