Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the decision by regulatory authorities in the United States of America to disallow further use of the Evusheld monoclonal antibody product; and what steps they will take to ensure appropriate prophylaxis and treatment against COVID-19 for vulnerable immunodeficient and immunocompromised patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Antivirals and Therapeutics Taskforce engages with other nations to share learning on the use, deployment and evaluation of therapeutics and antivirals. Evusheld (tixagevimab and cilgavimab) has a conditional marketing authorisation in the United Kingdom for the pre-exposure prophylaxis of COVID-19 and has been referred to the National Institute for Health and Care Excellence (NICE) to make recommendations for the National Health Service on whether it should be routinely funded by the NHS based on an assessment of clinical and cost effectiveness.
The final outcome of NICE’s evaluation on the use of Evusheld as a pre-exposure prophylactic treatment against COVID-19 is expected in April 2023.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many social care workers earning more than £20,480 they estimate will be recruited from overseas as a result of the new immigration visa rules; and what proportion of staff vacancies are expected to be filled further to those rules.
Answered by Lord Kamall
No specific estimate has been made. However, we are working with Skills for Care and the Home Office to produce guidance and seminars to equip adult social care providers with necessary tools and information to recruit successfully from overseas.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to protect individuals who are immuno-compromised and therefore cannot be vaccinated against COVID-19; and whether they plan to offer those individuals plasma from people who have either (1) recovered from COVID-19, or (2) been fully vaccinated.
Answered by Lord Bethell
All immunocompromised people have been offered a COVID-19 vaccination. We continue to monitor vaccine efficacy to identify groups, such as the immunocompromised, who may require additional support. Immunocompromised individuals are a priority cohort for research into therapeutic and prophylaxis treatments such as monoclonal antibody therapies, novel antivirals and repurposed compounds.
It is not yet possible to determine the exact cohort of patients who may benefit from these treatments, as this will depend on results released by ongoing trials as they conclude, licensing approval from the Medicines and Healthcare products Regulatory Agency and deployment planning. We are taking steps to ensure supply of treatments in the event that they are found to be effective. We are developing options for further clinical trials where necessary.
Convalescent plasma from people who have recovered from COVID-19 was found to not provide a clinical benefit in hospitalised patients in the RECOVERY clinical trial. However, we keep the evidence under review for all neutralising antibody therapies including convalescent plasma. The NHS Blood and Transplant study C-VELVET will provide information on the levels of antibodies produced by patients post vaccination and could support further research and development of antibody therapies.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many individuals are medically unable to be vaccinated against COVID-19, either because they are (1) immuno-compromised, (2) undergoing cancer treatment, or (3) undergoing any other treatment rendering them unsuitable for vaccination.
Answered by Lord Bethell
Public Health England does not hold this data.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to introduce a national system to enable care home residents to have meaningful visits from relatives by treating named family members in the same way as key workers who are tested weekly.
Answered by Lord Bethell
We understand how vital it is to allow care home residents to meet their loved ones safely. We appreciate the particular challenges visiting restrictions pose for people with dementia, people with learning disabilities and autistic adults, amongst others, as well as for their friends and family.
On 16 November, we began a trial of testing visitors to care homes. The aim is to support care home providers and families to work together to find the right balance between the benefits of visiting on wellbeing and quality of life, and the risk of transmission of COVID-19 to social care staff and vulnerable residents. This trial is currently taking place in around 21 care homes across three local authorities - Devon, Cornwall and Hampshire - with a view to rolling out nationally in December.
Visitors will still be expected to follow infection prevention and control procedures. Holding hands and hugs can be allowed with a negative test and personal protective equipment, but visitors should minimise contact as much as possible to reduce the risk of transmission.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what criteria they have established to assess independently the capacity of care homes to accept safely COVID-19 positive patients from hospital; and who is responsible for that assessment.
Answered by Lord Bethell
We are working with the Care Quality Commission (CQC) and the National Health Service to ensure everyone discharged from hospital has an updated COVID-19 test result and anyone testing positive is discharged to a setting that is assured to be able to provide safe care.
The CQC has worked with experts to develop an online infection prevention and control (IPC) inspection tool. If settings meet the expectations set out in the CQC’s IPC tool, they will be assured as having the practices and processes in place, at the time of the inspection, to provide appropriate post-discharge care for people who have tested COVID-19 positive.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the risk posed to the health of (1) individuals, and (2) the general public, of extending restrictions to address the COVID-19 pandemic for specific groups including (a) all over 60s regardless of health, (b) all over 70s regardless of health, (c) all BAME citizens, (d) all male citizens, and (e) all those with a body mass index over 30; how many people in each such group have been admitted to intensive care due to COVID-19; and what proportion of the total population of each group such numbers represent. [T]
Answered by Lord Bethell
On 2 June Public Health England published Disparities in the risk and outcomes of COVID-19. This report was subsequently updated in August 2020. The report finds that among people already diagnosed with COVID-19, people who were 80 years or older were seventy times more likely to die than those under 40. It also sets out that the risk of dying among those diagnosed with COVID-19 was also higher in males than females; higher in those living in the more deprived areas than those living in the least deprived; and higher in those in black, Asian and minority ethnic (BAME) groups than in white ethnic groups. The report notes that these inequalities largely replicate existing inequalities in mortality rates in previous years, except for BAME groups, as mortality was previously higher in white ethnic groups. The report’s analyses take into account age, sex, deprivation, region and ethnicity, but it does not take into account the existence of co-morbidities, which are strongly associated with the risk of death from COVID-19 and are likely to explain some of the differences. A copy of the report is attached.
On 22 October the Minister for Equalities, (Kemi Badenoch MP) published the first Quarterly report on progress to address COVID-19 health inequalities report to the Prime Minister and the Secretary of State for Health and Social Care on progress to tackle COVID-19 disparities experienced by individuals from an ethnic minority background, making 13 recommendations. This includes reviewing the effectiveness and impact of current actions being undertaken by relevant Government departments to directly lessen disparities in infection and death rates of COVID-19. As well as taking action to modify existing policy and policy in development to address these disparities, all of which the Prime Minister has accepted. A copy of this quarterly report is attached.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to enable young adults who are (1) autistic, or (2) disabled, and who are living in care homes and who do not have any specific risk factors for COVID-19 to be able to visit family at home; and if they have any such plans, what is the timetable to enable such visits. [T]
Answered by Lord Bethell
We are aware that limiting visits out of care homes is difficult for many families and residents. The Government recognises that this is a particularly challenging time for many disabled people and we are absolutely committed to ensuring they receive the support they need.
Guidance on visits out of care homes is in development and will be published shortly.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to instruct all care homes to ensure any Do Not Attempt CPR orders imposed since 1 March on any of their residents’ files are reviewed immediately, in consultation with residents or their representatives.
Answered by Lord Bethell
The Department has asked the Care Quality Commission (CQC) to review how Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were used during the COVID-19 pandemic, building on concerns that the CQC reported earlier in the year. Interim findings are expected to be reported later this year with a final report in early 2021.
Until the review reports its findings in early 2021, we will continue to work across the health and care system to address the issue. The Adult Social Care Winter Plan reiterates that DNACPR decisions should only ever be made on an individual basis and should be led by the clinical team. All health professionals nationally are expected to follow the clear statements on the use of individual DNACPR orders.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the financial stability of care home providers in England and Wales in the light of any additional pressures arising as a result of the COVID-19 pandemic.
Answered by Lord Bethell
We draw on a range of information to assess the financial position of the care sector in England. The Adult Social Care – our COVID-19 Winter Plan 2020/21, published on 18 September, underlines the Government’s commitment to support local authorities in England and the wider care sector, including care homes, to ensure that high quality, safe and timely care is provided to everyone who needs it. A copy of the Plan is attached.
We recognise that COVID-19 is imposing significant pressures on the social care sector. We have now made £4.6 billion available to local authorities so they can address pressures on local services caused by the pandemic, including in adult social care. The responsibility for adult social care in Wales is a devolved matter.