Lord Hunt of Kings Heath Portrait

Lord Hunt of Kings Heath

Labour - Life peer

Middle Level Bill Committee
4th Jun 2018 - 12th Jul 2018
Shadow Spokesperson (Health and Social Care)
8th Jan 2018 - 24th May 2018
Shadow Spokesperson (Cabinet Office)
27th Jun 2017 - 24th May 2018
Shadow Spokesperson (Education)
27th Jun 2017 - 24th May 2018
Shadow Spokesperson (Health)
6th Sep 2012 - 1st Nov 2017
Liaison Committee (Lords)
14th Dec 2015 - 11th Jul 2017
Shadow Deputy Leader of the House of Lords
8th Oct 2010 - 27th Jun 2017
House Committee (Lords)
14th Dec 2015 - 31st Aug 2016
Shadow Spokesperson (Cabinet Office)
8th Oct 2010 - 6th Sep 2012
Shadow Spokesperson (Home Affairs)
8th Oct 2010 - 6th Sep 2012
Leader's Group on Members Leaving the House (L)
1st Jul 2010 - 13th Jan 2011
Minister of State (Department of Energy and Climate Change)
5th Oct 2008 - 6th May 2010
Deputy Leader of the House of Lords
5th Oct 2008 - 6th May 2010
Minister of State (Department for Environment, Food and Rural Affairs) (Sustainable Development, Climate Change Adaptation and Air Quality) (also in the Department for Energy and Climate Change)
5th Oct 2008 - 9th Jun 2009
Parliamentary Under-Secretary (Ministry of Justice)
2nd Jul 2007 - 5th Oct 2008
Minister of State (Department of Health) (NHS Reform)
5th Jan 2007 - 28th Jun 2007
Parliamentary Under-Secretary (Department for Work and Pensions)
10th May 2005 - 4th Jan 2007
Merits of Statutory Instruments Committee
17th Dec 2003 - 7th May 2005
Parliamentary Under-Secretary (Department of Health)
1st Jan 1998 - 17th Mar 2003
Consolidation, &c., Bills (Joint Committee)
30th Apr 1998 - 11th Nov 1999


Select Committee Meeting
Wednesday 16th June 2021
15:00
Public Services Committee - Oral evidence
Subject: The role of public services in addressing child vulnerability
16 Jun 2021, 3 p.m.
At 3.00pm: Oral evidence
Anna Vignoles - Director at Leverhulme Trust
Polly Vizard - Associate Professorial Research Fellow and Associate Director at Centre for Analysis of Social Exclusion, London School of Economics and Political Science
Tina Haux - Director at The National Centre for Social Research
View calendar
Select Committee Meeting
Wednesday 23rd June 2021
15:00
Public Services Committee - Oral evidence
Subject: The role of public services in addressing child vulnerability
23 Jun 2021, 3 p.m.
At 3.00pm: Oral evidence
Sir Alan Wood CBE
Ms Cathy Ashley - Chief Executive at Family Rights Group
Professor Leon Feinstein - Director of the Rees Centre and Professor of Education and Children’s Social Care at Rees Centre, Department of Education, University of Oxford
At 4.00pm: Oral evidence
Simon Parker - Director for Transformation and Policy Capability at Policy Lab, Department for Education
Josh MacAlister - Chair at Independent Review of Children’s Social Care
View calendar
Select Committee Meeting
Thursday 24th June 2021
10:00
Public Services Committee - Oral evidence
Subject: The role of public services in addressing child vulnerability
24 Jun 2021, 10 a.m.
At 10.00am: Oral evidence
Cat Little - Director General, Public Spending at HM Treasury
Mark Sweeney - Director General, Cabinet Secretariat, Cabinet Office at Cabinet Office
Gus Jaspert - Director General and Interim Head of Number 10 Delivery Unit at Number 10 Delivery Unit
View calendar
Scheduled Event
Wednesday 30th June 2021
Oral questions - Main Chamber
Guidance restricting the performance of indoor amateur choirs to no more than 6 people
View calendar
Division Votes
Thursday 10th June 2021
Town and Country Planning (General Permitted Development etc.) (England) (Amendment) Order 2021
voted Aye - in line with the party majority
One of 122 Labour Aye votes vs 0 Labour No votes
Tally: Ayes - 260 Noes - 229
Speeches
Monday 14th June 2021
Covid-19: Vaccines and Pregnancy

My Lords, would it not be a good idea if the Chief Nursing Officer and the Chief Midwifery Officer gave …

Written Answers
Monday 14th June 2021
Medical Treatments: Technology
To ask Her Majesty's Government what plans they have to publish the (1) remit, (2) priorities, and (3) details of …
Early Day Motions
None available
Bills
Tuesday 25th May 2021
Organ Tourism and Cadavers on Display Bill [HL] 2021-22
A Bill to make amendments to the Human Tissue Act 2004 concerning consent to activities for the purposes of transplantation …
Tweets
Monday 14th June 2021
15:37
MP Financial Interests
None available

Division Voting information

During the current Parliamentary Session, Lord Hunt of Kings Heath has voted in 130 divisions, and 1 time against the majority of their Party.

23 Jun 2020 - Corporate Insolvency and Governance Bill - View Vote Context
Lord Hunt of Kings Heath voted Aye - against a party majority and against the House
One of 10 Labour Aye votes vs 104 Labour No votes
Tally: Ayes - 155 Noes - 326
View All Lord Hunt of Kings Heath Division Votes

Debates during the 2019 Parliament

Speeches made during Parliamentary debates are recorded in Hansard. For ease of browsing we have grouped debates into individual, departmental and legislative categories.

Sparring Partners
Lord Bethell (Conservative)
Parliamentary Under-Secretary (Department of Health and Social Care)
(95 debate interactions)
Baroness Williams of Trafford (Conservative)
Minister of State (Home Office)
(18 debate interactions)
Baroness Jolly (Liberal Democrat)
(11 debate interactions)
View All Sparring Partners
Department Debates
Department of Health and Social Care
(141 debate contributions)
Home Office
(44 debate contributions)
Department for International Trade
(14 debate contributions)
View All Department Debates
View all Lord Hunt of Kings Heath's debates

Commons initiatives

These initiatives were driven by Lord Hunt of Kings Heath, and are more likely to reflect personal policy preferences.

MPs who are act as Ministers or Shadow Ministers are generally restricted from performing Commons initiatives other than Urgent Questions.


Lord Hunt of Kings Heath has not been granted any Urgent Questions

Lord Hunt of Kings Heath has not been granted any Adjournment Debates

4 Bills introduced by Lord Hunt of Kings Heath


A Bill to require Her Majesty’s Government to introduce a Bill to regulate health and social care professions.


Last Event - 2nd Reading : House Of Lords
Friday 3rd February 2017

A Bill to make amendments to the Human Tissue Act 2004 concerning consent to activities for the purposes of transplantation outside the United Kingdom and consent for imported cadavers to be on display


Last Event - 1st Reading (Lords)
Tuesday 25th May 2021
(Read Debate)

A bill to amend the Human Tissue Act 2004 concerning consent to activities done for the purpose of transplantation outside the United Kingdom and consent for imported cadavers on display


Last Event - 1st Reading (Lords)
Tuesday 28th January 2020
(Read Debate)

A Bill to require Her Majesty's Government to introduce a Bill to regulate health and social care professions


Last Event - 1st Reading: House Of Lords
Tuesday 16th June 2015

Lord Hunt of Kings Heath has not co-sponsored any Bills in the current parliamentary sitting


282 Written Questions in the current parliament

(View all written questions)
Written Questions can be tabled by MPs and Lords to request specific information information on the work, policy and activities of a Government Department
1 Other Department Questions
8th Dec 2020
To ask Her Majesty's Government whether they undertook any review in 2018 into the reasons for the increase in the number of girls seeking gender reassignment; and if so, what was the outcome of that review.

The work by the Government Equalities Office has been superceded by NHS England commissioning an independent review into adolescent transgender healthcare, led by Dr Hilary Cass. One of the issues it will consider is the increase in the number of adolescents seeking the use of gender identity services.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
9th Mar 2021
To ask Her Majesty's Government how many care home residents and staff (1) tested positive for, and (2) died as a result of, COVID-19 in (a) England, (b) Northern Ireland, (c) Scotland, and (d) Wales, in (i) November 2020, (ii) December 2020, (iii) January, and (iv) February.

The information requested falls under the remit of the UK Statistics Authority. I have, therefore, asked the Authority to respond.

Professor Sir Ian Diamond | National Statistician

The Rt Hon. the Lord Hunt of Kings Heath OBE

House of Lords

London

SW1A 0PW

15 March 2021

Dear Lord Hunt,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking how many care home residents and staff (1) tested positive for, and (2) died as a result of, COVID-19 in (a) England, (b) Northern Ireland, (c) Scotland, and (d) Wales, in (i) November 2020, (ii) December 2020, (iii) January, and (iv) February (HL14039).

The Office for National Statistics (ONS) publishes statistics on deaths registered in England and Wales. Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. National Records for Scotland[1] and the Northern Ireland Statistics and Research Agency[2] are responsible for publishing statistics on deaths registered in Scotland and Northern Ireland respectively.

Table 1 below shows the number of deaths involving COVID-19 among care home residents registered for the months November 2020 to February 2021 in England and Wales. The term "care home residents" refers to all deaths where either (a) the death occurred in a care home or (b) the death occurred elsewhere but the place of residence of the deceased was recorded as a care home.

We do not hold any information on the number of care home staff who have died as a result of COVID-19 therefore we are not able to provide this information. The Department of Health and Social Care are responsible for data on care home infections.[3]

Yours sincerely,

Professor Sir Ian Diamond

Table 1: Number of deaths involving COVID-19 among care home residents registered from November 2020 to February 2021 in England and Wales[4],[5],[6],[7],[8],[9],[10]

Month

England

Wales

Nov-20

2,321

239

Dec-20

3,393

284

Jan-21

7,587

482

Feb-21

5,067

191

Source: Office for National Statistics

[1]https://www.nrscotland.gov.uk/

[2]https://www.nisra.gov.uk/

[3]https://www.gov.uk/government/organisations/department-of-health-and-social-care

[4] Deaths for England and Wales exclude non-residents.

[5] Figures are provisional for 2020 and 2021.

[6] The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U.071, U.072, U.099, U.109).

[7] Deaths "involving COVID-19" includes deaths that have COVID-19 mentioned anywhere on the death certificate, whether as underlying cause or not.

[8] These figures are calculated using the most up-to-date data we have available to get the most accurate estimates.

[9] Based on boundaries as of November 2020.

[10] Based on deaths registered in each calendar month.

Lord True
Minister of State (Cabinet Office)
27th Jan 2021
To ask Her Majesty's Government how many care home residents in England have died from COVID-19 (1) in hospital, (2) in hospices, and (3) in residential care and nursing homes, in total to date.

The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.

The Rt Hon. the Lord Hunt of Kings Heath

House of Lords

London

SW1A 0PW

04 February 2021

Dear Lord Hunt,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking how many care home residents in England have died from COVID-19 (1) in hospital, (2) in hospices, and (3) in residential care and nursing homes, in total to date (HL12649).

The Office for National Statistics (ONS) publishes mortality data that are compiled from information supplied when deaths are certified and registered as part of civil registration. The term ‘care home residents’ refers to all deaths where either (a) the death occurred in a care home or (b) the death occurred elsewhere but the place of residence of the deceased was recorded as a care home.

Table 1 below shows the number of deaths involving COVID-19 among care home residents by place of death, registered up to the 22nd January 2021 in England. We do not hold any information on the breakdown of residential or nursing homes therefore we have provided the number of care home residents who have died in a care home, which could be either residential or nursing care homes.

Yours sincerely,

Professor Sir Ian Diamond

Table 1: Number of deaths involving COVID-19 among care home residents by place of death registered up to 22nd January 2021, England[1][2][3][4][5][6]

Place of death

Number of deaths

Care home

23,324

Hospital

8,012

Hospice

70

Source: ONS

[1] All figures for 2020 and 2021 are provisional.

[2] Deaths for England exclude non-residents.

[3] The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U07.1 and U07.2).

[4] Deaths "involving COVID-19" includes deaths that had COVID-19 mentioned anywhere on the death certificate, whether as underlying cause or not.

[5] These figures are calculated using the most up-to-date data we have available to get the most accurate estimates.

[6] Based on boundaries as of November 2020.

Lord True
Minister of State (Cabinet Office)
19th Oct 2020
To ask Her Majesty's Government, further to the Written Answer by Lord True on 1 October (HL8184), which (1) processes, (2) structures, and (3) operations, of the Digital Data and Technology function were considered as part of the review they carried out over the summer.

The review was commissioned and overseen by the Chief Operating Officer for the Civil Service and Cabinet Office Permanent Secretary, Alex Chisholm. Announcements will be made in the usual way.

Lord True
Minister of State (Cabinet Office)
19th Oct 2020
To ask Her Majesty's Government, further to the Written Answer by Lord True on 1 October (HL8184), what were the terms of reference of the recent review into their Digital Data and Technology function.

The review was commissioned and overseen by the Chief Operating Officer for the Civil Service and Cabinet Office Permanent Secretary, Alex Chisholm. Announcements will be made in the usual way.

Lord True
Minister of State (Cabinet Office)
19th Oct 2020
To ask Her Majesty's Government, further to the Written Answer by Lord True on 1 October (HL8184), which members of the Digital Economy Council were invited to contribute to the review of their Digital Data and Technology function over the summer.

The review was commissioned and overseen by the Chief Operating Officer for the Civil Service and Cabinet Office Permanent Secretary, Alex Chisholm. Announcements will be made in the usual way.

Lord True
Minister of State (Cabinet Office)
16th Sep 2020
To ask Her Majesty's Government, when Doug Gurr will take up his role as an advisor to the Government Digital Service; what his role and responsibilities will be; and whether he will remain in post as head of Amazon UK.

As part of the wider Civil Service Modernisation and Reform programme, several members of the Digital Economy Council were invited to contribute to a review of HMG's Digital Data and Technology (DDaT) Function over the summer. The review was limited to the processes, structures and operations of the DDaT function, and did not consider particular strategies for government. The Cabinet Office will continue to consult members of the Digital Economy Council as it considers how to implement the recommendations. As always, robust measures are in place to manage possible conflicts and the perception of conflicts.

Lord True
Minister of State (Cabinet Office)
16th Sep 2020
To ask Her Majesty's Government what interests were declared by Doug Gurr as part of his appointment as an advisor to the Government Digital Service; and what plans they have to address any conflicts of interest.

As part of the wider Civil Service Modernisation and Reform programme, several members of the Digital Economy Council were invited to contribute to a review of HMG's Digital Data and Technology (DDaT) Function over the summer. The review was limited to the processes, structures and operations of the DDaT function, and did not consider particular strategies for government. The Cabinet Office will continue to consult members of the Digital Economy Council as it considers how to implement the recommendations. As always, robust measures are in place to manage possible conflicts and the perception of conflicts.

Lord True
Minister of State (Cabinet Office)
16th Sep 2020
To ask Her Majesty's Government whether Doug Gurr will advise on their cloud computing strategy in his role as advisor to the Government Digital Service.

As part of the wider Civil Service Modernisation and Reform programme, several members of the Digital Economy Council were invited to contribute to a review of HMG's Digital Data and Technology (DDaT) Function over the summer. The review was limited to the processes, structures and operations of the DDaT function, and did not consider particular strategies for government. The Cabinet Office will continue to consult members of the Digital Economy Council as it considers how to implement the recommendations. As always, robust measures are in place to manage possible conflicts and the perception of conflicts.

Lord True
Minister of State (Cabinet Office)
20th May 2020
To ask Her Majesty's Government what steps they took following the conclusion of Exercise Cygnus to ensure that the potential for staff absences to reach 50 per cent was built into business continuity planning in the event of a pandemic.

I refer the noble Lord to published documents, including for example the modelling of the Scientific Pandemic Influenza Group on Modelling from November 2018, which detailed a reasonable worst case scenario that up to 50% of the population could be ill - not that staff absences could reach 50%.

Lord True
Minister of State (Cabinet Office)
25th Feb 2020
To ask Her Majesty's Government why the G-Cloud 8 call-off contract agreed with Amazon Web Services in 2016 specified that Amazon Web Services had no liability for "direct loss, destruction, corruption, degradation or damage to the Buyer Data or the Buyer Personal Data or any copy of such Buyer Data".

It is the responsibility of individual buying authorities to agree terms and conditions with their chosen supplier when calling off from a framework agreement.

Specific terms and conditions agreed between parties when calling off from framework agreements are not reported back centrally to the Cabinet Office or the Crown Commercial Service.

Lord True
Minister of State (Cabinet Office)
25th Feb 2020
To ask Her Majesty's Government how many contracts they have agreed in the last five years with public cloud providers which specify that the server has no liability for direct loss, destruction, corruption, degradation or damage to the Buyer Data or the Buyer Personal Data or any copy of such Buyer Data.

It is the responsibility of individual buying authorities to agree terms and conditions with their chosen supplier when calling off from a framework agreement.

Specific terms and conditions agreed between parties when calling off from framework agreements are not reported back centrally to the Cabinet Office or the Crown Commercial Service.

Lord True
Minister of State (Cabinet Office)
28th Jan 2020
To ask Her Majesty's Government what assessment they have made of the impact of misinformation and disinformation on the last General Election; and what plans they have to mitigate any risks to the UK’s electoral system arising from such misinformation and disinformation.

The Government has a coordinated structure in place working with relevant organisations to identify and respond to emerging issues, and protect the safety and security of democratic processes. We have worked with a large number of organisations to do this, including social media companies and civil society organisations.

One way to combat the spread of misinformation or disinformation online and limit its potential impact on democratic debate is to ensure that people have the critical literacy skills and digital skills to enable them to assess and analyse the information they read online. In the Online Harms White Paper the Government committed to developing a new online media literacy strategy. This strategy will ensure a coordinated and strategic approach to online media literacy education and awareness for children, young people and adults. The Government is also taking action to increase public awareness with our Don’t Feed The Beast campaign. This aims to educate and empower those who see, inadvertently share and are affected by false and misleading information.

The Government remains committed to the integrity of UK elections and ensuring they are secure and fit for the modern age. We have announced that it will implement an imprints regime for digital election material. This will ensure greater transparency and make it clearer to the electorate who has produced and promoted online political materials.

Earl Howe
Deputy Leader of the House of Lords
15th Dec 2020
To ask Her Majesty's Government what assessment they have made of the impact of (1) pressure from activist groups, and (2) decisions not to allow academics to speak at universities, on the amount of research commissioned by universities into the number (a) of girls presenting with gender dysphoria at clinics, and (b) of people who regret that they undertook medical treatment for their gender dysphoria; and what steps, if any, they intend to take in response.

Universities are independent, autonomous organisations and are therefore responsible for their decisions relating to research priorities and which activities to support.

Lord Callanan
Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)
7th Jan 2020
To ask Her Majesty's Government what safeguards are in place to ensure that Amazon staff working on the contract with Amazon to provide health data from the NHS will receive a living wage and be treated with dignity and decency.

The Government is committed to ensuring fair pay and we are clear that all workers should be treated with dignity and decency. We have announced that in April 2020 the National Living Wage (NLW) will increase by 6.2 per cent to £8.72 for those aged 25 and over. This increase will mean that a full-time worker will see their pay increase by £930 over the year.

The Government considers the expert and independent advice of the Low Pay Commission (LPC) when setting the rates. The LPC draws on a wide range of analysis to make its recommendations – this includes independent research, stakeholder evidence and a consideration of impacts on businesses.

Workers who believe that they have been underpaid the minimum wage or treated unfairly at work may wish to contact the Advisory, Conciliation and Arbitration service (Acas) for impartial information and advice.

6th Jan 2021
To ask Her Majesty's Government whether they have agreed (1) a budget, and (2) a programme, to support the legacy of the Birmingham Commonwealth Games 2022.

Birmingham and the West Midlands region will benefit from a £778 million investment to stage the 2022 Commonwealth Games, including £594 million of funding from central government. This significant investment is driving legacy opportunities across both the West Midlands and UK, including job creation, community and sports facilities and a timely boost to businesses.

An additional £24 million investment from the government and the West Midlands Combined Authority to create a Tourism, Trade and Investment Programme will ensure the city, region and the UK can take advantage of the economic opportunities hosting the Games provides.

Games legacy is being planned and delivered by a collaboration of Games partners including the Department for Digital Culture, Media and Sport, Birmingham City Council, the West Midlands Combined Authority and the Organising Committee. A Legacy Plan is being prepared and will be published later in 2021.

Baroness Barran
Parliamentary Under-Secretary (Department for Digital, Culture, Media and Sport)
16th Sep 2020
To ask Her Majesty's Government what assessment they have made of the need to regulate the relationship between technology companies and the Government.

The Government’s approach to governing digital technologies seeks to drive growth and innovation across the UK, while ensuring the safety and security of the UK's citizens and promoting our democratic values.

Our approach to governing digital technology companies will be pro-innovation, agile and proportionate and we will ensure our regulators are equipped for the digital age. This will build confidence and clarity for businesses and consumers, boost innovation and investment, and reinforce the UK’s position as a global leader in innovation-friendly regulation.

Baroness Barran
Parliamentary Under-Secretary (Department for Digital, Culture, Media and Sport)
4th Mar 2020
To ask Her Majesty's Government what plans they have to establish a UK National Capability which treats data held by public bodies in the UK as a national asset.

Data is a critical resource for government, which enables more efficient, effective public services. The Public Accounts Committee held an inquiry in the use of data across government in June 2019. Government accepted many of its recommendations in late January 2020. DCMS and Cabinet Office are aiming to write to the Committee to set out our plans for the use of data across government.

While there are no specific plans for establishing a UK National Capability, DCMS is continuing to lead cross-government work to progress the UK's National Data Strategy, so that we can fully and responsibly unlock the power of data, for people and organisations across the UK.

We are not waiting for the strategy to refine our approach to data as a strategic asset. One recent example is the announcement in the March 2020 Budget that HM Land Registry, which holds location data that is important for the government and the economy, will be provided with £392 million to transition from a Trading Fund into part of central government.

Baroness Barran
Parliamentary Under-Secretary (Department for Digital, Culture, Media and Sport)
4th Mar 2020
To ask Her Majesty's Government what assessment they have made of the government of the United States’ Cloud Smart strategy; and what consideration they have given to adopting a similar strategy.

Emerging technologies can enable effective use of data for improving public services. DCMS is continuing to lead cross-government work to progress the UK's National Data Strategy, so that we can fully and responsibly unlock the power of data, for people and organisations across the UK.

The Government Digital Service (GDS) conducted extensive user research in August 2019 on the UK's Cloud Strategy which concluded that Cloud First is as relevant to government today as it was when it was introduced, and will remain a flagship technology policy.

This research considered international cloud strategies, such as Cloud Smart in the US, but concluded that Cloud First was a better fit for the UK government. This is for a number of reasons, including that many departments consider Cloud First to be a core part of their technology strategy, and that there is a need for government to provide a strong cloud message from the centre to encourage transformation. The user research showed that Cloud Smart was seen as “watering down” the high-level cloud message and many participants considered the name “Cloud Smart” to be confusing.

Baroness Barran
Parliamentary Under-Secretary (Department for Digital, Culture, Media and Sport)
4th Mar 2020
To ask Her Majesty's Government what assessment they have made of the government of Germany’s GAIA-X strategy; and what consideration they have given to adopting a similar strategy.

Up-to-date infrastructure and governance models are important parts of effective government data use. DCMS is continuing to lead cross-government work to progress the UK's National Data Strategy, so that we can fully and responsibly unlock the power of data, for people and organisations across the UK.

The Cabinet Office has recently published guidance for government departments on choosing a cloud strategy, and continues to regularly review similar strategies taken by other countries to assess their relevance for the UK government.

DCMS and Cabinet Office are also focused on producing a plan for the use of data across government. Initiatives like Germany’s GAIA-X strategy will be important to consider as my officials continue to develop our policy in this area.

Baroness Barran
Parliamentary Under-Secretary (Department for Digital, Culture, Media and Sport)
7th Dec 2020
To ask Her Majesty's Government what assessment they have made of whether all guidance provided by the PHSE Association to schools, including the resources produced by other organisations recommended in that guidance, is in line with (1) the law, and (2) the current advice issued by the Department for Education.

The department does not comment on resources from subject associations or other providers. The statutory Relationships, Sex and Health Education (RSHE) guidance sets out clear advice on choosing resources: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education. Schools should assess each resource they intend to use, to ensure that it is appropriate for the age and maturity of pupils, and sensitive to their needs.

The RSHE guidance and training resources have been designed to equip all schools to provide comprehensive teaching in these areas in an age-appropriate way. The guidance and materials should give schools the confidence to construct a curriculum that meets the needs of their pupils and reflects a diversity of views and backgrounds, whilst fostering all pupils’ respect for others, understanding of healthy relationships, and ability to look after their own wellbeing.

The department expects schools to consult with parents and to make reasonable decisions about the content of their curriculum.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
29th Sep 2020
To ask Her Majesty's Government what plans they have to meet with organisations which work with care leavers to discuss access to digital devices and the internet.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
29th Sep 2020
To ask Her Majesty's Government what plans they have to ensure that all services provided by local authorities for care leavers include access to a digital device and the internet.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
29th Sep 2020
To ask Her Majesty's Government what plans they have to ensure every care leaver in England has access to a digital device and the internet for at least 12 months when they first live independently.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
29th Sep 2020
To ask Her Majesty's Government what plans they have to improve the uptake of their scheme to provide digital devices and internet access for care leavers.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
8th Jun 2020
To ask Her Majesty's Government whether they are satisfied that the process being adopted by Ofqual for exceptional arrangements for awarding calculated grades in GCSEs, AS and A Levels takes sufficient account of recent improvement trends in the educational establishment the student is from.

Ofqual conducted a public consultation from 15-29 April, seeking views on aspects of the proposed assessment arrangements for GCSEs, AS and A levels, including standardisation of centre assessment grades. Ofqual received over 12,500 responses to their consultation, and on 22 May they published their decisions.

Ofqual have decided not to include the trajectory of exam centres’ results in the statistical standardisation process. This is due to potential unfairness caused by the unreliability of any trajectory predictions and the disadvantage that this might cause students in those centres with stable results.

Whilst this is a matter for Ofqual as the independent regulator of qualifications, I am satisfied that Ofqual’s approach is the best solution given these extraordinary circumstances.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
28th Jan 2020
To ask Her Majesty's Government what progress they have made in updating their School Food Standards to reduce sugar consumption, as set out in their childhood obesity plan for action, published in June 2018.

We are working with Public Health England to update the School Food Standards in relation to sugar and fibre.

On 7 May and 6 November 2019, we brought together an advisory group comprising of key stakeholders in the food, nutrition and health sectors. These stakeholders hold a wide breadth of knowledge and expertise in relation to school food. This was to discuss the proposed updates to the standards; we are considering those views and the next steps.

We will release more information on our plans for the update shortly.

Lord Agnew of Oulton
Minister of State (HM Treasury)
20th Jan 2020
To ask Her Majesty's Government what plans they have to review the remit of the Office for Students so that it can make direct grants to the Royal Birmingham Conservatoire commensurate with (1) the level of similar institutions in London, and (2) its national status.

Birmingham City University, of which The Royal Birmingham Conservatoire is a part, is registered with the Office for Students (OfS) in the approved (fee cap) category of the OfS’s register. It is funded by government, via the OfS, in a way that is consistent with the approach the OfS takes to other such providers, including those in London. While the Secretary of State for Education issues strategic guidance to the OfS, including its funding priorities, the OfS is ultimately responsible for funding decisions. The OfS is planning to review its funding method, including for specialist providers, and will consult on those changes in due course.

We do not have any plans to review the remit of the OfS in relation to their funding powers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
20th Jan 2020
To ask Her Majesty's Government what assessment they have made of whether funding for the Royal Birmingham Conservatoire is consistent with funding for similar institutions based in London.

Birmingham City University, of which The Royal Birmingham Conservatoire is a part, is registered with the Office for Students (OfS) in the approved (fee cap) category of the OfS’s register. It is funded by government, via the OfS, in a way that is consistent with the approach the OfS takes to other such providers, including those in London. While the Secretary of State for Education issues strategic guidance to the OfS, including its funding priorities, the OfS is ultimately responsible for funding decisions. The OfS is planning to review its funding method, including for specialist providers, and will consult on those changes in due course.

We do not have any plans to review the remit of the OfS in relation to their funding powers.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
13th Jan 2020
To ask Her Majesty's Government what assessment they have made of the survey by the British Association for Social Workers, launched in May 2018, which found that social workers spend 20 per cent of their time in direct contact with families, with one out of three social workers not working directly with children.

Securing further improvement in the quality of the children’s social care system is a priority. We welcome the contribution both of these reports make to these efforts. Whilst local authorities are responsible for the deployment of child and family social workers, the government is continuing to invest in practice improvement. This includes our £84 million investment in the Strengthening Families, Protecting Children programme; and securing better research and evidence about practice and the social work workforce such as through the What Works for Children’s Social Care. Our large-scale longitudinal study of child and family social workers will provide significant insights into the experience of child and family social workers and will help both the government and employers identify priorities for action.

Lord Agnew of Oulton
Minister of State (HM Treasury)
13th Jan 2020
To ask Her Majesty's Government what assessment they have made of the report by Frontline and the Centre for Public Impact A Blueprint for Children's Social Care, published on 20 November 2019, outlining a new model for children’s social care that allows social workers to spend more time with families and that aims to improve standards through increased supervision and transparency.

Securing further improvement in the quality of the children’s social care system is a priority. We welcome the contribution both of these reports make to these efforts. Whilst local authorities are responsible for the deployment of child and family social workers, the government is continuing to invest in practice improvement. This includes our £84 million investment in the Strengthening Families, Protecting Children programme; and securing better research and evidence about practice and the social work workforce such as through the What Works for Children’s Social Care. Our large-scale longitudinal study of child and family social workers will provide significant insights into the experience of child and family social workers and will help both the government and employers identify priorities for action.

Lord Agnew of Oulton
Minister of State (HM Treasury)
10th Nov 2020
To ask Her Majesty's Government what plans they have to amend the Equality Act 2010 as to change the protected characteristic of "sex" to "gender".

The Government has no plans to do this.

Baroness Berridge
Parliamentary Under-Secretary (Department for Education)
12th May 2020
To ask the Senior Deputy Speaker what assessment has been made of the time available to members of the House to participate in (1) Private Notice Questions, and (2) urgent questions from the House of Commons repeated as statements, which are being considered in Virtual Proceedings; and what plans there are to change the time available.

The Procedure Committee agreed on 11 May that the time allowed for a Private Notice Question should be increased from ten minutes to fifteen minutes. This change was approved by the House on 14 May. The allocation of time for the answers to Urgent Questions in the House of Commons repeated in the form of Oral Statements remains as if it were taking place in the Chamber, and there are currently no plans to extend the time allowed for these. The Procedure Committee will continue to keep these arrangements under review.

6th Jan 2021
To ask Her Majesty's Government what plans they have to hold discussions with the Birmingham Commonwealth Games 2022 organising committee and Network Rail over the case for improving the signage at Birmingham New Street Station for the Birmingham Commonwealth Games 2022.

The West Midlands Combined Authority, the Birmingham 2022 Organising Committee and Birmingham City Council are already working together and with other transport partners, on transport preparations and planning for the Games, covering the transportation of spectators, athletes and the Games Family, whilst at the same time ensuring that any disruption to transport users is kept to a minimum.

Baroness Vere of Norbiton
Parliamentary Under-Secretary (Department for Transport)
7th Jun 2021
To ask Her Majesty's Government whether the discount rates applied to health technology assessments are being included in the review by the National Institute for Health and Care Excellence of health technology assessment methods.

The National Institute for Health and Care Excellence (NICE) is currently reviewing the methods and processes it uses in the development of its technology appraisal and highly specialised technologies recommendations, including the discount rate. NICE expects to consult on a draft programme manual in summer, with implementation of the changes from early 2022.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jun 2021
To ask Her Majesty's Government what date they plan to launch the Innovative Medicines Fund.

Proposals for the Innovative Medicines Fund are in development and we expect NHS England and NHS Improvement and the National Institute for Health and Care Excellence to lead an engagement exercise later this year. A detailed timescale will be confirmed in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jun 2021
To ask Her Majesty's Government how they plan to measure the success of the Medical Technologies Directorate.

The new Medical Technologies Directorate within the Department was announced in May 2021. The Directorate is currently at a formative stage and recruitment to roles is about to commence. Although timelines are being finalised, we expect to publish a strategy including details of the remit, priorities, leadership, budget and accountabilities in early 2022. Success criteria will be determined once the Directorate budget has been finalised and the strategy has been finalised through engagement with industry and others.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jun 2021
To ask Her Majesty's Government what plans they have to publish the (1) remit, (2) priorities, and (3) details of the (a) leadership, (b) budget, and (c) lines of accountability, of the new Medical Technologies Directorate.

The new Medical Technologies Directorate within the Department was announced in May 2021. The Directorate is currently at a formative stage and recruitment to roles is about to commence. Although timelines are being finalised, we expect to publish a strategy including details of the remit, priorities, leadership, budget and accountabilities in early 2022. Success criteria will be determined once the Directorate budget has been finalised and the strategy has been finalised through engagement with industry and others.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2021
To ask Her Majesty's Government what progress they have made on securing cross-party consensus on reforming the adult social care system.

In March 2020, the Secretary of State for Health and Social Care wrote to Parliamentarians to initiate cross-party discussions. These discussions were paused as a result of COVID-19. As we emerge from the pandemic, we will be engaging with stakeholders and Parliamentarians to discuss priorities for reform.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Apr 2021
To ask Her Majesty's Government how many clinical negligence cases brought against the NHS in England were funded by (1) a conditional fee agreement, (2) legal aid, or (3) by some other form of funding, in each of the last five years for which figures are available; and how many cases in each of these categories resulted in a compensation payment.

The following table shows the number of cases notified in each of the previous five years under NHS Resolution’s clinical negligence indemnity schemes. This data excludes those cases falling under the Existing Liabilities Scheme for General Practice as this scheme mainly covers inherited liabilities.

2015/16

2016/17

2017/18

2018/19

2019/20

Conditional fee agreement

8,283

8,389

8,444

8,303

8,760

Legal Aid

305

234

157

148

118

Other funding

2,377

2,063

2,067

2,221

2,750

Information on the number of cases in each category which then lead to a compensation payment is not held in the format requested and could only be obtained at disproportionate cost.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Mar 2021
To ask Her Majesty's Government, further to the NHS referral to treatment (RTT) waiting times data January 2021, published on 11 March, how many patients in each acute trust in England have been waiting more than one year for treatment; and how many of those have been waiting for (1) 52 to 56, (2) 57 to 60, (3) 61 to 64, (4) 65 to 68, (5) 69 to 72, (6) 73 to 76, (7) 77 to 80, (8) 81 to 84, (9) 85 to 88, (10) 89 to 92, (11) 93 to 96, (12) 97 to 100, (13) 101 to 104, and (14) 105 and more, weeks.

Official statistics on National Health Service referral to treatment (RTT) waiting times published by NHS England and NHS Improvement show there were 304,044 patients waiting one year or more for treatment in England in January 2021. Tables showing the number of patients in each sustainability and transformation partnership and acute trust who have waited in excess of 52 weeks is attached due to the size of the data. Information for integrated care system areas is not held in the format requested. The information relating to other time periods is not held in the format requested.

NHS England and NHS Improvement will be including this data as part of their official published RTT monthly data collection for 2021-22. This will show the number of patients

waiting for over a year into weekly time bands, from 52-53 weeks to more than 104 weeks. This information will become available from June 2021.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Mar 2021
To ask Her Majesty's Government, further to the NHS referral to treatment (RTT) waiting times data January 2021, published on 11 March, how many patients in each sustainability and transformation partnership and integrated care system area have been waiting more than one year for treatment; and how many of those have been waiting for (1) 52 to 56, (2) 57 to 60, (3) 61 to 64, (4) 65 to 68, (5) 69 to 72, (6) 73 to 76, (7) 77 to 80, (8) 81 to 84, (9) 85 to 88, (10) 89 to 92, (11) 93 to 96, (12) 97 to 100, (13) 101 to 104, and (14) 105 and more, weeks.

Official statistics on National Health Service referral to treatment (RTT) waiting times published by NHS England and NHS Improvement show there were 304,044 patients waiting one year or more for treatment in England in January 2021. Tables showing the number of patients in each sustainability and transformation partnership and acute trust who have waited in excess of 52 weeks is attached due to the size of the data. Information for integrated care system areas is not held in the format requested. The information relating to other time periods is not held in the format requested.

NHS England and NHS Improvement will be including this data as part of their official published RTT monthly data collection for 2021-22. This will show the number of patients

waiting for over a year into weekly time bands, from 52-53 weeks to more than 104 weeks. This information will become available from June 2021.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Mar 2021
To ask Her Majesty's Government, further to the NHS referral to treatment (RTT) waiting times data January 2021, published on 11 March, how many patients in England have been waiting more than one year for treatment; and how many of those have been waiting for (1) 52 to 56, (2) 57 to 60, (3) 61 to 64, (4) 65 to 68, (5) 69 to 72, (6) 73 to 76, (7) 77 to 80, (8) 81 to 84, (9) 85 to 88, (10) 89 to 92, (11) 93 to 96, (12) 97 to 100, (13) 101 to 104, and (14) 105 and more, weeks.

Official statistics on National Health Service referral to treatment (RTT) waiting times published by NHS England and NHS Improvement show there were 304,044 patients waiting one year or more for treatment in England in January 2021. Tables showing the number of patients in each sustainability and transformation partnership and acute trust who have waited in excess of 52 weeks is attached due to the size of the data. Information for integrated care system areas is not held in the format requested. The information relating to other time periods is not held in the format requested.

NHS England and NHS Improvement will be including this data as part of their official published RTT monthly data collection for 2021-22. This will show the number of patients

waiting for over a year into weekly time bands, from 52-53 weeks to more than 104 weeks. This information will become available from June 2021.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2021
To ask Her Majesty's Government which national body or agency is responsible for conducting overarching, independent investigations into patient safety concerns in residential care homes in England.

The Healthcare Safety Investigation Branch (HSIB) can investigate individual safety concerns in care homes if the patient’s care is National Health Service-funded and the referral meets their investigation criteria.

The Care Quality Commission (CQC) monitors, inspects and regulate services to ensure they meet fundamental standards of quality and safety, while the local authority takes the lead in safeguarding cases. As part of this, the CQC inspects and rates residential care homes and nursing homes, which includes assessing how safe care homes are and taking action to protect people from harm and to hold those responsible for poor care to account. There are cases where both agencies may be involved. Complaints can also be investigated by the Health and Safety Executive, Health Service Ombudsman or Local Government Ombudsman.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2021
To ask Her Majesty's Government what plans they have to extend the remit of the Healthcare Safety Investigative Branch to conduct overarching, independent investigations into patient safety concerns in residential care homes in England.

The Healthcare Safety Investigation Branch (HSIB) conducts independent investigations of patient safety concerns in National Health Service-funded care across England. Currently, it can investigate patient safety concerns in care homes if the patient’s care is NHS-funded and meets the HSIB’s criteria for its national investigations. There are also plans in place to amend the NHS Health and Care Bill to extend the HSIB’s remit to identify and address patient safety risks in the provision of NHS services and other healthcare services in England.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2021
To ask Her Majesty's Government what guidance they provide to NHS commissioners on the principles of value-based procurement (VBP); whether such commissioners have to abide by those principles when making decisions on the provision of healthcare products and services to patients; if not, what plans they have to ensure that they do; and when they estimate that NHS Supply Chain will publish the results of its pilot programmes on VBP.

The Public Contract Regulations (PCR) 2015 form part of the procurement landscape alongside the NHS (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 (PPCCR). Made under Section 75 of the Health and Social Care Act 2012, the PPCCR apply to NHS England and NHS Improvement and clinical commissioning groups and are enforced by NHS England and NHS Improvement. Commissioners should ensure that they comply with both regimes when procuring healthcare services.

Regulation 68 of the PCR allows contracting authorities to determine the most economically advantageous tender and the lowest cost by using a life-cycle costing approach which includes all costs over the life cycle of works, supplies or services. Life-cycle costing is the key principle behind value based procurement. NHS Supply Chain has undertaken eight pilot studies with National Health Service trusts to assess how value based procurement can drive sustainable increased savings and improve patient outcomes in the NHS. The findings will be published later in the year and will then then be presented to and discussed with the NHS.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2021
To ask Her Majesty's Government whether the Public Health England guidance COVID-19: Guidance for maintaining services within health and care settings: Infection prevention and control recommendations, published on 21 January, applies to adult social care in England; and if not, why not.

The infection prevention and control (IPC) principles within the current guidance apply to healthcare staff in all healthcare settings, but do not apply to adult social care settings in England. The relevant guidance for workers in adult social care is the ‘How to Work Safely’ guidance documents, which must be followed to minimise the risk of transmission.

The evidence base and core principles informing the IPC guidance are the same as those that inform the 'How to Work Safely’ guidance for adult social care. The difference being in the implementation stage, where the many distinct adult social care settings require balanced risk assessments to be undertaken.

Copies of the guidances Personal protective equipment (PPE) – resource for care workers delivering homecare (domiciliary care) during sustained COVID-19 transmission in the UK and Personal protective equipment (PPE) – resource for care workers working in care homes during sustained COVID-19 transmission in England are attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2021
To ask Her Majesty's Government, further to their White Paper Integration and innovation: working together to improve health and social care for all, published on 11 February, what plans they have to provide clarity on the scope and limits of competitive tendering in the NHS; and what steps they are taking to reduce the level of bureaucracy for NHS commissioners and providers.

The National Health Service is currently consulting on the proposal for a new provider selection regime. The new regime is intended to provide significantly more flexibility to make decisions about arranging health care services in a streamlined way, including without competitive tendering, where this can be shown to be in the best interests of patients, taxpayers and the population. The new regime will be supported by regulations and statutory guidance, which will be informed by the results of the consultation. All other procurement will continue to be subject to Cabinet Office procurement processes.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 4 March (HL13668), what comparison they have made of the cost of Liothyronine (T3) in (1) the UK, and (2) EU member states; and what assessment they have made of any such comparison.

The Department has made no such comparison or assessment. All United Kingdom marketing authorisation holders of liothyronine are obliged to ensure that the product complies with the minimum standard as specified in the British Pharmacopoeia monograph for liothyronine tablets. Liothyronine on the market in European Union Member States may not comply with the updated British Pharmacopoeia monograph and therefore would not be considered therapeutically equivalent. Therefore, price comparisons would not be ‘like for like’.

In the UK, several marketing authorisations have been granted for liothyronine since 2016 and the reimbursement price has slowly been reducing as a direct response to more competition in the market.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Mar 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, published in October 2020, what steps they are taking to develop a national strategic focus on adapting NHS work systems to mitigate any risks associated with staff fatigue.

Following extensive engagement with front line staff, NHS England and NHS Improvement recently issued a suite of online products to support excellence in infection prevention and control measures. These products propose actions to tackle fatigue, including creating a culture of kindness and support, an environment which allows staff to speak up and a focus on changing behaviours in non-clinical areas, where staff have been found to be at greater risk of contracting COVID-19.

The National Health Service has put in place a national health and wellbeing offer, which will be maintained during 2021/22 and includes access to a confidential helpline and text service, a range of apps and an online portal of guidance and materials. The content of this offer will continue to be refreshed, based on staff feedback, usage rates and evidence of outcomes.

In November 2020, funding of £15 million was announced to establish 40 mental health and wellbeing hubs nationally. Twenty-two hubs are now active with the remaining due to mobilise by spring 2021. The NHS People Plan also puts health and wellbeing at its core. This includes a new wellbeing guardian role which will ensure board level scrutiny of health and wellbeing support for staff; continued support for staff to get to work and free car parking; a focus on healthy working environments and safe spaces for staff to rest and recuperate; and support to take breaks and annual leave.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Mar 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, published in October 2020, what steps they are taking to support NHS staff who have experienced fatigue and emotional distress during the COVID-19 pandemic; and what assessment they have made of the impact of such effects on staff on the NHS’s ability (1) to mitigate against nosocomial transmission, and (2) to respond to any further rise, of COVID-19.

Following extensive engagement with front line staff, NHS England and NHS Improvement recently issued a suite of online products to support excellence in infection prevention and control measures. These products propose actions to tackle fatigue, including creating a culture of kindness and support, an environment which allows staff to speak up and a focus on changing behaviours in non-clinical areas, where staff have been found to be at greater risk of contracting COVID-19.

The National Health Service has put in place a national health and wellbeing offer, which will be maintained during 2021/22 and includes access to a confidential helpline and text service, a range of apps and an online portal of guidance and materials. The content of this offer will continue to be refreshed, based on staff feedback, usage rates and evidence of outcomes.

In November 2020, funding of £15 million was announced to establish 40 mental health and wellbeing hubs nationally. Twenty-two hubs are now active with the remaining due to mobilise by spring 2021. The NHS People Plan also puts health and wellbeing at its core. This includes a new wellbeing guardian role which will ensure board level scrutiny of health and wellbeing support for staff; continued support for staff to get to work and free car parking; a focus on healthy working environments and safe spaces for staff to rest and recuperate; and support to take breaks and annual leave.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Mar 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, published in October 2020, what steps they are taking to develop staff health and wellbeing initiatives to assist with the emotional impact of the COVID-19 pandemic.

A comprehensive package of health and wellbeing services are in place for National Health Service staff, including helplines for counselling and support and free access to well-being apps. An extra £30 million has been invested in enhanced mental and occupational health support services and mental health hubs offering outreach and assessment services to help frontline staff receive rapid access to evidence based mental health services.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 February (HL13177), whether an intervention under the Health Service Medical Supplies (Costs) Act 2017 has taken place to control the cost of Liothyronine (T3); and if not, why not.

No such intervention has taken place. Several marketing authorisations have been granted for liothyronine since 2016 and the reimbursement price has been reducing as a direct response to more competition in the market.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals:management of the risk – a prospective safety investigation, published in October 2020, what steps they are taking to provide clarity about national responsibilities, ownership and process for the development of national infection prevention and control guidance.

We will work with partners to develop a transparent process to co-ordinate the development, dissemination and implementation of national guidance across the healthcare system to minimise the risk of nosocomial transmission of COVID-19. This includes agreeing roles and responsibilities, a clear process and timescales with NHS England and NHS Improvement, Public Health England and other system partners for infection prevention and control guidance development or review at a national and system level.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, published in October 2020, what steps they are taking to ensure that (1) NHS Trusts can comply with national infection prevention and control guidance and (2) hospital design takes account of (a) how staff interact in non-clinical areas, and (b) the way in which those interactions may increase the risk of nosocomial transmission.

Individual National Health Service organisations are responsible for implementing infection prevention and control measures in line with Public Health England’s national infection prevention and control (IPC) guidance to minimise in-hospital transmission of COVID-19 and support patient safety. The actions each organisation undertakes to meet the national IPC guidance must take into account the design of their estate and interactions between staff in both clinical and non-clinical areas.

NHS England and NHS Improvement’s ten key actions for boards on IPC and testing published on 17 November and revised on 23 December, emphasises the importance of organisations ensuring that their staff practise good hygiene, maintain social distancing, avoid car sharing, wear appropriate personal protective equipment at work including face masks in non-clinical settings and minimise movement between COVID-19 and non-COVID-19 areas. A copy of these actions is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2021
To ask Her Majesty's Government, further to the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, published in October 2020, what assessment they have made of the impact of hospital design on the transmission of infection; and what plans they have to issue new guidance on staff flow and interaction to mitigate that risk.

Individual National Health Service organisations are responsible for implementing infection prevention and control measures in line with Public Health England’s national infection prevention and control (IPC) guidance to minimise in-hospital transmission of COVID-19 and support patient safety. The actions each organisation undertakes to meet the national IPC guidance must take into account the design of their estate and interactions between staff in both clinical and non-clinical areas.

NHS England and NHS Improvement’s ten key actions for boards on IPC and testing published on 17 November and revised on 23 December, emphasises the importance of organisations ensuring that their staff practise good hygiene, maintain social distancing, avoid car sharing, wear appropriate personal protective equipment at work including face masks in non-clinical settings and minimise movement between COVID-19 and non-COVID-19 areas. A copy of these actions is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2021
To ask Her Majesty's Government what actions they took to improve (1) the efficacy, and (2) the capacity, of hospital ventilation systems following the publication of the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation in October 2020.

The current National Health Service infection prevention control principles recommend healthcare settings undertake a series of interventions to reduce the risk of transmission of infection, including on cleaning and decontamination of the environment and shared equipment and on ventilation.

In addition, the Health Technical Memorandum (HTM) 03-01: Specialised ventilation for healthcare premises is currently being updated and is going through final draft review and approval processes as is normal for all technical guidance. HTMs give comprehensive advice and guidance on the design, installation and operation of specialised building and engineering technology used in the delivery of healthcare.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2021
To ask Her Majesty's Government, what steps they are taking to ensure that the safety recommendations made in the report by the Healthcare Safety Investigation Branch COVID-19 transmission in hospitals:management of the risk – a prospective safety investigation, published in October 2020, are implemented.

The Department has worked closely with system partners to give careful consideration to the recommendations made and have accepted those recommendations that have been directed at the Department. Detailed actions outlining how the Department intends to implement the recommendations, are set out in our response to the report which is expected to be published by the Healthcare Safety Investigation Branch in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2021
To ask Her Majesty's Government what assessment they have made of (1) the press release by the Care Quality Commission (CQC) Care Quality Commission demands improved waiting times at Tavistock and Portman NHS Foundation Trust, published on 21 January, following its report Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and (2) the extent to which that press release reflects the findings of that report.

The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.

The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.

The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Feb 2021
To ask Her Majesty's Government what progress they have made in reducing the price charged for Liothyronine (T3).

Liothyronine is an unbranded generic medicine. The Department relies on competition between suppliers of unbranded generic medicines to keep prices down. Concerns about potential drug pricing abuses are a matter for the Competition and Markets Authority (CMA). With regards to liothyronine, in 2016 the CMA opened its investigation into allegations that the National Health Service was charged excessive and unfair prices for liothyronine by Advanz. In July 2020 it issued a supplementary statement of objections stating that the CMA continues provisionally to find that Advanz breached United Kingdom and European Union competition law from at least 1 January 2009 to at least 31 July 2017 by charging excessive and unfair prices for liothyronine in the UK.

Liothyronine was previously a single source generic product. However, several marketing authorisations have been granted for liothyronine since 2016 and the reimbursement price has slowly been reducing as a direct response to more competition in the market.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Feb 2021
To ask Her Majesty's Government what assessment they have made of (1) the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and (2) of whether the report adequately considered the potential (a) risk to, and (b) long-term consequences for, children and young people of using medication intended to suppress puberty.

The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.

The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.

The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Feb 2021
To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, what assessment they have made of the statement in that report that the High Court ruling on 1 December 2020 about the capacity and consent of children receiving hormone interventions for gender dysphoria has not impacted its findings.

The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.

The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.

The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Feb 2021
To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and the statement that “separate from our inspection the High Court made a ruling on the 1 December 2020 around capacity and consent of children receiving hormone intervention for gender dysphoria”, what discussions they have had with the CQC about undertaking a further review of the Gender Identity Services at Tavistock and Portman NHS Foundation Trust.

The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.

The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.

The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2021
To ask Her Majesty's Government what additional (1) clinical, and (2) palliative, care support, other than access to tele-medicine, has been available to carers providing end of life care (a) in residential care homes where there is no nursing presence, and (b) at home, during the COVID-19 pandemic.

NHS England and NHS Improvement have published a range of online only guidance and resources to support healthcare professionals, carers and those less accustomed to providing end of life care in a variety of settings including in-home care.

In addition, local areas provide access to medication and equipment, direct and specialist support, and education and training for care home staff. Supporting this, NHS England and NHS Improvement have also supplied pulse oximeters and iPads to care homes to enable them to connect better with general practice.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2021
To ask Her Majesty's Government what steps they are taking to track the number of patients who tested negative for COVID-19 on admission to hospital in England but then contracted COVID-19 whilst in hospital.

NHS England and NHS Improvement collect and publish data relating to the numbers of patients diagnosed in the community with COVID-19 and subsequently admitted to hospital or admitted to hospital and diagnosed with COVID-19 within eight days of admission. However, due to the incubation period of the virus and local differences in application of testing protocols, it is not possible to definitively determine how many of these patients contracted the virus whilst in hospital.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2021
To ask Her Majesty's Government what percentage of care homes in England have not carried out continuous (1) weekly, and (2) monthly, COVID-19 tests of staff and residents at any point since 7 September 2020 as part of their serial testing strategy.

The information is not held in the format requested.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2021
To ask Her Majesty's Government what estimate they have made of the percentage of the Infection Control Fund allocated to local authorities that has been used by residential care homes to ensure that staff who are isolating in line with COVID-19 guidance experience no loss of income.

The Department is still assuring the information that local authorities have provided on the final expenditure against the initial fund, which ran from May to September 2020. However, on 27 July, we published data that shows that 18.7% of the funding spent by 23 July was allocated to paying staff to self-isolate following a positive COVID-19 diagnosis, totalling over £47 million.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Jan 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 6 August 2020 (HL7091), what assessment they have made regarding the payment of clinical negligence damages in 2019/20 with regard to (1) the value for money, and (2) the quality, of the legal representation used by the NHS.

NHS Resolution has continued to increase the use of mediation and alternative dispute resolution to avoid the need for formal proceedings. NHS Resolution settles a majority of claims without court proceedings - in 2019/20, this was 75.1%. Less than 1% of all claims proceed to trial and NHS Resolution achieves a judgement in favour of the National Health Service in 75.3% of that subset of claims. NHS Resolution also negotiates large-scale contracts for its legal services, including fixed and capped fee arrangements, competitive hourly rates and performance management, ensuring value for money and a high quality service.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Jan 2021
To ask Her Majesty's Government what assessment they have made of the response of the Tavistock and Portman NHS Foundation Trust to concerns raised by clinicians about the use of puberty-blocking drugs to treat young people presenting with gender dysphoria.

The board of the Tavistock and Portman NHS Foundation Trust will meet to formally agree a remedial plan that responds to the various concerns. In the interim, the Chief Executive of the Trust has publicly acknowledged the need for improvements in the service and has announced plans for bringing in senior clinical expertise from outside the service to help implement change.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what estimate they have made of the (1) number, and (2) proportion, of women accessing NHS maternity care in England who had COVID-19 at the time they receive care, (a) at the most recent point for which information is available, and (b) overall since the onset of the COVID-19 pandemic.

This information is not held centrally.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what assessment they have made of the extent to which Care Quality Commission inspections of the Tavistock and Portman NHS Foundation Trust in each of the last five years investigated the ability of young people treated by the Gender Identity Development Service (1) to have sufficient understanding, and (2) to be able to assess, the potential long-term consequences of receiving puberty-blocking treatment.

In 2016, the Care Quality Commission (CQC) reviewed capacity and consent for young people during its inspection across the variety services provided by the Tavistock and Portman NHS Foundation Trust. To sufficiently assess capacity and consent for puberty-blocking treatment, a specific assessment by the CQC was required to identify practices at Tavistock and Portman NHS Foundation Trust, University College London Hospitals, and Leeds General Infirmary. This took place between September and November 2020 in response to concerns identified by the CQC and the subsequent reports will be published in due course.

From early 2019, the CQC has been monitoring the Trust’s action plan which includes capacity and consent for puberty-blocking treatment and has requested specific information from the trust on this topic.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what plans they have to instruct the Tavistock and Portman NHS Foundation Trust to publish data showing the proportion of those who were treated with puberty-blocking drugs who remained within the Gender Identity Development Service and later received cross-sex hormones.

NHS England is the responsible commissioner for the Gender Identity Development Service (GIDS). In response to the recent High Court ruling regarding treatment pathways at the GIDS, NHS England is considering the future data reporting requirements for the service. These considerations will also be informed by the planned publication of a report by the Care Quality Commission following its inspection of the GIDS in November 2020.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what plans they have to instruct the Tavistock and Portman NHS Foundation Trust to publish data on the number of young people, if any, who had been assessed to be suitable for treatment using puberty-blocking drugs but who were not prescribed such treatment because they were not considered Gillick competent.

NHS England is the responsible commissioner for the Gender Identity Development Service (GIDS). In response to the recent High Court ruling regarding treatment pathways at the GIDS, NHS England is considering the future data reporting requirements for the service. These considerations will also be informed by the planned publication of a report by the Care Quality Commission following its inspection of the GIDS in November 2020.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what plans they have to instruct the Tavistock and Portman NHS Foundation Trust to publish data on the number, or proportion, of young people referred to the Gender Identity Development Service since 2011 who had a diagnosis of autistic spectrum disorder.

NHS England is the responsible commissioner for the Gender Identity Development Service (GIDS). In response to the recent High Court ruling regarding treatment pathways at the GIDS, NHS England is considering the future data reporting requirements for the service. These considerations will also be informed by the planned publication of a report by the Care Quality Commission following its inspection of the GIDS in November 2020.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jan 2021
To ask Her Majesty's Government what plans they have to instruct the Tavistock and Portman NHS Foundation Trust to publish research showing the age distribution of those children treated with puberty-blocking drugs since 2011.

The pre-print of the outcome of a research study titled Short-term Outcomes of Pubertal Suppression in Selected Cohort of 12-15 Year Old Young People with Persistent Gender Dysphoria in the UK was published in December 2020. The final peer-reviewed version of the study is planned for publication during 2021.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government, further to the paper by Julian Guest et al Cohort study evaluating the burden of wounds to the UK’s NHS in 2017/18: update from 2012/13, published in the British Medical Journal on 22 December 2020, what steps they are taking in response to the finding that (1) the percentage of adults with a wound who were less than 65 years of age increased from 35 per cent in 2012/2013 to 67 per cent in 2017/2018, and (2) the percentage increase in people with diabetes in the same period.

An increase in wounds in younger patients is likely to be related to an increase in the prevalence of co-morbidities in a younger population, as chronic wounds are usually due to co-morbidities that affect wound healing, such as patients with diabetes, arterial disease and venous disease.

NHS England and NHS Improvement fund the National Wound Care Strategy Programme which is developing a number of quality improvement initiatives to prevent wounds and improve wound healing. NHS England and NHS Improvement also continue to prioritise diabetes prevention, including through The NHS Long Term Plan, which commits to fund a doubling of the NHS Diabetes Prevention Programme over the next five years, including a new digital option to widen patient choice and target inequality. Preventing diabetes and other co-morbidities is key to reducing the prevalence of wounds in adults.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government, further to the Written Answers by Lord Bethell on 25 February 2020 (HL793) and 17 December 2020 (HL11131) and the payment of damages in the majority of litigated clinical negligence claims, what assessment they have made of (1) the value for money, and (2) the quality, of the legal representation used by the NHS in such claims.

NHS Resolution negotiates large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise, including some of the recognised leaders in their field. The contracts include fixed and capped fee arrangements and competitive hourly rates, ensuring value for money. NHS Resolution manages their legal panel through service level agreements, which ensures a high quality of service is provided to the National Health Service. Most claims are settled without court proceedings or going to trial. Less than 1% of claims proceed to trial and in the majority of those claims, 75.3%, NHS Resolution successfully achieves a judgement in favour of the NHS.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government, further to the paper by Julian Guest et al Cohort study evaluating the burden of wounds to the UK’s NHS in 2017/18: update from 2012/13, published in the British Medical Journal on 22 December 2020, what steps they are taking to address the annual cost to the NHS of wound care.

The National Wound Care Strategy Programme (NWCSP) was commissioned by NHS England and NHS Improvement and launched in September 2018 to scope the development of a wound care national strategy for England that focuses on improving care relating to pressure ulcers, lower limb ulcers and surgical wounds. It addresses unwarranted variation in United Kingdom wound care services by proposing a move towards clinical pathways that flow across different provider organisations to better meet the needs of patients.

This will improve patient care through quicker diagnosis and access to appropriate treatment, leading to improved healing rates and reduced recurrence rates. Better healing and reduced recurrence will reduce overall prevalence of wounds, patient suffering, expenditure on inappropriate and ineffective treatments and the amount of clinical time spent on wound care. This will reduce the overall annual cost of wound care to the National Health Service. In the last 12 months, the NWCSP has audited the quality of care in secondary care pressure ulcer patients and published lower limb recommendations alongside a case for implementation. The surgical wounds recommendations have been finalised and are being published ahead of the implementation strategy. In 2021 the NWCSP will move into implementation while continuing to develop the resources and evidence to support this work.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government, further to the paper by Julian Guest et al Cohort study evaluating the burden of wounds to the UK’s NHS in 2017/18: update from 2012/13, published in the British Medical Journal on 22 December 2020, what steps they are taking to address the finding that "the annual prevalence of wounds increased by 71 per cent between 2012/2013 and 2017/2018".

The National Wound Care Strategy Programme (NWCSP) was commissioned by NHS England and NHS Improvement and launched in September 2018 to scope the development of a wound care national strategy for England that focuses on improving care relating to pressure ulcers, lower limb ulcers and surgical wounds. It addresses unwarranted variation in United Kingdom wound care services by proposing a move towards clinical pathways that flow across different provider organisations to better meet the needs of patients.

This will improve patient care through quicker diagnosis and access to appropriate treatment, leading to improved healing rates and reduced recurrence rates. Better healing and reduced recurrence will reduce overall prevalence of wounds, patient suffering, expenditure on inappropriate and ineffective treatments and the amount of clinical time spent on wound care. This will reduce the overall annual cost of wound care to the National Health Service. In the last 12 months, the NWCSP has audited the quality of care in secondary care pressure ulcer patients and published lower limb recommendations alongside a case for implementation. The surgical wounds recommendations have been finalised and are being published ahead of the implementation strategy. In 2021 the NWCSP will move into implementation while continuing to develop the resources and evidence to support this work.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government, further to the paper by Julian Guest et al Cohort study evaluating the burden of wounds to the UK’s NHS in 2017/18: update from 2012/13, published in the British Medical Journal on 22 December 2020, what plans they have to make structural changes to the NHS to improve the outcomes of patients with a wound.

The National Wound Care Strategy Programme (NWCSP) was commissioned by NHS England and NHS Improvement and launched in September 2018 to scope the development of a wound care national strategy for England that focuses on improving care relating to pressure ulcers, lower limb ulcers and surgical wounds. It addresses unwarranted variation in United Kingdom wound care services by proposing a move towards clinical pathways that flow across different provider organisations to better meet the needs of patients.

This will improve patient care through quicker diagnosis and access to appropriate treatment, leading to improved healing rates and reduced recurrence rates. Better healing and reduced recurrence will reduce overall prevalence of wounds, patient suffering, expenditure on inappropriate and ineffective treatments and the amount of clinical time spent on wound care. This will reduce the overall annual cost of wound care to the National Health Service. In the last 12 months, the NWCSP has audited the quality of care in secondary care pressure ulcer patients and published lower limb recommendations alongside a case for implementation. The surgical wounds recommendations have been finalised and are being published ahead of the implementation strategy. In 2021 the NWCSP will move into implementation while continuing to develop the resources and evidence to support this work.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Jan 2021
To ask Her Majesty's Government what assessment they have made of the accuracy of the report by the Care Quality Commission following its inspection from 25 to 29 January 2016 Specialist community mental health services for children and young people Quality Report, published on 27 May 2016.

Following its inspection of Tavistock and Portman NHS Foundation Trust’s specialist community mental health services for children and young people in January 2016, the Care Quality Commission (CQC) rated the core service as good. All CQC reports undergo a robust internal quality assurance process, as well as factual accuracy checks by the provider. In addition to this, the CQC’s ratings review team will consider any challenges from providers in regard to published ratings.

As part of the CQC's regulatory model, the CQC monitors providers on an ongoing basis. This activity helps the CQC to understand which services are progressing well and which are not and informs decisions about which core services are inspected and how frequently. The CQC have undertaken monitoring activity with Tavistock and Portman NHS Foundation Trust since the 2016 inspection.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2021
To ask Her Majesty's Government what assessment they have made of the effectiveness of the NHS Redress Act 2006 in resolving clinical negligence claims.

The Department is working intensively with the Ministry of Justice, other Government departments and NHS Resolution to address the costs of clinical negligence claims. We will publish a consultation on the next steps in 2021.

The Department has no plans to implement the NHS Redress Act 2006 and has not made a recent assessment of the effectiveness of the Act in resolving clinical negligence claims.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2021
To ask Her Majesty's Government what plans they have to implement the NHS Redress Act 2006.

The Department is working intensively with the Ministry of Justice, other Government departments and NHS Resolution to address the costs of clinical negligence claims. We will publish a consultation on the next steps in 2021.

The Department has no plans to implement the NHS Redress Act 2006 and has not made a recent assessment of the effectiveness of the Act in resolving clinical negligence claims.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2021
To ask Her Majesty's Government what assessment they have made of the steps taken by Tavistock and Portman NHS Foundation Trust in response to the report by the Care Quality Commission following its inspection on 25 to 29 January 2016 Specialist community mental health services for children and young people Quality Report, published on 27 May 2016, in particular its finding that not all patient risk assessments and records "contained accurate, up-to-date and complete information".

Following the most recent published inspection of Tavistock and Portman NHS Foundation Trust between August and September 2018, the Care Quality Commission (CQC) rated specialist community mental health services for children and young people as good overall, but found that there was still some room for improvement to ensure that each young person had an up-to-date recorded risk assessment.

The CQC also highlighted in their inspection report that some staff also needed to complete mandatory training on clinical risk assessment. These risks were included in the action plan issued to the trust by the CQC, which highlighted where improvement was required.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Dec 2020
To ask Her Majesty's Government what discussions they have had with the Tavistock and Portman NHS Foundation Trust about the steps that Trust is taking to assess whether the treatment provided by the Gender Identity Development Service adequately considers instances where patients present conditions of gender dysphoria which may resolve itself without intervention.

The Tavistock and Portman NHS Foundation Trust is primarily a psycho-social service that focuses on enabling the young person to choose the path which best suits their needs.

In September 2020, NHS England and NHS Improvement, who commission the service, announced that Dr Hilary Cass will lead an independent review into gender identity services for children and young people.

The review will be wide-ranging in scope looking into several aspects of gender identity services, with a focus on how care can be improved for children and young people including key aspects of care such as how and when they are referred to specialist services, and clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

The independent review will present recommendations to NHS England and NHS Improvement’s Quality and Innovation Committee.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Dec 2020
To ask Her Majesty's Government what assessment they have made of steps taken by the Board of Directors of the Tavistock and Portman NHS Foundation Trust (1) to monitor the Gender Identity Development Service, and (2) to address any concerns raised by clinicians of that Service.

The board of the Tavistock and Portman NHS Foundation Trust will meet to formally agree a remedial plan that responds to the various concerns. In the interim, the Chief Executive of the Trust has publicly acknowledged the need for improvements in the service and has announced plans for bringing in senior clinical expertise from outside the service to help implement change.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Dec 2020
To ask Her Majesty's Government what plans they have, if any, to develop a national comprehensive severe asthma guideline to ensure that people with severe asthma are identified and treated correctly.

NHS England and NHS Improvement have recently updated their specialised commissioning service specification for managing difficult and severe asthma. A copy of the service specification is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2020
To ask Her Majesty's Government what plans they have to take action against companies who are advertising puberty blocking drugs online.

Strict regulatory controls govern medicinal products for human use including their manufacture, distribution, retail sale and supply and advertisement.

Prescription-only medicines cannot be advertised direct to the public and an advertisement offering to sell or supply a prescription-only medicines directly to a patient would be likely to contravene the requirements of the Human Medicines Regulations 2012.

Any report of non-compliant activity relating the advertising of a POM would be investigated by the Medicines and Healthcare products Regulatory Agency and necessary action would be taken.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2020
To ask Her Majesty's Government what steps they are taking to ensure that Priadel lithium tablets continue to be supplied to patients in the UK.

Ensuring patients have access to the medicines they need is vital. The Department brought this matter to the attention of the Competition and Markets Authority (CMA) who opened an investigation.

Essential Pharma has now agreed to continue supplying Priadel to the National Health Service and we have agreed revised prices with the company. This means patients can continue to access this important treatment as normal without the need for widespread systematic switching. The CMA has received a proposed commitment from Essential Pharma that it will continue to supply Priadel for a minimum of five years, thereby securing the long-term availability of this crucial medicine.

We continue to communicate the most up to date information with the NHS, including general practices and mental health trusts and further updates are expected to be issued shortly. As supplies of Priadel remained available no central helpline was considered.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2020
To ask Her Majesty's Government what steps they are taking to ensure that patients having to switch to other lithium products because of a discontinuation of Priadel lithium tablets do not suffer harm or adverse events as a result of such a switch.

Ensuring patients have access to the medicines they need is vital. The Department brought this matter to the attention of the Competition and Markets Authority (CMA) who opened an investigation.

Essential Pharma has now agreed to continue supplying Priadel to the National Health Service and we have agreed revised prices with the company. This means patients can continue to access this important treatment as normal without the need for widespread systematic switching. The CMA has received a proposed commitment from Essential Pharma that it will continue to supply Priadel for a minimum of five years, thereby securing the long-term availability of this crucial medicine.

We continue to communicate the most up to date information with the NHS, including general practices and mental health trusts and further updates are expected to be issued shortly. As supplies of Priadel remained available no central helpline was considered.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2020
To ask Her Majesty's Government what guidance they have provided (1) to GPs, and (2) to mental health trusts, on advising patients that have to switch to other lithium products because of a discontinuation of Priadel lithium tablets.

Ensuring patients have access to the medicines they need is vital. The Department brought this matter to the attention of the Competition and Markets Authority (CMA) who opened an investigation.

Essential Pharma has now agreed to continue supplying Priadel to the National Health Service and we have agreed revised prices with the company. This means patients can continue to access this important treatment as normal without the need for widespread systematic switching. The CMA has received a proposed commitment from Essential Pharma that it will continue to supply Priadel for a minimum of five years, thereby securing the long-term availability of this crucial medicine.

We continue to communicate the most up to date information with the NHS, including general practices and mental health trusts and further updates are expected to be issued shortly. As supplies of Priadel remained available no central helpline was considered.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2020
To ask Her Majesty's Government what plans they have to establish a helpline for patients seeking advice about switching to other lithium products because of a discontinuation of Priadel lithium tablets.

Ensuring patients have access to the medicines they need is vital. The Department brought this matter to the attention of the Competition and Markets Authority (CMA) who opened an investigation.

Essential Pharma has now agreed to continue supplying Priadel to the National Health Service and we have agreed revised prices with the company. This means patients can continue to access this important treatment as normal without the need for widespread systematic switching. The CMA has received a proposed commitment from Essential Pharma that it will continue to supply Priadel for a minimum of five years, thereby securing the long-term availability of this crucial medicine.

We continue to communicate the most up to date information with the NHS, including general practices and mental health trusts and further updates are expected to be issued shortly. As supplies of Priadel remained available no central helpline was considered.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Dec 2020
To ask Her Majesty's Government what plans they have to introduce (1) fixed, and (2) capped, costs for defendant lawyers in clinical negligence cases up to £25,000 to deter any so-called 'delay, deny, defend' conduct.

NHS Resolution negotiates large-scale contracts for defendant legal services, using its position as a bulk purchaser to obtain the best expertise, including support for NHS Resolution’s work to learn from claims to improve safety, at value for money for the National Health Service. The contracts include fixed and capped fee arrangements and competitive hourly rates.

In response to increases in claimant legal costs and their tendency in low-value claims to be disproportionally high relative to damages awarded, we will consult shortly on a new claims-handling process and fixed costs for clinical negligence claims of up to £25,000 drawing on the Civil Justice Council’s recommendations published in October 2019.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
30th Nov 2020
To ask Her Majesty's Government what assessment they have made of the potential merits of running an awareness campaign on the symptoms and wider impact of Inflammatory Bowel Disease.

No specific assessment or plans have been made.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
30th Nov 2020
To ask Her Majesty's Government what plans they have (1) to mark, and (2) to support, Crohn’s and Colitis Awareness Week between 1 and 7 December.

No specific assessment or plans have been made.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
30th Nov 2020
To ask Her Majesty's Government what assessment they have made of the impact of the rejection of grants for brain tumour research by the National Institute for Health Research on the talent pool of brain tumour experts.

The National Institute for Health Research (NIHR) is helping researchers develop high-quality research proposals in this scientifically challenging area. To encourage such proposals, in April 2018 we called on the research community specifically for brain tumour research funding applications. There was an immediate increase in proposals which continue to be assessed by review panels of scientific experts and involving patients and public. We are relying on researchers to submit research proposals in this difficult area of research, with a number of research applications currently under consideration. The NIHR system uses a gold standard of peer review, essential in identifying and funding only those research proposals that are of high quality. An assessment of the success rate of applications to the NIHR on brain tumour research compared to all other areas grouped together reveals little difference.

The NIHR is also working with the Tessa Jowell Brain Cancer Mission towards funding a workshop for researchers to support them in submitting higher quality research. Additionally, through the Less Survivable Cancers Taskforce, the NIHR is working closely with NHS England, NHS Improvement and the National Cancer Research Institute to consider ways of increasing the number of high-quality research applications.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
30th Nov 2020
To ask Her Majesty's Government whether the pool of experts used by the National Institute for Health Research contains those who may be classified as brain tumour experts or brain tumour patient advocates.

The National Institute for Health Research (NIHR) is helping researchers develop high-quality research proposals in this scientifically challenging area. To encourage such proposals, in April 2018 we called on the research community specifically for brain tumour research funding applications. There was an immediate increase in proposals which continue to be assessed by review panels of scientific experts and involving patients and public. We are relying on researchers to submit research proposals in this difficult area of research, with a number of research applications currently under consideration. The NIHR system uses a gold standard of peer review, essential in identifying and funding only those research proposals that are of high quality. An assessment of the success rate of applications to the NIHR on brain tumour research compared to all other areas grouped together reveals little difference.

The NIHR is also working with the Tessa Jowell Brain Cancer Mission towards funding a workshop for researchers to support them in submitting higher quality research. Additionally, through the Less Survivable Cancers Taskforce, the NIHR is working closely with NHS England, NHS Improvement and the National Cancer Research Institute to consider ways of increasing the number of high-quality research applications.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
30th Nov 2020
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 25 November (HL9924), what assessment they have made of the rejection of all brain tumour research applications made so far this financial year by the National Institute of Health Research (NIHR); and what assessment they have made of the performance of NIHR.

The National Institute for Health Research (NIHR) is helping researchers develop high-quality research proposals in this scientifically challenging area. To encourage such proposals, in April 2018 we called on the research community specifically for brain tumour research funding applications. There was an immediate increase in proposals which continue to be assessed by review panels of scientific experts and involving patients and public. We are relying on researchers to submit research proposals in this difficult area of research, with a number of research applications currently under consideration. The NIHR system uses a gold standard of peer review, essential in identifying and funding only those research proposals that are of high quality. An assessment of the success rate of applications to the NIHR on brain tumour research compared to all other areas grouped together reveals little difference.

The NIHR is also working with the Tessa Jowell Brain Cancer Mission towards funding a workshop for researchers to support them in submitting higher quality research. Additionally, through the Less Survivable Cancers Taskforce, the NIHR is working closely with NHS England, NHS Improvement and the National Cancer Research Institute to consider ways of increasing the number of high-quality research applications.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Nov 2020
To ask Her Majesty's Government what NHS guidance is available on the circumstances in which surgery for pectus deformity can be accessed if it is deemed clinically necessary.

Decisions about surgical funding are made by clinical experts and therefore it would not be appropriate for Government to intervene.

Surgical treatment for individuals can be considered for pectus deformity if a clinician believes that a treatment or service, not routinely offered by the National Health Service, is the best treatment for their patient. In this case the clinician can, on behalf of their patient, make an individual funding request which takes into account individual clinical circumstances - for example, exceptional circumstances either in terms of clinical presentation or the ability of a patient to benefit.

NHS England has not issued any clinical guidance to doctors to assess the severity of pectus deformity or on the non-surgical options for pectus deformity treatment.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Nov 2020
To ask Her Majesty's Government, further to the Written Answers by Lord Bethell on 23 November (HL10163 and HL10164), what recommendations they (1) have published, and (2) intend to publish, about treatments for pectus excavatum in instances where an operation has not been approved.

Decisions about surgical funding are made by clinical experts and therefore it would not be appropriate for Government to intervene.

Surgical treatment for individuals can be considered for pectus deformity if a clinician believes that a treatment or service, not routinely offered by the National Health Service, is the best treatment for their patient. In this case the clinician can, on behalf of their patient, make an individual funding request which takes into account individual clinical circumstances - for example, exceptional circumstances either in terms of clinical presentation or the ability of a patient to benefit.

NHS England has not issued any clinical guidance to doctors to assess the severity of pectus deformity or on the non-surgical options for pectus deformity treatment.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Nov 2020
To ask Her Majesty's Government what assessment they have made of the potential inclusion of pectus deformity surgery in the Commissioning through Evaluation programme.

Any decision to fund surgery and make commissioning decisions by assessing needs, planning and prioritising is a matter for NHS England and NHS Improvement. It would therefore not be appropriate for the Government to influence their ‘Commissioning through Evaluation’ programme, which enables new clinical patient data to be collected for treatments that show significant promise.

NHS England and NHS Improvement advise that if new evidence on the surgical treatment for pectus deformity is presented, their current policy can be reviewed.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Nov 2020
To ask Her Majesty's Government what assessment they have made, if any, of the availability of pectus deformity surgery in (1) Scotland, (2) Wales, and (3) Northern Ireland; and whether they intend to review the guidance on commissioning surgery for pectus deformity procedures in light of this assessment.

Health is a devolved matter in the United Kingdom and each of the devolved administrations has established its own systems and processes for determining which at and how healthcare services will be available. In England, specialised services and treatments are the responsibility of NHS England and NHS Improvement and decisions are made in accordance with their published processes.

NHS England and NHS Improvement’s position on surgery for pectus deformity is set out in their clinical commissioning policy from February 2019. Their conclusion is that there is not enough evidence to routinely commission the intervention, although this policy will be reviewed when warranted by the receipt of new information.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Nov 2020
To ask Her Majesty's Government what assessment they have made of the statement by the Royal College of Surgeons of Edinburgh RCSEd responds to cancellation of elective surgery, lack of testing and concerns over NHS staff wellbeing, issued on 10 November.

National Health Service providers have worked hard to recover as much elective activity as possible whilst preparing for winter, making full use of available capacity. The Prime Minister has announced £3 billion of extra funding to support the NHS this winter and this includes ensuring the retention of the Nightingale hospital surge capacity and continued access to independent hospitals capacity to help meet patient demand. Essential care should only be postponed if a clinician and patient agree it is in the patient’s best interest.

Supporting the NHS workforce is crucially important and testing of staff remains a top priority. All NHS staff are eligible for priority testing for COVID-19, access is provided through pillar 1 testing and there is capacity within trusts to ensure staff can get tested.

To support the wider wellbeing of NHS staff the NHS People Plan published in July sets out our vision and immediate actions to make the NHS the best place to work, where our NHS people are valued and supported.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Nov 2020
To ask Her Majesty's Government what assessment they have made of the report by NHS England Clinical Commissioning Policy: Surgery for pectus deformity (all ages) Reference: 170113P, published on 22 February 2019, in particular its conclusions that existing published studies on the effectiveness of corrective pectus surgery had "serious weaknesses"; and what steps they are taking (1) to commission, and (2) to encourage, research into the effectiveness of such surgery in response to that finding.

NHS England and NHS Improvement published a clinical commissioning policy in February 2019 about surgical treatment for patients with physical complications arising from pectus deformity. Following a review of clinical practice and options for treatment, they determined that there is insufficient evidence to routinely commission a surgical intervention. However, this policy states that if new evidence is presented, the position can be reviewed.

It is right that decisions about either further research required or surgical funding are made by clinical experts. The position for commissioning surgery for individuals is for clinicians to make an individual funding request where they feel it is clinically appropriate - for example because of exceptional circumstances in terms of either clinical presentation or the ability of a patient to benefit.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Nov 2020
To ask Her Majesty's Government, further to the conclusion contained in the report by NHS England Clinical Commissioning Policy: Surgery for pectus deformity (all ages) Reference: 170113P, published on 22 February 2019, that "there is not sufficient evidence to support the routine commissioning of surgical treatment for pectus deformity", under which circumstance surgical treatment can be considered for pectus deformity.

NHS England and NHS Improvement published a clinical commissioning policy in February 2019 about surgical treatment for patients with physical complications arising from pectus deformity. Following a review of clinical practice and options for treatment, they determined that there is insufficient evidence to routinely commission a surgical intervention. However, this policy states that if new evidence is presented, the position can be reviewed.

It is right that decisions about either further research required or surgical funding are made by clinical experts. The position for commissioning surgery for individuals is for clinicians to make an individual funding request where they feel it is clinically appropriate - for example because of exceptional circumstances in terms of either clinical presentation or the ability of a patient to benefit.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Nov 2020
To ask Her Majesty's Government what assessment they have made of the decision of the Care Quality Commission (CQC) to use the word "gender" in place of the word "sex" in its communications; and what assessment they have made of the impact of that decision on the suitability of the CQC to undertake an impartial review of the Gender Identity Services for children and young people at the Tavistock and Portman NHS Foundation Trust.

The Care Quality Commission (CQC) have used the word ‘gender’ instead of ‘sex’ in their Equality, Diversity and Human Rights Policy and Principles of Workforce Equality Monitoring since these documents were introduced in 2011. These documents were reviewed by the CQC’s Staff Equality Networks and approved by the CQC’s Joint Negotiating and Consultation Committee, including trade union representatives and senior CQC managers, alongside external, national union officers, and were signed-off by the CQC Board at that time.

The CQC complete Equality Impact Assessments for new Human Resources policies, but this use of wording did not arise as an issue of concern at the time, has not been subject to a specific assessment and was not the subject of legal advice at the time. Government Legal Services have now reviewed our use of the word gender in these documents and confirmed that this meets the requirements of the Equality Act 2010.

The CQC are committed to equality and human rights throughout their work, and this approach underpins the way in which they register and inspect services. The decision has no impact on the CQC’s ability to ensure that health and social care services provide people with safe, effective, compassionate, high-quality care.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Nov 2020
To ask Her Majesty's Government what discussions they have had with the Care Quality Commission about the compliance with the Equality Act 2010 of its decision to use the word “gender” instead of “sex” in its Equality, Diversity and Human Rights Policy and its Principles of Workforce Equality Monitoring document.

The Care Quality Commission (CQC) have used the word ‘gender’ instead of ‘sex’ in their Equality, Diversity and Human Rights Policy and Principles of Workforce Equality Monitoring since these documents were introduced in 2011. These documents were reviewed by the CQC’s Staff Equality Networks and approved by the CQC’s Joint Negotiating and Consultation Committee, including trade union representatives and senior CQC managers, alongside external, national union officers, and were signed-off by the CQC Board at that time.

The CQC complete Equality Impact Assessments for new Human Resources policies, but this use of wording did not arise as an issue of concern at the time, has not been subject to a specific assessment and was not the subject of legal advice at the time. Government Legal Services have now reviewed our use of the word gender in these documents and confirmed that this meets the requirements of the Equality Act 2010.

The CQC are committed to equality and human rights throughout their work, and this approach underpins the way in which they register and inspect services. The decision has no impact on the CQC’s ability to ensure that health and social care services provide people with safe, effective, compassionate, high-quality care.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Nov 2020
To ask Her Majesty's Government, further to the decision of the Care Quality Commission (CQC) to use the word “gender” in place of the word “sex” in its communications, what assessment they have made of the suitability of the CQC to assess whether the bodies it inspects are applying single-sex exemptions in accordance with the Equality Act 2010.

The Care Quality Commission (CQC) have used the word ‘gender’ instead of ‘sex’ in their Equality, Diversity and Human Rights Policy and Principles of Workforce Equality Monitoring since these documents were introduced in 2011. These documents were reviewed by the CQC’s Staff Equality Networks and approved by the CQC’s Joint Negotiating and Consultation Committee, including trade union representatives and senior CQC managers, alongside external, national union officers, and were signed-off by the CQC Board at that time.

The CQC complete Equality Impact Assessments for new Human Resources policies, but this use of wording did not arise as an issue of concern at the time, has not been subject to a specific assessment and was not the subject of legal advice at the time. Government Legal Services have now reviewed our use of the word gender in these documents and confirmed that this meets the requirements of the Equality Act 2010.

The CQC are committed to equality and human rights throughout their work, and this approach underpins the way in which they register and inspect services. The decision has no impact on the CQC’s ability to ensure that health and social care services provide people with safe, effective, compassionate, high-quality care.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Nov 2020
To ask Her Majesty's Government what assessment they have made of access to pectus excavatum surgery for patients treated in the Tees Valley CCG area who have met the criteria set out by NHS England in Clinical Commissioning Policy: Surgery for pectus deformity (all ages), published on 22 February 2019.

The NHS England and NHS Improvement online publication Clinical Commissioning Policy relating to surgery for pectus deformity (all ages) sets out the policy position for commissioning surgery for pectus deformity.

NHS England has concluded that there is not sufficient evidence to support the routine commissioning of surgical treatment for pectus deformity.

NHS England is always willing to look at new evidence and, where appropriate, consider revising policy positions. NHS England and NHS Improvement have been working with clinicians and the National Institute for Health Research to identify ways to close the gaps in the current evidence base, for example through formal research.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Nov 2020
To ask Her Majesty's Government what steps they are taking to ensure that surgery to treat pectus excavatum in patients residing in the Tees Valley CCG area can take place in cases where the patient is likely to have clinical and functional benefits from that surgery.

The NHS England and NHS Improvement online publication Clinical Commissioning Policy relating to surgery for pectus deformity (all ages) sets out the policy position for commissioning surgery for pectus deformity.

NHS England has concluded that there is not sufficient evidence to support the routine commissioning of surgical treatment for pectus deformity.

NHS England is always willing to look at new evidence and, where appropriate, consider revising policy positions. NHS England and NHS Improvement have been working with clinicians and the National Institute for Health Research to identify ways to close the gaps in the current evidence base, for example through formal research.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2020
To ask Her Majesty's Government what steps they are taking to encourage an increase in research into brain tumours.

In 2018 the Government announced £40 million over five years for brain tumour research as part of the Tessa Jowell Brain Cancer Mission through the National Institute for Health Research (NIHR).

The NIHR is taking action to help researchers develop high-quality research proposals in this scientifically challenging area. To encourage such proposals, we released a public announcement to the research community in April 2018, which makes clear our desire to receive brain tumour research funding applications. This led to an immediate increase in proposals, which continues to be assessed by relevant review panels of scientific experts. We are relying on researchers to submit research proposals in this difficult area of research.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2020
To ask Her Majesty's Government what steps they are taking to provide additional support to the families of children and young adults with brain tumours.

Clinical support is ongoing linked to individual treatment plans and children will be seen regularly by specialists. This is to check their progress and how well they are recovering from treatment. It is also to check that they don’t have any long-term problems from treatment.

By 2021, where appropriate every person diagnosed with cancer, including children and young adults, will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This will be delivered in line with the National Health Service Comprehensive Model for Personalised Care. This will empower people and their families to manage their care and the impact of their cancer and maximise the potential of digital and community-based support.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2020
To ask Her Majesty's Government, further to the Dynamic CO-CIN report to SAGE and NERVTAG (recent cases) and the Dynamic CO-CIN report to SAGE and NERVTAG (all cases), published on 29 September, that illustrated inpatient proportion and onset occurrence of hospital acquired COVID-19 since March, what criteria they used to assess (1) the ethical issues, and (2) the clinical safety of vulnerable communities, when deciding to continue to discharge patients into care homes during the COVID-19 pandemic.

The Department, working with Public Health England and the National Health Service, continue to closely monitor the emerging domestic and international evidence, and keep our policies under continuous review. Throughout the pandemic, it has continued to be our priority to ensure that people are discharged safely from hospital to the most appropriate place and that they receive the care and support they need.

All individuals must be tested, and receive their result, prior to discharge from hospital to a care home. Building on the commitments of the Adult Social Care Winter Plan, we are working with the Care Quality Commission and the NHS to ensure that anyone testing positive is discharged to a designated setting that is assured to be able to provide safe care. No care home should be forced to admit an existing or new resident to the care home if they do not feel they can provide the appropriate care.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2020
To ask Her Majesty's Government what assessment they have made of the research by the Translational Neuroscience Research Group et al Does Lithium Deserve a Place in the Treatment Against COVID-19?, published on 27 October, on the effects of using lithium to treat patients with COVID-19.

The Department has noted the findings from this small observational study and is considering carefully all available evidence around the potential of different drugs for use in treating COVID-19, including from clinical trials in the United Kingdom and overseas.

The COVID-19 Therapeutics Taskforce is responsible for the end-to-end-provision of treatments, from clinical trials to delivery of treatments at scale to the patient population. The taskforce is closely monitoring positive signals from clinical trials to ensure that any products deemed safe and effective in treating COVID-19 can rapidly be brought into wider use across the National Health Service in the UK. The taskforce will continue to monitor lithium carbonate as further trial results become available.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2020
To ask Her Majesty's Government what plans they have to meet Asthma UK and the British Lung Foundation to discuss ways in which respiratory care in the NHS can be improved.

Representatives from Asthma UK and the British Lung Foundation are closely involved in the work on respiratory care within NHS England and NHS Improvement. Alison Cook, Director of External Affairs, Asthma UK and British Lung Foundation Partnership, co-chairs the National Delivery Board for Respiratory Disease and are represented on our expert advisory and working groups. In addition, there are meetings every two weeks to update on communications and relevant projects.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2020
To ask Her Majesty's Government what assessment they have made of the report by Asthma UK and the British Lung Foundation Recovery and reset for respiratory: restoring and improving basic care for patients with lung disease, published in October.

The report, published by Asthma UK and the British Lung Foundation, has been noted by officials. The recommendations within the report are welcomed, as there is currently working on going in these areas.

General practitioners and their teams have played and continue to play a crucial role in our response to the COVID-19 pandemic and in ensuring that people can get the care they need - between March and August 122.8 million appointments took place in general practice.

Available data indicates that there were over 2.5 million online consultations submissions and over 195,000 video consultations. While appointment numbers dipped at the outset of the pandemic, activity has now returned to pre-COVID-19 levels.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2020
To ask Her Majesty's Government what steps they have taken in response to the report by the Faculty of Dental Services of the Royal College of Surgeons A resumption of dental services?, published on 2 October.

The Department welcomes the report by the Faculty of Dental Service of the Royal College of Surgeons. The main recommendations in the report are in line with actions that have already been taken.

National Health Service dental services will remain open and offering face to face care during this new period of increased restrictions. This is in line with the wider drive to ensure as much healthcare as possible remains available during this period.

A dedicated personal protective equipment (PPE) portal has been developed to deliver PPE, needed as a result of the COVID-19 pandemic, free of charge to providers of NHS services, including NHS dental contractors. As of 4 November, over 5,100 NHS dental and orthodontic providers in England have registered with the PPE portal and over 36 million items have been delivered.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2020
To ask Her Majesty's Government what plans they have to commend the new liothyrine patient pathway agreed by the Norfolk and Waveney Clinical Commissioning Group to other Clinical Commissioning Groups in England.

The Government has no plans.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Sep 2020
To ask Her Majesty's Government what progress they have made towards halving rates of stillbirths, neonatal and maternal deaths, and brain injuries occurring during or soon after birth from 2010 levels by 2025 as announced as part of their maternity strategy in November 2017.

Overall, the outcome data shows that maternity and neonatal services are making clear progress to achieve the Maternity Safety Ambition for a 20% reduction in these outcomes by 2020 and a 50% reduction by 2025. Since 2010, there has been a 25% reduction in the stillbirth rate, a 26% reduction in the neonatal mortality rate for babies born over the 24-week gestational age of viability and a 14% reduction in the maternal mortality rate.

According to a definition developed to monitor the ambition, the brain injury rate fell to 5.1 per 1,000 births in 2017, after rising from 4.9 to 5.4 per 1,000 births between 2012 and 2014. The rate of term infants with hypoxic ischaemic encephalopathy fell by 11.8% between 2014 and 2017.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Sep 2020
To ask Her Majesty's Government whether Care Quality Commission staff are required to undertake a COVID-19 test before entering a care home to inspect it.

There are no current plans to make Care Quality Commission (CQC) inspectors/staff eligible for regular asymptomatic testing as they do not meet the definition for the pilots that we are rolling out in Northamptonshire, Cambridgeshire and Peterborough.

The definition of those eligible states “‘An individual who visits care homes two or more times each week and where carrying out their role requires them to be within one metre of residents.”

The CQC’s inspectors/staff are not considered eligible for the testing pilot as they do not need to be within one metre of residents to carry out their role.

Our testing policy is based on clinical advice on relative priorities and available testing capacity and our testing policies continue to be reviewed on an ongoing basis.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Sep 2020
To ask Her Majesty's Government what steps they are taking to ensure that the Care Quality Commission discloses mortality rates for individual care homes.

The Care Quality Commission’s (CQC) mission to keep people safe is always at the heart of its decisions. The CQC has taken the decision not to publish location level death data without context, since this would not provide an assessment of quality or safety of individual homes currently facing an unprecedented challenge. Where the CQC has concerns about quality or safety, it will inspect the service and publish their findings. It has recently written to all adult social care providers to remind them that they have a duty to be transparent and share appropriate information with families about outbreaks and deaths. The CQC is keeping its current position not to disclose provider-level deaths data under review.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Sep 2020
To ask Her Majesty's Government when they expect the residents and staff of every care home in England to receive regular testing for COVID-19.

We have met our 7 September target - we have provided testing kits to all care homes for older people and people with dementia who have registered for regular retesting kits. We are also contacting the small number of remaining care homes who have not registered to encourage them to do so.

All other adult care homes have been able to place orders for test kits from 31 August. Over 2,000 specialist homes have registered for retesting.

We have the capacity to send out over 100,000 test kits to care homes each day across the country, prioritising high priority outbreak areas and areas of concern.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Sep 2020
To ask Her Majesty's Government what plans they have to consider adopting the Buurtzorg model for the provision of social care.

Under the Care Act 2014, local authorities are required to shape their local markets, and ensure that people have a range of high quality, sustainable and person-centred care and support options available to them, and that they can access the services that best meets their needs.

Elements of the Buurtzorg model have previously been tested in England. In 2017 a coalition of partners agreed to work together to design and deliver a project to test a Buurtzorg inspired model of working. Tests concluded that a purist model of the Buurtzorg Model in the health and social care system was not practical, but work has been undertaken to implement some of the core elements of the model.

No assessment has been made of the Local Cornerstone Year Two Report 2019, published by Cornerstone in April 2019.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Sep 2020
To ask Her Majesty's Government what assessment they have made of the report by Cornerstone Local Cornerstone Year Two Report 2019, published in April 2019, with particular regard to the use of the Buurtzorg model for social care.

Under the Care Act 2014, local authorities are required to shape their local markets, and ensure that people have a range of high quality, sustainable and person-centred care and support options available to them, and that they can access the services that best meets their needs.

Elements of the Buurtzorg model have previously been tested in England. In 2017 a coalition of partners agreed to work together to design and deliver a project to test a Buurtzorg inspired model of working. Tests concluded that a purist model of the Buurtzorg Model in the health and social care system was not practical, but work has been undertaken to implement some of the core elements of the model.

No assessment has been made of the Local Cornerstone Year Two Report 2019, published by Cornerstone in April 2019.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jul 2020
To ask Her Majesty's Government whether the £143.5 million for NHS legal costs listed on page 18 of the report by NHS Resolution, Annual report and accounts 2019/20, published on 16 July, includes staff costs and office costs incurred in connection with clinical negligence cases.

National Health Service legal costs do not include staff and office costs incurred in connection with clinical negligence cases.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Jul 2020
To ask Her Majesty's Government what assessment they have made of the consistency of the answer on Data Protection Impact Assessments by the Secretary of State for Health on 20 July (HC Deb, col 1865) with section 251(7) of the National Health Service Act 2006.

We are compliant with the requirements of data protection legislation, ensuring data is used in a safe, secure and legal way. As such, we are completing all necessary Data Protection Impact Assessments in order to meet our obligations to do so, under the General Data Protection Regulation as implemented by the Data Protection Act 2018.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
23rd Jul 2020
To ask Her Majesty's Government what assessment has been made by NICE of the suitability of applying the 1.5 per cent non-reference discount rate for one time gene therapies that offer long-term health benefits.

The National Institute for Health and Care Excellence (NICE) is considering discounting in its ongoing methods review for both technology appraisals and highly specialised technologies. This includes consideration of different discount rates, including reference-case and non-reference-case, and the circumstances in which they might be considered.

As of May 2019, nine pieces of technology appraisal (TA) guidance and three pieces of highly specialised technologies (HST) guidance include discussions about discounting, specifically the appropriateness of using non-reference-case discount rates.

Non-reference-case rates were considered appropriate in one TA (TA538) and partially in one HST evaluation (HST7). Where non-reference-case discounting was not accepted, the committee’s considerations varied according to the circumstances of the individual appraisals; common themes included whether the technology aligned with the intention of the non-reference-case discounting criteria, uncertainties about long-term health effects, and whether the treatment would restore patients to ‘full or near full health’.

The discount rates applied by NICE in its health technology assessments are specified in its methods guides. These specify that the reference case discount rate is 3.5% per year for costs and health effects; a non-reference-case discount rate of 1.5% per year for costs and health effects may be considered in specific circumstances.

Sensitivity analyses using rates of 1.5% for both costs and health effects may be presented alongside the reference-case analysis. In certain cases, cost-effectiveness analyses are very sensitive to the discount rate used, and in these circumstances a non-reference-case discount rate for costs and outcomes may be considered.

NICE is considering whether there is a case for change in discounting in its ongoing methods review for both technology appraisals and highly specialised technologies.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
23rd Jul 2020
To ask Her Majesty's Government how many times NICE (1) has accepted, and (2) has rejected, a manufacturer request to apply the 1.5 per cent non-reference discount rate as part of a single technology appraisal final appraisal determination in the last five years; in which technology appraisal guidance documents that discount rate was applied; and in each case, what were the reasons for (a) the acceptance, and (b) the rejection, of such a request.

The National Institute for Health and Care Excellence (NICE) is considering discounting in its ongoing methods review for both technology appraisals and highly specialised technologies. This includes consideration of different discount rates, including reference-case and non-reference-case, and the circumstances in which they might be considered.

As of May 2019, nine pieces of technology appraisal (TA) guidance and three pieces of highly specialised technologies (HST) guidance include discussions about discounting, specifically the appropriateness of using non-reference-case discount rates.

Non-reference-case rates were considered appropriate in one TA (TA538) and partially in one HST evaluation (HST7). Where non-reference-case discounting was not accepted, the committee’s considerations varied according to the circumstances of the individual appraisals; common themes included whether the technology aligned with the intention of the non-reference-case discounting criteria, uncertainties about long-term health effects, and whether the treatment would restore patients to ‘full or near full health’.

The discount rates applied by NICE in its health technology assessments are specified in its methods guides. These specify that the reference case discount rate is 3.5% per year for costs and health effects; a non-reference-case discount rate of 1.5% per year for costs and health effects may be considered in specific circumstances.

Sensitivity analyses using rates of 1.5% for both costs and health effects may be presented alongside the reference-case analysis. In certain cases, cost-effectiveness analyses are very sensitive to the discount rate used, and in these circumstances a non-reference-case discount rate for costs and outcomes may be considered.

NICE is considering whether there is a case for change in discounting in its ongoing methods review for both technology appraisals and highly specialised technologies.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
23rd Jul 2020
To ask Her Majesty's Government whether NICE applies the recommendations of the HM Treasury's Green Book concerning the application of a 1.5 per cent discount rate for health benefits and costs; and if not, why not.

The National Institute for Health and Care Excellence (NICE) is considering discounting in its ongoing methods review for both technology appraisals and highly specialised technologies. This includes consideration of different discount rates, including reference-case and non-reference-case, and the circumstances in which they might be considered.

As of May 2019, nine pieces of technology appraisal (TA) guidance and three pieces of highly specialised technologies (HST) guidance include discussions about discounting, specifically the appropriateness of using non-reference-case discount rates.

Non-reference-case rates were considered appropriate in one TA (TA538) and partially in one HST evaluation (HST7). Where non-reference-case discounting was not accepted, the committee’s considerations varied according to the circumstances of the individual appraisals; common themes included whether the technology aligned with the intention of the non-reference-case discounting criteria, uncertainties about long-term health effects, and whether the treatment would restore patients to ‘full or near full health’.

The discount rates applied by NICE in its health technology assessments are specified in its methods guides. These specify that the reference case discount rate is 3.5% per year for costs and health effects; a non-reference-case discount rate of 1.5% per year for costs and health effects may be considered in specific circumstances.

Sensitivity analyses using rates of 1.5% for both costs and health effects may be presented alongside the reference-case analysis. In certain cases, cost-effectiveness analyses are very sensitive to the discount rate used, and in these circumstances a non-reference-case discount rate for costs and outcomes may be considered.

NICE is considering whether there is a case for change in discounting in its ongoing methods review for both technology appraisals and highly specialised technologies.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
21st Jul 2020
To ask Her Majesty's Government whether they can provide the information set out in figure 5 on page 50 of the NHS Resolution annual report and accounts 2019/20, published on 16 July, in respect of clinical negligence cases only.

NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

NHS Resolution has provided information on the number of clinical negligence claims settled in 2018/19 and 2019/20 with or without damages, which is attached due to the size of the data.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2020
To ask Her Majesty's Government whether the control of patient information notices published by the Department of Health and Social Care covers the release of patient identifiable information to local public health teams; and if so, whether any policy prevents local Directors of Public Health from receiving such information.

It is of vital importance that the health and care sector is able to access the data it needs to respond to COVID-19. A Control of Patient Information Notice was issued to require a range of organisations to share and process data for COVID-19 purposes. This should include sharing data with public health teams responding to COVID-19.

The Notice only applies to data processed for COVID-19 purposes and organisations must also meet other regulatory and legal requirements such as the General Data Protection Regulation.

Public Health England is making available to all local authorities information on positive tests

for COVID-19. Public Health England also routinely shares personal data with local authorities to manage and control local clusters and outbreaks of certain infectious diseases.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2020
To ask Her Majesty's Government what estimate they have made of the number of people who are shielding due to COVID-19 who will be (1) working from home, (2) returning to work outside their home, and (3) not able to work due to the nature of their job, on 1 August.

Those who have received a shielding patient letter remain in the Clinically Extremely Vulnerable category and should continue to follow the updated guidance for the clinically extremely vulnerable.

If incidence does not rise, from 1 August the Government will further relax advice to those shielding, bringing it in line with the advice to those who are clinically vulnerable. This means that if they are unable to work from home but can work on site, they should do so, provided the business is COVID-safe.

We have made no estimate of the numbers of people shielding who will be working from home, returning to work outside their home, and not able to work due to the nature of their job, on 1 August.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2020
To ask Her Majesty's Government what estimate they have made of the threshold transmission rate for COVID-19 that, if reached, will increase the risk to extremely vulnerable patients to the extent that COVID-19 shielding measures have to be reapplied.

We are continuing to monitor the prevalence of COVID-19 in the community. If the R rate or level of COVID-19 in the community start to rise as a result of the recent relaxation of wider lockdown measures or other factors, then it may be necessary to advise that more restrictive measures should be taken again in order for people at highest risk from COVID-19 to keep themselves safe.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2020
To ask Her Majesty's Government what steps they are taking to ensure that those who are shielding from COVID-19 receive the correct information for their specific condition to ensure that they are able to live safely throughout the COVID-19 pandemic.

The National Health Service has asked service providers, including general practitioners, to undertake a series of actions to support people who have been asked to shield. This includes ensuring every shielding individual has a named care coordinator to help them with their healthcare and any changing or emerging health needs.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Jun 2020
To ask Her Majesty's Government how many care home residents who were admitted to hospital on, or after, 1 April with suspected, or confirmed, COVID-19, died in hospital.

The data is not available in the format requested.

Data is collected on hospital admissions from care homes and will be published for April 2020 at the end of June 2020. Data is also collected for the number of people who have died in hospital from COVID-19 and this is reported online by NHS England on a daily basis. However, we are not able to correlate the two data sets in the format requested.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government how many care home residents were admitted to hospital for another condition, and died in hospital of COVID-19, since 1 April.

The data is not available in the format requested.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government what assessment they have made of the additional costs imposed on dental surgeries that will need to purchase personal protective equipment in order to reopen.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet PPE - note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government whether the NHS will cover the additional costs imposed on dental surgeries that will need to purchase personal protective equipment in order to reopen, for (1) NHS practices, and (2) mixed NHS and private practices.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet PPE - note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government what support is available to dental surgeries to offset any additional costs of personal protective equipment, and to compensate for reduced patient numbers following the COVID-19 pandemic.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet PPE - note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government what assessment they have made of (1) the number of available appointments in dental surgeries given shortages in personal protective equipment, the requirement to follow social distancing measures and reduced public confidence, and (2) the impact on dental health of reductions in dental services following the Covid-19 pandemic.

No data is collected centrally on the number of available National Health Service appointments in dental practices. Routine dental care has been restarted but safety of clinicians and patients is the priority. As with almost all areas of healthcare the infection prevention and control requirements of the pandemic period mean that at least initially dentists will be able to deliver fewer treatments per day. NHS England and NHS Improvement has been clear that dentists should only increase service as fast as is compatible with maximising safety.

Most high street dentists purchase personal protective equipment (PPE) via dental wholesalers which supply a range of equipment needed by dentists including PPE. During the COVID-19 pandemic the Government is working closely with industry, the National Health Service, social care providers and the army to ensure that PPE is delivered to those who need it. Our priority is ensuring the safety of patients and all health care workers, including dentists. This includes supporting dental wholesalers to stock the equipment needed by general dental practice to safely support practices to restart face to face dental care.

NHS England and NHS Improvement took steps to minimise any impact of the suspension of routine dentistry at the peak of the pandemic by setting up urgent dental centres to deliver treatment urgently needed. Urgent dental treatment has therefore been available throughout the pandemic period through the over 600 such centres set up. These centres continue to operate through the restart period ensuring that patients who need urgent treatment can receive it.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Jun 2020
To ask Her Majesty's Government how many patients have been discharged from NHS hospitals to care homes since 19 March.

On 2 June, NHS England published data that showed 22,497 patients were discharged from hospitals in England to registered care homes and hospices between 19 March 2020 and 16 April 2020. We do not currently have access to data post-16 April 2020. The data is based on day of discharge and excludes privately funded people discharged from privately run hospitals to care homes.

It is our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Jun 2020
To ask Her Majesty's Government what plans they have to achieve anonymisation where necessary of personal data provided to Palantir Technologies UK for COVID-19 analysis, in the light of research suggesting that health data cannot be effectively anonymised.

NHS England is the data controller for data processed in the NHS COVID-19 Data Store. Data is de-identified by National Health Service staff before the data is analysed on Palantir's platform. As such, no identifiable data is being accessed for modelling for NHS England. Data is only processed under instruction by NHS England and Palantir cannot use the data for its own purposes.

All data in the NHS COVID-19 Data Store is under NHS England and NHS Improvement’s control. All data held in the NHS COVID-19 Data Store remains under the control of the NHS at all times and is being processed in accordance with the law.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Jun 2020
To ask Her Majesty's Government what plans they have to increase COVID-19 testing specifically for frontline NHS staff; and what is their assessment of the survey finding that 83.6 per cent of doctors surveyed had not been tested for COVID-19 since the pandemic began.

The Government’s overall ambition is to ensure that everyone who needs a test can get one. Increasing testing capacity is a top priority and we are working around the clock and across the country to protect the vulnerable, support the National Health Service and save lives.

NHS staff can be tested in the NHS workplace, or by using the online portal to book a test at a Regional Testing Site, or by ordering a home testing kit.

Reaching a daily testing capacity of 200,000 was an important milestone, but this is by no means the end of our ramping up of testing. We plan further increases through the summer and into the autumn through a combination of improvements to existing labs, new partnerships and bringing on board novel tests.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Jun 2020
To ask Her Majesty's Government, further to the Written Answer by Lord True on 4 June (HL4779), what assessment they have made of reports that NHS representatives estimated during Exercise Cygnus that staff absenteeism could be as high as 40 per cent and that the Department for Work and Pensions based its exercise response on a figure of 50 per cent; and what plans they have to reassess the Written Answer by Lord True.

The UK Influenza Pandemic Preparedness Strategy 2011 identified that up to 50% of the workforce may require time off at some stage over the entire period of an influenza pandemic, with 15-20% of staff absent on any given day. However, some small organisational units (five to 15 staff) or small teams within larger organisational units where staff work in close proximity are likely to suffer higher percentages of staff absences, with potentially 30-35% absent on any given day.

Each Government department is responsible for ensuring its own preparedness, and that of the sectors for which it is responsible, to manage the impacts of a pandemic. The Cabinet Office and the Department of Health and Social Care have supported departments to assess and improve the resilience of their sectors to operate in a pandemic, particularly in respect to a reduced workforce.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
20th May 2020
To ask Her Majesty's Government how they intend to ensure that all personal data provided to Palantir Technologies UK (1) is, and (2) continues to be, anonymised; and what assessment they have made of research by Imperial College London and others that suggests that such data cannot be effectively anonymised.

Data is de-identified by National Health Service staff before it is inputted into the NHS Data Store.

NHS England is the data controller for data processed in the NHS Data Store. Palantir Technology UK is engaged by NHS England under contract as a data processor. As a data processor, the organisation does have access to the data but can only process it under instruction from NHS England.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
20th May 2020
To ask Her Majesty's Government what steps they took following the conclusion of Exercise Cygnus to ensure that the contribution of the voluntary sector was more apparent in pandemic plans and communications activities.

The lessons from Exercise Cygnus continue to inform our preparedness, including strengthening health, care and voluntary sector plans to surge and flex beyond normal capacity.

Government departments and agencies are working with organisations across the voluntary and charity sector to ensure the sector’s valuable expertise contributes to better outcomes for people affected by the crisis.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
20th May 2020
To ask Her Majesty's Government whether the COVID-19 R-number is calculated separately for transmission in (1) the community, (2) hospitals, (3) care homes, and (4) different UK regions; and if so, what plans they have to publish those separate R-numbers.

The Government Office for Science currently publishes the latest estimate of the United Kingdom-wide range for R on a weekly basis. Because outbreaks in care homes, hospitals and the community are interlinked, the Scientific Advisory Group for Emergencies (SAGE) and its subgroups do not calculate them separately. The current range is estimated to be 0.7-1.0 and is based on latest data available to determine infection and transmission rates.

The Government is committed to publishing the scientific evidence that has informed the SAGE’s advice. These papers are being published in batches. The latest batches were released on 20 May and 22 May and the next batch will be published in due course. The full list of papers reviewed to date is available in an online only format on GOV.UK. This list will be updated to reflect papers considered at recent and future meetings.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
20th May 2020
To ask Her Majesty's Government whether there has been a written contract, or other legal act, as required by the Information Commissioner’s Office, between Palantir Technologies UK and the Department of Health and Social Care, governing the processing of personal data by Palantir Technologies UK; and if so, what plans they have to publish that contract for public scrutiny.

Palantir has been contracted by NHS England to work on the NHS Data Store. The contract will be published in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
20th May 2020
To ask Her Majesty's Government whether any Data Protection Impact Assessments, required under data protection legislation, or any other impact assessments have been carried out on the processing of personal health data by Palantir Technologies UK; whether the Information Commissioner’s Office or other regulatory bodies have been notified of such impact assessments; and what plans they have to publish any such impact assessments for public scrutiny.

A Data Protection Impact Assessment has been carried out for the NHS Data Store and is being published in due course by NHS England.

NHS England and the Department have been working closely with the Information Commissioner’s Office during the COVID-19 crisis.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what assessment they have made of results of the survey conducted by the Royal College of Surgeons of Edinburgh and the Doctor’s Association UK, published on 7 May, which found that 83.6 per cent of those doctors surveyed had not been tested for COVID-19 since the pandemic began; and what steps they are taking to increase testing specifically for front line NHS staff.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet Testing – note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the contribution of the social care sector during the COBR meetings or in discussions in the lead up to those meetings.

Exercise Cygnus was a national level pandemic influenza exercise involving Ministers and officials from the Department of Health and Social Care; other Government departments; devolved administrations; NHS England; Public Health England and local agencies.

As is usual for emergency preparedness exercises, participants were debriefed and outcomes evaluated at the conclusion of the exercise. The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners. We have drawn on all the levers that the Government has to help social care providers look after the people in their care.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the level of additional pressure the voluntary sector could absorb from the social care sector during a pandemic.

Working across Government and with stakeholders, the lessons from Exercise Cygnus have informed our preparedness, such as development of draft legislation support to the response to a future influenza pandemic, and strengthening health, care and voluntary sector plans to surge and flex beyond normal operations. Learning the lessons from preparedness exercises, as well as other sources of expertise has ensured that the United Kingdom remains well prepared for infectious disease outbreaks.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the work needed to develop a method for (1) mapping capacity of, and (2) providing strategic national direction to, voluntary resources during a pandemic.

Working across Government and with stakeholders, the lessons from Exercise Cygnus have informed our preparedness, such as development of draft legislation support to the response to a future influenza pandemic, and strengthening health, care and voluntary sector plans to surge and flex beyond normal operations. Learning the lessons from preparedness exercises, as well as other sources of expertise has ensured that the United Kingdom remains well prepared for infectious disease outbreaks.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the level of engagement in the voluntary sector in advance as well as the capacity of that sector to assist in the event of a pandemic.

Working across Government and with stakeholders, the lessons from Exercise Cygnus have informed our preparedness, such as development of draft legislation support to the response to a future influenza pandemic, and strengthening health, care and voluntary sector plans to surge and flex beyond normal operations. Learning the lessons from preparedness exercises, as well as other sources of expertise has ensured that the United Kingdom remains well prepared for infectious disease outbreaks.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
18th May 2020
To ask Her Majesty's Government what analysis they have undertaken into whether there is any correlation between COVID-19 infection and low levels of vitamin D.

Public Health England (PHE) is monitoring the evidence on nutrition and COVID-19 and seeking the advice of the Scientific Advisory Committee on Nutrition (SACN) as appropriate. PHE is carrying out a rapid review of recent evidence relating to vitamin D and the prevention of acute respiratory tract infections for SACN to consider at its meeting in June 2020.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what actions they took following the conclusion of Exercise Cygnus.

The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners.

Working across Government and with stakeholders the lessons from Exercise Cygnus, along with expert advice, have informed our preparedness. Developments include strengthening health and care sector plans to surge and flex systems and resources beyond normal operations and stockpiling personal protective equipment specifically for an influenza pandemic.

Plans for the discharge of patients who no longer need acute care follow the ‘Discharge to Assess’ model; wherever possible, people who are clinically ready will be supported to return to their place of residence, where assessment of longer-term needs will take place. The safety of residents and staff is always a priority and patients should not be discharged unless it is clinically safe to do so.

COVID-19 hospital discharge service requirements was published on 19 March 2020. These requirements follow the ‘Discharge to Assess’ model. A copy is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to ensure that the UK’s preparedness and response, in terms of its plans, policies and capability, was sufficient to cope with the extreme demands of a pandemic.

The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners.

Working across Government and with stakeholders the lessons from Exercise Cygnus, along with expert advice, have informed our preparedness. Developments include strengthening health and care sector plans to surge and flex systems and resources beyond normal operations and stockpiling personal protective equipment specifically for an influenza pandemic.

Plans for the discharge of patients who no longer need acute care follow the ‘Discharge to Assess’ model; wherever possible, people who are clinically ready will be supported to return to their place of residence, where assessment of longer-term needs will take place. The safety of residents and staff is always a priority and patients should not be discharged unless it is clinically safe to do so.

COVID-19 hospital discharge service requirements was published on 19 March 2020. These requirements follow the ‘Discharge to Assess’ model. A copy is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to develop a plan to ensure that, in the event of a surge in patients, the health and social care sectors could make a quick decision on whether someone stays in hospital or is discharged to residential care, community care or home for treatment or care.

The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners.

Working across Government and with stakeholders the lessons from Exercise Cygnus, along with expert advice, have informed our preparedness. Developments include strengthening health and care sector plans to surge and flex systems and resources beyond normal operations and stockpiling personal protective equipment specifically for an influenza pandemic.

Plans for the discharge of patients who no longer need acute care follow the ‘Discharge to Assess’ model; wherever possible, people who are clinically ready will be supported to return to their place of residence, where assessment of longer-term needs will take place. The safety of residents and staff is always a priority and patients should not be discharged unless it is clinically safe to do so.

COVID-19 hospital discharge service requirements was published on 19 March 2020. These requirements follow the ‘Discharge to Assess’ model. A copy is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the capacity of care homes to deal with patients being diverted to such homes from NHS hospitals in the event of a pandemic.

The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners.

Working across the Government and with stakeholders, the lessons from Exercise Cygnus have informed our preparedness, including strengthening health sector plans to surge and flex systems and resources beyond normal operations, and stockpiling personal protective equipment specifically for a pandemic influenza, informed by expert advice.

The safety of residents and staff is always a priority and patients should not be discharged unless it is clinically safe to do so. We have provided extensive support and guidance to care homes throughout the COVID-19 pandemic. We have also provided local authorities with £3.2 billion to help them deal with the impacts of COVID-19, as well as £1.3 billion to enhance the National Health Service discharge process.

We have established the Capacity Tracker as the single mechanism across the country to report bed vacancies and help manage demand and monitor workforce pressures in care homes during this incident. We strongly encourage care homes to contribute regularly to this tracker.

This is an unprecedented global pandemic and we will continue to review our guidance and national support in line with the latest scientific advice.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to review the capacity of the social care system to be able to provide the level of support needed if the NHS implemented its proposed reverse triage plans which would include the movement of patients from hospitals into social care facilities.

The lessons identified from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners.

Working across the Government and with stakeholders, the lessons from Exercise Cygnus have informed our preparedness, including strengthening health sector plans to surge and flex systems and resources beyond normal operations, and stockpiling personal protective equipment specifically for a pandemic influenza, informed by expert advice.

The safety of residents and staff is always a priority and patients should not be discharged unless it is clinically safe to do so. We have provided extensive support and guidance to care homes throughout the COVID-19 pandemic. We have also provided local authorities with £3.2 billion to help them deal with the impacts of COVID-19, as well as £1.3 billion to enhance the National Health Service discharge process.

We have established the Capacity Tracker as the single mechanism across the country to report bed vacancies and help manage demand and monitor workforce pressures in care homes during this incident. We strongly encourage care homes to contribute regularly to this tracker.

This is an unprecedented global pandemic and we will continue to review our guidance and national support in line with the latest scientific advice.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
13th May 2020
To ask Her Majesty's Government what steps they took, following the conclusion of Exercise Cygnus, to ensure that additional funding was made available for purchasing equipment from stockpiles to be used for satellite care so that timely decisions could be made regarding the discharge of patients from hospitals to residential care, community care or home.

The lessons learned from Exercise Cygnus continue to be considered by the Government and a range of stakeholders, including expert advisory groups and local emergency planners in reviewing response plans. As part of the Pandemic Influenza Preparedness Programme we maintain national stocks of clinical countermeasures for a future influenza pandemic with arrangements in place for how these would be distributed in an emergency. The content of the stockpiles is informed by scientific and clinical advice and kept under review. The Department receives advice on these matters from Public Health England and various independent Government advisory committees including NERVTAG and the Joint Committee on Vaccination and Immunisation.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th May 2020
To ask Her Majesty's Government what arrangements have been made to incorporate information from the King's College London and ZOE COVID-19 symptom tracking application into the submission of information and advice to ministers.

Project OASIS is a combined effort between NHSX and the jHub to create a much clearer picture of the public’s experience with COVID-19 by incorporating data from third party symptom tracker apps commonly used by the public with the National Health Service’s own internal data. The data will be used by the NHS to understand the spread of COVID-19 at a national and local level.

At the point that the OASIS platform began ingesting data there were seven app providers that had committed to provide data. Following discussions with the King’s College London team, NHSX has been working with Health Data Research UK (HDR) to onboard the data from the C-19 Covid Symptom Tracker (Zoe app) into project OASIS. These discussions are at the final stages as at 20 May 2020. When this is agreed HDR will be added as a contributor to project OASIS on the NHSX website.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th May 2020
To ask Her Majesty's Government what assessment they have made of the ability for patients to access urgent dental services which do not meet the current criteria for treatment.

National Health Service dentistry was reorganised in late March along with other NHS primary care services to minimise face to face care to contain the spread of COVID-19 during the peak of the pandemic. Dentists were asked to suspend all routine treatment and instead to offer urgent advice and, where required, prescriptions for antibiotics by telephone. Urgent treatment was made available through urgent dental centres (UDCs) set up in each NHS region.

As of 25 May, there are currently over 550 UDCs open. Patients are triaged into UDCs by their own dentistry or through NHS 111. The UDCs are expected to provide, where urgently needed, the full range of dental treatment normally available on the NHS.

The NHS England and NHS Improvement guidance issued from the Chief Dental Officer on 25 March applied directly only to NHS dental care. When providing private care dentists should consider any advice or guidance issued by regulators, the relevant professional body, Chief Professional Officers, or the NHS, as appropriate. All official guidance should be considered in delivery of private or NHS treatment but guidance issued to the NHS is only binding for NHS care.

NHS England and NHS Improvement announced on 28 May that NHS dentistry outside urgent care centres will begin to restart from 8 June with the aim of increasing levels of service as fast as is compatible with maximising safety

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th May 2020
To ask Her Majesty's Government what discussions they have had with the organisers of the King's College London and ZOE COVID-19 symptom tracking application about the provision of financial support.

Whilst NHSX has been approached by a number of symptom trackers and products with regards to funding we do not fund products in this space. Any trackers that we do work with are providing their data for free through project OASIS, a project between NHSX and the jHub.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Mar 2020
To ask Her Majesty's Government what assessment they have made of the report by the Nuffield Council on Bioethics Ethical considerations in responding to the COVID-19 pandemic, published on 17 March; and what discussions they have had with National Health Service leaders about that report.

The United Kingdom Government’s response to the COVID-19 pandemic has been guided by the advice of the Scientific Advisory Group for Emergencies (SAGE) with the sole purpose of minimising loss of life. The Government has published the scientific evidence relied on by SAGE which can be found online via GOV.UK.

The report by the Nuffield Council on Bioethics Ethical considerations in responding to the COVID-19 pandemic has not been formally considered or assessed by SAGE. However, individual contributors to SAGE may consider a range of evidence for their own work.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2020
To ask Her Majesty's Government what assessment they have made of the research by the Health Services Journal, published on 5 March, which showed that there was an average wait time of over 33 minutes for a Category 2 emergency ambulance between April and September 2019 in all Clinical Commissioning Groups in the Mid and South Essex sustainability and transformation partnership.

No assessment has been made. All English ambulance services have adopted the Ambulance Response Programme model, and report data at trust level against the Ambulance Quality Indicators. There is no central data collection at clinical commissioning group level and no further assessment will be made, as it is a matter for local commissioners.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2020
To ask Her Majesty's Government what is their latest estimate of the cost of putting an existing liabilities scheme in place to cover claims for historical NHS clinical negligence liabilities.

The costs NHS Resolution incur in 2019-20 in relation to general practitioner (GP) indemnity (including oversight arrangements prior to establishment of the Existing Liabilities Scheme for General Practice in April) will be reported in the 2019-20 annual accounts of NHS Resolution, once the audit process for the costs is complete.

An Impact Assessment was carried out for the introduction of the state indemnity scheme for general practice. The state scheme provides the best balance of costs, benefits and risks as it provides a more affordable system that can reduce costs for GPs and remove a barrier to GP recruitment; gives the Department more control over the impact of increases in the cost of clinical negligence on GP incomes; and in moving discretionary cover to the Government brings arrangements into line with the position of clinicians in National Health Service trusts.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2020
To ask Her Majesty's Government whether they will publish the terms of the agreement with the Medical Protection Society covering NHS clinical negligence claims made against their GP members in respect of liabilities arising before 1 April 2019.

The agreement with the Medical Protection Society (MPS) is such that the MPS will contribute a certain amount of assets for the relevant liabilities. The price paid was agreed via commercial negotiations. Through negotiations, the Department has been guided by the need to act fairly and prudently when managing the public purse.

The Department currently has no plans to publish the terms of the agreement with the Medical Protection Society covering National Health Service clinical negligence claims made against their general practitioner members in respect of liabilities arising before 1 April 2019, which is subject to confidentiality provisions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2020
To ask Her Majesty's Government how they have ensured value for money in respect of the establishment of the new state indemnity scheme for general practice operated by NHS Resolution.

The costs NHS Resolution incur in 2019-20 in relation to general practitioner (GP) indemnity (including oversight arrangements prior to establishment of the Existing Liabilities Scheme for General Practice in April) will be reported in the 2019-20 annual accounts of NHS Resolution, once the audit process for the costs is complete.

An Impact Assessment was carried out for the introduction of the state indemnity scheme for general practice. The state scheme provides the best balance of costs, benefits and risks as it provides a more affordable system that can reduce costs for GPs and remove a barrier to GP recruitment; gives the Department more control over the impact of increases in the cost of clinical negligence on GP incomes; and in moving discretionary cover to the Government brings arrangements into line with the position of clinicians in National Health Service trusts.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2020
To ask Her Majesty's Government how they have ensured value for money in respect of the agreement with the Medical Protection Society covering NHS clinical negligence claims made against their GP members for liabilities arising before 1 April 2019.

The agreement with the Medical Protection Society (MPS) is such that the MPS will contribute a certain amount of assets for the relevant liabilities. The price paid was agreed via commercial negotiations. Through negotiations, the Department has been guided by the need to act fairly and prudently when managing the public purse.

The Department currently has no plans to publish the terms of the agreement with the Medical Protection Society covering National Health Service clinical negligence claims made against their general practitioner members in respect of liabilities arising before 1 April 2019, which is subject to confidentiality provisions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Mar 2020
To ask Her Majesty's Government what estimate they have made of the amount that (1) Crawley Clinical Commissioning Group, and (2) Horsham and Mid Sussex Clinical Commissioning Group, are predicted to overspend in the 2019–20 financial year.

The latest National Health Service financial forecasts show NHS Crawley Clinical Commissioning Group (CCG) is forecasting a deficit of approximately £13 million and NHS Horsham and Mid Sussex CCG is forecasting a deficit of approximately £33.5 million. These figures include receipt of Commissioner Sustainability Funding.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2020
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 9 March (HL1750), whether they plan to make changes to the NHS constitution for England if they make changes to NHS access standards.

The NHS England and NHS Improvement Clinically-led Review of Access Standards is still underway. The existing National Health Service performance standards remain in place, and the Government will respond to the recommendations of the review once it has concluded.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2020
To ask Her Majesty's Government how many ambulance services responded to 90 per cent of Category 2 calls within 40 minutes in 2018–19.

The English ambulances services whose 90th percentile response time for category 2 calls was within 40 minutes in 2018-19 are shown in the following table.

Ambulance Service

Category 2 2018-19 response times

Isle of Wight Ambulance Service

37:46

London Ambulance Service

39:40

South Central Ambulance Service

33:13

South East Coast Ambulance Service

36:42

West Midlands Ambulance Service

22:11

The 90th centiles for 2018-19 are an estimated position based on monthly aggregated data. Until 9 October 2018, Isle of Wight Ambulance Service continued to use the old Red 1/Red 2/Green categories operationally, and then assign each incident to the new categories C1 to C4 for data reporting. As such, its response times reflected the old category used for each incident, rather than the new category assigned to.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2020
To ask Her Majesty's Government what assessment they have made of the research by the Health Services Journal, published on 5 March, which showed that 10 per cent of Category 2 calls for ambulance service in Lincolnshire East between April and September 2019 were not responded to until nearly 90 minutes had passed.

No assessment has been made. All English ambulance services have adopted the Ambulance Response Programme model, and report data at trust level against the Ambulance Quality Indicators. There is no central data collection at clinical commissioning group level and no further assessment will be made, as it is a matter for local commissioners.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2020
To ask Her Majesty's Government what assessment they have made of the research by the Health Services Journal, published on 5 March, which showed that one in 10 patients who had made a Category 2 call for an ambulance service between April and September 2019 waited more than an hour for an ambulance in 27 Clinical Commissioning Group areas.

No assessment has been made. All English ambulance services have adopted the Ambulance Response Programme model, and report data at trust level against the Ambulance Quality Indicators. There is no central data collection at clinical commissioning group level and no further assessment will be made, as it is a matter for local commissioners.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Mar 2020
To ask Her Majesty's Government on what basis they decided to lift the legal directions on the Crawley Clinical Commissioning Group and the Horsham and Mid Sussex Clinical Commissioning Group.

Crawley Clinical Commissioning Group (CCG) will merge with the Horsham and Mid Sussex CCG to form a new West Sussex CCG from 1 April 2020. The directions needed to be reviewed before the merger date and reapplied to the new entity if necessary, or they would lapse as the existing CCG legal entities would cease.

Following a review, NHS England concluded that the CCGs had addressed the directions as written. However, there remained a significant financial challenge.

The new leadership in the CCGs, together with the other partners, have created a recovery board to develop and deliver a financial recovery strategy and plan for these CCGs and their successor. As a result, NHS England has decided that legal directions can be removed.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2020
To ask Her Majesty's Government which NHS organisations are subject to legal directions; and what in each case is the predicted deficit for the current financial year.

Clinical commissioning groups (CCGs) are the only National Health Service organisation which legal directions can be applied to. There are currently five CCGs subject to NHS England directions. These are NHS Vale of York CCG, NHS Wirral CCG, NHS Cambridge and Peterborough CCG, NHS Shropshire CCG and NHS Southport and Formby CCG.

NHS Vale of York CCG planned for a deficit of approximately £19 million, and the latest published forecasts say they expect to meet this plan.

NHS Wirral CCG planned to break even, and the latest published forecasts say they expect to meet this plan.

NHS Cambridge and Peterborough CCG planned for a deficit of approximately £75 million, and the latest published forecasts say they expect to meet this plan.

NHS Shropshire CCG planned for a deficit of approximately £23 million, and the latest published forecast said they would meet that plan.

NHS Southport and Formby CCG planned to break even, and the latest published forecast said they would meet that plan.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2020
To ask Her Majesty's Government what is their latest estimate of the cost of the establishment of the state indemnity scheme for general practice, operated by NHS Resolution.

The costs of the establishment of Clinical Negligence Scheme for General Practice will be reported in the 2019-20 annual accounts of NHS Resolution, once the audit process for the costs is complete.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2020
To ask Her Majesty's Government what assessment they have made of the research undertaken by the Health Services Journal, published on 5 March, which showed the number of clinical commissioning group areas which met the 18 minute target for category 2 emergency ambulance calls.

No assessment has been made. All English ambulance services have adopted the Ambulance Response Programme model, and report data at trust level against the Ambulance Quality Indicators. There is no central data collection at clinical commissioning group level and no further assessment will be made, as it is a matter for local commissioners.

The Joint Ambulance Improvement Programme is taking forward the recommendations in Lord Carter of Coles’ report Operational productivity and performance in English NHS Ambulance Trusts: Unwarranted variations.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
9th Mar 2020
To ask Her Majesty's Government, further to the answer by Lord Bethell on 3 March (HL Deb, col 503), whether the proposed review of the arrangements for clinical negligence payments will account for (1) payment of NHS lawyers' fees by contingent arrangement, (2) repeal of section 2(4) of the Law Reform (Personal Injuries) Act 1948, and (3) fixed or capped costs for NHS defence lawyers.

The Department is working with the Ministry of Justice, other Government departments and NHS Resolution, looking at a wide range of options to address the drivers of cost of clinical negligence claims. We will update Parliament in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Mar 2020
To ask Her Majesty's Government, pursuant to section 2(4) of the Law Reform (Personal Injuries) Act 1948, how much was paid in damages for clinical negligence claims by both (1) settlement, and (2) judgment award, above what would have been paid in accordance with common law negligence principles of compensation in the last three years for which the information is available.

NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

NHS Resolution does not hold the information requested and does not make estimates of how much the additional costs of section 2(4) are when settling the payment of clinical negligence claims.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Mar 2020
To ask Her Majesty's Government what plans they have to repeal section 2(4) of the Law Reform (Personal Injuries) Act 1948.

The Department is working with the Ministry of Justice, other Government departments and NHS Resolution, looking at a wide range of options to address the drivers of cost of clinical negligence claims.

We will update Parliament in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
4th Mar 2020
To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 21 January (HL127), whether the contract signed with Amazon to provide health data from the NHS specifies whether Amazon has liability for (1) the loss, (2) the destruction, (3) the corruption, (4) the desegregation, or (5) the damage, of health data.

No patient data is being shared with Amazon as part of this agreement. The collaboration with Amazon simply connects people to medically verified information on a range of different medical conditions, symptoms and treatments which is already freely available online through the National Health Service website. Use of Amazon Alexa is just an alternative mechanism for accessing that information.

The agreement with Amazon clearly stipulates that neither party is liable for any loss of data. The data referred to in this agreement is the medically verified NHS information that is already freely available on the NHS website. It does not concern patient data, as this is not being shared with Amazon. There is no significant risk for the NHS concerning the loss, destruction, corruption, desegregation or damage of this data.

This agreement with Amazon will help people manage their own healthcare more effectively, reaching a far greater number of citizens. This will enable people to take better control of their own healthcare needs, thereby potentially helping with prevention and early diagnosis.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government whether the new operating targets for the NHS will be included in the Handbook to the NHS Constitution for England.

The clinically-led review of National Health Service access standards is ongoing. NHS England and NHS Improvement’s final recommendations to the Government are due by the spring.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government whether they will maintain the right to be seen by a cancer specialist within a maximum of 2 weeks from GP referral for urgent referrals where cancer is suspected, contained in the Handbook to the NHS Constitution for England, when new operating standards are introduced.

The clinically-led review of National Health Service access standards is ongoing. NHS England and NHS Improvement’s final recommendations to the Government are due by the spring.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government whether the new operating standard for 28 day diagnosis for cancer, to be introduced in the NHS from April 2020, will be made a right in the Handbook to the NHS Constitution.

The clinically-led review of National Health Service access standards is ongoing. NHS England and NHS Improvement’s final recommendations to the Government are due by the spring.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government what assessment they have made of the performance of the NHS in meeting the standard set in the Five Year Forward View for Mental Health that at least 25 per cent of Early Interventions in Psychosis Services should meet level three standards by 2018/19.

Data on Early Intervention in Psychosis (EIP) services is included in the NHS Mental Health Dashboard, which brings together data from across mental health services to measure performance. The most recent Dashboard shows that 18% of EIP services nationally and 6% of services in the East of England region achieved level-3 National Institute for Health and Care Excellence concordance in 2018/19.

NHS England and NHS Improvement’s East of England Regional Team is supporting these services to move towards a standalone model and is committed to achieving the NHS Long Term Plan goal of having 95% of services operating at level 3 by 2023/24.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government what assessment they have made of the performance of the East of England NHS in meeting the standard set in the Five Year Forward View for Mental Health that at least 25 per cent of Early Interventions in Psychosis Services should meet level three standards by 2018/19.

Data on Early Intervention in Psychosis (EIP) services is included in the NHS Mental Health Dashboard, which brings together data from across mental health services to measure performance. The most recent Dashboard shows that 18% of EIP services nationally and 6% of services in the East of England region achieved level-3 National Institute for Health and Care Excellence concordance in 2018/19.

NHS England and NHS Improvement’s East of England Regional Team is supporting these services to move towards a standalone model and is committed to achieving the NHS Long Term Plan goal of having 95% of services operating at level 3 by 2023/24.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Mar 2020
To ask Her Majesty's Government how many medicines are prescribed on the NHS which pre-date the NICE technology appraisal guidance process; and, what steps they are taking to mitigate the risk of such drugs being withheld from patients.

The National Institute for Health and Care Excellence (NICE) technology appraisal guidance process was introduced in 1999. We have interpreted this question as referring to individual medicines distinguished by their generic names. It should be noted that the number of medicines is not the same as the number of products. The figures given also differ from volumes of prescriptions or spending.

Out of 2,538 medicines used in the National Health Service in 2018/19, including medicines prescribed by general practitioners and used in hospitals, 1,799 (71%) had a best estimate launch date in the United Kingdom pre-dating the NICE appraisal process.

The NHS does not have unlimited resources and NHS commissioners have to make difficult decisions about commissioning care. In the absence of a positive technology appraisal or highly specialised technology recommendation by NICE, NHS commissioners should make funding decisions on individual treatments based on an assessment of the available evidence. This is reflected in the NHS Constitution as a right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Feb 2020
To ask Her Majesty's Government, further to the study in the British Medical Journal by Julian Guest Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, published on 22 January, what action, if any, they propose to take in response to the estimated 834,000 health-associated infections that occurred in a healthcare setting in 2016–17.

A survey undertaken in 2016/17 by the European Centre for Disease Control to detect the number of healthcare associated infections (HCAIs), estimated the number in England to be much lower than those in this report at approximately 206,000. Public Health England is developing robust methodologies that will enable greater certainty in estimates of the numbers and costs of HCAIs.

While there have been year-on-year reductions in MRSA and C. difficile; E. coli, MSSA, Klebsiella and Pseudomonas infections have increased. From April 2020, the NHS will introduce an annual national reduction target for these bloodstream infections.

NHS England and NHS Improvement take a systematic approach to the prevention of infections with a sustained focus at national level. Action on HCAIs forms part of wide- ranging commitments made in the NHS Long Term Plan for preventing ill health among the National Health Service workforce.

The United Kingdom’s national action plan on antimicrobial resistance has a strong focus on infection prevention and control and includes the commitment to support research that will help target front line interventions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Feb 2020
To ask Her Majesty's Government, further to the study in the British Medical Journal by Julian Guest Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, published on 22 January, what action, if any, they propose to take in response to the estimated 28,500 patients that died from a health-associated infection in a healthcare setting in 2016–17.

A survey undertaken in 2016/17 by the European Centre for Disease Control to detect the number of healthcare associated infections (HCAIs), estimated the number in England to be much lower than those in this report at approximately 206,000. Public Health England is developing robust methodologies that will enable greater certainty in estimates of the numbers and costs of HCAIs.

While there have been year-on-year reductions in MRSA and C. difficile; E. coli, MSSA, Klebsiella and Pseudomonas infections have increased. From April 2020, the NHS will introduce an annual national reduction target for these bloodstream infections.

NHS England and NHS Improvement take a systematic approach to the prevention of infections with a sustained focus at national level. Action on HCAIs forms part of wide- ranging commitments made in the NHS Long Term Plan for preventing ill health among the National Health Service workforce.

The United Kingdom’s national action plan on antimicrobial resistance has a strong focus on infection prevention and control and includes the commitment to support research that will help target front line interventions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Feb 2020
To ask Her Majesty's Government, further to the study in the British Medical Journal by Julian Guest Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, published on 22 January, what action, if any, they propose to take in response to the estimated 7.1 million bed days in NHS hospitals in England that were occupied by patients with a health-associated infection in 2016–17.

A survey undertaken in 2016/17 by the European Centre for Disease Control to detect the number of healthcare associated infections (HCAIs), estimated the number in England to be much lower than those in this report at approximately 206,000. Public Health England is developing robust methodologies that will enable greater certainty in estimates of the numbers and costs of HCAIs.

While there have been year-on-year reductions in MRSA and C. difficile; E. coli, MSSA, Klebsiella and Pseudomonas infections have increased. From April 2020, the NHS will introduce an annual national reduction target for these bloodstream infections.

NHS England and NHS Improvement take a systematic approach to the prevention of infections with a sustained focus at national level. Action on HCAIs forms part of wide- ranging commitments made in the NHS Long Term Plan for preventing ill health among the National Health Service workforce.

The United Kingdom’s national action plan on antimicrobial resistance has a strong focus on infection prevention and control and includes the commitment to support research that will help target front line interventions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Feb 2020
To ask Her Majesty's Government, further to the study in the British Medical Journal by Julian Guest Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, published on 22 January, what action, if any, they propose to take in response to the estimated 79,700 days of absenteeism that occurred amongst frontline healthcare professionals working in NHS hospitals in England as a result of health-associated infections in 2016–17.

A survey undertaken in 2016/17 by the European Centre for Disease Control to detect the number of healthcare associated infections (HCAIs), estimated the number in England to be much lower than those in this report at approximately 206,000. Public Health England is developing robust methodologies that will enable greater certainty in estimates of the numbers and costs of HCAIs.

While there have been year-on-year reductions in MRSA and C. difficile; E. coli, MSSA, Klebsiella and Pseudomonas infections have increased. From April 2020, the NHS will introduce an annual national reduction target for these bloodstream infections.

NHS England and NHS Improvement take a systematic approach to the prevention of infections with a sustained focus at national level. Action on HCAIs forms part of wide- ranging commitments made in the NHS Long Term Plan for preventing ill health among the National Health Service workforce.

The United Kingdom’s national action plan on antimicrobial resistance has a strong focus on infection prevention and control and includes the commitment to support research that will help target front line interventions.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what assessment they have made of the report by NHS Health Scotland Minimum Unit Pricing (MUP) for alcohol evaluation, published in November 2019, in particular the finding that the volume of pure alcohol sold per adult through the off trade in Scotland fell by 7.3 per cent in contrast to an increase of 5.9 per cent in England and Wales over the same period.

No formal assessment has been made of the report by NHS Health Scotland on minimum unit pricing (MUP) of alcohol. The Scottish Government is taking forward a comprehensive evaluation of the impact of introducing MUP. The Scottish legislation also includes a sunset clause and the Scottish Government are required to present a report on the impact of MUP to their Parliament five years after implementation which will be published in 2023.

There are no plans for the introduction of MUP in England. The Government will continue to monitor the progress of MUP in Scotland and will consider available evidence of its impact, including the report by NHS Scotland.

This is the answer for HL1750.

The clinically-led review of National Health Service access standards is ongoing. The NHS is currently trialling how these might work and any recommended changes will be based on clinical evidence to ensure the best outcome for patients. NHS England and NHS Improvement’s final recommendations to the Government are due by the spring.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what plans they have to introduce minimum unit pricing for sales of alcohol in England.

No formal assessment has been made of the report by NHS Health Scotland on minimum unit pricing (MUP) of alcohol. The Scottish Government is taking forward a comprehensive evaluation of the impact of introducing MUP. The Scottish legislation also includes a sunset clause and the Scottish Government are required to present a report on the impact of MUP to their Parliament five years after implementation which will be published in 2023.

There are no plans for the introduction of MUP in England. The Government will continue to monitor the progress of MUP in Scotland and will consider available evidence of its impact, including the report by NHS Scotland.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what changes will be required to the NHS Constitution for England as a result of the introduction of new operational targets for the NHS.

No formal assessment has been made of the report by NHS Health Scotland on minimum unit pricing (MUP) of alcohol. The Scottish Government is taking forward a comprehensive evaluation of the impact of introducing MUP. The Scottish legislation also includes a sunset clause and the Scottish Government are required to present a report on the impact of MUP to their Parliament five years after implementation which will be published in 2023.

There are no plans for the introduction of MUP in England. The Government will continue to monitor the progress of MUP in Scotland and will consider available evidence of its impact, including the report by NHS Scotland.

This is the answer for HL1750.

The clinically-led review of National Health Service access standards is ongoing. The NHS is currently trialling how these might work and any recommended changes will be based on clinical evidence to ensure the best outcome for patients. NHS England and NHS Improvement’s final recommendations to the Government are due by the spring.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what assessment they have made of the reasons for the reported increase in rates of sexually transmitted infections in England.

Several factors have contributed to the increase in sexually transmitted infections (STIs) seen in England over the last decade. These include better detection through policies that increase testing among those most at risk of STIs and behavioural changes that increase the risk of transmission of STIs.

Sexually transmitted infections and screening for chlamydia in England, 2018, published in June 2019, accompanies the most recent annual official statistics release of data about sexually transmitted infections in England. The report states that the total number of sexual health screens (tests for chlamydia, gonorrhoea, syphilis and HIV) has increased over the last five years (22%; from 1,603,744 in 2014 to 1,955,108 in 2018). The report considers the role of sexual behaviours such as an increase in partner numbers and condomless intercourse in the increases seen. A copy of the report is attached.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what assessment they have made of the barriers related to (1) ethnicity, (2) gender, (3) age, (4) sexuality, and (5) English literacy level, associated with accessing sexual health services.

No specific assessment has been made. Local authorities in England are mandated to provide comprehensive open access sexual health services including access to the full range of contraception and sexually transmitted infection testing and treatment.

Work on the development of a new national sexual and reproductive health strategy is underway with the Department working with Public Health England, NHS England and NHS Improvement, local government and other partners. Details of the strategy’s scope will be announced in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2020
To ask Her Majesty's Government what action they are taking to invest in research on sexually transmitted infections; and in particular any such research related to (1) prevention, (2) testing, and (3) partner notification.

The Department invests over £1 billion a year in health research through the National Institute for Health Research (NIHR). The NIHR supports a broad range of research on sexually transmitted infections through both its infrastructure and research programmes. This investment includes the NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, a partnership between Public Health England and University College London. Research at the unit is wide-ranging and includes behavioural studies relating to prevention and partner notification, plus research to assess the feasibility of routine testing in primary care settings.

We recognise that robust data collection will enable policy makers, commissioners and providers to better identify potential health risks and provide targeted prevention and early intervention work.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2020
To ask Her Majesty's Government how they intend to ensure that their commitment for all health and care organisations to be compliant with the national data opt-out policy by 2020 will be met following the closure of the National Data Opt Out programme.

Organisations are required to comply with the National Data Opt-out by 31 March 2020.

Local health and adult social care organisations as Data Controllers are required to assure themselves that they are complying with the opt out requirements. This requirement is set out in Information Standards Notice DCB3058. Organisations are also obligated to ensure the organisation’s privacy notice reflects that they apply the opt out.

Organisations must confirm their compliance with the opt out when submitting their annual Data Security and Protection (DSP) toolkit return. All organisations that have access to National Health Service patient data and systems must use this toolkit to provide assurance that they are practising good data security and that personal information is handled correctly. Information on which organisations have achieved ‘standards met’ on the DSP toolkit will be published in due course by NHS Digital.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2020
To ask Her Majesty's Government what assessment they have made of the research in the British Medical Journal, Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, published on 22 January.

Preventing and controlling the spread of healthcare associated infections continues to be a priority for this Government and we welcome this study’s contribution to the evidence base.

As the authors of the report highlight, a number of the model inputs are assumptions or uncertain values. Application of appropriate methodology is important in gaining unbiased estimates of the key cost and health parameters attributable to length of stay and mortality attributable to infection; Public Health England is collaborating with academia to develop such methodologies. This will enable greater certainty in estimates of the cost and outcomes attributable to these infections.

NHS England and NHS Improvement continues to work to prevent, diagnose and treat infection appropriately, reducing the burden and the costs of healthcare associated infection in our trusts and in the community and maintaining the low level of Methicillin-Resistant Staphylococcus Aureus and Clostridium difficile (C. difficile) infections since 2012.

The United Kingdom’s national action plan for antimicrobial resistance, published on 24 January 2019, includes a strengthened focus on infection prevention and control and sets an ambition to halve levels of healthcare associated Gram-negative blood stream infections by 2023-24.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2020
To ask Her Majesty's Government what assessment they have made of the report T3 Prescribing Survey Report, published on 7 February; and in particular the reported failure by Clinical Commissioning Groups to follow NHS England’s Regional Medicines Optimisation Committee’s revised Guidance–Prescribing of Liothyronine, published in July 2019.

We have made no such assessment.

NHS England and NHS Improvement along with NHS Clinical Commissioners’ latest guidance for clinical commissioning groups, taking into account comments from the British Thyroid Association, was published in June 2019. The National Institute for Health and Care Excellence also published guidelines in November 2019 stating that liothyronine should not be offered routinely for primary hypothyroidism, either alone, or in combination with levothyroxine.

Representatives of NHS England and NHS Improvement and NHS Clinical Commissioners met with representatives from the Thyroid Trust, Healthwatch England, Lord Hunt of Kings Heath and Lord Borwick of Hawkshead on 13 February 2020. NHS England and NHS Improvement will clarify guidance within the National Health Service system. This guidance will set out that the recommendation of the clinical working group was that liothyronine should not be routinely prescribed in primary care; but there may be circumstances where prescribing of the medication is clinically appropriate for individual patients as determined by endocrinologists providing NHS services, after a carefully audited trial of at least three months duration of the medicine.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Feb 2020
To ask Her Majesty's Government what will be the process for drafting the national sexual and reproductive health strategy.

Work on the development of a new national sexual and reproductive health strategy is underway, with the Department working with Public Health England, NHS England and NHS Improvement, local government and other partners. Initial engagement with stakeholders has already taken place and we are also considering the responses to the Green Paper Advancing our Health along with suggestions for priority areas for the new strategy we received through the consultation process. Details of the strategy’s scope, plans for more formal engagement with external organisations, timing of publication and implementation will be announced in due course.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Feb 2020
To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 6 February (HL793), what assessment they have made of the performance of NHS Resolution, following the payment of damages in 2,872 out of 3,487 cases were proceedings had been issued in 2018–19.

NHS Resolution has a responsibility to settle justified clinical negligence and other claims against the National Health Service in England fairly and swiftly, and to defend against unjustified claims, to protect NHS resources.

The majority of claims are resolved through alternative dispute resolution, without any formal proceedings being issued and the number of claims moving into formal litigation has continued to drop in recent years, from a litigation rate of 34% in 2016-17 to 31% in 2018-19.

The Department holds NHS Resolution to account for its performance and is satisfied with the progress NHS Resolution is making on delivering on its strategic aims, including its efforts to avoid unnecessary litigation.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government what discussions they have had with Derbyshire County Council about its plans to close a number of direct care homes for older people.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government what plans they have to review the proposal by Derbyshire County Council to close Ladycross Care Home, particularly in respect of the cost of remediation of the home compared to the costs of reparation of other homes which are scheduled to remain open.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government what assessment they have made of the impact on the health and well-being of residents as a result of having to leave their care home because of the proposals by Derbyshire County Council to close a number of direct care homes for older people.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government whether they have any plans to make a grant to Derbyshire County Council to enable it to improve the condition of its direct care homes for older people.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government what assessment they have made of whether, on the basis of evidence contained in the submission to the Derbyshire County Council Cabinet on 23 January, suitable alternatives exist for residents to go to if they are forced to leave their care home as a result of the proposals by that Council to close a number of direct care homes for older people.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2020
To ask Her Majesty's Government what plans they have to discuss with Derbyshire County Council its proposals to close Ladycross House direct care home; and whether any such discussion will cover the findings of the condition survey commissioned by that Council into the building and site.

Commissioning social care services is a matter for local authorities who are best placed to understand the needs of local people and communities, and how best to meet them. The Department therefore has no plans to discuss with Derbyshire County Council its proposals to close a number of direct care homes for older people, including Ladycross Care Home. We therefore have also not made an assessment of the impact of these closures on the health and well-being of residents, or of suitable alternatives for residents. The Department does support local authorities by funding a number of sector-led improvement activities. These are delivered in partnership with the Local Government Association and Association of Directors of Adult Social Services.

In addition, we are providing councils with access to an additional £1.0 billion for adults and children’s social care next year through the new social care grant and the ability to raise over £500 million from the additional 2% precept. This is on top of £2.5 billion of existing grants provided by the Government.

Derbyshire County Council is set to receive an additional £15.7 million from the new Social Care Grant and could raise up to £7.5 million of additional funding specifically for adult social care in 2020-21 through the precept.

Lord Bethell
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Feb 2020
To ask Her Majesty's Government what assessment they have made of the operation of data protection legislation in respect of Clinical Commissioning Groups asking to see patients' personal health data when reviewing the use of liothyronine for the purposes of cost cutting.

Clinical commissioning groups (CCGs) are legally responsible, as data controllers in their own right, to abide by data protection legislation when processing any data. The Department does not assess their operation of data protection legislation.

CCGs are the responsible commissioner for the prescription of liothyronine and it is for CCGs to have regard to guidance set out by the National Institute for Health and Care Excellence (NICE) and NHS England and NHS Improvement.

4th Feb 2020
To ask Her Majesty's Government what assessment they have made of the causes of the decline in uptake of vaccinations.

To assess the causes of the decline in uptake of vaccinations, Public Health England (PHE) undertakes annual surveys of parents and adolescents to understand how knowledge, beliefs and attitudes towards immunisation, vaccine safety and disease severity influence vaccine uptake decision-making.

PHE believes that the causes of the decline in vaccine include access to services and inconsistencies in reminder communications from healthcare professionals. More information on the survey can be found in the attached National Audit Office report, Investigation into pre-school vaccinations.

The Government is committed to improving the uptake of vaccinations which is why we will shortly be publishing a vaccine strategy.

4th Feb 2020
To ask Her Majesty's Government what evidence they have collected to show the effectiveness of actions, taken since 2016, to improve the uptake of vaccinations of children.

The NHS Long Term Plan set out a clear commitment to improve uptake of vaccinations and a range of action has been taken. This has included expanding key childhood vaccination programmes. All primary school children are now eligible for their seasonal flu vaccination through the National Health Service school vaccination programme after it was extended to include year 6 this season. NHS Digital is due to publish the annual vaccine uptake data, collected by Public Health England, for 2019/20 in September 2020, which will give some indication of whether these interventions have started to be effective.

General practice plays an invaluable role in the delivery of vaccination services, especially for children. During 2019, NHS England and NHS Improvement undertook the most significant review of vaccination and immunisation payment mechanisms since 1990. The findings of this extensive review identified a range of effective interventions. The recent update to the general practitioner (GP) contract confirmed the interventions will see the biggest reforms to the payment and incentive system in 30 years to support GP practices improve vaccination coverage.

4th Feb 2020
To ask Her Majesty's Government what estimate they have made of the number of children aged five who have not had both doses of the MMR vaccination.

Public Health England reports childhood vaccination coverage statistics for England. In 2018/19 there were 94,342 children aged five years who did not have a record of receiving both doses of the Measles Mumps Rubella (MMR) vaccine. Of these, 55,916 children had received dose one of MMR and 38,426 had no record of receiving MMR.

4th Feb 2020
To ask Her Majesty's Government what assessment they have made of the study from the University of Cambridge The costs of switching to low global-warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England, published on 30 October 2019, which found that switching to more environmentally friendly asthma inhalers could achieve large cabon saving and reduce drug costs.

NHS England and NHS Improvement are aware of and have considered the study referenced. The findings are being taken into account alongside other evidence in understanding the impact on patient care, the environmental impact and the costs involved in a change in the mix of inhalers to lower carbon alternatives.

As set out in the NHS Long Term Plan, the National Health Service restated its commitment to the carbon targets in the UK Government Climate Change Act 2008, reducing carbon emissions, on a 1990 baseline, by:

- 34% by 2020; and

- 51% by 2025

In particular, the NHS Long Term Plan commits that a substantial reduction in the carbon impact of inhalers and anaesthetics over 10 years, will contribute to the overall NHS carbon reduction targets. The propellants used in pressurised inhalers are potent greenhouse gases.

4th Feb 2020
To ask Her Majesty's Government whether they are satisfied that the Kingston NHS Foundation Trust is able to maintain permanently a minimum number of 797 car parking spaces for patients, visitors and staff, in line with planning obligations, as a result of the sale of a plot of hospital land to residential developers.

The appropriateness of parking is the responsibility of the local National Health Service trust.

NHS organisations have autonomy to make decisions that best suit their local circumstances.

4th Feb 2020
To ask Her Majesty's Government what action the Kingston NHS Foundation Trust is taking to ensure the re-provision of 75 permanent, as opposed to temporary, parking spaces for the benefit of patients, visitors and staff to replace those lost as a result of the sale of a plot of hospital land.

The appropriateness of parking is the responsibility of the local National Health Service trust.

NHS organisations have autonomy to make decisions that best suit their local circumstances.

3rd Feb 2020
To ask Her Majesty's Government what action they are taking to ensure that the performance standard for the uptake of nearly all routine pre-school vaccinations is met.

As announced in the Prevention Green Paper, Advancing our health: prevention in the 2020s published in July 2019, the Government is committed to publishing a national Vaccine Strategy which will be available shortly. As part of this strategy, we are considering a wide array of options, including rolling out text reminder services to families, to increase our vaccination uptake rates and ensure they reach the 95% standard set for the majority of vaccine programmes.

3rd Feb 2020
To ask Her Majesty's Government what assessment they have made of the impact of anti-vaccination messages on the uptake of all routine pre-school vaccinations.

England’s national vaccination programme is well-regarded globally, with uptake levels for most of our pre-school vaccinations above 90%. Parental attitudinal surveys conducted by Public Health England demonstrate that there is high confidence in our vaccine programmes and that 94% of parents rate the National Health Service as the most trusted source of information on immunisation.

However, despite a recent uptick in vaccination uptake rates, the Department remains concerned about the slow and steady decline in vaccine uptake rates since 2013. Whilst the impact of anti-vaccination messaging on uptake is hard to quantify, we take the issue of misinformation about vaccines extremely seriously. We are working across Government and with social media companies on innovative ways to tackle the proliferation of anti-vaccine messaging on their sites and ensuring that reputable sources are the most prominent.

3rd Feb 2020
To ask Her Majesty's Government what action they are taking to improve consistency by healthcare professionals in reminding parents to vaccinate their children.

The Department is aware that effective reminder systems are likely to be a key factor in improving vaccine uptake. This was highlighted in the January 2019 Royal Society for Public Health report Moving the Needle, which noted that such services are desired by 80% of United Kingdom adults surveyed. As such, the Department is considering options for improved, and more consistent, methods for reminding parents of vaccination appointments, including rolling out a text reminder service, as announced by the Secretary of State for Health and Social Care in November 2019.

More widely, the Government is committed to publishing a national Vaccine Strategy as announced in July 2019 as part of the Prevention Green Paper, Advancing our health: prevention in the 2020s. The strategy, which will be published shortly, carefully considers an array of options to improve our vaccine uptake rates.

3rd Feb 2020
To ask Her Majesty's Government what action they are taking to make it easier for parents to access vaccination services for their children.

As announced in the June 2019 Prevention Green Paper, Advancing our health: prevention in the 2020s, the Government is committed to publishing a Vaccine Strategy, which considers a range of actions to address access to vaccination services as an important factor in improving vaccine uptake.

In addition, the NHS Long Term Plan committed to a fundamental review of general practitioner (GP) vaccination and immunisation standards, funding and procurement, alongside a review of GP access. Interim findings of this work were published on 25 October and are being fed into the ongoing GP contract negotiations.

28th Jan 2020
To ask Her Majesty's Government what plans they have to publish the paper circulated by the Department of Health and Social Care’s Medicine and Supply Team to the NHS in November 2019 detailing the extent and range of drug shortages in the NHS.

The Department has no plans to publish at this time.

27th Jan 2020
To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 21 January (HL127), how they intend to assess (1) how any potential for Alexa to help with "prevention and early diagnosis" is being delivered in practice; and (2) whether such an approach is within the broader public interest.

The agreement with Amazon to provide medically verified National Health Service information from the NHS website, through its voice assistant Alexa, will help people become more informed about a range of medical conditions, their symptoms, and their potential treatments. Greater access to that information from the NHS will help people manage their own healthcare more effectively, reaching a far greater number of United Kingdom citizens, which could help with prevention and early diagnosis.

Significantly, it will help those who rely on voice-activated technology, such as elderly people or blind and visually impaired people, to access expert, accurate and safe medical information from the NHS.

27th Jan 2020
To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 22 January (HL258), whether they can provide the information set out in Figure 3 on page 37 of the NHS Resolution Annual report and accounts 2018/19, published on 11 July 2019, in respect of clinical negligence cases only.

NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

The following table shows settled clinical negligence claims in financial years 2017/18 and 2018/19.

Financial Year

Settlement Type

Number of claims settled with damages

Number of claims settled with no damages

% damages

% No damages

2017/18

No proceedings

3,932

4,119

3,932 (33.1%)

4,119 (34.6%)

2018/19

No proceedings

4,015

3,858

4,015 (35.2%)

3,858 (33.8%)

2017/18

Proceedings

2,989

780

2,989 (25.1%)

780 (6.6%)

2018/19

Proceedings

2,872

615

2,872 (25.2%)

615 (5.4%)

2017/18

Trial

28

48

28 (0.2%)

48 (0.4%)

2018/19

Trial

22

35

22 (0.2%)

35 (0.3%)

Note:

The percentage figures in the table may not add to exactly 100% due to rounding.

27th Jan 2020
To ask Her Majesty's Government what assessment they have made of (1) the extent, and (2) the range, of drug shortages in the NHS.

The majority of medicines are dispensed in England every day without issue, with over two million prescription items dispensed each day. However, the production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Supply problems can affect a wide range of drugs and can arise for various reasons, such as manufacturing issues, problems with the raw ingredients and batch failures.

The Department has well established processes to manage and mitigate supply problems that may arise at any one time and works closely with the Medicines and Healthcare Regulatory Authority (MHRA), the pharmaceutical industry, NHS England and NHS Improvement and others operating in the supply chain, to help prevent shortages and to ensure that the risks to patients are minimised when they do arise.

Where issues do arise, the Department will use a host of tools which might include working with the MHRA to expedite regulatory procedures, working with manufacturers to manage remaining supplies and expedite the delivery of further stock and commissioning clinical advice on alternative options from specialist clinicians.

Furthermore, the team routinely works with specialist importer companies to obtain unlicensed products from abroad to help to manage supply issues affecting the National Health Service.

Occasionally the team will work with wholesalers and suppliers to put demand management processes in place to ensure the equitable distribution of stock throughout the country as this ensures the NHS can continue to access the medicines it requires.

27th Jan 2020
To ask Her Majesty's Government what assessment they have made of the causes of drug shortages in the NHS.

The majority of medicines are dispensed in England every day without issue, with over two million prescription items dispensed each day. However, the production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Supply problems can affect a wide range of drugs and can arise for various reasons, such as manufacturing issues, problems with the raw ingredients and batch failures.

The Department has well established processes to manage and mitigate supply problems that may arise at any one time and works closely with the Medicines and Healthcare Regulatory Authority (MHRA), the pharmaceutical industry, NHS England and NHS Improvement and others operating in the supply chain, to help prevent shortages and to ensure that the risks to patients are minimised when they do arise.

Where issues do arise, the Department will use a host of tools which might include working with the MHRA to expedite regulatory procedures, working with manufacturers to manage remaining supplies and expedite the delivery of further stock and commissioning clinical advice on alternative options from specialist clinicians.

Furthermore, the team routinely works with specialist importer companies to obtain unlicensed products from abroad to help to manage supply issues affecting the National Health Service.

Occasionally the team will work with wholesalers and suppliers to put demand management processes in place to ensure the equitable distribution of stock throughout the country as this ensures the NHS can continue to access the medicines it requires.

27th Jan 2020
To ask Her Majesty's Government what prioritisation process is used by the NHS for the rationing of essential drugs in cases when there is a shortage of such drugs.

The majority of medicines are dispensed in England every day without issue, with over two million prescription items dispensed each day. However, the production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Supply problems can affect a wide range of drugs and can arise for various reasons, such as manufacturing issues, problems with the raw ingredients and batch failures.

The Department has well established processes to manage and mitigate supply problems that may arise at any one time and works closely with the Medicines and Healthcare Regulatory Authority (MHRA), the pharmaceutical industry, NHS England and NHS Improvement and others operating in the supply chain, to help prevent shortages and to ensure that the risks to patients are minimised when they do arise.

Where issues do arise, the Department will use a host of tools which might include working with the MHRA to expedite regulatory procedures, working with manufacturers to manage remaining supplies and expedite the delivery of further stock and commissioning clinical advice on alternative options from specialist clinicians.

Furthermore, the team routinely works with specialist importer companies to obtain unlicensed products from abroad to help to manage supply issues affecting the National Health Service.

Occasionally the team will work with wholesalers and suppliers to put demand management processes in place to ensure the equitable distribution of stock throughout the country as this ensures the NHS can continue to access the medicines it requires.

27th Jan 2020
To ask Her Majesty's Government whether unlicensed medicines are used to help with any shortages of drug supply in the NHS; and if so, how many.

The majority of medicines are dispensed in England every day without issue, with over two million prescription items dispensed each day. However, the production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Supply problems can affect a wide range of drugs and can arise for various reasons, such as manufacturing issues, problems with the raw ingredients and batch failures.

The Department has well established processes to manage and mitigate supply problems that may arise at any one time and works closely with the Medicines and Healthcare Regulatory Authority (MHRA), the pharmaceutical industry, NHS England and NHS Improvement and others operating in the supply chain, to help prevent shortages and to ensure that the risks to patients are minimised when they do arise.

Where issues do arise, the Department will use a host of tools which might include working with the MHRA to expedite regulatory procedures, working with manufacturers to manage remaining supplies and expedite the delivery of further stock and commissioning clinical advice on alternative options from specialist clinicians.

Furthermore, the team routinely works with specialist importer companies to obtain unlicensed products from abroad to help to manage supply issues affecting the National Health Service.

Occasionally the team will work with wholesalers and suppliers to put demand management processes in place to ensure the equitable distribution of stock throughout the country as this ensures the NHS can continue to access the medicines it requires.

21st Jan 2020
To ask Her Majesty's Government what responsibility NHS Property Services and NHS organisations have to ensure that NHS buildings which are of special architectural or historical interest, are considered for listing through an application to Historic England.

Guidance is provided to the National Health Service on the management of buildings of special architectural or historical interest in Health Building Note 00-08 Part B: Supplementary information for Part A - Strategic framework for the efficient management of healthcare estates and facilities. A copy of the guidance is attached.

There is no requirement under existing guidance Health Building Notes, the National Planning Policy Framework or at local level for any organisation, including the NHS, to request for an asset to be listed. There is only an obligation once something is listed by Heritage England (on behalf of the Secretary of State) or local listed status.

The Government’s policy for conserving and enhancing the historic environment including historic buildings is set out in the National Planning Policy framework. Trusts are responsible for implementing this guidance locally. Guidance is reviewed periodically to ensure it remains fit for purpose and at this time there are no current plans to amend or update this guidance.

21st Jan 2020
To ask Her Majesty's Government whether either NHS Property Services or the Kingston Hospital NHS Foundation Trust considered applying for a listing through an application to Historic England in respect of the Regent Wing at Kingston Hospital before selling the building for commercial development.

NHS Property Services report that it does not own any part of the estate of Kingston Hospital.

The Regent Wing required major capital investment to make it fit for purpose and would not provide appropriate modern healthcare facilities. The Trust has therefore saved substantial costs by disposing of the asset but has also been able to utilise the proceeds for other capital projects across the estate.

Before disposing of the asset, the Trust undertook a full heritage survey of the Regent Wing as part of its pre-application process with the local authority – no comments were made by the local community or local authority. The building was not found to be of significant worth nationally.

In addition, it undertakes regular community engagement sessions led by the Trust’s Chief Executive Officer, which has included the Regent Wing disposal. The purchaser of the site is planning to utilise it to develop residential accommodation.

21st Jan 2020
To ask Her Majesty's Government what discussions NHS Property Services and the Kingston Hospital NHS Foundation Trust have had with the local community about the future use of the Regent Wing at Kingston Hospital.

NHS Property Services report that it does not own any part of the estate of Kingston Hospital.

The Regent Wing required major capital investment to make it fit for purpose and would not provide appropriate modern healthcare facilities. The Trust has therefore saved substantial costs by disposing of the asset but has also been able to utilise the proceeds for other capital projects across the estate.

Before disposing of the asset, the Trust undertook a full heritage survey of the Regent Wing as part of its pre-application process with the local authority – no comments were made by the local community or local authority. The building was not found to be of significant worth nationally.

In addition, it undertakes regular community engagement sessions led by the Trust’s Chief Executive Officer, which has included the Regent Wing disposal. The purchaser of the site is planning to utilise it to develop residential accommodation.

21st Jan 2020
To ask Her Majesty's Government what plans they have, if any, to issue guidance to NHS Property Services and NHS organisations to encourage the listing of NHS buildings of special architectural or historical interest through an application to Historic England.

Guidance is provided to the National Health Service on the management of buildings of special architectural or historical interest in Health Building Note 00-08 Part B: Supplementary information for Part A - Strategic framework for the efficient management of healthcare estates and facilities. A copy of the guidance is attached.

There is no requirement under existing guidance Health Building Notes, the National Planning Policy Framework or at local level for any organisation, including the NHS, to request for an asset to be listed. There is only an obligation once something is listed by Heritage England (on behalf of the Secretary of State) or local listed status.

The Government’s policy for conserving and enhancing the historic environment including historic buildings is set out in the National Planning Policy framework. Trusts are responsible for implementing this guidance locally. Guidance is reviewed periodically to ensure it remains fit for purpose and at this time there are no current plans to amend or update this guidance.

21st Jan 2020
To ask Her Majesty's Government what assessment they have made of the benefits that may accrue to the Kingston Hospital NHS Foundation Trust from the sale of the Regent Wing at Kingston Hospital to a commercial developer.

NHS Property Services report that it does not own any part of the estate of Kingston Hospital.

The Regent Wing required major capital investment to make it fit for purpose and would not provide appropriate modern healthcare facilities. The Trust has therefore saved substantial costs by disposing of the asset but has also been able to utilise the proceeds for other capital projects across the estate.

Before disposing of the asset, the Trust undertook a full heritage survey of the Regent Wing as part of its pre-application process with the local authority – no comments were made by the local community or local authority. The building was not found to be of significant worth nationally.

In addition, it undertakes regular community engagement sessions led by the Trust’s Chief Executive Officer, which has included the Regent Wing disposal. The purchaser of the site is planning to utilise it to develop residential accommodation.

16th Jan 2020
To ask Her Majesty's Government what assessment they have made of the impact of bureaucratic processes in social work, in particular (1) management chains, (2) paper work, and (3) culture; and what steps they intend to take in response.

We have made no such assessment.

16th Jan 2020
To ask Her Majesty's Government what assessment they have made of the test and learn initiatives piloted across the UK using the Buurtzorg nursing model.

NHS England and NHS Improvement are committed to learning from a wide range of models of care from across the world to help improve patient care.

NHS England and NHS Improvement officials met once with representatives of Buurtzorg UK in 2019 and have previously visited the Netherlands to gain first-hand experience of this model of care. Whilst there are no current plans to encourage the introduction of the model in its pure form to the National Health Service, underpinning elements of the model for example, supported self-management and person-centred care, are strongly encouraged.

Given the Buurtzorg model continues to be trialled in a few areas in England, no national assessments have been undertaken.

9th Jan 2020
To ask Her Majesty's Government how many clinical negligence claims involving the NHS were litigated because of issues in dispute involving breach of duty or causation in the last year for which figures are available.

NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

NHS Resolution is unable to provide the data requested as they do not capture the specific reason for litigation broken down into the categories referred to.

In view of the nature of litigation, disputes can arise concerning breach of duty, causation and quantum, or a mixture of all of them. The NHS Resolution five-year strategy, published in 2017, references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings.

8th Jan 2020
To ask Her Majesty's Government what assessment they have made of the performance of NHS Resolution in its case assessment and its possible use of speculative denials.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England, and shares learning from claims to help improve safety for patients and staff. NHS Resolution has a responsibility to settle justified claims fairly and promptly and defend unjustified claims to secure NHS resources. Each case must be considered on its own merits and it is important that a proper investigation is undertaken. NHS Resolution aims to get to the right answer as quickly as possible in every case and to help resolve claims sooner, and without the need for court proceedings. To support this NHS Resolution launched a new mediation service in December 2016.

NHS Resolution strategy specifically references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings. NHS Resolution challenges important issues of principle in the courts, including the appeals courts where necessary. Decisions to go to trial are not taken lightly but sometimes it is necessary so that public funds are not spent on compensating cases which do not have merit. In 2018/19, of 106 cases taken to trial with court judgements handed down, NHS Resolution successfully defended 69%. Testing claims at trial often has wider implications for other similar cases, potentially deterring further claims without merit. In 2018/19 over 70% of claims were settled without formal court proceedings being taken. It is not possible to estimate conclusively how many litigated clinical negligence claims will result in damages being paid.

NHS Resolution is an arm’s length body of the Department and is accountable to the Department. Its performance is subject to regular review through the Department’s sponsorship arrangements. The Department’s assessment is that NHS Resolution is a well-run and efficient organisation and that it has had some success, within the current legal framework, in containing the cost of NHS litigation. The National Audit Office, in its report Managing the costs of clinical negligence in trusts published in September 2017, corroborated with this assessment. A copy of the report is attached.

NHS Resolution regularly agrees large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise at value for money for the health service. The contracts include a combination of fixed and capped fees as well as competitive hourly rates for its panel firms, which are also required to support NHS Resolution’s work to learn from claims to improve safety.

8th Jan 2020
To ask Her Majesty's Government what estimate they have made of the percentage of litigated clinical negligence claims involving the NHS which result in damages being paid to the claimant.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England, and shares learning from claims to help improve safety for patients and staff. NHS Resolution has a responsibility to settle justified claims fairly and promptly and defend unjustified claims to secure NHS resources. Each case must be considered on its own merits and it is important that a proper investigation is undertaken. NHS Resolution aims to get to the right answer as quickly as possible in every case and to help resolve claims sooner, and without the need for court proceedings. To support this NHS Resolution launched a new mediation service in December 2016.

NHS Resolution strategy specifically references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings. NHS Resolution challenges important issues of principle in the courts, including the appeals courts where necessary. Decisions to go to trial are not taken lightly but sometimes it is necessary so that public funds are not spent on compensating cases which do not have merit. In 2018/19, of 106 cases taken to trial with court judgements handed down, NHS Resolution successfully defended 69%. Testing claims at trial often has wider implications for other similar cases, potentially deterring further claims without merit. In 2018/19 over 70% of claims were settled without formal court proceedings being taken. It is not possible to estimate conclusively how many litigated clinical negligence claims will result in damages being paid.

NHS Resolution is an arm’s length body of the Department and is accountable to the Department. Its performance is subject to regular review through the Department’s sponsorship arrangements. The Department’s assessment is that NHS Resolution is a well-run and efficient organisation and that it has had some success, within the current legal framework, in containing the cost of NHS litigation. The National Audit Office, in its report Managing the costs of clinical negligence in trusts published in September 2017, corroborated with this assessment. A copy of the report is attached.

NHS Resolution regularly agrees large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise at value for money for the health service. The contracts include a combination of fixed and capped fees as well as competitive hourly rates for its panel firms, which are also required to support NHS Resolution’s work to learn from claims to improve safety.

8th Jan 2020
To ask Her Majesty's Government what assessment they have made of the criteria by which the NHS assesses the merits of clinical negligence claims prior to litigation.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England, and shares learning from claims to help improve safety for patients and staff. NHS Resolution has a responsibility to settle justified claims fairly and promptly and defend unjustified claims to secure NHS resources. Each case must be considered on its own merits and it is important that a proper investigation is undertaken. NHS Resolution aims to get to the right answer as quickly as possible in every case and to help resolve claims sooner, and without the need for court proceedings. To support this NHS Resolution launched a new mediation service in December 2016.

NHS Resolution strategy specifically references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings. NHS Resolution challenges important issues of principle in the courts, including the appeals courts where necessary. Decisions to go to trial are not taken lightly but sometimes it is necessary so that public funds are not spent on compensating cases which do not have merit. In 2018/19, of 106 cases taken to trial with court judgements handed down, NHS Resolution successfully defended 69%. Testing claims at trial often has wider implications for other similar cases, potentially deterring further claims without merit. In 2018/19 over 70% of claims were settled without formal court proceedings being taken. It is not possible to estimate conclusively how many litigated clinical negligence claims will result in damages being paid.

NHS Resolution is an arm’s length body of the Department and is accountable to the Department. Its performance is subject to regular review through the Department’s sponsorship arrangements. The Department’s assessment is that NHS Resolution is a well-run and efficient organisation and that it has had some success, within the current legal framework, in containing the cost of NHS litigation. The National Audit Office, in its report Managing the costs of clinical negligence in trusts published in September 2017, corroborated with this assessment. A copy of the report is attached.

NHS Resolution regularly agrees large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise at value for money for the health service. The contracts include a combination of fixed and capped fees as well as competitive hourly rates for its panel firms, which are also required to support NHS Resolution’s work to learn from claims to improve safety.

8th Jan 2020
To ask Her Majesty's Government when they expect the NHS to meet its target of referring patients for treatment for cancer within 62 days.

Cancer is a priority for this Government and survival rates are at a record high. The National Health Service is finding and treating more cancers in line with the ambitions set out in the Long Term Plan. Demand continues to rise and more people are also being diagnosed than ever before. The increasing demand has created a challenge in achieving the standard that 85% of patients commence treatment within 62 days following an urgent referral.

NHS England and NHS Improvement are working with providers, local systems and Cancer Alliances to improve performance. This includes £200 million investment in diagnostic equipment, the implementation of optimal timed diagnosis pathways and new Rapid Diagnostic Centres and actions to increase staff in key cancer and diagnostic professions.

Further to this, at the Government’s request, NHS England and NHS Improvement are working with clinical leaders across the system to review our performance standards and will update on this in due course.

8th Jan 2020
To ask Her Majesty's Government what assessment they have made of the practice of NHS Resolution of paying fees for legal services regardless of outcome.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England, and shares learning from claims to help improve safety for patients and staff. NHS Resolution has a responsibility to settle justified claims fairly and promptly and defend unjustified claims to secure NHS resources. Each case must be considered on its own merits and it is important that a proper investigation is undertaken. NHS Resolution aims to get to the right answer as quickly as possible in every case and to help resolve claims sooner, and without the need for court proceedings. To support this NHS Resolution launched a new mediation service in December 2016.

NHS Resolution strategy specifically references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings. NHS Resolution challenges important issues of principle in the courts, including the appeals courts where necessary. Decisions to go to trial are not taken lightly but sometimes it is necessary so that public funds are not spent on compensating cases which do not have merit. In 2018/19, of 106 cases taken to trial with court judgements handed down, NHS Resolution successfully defended 69%. Testing claims at trial often has wider implications for other similar cases, potentially deterring further claims without merit. In 2018/19 over 70% of claims were settled without formal court proceedings being taken. It is not possible to estimate conclusively how many litigated clinical negligence claims will result in damages being paid.

NHS Resolution is an arm’s length body of the Department and is accountable to the Department. Its performance is subject to regular review through the Department’s sponsorship arrangements. The Department’s assessment is that NHS Resolution is a well-run and efficient organisation and that it has had some success, within the current legal framework, in containing the cost of NHS litigation. The National Audit Office, in its report Managing the costs of clinical negligence in trusts published in September 2017, corroborated with this assessment. A copy of the report is attached.

NHS Resolution regularly agrees large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise at value for money for the health service. The contracts include a combination of fixed and capped fees as well as competitive hourly rates for its panel firms, which are also required to support NHS Resolution’s work to learn from claims to improve safety.

7th Jan 2020
To ask Her Majesty's Government what length of contract has been agreed with Amazon to provide health data from the NHS.

This agreement is not exclusive. There are over 2,000 other organisations that are accessing and using information from the National Health Service website in a similar way.

We want to continue working with Amazon and other companies in order to ensure that citizens have access to the best source of verified health information, and therefore this contract is intended to be open-ended. We will continue to review our relationships with Amazon and other organisations that are using information taken from the NHS website to ensure that they continue to provide the best possible service.

7th Jan 2020
To ask Her Majesty's Government what assessment they have made of the artificial intelligence system used in relation to the contract with Amazon to provide health data from the NHS; and how that system compares with alternatives on the market.

National Health Service website content is available for all organisations if they have agreed with NHS terms of use. This agreement is not exclusive and open to any vendor who complies with the terms of the license agreement. NHS Digital assesses and evaluates companies’ compliance with the terms of use. It does not compare this system with alternatives on the market.

7th Jan 2020
To ask Her Majesty's Government what benefits are anticipated to be accrued by the NHS as a result of the contract with Amazon to provide health data from the NHS.

Increased access for patients to information on the National Health Service website will help people become better informed, receiving NHS accredited information on the symptoms of different healthcare issues. This will enable people to take better control of their own healthcare needs, thereby potentially helping with prevention and early diagnosis.

7th Jan 2020
To ask Her Majesty's Government when they expect the NHS to meet the Consultant Led Treatment waiting time target.

Demand on the National Health Service hospitals continues to grow, with an increase in attendances to accident and emergency of over 6% in December 2019 compared to December 2018. Despite this increase in demand, the NHS continues to provide high quality care, and is seeing more people than ever before, in a timely manner.

The NHS Long Term Plan sets out our plans for transformation and improvement across the NHS. In the shorter term, the NHS Accountability Framework for 2019-20 outlines how NHS England and NHS Improvement will continue ongoing service development so that performance is maintained and improved, including with the commencement of the redesign of outpatient services.

Further to this, at the Government’s request, NHS England and NHS Improvement is also working with clinical leaders across the system to review our performance standards and will update on this in due course.

7th Jan 2020
To ask Her Majesty's Government when they expect the NHS to meet the four hour accident and emergency waiting time target.

Demand on the National Health Service hospitals continues to grow, with an increase in attendances to accident and emergency of over 6% in December 2019 compared to December 2018. Despite this increase in demand, the NHS continues to provide high quality care, and is seeing more people than ever before, in a timely manner.

The NHS Long Term Plan sets out our plans for transformation and improvement across the NHS. In the shorter term, the NHS Accountability Framework for 2019-20 outlines how NHS England and NHS Improvement will continue ongoing service development so that performance is maintained and improved, including with the commencement of the redesign of outpatient services.

Further to this, at the Government’s request, NHS England and NHS Improvement is also working with clinical leaders across the system to review our performance standards and will update on this in due course.

19th Dec 2019
To ask Her Majesty's Government what monitoring arrangements in relation to (1) patient confidentiality, (2) intellectual property, and (3) other data, have been built into the agreement to share NHS health data with Amazon.

The agreement between the Department and Amazon is clear that none of the data generated will be shared with third parties; that it will not be used for selling products or making product recommendations to Amazon users; nor is it building any form of health profiles on Amazon customers.

NHS Digital are working closely with Amazon to assess the effectiveness of the service. The algorithm used by Amazon is still learning and will be updated continuously to learn how people are asking questions about health conditions.

All information is treated with high confidentiality and Amazon use multi-factor authentication to restrict access, service encryption, and audits of our control environment to protect it. No Amazon employee has direct access to information that can identify the person or account, and Amazon have the appropriate measures in place to ensure General Data Protection Regulation compliance.

Patients already use Alexa and other devices to search for health information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the National Health Service instead of from a range of other sources, such as non-United Kingdom websites.

This agreement is not exclusive. There are over 2,000 other organisations that are accessing and using information from the NHS website in a similar way.

19th Dec 2019
To ask Her Majesty's Government whether they gave any consideration to the potential development of an NHS app to provide the service that has now been contracted to Amazon to share health data from the NHS.

There is already an app, called the NHS App, which provides the same information as the National Health Service website on a range of conditions, their symptoms and their treatments.

More modes to access medically verified NHS information will give United Kingdom citizens a better understanding of different medical conditions. The agreement with Amazon is convenient for those who rely on voice-activated technology, in particular blind and visually impaired people.

This is a mutually beneficial collaboration that will enable greater numbers of people to access information accredited by the NHS, helping to put people in control of their own healthcare. The information being provided to users of Alexa devices asking questions is already freely available through the NHS website. This is an alternative mechanism for delivering that information. Patients already use Alexa and other devices to search for information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the NHS instead of from a range of other sources, such as non-UK websites.


19th Dec 2019
To ask Her Majesty's Government what income they have received as a result of the agreement to share NHS data with Amazon.

The service provided by Amazon connects people to medical information that is already freely available through the National Health Service website. Patients already use Alexa and other devices to search for information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the NHS instead of from a range of other sources, such as non-United Kingdom websites.

The agreement signed between the Department and Amazon is designed to enable greater numbers of people to access information accredited by the NHS, helping to put people in control of their own healthcare. This agreement is not exclusive. There are over 2,000 other organisations that are accessing and using information from the NHS website in a similar way.

There is no cost to the taxpayer, nor have we received any income as a result of the agreement to share this freely available information from the NHS website with Amazon. This new service through Alexa will enable a greater number of people to access it and help them to manage their own healthcare.

19th Dec 2019
To ask Her Majesty's Government what safeguards to protect (1) patient confidentiality, (2) intellectual property, (3) data, and (4) other materials, from inappropriate use have been built into the agreement to share NHS health data with Amazon.

No patient data is being shared with Amazon as part of this agreement. The collaboration with Amazon simply connects people to information that is already freely available through the National Health Service website. Use of Amazon Alexa is an alternative mechanism for accessing that information. Patients already use Alexa and other devices to search for information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the NHS instead of from a range of other sources, such as non-United Kingdom websites.

This agreement is not exclusive. There are over 2,000 other organisations that are accessing and using information from the NHS website in a similar way.

The agreement signed between the Department and Amazon is clear that none of the data generated through voice search using Alexa will be shared with third parties; that it will not be used for selling products or making product recommendations to Amazon users; nor is it building any form of health profiles on Amazon customers.

All information is treated with high confidentiality and Amazon use multi-factor authentication to restrict access, service encryption, and audits of our control environment to protect it. The information that Amazon collects is only used to train its speech recognition software and natural language understanding systems, so Alexa can better understand the requests of users and ensure the service works well for everyone. No Amazon employee has direct access to information that can identify the person or account, and Amazon have the appropriate measures in place to ensure General Data Protection Regulation compliance.

19th Dec 2019
To ask Her Majesty's Government whether the contract with Amazon to share health data from the NHS was put out to competitive tender.

The agreement with Amazon is non-exclusive and we want to work with other organisations to arrange for the content to be provided on other home devices. There are currently over 2,000 other organisations using content from the National Health Service website.

This is a mutually beneficial collaboration that will enable greater numbers of people to access health information accredited by the NHS, helping to put people in control of their own healthcare. The information being provided to users of Alexa devices asking questions is already freely available through the NHS website. This is an alternative mechanism for delivering that information. Patients already use Alexa and other devices to search for information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the NHS instead of from a range of other sources, such as non-United Kingdom websites.

NHS Digital and NHSX have built an interface (known technically as an API, or Application Programming Interface) to content on the NHS website so that other organisations can use it to make NHS information available through their own sites. It is freely available.

The service available through Alexa enables a greater number of people to access certified NHS information from a trusted source, instead of potentially misleading information from a range of worldwide websites where the information may not have been clinically assessed.


19th Dec 2019
To ask Her Majesty's Government why several sections of the contract to share NHS data with Amazon were redacted when placed in the public domain.

The agreement between the Department and Amazon is about using content from the National Health Service website to provide reliable and informative answers to basic health questions asked to Amazon’s virtual assistant voice service, Alexa. This content is already freely available on the NHS website. Patients already use Alexa and other devices to search for information on a range of health issues. This agreement ensures that the information they receive from Alexa is medically verified by the NHS instead of from a range of other sources, such as non-United Kingdom websites.

This agreement is not exclusive. There are over 2,000 other organisations that are accessing and using information from the NHS website in a similar way.

A limited number of clauses have been redacted due to being exempt under Section 43(2) of the Freedom Of Information Agreement, which exempts information where the release would, or would be likely to, prejudice the commercial interests of any entity, including the public authority holding the information.

In this case, we consider that the release of the redacted clauses would be likely to prejudice the commercial interests of Amazon on the basis that it would make public the non-standard terms that Amazon has been willing to enter into in respect of this agreement. Disclosure of the redacted clauses has potential to prejudice existing agreements between Amazon and other parties, which could result in other parties challenging Amazon over the terms and conditions of their agreements.

In addition, certain personal information has been redacted in the agreement. This information is exempt from disclosure under Section 40(2) of Freedom Of Information Agreement as disclosure of this personal information would breach the data protection principles. In particular, we consider that the disclosure of this personal information would be unfair and breach the first data principle.

7th Dec 2020
To ask Her Majesty's Government what representations they have made to the government of China about the reported abduction of Meihong Wang by police in Harbin, Heilongjiang Province on 23 November.

We are aware of the reported abduction of Meihong Wang in Harbin, China. We remain deeply concerned about the persecution of Christians, Muslims, Buddhists, Falun Gong practitioners and others on the grounds of their religion or belief in China. The freedom to practise, change or share ones faith or belief without discrimination or violent opposition is a human right that all people should enjoy. We regularly raise our concerns about the human rights situation with the Chinese authorities, and will continue to do so.

Lord Ahmad of Wimbledon
Minister of State (Foreign, Commonwealth and Development Office)
15th Oct 2020
To ask Her Majesty's Government whether the British Consulate in Hong Kong is monitoring and assessing (1) resignations from, (2) appointments to, and (3) moves of members within, the judiciary in Hong Kong; what assessment they have made, if any, of the desirability of members of the British judiciary being seconded to serve in the courts of the region to implement the provisions of the Hong Kong national security law; and what criteria they use to make any such assessment.

Hong Kong's independent judiciary is a cornerstone of its economic success and way of life. As the Foreign Secretary said to the Foreign Affairs Committee on 6 October, judicial appointments to the Hong Kong Court of Final Appeal are made independently. The Foreign Secretary and the Lord Chancellor will continue their consultations with the Supreme Court, building on assessments from the Consulate-General in Hong Kong and others.

Lord Ahmad of Wimbledon
Minister of State (Foreign, Commonwealth and Development Office)
10th Mar 2020
To ask Her Majesty's Government what representations they intend to make to the World Health Organisation to consider the report of the World Organisation to Investigate the Persecution of Falun Gong which showed that over 7,000 doctors in China are involved in the systematic killing of prisoners through the enforced body harvesting trade in that country.

We consult and share assessments with the World Health Organisation (WHO) on a range of issues, including on allegations of forced organ harvesting. We will continue to consult the WHO on its assessment of the organ transplant system in China.

Lord Ahmad of Wimbledon
Minister of State (Foreign, Commonwealth and Development Office)
9th Mar 2020
To ask Her Majesty's Government what representations they have made to the World Health Organisation to set out the full reasons why it believes that the government of China has an ethical voluntary organ transplant system in place.

We consult and share assessments with the World Health Organisation (WHO) on a range of issues, including on allegations of forced organ harvesting. We will continue to consult the WHO on its assessment of the organ transplant system in China.

Lord Ahmad of Wimbledon
Minister of State (Foreign, Commonwealth and Development Office)
9th Mar 2020
To ask Her Majesty's Government what representations they plan to make to the World Health Organisation to review its stance on the the government of China's organ transplant system following the China Tribunal's findings that that government's forced organ harvesting constitutes a crime against humanity.

We are carefully reviewing the allegations in the recently released China Tribunal report. The Government's position remains that, if true, allegations of forced organ harvesting would constitute a gross violation of human rights. We take such allegations seriously and will continue to consult with the World Health Organization and international partners on this matter.

Lord Ahmad of Wimbledon
Minister of State (Foreign, Commonwealth and Development Office)
22nd Feb 2021
To ask Her Majesty's Government what has been the outcome of their invitation for stakeholders to respond to their policy paper VAT and the Public Sector: Reform to VAT refund rules, published in August 2020.

The Government is currently reviewing the responses received following the publication of the policy paper. The Government will announce its next steps in due course.

Lord Agnew of Oulton
Minister of State (HM Treasury)
3rd Sep 2020
To ask Her Majesty's Government when they expect to publish the review into the application of VAT as applied to the NHS.

The Section 41 policy paper on the review into the application of VAT to the NHS was published on 27 August 2020 on the GOV.UK website as ‘VAT and the Public Sector: Reform to VAT Refund Rules’.
Lord Agnew of Oulton
Minister of State (HM Treasury)
6th Jul 2020
To ask Her Majesty's Government what measures will be in place by 1 August to support those who are shielding from COVID-19 who cannot return to work because their workplace is not safe, but who cannot be furloughed as the deadline has passed and who will not be able to claim Statutory Sick Pay under the Government's plans to end the shielding programme on 31 July.

On 22 June, the Prime Minister announced that the Government will relax the current public health guidance for those identified as Clinically Extremely Vulnerable (CEV) to shield at home. This means from 1 August they will be able to return to work if they are unable to work from home, provided their workplace is COVID-safe.

It is important that this group continue to take careful precautions, and employers should do all they can to enable them to work from home where this is possible, including moving them to another role if required. Where this is not possible, the CEV should be provided with the safest on-site roles that enable them to maintain social distancing from others.

If employers cannot provide a safe working environment, the CEV will continue to have access to an unprecedented package of financial support. This is not limited to the Coronavirus Job Retention Scheme, but also includes the Self-Employment Income Support Scheme and an increase in the generosity of welfare payments worth a further £8bn.

Lord Agnew of Oulton
Minister of State (HM Treasury)
3rd Feb 2020
To ask Her Majesty's Government when they expect to publish the review into the application of VAT as applied to the NHS.

The Government is currently working on the section 41 VAT policy paper and this will be published in due course.

Earl of Courtown
Captain of the Queen's Bodyguard of the Yeomen of the Guard (HM Household) (Deputy Chief Whip, House of Lords)
3rd Mar 2021
To ask Her Majesty's Government what assessment they have made of the likely number of people coming from Hong Kong under the British National (Overseas) visa moving to different geographic regions in the UK.

On 31 January the Home Office launched the new Hong Kong British National (Overseas) (BN(O)) route.

Since then, the Ministry of Housing, Communities and Local Government (MHCLG) has been working with partners across Whitehall and beyond to help new arrivals to settle into life in the UK. Planning assumptions and guidance on which services may need to prepare for BN(O) arrivals have been shared with local authorities and MHCLG will continue to work closely with local authorities to ensure that impacts on existing service provision are understood and addressed as appropriate.

We are clear landlords must take extra care to ensure no-one is discriminated against when carrying out right to rent checks. Successful applicants for the BN(O) route will receive either a biometric residence permit (BRP) or digital status, which will enable them to evidence their right to rent a property in the UK.

It is not standard practice for the Home Office to collect data around where people choose to settle once they receive their migration status. BN(O) status holders are entitled to settle wherever they choose within the United Kingdom.

The UK Government looks forward to welcoming applications from those individuals who wish to make our United Kingdom their home.

Baroness Williams of Trafford
Minister of State (Home Office)
3rd Mar 2021
To ask Her Majesty's Government what (1) discussions they are having with, and (2) guidance they have issued to, (a) local authorities, (b) landlord representatives, and (c) housing associations, to ensure that people coming to the UK from Hong Kong under the British National (Overseas) visa are able (i) to secure appropriate housing, and (ii) are not disadvantaged under the Right to Rent scheme by the need to demonstrate their immigration status.

On 31 January the Home Office launched the new Hong Kong British National (Overseas) (BN(O)) route.

Since then, the Ministry of Housing, Communities and Local Government (MHCLG) has been working with partners across Whitehall and beyond to help new arrivals to settle into life in the UK. Planning assumptions and guidance on which services may need to prepare for BN(O) arrivals have been shared with local authorities and MHCLG will continue to work closely with local authorities to ensure that impacts on existing service provision are understood and addressed as appropriate.

We are clear landlords must take extra care to ensure no-one is discriminated against when carrying out right to rent checks. Successful applicants for the BN(O) route will receive either a biometric residence permit (BRP) or digital status, which will enable them to evidence their right to rent a property in the UK.

It is not standard practice for the Home Office to collect data around where people choose to settle once they receive their migration status. BN(O) status holders are entitled to settle wherever they choose within the United Kingdom.

The UK Government looks forward to welcoming applications from those individuals who wish to make our United Kingdom their home.

Baroness Williams of Trafford
Minister of State (Home Office)
14th Sep 2020
To ask Her Majesty's Government whether a British national (overseas) citizen who is ordinarily resident in Hong Kong but is in the UK for a permitted six-month, visa-free stay would be allowed to remain in the UK for the duration of their application process for a new Hong Kong BN(O) Visa, even if this exceeded the initial six-month period.

BN(O) citizens whose current grant of leave in the UK is due to expire before the new Hong Kong BN(O) Visa is launched, should look to extend their leave in line with the rules of their existing route and then apply for the Hong Kong BN(O) Visa when it is available. Those who apply to the scheme before their leave expires will be able to remain in the UK whilst their application is considered.

We are considering options for those individuals whose leave is due to expire and who are unable to extend their leave before the new route is launched. We will set out further details in due course.

Baroness Williams of Trafford
Minister of State (Home Office)
28th Jan 2020
To ask Her Majesty's Government what assessment they have made of the effectiveness of current fire regulations in protecting residents of both public and private care homes, particularly taking into account the prevalence of (1) reduced mobility, and (2) dementia, of such residents.

The Regulatory Reform (Fire Safety) Order 2005 applies to care homes and requires the responsible person to carry out a fire risk assessment of the premises and put in place – and maintain – appropriate fire protection measures to mitigate the risk to life from fire. The fire risk assessment should be reviewed regularly to ensure the ongoing fire safety of residents and staff, considering the physical and mental health of those on the premises. Government has made available guidance to support responsible persons in complying with the provisions of the Fire Safety Order, including specific guidance for those responsible for healthcare premises.

The Home Office published a Call for Evidence on the Fire Safety Order in 2019 to test whether the legislation is fit for purpose for all premises within its scope and, where appropriate, is aligned to wider building safety regimes. The responses are being considered and a follow up consultation is planned for spring 2020.

Baroness Williams of Trafford
Minister of State (Home Office)
21st Sep 2020
To ask Her Majesty's Government what assessment they have made of the number of specialist BME refuges for victims of domestic violence that have closed in the last 12 months as a result of local authorities switching contracts to larger generic charities.

The Government does not hold this data centrally. Local authorities often make commissioning decisions based on their specific local needs.

The Government recognises the support that BAME specialist refuges provide for victims of domestic abuse and their children. During 2020/21 we have funded and supported specialist refuges, including BAME specialist services, through our £10 million domestic abuse COVID-19 emergency funding.

Lord Greenhalgh
Minister of State (Home Office)
21st Sep 2020
To ask Her Majesty's Government what discussions they intend to have with local authorities about the case for changing procurement policies to ensure that local specialist services including BME refuges for victims of domestic violence continue to receive contracts.

Depending on the value of any specific contracting opportunity, local authorities will need to comply with the general principles of procurement outlined in the Public Contracts Regulations 2015. This includes a regulatory responsibility to apply equal treatment to bidding organisations. Local authorities are also required to consider the Social Value Act as part of their contracting processes.

My officials have held workshops with local authorities from across the country to support them in preparing for the implementation of the new duty, including discussions on the importance of assessing the needs of all victims and providing specialist domestic abuse services as required. We will continue to work closely with local authorities and the sector.

Lord Greenhalgh
Minister of State (Home Office)
12th May 2020
To ask Her Majesty's Government what guidance they have given to local resilience forums about engagement with voluntary organisations in response to the COVID-19 pandemic.

The role of the voluntary sector in supporting the preparation, response and recovery from emergencies is set out in Chapter 14 of the Cabinet Office’s publication on Emergency Preparedness. Local Resilience Forums (LRFs) have well established structures in place to work with voluntary sector organisations and we expect them to do so.

To support their work, Government published advice on how the voluntary, community and social enterprise sector can safely and effectively support the country through Covid-19. Furthermore, we announced a £750 million package of support for charities to ensure they can continue their vital work during the Covid-19 outbreak.

Lord Greenhalgh
Minister of State (Home Office)
12th Feb 2020
To ask Her Majesty's Government wat assessment they have made of the research conducted by Which? into the effectiveness of carbon monoxide alarms, published in June 2018.

In 2019, the Office for Product Safety and Standards examined a small sample of carbon monoxide and smoke alarms for compliance with safety requirements. It found that nine out of ten were compliant and the remaining carbon monoxide product was over-sensitive which did not give rise to safety concerns.

UK product safety legislation requires products, including carbon monoxide alarms, to be safe before they can be sold to consumers. Where the installation of carbon monoxide alarms is required by law or recommended, Government advice is that they should comply with British Standard BS EN 50291.

Baroness Bloomfield of Hinton Waldrist
Baroness in Waiting (HM Household) (Whip)
28th Jan 2020
To ask Her Majesty's Government what assessment they have made of the capacity of planning legislation to allow for the assessment of (1) the potential increase of mobility scooter use, and (2) any increase in risk to users of mobility scooters and others arising out of that increase, due to the building of care properties.

The National Planning Policy Framework makes clear that applications for development should address the needs of people with disabilities and reduced mobility in relation to all modes of transport, and that developments should create places that are safe, inclusive and accessible. These policies should ensure that when considering planning applications, such as the building of care properties, local authorities take account of the needs of all users, including users of mobility scooters, and satisfy their obligations under the equalities legislation.

The department's officials have been working closely with officials at DfT to produce planning practice guidance on sustainable transport and accessibility which will be published shortly, and will sit alongside the National Design Guide which provides guidance on designing movement networks that are safe and accessible for all.

Viscount Younger of Leckie
Lord in Waiting (HM Household) (Whip)
13th Jan 2020
To ask Her Majesty's Government what plans they have to ensure that new proposals to reform leasehold law should include new retirement homes.

In developing and taking forward leasehold reforms, the Government is taking into consideration all relevant sectors of the UK housing market, including new retirement homes.

Viscount Younger of Leckie
Lord in Waiting (HM Household) (Whip)
13th Jan 2020
To ask Her Majesty's Government what assessment they have made of the finding by The Times, published on 23 November 2019, of the loss in value of new build retirement homes as a result of ground rent and service charges levied by management companies.

Unfair leasehold practices have no place in a modern housing market. The Government is taking forward a comprehensive programme to reform leasehold. This includes reducing ground rents on future leases to a zero and banning new leasehold houses.

The Government’s response to the technical consultation Implementing reforms to the leasehold system in England, published on 27 June 2019, set out that in future, purchasers of retirement homes must be offered the choice between paying ground rents on their new home or purchasing the property with zero ground rents (but with a higher sales price). In addition, ground rents cannot be used where event (exit) fees apply.

The law is clear that service charges must be reasonable and, where costs relate to work or services, the work or services must be of a reasonable standard. Leaseholders may make an application to the First-tier Tribunal to make a determination on the reasonableness of their service charges.

In October 2018 my Department established an independent Regulation of Property Agents working group, chaired by Lord Best, to raise standards across the property sector, which also considered how fees such as service charges should be presented to consumers, and whether they should be capped or banned. The working group reported in July 2019 and we are considering their recommendations.

Viscount Younger of Leckie
Lord in Waiting (HM Household) (Whip)
13th Jan 2020
To ask Her Majesty's Government, further to the investigation by The Times of the loss in value of new build retirement homes as a result of ground rent and service charges levied by management companies where house builders suggest to prospective buyers that they use solicitors proposed by the house builder, published on 23 November 2019, what plans they have to ensure that independent advice is made available to such buyers.

Home buyers are under no obligation to use the solicitor recommended by their developer and the Government makes this point clearly in its How to Buy a Home guide (attached). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/829864/6.5492_-_MHCLG_-_How_to_Buy_Guide_WEB.PDF

There can be beneficial reasons for a property buyer to use a solicitor proposed by the house builder, such as greater familiarity with the processes of the house builder leading to fewer delays in the conveyancing process. The Solicitors Regulation Authority, however, is clear in setting standards of conduct and behaviour and provides a framework for ethical and competent practice.

If a homebuyer has a complaint against a conveyancer or solicitor, an estate agent, property developer, landlord or freeholder or management agent, they do have a right of redress. Trading Standards have published guidance for leaseholders seeking redress, which is available (attached) here: https://en.powys.gov.uk/article/7263/Guidance-for-consumers-seeking-redress-for-leasehold-matters.

Viscount Younger of Leckie
Lord in Waiting (HM Household) (Whip)
13th Jan 2020
To ask Her Majesty's Government, further to the findings, published by The Times on 23 November 2019, of the loss in value of new build retirement homes, whether they intend to hold discussions with the Solicitors Regulation Authority about housebuilders suggesting to prospective buyers that they use solicitors proposed by the house builder.

Home buyers are under no obligation to use the solicitor recommended by their developer and the Government makes this point clearly in its How to Buy a Home guide (attached). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/829864/6.5492_-_MHCLG_-_How_to_Buy_Guide_WEB.PDF

There can be beneficial reasons for a property buyer to use a solicitor proposed by the house builder, such as greater familiarity with the processes of the house builder leading to fewer delays in the conveyancing process. The Solicitors Regulation Authority, however, is clear in setting standards of conduct and behaviour and provides a framework for ethical and competent practice.

If a homebuyer has a complaint against a conveyancer or solicitor, an estate agent, property developer, landlord or freeholder or management agent, they do have a right of redress. Trading Standards have published guidance for leaseholders seeking redress, which is available (attached) here: https://en.powys.gov.uk/article/7263/Guidance-for-consumers-seeking-redress-for-leasehold-matters.

Viscount Younger of Leckie
Lord in Waiting (HM Household) (Whip)
8th Mar 2021
To ask Her Majesty's Government what plans they have to introduce a new section to Procedures for searching people: PSI 07/2016, published on 26 July 2016, on the conduct of searches by transgender prison officers.

The national policy on the searching of prisoners, staff and visitors (PSI 07/2016 – Searching of the Person) is currently under review and a revised version is intended to be published later this year.

The updated policy will include direction on transgender staff conducting searches. This will account for staff with or without a Gender Recognition Certificate (GRC).

In reviewing the policy, Her Majesty’s Prison and Probation Service (HMPPS) has consulted with the Government’s Legal Department and HMPPS Equalities Team. The new policy will be compliant with the Equality Act 2010, Gender Recognition Act 2004 and the European Convention of Human Rights.

Lord Wolfson of Tredegar
Parliamentary Under-Secretary (Ministry of Justice)
8th Mar 2021
To ask Her Majesty's Government what steps they are taking to ensure that their review of Procedures for searching people: PSI 07/2016, published on 26 July 2016, takes account of the Equality Act 2010.

The national policy on the searching of prisoners, staff and visitors (PSI 07/2016 – Searching of the Person) is currently under review and a revised version is intended to be published later this year.

In reviewing the policy, Her Majesty’s Prison and Probation Service (HMPPS) has consulted with the Government’s Legal Department and HMPPS Equalities Team. The new policy will be compliant with the Equality Act 2010, Gender Recognition Act 2004 and the European Convention of Human Rights.

The updated policy will include direction on transgender staff conducting searches. This will account for staff with or without a Gender Recognition Certificate (GRC).

Lord Wolfson of Tredegar
Parliamentary Under-Secretary (Ministry of Justice)
8th Mar 2021
To ask Her Majesty's Government what plans they have to revise the current policy that women prisoners have the right to be searched only by officers of female sex assigned at birth, as outlined in Procedures for searching people: PSI 07/2016, published on 26 July 2016, as part of their review of those procedures.

The national policy on the searching of prisoners, staff and visitors (PSI 07/2016 – Searching of the Person) is currently under review and a revised version is intended to be published later this year. The updated policy will include direction on transgender staff conducting searches. This will encompass staff with or without a Gender Recognition Certificate (GRC).

This policy allows for male officers to conduct rub down searches on the same sex only and female officers to conduct rub down searches on both sexes and has been in place since 1992. Full searches must only be conducted by a person of the same sex.

In accordance with the Gender Recognition Act (GRA) 2004, transgender people may apply for a Gender Recognition Certificate (GRC). Prisoners and staff members in receipt of a GRC have the legal right to be treated as their acquired gender in every respect.

In reviewing the policy, Her Majesty’s Prison and Probation Service (HMPPS) has consulted with the Government’s Legal Department and HMPPS Equalities Team. The new policy will be compliant with the Equality Act 2010, Gender Recognition Act 2004 and the European Convention of Human Rights.

Lord Wolfson of Tredegar
Parliamentary Under-Secretary (Ministry of Justice)