Lord Hunt of Kings Heath

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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

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

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.

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.

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

The information is not available in the format requested.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

The information requested is shown in the following table.

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.

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.

The Department does not hold the data requested.

The Department does not hold the data requested.

No specific assessment has been made.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

We have made no such assessment.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The information is not held in the format requested.

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.

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.

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.

This information is not held centrally.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

No specific assessment or plans have been made.

No specific assessment or plans have been made.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The Government has no plans.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The data is not available in the format requested.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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 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.

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.