Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many technology appraisals NICE has undertaken for medicines which have successfully passed through the Early Access to Medicines Scheme; and how long it has taken for a NICE recommendation to be reached on each of those appraisals.
Answered by Lord O'Shaughnessy
To date, the National Institute for Health and Care Excellence (NICE) has published final technology appraisal guidance on 18 drugs with a positive Scientific Opinion through the Early Access to Medicines Scheme. Information on the length of time between receipt of a positive Scientific Opinion and final NICE technology appraisal guidance for each drug is attached due to the size of the data.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they plan to carry out a review into the number of prisoners with mental health issues in the UK in order to establish ways in which those suffering from serious mental health problems can be diverted to mental health care outside prison before or on release.
Answered by Lord O'Shaughnessy
We recognise that there are high numbers of people in prison with mental ill health, and it is essential that they are treated in the most appropriate environment for their needs.
Whilst some prisoners may be mentally unwell, and despite sometimes complex emotional and behavioural needs, it may not be clinically appropriate for them to be transferred to a mental health inpatient bed. There may be other services more appropriate to their needs that can be delivered outside inpatient mental health facilities.
There are no plans for a review. However there is already work underway to ensure people are diverted to mental health care services outside prison either before or on their release, and to improve mental health services within prisons.
Liaison and Diversion services operate at police stations and courts, to identify and assess people with vulnerabilities (substance misuse, mental health problems) and refer them into appropriate services and, where appropriate, away from the justice system altogether. Information from Liaison and Diversion assessments is used by the police and courts to inform sentencing decisions. These services cover 82% of the population with full roll out expected by 2020.
The Department of Health and Social Care and the Ministry of Justice have worked with NHS England and Public Health England to develop a Community Sentence Treatment Requirement ‘protocol’. The protocol aims to increase the use of community sentences with drug, alcohol and mental health treatment requirements as an alternative to custody to improve health outcomes and reduce reoffending. It sets out what is expected from all involved agencies to ensure improved access to mental health and substance misuse treatment for offenders who need it.
Work is also underway to improve support for prisoners whilst they are in prison. NHS England is focussing on an offender mental health pathway which will ensure that offenders are directed to the most appropriate intervention to their needs at the right time in the criminal justice system. The programme of work includes ensuring timely and appropriate transfers to a mental health hospital, timely remission to prison as part of a planned episode of care, and to ensure that those requiring treatment for mental ill health have access to high quality care.
New service specifications have been published for both low and medium secure hospitals as well as prison mental health services. The Prison Mental Health Specification embeds the Quality Standards for Prison Mental Health Services developed by the Royal College of Psychiatrists to ensure high quality care for all. Draft guidance for timely and appropriate transfers and remissions of care to and from a mental health hospital is currently in production.
Following release from prison, NHS England is working with partners to develop better pathways of care from custody. Drawing on learning from existing services we are investigating how best to ensure continuity of care post custody.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to provide improved mental health care for prisoners following the estimates produced by the Centre for Mental Health, published in June, which suggest that there are 21,000 mentally ill people in prison but only 3,600 beds available for mental health patients.
Answered by Lord O'Shaughnessy
We recognise that there are high numbers of people in prison with mental ill health, and it is essential that they are treated in the most appropriate environment for their needs.
Whilst some prisoners may be mentally unwell, and despite sometimes complex emotional and behavioural needs, it may not be clinically appropriate for them to be transferred to a mental health inpatient bed. There may be other services more appropriate to their needs that can be delivered outside inpatient mental health facilities.
There are no plans for a review. However there is already work underway to ensure people are diverted to mental health care services outside prison either before or on their release, and to improve mental health services within prisons.
Liaison and Diversion services operate at police stations and courts, to identify and assess people with vulnerabilities (substance misuse, mental health problems) and refer them into appropriate services and, where appropriate, away from the justice system altogether. Information from Liaison and Diversion assessments is used by the police and courts to inform sentencing decisions. These services cover 82% of the population with full roll out expected by 2020.
The Department of Health and Social Care and the Ministry of Justice have worked with NHS England and Public Health England to develop a Community Sentence Treatment Requirement ‘protocol’. The protocol aims to increase the use of community sentences with drug, alcohol and mental health treatment requirements as an alternative to custody to improve health outcomes and reduce reoffending. It sets out what is expected from all involved agencies to ensure improved access to mental health and substance misuse treatment for offenders who need it.
Work is also underway to improve support for prisoners whilst they are in prison. NHS England is focussing on an offender mental health pathway which will ensure that offenders are directed to the most appropriate intervention to their needs at the right time in the criminal justice system. The programme of work includes ensuring timely and appropriate transfers to a mental health hospital, timely remission to prison as part of a planned episode of care, and to ensure that those requiring treatment for mental ill health have access to high quality care.
New service specifications have been published for both low and medium secure hospitals as well as prison mental health services. The Prison Mental Health Specification embeds the Quality Standards for Prison Mental Health Services developed by the Royal College of Psychiatrists to ensure high quality care for all. Draft guidance for timely and appropriate transfers and remissions of care to and from a mental health hospital is currently in production.
Following release from prison, NHS England is working with partners to develop better pathways of care from custody. Drawing on learning from existing services we are investigating how best to ensure continuity of care post custody.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that (1) patients in the UK benefit from a continued supply of radiopharmaceuticals that meet the CE-marking for technical and safety standards, and (2) UK companies continue to be able to get their own items and equipment CE-marked and sold in Europe, post-Brexit and the UK’s withdrawal from Euratom.
Answered by Lord O'Shaughnessy
The safety and security of radioactive materials is a top priority for the Government. The United Kingdom already has robust domestic legislation in place to ensure that the keeping, movement and use of radioactive sources is tightly regulated, whether on nuclear sites or in hospitals. The UK’s regulatory regime is based on international regulatory requirements for sources informed by the International Atomic Energy Agency. The UK will continue to meet its international obligations in full and ensure that UK law and regulatory oversight continues to deliver the highest standards of safety, in line with the relevant international frameworks.
Radio pharmaceuticals are also subject to European medicines regulation which establishes a licensing regime and controls on the quality of materials, as well as manufacturing and distribution processes within Europe. In the UK, human medicines are subject to national human medicines legislation which transposes the requirements of the European regulatory regime. This regime is enforced by the Medicines and Healthcare Products Regulatory Agency (MHRA) and MHRA will continue to do so after our withdrawal from the European Union.
The Government's top priority for life sciences during the negotiations is to protect the safety of patients and ensure the integrity of cross-European public health systems. The Government will seek a mutually beneficial future partnership between the UK and EU that is in the interests of both sides, which builds on the convergence between our regulatory systems and gives business the maximum freedom to trade with and operate within European markets.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that patients in the UK continue to receive, post-Brexit, radiological examinations and radiotherapy procedures using equipment that meets European standards of technical capability and safety.
Answered by Lord O'Shaughnessy
New legislation implementing European Union patient safety standards for medical exposures in the United Kingdom comes into force on 6 February 2018. These regulations ensure that individuals are protected when exposed to ionising radiation from medical equipment for imaging or treatment purposes and include provisions relating to quality assurance, testing and use of medical radiological equipment.
The Department is working on ensuring the best outcome for the health and social care system following the UK’s exit from the EU. All relevant teams within the Department and other relevant Government departments and agencies are involved with this work and assessing the implications of the UK leaving the EU on their area. The UK expects to continue to be at the forefront of international activities in radiation protection through its activities with the International Atomic Energy Agency.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that provision is made for the implementation of European technical and safety standards in relation to medical radiation equipment used in the UK post-Brexit and the UK’s withdrawal from Euratom.
Answered by Lord O'Shaughnessy
New legislation implementing European Union patient safety standards for medical exposures in the United Kingdom comes into force on 6 February 2018. These regulations ensure that individuals are protected when exposed to ionising radiation from medical equipment for imaging or treatment purposes and include provisions relating to quality assurance, testing and use of medical radiological equipment.
The Department is working on ensuring the best outcome for the health and social care system following the UK’s exit from the EU. All relevant teams within the Department and other relevant Government departments and agencies are involved with this work and assessing the implications of the UK leaving the EU on their area. The UK expects to continue to be at the forefront of international activities in radiation protection through its activities with the International Atomic Energy Agency.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that patient radiation safety will not be compromised by less regulation of UK healthcare establishments providing patient care when compared to patients in Europe, once the UK has left Euratom.
Answered by Lord O'Shaughnessy
To ensure patient radiation safety in United Kingdom healthcare establishments, the Ionising Radiation (Medical Exposure) Regulations 2017 will come into force on 6 February 2018. These Regulations implement the medical exposure aspects of a European Directive (2013/59/Euratom) and provide regulation of medical exposures within the UK to the same standards as those of other European Union Member States. The Directive, and these Regulations, are not expected to be revised in the next 15 years.
The Government is fully aware of the importance of medical radioisotopes and the reliance on nuclear medicine for diagnostic procedures in the National Health Service. The UK’s ability to import medical isotopes from Europe and the rest of the world will not be affected by withdrawal from Euratom. It is in the interest of both the UK and EU to avoid disruption in the timely access of treatment to patients; and to ensure that cross-border trade with the EU is frictionless as possible. This will be part of the broader negotiations of the UK’s future relations with the EU.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure the future participation and collaboration of UK medical physicists in European medical radiation safety research projects, and to avoid the potential loss of UK scientific expertise in that area over time.
Answered by Lord O'Shaughnessy
The United Kingdom is a world leader in nuclear research and development and the Government is committed to maintaining and building on our lead in this important field. The Government has indicated that that it wishes to continue collaboration in nuclear research with UK medical physicists and European Union partners. We welcome dialogue with the EU and Euratom on options for future collaboration in this field and look forward to those discussions beginning in due course.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are undertaking to safeguard the continued involvement and funding of UK medical physicists on existing European medical radiation protection projects after leaving Euratom.
Answered by Lord O'Shaughnessy
The United Kingdom is a world leader in nuclear research and development and the Government is committed to maintaining and building on our lead in this important field. The Government has indicated that that it wishes to continue collaboration in nuclear research with UK medical physicists and European Union partners. We welcome dialogue with the EU and Euratom on options for future collaboration in this field and look forward to those discussions beginning in due course.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that the UK radiopharmaceutical supply after leaving Euratom might be relied upon to not have an impact on patients, in terms of (1) timeliness of delivery, and (2) the quantity supplied of radiopharmaceutical supplies produced (a) in the EU, and (b) outside the EU.
Answered by Lord O'Shaughnessy
The Government is fully aware of the importance of medical radioisotopes and the reliance on nuclear medicine for diagnostic procedures in the National Health Service. The United Kingdom’s ability to import medical isotopes from Europe and the rest of the world will not be affected by withdrawal from Euratom. It is in the interest of both the UK and European Union to avoid disruption in the timely access of treatment to patients; and to ensure that cross-border trade with the EU is frictionless as possible. This will be part of the broader negotiations of the UK’s future relations with the EU.