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 25th May 2022
16:00
Public Services Committee - Oral evidence
Subject: Levelling Up
25 May 2022, 4 p.m.
At 4.00pm: Oral evidence
Neil O'Brien MP - Parliamentary Under-Secretary of State (Minister for Levelling Up, The Union and Constitution) at Department for Levelling Up, Housing and Communities
Will Garton - Director General, Levelling Up at Department for Levelling Up, Housing and Communities (DLUHC)
View calendar
Scheduled Event
Tuesday 7th June 2022
Oral questions - Main Chamber
Addressing the reported shortage of NHS dentists
View calendar
Select Committee Meeting
Wednesday 15th June 2022
15:00
Division Votes
Wednesday 27th April 2022
Elections Bill
voted Aye - in line with the party majority
One of 59 Labour Aye votes vs 0 Labour No votes
Tally: Ayes - 150 Noes - 208
Speeches
Wednesday 18th May 2022
St George’s Hospital: Patient Deaths
I am grateful to the Minister. This is a serious issue. An independent review into cardiac surgery at St George’s …
Written Answers
Friday 20th May 2022
National Institute for Health and Care Excellence
To ask Her Majesty's Government whether they plan to publish the names of the organisations which took part in the …
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 …
MP Financial Interests
None available

Division Voting information

During the current Parliamentary Session, Lord Hunt of Kings Heath has voted in 246 divisions, and 2 times 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
16 Mar 2022 - Health and Care Bill - View Vote Context
Lord Hunt of Kings Heath voted No - against a party majority and in line with the House
One of 24 Labour No votes vs 51 Labour Aye votes
Tally: Ayes - 145 Noes - 179
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)
(92 debate interactions)
Lord Kamall (Conservative)
Parliamentary Under-Secretary (Department of Health and Social Care)
(49 debate interactions)
Baroness Williams of Trafford (Conservative)
Minister of State (Home Office)
(16 debate interactions)
View All Sparring Partners
Department Debates
Department of Health and Social Care
(259 debate contributions)
Home Office
(52 debate contributions)
Leader of the House
(43 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 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 - 3rd Reading (Lords)
Friday 4th March 2022
(Read Debate)

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
(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


449 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
3 Other Department Questions
4th Apr 2022
To ask Her Majesty's Government what assessment they have made of the Rural Services Network's Rural Lens Review of the Levelling Up White Paper, published in March; and what subsequent consideration they have given to the scope of the levelling up policy.

The Government has reviewed in detail the work of the Rural Services Network and officials have been in contact with the Network regarding the Rural Lens Review.

Building on the Levelling Up White Paper, the Rural Proofing Report will be published later in the year. This report will outline how government departments are working to develop levelling up in rural areas through targeted approaches where necessary. This report will also set out how we are strengthening the rural economy, developing rural infrastructure, delivering rural services and managing the natural environment.

Lord Greenhalgh
Minister of State (Home Office)
5th Jul 2021
To ask Her Majesty's Government whether Government departments treat any of the protected characteristics under the Equality Act 2010, excluding disability, as taking precedence over any other.

The Equality Act 2010 does not recognise any precedence of rights beyond the special circumstances of disability. However, in situations where there are multiple protected characteristics to be considered, Government Departments, like other employers or service providers, need to take decisions based on the facts.

Where the relevant conditions apply, Departments may also choose to take targeted action to advance the interests of and/or meet the specific needs of groups with a particular protected characteristic in accordance with the positive action provisions in the Act.

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.

15th Nov 2021
To ask Her Majesty's Government when they will publish the review into the language used in drafting legislation.

A response on this issue is in the process of being finalised. I hope to respond to Noble Lords before the House rises for the Christmas recess.

Lord True
Minister of State (Cabinet Office)
26th Oct 2021
To ask Her Majesty's Government what plans they have to review the functions of the Parliamentary and Health Service Ombudsman to ensure that it investigates a higher proportion of complaints received than is current practice.

The Parliamentary and Health Service Ombudsman is a crown servant that reports directly to Parliament. The Ombudsman is not responsible to the Government for its performance and sets its own standards for practice in how it handles complaints. I understand the Noble Lord is in contact with the Ombudsman who can explain in further detail the organisation's current practice in this area. Further to this the Noble Lord may wish to write to the Public Administration and Constitutional Affairs Committee that acts as the primary accountability body for the Ombudsman.

Lord True
Minister of State (Cabinet Office)
26th Oct 2021
To ask Her Majesty's Government what plans they have to review the functions of the Parliamentary and Health Service Ombudsman to ensure that it (1) collects, (2) analyses, and (3) publishes, data on complaints involving the death of patients that it has decided not to investigate.

The Parliamentary and Health Service Ombudsman is a crown servant that reports directly to Parliament. The Ombudsman is not responsible to the Government for its performance and sets its own standards for practice in how it handles complaints. I understand the Noble Lord is in contact with the Ombudsman who can explain in further detail the organisation's current practice in this area. Further to this the Noble Lord may wish to write to the Public Administration and Constitutional Affairs Committee that acts as the primary accountability body for the Ombudsman.

Lord True
Minister of State (Cabinet Office)
6th Sep 2021
To ask Her Majesty's Government when they will next review retained papers relating to allegations of a security service plot against Harold Wilson to decide whether they can be released; and what criteria will be used in this review.

Under the Public Records Act these papers were originally recommended for closure for at least 100 years. However, in line with current best practice, these papers will be reviewed in 2026 and every ten years thereafter.

Lord True
Minister of State (Cabinet Office)
12th Jul 2021
To ask Her Majesty's Government whether they will publish the results of the inquiry by Lord Hunt of Tanworth in 1996 into allegations of a security service plot against Harold Wilson.

Official papers relating to allegations of a security service plot against Harold Wilson are retained by the Cabinet Office. Retained papers are reviewed regularly to decide whether they can be released.

Lord True
Minister of State (Cabinet Office)
30th Jun 2021
To ask Her Majesty's Government, further to recent statements by the Equality and Human Rights Commission about its withdrawal from the Stonewall Diversity Champion scheme, what steps they are taking to ensure their expenditure on workplace diversity and inclusion initiatives (1) offers value for money, (2) is fairly balanced, and (3) is reasonable and proportionate, taking into account the rights of all persons with any of the protected characteristics set out in the Equality Act 2010.

The Government has committed to a new standard for diversity and inclusion in the Civil Service which will promote a diversity of backgrounds and opinions. We are committed to fair, inclusive workplaces which draw on the talents of the widest possible range of backgrounds, especially people from non-traditional educational routes and from outside London and the South East.

It is fundamental that everyone is able to seize opportunities in the workplace without fear of discrimination or harassment.

Memberships of external schemes are kept under review, to ensure value for taxpayers’ money. A number of public bodies have resolved to best champion inclusion through internal programmes.

Lord True
Minister of State (Cabinet Office)
30th Jun 2021
To ask Her Majesty's Government, further to recent statements by the Equality and Human Rights Commission about its withdrawal from the Stonewall Diversity Champions scheme, what steps they are taking to ensure their departments are (1) inclusive workplaces, (2) attracting people from all backgrounds, and (3) workplaces where every employee is treated in line with the Equality Act 2010.

The Government has committed to a new standard for diversity and inclusion in the Civil Service which will promote a diversity of backgrounds and opinions. We are committed to fair, inclusive workplaces which draw on the talents of the widest possible range of backgrounds, especially people from non-traditional educational routes and from outside London and the South East.

It is fundamental that everyone is able to seize opportunities in the workplace without fear of discrimination or harassment.

Memberships of external schemes are kept under review, to ensure value for taxpayers’ money. A number of public bodies have resolved to best champion inclusion through internal programmes.

Lord True
Minister of State (Cabinet Office)
30th Jun 2021
To ask Her Majesty's Government what steps they are taking to ensure their workplace policies and procedures do not potentially infringe any person's ability to enjoy their fundamental rights and freedoms under the Human Rights Act 1998.

When formulating and reviewing workplace policies and procedures, government departments have due regard for all legal requirements, including the rights and freedoms in Schedule 1 of the Human Rights Act 1998.

Lord True
Minister of State (Cabinet Office)
14th Jun 2021
To ask Her Majesty's Government what is their policy for the use of self-destructing messages in communications with Government departments where no record of these messages is retained.

The Government acts in accordance with the Code of Practice on the management of records issued under section 46 of the Freedom of Information Act 2000.

This includes advice on the disposal of ephemeral information and how to keep records needed for business, regulatory, legal and accountability purposes.

The Government is reviewing how guidance can be updated to reflect contemporary information management practice in the modern digital working environment.

Lord True
Minister of State (Cabinet Office)
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)
17th Sep 2020
To ask Her Majesty's Government how many representatives of small and medium-sized enterprises are appointed to Cabinet Office advisory panels; and what plans they have, if any, to increase this number.

The Small Business Advisory Panel provides feedback and challenge on increasing government spend with small and medium-sized enterprises. Information about the work of the panel is published at gov.uk/government/publications/sme-panel.

Martin Traynor OBE serves as the Small Business Crown Representative, making sure that small businesses have improved access to government contracts.

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
11th Oct 2021
To ask Her Majesty's Government how much they have invested in mathematical sciences in each higher education institution in the UK for (1) teaching, and (2) research.

The UK is a world leader in Mathematics, accounting for the 5th largest share of publications but the third largest share of the top 1% and 10% most cited publications.

Between Financial Year 2015-2016 and September 2021, EPSRC committed £259.9m to research grants Mathematical Sciences. This includes commitment from the Additional Funding Programme. At this current time, EPSRC are unable to make a direct comparison to international averages.

Following the Government’s announcement in January 2020 to invest additional funding into Mathematical Sciences, UKRI has awarded around £104 million of additional funding to the discipline, over and above EPSRC’s core Mathematical Sciences Theme budget. The additional funding has covered institutes, small and large research grants, fellowships, doctoral studentships and postdoctoral awards.

On the 27 October 2021, the Government will announce the outcome of the Comprehensive Spending Review. Once that has concluded, BEIS and UKRI will set out how we meet the commitment to invest additional funding into Mathematical sciences in forthcoming years, as part of the allocations process.

Lord Callanan
Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)
11th Oct 2021
To ask Her Majesty's Government what is the breakdown of (1) actual, and (2) planned, expenditure of their £300 million investment in the mathematical sciences.

The UK is a world leader in Mathematics, accounting for the 5th largest share of publications but the third largest share of the top 1% and 10% most cited publications.

Between Financial Year 2015-2016 and September 2021, EPSRC committed £259.9m to research grants Mathematical Sciences. This includes commitment from the Additional Funding Programme. At this current time, EPSRC are unable to make a direct comparison to international averages.

Following the Government’s announcement in January 2020 to invest additional funding into Mathematical Sciences, UKRI has awarded around £104 million of additional funding to the discipline, over and above EPSRC’s core Mathematical Sciences Theme budget. The additional funding has covered institutes, small and large research grants, fellowships, doctoral studentships and postdoctoral awards.

On the 27 October 2021, the Government will announce the outcome of the Comprehensive Spending Review. Once that has concluded, BEIS and UKRI will set out how we meet the commitment to invest additional funding into Mathematical sciences in forthcoming years, as part of the allocations process.

Lord Callanan
Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)
11th Oct 2021
To ask Her Majesty's Government (1) how much they have spent on mathematical sciences at higher education institutions in the UK, and (2) how this compares to the international average.

The UK is a world leader in Mathematics, accounting for the 5th largest share of publications but the third largest share of the top 1% and 10% most cited publications.

Between Financial Year 2015-2016 and September 2021, EPSRC committed £259.9m to research grants Mathematical Sciences. This includes commitment from the Additional Funding Programme. At this current time, EPSRC are unable to make a direct comparison to international averages.

Following the Government’s announcement in January 2020 to invest additional funding into Mathematical Sciences, UKRI has awarded around £104 million of additional funding to the discipline, over and above EPSRC’s core Mathematical Sciences Theme budget. The additional funding has covered institutes, small and large research grants, fellowships, doctoral studentships and postdoctoral awards.

On the 27 October 2021, the Government will announce the outcome of the Comprehensive Spending Review. Once that has concluded, BEIS and UKRI will set out how we meet the commitment to invest additional funding into Mathematical sciences in forthcoming years, as part of the allocations process.

Lord Callanan
Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)
7th Sep 2021
To ask Her Majesty's Government what plans they have to support the research of all forms of mathematics at universities in England.

In academic year 2020-21, Research England allocated £66.4 million to Mathematical Sciences. This financial year the Engineering and Physical Sciences Research Council, part of UK Research and Innovation (UKRI), is forecasting a spend of £50.975 million on Mathematical Sciences research in English universities. Plans for funding for future years will be dependent on the outcome of the recently announced Spending Review.

Lord Callanan
Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)
7th Sep 2021
To ask Her Majesty's Government what plans they have to promote the study and research of mathematics at universities in England.

In academic year 2020-21, Research England allocated £66.4 million to Mathematical Sciences. This financial year the Engineering and Physical Sciences Research Council, part of UK Research and Innovation (UKRI), is forecasting a spend of £50.975 million on Mathematical Sciences research in English universities. Plans for funding for future years will be dependent on the outcome of the recently announced Spending Review.

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 Education)
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 Education)
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 Education)
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 Education)
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 Education)
5th Jan 2022
To ask Her Majesty's Government what assessment they have made of the consistency of the guidance issued for completion of the School Census 2021/22 in relation to the recording of gender with the Education (Information about Individual Pupils) (England) Regulations 2013.

The department’s guidance for completing the school census specifies that in this context, gender should be specified as either 'M' (male) or 'F' (female) (which may be different from the individual’s legal sex). This should be self-declared and recorded according to the wishes of the parent and/or pupil. The school census does not collect the ‘sex’ of pupils.

The department believes that this guidance is consistent, but the changing use of language in this area, and the evolving needs of the school population, have led to the department reviewing its data standards. The department intends to publish a new standard making a distinction between ‘sex’ and ‘gender’ in the coming months. School census guidance will need to be updated to conform to the new data standard.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Jan 2022
To ask Her Majesty's Government what meaning they ascribe to the word 'gender' in the context of the Education (Information about Individual Pupils) (England) Regulations 2013.

The department’s guidance for completing the school census specifies that in this context, gender should be specified as either 'M' (male) or 'F' (female) (which may be different from the individual’s legal sex). This should be self-declared and recorded according to the wishes of the parent and/or pupil. The school census does not collect the ‘sex’ of pupils.

The department believes that this guidance is consistent, but the changing use of language in this area, and the evolving needs of the school population, have led to the department reviewing its data standards. The department intends to publish a new standard making a distinction between ‘sex’ and ‘gender’ in the coming months. School census guidance will need to be updated to conform to the new data standard.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
15th Sep 2021
To ask Her Majesty's Government what was their response to the letter from Amanda Spielman, Her Majesty's Chief Inspector, about Ofsted's monitoring of inspectorates for independent schools, sent to the Secretary of State for Education on 6 November 2018.

In her letter of 6 November 2018, Her Majesty’s Chief Inspector (HMCI) recommended a review of the monitoring arrangements in place at the time and that new ones should be put in their place. Such a review was carried out by departmental officials, working alongside officials in Ofsted and at the Independent Schools Inspectorate (ISI). Following this review, new directions were issued to HMCI on 4 November 2019.

The new arrangements outlined above were aimed at giving greater flexibility to Ofsted and ISI to develop a joint programme of work to exchange and develop their mutual knowledge and understanding of inspecting independent schools.

It is worth noting that the School Inspection Service, which previously undertook inspections of some independent schools, has now closed and that there is now only one independent inspectorate, ISI. As such, and given the new directions issued on 4 November 2019, HMCI should no longer have regard to the matters in the February 2015 directions, which were the subject of the 6 November 2018 letter.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
20th Jul 2021
To ask Her Majesty's Government, further to the Written Answers by Baroness Berridge on 13th July (HL1530, HL1531 and HL1532), why they do not collect data on the use of handcuffs on looked after children; whether the regulations cited apply to those transporting looked after children from one location to another; what specific steps are taken during Ofsted inspections to assess compliance with the regulations both (1) in children’s homes, and (2) in transport between locations; and whether they intend to review the policy and its practical implementation in these areas.

Children’s Homes (England) Regulations 2015 and accompanying statutory guidance, ‘Guide to the Children’s Homes Regulations including the quality standards’, include provisions around behaviour and restraint. Responsibility for the welfare of children while transported, including from one location to another, from a secure children’s home is noted in the protection of children quality standard, Regulation 12. The registered person and local authority overall have a responsibility to ensure that children are kept safe, and their welfare promoted.

All incidents of restraint when a young person is cared for by a children’s home must be recorded and made available to Ofsted during an inspection. If transportation is arranged by the local authority who has responsibility for the child, then the care of the child would fall to them. Where local authorities have contract arrangements with transport services, restraint should only be used in very limited circumstances, in accordance with government guidance on the use of restraint, and must always be necessary and proportionate.

During all inspections of children’s homes, inspectors assess all incidents of restraint. Where a provider has restrained a child in a way that does not comply with the regulations, Ofsted will take action. This can include suspension of a service if they believe that children are at risk due to the inappropriate use of restraint or restrictive practices.

Data is not collected by the Department for Education on the use of restraint. This is collected by Ofsted.

29th Jun 2021
To ask Her Majesty's Government what data they hold on (1) the numbers of children who are handcuffed whilst in the care of local government and not charged with or convicted of any offence, and (2) the reasons for such restraints being used.

Legislation is in place to ensure that the use of restraint in respect of looked-after children is used in very limited circumstances and must be necessary and proportionate. Under the Children’s Homes (England) Regulations (2015), all incidents of restraint when a young person is cared for by a children’s home must be recorded.

Regulation 20(1) states that the only purposes for which restraint can be used in a children's home are to prevent injury to any person (including the child who is being restrained) or to prevent serious damage to the property of any person. In addition, restraint may be used on a child in a secure children's home for the purpose of preventing a child from absconding from the home. Regulation 20(2) states that restraint in relation to a child must be necessary and proportionate.

Similar regulations apply to children in foster care. Regulation 13(2)(b) of the Fostering Services (England) Regulations 2011 states that fostering service providers must take all reasonable steps to ensure that no child placed with a foster parent is subject to any measure of control, restraint or discipline which is excessive or unreasonable.

Ofsted regularly inspect all children’s homes in England to ensure they are complying with their legal duties, which include detailing incidents of restraint. Ofsted also inspects local authorities’ fostering services and independent fostering agencies to ensure they are meeting their duties and responsibilities. The department does not collect data on the use of handcuffs for children in the care system.

29th Jun 2021
To ask Her Majesty's Government what assessment they have made of the article 'Children in care as young eleven handcuffed like 'dangerous animals' published by the Sunday Express on 27 June; and what steps they intend to take in response to the claim that children in the care of local government, who are not charged with or convicted of any offence, are routinely being handcuffed.

Legislation is in place to ensure that the use of restraint in respect of looked-after children is used in very limited circumstances and must be necessary and proportionate. Under the Children’s Homes (England) Regulations (2015), all incidents of restraint when a young person is cared for by a children’s home must be recorded.

Regulation 20(1) states that the only purposes for which restraint can be used in a children's home are to prevent injury to any person (including the child who is being restrained) or to prevent serious damage to the property of any person. In addition, restraint may be used on a child in a secure children's home for the purpose of preventing a child from absconding from the home. Regulation 20(2) states that restraint in relation to a child must be necessary and proportionate.

Similar regulations apply to children in foster care. Regulation 13(2)(b) of the Fostering Services (England) Regulations 2011 states that fostering service providers must take all reasonable steps to ensure that no child placed with a foster parent is subject to any measure of control, restraint or discipline which is excessive or unreasonable.

Ofsted regularly inspect all children’s homes in England to ensure they are complying with their legal duties, which include detailing incidents of restraint. Ofsted also inspects local authorities’ fostering services and independent fostering agencies to ensure they are meeting their duties and responsibilities. The department does not collect data on the use of handcuffs for children in the care system.

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.

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.

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.

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.

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.

24th Jul 2020
To ask Her Majesty's Government whether all resources recommended or promoted for use by schools by the Department for Education are checked for compliance with (1) safeguarding procedures, (2) the Equality Act 2010, (3) the Public Sector Equality Duty, and (4) the statutory guidance on Relationship Education, Relationship and Sex Education and Health Education.

We want to support all young people to be happy, healthy, and safe. We also want to equip them for adult life and to make a positive contribution to society. That is why we are making Relationships Education compulsory for primary school-aged pupils, Relationships and Sex Education (RSE) compulsory for secondary school-aged pupils, and Health Education compulsory for pupils in all state-funded schools from September 2020.

In light of the circumstances caused by the COVID-19 outbreak, and following engagement with the sector, the department is reassuring schools that although the subjects will still be compulsory from 1 September 2020, schools have flexibility over how they discharge their duty within the first year of compulsory teaching.

The safety of children is our top priority. We expect all schools to ensure that the materials and teaching resources they use are appropriate, and to ensure that they comply with their statutory duty to safeguard children’s welfare. The statutory guidance sets out clear advice on choosing resources. 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, where relevant.

The department does not recommend specific resources but has suggested resources for schools to consider as set out in Annex B of the statutory guidance. We encourage schools to use resources that have been quality assured by reputable organisations, such as the NSPCC on safeguarding issues. The department will be providing further advice to schools on choosing appropriate resources and is developing teacher training modules for these subjects, which the department has quality assured and recommends.

Schools must consult with parents on the school’s RSE policy. Schools should also ensure that, when they engage parents, they provide examples of the resources they plan to use, for example the books or materials they will use in lessons. The statutory guidance can be accessed via the following link: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education.

In covering the content of the new subjects, the guidance also sets out schools’ duty to comply with relevant requirements of the Equality Act 2010 including the Public Sector Equality Duty. Schools should also be aware of their duties regarding impartiality and balanced treatment of political issues in the classroom to ensure content is handled in an appropriate way.

At the heart of these subjects there is a focus on keeping children safe, and schools can play an important role in preventative education. Keeping Children Safe in Education (KCSIE) sets out that all schools and colleges should ensure children are taught about safeguarding, including how to stay safe online, as part of providing a broad and balanced curriculum. The guidance can be accessed via the following link: https://www.gov.uk/government/publications/keeping-children-safe-in-education--2.

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.

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.

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.

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.

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.

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.

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.

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)
13th Sep 2021
To ask Her Majesty's Government how many people in England received the Carer's Allowance in (1) April 2019, and (2) April 2021.

DWP statistics on the number of Carer’s Allowance claims in payment are publicly available online via StatXplore. These statistics are released on a quarterly basis, for the following months: February, May, August and November. The most recent available statistics are for February 2021.

The figures requested are therefore not available for April 2021. The figure from the most recent release of these statistics is included in the response instead. For an annual comparison, the figure for February 2019 is also included in this response.

The number of people in England who received Carer’s Allowance in February 2019 was 736,624.

The number of people in England who received Carer’s Allowance in February 2021 was 794,816.

Baroness Stedman-Scott
Parliamentary Under-Secretary (Department for Work and Pensions)
11th May 2022
To ask Her Majesty's Government what plans they have to address capacity issues being experienced by the National Institute of Health and Care Excellence.

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2022
To ask Her Majesty's Government what discussions they have held with the National Institute of Health and Care Excellence in relation to its plans to deal with capacity issues.

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2022
To ask Her Majesty's Government what assessment they have made of the (1) impact on technology appraisals, and (2) timely access to medicines, of current capacity issues experienced by the National Institute for Health and Care Excellence.

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2022
To ask Her Majesty's Government what plans they have to work with the diagnostics industry to (1) solicit, and (2) implement, feedback on the (a) efficiency, and (b) transparency, of regulatory bodies as part of ongoing reviews of the Coronavirus Test Device Approvals process.

The UK Health Security Agency regularly engages with the diagnostics industry in the United Kingdom and others on the Coronavirus Test Device Approvals (CTDA) process. We will review the CTDA process due by the end of the year and consider its efficiency and transparency.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
10th May 2022
To ask Her Majesty's Government what steps they are taking to address the reported bottleneck in the Coronavirus Test Device Approval process.

Current delays in the Coronavirus Test Device Approval (CTDA) process have been due to further information being sought from applicants during the validation process. However, to ensure applications meet the required standards, expert support has been provided by officials, with 60% of approvals being processed in the last three months.

The number of scientific advisors has also been increased to meet demand. Online guidance for applicants has also been updated to provide greater clarity for acceptance criteria for the range of viral loads within positive samples. Officials continue to work with applicants to provide support during the process and minimise any potential delays.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
10th May 2022
To ask Her Majesty's Government whether they plan to publish the names of the organisations which took part in the early engagement programme with the National Institute for Health and Care Excellence before the publication of its new methods and processes for its health technology evaluation programme.

While there was no specific early engagement programme, the National Institute for Health and Care Excellence’s (NICE) recent review of its methods and processes for health technology evaluation was overseen by a steering group and working group. The organisations which participated in these groups are as follows:

Centre for Health Technology Evaluation, NICE;

Centre for Guidelines, NICE;

Centre for Health Economics, University of York;

NHS England and NHS Improvement;

The Office for Life Sciences;

The Department of Health and Social Care;

NICE appraisal committee;

British In Vitro Diagnostics Association;

The Association of the British Pharmaceuticals Industry;

The Psoriasis and Psoriatic Arthritis Alliance;

The British Medical Journal Technology Assessment Group;

The Ethical Medicines Industry Group;

The BioIndustry Association;

Genetic Alliance;

ReCor Medical UK, Association of British HealthTech Industries;

School of Health and Related Research, the University of Sheffield;

Alzheimer's Research UK.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Apr 2022
To ask Her Majesty's Government what steps they are taking to address social worker shortages in (1) specialist adult cystic fibrosis centres, and (2) specialist paediatric cystic fibrosis centres.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Apr 2022
To ask Her Majesty's Government what plans they have to improve the state of primary care in the NHS.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Apr 2022
To ask Her Majesty's Government what steps they are taking to ensure that the NHS meets core targets on performance, including (1) the standard of 95 per cent of patients being admitted, discharged or transferred within four hours of arrival, (2) the 18 week referral-to-treatment target for planned (elective) consultant-led care, and (3) the 62 day wait standard for cancer.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Apr 2022
To ask Her Majesty's Government whether they will place in the Library of the House a list of the projects that have been given access to the Palantir Foundry parts of NHS England’s COVID-19 Data Store.

Palantir provide the National Health Service with a software platform for the secure, reliable and timely processing of data. Within the platform, NHS analysts have developed dashboards, forecasts and planning tools, using de-identified data. These are known as use cases, which are as follows:

  • The Strategic Decision-Makers Dashboard, which provides a unified dashboard to assist executives across the health and care system to coordinate the national response to COVID-19;

  • The Recovery of Critical Services Dashboard supports service recovery planning as a result of the COVID-19 pandemic;

  • The Early Warning System forecasts COVID-19 patient admissions and types of bed capacity three weeks in advance;

  • The Supply Management Capability provides tools to manage the supply and demand of classification resources such as personal protective equipment, ventilation and oxygen equipment and intensive care unit consumables, supporting end-to-end management of these resources;

  • The Immunisation and Vaccination Management Capability enables the end-to-end management of the NHS COVID-19 vaccination programme; and

  • The Trust Care Coordination Solution provides trusts with functionality and modules to cleanse elective waiting lists and optimise theatre scheduling and capacity.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
4th Apr 2022
To ask Her Majesty's Government what assessment they have made of the endorsement by the Ockenden Review, published on 30 March, of the recommendations of the House of Commons Health and Social Care Committee's report The safety of maternity services in England (Session 2021–22, HC19).

We have committed to implement the specific recommendations made by the Ockenden Review. This includes £127 million for maternity services in England to increase the workforce and fund programmes to strengthen leadership and retention. This is in addition to £95 million announced in 2021 to support the recruitment of 1,200 midwives and 100 consultant obstetricians and multi-disciplinary team training.

The Review endorsed the Department’s plans to create a special health authority to continue the maternity investigation programme run by the Healthcare Safety Investigation Branch. We will continue to plan for the special health authority to commence its work from April 2023.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2022
To ask Her Majesty's Government whether they will publish the terms of reference for NHS England's upcoming workforce strategy.

Further information on the strategy, its conclusions and terms of reference will be published in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2022
To ask Her Majesty's Government which sectors have been consulted as part of (1) the Health Education England's review of long-term strategic trends for the health and social care workforce, and (2) the upcoming NHS England strategy.

In July 2021, the Department commissioned Health Education England (HEE) to with NHS England and NHS Improvement, Skills for Care and stakeholders in the health and social care sectors to develop a long term strategic framework for health and social care workforce planning. Engagement has taken place with senior leaders, frontline staff, the future workforce, academics, think tanks, charities, trade unions, those who receive and care and support and their representatives.

A call for evidence took place in autumn 2021. which elicited 322 responses. Over half of responses were from individuals, which included members of the health and social care workforce, people who need and receive care and support and interested individuals. The remaining responses were received from organisations, including trade unions, charities, professional bodies and Royal Colleges. HEE has held three large-scale events to support the development of the framework, engaging over 200 senior leaders and professionals in the health and social care system, as well as people who need and receive care and their representatives.

The Department has recently commissioned NHS England and NHS Improvement to develop a workforce strategy. Further information on the strategy and its conclusions will be available in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Mar 2022
To ask Her Majesty's Government whether community pharmacists have been considered as part of NHS England's upcoming workforce strategy.

Further information on the strategy, including which staff groups will be within its scope, will be available in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2022
To ask Her Majesty's Government what steps they are taking to strengthen the role of the Care Quality Commission in addressing (1) residential care home visits being blocked following a complaint being raised, and (2) evictions from residential care homes following a complaint being raised.

Blocking visits or evicting a patient following a complaint being raised would be a breach of existing regulations and the Care Quality Commission (CQC) is clear that appropriate action will be taken if it finds a provider has failed in its responsibilities. Any such cases shared with the CQC will be investigated as part of its ongoing monitoring of providers. The CQC reinforces the principle that care homes must enable, rather than restrict, visiting and blanket bans on visiting are unacceptable. The CQC seeks assurances from care home providers on how visits are enabled and verifies this information during inspections.

Although the CQC is not able to address individual complaints, it can direct people to the Local Government and Social Care Ombudsman, which can investigate such complaints in all adult care services.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2022
To ask Her Majesty's Government what steps they are taking to improve the complaints system for people raising concerns about care or a care setting.

By law, all health and social care services must have a procedure for dealing efficiently with complaints and those who have experienced poor-quality care have the right to complain to the organisation which provided or paid for the care. If an individual is not satisfied with the way a provider or local authority has dealt with a complaint, they may escalate it to the Local Government and Social Care Ombudsman. The Care Quality Commission also reviews how providers address complaints when reviewing how responsive and well-led a care home is, in addition to ensuring residents and relatives know how to raise concerns and feel they are listened to. We will keep the potential for further action to improve the complaints system under review.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2022
To ask Her Majesty's Government what assessment they have made of the impact of removing free lateral flow testing for care home visitors on unpaid carers.

The testing regime in adult social care from 1 April 2022 is currently under review and further details will be available shortly. We will continue to keep the impact of these COVID-19 policies on people with caring responsibilities, including unpaid carers, under review.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2022
To ask Her Majesty's Government what plans they have, if any, to grant the Care Quality Commission the authority to investigate individual complaints.

We have no plans to do so. The Local Government and Social Care Ombudsman investigates individual complaints about adult social care services, whereas the Care Quality Commission monitors, inspects and regulates health and care services to ensure they meet standards of quality and safety. While independent, the two organisations share information where appropriate.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Mar 2022
To ask Her Majesty's Government, further the publication by NICE of NICE healthy technology evaluations: the manual on 22 January, how they plan to fast-track any “true innovation” which is supported by (a) NICE MedTech Innovation Briefing, or (b) other “sufficient” evidence, into the relevant NHS Supply Chain Framework agreement.

The National Institute for Health and Care Excellence (NICE) has no current plans to fast-track any ‘true innovation’ supported by MedTech Innovation Briefings (MIBs) or other ‘sufficient’ evidence. NICE’s MIBs are designed to support the National Health Service, social care commissioners and staff considering using new medical devices and other medical or diagnostic technologies. MIBs aim to be fast, flexible and responsive to the need for information on innovative technologies, which do not make recommendations or constitute NICE guidance and follow a much shorter development process.

In addition, technologies where NICE has issued a MIB are not automatically adopted into the NHS Supply Chain. It is for the relevant commissioner to make decisions on usage, taking into account the available evidence. Should production capacity be unable to meet MIBs’ demand in a given period, prioritisation of the commissioning schedule will be made based on the importance of the topics to the NHS and in discussion with NHS England where necessary.

The MedTech Funding Mandate was introduced in April 2021 to support an accelerated uptake of clinically effective and cost-saving medical devices, diagnostics and digital technologies recommended through NICE’s medical technologies or diagnostics guidance. NHS Supply Chain was the agreed route for the first four products selected by NHS England and NHS Improvement to be funded in 2021/22.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Mar 2022
To ask Her Majesty's Government, further to the publication by NICE of NICE healthy technology evaluations: the manual on 22 January, how they plan to define “sufficient evidence” while recognising that in early-stage development and “true” innovation there may not be a comparator for evidential purpose.

There is no plan to define sufficient evidence. Decisions on whether there is sufficient evidence to recommend a technology as clinically and cost effective are taken by the National Institute for Health and Care Excellence (NICE) in line with its established methods and processes and through consultation with interested parties.

Where there is uncertainty, NICE is able to recommend the most promising new cancer medicines for use through the Cancer Drugs Fund, which supports patient access while further information is collected on effectiveness to inform a future decision on routine funding. NICE and NHS England and NHS Improvement have recently consulted on proposals to create an Innovative Medicines Fund that will extend the Cancer Drugs Fund model to non-cancer drugs.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Feb 2022
To ask Her Majesty's Government what steps they are taking to ensure the transparency and accountability of (1) charitable, and (2) private, care home providers in England.

We are exploring ways to allow more transparent feedback about services and offer other comparative information, including on price. Providers are accountable to the Care Quality Commission (CQC), which is the independent regulator of health and social care in England. The CQC regulate services to make sure they meet fundamental standards of safety and quality. When registering with the CQC, providers must demonstrate they meet a range of suitability criteria, including suitable premises and that they have the financial resources needed to provide and continue to provide the services as described in their application to the required standards.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Feb 2022
To ask Her Majesty's Government, further recent decision by NICE to change the way medicines and other health technologies are evaluated for use in the NHS in England, what steps they will take (1) to develop a definition of innovation that differentiates transformative technologies, and (2) to consult on such a definition.

The National Institute for Health and Care Excellence (NICE) has embedded relevant considerations for innovative technologies throughout its health technology evaluations. NICE has not defined innovation in its updated methods and processes manual for health technology assessments. However, NICE will work with other partners from the Accelerated Access Collaborative to develop a definition of ‘disruptive technologies’. NICE keeps its methods and processes under review and will consult with stakeholders on any proposed changes.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Feb 2022
To ask Her Majesty's Government what discussions they have had with providers of care homes in England on the impact of changes in models of care that have resulted in decisions to close care homes.

The Department has engaged with over 200 stakeholders, including providers of care across every region in England. We will continue to engage with providers as social care reform plans are implemented. As part of the reforms, we are aiming to support a range of models of care that will promote personalisation to better meet individuals’ needs.

Local authorities are best placed to understand and plan for the care needs of their populations and to develop and build local market capacity. Under the Care Act 2014, local authorities have a temporary duty to ensure continuity of care if a provider fails or exits the market.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Feb 2022
To ask Her Majesty's Government what assessment they have made of the impact of care home closures in England since 2019 on the ability of the NHS to discharge elderly patients from hospital.

No formal assessment has been made. We have established a national discharge taskforce to reduce delayed discharges and ensure patients are only in hospital for as long as they need to be. In addition, we have provided £462.5 million via local authorities during the winter for care providers to increase recruitment and existing care support.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Feb 2022
To ask Her Majesty's Government what assessment they have made of the (1) number of care home closures in England in the past three years, and (2) the impact these closures have had on the health and wellbeing of the residents affected.

The Care Quality Commission (CQC) publishes data on locations that were previously regulated by the CQC and have since been deactivated. A location can be deactivated for several reasons and does not mean that the service has closed in every instance. For example, it may have re-registered due to changes in its legal structure or its address.

The following table below shows the number of care home deactivations in England in each year from 2019 to January 2022.

Year of deactivation

Total number of care home deactivations

2019

544

2020

426

2021

486

2022

52

Note:

A nursing home is a ‘care home service with nursing’ and a residential home is a ‘care home without nursing’. A care home location which has both service types is also classified as a nursing home.

The figures provided represent the number of care homes that have deactivated excluding locations that have a published 'successor' organisation where the service continues, but under new registration due to a legal entity change or a change in the provider. It may take several months for a ’successor’ location to be published following a location deactivating and a new location activating. Under the Care Act 2014, local authorities also have a temporary duty to ensure continuity of care if a provider fails or exits the market.

No specific assessment has been made of the impact of care home closures on the health and wellbeing of residents.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2022
To ask Her Majesty's Government what steps they will take to ensure that members of the public are given a direct opportunity to raise concerns about matters relating to (1) health, and (2) care, at the meetings of (a) Integrated Care Boards, (b) Integrated Care Partnerships, and (c) Health and Well-Being Boards.

The Health and Care Bill proposes duties on integrated care boards (ICBs) to involve people in their decisions about health and care. Subject to the passage of the Bill, ICBs, integrated care partnerships and Health and Wellbeing Boards will have duties to consult with or involve the public in their plans and strategies. Currently, NHS England assesses each clinical commissioning group on its delivery against the patient and public involvement duties through the NHS Oversight Framework. We expect that this will continue for Integrated Care Boards. Each area should determine how to involved its population most effectively, including through attendance at meetings.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Feb 2022
To ask Her Majesty's Government what plans they have to ensure that meetings of (1) Integrated Care Boards, (2) Integrated Care Partnerships, and (3) Health and Well-Being Boards, are held in public.

The government expects integrated care boards (ICBs), integrated care partnerships (ICPs), and Health and Wellbeing Boards to operate in an open and transparent manner, including holding meetings in public. ICBs and Health and Wellbeing Boards will be subject to the requirement in the Public Bodies (Admissions to Meetings) Act 1960 to hold meetings in public, excepting certain specific circumstances. While not subject to the 1960 Act, we have been clear that we expect ICPs to follow the same principles.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2022
To ask Her Majesty's Government what assessment they have made, if any, of the Tavistock and Portman NHS Foundation Trust to ensure that it is not discriminating against people with protected beliefs within its employment process.

No formal assessment of the Tavistock and Portman NHS Foundation Trust’s appointments process for non-executives has been made. The appointment of chairs and non-executive directors of National Health Service foundation trusts is conducted by the council of governors which is obliged to comply with all equality laws and recruitment best practice.

The Tavistock and Portman NHS Foundation Trust, as with other NHS trusts and foundation trusts, apply equality laws and best practice during recruitment and welcome applications from any suitably qualified candidate. This includes whether the candidate meets the NHS-wide criteria of promoting and respecting equality, diversity, and inclusion.

In 2013, Monitor published Your statutory duties: A reference guide for NHS foundation trust governors. This guidance sets out the statutory duties for governors of NHS foundation trusts, including appointing and removing the chair and other non-executive directors. The guidance states that the procedure for all appointments or reappointments must be formal, rigorous and transparent. The appointment must be awarded on merit and based on objective criteria

developed in the best interests of the trust. The process should be described in the NHS foundation trust’s annual report. A copy of the guidance is attached.

The Tavistock and Portman NHS Foundation Trust is now receiving mandated support from NHS England and NHS Improvement under the System Oversight Framework.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2022
To ask Her Majesty's Government what plans they have, if any, to issue advice to NHS Foundation Trusts on the appointment process of Chairs and non-executives to ensure that applicants’ views on gender are not used to exclude them from consideration.

No formal assessment of the Tavistock and Portman NHS Foundation Trust’s appointments process for non-executives has been made. The appointment of chairs and non-executive directors of National Health Service foundation trusts is conducted by the council of governors which is obliged to comply with all equality laws and recruitment best practice.

The Tavistock and Portman NHS Foundation Trust, as with other NHS trusts and foundation trusts, apply equality laws and best practice during recruitment and welcome applications from any suitably qualified candidate. This includes whether the candidate meets the NHS-wide criteria of promoting and respecting equality, diversity, and inclusion.

In 2013, Monitor published Your statutory duties: A reference guide for NHS foundation trust governors. This guidance sets out the statutory duties for governors of NHS foundation trusts, including appointing and removing the chair and other non-executive directors. The guidance states that the procedure for all appointments or reappointments must be formal, rigorous and transparent. The appointment must be awarded on merit and based on objective criteria

developed in the best interests of the trust. The process should be described in the NHS foundation trust’s annual report. A copy of the guidance is attached.

The Tavistock and Portman NHS Foundation Trust is now receiving mandated support from NHS England and NHS Improvement under the System Oversight Framework.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Feb 2022
To ask Her Majesty's Government what assessment they have made, if any, of the appointments process for non-executives on the Board of the Tavistock and Portman NHS Foundation Trust to ensure that applicants are not excluded from consideration based on their views of gender.

No formal assessment of the Tavistock and Portman NHS Foundation Trust’s appointments process for non-executives has been made. The appointment of chairs and non-executive directors of National Health Service foundation trusts is conducted by the council of governors which is obliged to comply with all equality laws and recruitment best practice.

The Tavistock and Portman NHS Foundation Trust, as with other NHS trusts and foundation trusts, apply equality laws and best practice during recruitment and welcome applications from any suitably qualified candidate. This includes whether the candidate meets the NHS-wide criteria of promoting and respecting equality, diversity, and inclusion.

In 2013, Monitor published Your statutory duties: A reference guide for NHS foundation trust governors. This guidance sets out the statutory duties for governors of NHS foundation trusts, including appointing and removing the chair and other non-executive directors. The guidance states that the procedure for all appointments or reappointments must be formal, rigorous and transparent. The appointment must be awarded on merit and based on objective criteria

developed in the best interests of the trust. The process should be described in the NHS foundation trust’s annual report. A copy of the guidance is attached.

The Tavistock and Portman NHS Foundation Trust is now receiving mandated support from NHS England and NHS Improvement under the System Oversight Framework.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2022
To ask Her Majesty's Government whether NHS England will consider local authority members for appointment to the Chairs of Integrated Care Boards.

The minimum membership of integrated care boards (ICBs) includes at least one member from the local authority or local authorities with statutory social care responsibility whose area falls partly or wholly within the area of the ICB. Appointments, or designate appointments, for these ICB board members have not yet been made.

A process has taken place to identify intended ICB chairs, or designate chairs, in preparation for establishment of ICBs. These appointments are anticipated to be confirmed following the completion of the passage of the Health and Care Bill. Individuals with a role in any health and care organisation in a particular area are not eligible for these independent chair roles due to perceived or actual conflicts of interest. This exclusion is not specific to local authority members and applies to anyone with a role in a local health or care organisation.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2022
To ask Her Majesty's Government whether NHS England, in its guidance to the NHS on the appointment of members to Integrated Care Boards, will ask for a rerun of local authority appointments so that local authority members will have an opportunity for appointment.

The minimum membership of integrated care boards (ICBs) includes at least one member from the local authority or local authorities with statutory social care responsibility whose area falls partly or wholly within the area of the ICB. Appointments, or designate appointments, for these ICB board members have not yet been made.

A process has taken place to identify intended ICB chairs, or designate chairs, in preparation for establishment of ICBs. These appointments are anticipated to be confirmed following the completion of the passage of the Health and Care Bill. Individuals with a role in any health and care organisation in a particular area are not eligible for these independent chair roles due to perceived or actual conflicts of interest. This exclusion is not specific to local authority members and applies to anyone with a role in a local health or care organisation.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Feb 2022
To ask Her Majesty's Government whether, in their review of single-sex wards, NHS England will consult women’s groups.

A wide range of stakeholders are being consulted, including women’s groups.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2022
To ask Her Majesty's Government, further to the decision by NICE to change the way medicines and other health technologies are evaluated for use in the NHS, what steps they will take to develop a definition of innovation which differentiates transformative technologies, together with the consultative process that will achieve this.

The National Institute for Health and Care Excellence (NICE) has embedded relevant considerations for innovative technologies throughout its health technology evaluations. NICE has not defined innovation in its updated methods and processes manual for health technology assessments. However, NICE will work with other partners from the Accelerated Access Collaborative to develop a definition of ‘disruptive technologies’. NICE keeps its methods and processes under review and will consult with stakeholders on any proposed changes.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2022
To ask Her Majesty's Government, further to the recent decision by NICE to change the way medicines and other health technologies are evaluated for use in the NHS, how "sufficient evidence" will be defined recognising that in respect of early-stage development and “true” innovation, there may be no comparator for evidential purpose.

The National Institute for Health and Care Excellence’s (NICE) updated health technology evaluation manual sets out how different types of evidence will be used to inform the evaluation and how comparators will be identified. The potential comparators used in each evaluation are set out in a scope developed through consultation with stakeholders. Decisions on the most appropriate comparator used to make recommendations are taken by expert committees guided by established practice in the National Health Service.

A copy of NICE health technology evaluations: the manual is attached.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jan 2022
To ask Her Majesty's Government, further to the recent decision by NICE to change the way medicines and other health technologies are evaluated for use in the NHS, how they will ensure fast-tracking any true innovation is supported by the NICE MedTech Innovation Briefing (MIB) or other "sufficient evidence" into the relevant concurrent NHS Supply Chain Framework agreement, in order to facilitate the opportunity and time to enable the gathering of "sufficient evidence".

The Medtech Funding Mandate was introduced in April 2021 to support the use of clinically effective and cost-saving medical devices, diagnostics and digital technologies that have been recommended through the National Institute for Health and Care Excellence’s (NICE) medical technologies or diagnostics guidance. NHS Supply Chain is the agreed route for the first four products selected by NHS England and NHS Improvement to be funded in 2021/22.

NICE’s Medtech innovation briefings are designed to support National Health Service and social care commissioners and staff considering using new medical devices and other medical or diagnostic technologies. The briefings do not constitute NICE guidance but are designed to be fast, flexible and responsive to the need for information on innovative technologies.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Jan 2022
To ask Her Majesty's Government whether they will publish a list of (1) organisations, and (2) project titles, that in 2021 had any access to data via NHS England's National Commissioning Data Repository; and for each organisation or project, whether they will provide a brief description of its purpose.

The National Commissioning Data Repository is only used by NHS England and NHS Improvement employees for commissioning data purposes and does not share data with external organisations. Therefore, NHS England and NHS Improvement do not publish the information requested.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Jan 2022
To ask Her Majesty's Government what assessment they have made of (1) the provision of care homes in Derbyshire, and (2) proposals by Derbyshire County Council to close care homes in the county.

The commissioning of care and support services is a matter for local authorities, who are best placed to understand and plan for the care needs of their local populations. There are currently 271 active locations registered as care homes in the county of Derbyshire. Of these, nine are rated outstanding, 200 are rated as good, 52 are rated as requires improvement and seven are rated as inadequate. Three services do not currently have a rating.

No assessment has been made of the proposals by Derbyshire County Council.

Under the Care Act 2014, local authorities have a temporary duty to ensure people’s needs for care and support continue to be met if a provider fails or exits the market due to business failure. This ensures that people continue to receive the care and support they need if their adult social care provider is no longer able to carry on delivering services.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Jan 2022
To ask Her Majesty's Government what plans they have to implement targets for NHS eye care services to reduce waiting times for follow-up appointments.

We have no plans to introduce targets. All follow up appointments should take place when clinically appropriate.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Jan 2022
To ask Her Majesty's Government what discussions, if any, they have had with Derbyshire County Council regarding the council’s proposals to close care homes in the county.

We have had no such discussions. The commissioning of care and support services is a matter for local authorities, who are best placed to understand and plan for the care needs of their local populations. 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.

Providers entering and exiting, including changes to local authority provided services, is a normal part of a functioning market and local authorities should have appropriate plans in place to minimise any impacts.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Jan 2022
To ask Her Majesty's Government when they expect to confirm the appointment of the National Clinical Director for Eye Care.

NHS England and NHS Improvement have advised they are planning to commence the recruitment process shortly for the role of a National Clinical Director for Eye Care.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Jan 2022
To ask Her Majesty's Government what steps they are taking to (1) support, and (2) care for, those suffering from Fetal Valproate Spectrum Disorder.

Services for children with all neurodevelopmental disorders is primarily managed as local to the families as possible by multidisciplinary teams within local Child Development Centres. This ensures joined up local services across health, maternity, education and social care systems.

The National Health Service has commissioned the Paediatric Neurosciences Clinical Reference Group to support the development of pathways of care service specification and to support improvements for patient support and co-ordination. Clear, structured communication between these teams will ensure targeted follow-up of infants at risk.

A multi-disciplinary expert clinical group with experience in responding to and managing teratogen exposure has been established, chaired by Dr Charlie Fairhurst and will report its recommendations to NHS England and NHS Improvement in March 2022.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2022
To ask Her Majesty's Government what steps the MedTech Directorate is taking to ensure effective engagement during the development of strategy for the medical devices market with (1) patient associations, (2) clinician nurse specialist groups, and (3) manufacturers and suppliers of relevant medical devices.

The MedTech strategy is planned for publication in the first half of 2022. It will consider regulation, resilience, sustainability and innovation to ensure safety, clinical efficacy and value for money. It aims to ensure resilience in supply chains, enhance innovation, build infrastructure including data and collaboration with industry.

The MedTech Directorate has engaged stakeholders in public bodies and with industry on the strategy’s objectives and priorities. The strategy does not meet the formal requirement to undertake a public consultation. Engagement has focused on those stakeholders most impacted by the strategy in industry and the healthcare system. Once the strategy is drafted, we will seek their feedback and endorsement including through the NHS Medical Advisory Group. This is formed of clinicians, nurses, public bodies and industry via trade associations, manufacturers and suppliers of relevant medical devices.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2022
To ask Her Majesty's Government when the MedTech Directorate will publish their strategy on the medical devices market; when the strategy will be opened up for public consultation; and in what form the consultation will take place.

The MedTech strategy is planned for publication in the first half of 2022. It will consider regulation, resilience, sustainability and innovation to ensure safety, clinical efficacy and value for money. It aims to ensure resilience in supply chains, enhance innovation, build infrastructure including data and collaboration with industry.

The MedTech Directorate has engaged stakeholders in public bodies and with industry on the strategy’s objectives and priorities. The strategy does not meet the formal requirement to undertake a public consultation. Engagement has focused on those stakeholders most impacted by the strategy in industry and the healthcare system. Once the strategy is drafted, we will seek their feedback and endorsement including through the NHS Medical Advisory Group. This is formed of clinicians, nurses, public bodies and industry via trade associations, manufacturers and suppliers of relevant medical devices.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jan 2022
To ask Her Majesty's Government what are the (1) objectives, and (2) timeline, of the strategy being developed by the MedTech Directorate in relation to innovation, resilience, effectiveness and value for money in the medical devices sector.

The MedTech strategy is planned for publication in the first half of 2022. It will consider regulation, resilience, sustainability and innovation to ensure safety, clinical efficacy and value for money. It aims to ensure resilience in supply chains, enhance innovation, build infrastructure including data and collaboration with industry.

The MedTech Directorate has engaged stakeholders in public bodies and with industry on the strategy’s objectives and priorities. The strategy does not meet the formal requirement to undertake a public consultation. Engagement has focused on those stakeholders most impacted by the strategy in industry and the healthcare system. Once the strategy is drafted, we will seek their feedback and endorsement including through the NHS Medical Advisory Group. This is formed of clinicians, nurses, public bodies and industry via trade associations, manufacturers and suppliers of relevant medical devices.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Jan 2022
To ask Her Majesty's Government what plans they have to ensure that irreversible electroporation for the treatment of prostate cancer is made available more widely in the NHS, following the pilot by University College London Hospital NHS Foundation Trust.

At present, nanoknife or irreversible electroporation treatment should only be provided to prostate cancer patients in the National Health Service in England as part of research studies, in line with recommendations made by National Institute for Health and Care Excellence (NICE). As this procedure would fall within NHS England and NHS Improvement’s direct commissioning responsibility for specialised services, clinicians can submit new policy applications at any time, where they consider that there is clear evidence of benefit for patients.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2021
To ask Her Majesty's Government what assessment they have made of (1) the survey by the Association of Directors in Adult Social Services, published on 29 November, and (2) in particular, the findings that (a) almost 400,000 people are now waiting for an assessment of their needs, and (b) more than 1.5 million hours of commissioned home care could not be provided between August and September because of a lack of staff.

We have noted the results of this survey, which improves the evidence base for the demand for social care and current issues of concern to local authority leaders in the sector. Local authorities are responsible for assessing an individual’s eligibility for care and support and for meeting care needs in their local area. On 10 December 2021 we announced £300 million to support local authorities and care providers to recruit and retain staff through winter. This is in addition to the existing £162.5 million Workforce Recruitment and Retention Fund. We have also launched a new phase of our national recruitment campaign which will run until March 2022.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Nov 2021
To ask Her Majesty's Government whether they expect to publish the (1) Wade-Gery, and (2) Goldacre, reviews before the committee stage of the Health and Care Bill in the House of Lords.

The Wade-Gery Review was published on 23 November. The Goldacre Review will be published early in 2022, which is likely to be after Committee stage of the Bill in the House of Lords.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2021
To ask Her Majesty's Government what steps they are taking to improve the quality of lateral flow tests.

All tests are robustly assessed through laboratory validation, as precursor to procurement. To improve the quality of lateral flow tests The UK Health Security Agency (UKHSA) has recently introduced additional criteria that devices must meet to be accepted for validation. The criteria focus on improvements to the usability, sustainability and performance of lateral flow antigen tests, compared to devices currently available. In addition, the UKHSA works with suppliers to improve the sustainability and usability of lateral flow devices, such as reducing the amount of packaging.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2021
To ask Her Majesty's Government how many suppliers of COVID-19 tests have submitted information regarding their products for desktop reviews.

As of 16 November 2021, 173 applications for COVID-19 test device products have been subject to desktop review by the UK Health Security Agency. As of 16 November, 108 suppliers have submitted information as part of the desktop review validation process. However, in order to be triaged for desktop review, every application must submit accompanying data in the first instance regarding their product. There are currently 93 COVID-19 test device product applications which are ‘pending information’, where further information has been requested from the supplier.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2021
To ask Her Majesty's Government how many COVID-19 test device products have been subject to desktop reviews by the UK Health Security Agency.

As of 16 November 2021, 173 applications for COVID-19 test device products have been subject to desktop review by the UK Health Security Agency. As of 16 November, 108 suppliers have submitted information as part of the desktop review validation process. However, in order to be triaged for desktop review, every application must submit accompanying data in the first instance regarding their product. There are currently 93 COVID-19 test device product applications which are ‘pending information’, where further information has been requested from the supplier.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 26 October (HL3010) and the statement by the Home Secretary on 23 October about the distortion caused to female crime statistics by the recording of offences by transwomen within this category, what assessment they have made of similar concerns regarding data collection by NHS England.

The Unified Information Standard for Protected Characteristics will assist in improving the consistency and comparability of healthcare data, improving our understanding of service access and outcomes by protected characteristics. Greater transparency should enable service improvement and assist the National Health Service in meeting its duties under equalities legislation.

The recommendations are based on the views of stakeholders as well as a comprehensive review of available evidence and literature. The report, once published, will be accompanied by further stakeholder engagement, including with groups who do not wish their sex to be redefined. The report recommends recording of sex at birth and collection of data on gender reassignment. The detail of how this recommendation could be implemented will require further stakeholder engagement in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 26 October (HL3010), what assessment they have made of the recommendation by NHS England and NHS Improvement that the Universal Information Standards for sex and gender should include (1) the gender identity categories (a) male (including transman), (b) female (including transwoman), and (c) non-binary, and (2) a question about whether the individual’s gender identity was the same at birth.

The Unified Information Standard for Protected Characteristics will assist in improving the consistency and comparability of healthcare data, improving our understanding of service access and outcomes by protected characteristics. Greater transparency should enable service improvement and assist the National Health Service in meeting its duties under equalities legislation.

The recommendations are based on the views of stakeholders as well as a comprehensive review of available evidence and literature. The report, once published, will be accompanied by further stakeholder engagement, including with groups who do not wish their sex to be redefined. The report recommends recording of sex at birth and collection of data on gender reassignment. The detail of how this recommendation could be implemented will require further stakeholder engagement in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 26 October (HL3010), what plans they have to engage with stakeholders before the publication of NHS England's Unified Information Standard on Protected Characteristics including with groups who do not wish sex to be redefined.

The Unified Information Standard for Protected Characteristics will assist in improving the consistency and comparability of healthcare data, improving our understanding of service access and outcomes by protected characteristics. Greater transparency should enable service improvement and assist the National Health Service in meeting its duties under equalities legislation.

The recommendations are based on the views of stakeholders as well as a comprehensive review of available evidence and literature. The report, once published, will be accompanied by further stakeholder engagement, including with groups who do not wish their sex to be redefined. The report recommends recording of sex at birth and collection of data on gender reassignment. The detail of how this recommendation could be implemented will require further stakeholder engagement in due course.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2021
To ask Her Majesty's Government what assessment they have made of the report published by the Royal College of Anaesthetists Working together to improve retention in anaesthesia, published on 30 September, in particular its finding that "1 in 4 Consultants and 1 in 5 SAS Anaesthetists planned to leave the NHS within five years"; and what steps they intend to take to promote the retention of NHS staff.

The Government appreciates the dedication and contribution of Anaesthetists to our National Health Service. As of the end of July 2021, we saw an increase of 2.3% in full time equivalent (FTE) doctors and 2.0% FTE Specialty doctors and associate specialist doctors working in the NHS in the specialism of anaesthetics compared to a year ago. The NHS England and NHS Improvement National Retention Programme team are engaging with the Royal College of Anaesthetists to agree a way forward to implement the report’s recommendations. The NHS retention programme is using data to continuously understand why NHS staff leave, resulting in targeted interventions to encourage them to stay, with a particular focus on colleagues closer to retirement and those at the start of the career. These include: pension support, access to a range of health and wellbeing initiatives, flexible working opportunities, mentoring and coaching as well as targeted training such as the Health Education England programme “Enhancing Junior Doctors Working Lives” which encourages doctors to stay in training.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2021
To ask Her Majesty's Government what plans they have to fund additional higher anaesthetic training places as part of this year’s Spending Review; and what assessment they have made of (1) the current staffing level of anaesthetists, and (2) the costs of relying on (a) agency, and (b) bank, staff to fill any shortages.

Following the outcome of the Spending Review 2021, spending plans for individual budgets for 2022/2023 to 2024/2025 inclusive, including for training posts for higher anaesthetics and other specialities, will be subject to a detailed financial planning exercise and finalised in due course.

At the end of July 2021 there were 13,012 full time equivalent doctors working in the NHS in the specialism of anaesthetics, an increase of 293 (2.3%) since July 2020. This includes trainees, specialists and doctors on other contracts.

Data on agency and bank usage for anaesthetists is not available, as it is not collected or held by NHS England and NHS Improvement to specialty level.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd Nov 2021
To ask Her Majesty's Government what assessment they have made of the impact of pension rules on the (1) reduction in clinical hours, and (2) early retirement, of senior doctors.

As an individual may choose to reduce their working hours or take early retirement for a range of reasons, it is not possible to isolate the impact of any single factor such as pension rules. However, we continue to monitor the retirement patterns and hours worked by senior doctors. The available evidence does not suggest any substantial change in consultant working hours. NHS Digital workforce statistics show the participation rate or average contracted hours per person, has been stable for several years.

Data from the NHS Business Services Authority, which administer the NHS Pension Scheme, shows that number of consultants taking voluntary early retirement as a proportion of all consultant retirements has not changed significantly over the last five years.

A small but significant portion of senior doctors will amass pensions in excess of their allowances for tax-free pension saving. Last year, the Government addressed this issue by increasing thresholds by £90,000 to remove all staff with earnings below £200,000 from the scope of the taper. An estimated 96% of general practitioners and 98% of consultants are out of scope of the taper based on their National Health Service earnings.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what support is available nationally for patients experiencing the extreme (1) physical, and (2) mental, topical steroid withdrawal symptoms identified in the Medicines and Healthcare products Regulatory Agency report Topical steroid withdrawal reactions: a review of the evidence, published on 15 September 2021.

No additional steps are being taken to identify patients at risk of overuse of, or experiencing withdrawal symptoms from, using topical steroids. Patients on long term medication are offered regular Structured Medication Reviews (SMRs) through their GP practice. SMRs are an evidence-based and comprehensive review of a patient’s medication, taking into consideration all aspects of their health.

Patients should consult their doctor or a pharmacist if they have any concerns or experience any side effects or withdrawal symptoms.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what additional steps they intend to take to identify patients at risk of long-term overuse of mid to high potency topical steroids, as a result of the recent Medicines and Healthcare products Regulatory Agency report Topical steroid withdrawal reactions: a review of the evidence, published on 15 September.

No additional steps are being taken to identify patients at risk of overuse of, or experiencing withdrawal symptoms from, using topical steroids. Patients on long term medication are offered regular Structured Medication Reviews (SMRs) through their GP practice. SMRs are an evidence-based and comprehensive review of a patient’s medication, taking into consideration all aspects of their health.

Patients should consult their doctor or a pharmacist if they have any concerns or experience any side effects or withdrawal symptoms.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what assessment they have made of the cost-saving implications of using video conferencing for (1) the delivery of mental health services, and (2) non-emergency GP consultations.

No assessment has been made on the cost-saving implications of using video conferencing for delivery of mental health services or non-emergency General Practitioner (GP) consultations. Video consultations allow many more people to receive safe and effective care without the cost and disruption of having to travel to their GP, hospital or clinic.

NHSX and NHS Digital are working with NHS England and NHS Improvement to support the continued deployment and effective implementation of video consultations across primary and secondary care. Mental health services largely remained open for business during the pandemic as services were quickly moved to providing advice and support remotely, either through telephone/videoconferencing or digital services.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what plans they have to commission research to establish the (1) dependency, and (2) withdrawal, risks associated with extended prescribed use of mid to high potency topical steroids, following the Medicines and Healthcare products Regulatory Agency report Topical steroid withdrawal reactions: a review of the evidence, published on 15 September.

The Department funds research on health and social care through the National Institute for Health Research (NIHR). The usual practice of NIHR is not to ring-fence funds for expenditure on particular topics. Research proposals in all areas compete for the funding available. The NIHR welcomes funding applications for research into any aspect of human health including the risks associated with the use of high potency topical steroids. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality. In all disease areas, the amount of NIHR funding depends on the volume and quality of scientific activity.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what assessment they have made of the volume of long-term community prescribing of mid to high potency topical steroids for (1) children, and (2) adults, in England between 2018 and 2020.

The Department has not made an assessment. Decisions about prescribing rest with the general practitioner or other prescriber who has clinical responsibility for that particular aspect of a patient’s care. Prescribing is informed by a range of factors, including any national or local prescribing guidelines but, ultimately, the decision on what to prescribe is made by the prescriber themselves, using their own clinical judgement.

The National Institute for Health and Care Excellence has made recommendations on the prescribing of topical steroids in a number of its clinical guidelines, including those on atopic eczema in those under 12 years of age, psoriasis, and osteoarthritis. It has also published technology appraisals guidance on the frequency of application of topical corticosteroids for atopic eczema.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2021
To ask Her Majesty's Government what assessment they have made of the potential for video communication technology to assist with the backlog of healthcare appointments that accumulated during the COVID-19 pandemic.

The National Health Service (NHS) is helping people to access healthcare services both face to face and virtually, via video and telephone consultations. NHS England and NHS Improvement are monitoring the use of virtual consultations as part of the National Outpatients Transformation Programme. There have been over 29 million virtual consultations since April 2020, protecting access to services and reducing the need for extra Personal Protective Equipment in hospital outpatient clinics. Virtual consultations are a key part of modern outpatient services, making up almost a quarter of all outpatient appointments.

General Practice teams are using triage and virtual consultations to minimise COVID-19 infection risks and manage demand by navigating patients to the right services. Virtual consultations remain an important part of the NHS’s plans for recovering elective services.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Oct 2021
To ask Her Majesty's Government how many care home residents who received two initial doses of the COVID-19 vaccine have now received their booster dose.

The information requested is not currently available. However, NHS England is planning to publish data on booster vaccine uptake in care homes shortly.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Oct 2021
To ask Her Majesty's Government what assessment they have made of the reasons for regional delays in eligible individuals (1) being invited for an influenza vaccine at their GP practice, and (2) being able to book an influenza vaccine at a local pharmacy.

No assessment has been made as stock is ordered and managed locally by providers. General practitioner practices and local pharmacies manage appointment bookings according to their supply of stock.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
26th Oct 2021
To ask Her Majesty's Government what assessment they have made of the local variations in delays to people in all eligible groups receiving the COVID-19 booster vaccination.

The Department and the National Health Service continue to monitor the pace of the COVID-19 booster vaccination programme and work closely with regional teams to ensure those eligible have timely access to appointments. The NHS assesses any potential delays to the programme, including between different local areas.

The National Booking Service has now been updated to allow those eligible to pre-book their booster vaccination five months after their second dose. As of 13 November 2021, more than 12.6 million people in the United Kingdom had received their booster vaccination or third dose, helping to ensure the vital protection is maintained over the winter months.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government how many people in England are waiting to have spirometry testing in primary care; and how many people are waiting for their diagnosis of suspected lung disease to be confirmed.

The information is not available in the format requested.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government what plans they have to tackle the backlogs in (1) respiratory care, (2) respiratory diagnosis, and (3) referrals for urgent care, for those with lung conditions.

NHS England and Improvement (NHSEI) has worked with local leaders to update its plans and priorities, including for respiratory services, with a renewed focus on continuing the recovery of non-COVID care and tackling long waits.

The priorities in recovery of services includes tackling the COVID backlog for non-urgent treatment such as eliminating waits of two years or more, stopping the increase in one year plus waits, and stabilising total waiting lists.

£1.5 billion is being made available to help local teams increase their capacity and invest in other proven measures to achieve these goals.

There has been no official assessment made on the effect of the COVID-19 outbreak on waiting times for respiratory diagnostic appointments. However, the NHS is determined to tackle backlogs and is taking steps to restore services and improve waiting times as a priority, including services for respiratory patients. This year, we are providing a record amount of funding to the NHS, which includes £2 billion to help tackle the backlog that built up during the pandemic. We have also committed £8 billion over the next three years to step up elective activity and transform elective services.

Elective waiting lists, which include those with respiratory symptoms, are managed at system as well as trust level. Digital solutions are available to ensure the most clinically urgent patients are managed first, which will help improve waiting times.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government what plans they have to develop a respiratory services recovery plan to restore healthcare services for patients with lung disease where diagnostics are now (1) back to, or (2) above, pre-pandemic levels.

The 2021/22 Priorities and Operational Planning Guidance priorities for NHS England and NHS Improvement includes tackling the backlog for non-urgent treatment, such as services for lung disease patients. This aims to stabilise total waiting lists, eliminate waiting times of two years or more and the increase in waiting times of more than one year. We have made available £1.5 billion to assist local teams increase their capacity and invest in other measures to achieve these priorities.

The Spending Review 2021 announced £2.3 billion to increase the volume of diagnostic activity and open community diagnostic centres to provide more clinical tests, including for patients with lung disease.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government how many community diagnostic hubs per million people they plan to create; and what steps are they taking to ensure that respiratory diagnostic tests will be a core part of their function.

Following the announcement of £2.3 billion of capital investment in diagnostic services in the recent Spending Review, the National Health Service plans to establish at least 100 community diagnostic centres (CDCs) over the next three years, or approximately 1.8 per million people. This is based on the recommendations of Professor Sir Mike Richards’ review, which recommended establishing 165 CDCs or three per million people in England.

The core specification for CDCs includes a range of respiratory diagnostics, including lung function testing. In addition, local integrated care systems will be able to supplement these with additional services for respiratory patients according to local needs.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government what is the timescale for the rollout of (1) community diagnostic hubs pilots, and (2) the remaining community diagnostic hubs.

The National Health Service is planning to establish 44 community diagnostic centres across England this year. Centres will begin to provide services over the next six months, with all fully operational by March 2022. Thirty seven early adopter sites are already open and provided an additional 96,000 tests by the 10 October. Regions are working with local trusts and systems, diagnostic networks and primary care services to determine the location and configuration of services, based on the needs of the local population.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Oct 2021
To ask Her Majesty's Government what data are available on the scale of spirometry testing, following the publication of guidance in April on the safe resumption of such testing.

The information is not available in the format requested and could only be obtained at disproportionate cost.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government, further to the Department of Health and Social Care and the Office for National Statistics Direct and Indirect health impacts of COVID-19 in England, published on 17 September, what assessment they have made of the 51 per cent decrease in the number of newly diagnosed cases of Chronic Obstructive Pulmonary Disease in 2020 compared to 2019.

No official assessment has been made of the reduction of diagnosed cases of chronic obstructive pulmonary disease.

As announced as a part of the spending review, £2.3 billion has been allocated to increase the volume of diagnostic activity and roll out Community Diagnostic Centres (CDC) to help clear backlogs of people waiting for clinical tests, such as MRIs, ultrasounds, and CT scans.

This will help to improve the waiting times for conditions such as chronic obstructive pulmonary disease and increase the number of people seen for diagnostic tests.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government what assessment they have made of whether liothyronine should be declassified as a high-cost medicine following the Competition and Markets Authority ruling and fine issued to Advanz for artificially inflating the price of thyroid tablets.

National Health Service clinical commissioners have promoted national guidance through their bulletins with clinical commissioning groups members. National guidance recommends that in circumstances where levothyroxine has failed, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of liothyronine for at least three months duration.

We have made no assessment on whether liothyronine should be de-classified as a high cost medicine. To date, NHS England NHS Improvement have not conducted any specific assessments on liothyronine following the Competition and Markets Authority ruling. This will be considered as part of any formal review to national guidance.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government what steps NHS Clinical Commissioners took to communicate national guidance for the prescribing of liothyronine to local NHS bodies; and whether that guidance says that liothyronine may only be prescribed when recommended by a specialist after treatment using levothyroxine has failed.

National Health Service clinical commissioners have promoted national guidance through their bulletins with clinical commissioning groups members. National guidance recommends that in circumstances where levothyroxine has failed, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of liothyronine for at least three months duration.

We have made no assessment on whether liothyronine should be de-classified as a high cost medicine. To date, NHS England NHS Improvement have not conducted any specific assessments on liothyronine following the Competition and Markets Authority ruling. This will be considered as part of any formal review to national guidance.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government whether they will conduct a review of (1) the actions of NHS England, and (2) the impact on patients with thyroid conditions, following the Competition and Markets Authority’s ruling and fine issued to Advanz for artificially inflating the price of thyroid tablets.

We have no plans to do so. NHS England and NHS Improvement’s guidance Items which should not routinely be prescribed in primary care: Guidance for CCGs identifies items which are clinically effective but where more cost-effective products are available. This includes liothyronine and other products that have been subject to excessive price inflation.

The guidance states that there are three categories for such items which are as follows:

- Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns;

- Products which are clinically effective but where more cost-effective products are available, including some products that have been subject to excessive price inflation; and

- Products which are clinically effective but due to the nature of the product are deemed a low priority for National Health Service funding.

Liothyronine was included in the second category. Additionally, it was noted that there was limited evidence to support its routine prescribing in preference to levothyroxine. A copy of this guidance is attached. NHS England and NHS Improvement will review the guidance on a regular basis to ensure that any updated evidence on clinical and cost effectiveness is considered.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government what plans they have to address excessive staff workload in the NHS.

The National Health Service has established a People Recovery Task Force to ensure that all NHS staff, including students and trainees, are able to recover and maintain their wellbeing as we plan and deliver the restoration of services. We have put in place a comprehensive support package available to all NHS staff which includes health and wellbeing apps, a counselling helpline and text service, as well as 40 mental health hubs.

In the longer term we are addressing capacity in the workforce by delivering 50,000 more nurses and ensuring a sustainable supply of staff in future. We funded an extra 1,500 undergraduate medical school places per year at English universities in 2020/21, with the total number of medical school training places in England now at 7,500 per year.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Oct 2021
To ask Her Majesty's Government what plans they have to fund additional higher anaesthetic training places as part of this year’s Spending Review.

The forthcoming Spending Review will set out our plans for future investment in the National Health Service workforce.

The number of anaesthetists has increased by over 26% since 2010. In 2020 Health Education England recruited 410 anaesthetic trainees across England with a 100% fill rate nationally. We continue to monitor the effectiveness of the current arrangements and consider the further expansion of specialty training places, including anaesthesia.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Oct 2021
To ask Her Majesty's Government what plans they have, if any, to discuss with NHS England their support for the NHS Rainbow Badge Project, further to the latter's use of the term Trans-Exclusionary Radical Feminist (TERF) on a recent social media post; and whether NHS England's contracts with the NHS Rainbow Project cover the use of offensive terms.

NHS England commissions the LGBT Foundation to deliver the NHS Rainbow Badge project which is intended to help lesbian, gay, bisexual and trans people to seek care from the National Health Service with confidence. The social media account is not run on behalf of NHS England and does not represent its views.

The post was deleted and those with access to the account reminded of the standards which are expected.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Oct 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what assessment they have made of the reduction in cost of Liothyronine (T3) in the UK, compared to the cost of the medication in other parts of Europe.

We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Oct 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what plans they have to encourage further marketing authorisations for Liothyronine (T3).

We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Oct 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what assessment they have made as to whether the fall in the price of Liothyronine (T3) is related to increased competition from marketing authorisations granted since 2016.

We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government when NHS England's Unified Information Standard on Protected Characteristics report will be published; and what engagement with stakeholders will take place before its publication.

NHS England and NHS Improvement have submitted the Unified Information Standard for Protected Characteristics scoping project reports to the Department.

We are currently reviewing the recommendations of the reports and will provide an update shortly. We are also considering continued engagement with stakeholders who contributed to the development of the scoping project.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 29 September (HL2490), whether organisations that work on men's violence against women and girls will be consulted as part of the review of NHS England and NHS Improvement’s guidance, 'Delivering same-sex accommodation'.

The review of the guidance will include a six-week engagement period, during which all relevant stakeholders, including organisations that work on men’s violence against women and girls and gender critical organisations, will have the opportunity to contribute.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 29 September (HL2490), whether they plan to consult gender critical organisations in the review of mixed sex accommodation guidance.

The review of the guidance will include a six-week engagement period, during which all relevant stakeholders, including organisations that work on men’s violence against women and girls and gender critical organisations, will have the opportunity to contribute.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government what steps they are taking to ensure that the NHS refers to "women" whenever appropriate in its publications and clinical guidance.

It is for individual National Health Service organisations to decide on the format and content of any publications or clinical guidance they produce, taking into account any legislative requirements or examples of good practice. NHS England and NHS Improvement refer to ‘women’ in their publications and clinical guidance where appropriate.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government what steps they are taking to ensure that the NHS refers to "women" when sending out invitations for cervical screening, as proposed by the Secretary of State for Health and Social Care in his speech on 5 October.

The invitation letter for a cervical screening appointment and the information available online states that ‘cervical screening is for women and people with a cervix’. This wording has been tested with users and there are a range of measures to ensure that as many of the population eligible for cervical screening as possible attend screening. This includes providing appointments in sexual health clinics and information and resources to reassure those worried about attending.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Oct 2021
To ask Her Majesty's Government what steps they are taking to ensure that debates in the NHS over transgender rights are conducted with "compassion and sensitivity", as proposed by the Secretary of State for Health and Social Care in his speech on 5 October.

The National Health Service provides care to all people regardless of their gender identity and we are working with the NHS to ensure that the rights of all groups are protected. Discussions on transgender care take place professionally, where all views are considered and where the focus is on delivering improved healthcare outcomes.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Oct 2021
To ask Her Majesty's Government what assessment they have made of the proposal by the Medical Technologies Directorate to adopt evidence assessment processes used in relation to pharmaceutical products to assess innovative medical devices.

The Medical Technologies Directorate is working with public sector and industry stakeholders to consider various approaches to the product pathway for medical devices as part of a wider strategy. Plans to publish this strategy will be brought forward in due course.

Clinicians have the professional autonomy to choose an appropriate treatment based on the best available evidence. Mandatory adoption of certain devices could interfere with this clinical judgement and undermine the patient-doctor relationship. We will consider the access and appropriate adoption of innovative devices with other organisations such as the National Institute for Health and Care Excellence and the Accelerated Access Collaborative.

Many aspects of the medicines model are not transferable given the differences between the two sectors in terms of product range, scope, diversity of suppliers and level of Government involvement in the market. A review of proposals which could drive consistency in evaluation of innovation will be taken forward as part of the strategy development work.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Oct 2021
To ask Her Majesty's Government what assessment they have made of the proposals by the Medical Technologies Directorate for mandatory adoption of innovative medical devices; and what proportion of all submissions to the Directorate are forecast to benefit from mandatory adoption.

The Medical Technologies Directorate is working with public sector and industry stakeholders to consider various approaches to the product pathway for medical devices as part of a wider strategy. Plans to publish this strategy will be brought forward in due course.

Clinicians have the professional autonomy to choose an appropriate treatment based on the best available evidence. Mandatory adoption of certain devices could interfere with this clinical judgement and undermine the patient-doctor relationship. We will consider the access and appropriate adoption of innovative devices with other organisations such as the National Institute for Health and Care Excellence and the Accelerated Access Collaborative.

Many aspects of the medicines model are not transferable given the differences between the two sectors in terms of product range, scope, diversity of suppliers and level of Government involvement in the market. A review of proposals which could drive consistency in evaluation of innovation will be taken forward as part of the strategy development work.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Oct 2021
To ask Her Majesty's Government whether they will request that the Medical Technologies Directorate publish a definition of “innovative medical devices”.

We have previously discussed the need for a definition of innovation within medical devices with the industry. As part of our overall strategy, we will engage with the public sector, industry and healthcare provider organisations to develop this definition.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Sep 2021
To ask Her Majesty's Government what assessment they have made of the National Health Service supply chain's record in adopting innovative medical devices.

NHS Supply Chain does not determine which products are appropriate for adoption by the National Health Service but respond where products are selected by NHS England and NHS Improvement for adoption via routes such as MedTech Funding and the Accelerated Access Collaborative.

Medical devices cover a wide spectrum of products, including digital health. A number of procurement frameworks have been established allow the NHS to procure digital innovations. Such framework agreements already accommodate medical device innovations from existing suppliers and there are currently no plans for additional frameworks. Initiatives such as the Rapid Uptake Products programme facilitate stronger adoption of proven innovations, by identifying products with the National Institute for Health and Care Excellence’s approval which support the NHS Long Term Plan’s key clinical priorities.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Sep 2021
To ask Her Majesty's Government what assessment they have made of the effectiveness of competition in keeping the price of generic medicine down; and what plans they have to ensure the National Health Service does not pay inflated prices for such medicine.

Competition to reduce the prices of generic medicines has led to some of the lowest prices in Europe and allows prices to react to the market. Anti-competitive behaviour, including excessive pricing, is a matter for the Competition and Markets Authority (CMA). The Department asks the CMA to investigate where it has concerns about abuses of competition law for generic medicines. Where companies are found by the CMA to be in breach of the legislation, the Department will seek damages and invest that money back into the National Health Service.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Sep 2021
To ask Her Majesty's Government, further to the finding by the Competition and Markets Authority that drug companies had over-charged the National Health Service, what plans they have to reduce the price that the National Health Service pays for liothyronine.

Since 2016, several marketing authorisations have been granted for liothyronine, therefore the National Health Service reimbursement price in primary care has been reducing as a direct response to more competition in the market.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Sep 2021
To ask Her Majesty's Government what plans they have (1) to produce a strategy for the transition to adult care of children with autism who have brain tumours, and (2) to review the age classification for when people with autism are considered to be young adults.

The Department has no plans to produce a specific strategy or to review the age at which autistic people are considered to be young adults. However, on 21 July, we published The national strategy for autistic children, young people and adults: 2021 to 2026. The new strategy is aimed at tackling the health and care inequalities autistic people face and includes supporting positive transitions into adulthood for autistic children and young people, including those with co-occurring conditions. A copy of the strategy is attached. Health and social care services should adhere to the National Institute for Health and Care Excellence’s guidelines when supporting autistic children to adult care.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Sep 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 29 July (HL2215), how many of the 34 clinical negligence claims taken to trial in 2020/21 went to (1) the High Court, or (2) the County Courts.

NHS Resolution has advised that of the 34 clinical negligence claims taken to trial in 2020/21, 12 went to higher courts, including the High Court and 22 went to County Courts.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Sep 2021
To ask Her Majesty's Government what plans they have to publish a strategy for the (1) prevention, and (2) treatment, of brain tumours in children and young adults, and (3) aftercare for such people.

NHS England has no plans to do so.

Services for the treatment of brain tumours in children and young adults falls under NHS England’s direct commissioning responsibilities for specialised services. The NHS Long Term Plan includes a number of commitments for improving the outcomes and experience of children, teenagers and young adults with cancer including: implementing networked care; simplifying pathways and transitions between service; ensuring that every patient has access to specialist care and increasing participation in clinical research.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Sep 2021
To ask Her Majesty's Government what tariff income formula they will use to calculate personal care funding entitlement for those with assets between £20,000 and £100,000 under the plans for England set out in Build Back Better: Our Plan for Health and Social Care, published on 7 September.

The upper capital limit will increase from £23,250 to £100,000 and lower capital limit from £14,250 to £20,000. Anyone with assets between the capital limits will be expected to contribute towards the cost of their care from their income, but if that is not sufficient, they will contribute no more than 20% of their chargeable assets per year. Those with £20,000 or less will pay what they can afford from their income only, leaving their assets fully protected. These changes allow for an increase in number of people who benefit directly from state support in the social care system from around half to two thirds in the long term.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Sep 2021
To ask Her Majesty's Government, further to their report Build Back Better: Our Plan for Health and Social Care, published on 7 September, what plans they have to make changes to the formula used for eligibility funding in adult social care financial assessments.

The upper capital limit will increase from £23,250 to £100,000 and lower capital limit from £14,250 to £20,000. Anyone with assets between the capital limits will be expected to contribute towards the cost of their care from their income, but if that is not sufficient, they will contribute no more than 20% of their chargeable assets per year. Those with £20,000 or less will pay what they can afford from their income only, leaving their assets fully protected. These changes allow for an increase in number of people who benefit directly from state support in the social care system from around half to two thirds in the long term.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2021
To ask Her Majesty's Government what plans they have, if any, to commission a review of the provision of single sex accommodation by NHS Trusts.

No assessment has been made of the process used by National Health Service trusts for arranging these facilities nor the provision of single sex wards.

We expect all NHS trusts to follow all aspects of NHS England and NHS Improvement’s guidance Delivering same-sex accommodation, which sets out the small number of clinical circumstances where mixed-sex accommodation can be justified and also allows, in Annex B, for people to be allocated to wards according to their presentation, such as their preferred dress and pronouns . A copy of the guidance is attached. NHS England and NHS Improvement are currently reviewing this guidance, including whether the Annex is consistent with the provision of single sex wards.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2021
To ask Her Majesty's Government what assessment they have made as to whether Annex B in NHS England's Delivering same sex accommodation guidance is consistent with the aim to provide of single sex wards by NHS Trusts.

No assessment has been made of the process used by National Health Service trusts for arranging these facilities nor the provision of single sex wards.

We expect all NHS trusts to follow all aspects of NHS England and NHS Improvement’s guidance Delivering same-sex accommodation, which sets out the small number of clinical circumstances where mixed-sex accommodation can be justified and also allows, in Annex B, for people to be allocated to wards according to their presentation, such as their preferred dress and pronouns . A copy of the guidance is attached. NHS England and NHS Improvement are currently reviewing this guidance, including whether the Annex is consistent with the provision of single sex wards.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2021
To ask Her Majesty's Government what assessment they have made of the provision of single sex wards by NHS trusts.

No assessment has been made of the process used by National Health Service trusts for arranging these facilities nor the provision of single sex wards.

We expect all NHS trusts to follow all aspects of NHS England and NHS Improvement’s guidance Delivering same-sex accommodation, which sets out the small number of clinical circumstances where mixed-sex accommodation can be justified and also allows, in Annex B, for people to be allocated to wards according to their presentation, such as their preferred dress and pronouns . A copy of the guidance is attached. NHS England and NHS Improvement are currently reviewing this guidance, including whether the Annex is consistent with the provision of single sex wards.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2021
To ask Her Majesty's Government what assessment they have made of the processes that NHS trusts use (1) to arrange and specify facilities for transgender patients, and (2) to take into account the needs of other patients who may be sharing facilities with transgender patients.

No assessment has been made of the process used by National Health Service trusts for arranging these facilities nor the provision of single sex wards.

We expect all NHS trusts to follow all aspects of NHS England and NHS Improvement’s guidance Delivering same-sex accommodation, which sets out the small number of clinical circumstances where mixed-sex accommodation can be justified and also allows, in Annex B, for people to be allocated to wards according to their presentation, such as their preferred dress and pronouns . A copy of the guidance is attached. NHS England and NHS Improvement are currently reviewing this guidance, including whether the Annex is consistent with the provision of single sex wards.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Sep 2021
To ask Her Majesty's Government what input they had into the NHS Surge and Triage briefing paper drawn up by NHS England in 2016 following a pandemic planning exercise which discussed the withdrawal of hospital care from elderly patients in the event of a severe flu pandemic.

The draft 2016 briefing paper was developed by NHS England and NHS Improvement for clinical deliberation and discussion with the then Chief Medical Officer.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Sep 2021
To ask Her Majesty's Government what was the basis for the Department of Health and Social Care’s reported instruction in communications advice to NHS Trusts to describe new wings or units of existing hospitals as new hospitals.

The schemes named on 2 October are all hospitals which are in need of investment, but those needs are not all identical and vary across a number of factors. In determining which schemes to take forward and ensure that each hospital could benefit from the most effective and efficient solution for its local requirements, it was necessary to establish common criteria for what constitutes a new hospital. All schemes that are part of the programme are consistent with these criteria.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Sep 2021
To ask Her Majesty's Government what plans they have to publish the communications advice issued by the Department of Health and Social Care to NHS Trusts on the new hospitals programme.

In October 2020 we announced details of 32 new hospitals to be built by 2030. To support communications around the plans for their schemes, the Department has issued guidance for information to trusts in the programme. A redacted copy of the guidance is attached, with personal information removed.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Sep 2021
To ask Her Majesty's Government what plans they have to reconsider their response to the recommendation in the report of the Independent Medicines and Medical Devices Safety Review First do no harm, published on 8 July 2020, that separate schemes should be set up to meet the cost of providing additional care and support to those who have experienced avoidable harm from hormone pregnancy tests, valproate and pelvic mesh interventions.

The Government did not accept this recommendation and there are no plans to reconsider this response. Our priority is to make medicines and devices safer and we are pursuing a wide range of activity to further this aim. The response explains the changes that have been put in place since the Independent Medicines and Medical Devices Safety Review report’s publication and the further action the Government will take to implement the recommendations accepted and to improve patient safety.

Lord Kamall
Parliamentary Under-Secretary (Department of Health and Social Care)
20th Jul 2021
To ask Her Majesty's Government whether they will provide the information set out in figure 16 on page 55 of the NHS Resolution annual report and accounts 2020/21 in respect of clinical negligence cases only for the year 2020/21.

The information requested is shown in the following table.

Settlement type

Total number of clinical negligence claims

Number of claims settled with damages

Number of claims settled with No damages

Percentage of all claims settled, with damages

Percentage of all claims settled, no damages

No proceedings

8,941

4,568

4,373

37.94%

36.32%

Proceedings

3,066

2,478

588

20.58%

4.88%

Trial

34

10

24

0.08%

0.2%

15th Jul 2021
To ask Her Majesty's Government how many full time equivalent NHS contracts for (1) registered nurses, and (2) health care assistants, there were in hospital trusts and community trusts in England in each year between 2010 and 2019.

NHS Digital publishes Hospital and Community Health Services workforce statistics for England. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care, general practice surgeries, local authorities or other providers. The following table shows the number of full time equivalent (FTE) registered nurses including health visitors and healthcare assistants as at September each year between 2010 and 2019.

FTE registered nurses

FTE healthcare assistants

September 2010

279,883

44,024

September 2011

277,047

45,401

September 2012

271,407

47,174

September 2013

274,627

51,645

September 2014

278,981

54,533

September 2015

281,474

58,919

September 2016

284,288

63,103

September 2017

283,853

65,840

September 2018

285,674

66,880

September 2019

291,533

70,331

15th Jul 2021
To ask Her Majesty's Government what early intervention measures and improvements to 'continuity of care' for patients with chronic respiratory conditions were adopted between 2010 and 2019 in England.

A series of early intervention measures and improvements to continuity of care were adopted between 2010 and 2019.

In 2011, the Department’s outcomes strategy for chronic obstructive pulmonary disease (COPD) and asthma set out an objective to reduce the number of people with COPD who die prematurely. This was through a proactive approach to early identification, diagnosis and intervention, and proactive care and management at all stages of the disease. The outcomes strategy for COPD and asthma is attached.

In 2013, a guide to performing quality assured diagnostic spirometry was produced. The foreword of the guide says that around a quarter of people on general practice COPD registers did not meet the diagnostic criteria for COPD, and it could be that misdiagnosis occurred because much of the diagnostic spirometry performed failed to meet the essential quality standards. The guide was published to support accurate diagnosis of respiratory conditions. This guide is attached.

Developed in 2017, the NHS RightCare COPD pathway defines the core components of an optimal service for people with COPD. This includes timely access to Pulmonary Rehabilitation as part of the optimal treatment pathway and timely diagnosis as part of the pathway which help with early intervention measures.

The final measure adopted in this period was The National Asthma and COPD Audit Programme which was launched in March 2018 and is led by the Royal College of Physicians. The aims of this programme are to improve quality of care, services, and clinical outcomes for patients with asthma and COPD by collecting and providing data on a range of quality improvement indicators.

15th Jul 2021
To ask Her Majesty's Government how many additional cases of COVID-19 have been reported in those care homes approved by Care Quality Commission as ‘designated settings’ for receiving patients discharged from hospital with COVID-19 in England since the scheme was fully implemented.

The Department does not hold the data requested.

15th Jul 2021
To ask Her Majesty's Government how many full time equivalent specialist respiratory community nurses were working in England to support patients with chronic respiratory conditions in each year between 2010 and 2019.

The Department does not hold the data requested.

15th Jul 2021
To ask Her Majesty's Government what assessment they have made of any possible correlation between patients being discharged from hospital with COVID-19 (1) to their own homes, and (2) subsequent COVID-19 transmission to family members or paid carers, during the period March 2020 to March 2021.

No specific assessment has been made.

12th Jul 2021
To ask Her Majesty's Government what plans they have to communicate (1) to affected patients, and (2) to the general public, that there are many people in the UK for whom COVID-19 vaccines do not offer the same level of protection as they do for the rest of the population.

Public Health England (PHE) is monitoring vaccine effectiveness via their surveillance strategy, which was released to the public and health professionals. The latest results showed COVID-19 vaccines to be highly effective, including for most people in clinical risk groups. Preliminary results for the OCTAVE study, which looks at vaccine efficacy in specific at-risk groups are also expected to be published shortly to provide a greater understanding on the level of protection provided.

The Deputy Chief Medical Officer and NHS England’s National Medical Director wrote to clinicians on 16 July to provide an overview of vaccine efficacy in those with immunosuppression. This included additional information to inform conversations between clinicians and patients on the individual’s level of risk. The Department is regularly updating stakeholders in the charitable and healthcare sectors on vaccine efficacy for all groups.

12th Jul 2021
To ask Her Majesty's Government what estimates they have made of the numbers of patients in England who remain clinically extremely vulnerable to COVID-19 as of 19 July because (1) the vaccines are not effective for them due to their underlying condition, or (2) they have not received a vaccine.

We have not made a specific estimate.

Approximately 9% of clinically extremely vulnerable people have not received their first dose of a COVID-19 vaccine and thus remain at risk. A further 4% have received a single dose.

12th Jul 2021
To ask Her Majesty's Government what plans they have to support immunocompromised or immunosuppressed people, who are not protected by the COVID-19 vaccines and are clinically extremely vulnerable to the virus, to protect themselves after 19 July.

Guidance for clinically extremely vulnerable individuals, 19 July guidance on protecting people who are clinically extremely vulnerable from COVID-19, was published on 12 July and is available in an online only format. The guidance outlines support for all clinically extremely vulnerable people, including those who are immunocompromised or immunosuppressed. Available support includes the NHS Volunteer Responders service and a range of mental health and wellbeing support. The Coronavirus Job Retention Scheme is available until 30 September and local councils may be able to provide additional support. If concerned, an individual’s general practitioner practice or specialist can provide them with personalised advice on any additional precautions they should take.

In addition, immunocompromised individuals are a priority cohort for research into therapeutic and prophylaxis treatments such as monoclonal antibody therapies, novel antivirals and repurposed compounds.

7th Jul 2021
To ask Her Majesty's Government what steps they will take to ensure that public interest in the NHS is protected when private companies receiving NHS contracts already hold seats on Integrated Care System Boards, giving them influence on NHS decision-making.

Integrated care boards (ICBs) will be National Health Service bodies, bringing in representatives from a range of other bodies including NHS commissioners and providers. The Board will, as a minimum, include a Chair, Chief Executive and representatives from NHS trusts, general practice and local authorities.

Local areas will have the flexibility to determine any further representation on their board. This would be subject to local agreement and approval by NHS England. We do not expect independent providers to have seats on the ICB.

6th Jul 2021
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 28 April (HL15156), what assessment they have made of their compliance with the Public Sector Equality Duty, particularly section 149 (1b) of the Equality Act 2010.

As required by the Equality Act 2010 (Specific Duties and Public Authorities) Regulations 2017, the Department’s Annual Report for 2020 provides an overview on how it complied with the Public Sector Equality Duty between April 2020 and March 2021. Our compliance in relation to section 149 (1b) of the Equality Act 2010 included actions to improve COVID-19 vaccine uptake among some ethnic minorities; provision of transparent personal protective equipment to support people who are deaf and people with hearing loss; publishing the National Suicide Prevention Strategy progress report with a commitment to address the lack of LGBT+ self-harm and suicide data; and establishing the Maternity Inequalities Oversight Forum to address the inequalities for women and babies from different ethnic backgrounds and socio-economic groups.

22nd Jun 2021
To ask Her Majesty's Government what plans they have to establish an independent review into the work of Serenity Integrated Mentoring.

NHS England and NHS Improvement have written to the medical directors of National Health Service mental health trusts asking them to review the implementation of Serenity Integrated Mentoring and similar models in trusts, in partnership with local patient representatives and those who might have been in the care of such models. It is too soon to know the outcome of these reviews. Once completed, NHS England and NHS Improvement intend to gather learning from these local reviews, to inform the expansion and transformation of community and crisis care services for adults and older adults with mental health needs as part of the NHS Long Term Plan. We have no plans to establish an independent review.

22nd Jun 2021
To ask Her Majesty's Government what was the outcome of the review commissioned by NHS England into services provided by Serenity Integrated Mentoring.

NHS England and NHS Improvement have written to the medical directors of National Health Service mental health trusts asking them to review the implementation of Serenity Integrated Mentoring and similar models in trusts, in partnership with local patient representatives and those who might have been in the care of such models. It is too soon to know the outcome of these reviews. Once completed, NHS England and NHS Improvement intend to gather learning from these local reviews, to inform the expansion and transformation of community and crisis care services for adults and older adults with mental health needs as part of the NHS Long Term Plan. We have no plans to establish an independent review.

8th Jun 2021
To ask Her Majesty's Government what plans they have (1) to put in place a framework agreement specifically for the adoption of medical devices innovation, and (2) to ensure that each procurement framework agreement has a section specifically for innovation adoption to speed up the use of innovative medical devices for patients.

There are currently no plans for an additional framework agreement for medical device innovation. However, current frameworks do accommodate innovations from existing suppliers.

8th Jun 2021
To ask Her Majesty's Government what plans they have to introduce a separate budgeting and adoption process for medical devices designated as innovative products.

The NHS Long Term Plan committed to accelerate the uptake of selected innovative medical devices, diagnostics and digital products by developing the MedTech Funding Mandate, which was launched on 1 April 2021. While local commissioners and providers decide how to allocate their resources in light of local priorities, the MedTech Funding Mandate will ensure specified National Institute for Health and Care Excellence approved, cost saving innovations are available to patients and funded locally.

8th Jun 2021
To ask Her Majesty's Government what plans they have to follow the approach of the government of the United States' Food and Drug Administration in adapting regulatory requirements by putting clinical evidence into the post-market approval phase and improving the introduction of medical innovation devices.

The Medicines and Healthcare products Regulatory Agency (MHRA) is will conduct a public consultation this summer on the future medical device regulatory regime. This consultation will inform future amendments made to the United Kingdom Medical Device Regulations 2002 as required under the Medicines and Medical Devices Act 2021. The public consultation will cover various aspects of the medical device regulations, including requirements relating to clinical investigations and evidence. The MHRA is committed to ensuring that both pre- and post-market standards are enhanced to protect UK patients whilst supporting innovation with greater alignment with international standards for pre-market clinical data. This will ensure that the domestic medical devices regime remains fit for purpose in an evolving public health environment and facilitates a sector that embraces innovation.

8th Jun 2021
To ask Her Majesty's Government how many of the medical device innovations sent from the HealthTec Connect portal in its first 12 months to (1) NHS, and (2) Government, agencies, have since been adopted by NHS Supply Chain.

In the first 12 months of HealthTech Connect’s operation, 180 technologies were submitted, of which 142 were shared with NHS Supply Chain. None were selected.

NHS Supply Chain do not determine which products are appropriate for adoption by the National Health Service but may respond where products are selected by NHS England and NHS Improvement for adoption via routes such as MedTech Funding and the Accelerated Access Collaborative.

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.

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.

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.

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.

7th Jun 2021
To ask Her Majesty's Government whether they will publish the 2016 NHS Digital report on the Care.data programme.

We will publish the report on the Care.Data program in the Autumn.

7th Jun 2021
To ask Her Majesty's Government what steps they are taking to ensure medicines licensed by the Medicines and Healthcare products Regulatory Agency (MHRA), through Oribis and the Innovative Licensing and Access Pathway (ILAP), are promptly reimbursed by the NHS.

The National Institute for Health and Care Excellence (NICE) is committed to publishing draft guidance on new medicines at the time of licensing, with final guidance published within three months of licensing wherever possible. The Medicines and Healthcare products Regulatory Agency, NICE and NHS England and NHS Improvement are working together to ensure that there is an integrated, timely approach to supporting access for National Health Service patients to products licensed through Project Orbis and the Innovative Licensing and Access Pathway. Interim access arrangements may be considered where NICE’s guidance is not anticipated to be published in line with the three month timeframe.

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.

21st Apr 2021
To ask Her Majesty's Government, further to their announcement on 6 March of a call for evidence in support of a new Women's Health Strategy, whether have they assessed the merits of developing a men's health strategy.

We have made no such assessment.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 Tre