Mary Glindon

The listed events regime strikes a balance between retaining free-to-air sporting events for the public while allowing rights holders to negotiate agreements in the best interests of their sport.

To give equal recognition to disabled and women’s sports, the government is currently consulting on the addition of the Paralympics and certain women’s events to the listed events regime. However, the government does not have any plans to carry out a full review of the list.

This Government is committed to the future of the Tyne and Wear Metro system. We have invested nearly £600m towards renewals and running costs and I am currently considering future long term investment commitments to support this vital transport system to the region. Furthermore, in the 2017 Autumn Budget, the Chancellor announced a £337m direct grant to deliver a new fleet of trains for the Tyne and Wear Metro.

Since March 2020 we have increased the number of colleagues with the IT to enable them to work more flexibly by over 50,000, meaning almost 74,000 people in total have equipment to enable them to work from home. This is approximately 81% of our workforce. Every day more colleagues are able to work from home as we continue to roll out more IT equipment to ensure that everyone in DWP is enabled to work from home where appropriate by the end of March 2021.

We are limiting how many colleagues remain working in an office setting in order to balance the need to provide essential public facing services for citizens, whilst maintaining safe social distancing in line with Government guidelines. Examples of such roles are some of our Jobcentre services (which provide vital face to face support for our most vulnerable citizens), and clerical processes such as Industrial Injuries Disablement Benefit applications.

Currently, around 31,000 DWP employees are consistently working from an office, with approximately a further 5,000 working from a combination of home and a DWP office location. Combined, this accounts for around 42% of the DWP employees who currently attend an office during the working week.

Since March 2020 the Department has increased the number of colleagues with IT which enables them to work more flexibly, including from home, by over 50,000. This means almost 74,000 people in total now have kit to enable them to work this way, which is approximately 81 per cent of our workforce.

The Department continues the roll-out of IT kit as quickly as it can, delivering over 2,500 pieces of IT equipment a week to ensure that everyone in DWP is enabled to work flexibly by the end of March.

The roll out has been delivered according to a carefully planned set of priorities in order to keep our colleagues safe whilst keeping our services running and has been delivered to plan.

Some job roles can only be done in the office or individuals’ personal circumstances mean they do not wish to work from home - these colleagues will continue to use their existing desk-based IT. Where colleagues are required to work in an office, please be assured that measures are in place which follow all Government guidance on social distancing to ensure the safety of colleagues.

The digital system ‘Apply for a NINo’ is for citizens to make an on-line application for a National Insurance number. The limited trial started in mid-October 2020 and is scheduled to run until January 2021. Once we receive confirmation that the service meets Government Digital Standards, we will then be able to extend the service to all applicants.

When applying for a National Insurance number, all applicants are required to have their identity verified. This verification is completed through attendance at a face to face interview with DWP unless we are able to confirm another Government Department has already done this.

The department does not hold information on the numbers of British Citizens who are waiting for a National Insurance Number (NINo) to be allocated.

The vast majority of British Citizens receive a NINo from HMRC shortly before their 16th birthday if they have been part of a Child Benefit Claim.

The Department for Work and Pensions is responsible for the allocation of National Insurance Numbers (NINos) to adults in the UK. The NINo is an administrative reference number, unique to each individual and used by both DWP and HMRC to link an individual to their National Insurance Contributions and record the payment of Social Security Benefits.

Possession of a National Insurance number does not demonstrate that an individual has a right to work in the UK, this is determined by Home Office legislation. A list of acceptable documents that enables an individual to demonstrate they have the right work is set out in the Employers Guide to Right to Work Checks.

https://www.gov.uk/prove-right-to-work

I refer the hon. Member to the answer I gave on 9 June 2020 to Question UIN 52251.

Both DWP and Interserve have implemented HR policies which fully comply with the Covid-19 guidance published by Public Health England (PHE) via Gov.uk.

These policies each cover the three areas highlighted for the respective separate workforces.

All Interserve cleaners have been provided and continue to be re-supplied with the appropriate PPE to carry out the cleaning tasks in accordance with our Company COVID-19 PPE risk assessment and specific DWP Task Risk Assessments which both comply with all published Government guidelines and advice. Appropriate PPE in the form of protective gloves is being provided to all cleaning staff.

The cleaners are classed as Key Workers and each have been provided with written correspondence to confirm this status.

The cleaners and their household members are eligible for COVID-19 testing subject to showing symptoms in accordance with our Company testing programme, or they may apply through the Government route themselves.

The Department wrote to all its suppliers, including Interserve, reaffirming that they should follow the guidance issued via Public Health England on Gov.uk and has been working closely with them since the start of the COVID-19 outbreak to ensure appropriate measures are put in place.

Where reasonable adjustments can be made to allow the colleague to attend work, then Interserve is implementing those adjustments. These adjustments can include shorter hours, flexible start/finish times to avoid busy commutes, and social distancing in the workplace. Where reasonable adjustments cannot be made to support a safe working environment for colleagues who identify as vulnerable then arrangements are made for the colleague to remain at home on full pay. Additionally, appropriate PPE in the form of protective gloves is being provided to all cleaning staff.

Interserve colleagues who may be caring for vulnerable dependants who require “shielding” are being advised to raise this with their line manager so that reasonable adjustments such as those above can be explored.

The Department places a strong emphasis on engaging with stakeholders to inform health and disability policy to ensure we are addressing the right problems in the welfare system. Muscular Dystrophy UK’s report entitled ‘Below standard: MDUK’s assessment of the benefits system’ offers insights into the challenges faced by people living with muscle-wasting conditions.

Government will reflect carefully on these findings as part of the National Disability Strategy, which will be published by the end of the year, and in the DWP Green Paper on health and disability benefits and support.

The NHS North Tyneside Clinical Commissioning Group (CCG) has been working to reduce waiting times for treatment, although this is impacted by COVID-19. The CCG have made use of locums and an Elective Recovery Framework and a Recovery Plus programme have been developed to address waiting times, with system-wide solutions established with local integrated care systems.

There are no plans to fully delegate NHS England’s functions for specialised services in 2022/23. Subject to the passage of the Health and Care Bill, certain specialised services may become subject to joint commissioning arrangements between NHS England and integrated care boards during 2022/23. The services which would benefit from this more integrated commissioning approach remain under consideration. Further details will be provided before April 2022.

NHS England will remain accountable for all specialised services, including those that are jointly commissioned or delegated. NHS England will retain responsibility for setting national standards and clinical policies determining access to both new and existing treatments. There are currently no plans to delist any services as specialised services.

We have consulted widely on issues related to the Conference of the Parties to the World Health Organization Framework Convention on Tobacco Control. In line with Article 5.3 of the Convention, the Department engages only with those stakeholders and experts who are independent of the tobacco industry.

Information on specific allocations through the Elective Recovery Fund to each elective service in England is not held centrally.

As set out in the National Health Service ‘2021/22 priorities and operational planning guidance’, systems are asked to deliver activity levels above set thresholds in order to access this additional funding. This will increase activity including in neurology services for patients affected by Parkinson’s.

Information on specific allocations through the Elective Recovery Fund to each elective service in England is not held centrally.

As set out in the National Health Service ‘2021/22 priorities and operational planning guidance’, systems are asked to deliver activity levels above set thresholds in order to access this additional funding. This will increase activity including in neurology services for patients affected by Parkinson’s.

Following discussions with the Government of Malta, they are now accepting all travellers vaccinated with vaccine batch releases approved by the Medicines and Healthcare products Regulatory Agency. This includes accepting all those who have received the AstraZeneca vaccine manufactured in the Serum Institute of India under the United Kingdom’s vaccination programme.

NHS Digital proactively promoted the new collection approach with all media outlets, using social media channels to promote information. Patient facing materials have been developed by NHS Digital for general practitioners to use. Following the announcement that the data collection will be delayed until 1 September 2021, NHS Digital intends to use the next two months to continue to enhance communications and further raise awareness with the public about the new collection and its benefits.

Only the information that is required to meet a legally permitted use will be accessed. The data will only be used for health and care planning and research purposes by organisations that have a legal basis and legitimate need to use the data. NHS Digital publishes the details of the data shared on their data release register. All requests to access general practitioner (GP) data are scrutinised by NHS Digital against stringent criteria, then two independent panels which include GP representatives.

Any National Health Service organisation, such as a clinical commissioning group, or a national arm’s length body or research organisation can request access to the data. The data collected from GPs does not include the names and addresses of individuals or their contact numbers and is pseudonymised at source to further protect the identity of patients. The implementation date of this data collection will now be 1 September 2021.

Only the information that is required to meet a legally permitted use will be accessed. The data will only be used for health and care planning and research purposes by organisations that have a legal basis and legitimate need to use the data. NHS Digital publishes the details of the data shared on their data release register. All requests to access general practitioner (GP) data are scrutinised by NHS Digital against stringent criteria, then two independent panels which include GP representatives.

Any National Health Service organisation, such as a clinical commissioning group, or a national arm’s length body or research organisation can request access to the data. The data collected from GPs does not include the names and addresses of individuals or their contact numbers and is pseudonymised at source to further protect the identity of patients. The implementation date of this data collection will now be 1 September 2021.

The Department does not hold the information requested.

We have made no such estimate.

However, we are committed to reducing smoking prevalence and the associated costs to the National Health Service. A new Tobacco Control Plan will be published later this year.

The Department encourages all smokers to quit or move to less harmful products, such as e-cigarettes, if they are unable to quit. In England, an estimated 2.5 million people use e-cigarettes, the majority of whom no longer smoke. In addition, around 50,000 people a year quit smoking through switching to e-cigarettes, who would not have quit through other means.

The Better Health mass media smoking cessation campaign, delivered by Public Health England and as part of a package of tobacco control measures, has been effective at helping challenge misinformation surrounding e-cigarettes. Alongside this, local stop smoking services advise smokers of the benefits of switching to less harmful products, with some offering free vaping starter kits.

The Department encourages all smokers to quit or move to less harmful products, such as e-cigarettes, if they are unable to quit. In England, an estimated 2.5 million people use e-cigarettes, the majority of whom no longer smoke. In addition, around 50,000 people a year quit smoking through switching to e-cigarettes, who would not have quit through other means.

The Better Health mass media smoking cessation campaign, delivered by Public Health England and as part of a package of tobacco control measures, has been effective at helping challenge misinformation surrounding e-cigarettes. Alongside this, local stop smoking services advise smokers of the benefits of switching to less harmful products, with some offering free vaping starter kits.

The Department continues to monitor any new, high quality evidence from clinical trials on the effectiveness of different therapeutics for COVID-19 and works to ensure that any identified as credible or plausible are rapidly considered for entry into a United Kingdom priority platform clinical trial. Additionally, the Scientific Advisory Committee on Nutrition (SACN) secretariats are monitoring the evidence around nutrition and COVID-19 and are due to update the SACN at their next meeting in June 2021.

The Department does not maintain a position on any complementary or alternative medicine treatments. It is the responsibility of local National Health Service organisations to make decisions on the commissioning and funding of any healthcare treatments for NHS patients, taking into account issues around safety and clinical and cost-effectiveness. The National Institute for Health and Care Excellence does not currently recommend that homeopathy should be used in the treatment of any health condition.

The Government continues to review the evidence of reduced risk products such as e-cigarettes, including their harms and usefulness as an aid to stop smoking. Although not risk free, current evidence suggests e-cigarettes are less harmful to health than smoking and can help some people quit.

Public Health England (PHE), through their stop smoking campaigns, provide information, advice and support on using e-cigarettes to help smokers quit. Smokers can also access local stop smoking services who provide a range of quitting methods to suit the individual smoker’s preferences and this may include support for smokers who wish to use e-cigarettes to quit smoking. The highest success rates in these services are seen among those combining expert advice with e-cigarettes.

In line with the Government’s commitment to article 5.3 of the World Health Organization Framework Convention on Tobacco Control, the Department only meets with vape trade organisations who are independent of the tobacco industry. The Department and PHE meet with the Independent British Vape Trade Association to discuss industry concerns and wider regulatory matters, including misinformation.

The Government continues to review the evidence of reduced risk products such as e-cigarettes, including their harms and usefulness as an aid to stop smoking. Although not risk free, current evidence suggests e-cigarettes are less harmful to health than smoking and can help some people quit.

Public Health England (PHE), through their stop smoking campaigns, provide information, advice and support on using e-cigarettes to help smokers quit. Smokers can also access local stop smoking services who provide a range of quitting methods to suit the individual smoker’s preferences and this may include support for smokers who wish to use e-cigarettes to quit smoking. The highest success rates in these services are seen among those combining expert advice with e-cigarettes.

In line with the Government’s commitment to article 5.3 of the World Health Organization Framework Convention on Tobacco Control, the Department only meets with vape trade organisations who are independent of the tobacco industry. The Department and PHE meet with the Independent British Vape Trade Association to discuss industry concerns and wider regulatory matters, including misinformation.

The Government continues to review the evidence of reduced risk products such as e-cigarettes, including their harms and usefulness as an aid to stop smoking. Although not risk free, current evidence suggests e-cigarettes are less harmful to health than smoking and can help some people quit.

Public Health England (PHE), through their stop smoking campaigns, provide information, advice and support on using e-cigarettes to help smokers quit. Smokers can also access local stop smoking services who provide a range of quitting methods to suit the individual smoker’s preferences and this may include support for smokers who wish to use e-cigarettes to quit smoking. The highest success rates in these services are seen among those combining expert advice with e-cigarettes.

In line with the Government’s commitment to article 5.3 of the World Health Organization Framework Convention on Tobacco Control, the Department only meets with vape trade organisations who are independent of the tobacco industry. The Department and PHE meet with the Independent British Vape Trade Association to discuss industry concerns and wider regulatory matters, including misinformation.

It is for individual organisations and businesses to implement their own policies on e-cigarette use in the workplace. Public Health England has published guidance to support organisations in developing policies around vaping in workplaces and public places and recommend such policies to be evidence-based. The guidance is available at the following link: https://www.gov.uk/government/publications/use-of-e-cigarettes-in-public-places-and-workplaces

Local authorities are responsible for providing stop smoking services in their communities and are best placed to identify those in need of support and how to deliver an effective service. Public Health England provides analytical toolkits, assessments and guidance to help local authorities.

The Government is conducting a Post Implementation Review of both the Standardised Packaging of Tobacco Products Regulations 2015 and the Tobacco and Related Products Regulations 2016 to assess if the regulations have met their objectives. As part of this review a public consultation is being conducted, which was open until 19 March 2021. The responses, alongside other available evidence, will be fully analysed and used to inform the Post Implementation Review.

This Government is committed to levelling up in society to ensure no communities get left behind. This is why we announced our bold ambition for England to be Smokefree by 2030 because we want to continue to address the harms from smoking. As part of this commitment, we have announced the publication of a new Tobacco Control Plan which will set out our roadmap to achieving this challenging ambition. The Plan is due to be published in Summer 2021.

The deadline for the Universal and Accelerator drug treatment grant applications is fixed. Where there are exceptional circumstances, Public Health England will work with local areas on a case by case basis to ensure they can submit applications. Local authorities have now received their indicative allocations, proposal templates and supporting materials.

As part of delivering the commitments set out in ‘Tackling obesity: empowering adults and children to live healthier lives’, the Government announced £100 million extra funding for healthy weight programmes. Of this funding, around £35 million will be allocated to councils and £35 million to the National Health Service to be invested into weight management services. This will enable up to 700,000 adults to have access to support that can help them to achieve a healthy weight, from access to digital apps, weight management groups or individual coaches, to specialist clinical support.

The remaining £30 million will fund initiatives to help people maintain a healthy weight, including access to the free NHS 12 week weight loss plan app, continuing the Better Health marketing campaign to motivate people to make healthier choices, and upskilling healthcare professionals. Decisions about the provision of tier 3 and 4 weight management services, are made at a local level, reflecting varying pressures on local health systems and availability of capacity, including use of the independent sector, and taking into account of the rate of recovery of elective services following the COVID-19 pandemic.

As part of delivering the commitments set out in ‘Tackling obesity: empowering adults and children to live healthier lives’, the Government announced £100 million extra funding for healthy weight programmes. Of this funding, around £35 million will be allocated to councils and £35 million to the National Health Service to be invested into weight management services. This will enable up to 700,000 adults to have access to support that can help them to achieve a healthy weight, from access to digital apps, weight management groups or individual coaches, to specialist clinical support.

The remaining £30 million will fund initiatives to help people maintain a healthy weight, including access to the free NHS 12 week weight loss plan app, continuing the Better Health marketing campaign to motivate people to make healthier choices, and upskilling healthcare professionals. Decisions about the provision of tier 3 and 4 weight management services, are made at a local level, reflecting varying pressures on local health systems and availability of capacity, including use of the independent sector, and taking into account of the rate of recovery of elective services following the COVID-19 pandemic.

On 5 March, we announced that £79 million of this funding would be used to boost mental health support for children and young people. An announcement is expected to be made shortly giving further details on how the remainder of the £500 million will be spent.

On 5 March, we announced that £79 million of this funding would be used to boost mental health support for children and young people. An announcement is expected to be made shortly giving further details on how the remainder of the £500 million will be spent.

No such assessment has been made. However, since September 2020, the Improving Access to Psychological Therapies (IAPT) dataset has begun to collect information regarding the specific long term conditions that people presenting to IAPT services have in order to allow NHS England and NHS Improvement to better monitor access and outcomes for different groups accessing IAPT– long term conditions services.

NHS Digital will be publishing long term conditions specific breakdowns of IAPT data later this month and we anticipate including a Parkinson’s specific analysis of the data later in the year, subject to there being sufficient numbers of patients presenting with Parkinson’s in order to facilitate this analysis.

No Improving Access to Psychological Therapies for Long Term Condition services have been commissioned specifically for people with Parkinson’s or neurological conditions.

Public Health England (PHE) launched the Better Health campaign in July 2020 to support people, particularly middle-aged adults, to lead healthier lifestyles. Within the campaign, the Drink Free Days App is one of the support tools provided. PHE’s ‘Drinkline’ is also a free, confidential national alcohol helpline for people worried about their own or someone else's drinking.

PHE continues to plan social marketing activity across a range of health-related behaviours. Plans will be developed with consideration to a number of factors including the existing circumstances relating to COVID-19, the relative economic payback of campaigns on a specific behaviour, the severity and scale of the risk attached to each behaviour and the strength of the evidence base that marketing can help change behaviours. The Department will consider the recommendations made in Drink Wise, Age Well report.

Public Health England (PHE) launched the Better Health campaign in July 2020 to support people, particularly middle-aged adults, to lead healthier lifestyles. Within the campaign, the Drink Free Days App is one of the support tools provided. PHE’s ‘Drinkline’ is also a free, confidential national alcohol helpline for people worried about their own or someone else's drinking.

PHE continues to plan social marketing activity across a range of health-related behaviours. Plans will be developed with consideration to a number of factors including the existing circumstances relating to COVID-19, the relative economic payback of campaigns on a specific behaviour, the severity and scale of the risk attached to each behaviour and the strength of the evidence base that marketing can help change behaviours. The Department will consider the recommendations made in Drink Wise, Age Well report.

In October 2020 NHS England and NHS Improvement announced a commitment to a five point plan for ‘long’ COVID-19, which included the commissioning of the National Institute for Health and Care Excellence (NICE) to develop a clinical case definition and associated guidance for long COVID-19 alongside the Royal College of General Practitioners. The ‘COVID-19 rapid guideline: managing the long-term effects of COVID-19’ was published on 18 December 2020.
Since evidence is not yet available on the effectiveness of herbal medicine in treating long COVID-19, NICE has made no recommendation relating to it. As more evidence emerges on the condition and its management, it will give us a better understanding on the most appropriate interventions and guidance and recommendations will be reviewed accordingly.

Under the Abortion Act 1967, any complication known to the registered medical practitioner terminating the pregnancy should be reported to the Chief Medical Officer on the Abortion Notification (HSA4) form. All serious incidents should be reported by the provider to their commissioner, the Care Quality Commission and other relevant organisations in line with the serious incident framework published by NHS England and NHS Improvement at the following link:

https://improvement.nhs.uk/resources/serious-incident-framework/

The National Institute for Health and Care Excellence published new guidelines on twin and triplet pregnancy, NG137, in September 2019. The guideline sets out care that should be offered to women with a twin or triplet pregnancy in addition to the routine care that is offered to all women during pregnancy. It aims to reduce the risk of complications and improve outcomes for women and their babies.

The Department has no plans to undertake an assessment of the effect of multiple gestation on pregnancy and the effectiveness of the medical advice given to parents on multiple gestation at this time.

The Department does not set clinical practice. To support clinical practice, the Royal College of Obstetricians and Gynaecologists has considered the issue of fetal pain and awareness in its guidelines ‘The Care of Women Requesting Induced Abortion’ and ‘Fetal Awareness: Review of Research and Recommendations for Practice’, which are available at the following links:

https://www.rcog.org.uk/globalassets/documents/guidelines/abortion-guideline_web_1.pdf

https://www.rcog.org.uk/globalassets/documents/guidelines/rcogfetalawarenesswpr0610.pdf

The Department expects clinicians to follow the Royal College of Obstetricians and Gynaecologists’ guidance on Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales, which states that all staff involved in the care of a woman or couple facing a possible termination of pregnancy must adopt a non-directive, non-judgemental and supportive approach.

The Royal College is currently reviewing its clinical guidelines and guidance for the care of women through antenatal screening and further diagnostic testing. A new core curriculum for professionals working in maternity and neonatal services has been developed by the Maternity Transformation Programme, which includes training on ultrasound scanning and related conversations.

The Department has not made a specific assessment of the merits of developing a brain workforce. However, NHS England and NHS Improvement, working closely with partners including Health Education England and the National Neurosciences Advisory Group, are taking a range of action to strengthen the neurology workforce. This includes ongoing work to improve integration of care for neurology patients and developing, as part of the National Stroke Programme, a stroke-specific education framework to ensure a sustainable and appropriately skilled workforce.

Under the Abortion Act 1967, a pregnancy may be lawfully terminated by a registered medical practitioner in approved premises, if two medical practitioners are of the opinion, formed in good faith, that the abortion is justified under one or more of grounds A to G. Ground E refers to cases where “there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”. There can be multiple reasons for an abortion for a fetal abnormality, therefore there can be more than one medical condition mentioned on a HSA4 form.

Selective abortions are abortions where the number of fetuses in the womb is reduced.

There were 55 mentions of medical conditions for selective abortions performed under ground E between January to June 2020, a breakdown of which is available in the attached table.

NHS Digital data collection for open repair of spina bifida in a fetus was introduced from 1 April 2020. However, finalised Hospital Episode Statistics data is only available up to March 2020, so we are unable to provide this information.

NHS England and NHS Improvement commissioned a United Kingdom-wide ‘Open fetal surgery to treat foetuses with open spina bifida’ service since November 2019. Since the start of the service to the end of July 2020, surgery has been undertaken on 13 unborn babies and the total cost of these surgeries was £164,021.

The Department has not made a recent assessment on the effect of advice from healthcare professionals following prenatal disability diagnoses on the decision of pregnant women to continue or terminate their pregnancy.

The Royal College of Obstetricians and Gynaecologists has published guidance on Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales. The guidance sets out that all staff involved in the care of a woman or couple facing a possible termination of pregnancy must adopt a non-directive, non-judgemental and supportive approach.

Membership of the Population Health Improvement Stakeholder Advisory Group is as follows. We expect the group to meet during October, with dates to be confirmed.

Jeanelle de Gruchy, The Association of Directors of Public Health, President

James Jamieson, Local Government Association, Chair

Seema Kennedy, Former Public Health Minister

Helen Stokes-Lampard, Academy of Medical Royal Colleges, Chair

Matt Fagg, NHS England and Improvement, Director of Prevention

Matthew Winn, NHS England and Improvement, Improvement Director of Community Health

Ed Garratt, Suffolk ICS, Executive Lead for the Suffolk and North East Essex Integrated Care System (ICS)

Professor Maggie Rae, Faculty of Public Health, President

Danny Mortimer, NHS Confederation Chief Executive

Dr Jennifer Dixon, Health Foundation Chief Executive

Paul Najsarek, SOLACE, Chief Executive of Ealing Council

Professor Jo Pritchard MBE, Social Enterprise UK Chief Executive

Professor John Newton, Public Health England (PHE), Director of Health Improvement

Dr Jenny Harries, DHSC Deputy Chief Medical Officer

Professor Paul Cosford, Emeritus Medical Director, PHE

Chief Medical Advisor, NHS Test and Trace

Professor John Deanfield, Consultant Paediatric Cardiologist and Chair, NHS Health Checks Review

Professor Sir John Bell, Life Sciences Champion

Professor Kevin Fenton, PHE, Regional Director, London

Christina Marriott, Royal Society of Public Health, Chief Executive

Martin Reeves, Coventry City Council, Chief Executive,

Paul Farmer, MIND, Chief Executive

Professor Susan Jebb, Nuffield Institute of Primary Health Care Sciences, Professor of Diet and Population Health

Louise Patten, NHS Clinical Commissioners, Chief Executive

Sally Warren, The King’s Fund, Director of Policy

Professor Lord Patel of Bradford OBE

Donna Kinnair, Royal College of Nursing, Chief Executive/General Secretary

The membership of the stakeholder advisory group is shown in the following table. The schedule of its recent meetings is as follows:

2 September

10 September

16 September

24 September

Future dates are to be confirmed.

Entacapone 200 milligram (mg) tablets are currently listed in Category M of Part VIII of the Drug Tariff. Reimbursement prices of generic medicines in Category M are calculated on the basis of sales and volume data provided from manufacturers and they also include an element of medicine margin. For a product to be considered for addition to a category or to move from one category to another – the guideline criteria relevant to the category in which the product may be placed needs to be met. This is constantly kept under review for all products listed in the Drug Tariff including entacapone 200mg tablets.

Reimbursement prices paid to community pharmacies for dispensed medicines are reviewed on a monthly basis. For example, the reimbursement price for entacapone was recently reviewed for October. Due to fluctuations in selling prices, there is also a mechanism which allows for reimbursement prices to be reviewed in month. These reimbursement prices are referred to as concessionary prices. Entacapone 200 milligram tablets were granted a concessionary price in August.

On 19 March the Department published Hospital Discharge Service Requirements, in partnership with NHS England, which applies to clinical commissioning groups (CCGs). This is available at the following link:

https://www.gov.uk/government/publications/coronavirus-covid-19-hospital-discharge-service-requirements

On 19 March the Department published Hospital Discharge Service Requirements, in partnership with NHS England, which applies to clinical commissioning groups (CCGs). This is available at the following link:

https://www.gov.uk/government/publications/coronavirus-covid-19-hospital-discharge-service-requirements

Local authorities are responsible for assessing local needs and commissioning drug prevention, treatment and harm reduction services to meet these needs. This includes providing needle and syringe programmes in their areas.

Public Health England supports local authorities in their work of needs assessment and commissioning services by providing advice, guidance and data.

Local authorities are responsible for assessing local drug needs and commissioning prevention, treatment and harm reduction services and interventions, which include needle exchange provision.

NHS England and NHS Improvement are working with PHE to review the harm reduction activity that is currently available.

During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. The Secretary of State is keeping measures under review.

The Department is working closely with NHS England and NHS Improvement to agree a date for the resumption of CHC assessments. On agreement, restart guidance will be published and shared with clinical commissioning groups.

We are informed by NHS England and NHS Improvement that the National Health Service nationally has not cancelled any facility for repeat prescriptions. While ordering online has proven hugely popular because of the convenience and ease, we know this will not be possible for everyone. National guidance is clear that every local practice must put in place a system for repeat prescriptions, which can include online and phone orders, to meet the needs of their own patients.

This information is not collected centrally.

No assessment has been made of the effect on prescription charge revenue of the guidance on ‘Conditions for which over the counter items should not routinely be prescribed in primary care’.

There are no plans to make such an assessment or to change the system for prescription charges and exemptions. Prescription charges are a valuable income source for the National Health Service and are particularly important given increasing demands on the NHS. Extensive arrangements are already in place to help people access NHS prescriptions, including a broad range of NHS prescription charge exemptions.

The NHS Business Services Authority processes the NHS Low Income Scheme and issues HC2 certificates. It does not hold data on how many people have used their certificate after it is issued; and multiple people in a household in addition to the applicant might be covered by a certificate, including partner and children. However, data is supplied on the number of HC2 certificates issued in 2014/15, 2015/16, 2017/18 and 2018/19. This is shown in the following table:

Data is recorded April-March. Data provided is recorded on a monthly basis and recorded in the NHS Low Income Scheme Annual Statistics Report. This data relates to the number of certificates issues, not the number of people supported by the NHS Low Income Scheme.

Data on prescriptions dispensed in the community is collected by the number of items, or the cost. Data is not held about the number of people who obtain a prescription.

If a prescription item is recalled, the patient is issued with a new prescription for an alternative product which will then be dispensed as a separate item. The prescriptions data systems are unable to identify this as a replacement product, therefore this information is not held centrally.

We originally made up to £1.3 billion available via the National Health Service to support the discharge process. This has been supplemented by an additional £588 million as part of the announcement by the Prime Minister on 17 July that £3 billion is being made available to support the NHS this winter. This funding has been made available to and drawn down by clinical commissioning groups (CCGs), working with their local authority partners to support appropriate discharge from acute settings. We do not hold information on the breakdown of how CCGs have used the funds split between NHS and non-NHS providers.

The Department has not made such an estimate. Decisions about the appointment of neuropsychiatrists and neuropsychologists are determined locally by National Health Service trusts and according to demand.

We remain committed to growing the mental health workforce to achieve the ambitions set out in the NHS Long Term Plan. The interim NHS People Plan, published in June 2019 set out actions to reduce vacancies and secure the staff we need for the future. Since then, there have been a number of initiatives put in place to increase the National Health Service mental health workforce. The final People Plan will be published in due course, will set out a further robust plan for growth in the nursing and medical workforce.

The mental health workforce has increased by over 9,500 (8.8%) between March 2017 (the baseline year for Stepping Forward, The Mental Health Workforce Plan for England) and March 2020.

During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.

CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.

To ensure the delivery of high-quality assessments, there is a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.

During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.

CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.

To ensure the delivery of high-quality assessments, there is a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.

During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.

CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.

To ensure the delivery of high-quality assessments, there is a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.

In March 2018, NHS England and NHS Improvement and NHS Clinical Commissioners published ‘Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for Clinical Commissioning Groups’, available at the following link:

https://www.england.nhs.uk/publication/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed-in-primary-care-guidance-for-ccgs/

Since publication, there has been a reduction in spend of £32 million on over the counter items. This reduction includes spending on over the counter items for conditions that are self-limiting and conditions which lend themselves to self-care, as well as vitamins, minerals and probiotics.

This estimate is correct as at 10 July 2020. It should be noted that the list of over the counter products is updated as new products become available.

We are committed to looking at what further action can be taken to improve weight management services to better support people living with obesity to achieve a healthier weight.

Through the three chapters of our childhood obesity plan we are delivering a wide range of measures to help achieve our bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030. We will be responding to the consultations from chapter two of the plan and taking forward measures outlined in chapter three as soon as we can.

We remain committed to reviewing what more can be done and will continue to monitor progress and emerging evidence.

We recognise the crucial role that day services and respite care plays both for unpaid carers and the people who use these services.

Decisions on the running and re-opening of day services are made on a local basis.

We have worked with the Social Care Institute for Excellence to publish guidance to help make decisions on restarting services and to provide quality care safely. The guidance was is for commissioners, providers, families and unpaid carers to ensure effective planning in opening and delivery of care in day services and is available at the following link:

https://www.scie.org.uk/care-providers/coronavirus-covid-19/day-care/safe-delivery

Public Health England has also developed an illustrated guide for the use of personal protective equipment in community and social care settings, which is available at the following link:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/905630/PHE_illustrative_PPE_guide_for_community_and_social_care_settings_17b.pdf

Local authorities and service providers should have maintained contact with carers and people who use their services throughout the lockdown. They will now be discussing arrangements to reintroduce care packages including where possible day care provision and respite breaks.

The response to the COVID-19 pandemic has shown that the United Kingdom healthcare research and approvals system has the agility and flexibility to respond efficiently to a national crisis. The Medicines and Healthcare products Regulatory Agency (MHRA) and Health Research Authority (HRA) instigated procedures for rapid advice, reviews and approvals for COVID-19 trials, prioritising these and authorising them in about one week.

As of 2 July, a total of 50 trials for the treatment or prevention of COVID-19 have been approved by both the MHRA and the HRA in an average of 12 days. Both the MHRA and the HRA have produced guidance on regulatory flexibilities available to clinical trial sponsors and proportionate approaches so that trials could be run as efficiently as possible.

In collaboration with trial sponsors and partners across the healthcare system a ‘lessons learned’ exercise will determine which initiatives in the emergency situation would be appropriate and sustainable in the ‘business as usual’ situation.

As part of our concerted national efforts in response to the COVID-19 pandemic, we will continue doing everything we can to ensure patients continue to have access to safe and effective medicines, including those used in the treatment of Parkinson’s disease.

The Department has well-established procedures to deal with medicine shortages and is working closely with industry, the National Health Service and others in the supply chain to reduce the likelihood of future shortages resulting from COVID-19 or any other cause.

The Government, pharmaceutical industry and NHS will always work closely together to help ensure patients have access to the medicines and treatments they need under all scenarios including those medicines used in the treatment of Parkinson’s disease.

We continue to work closely with the National Health Service and partners and guidance has already been issued to the NHS on the process of starting to restore urgent non-COVID-19 services in a safe way, with excellence in infection prevention and control as a key principle. The approach to the reset of services will be flexed at local level according to capacity and demand in different parts of the country, and will be gradual. The NHS ‘Help us to help you’ media campaign also encourages all patients in need of urgent or emergency medical care to seek appropriate treatment.

We are unable to provide the data as requested.

The information on whether appointments take place face-to-face or by phone or video is only available in the Improving Access to Psychological Therapies annual publications.

This information covering the period 1 April 2019 - 31 March 2020 is due to be published on 30 July 2020.

National Health Service mental health services have remained open for business throughout the COVID-19 outbreak, including delivering support digitally and over the phone where possible. In doing so, the NHS has been clear on the importance of maintaining face to face care for those patients who need it, and of patient choice in determining suitability for digital appointments.

When delivering face to face appointments, mental health services are expected to follow the latest guidance on the use of personal protective equipment in healthcare settings to support infection prevention and control. Services will be further enabled by the roll out of the NHS Test and Trace service to reduce transmission risk and deliver face to face services in as safe a way as possible.

The National Health Service has issued guidance to services to support them in managing demand and capacity across inpatient and community mental health services and keeping services open for business.

There is broad consensus that there is the potential for an increase in demand and we are working with the NHS, Public Health England and other key partners to gather evidence and assess the potential longer-term mental health impacts and plan for how to support mental health and wellbeing throughout the ‘recovery’ phase.

Throughout the COVID-19 outbreak, the National Health Service has been clear on the importance of maintaining face to face care for those patients who need it, and of patient choice in determining suitability for digital appointments.

When delivering face to face appointments, mental health services are expected to follow the latest guidance on the use of personal protective equipment in healthcare settings to support infection prevention and control. Services will be further enabled by the roll out of the NHS Test and Trace service to reduce transmission risk and deliver face to face services in as safe a way as possible.

As set out in the National Institute for Health and Care Excellence guideline ‘Parkinson’s disease in adults’, published in July 2017, symptoms such as hallucinations are an increased risk for people taking some Parkinson’s disease medications. The guidance sets out that people with Parkinson’s disease should have a comprehensive care plan agreed between themselves, their family members and carers and specialist and secondary healthcare providers. Family members and carers (as appropriate) should be provided with information about the condition, their entitlement to a Carer’s Assessment and the support services available. Patients should be regularly reviewed and offered an accessible point of contact with specialist services. The guidance can be found at the following link:

www.nice.org.uk/guidance/ng71/resources/parkinsons-disease-in-adults-pdf-1837629189061

As a result of COVID-19, digital and remote general practitioner consultations and outpatient appointments as means to support patients, where clinically appropriate, have become the norm across England. Providers have been rolling out remote consultations using video, telephone, email and text message services as a priority, including for those with neurological conditions such as Parkinson’s disease.

Where digital and remote consultations are not possible, clinicians should carry out face to face consultations where necessary.

We recognise the crucial role that unpaid carers play in supporting people with conditions like dementia, especially during the pandemic.

On 8 April we published COVID-19 guidance for unpaid carers on GOV.UK to support carers during the pandemic, which includes general advice on infection control and caring where someone has symptoms. The guidance is available at the following link:

https://www.gov.uk/government/publications/coronavirus-covid-19-providing-unpaid-care

We have commissioned research through the National Institute for Health Research on the best ways to mitigate the psychological and social impact of COVID-19 on people with dementia living in the community and their family carers. Work has already started with phased outputs to August 2020.

On 8 April we published guidance for unpaid carers on GOV.UK, which includes advice on infection control, caring where someone has symptoms and links to other information and support.

There is other guidance also published on GOV.UK for everyone, including unpaid carers, on self-care and mental health wellbeing.

The Local Government and Social Care Ombudsman has started to restart suspended complaints and anticipates reopening for new complaints in the coming weeks. Members of the public will not lose their right of appeal, and complaints regarding the COVID-19 outbreak period will be considered in due course. The Ombudsman is not an emergency service, and members of the public are required by law to first have their complaints investigated by their council or care provider. The Ombudsman has also opened up a helpline to give advice and support to concerned members of the public.

The Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP) will take forward work to fill the gaps in our understanding, review existing policies and develop new ones where needed. The Terms of Reference for that work can be found online.

Public Health England (PHE) has commissioned research to understand how weight management services have adapted, due to COVID-19, to support people living with obesity. It will explore how these services might need to adapt and flex in response to the recovery strategy, and what measures are required to facilitate this. PHE is also leading on a programme of work to support local areas to improve the environment that people live, work and play in. Through providing information and tools to enable local public health and planning teams to develop and promote healthy weight environments.

Through the three chapters of ‘Childhood obesity: a plan for action’ we are bringing forward a wide range of measures to reduce the prevalence of children who are obese. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating. Many of the measures in the plan will have an impact on reducing obesity across all age groups.

Unicef’s ‘State of the World's Children’ report, published in October 2019, recognised that “the United Kingdom is paving the way to ensure that all children grow up in a healthy food environment”. The Unicef report is available at the following link:

www.unicef.org/media/61356/file/SOWC-2019.pdf

NHS Digital has advised that the Hospital Episodes Statistics uses World Health Organization International Classification of Diseases v.10 (ICD-10) to record the main diagnosis and any secondary co-morbidities. Within ICD-10 obesity is assigned as code E66 and this will be recorded on any episode of care where a clinical diagnosis of obesity has been made. The NHS Digital coding standard DCS.IV.3: Obesity (E66) states: Codes in category E66 Obesity must only be coded when a diagnosis of obesity is recorded in the medical record. Where body mass index (BMI) has been recorded in the medical record, this must not be used to assign a code from category E66.- Obesity. A clinical coder must always refer to the responsible consultant to confirm the clinical significance of a test result, for example BMI reading and/or relationship to a specific condition.

Through the three chapters of ‘Childhood obesity: a plan for action’ we are delivering a wide range of measures to help achieve our bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating.

The Government has set out its plan to return life to as near normal as we can, for as many people as we can, as quickly and fairly as possible in order to safeguard livelihoods, but in a way that is safe and continues to protect our NHS. The full guidance can be found at the following link:

https://www.gov.uk/government/publications/staying-alert-and-safe-social-distancing/staying-alert-and-safe-social-distancing

Through the three chapters of ‘Childhood obesity: a plan for action’ we are delivering a wide range of measures to help achieve our bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating.

The Government has set out its plan to return life to as near normal as we can, for as many people as we can, as quickly and fairly as possible in order to safeguard livelihoods, but in a way that is safe and continues to protect our NHS. The full guidance can be found at the following link:

https://www.gov.uk/government/publications/staying-alert-and-safe-social-distancing/staying-alert-and-safe-social-distancing

Through the three chapters of ‘Childhood obesity: a plan for action’ we are bringing forward a wide range of measures to reduce the prevalence of children who are obese. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating. Many of the measures in the plan will have an impact on reducing obesity across all age groups.

Unicef’s ‘State of the World's Children’ report, published in October 2019, recognised that “the United Kingdom is paving the way to ensure that all children grow up in a healthy food environment”. The Unicef report is available at the following link:

www.unicef.org/media/61356/file/SOWC-2019.pdf

NHS Digital has advised that the Hospital Episodes Statistics uses World Health Organization International Classification of Diseases v.10 (ICD-10) to record the main diagnosis and any secondary co-morbidities. Within ICD-10 obesity is assigned as code E66 and this will be recorded on any episode of care where a clinical diagnosis of obesity has been made. The NHS Digital coding standard DCS.IV.3: Obesity (E66) states: Codes in category E66 Obesity must only be coded when a diagnosis of obesity is recorded in the medical record. Where body mass index (BMI) has been recorded in the medical record, this must not be used to assign a code from category E66.- Obesity. A clinical coder must always refer to the responsible consultant to confirm the clinical significance of a test result, for example BMI reading and/or relationship to a specific condition.

Through chapter three of the childhood obesity plan, published in July 2019 as part of ‘Advancing our health: prevention in the 2020s’, we are exploring how we can support individuals to achieve and maintain a healthier weight. As part of this process, we have launched a review into weight management services to understand how we can empower people living with obesity to achieve and maintain a healthier weight and we are working with NHS England to develop approaches to improve the quality of brief advice given by health and care professionals on weight management in general practice.

The Department recognises the stigma associated with overweight and obesity, and is taking action to meet our bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030.

Through chapter three of the childhood obesity plan, published in July 2019 as part of ‘Advancing our health: prevention in the 2020s’, we are exploring how we can support individuals to achieve and maintain a healthier weight. As part of this process, we have launched a review into weight management services to understand how we can empower people living with obesity to achieve and maintain a healthier weight and we are working with NHS England to develop approaches to improve the quality of brief advice given by health and care professionals on weight management in general practice.

The Department recognises the stigma associated with overweight and obesity, and is taking action to meet our bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030.

The Department has not made a recent assessment of the effect of the takeaway delivery sector on levels of obesity.

Through the second chapter of our Childhood Obesity Plan, published in June 2018, we have consulted on introducing consistent calorie labelling in the out-of-home sector to help families make healthier choices. The consultation closed in December 2018. We will publish our response as soon as we can.

The Department has not made a recent assessment of the effect of the takeaway delivery sector on levels of obesity.

Through the second chapter of our Childhood Obesity Plan, published in June 2018, we have consulted on introducing consistent calorie labelling in the out-of-home sector to help families make healthier choices. The consultation closed in December 2018. We will publish our response as soon as we can.

The Government is committed to tackling health harms from alcohol and supporting the most vulnerable at risk from alcohol misuse. We are introducing measures including the NHS Long Term Plan to reduce hospital admissions, along with ambitions and commitments to improve cancer outcomes and services in England. We will encourage people to moderate their drinking as outlined in the Prevention Green Paper through low and no alcohol products. The UK CMOs’ Low Risk Drinking guidelines highlight that the risk of developing a range of health problems, including cancer, increases the more you drink on a regular basis. The new drinking guidelines are included in a range of public health messaging-the ‘One You’ service on www.nhs.uk.

Local authorities are responsible for assessing local needs and commissioning drug and alcohol prevention, treatment and harm reduction services to meet these needs. It is important that these services are maintained during the COVID-19 pandemic. Guidance to support commissioners and providers of services for people who use drugs and alcohol during the COVID-19 pandemic is being developed as of 2 April 2020 and will be published shortly.

The Government and the National Health Service will not tolerate any form of verbal or physical abuse against NHS staff. The NHS recently agreed the Joint Agreement on Offences Against Emergency Workers with the police and the Crown Prosecution Service. This Joint Agreement provides a framework to ensure effective investigation and prosecution of cases where staff are the victim of a crime and sets out the standards victims of these crimes can expect. This Joint Agreement also sets out the support that NHS staff will receive from their line manager or supervisor if they are victims of abuse or violence.

Local authorities are responsible for assessing the needs of their local population, including people with alcohol dependency, and commissioning services to meet these needs.

Public Health England (PHE) supports local authorities in their work of needs assessment and commissioning alcohol prevention and treatment services by providing advice, guidance and data.

PHE is allocating £10.5 million of funding to help improve the lives of adults and children affected by alcohol. This includes £4.5 million innovation fund for local projects working with children and families and £6 million capital fund to improve access to alcohol treatment in the community. More information can be viewed at the following link:

https://www.gov.uk/government/news/funding-awarded-to-23-projects-to-help-those-affected-by-alcohol

As part of the NHS Long Term Plan, NHS England and NHS Improvement, with support from PHE, is helping acute hospitals with the highest rates of alcohol harm to establish or improve specialist alcohol care teams.

It is estimated that fully optimised alcohol care teams in the 25% of hospitals with the highest rates of alcohol-dependence-related admissions could prevent 50,000 admissions over five years. The NHS Long Term Plan can be viewed at the following link:

https://www.longtermplan.nhs.uk/

Local authorities are responsible for assessing the needs of their local population, including people with alcohol dependency, and commissioning services to meet these needs.

Public Health England (PHE) supports local authorities in their work of needs assessment and commissioning alcohol prevention and treatment services by providing advice, guidance and data.

PHE is allocating £10.5 million of funding to help improve the lives of adults and children affected by alcohol. This includes £4.5 million innovation fund for local projects working with children and families and £6 million capital fund to improve access to alcohol treatment in the community. More information can be viewed at the following link:

https://www.gov.uk/government/news/funding-awarded-to-23-projects-to-help-those-affected-by-alcohol

As part of the NHS Long Term Plan, NHS England and NHS Improvement, with support from PHE, is helping acute hospitals with the highest rates of alcohol harm to establish or improve specialist alcohol care teams.

It is estimated that fully optimised alcohol care teams in the 25% of hospitals with the highest rates of alcohol-dependence-related admissions could prevent 50,000 admissions over five years. The NHS Long Term Plan can be viewed at the following link:

https://www.longtermplan.nhs.uk/

In 2018, Public Health England’s Drink Free Days campaign highlighted the harm associated with drinking alcohol including cancer, weight gain and high blood pressure, and encourages middle-aged drinkers to use the tactic of taking more days off from drinking as a way of reducing their health risks from alcohol.

The links between alcohol and cancer are also highlighted in PHE’s One You campaign, available to view at the following link:

https://www.nhs.uk/oneyou/for-your-body/drink-less/

The Government is committed to tackling health harms from alcohol and supporting the most vulnerable at risk from alcohol misuse. We are introducing measures including the NHS Long Term Plan to reduce hospital admissions, along with ambitions and commitments to improve cancer outcomes and services in England. We will encourage people to moderate their drinking as outlined in the Prevention Green Paper through low and no alcohol products. The United Kingdom’s Chief Medical Officers’ Low Risk Drinking guidelines highlight that the risk of developing a range of health problems, including cancer, increases the more you drink on a regular basis. The new drinking guidelines are included in a range of public health messaging on the ‘One You’ service.

The Government has worked with the alcohol industry to ensure that alcohol labels reflect the United Kingdom Chief Medical Officer’s Low Risk Drinking Guidelines for drinks produced after 1 September 2019. The industry has committed to comply with this requirement. We will keep progress with compliance under review.

The Department supports the aims of world obesity day and is delivering a world-leading childhood obesity plan to reduce the prevalence of children who are obese. This has been recognised in Unicef’s ‘State of the World's Children’ report, published in October 2019, as ‘paving the way to ensure that all children grow up in a healthy food environment’. The Unicef report is available at the following link:

www.unicef.org/media/61356/file/SOWC-2019.pdf

We have launched a review into weight management services to understand how we can empower people living with obesity to achieve and maintain a healthier weight and we are working with NHS England to develop approaches to improve the quality of brief advice given by health and care professionals on weight management in general practice.

Through the three chapters of ‘Childhood obesity: a plan for action’ we are bringing forward a wide range of measures to reduce the prevalence of children who are obese. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating.

The Department supports the aims of world obesity day and is delivering a world-leading childhood obesity plan to reduce the prevalence of children who are obese. This has been recognised in Unicef’s ‘State of the World's Children’ report, published in October 2019, as ‘paving the way to ensure that all children grow up in a healthy food environment’. The Unicef report is available at the following link:

www.unicef.org/media/61356/file/SOWC-2019.pdf

We have launched a review into weight management services to understand how we can empower people living with obesity to achieve and maintain a healthier weight and we are working with NHS England to develop approaches to improve the quality of brief advice given by health and care professionals on weight management in general practice.

Through the three chapters of ‘Childhood obesity: a plan for action’ we are bringing forward a wide range of measures to reduce the prevalence of children who are obese. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating.

The Department supports the aims of world obesity day and is delivering a world-leading childhood obesity plan to reduce the prevalence of children who are obese. This has been recognised in Unicef’s ‘State of the World's Children’ report, published in October 2019, as ‘paving the way to ensure that all children grow up in a healthy food environment’. The Unicef report is available at the following link:

www.unicef.org/media/61356/file/SOWC-2019.pdf

We have launched a review into weight management services to understand how we can empower people living with obesity to achieve and maintain a healthier weight and we are working with NHS England to develop approaches to improve the quality of brief advice given by health and care professionals on weight management in general practice.

Through the three chapters of ‘Childhood obesity: a plan for action’ we are bringing forward a wide range of measures to reduce the prevalence of children who are obese. We have seen important successes including the average sugar content of drinks subject to the soft drinks industry levy decreasing by 28.8% between 2015 and 2018, and significant investment being made in schools to promote physical activity and healthy eating.

The Government has not made an estimate of the proportion of payroll employee jobs affected by the rise in National Insurance contributions from April 2022 as this information is not available.

Individual employees are not directly impacted by the employer National Insurance rise which is paid by employers.

144 businesses have received a refund. In addition, 157 claims have been rejected as invalid, and 474 are in the process of validation.

The Government does not publish the level of data requested in order to prevent the release of potentially disclosive information.

The Government is closely monitoring the impacts of the pandemic and period of low oil prices on the upstream oil and gas industry and continues to engage closely with a range of stakeholders from the sector.

Throughout this crisis, the Government has sought to protect people’s jobs and livelihoods, and support businesses and public services across the UK. The Government has spent over £280 billion to do so this year.

Covid-19 related grants and payments available to businesses and individuals across the country include the Coronavirus Job Retention Scheme (CJRS) and the Self-Employed Income Support Scheme (SEISS). Further grants to help businesses include the Additional Restrictions Grant (ARG) to local authorities in England.

The Chancellor postponed the Job Support Scheme and has announced the extension of the Coronavirus Job Retention Scheme until the end of March 2021. This scheme provides support for the whole of the UK and employers in the coach sector can access the scheme and claim the grant if they meet the CJRS criteria.

The Government will continue to work closely with representatives from the coach sector including the Confederation of Passenger Transport, and across government departments, to understand the ongoing risks and issues, including demand considerations and how these could be addressed.

The competition for the operation of the new prison at Wellingborough has not yet concluded as we are still in the standstill period. We intend to announce the outcome in due course.

The operator contracts between the Department and all private prison providers require the Contractor to be responsible for all staffing matters, including ensuring staff have the training and experience necessary for safe and decent prisons. This is monitored to ensure the standards are maintained across the lifetime of the contract. Mandating minimum staffing levels for private prison operators would restrict their ability to introduce and foster innovation, and their flexibility to adjust their staffing levels across the lifetime of the contract according to the needs and demands created by any changes to the prison population or in risk. It could also deter them from engaging with expertise and professional support in the local and wider community and hinder their ability to respond quickly to new challenges and opportunities.

As part of the Prison Operator Competition, subject matter experts scrutinise and validate proposed staffing levels within operators’ bids to ensure delivery of operations to a decent, safe, secure and rehabilitative standard. The competition for the operation of the new prison at Wellingborough was not about the difference or preference between the public and private sector. We have been clear through this competition we expected bidders to provide high quality, value for money bids that deliver effective regimes to meet the specific needs of prisoners. Our priority is to help prisoners turn their lives around to prevent reoffending and future victims.

We hold both public and private sector prisons to account for the outcomes they deliver. PSI 2017/07 only applies to public sector prisons, however, private prisons will have their own similar systems in place to ensure they provide the required services and use the levels of staff determined as required and appropriate. These are robustly scrutinised for the lifetime of the contract to ensure that the required standards are met.

Throughout the COVID-19 pandemic, construction at the new prison at Wellingborough and early works at Glen Parva has continued safely, with workers following PHE guidance and the Construction Leadership Council’s Site Operating Procedures. We expect the new prison at Wellingborough will open late 2021.

While no decisions have been made on who will operate the recently announced four new prisons, we maintain this government’s commitment to a mixed market in custodial services. It is our ambition that at least one of these new prisons will be operated by the public sector. In this scenario, HMPPS would not be required to go through a bidding process. In the event that any of the new prisons were competed these would be done through the Prison Operator Services Framework via a mini competition. In this case, HMPPS would not take part in the mini competition but would instead provide a public sector benchmark against which operators’ bids can be assessed. If bids do not meet quality or value for money thresholds, HMPPS would take on the operator role.

The competition for the operation of the new prison at Wellingborough has not yet concluded as we are still in the standstill period. We intend to announce the outcome in due course.

The operator contracts between the Department and all private prison providers require the Contractor to be responsible for all staffing matters, including ensuring staff have the training and experience necessary for safe and decent prisons. This is monitored to ensure the standards are maintained across the lifetime of the contract. Mandating minimum staffing levels for private prison operators would restrict their ability to introduce and foster innovation, and their flexibility to adjust their staffing levels across the lifetime of the contract according to the needs and demands created by any changes to the prison population or in risk. It could also deter them from engaging with expertise and professional support in the local and wider community and hinder their ability to respond quickly to new challenges and opportunities.

As part of the Prison Operator Competition, subject matter experts scrutinise and validate proposed staffing levels within operators’ bids to ensure delivery of operations to a decent, safe, secure and rehabilitative standard. The competition for the operation of the new prison at Wellingborough was not about the difference or preference between the public and private sector. We have been clear through this competition we expected bidders to provide high quality, value for money bids that deliver effective regimes to meet the specific needs of prisoners. Our priority is to help prisoners turn their lives around to prevent reoffending and future victims.

We hold both public and private sector prisons to account for the outcomes they deliver. PSI 2017/07 only applies to public sector prisons, however, private prisons will have their own similar systems in place to ensure they provide the required services and use the levels of staff determined as required and appropriate. These are robustly scrutinised for the lifetime of the contract to ensure that the required standards are met.

Throughout the COVID-19 pandemic, construction at the new prison at Wellingborough and early works at Glen Parva has continued safely, with workers following PHE guidance and the Construction Leadership Council’s Site Operating Procedures. We expect the new prison at Wellingborough will open late 2021.

While no decisions have been made on who will operate the recently announced four new prisons, we maintain this government’s commitment to a mixed market in custodial services. It is our ambition that at least one of these new prisons will be operated by the public sector. In this scenario, HMPPS would not be required to go through a bidding process. In the event that any of the new prisons were competed these would be done through the Prison Operator Services Framework via a mini competition. In this case, HMPPS would not take part in the mini competition but would instead provide a public sector benchmark against which operators’ bids can be assessed. If bids do not meet quality or value for money thresholds, HMPPS would take on the operator role.

The competition for the operation of the new prison at Wellingborough has not yet concluded as we are still in the standstill period. We intend to announce the outcome in due course.

The operator contracts between the Department and all private prison providers require the Contractor to be responsible for all staffing matters, including ensuring staff have the training and experience necessary for safe and decent prisons. This is monitored to ensure the standards are maintained across the lifetime of the contract. Mandating minimum staffing levels for private prison operators would restrict their ability to introduce and foster innovation, and their flexibility to adjust their staffing levels across the lifetime of the contract according to the needs and demands created by any changes to the prison population or in risk. It could also deter them from engaging with expertise and professional support in the local and wider community and hinder their ability to respond quickly to new challenges and opportunities.

As part of the Prison Operator Competition, subject matter experts scrutinise and validate proposed staffing levels within operators’ bids to ensure delivery of operations to a decent, safe, secure and rehabilitative standard. The competition for the operation of the new prison at Wellingborough was not about the difference or preference between the public and private sector. We have been clear through this competition we expected bidders to provide high quality, value for money bids that deliver effective regimes to meet the specific needs of prisoners. Our priority is to help prisoners turn their lives around to prevent reoffending and future victims.

We hold both public and private sector prisons to account for the outcomes they deliver. PSI 2017/07 only applies to public sector prisons, however, private prisons will have their own similar systems in place to ensure they provide the required services and use the levels of staff determined as required and appropriate. These are robustly scrutinised for the lifetime of the contract to ensure that the required standards are met.

Throughout the COVID-19 pandemic, construction at the new prison at Wellingborough and early works at Glen Parva has continued safely, with workers following PHE guidance and the Construction Leadership Council’s Site Operating Procedures. We expect the new prison at Wellingborough will open late 2021.

While no decisions have been made on who will operate the recently announced four new prisons, we maintain this government’s commitment to a mixed market in custodial services. It is our ambition that at least one of these new prisons will be operated by the public sector. In this scenario, HMPPS would not be required to go through a bidding process. In the event that any of the new prisons were competed these would be done through the Prison Operator Services Framework via a mini competition. In this case, HMPPS would not take part in the mini competition but would instead provide a public sector benchmark against which operators’ bids can be assessed. If bids do not meet quality or value for money thresholds, HMPPS would take on the operator role.

As a Government, we have outlined the risks posed by the COVID-19 virus, and the control measures required to avoid exposure and transmission. In parallel, we have been clear that the work of the justice system must continue throughout the prevailing public health emergency. Accordingly, it has been necessary to keep some courts and tribunal buildings open, and we are working hard to open more so long as that can be achieved safely.

HMCTS is committed to ensuring the health, safety and welfare of all staff, members of the judiciary and visitors to its sites, as far as it is reasonably practical whilst they are on the premises.

In order to aid implementation of the required control measures, and to monitor and assure ourselves of compliance, we developed and implemented an assessment tool to be carried out in each of our open sites.

The tool was developed in consultation with trade union health and safety representatives. The finalised tool was issued to each site, with instruction that it should wherever possible be completed in conjunction and consultation with a Trade Union representative. I understand that wherever possible our officials did conduct those assessments with trade union colleagues, and continue to do so as the results are regularly reviewed.

We are confident that our open sites are safe, and can confirm risk assessments will be available to be shared on request very soon.

A judicial led Jury Trials Working Group (JTWG) was set up to establish ways in which jury trials can be commenced safely. The JTWG developed a Crown Court Jury Trial checklist which was discussed with the Departmental Trade Union Side (DTUS) on 30 April and a copy shared with them on 4 May. Completed risk assessments were shared with the DTUS before the first jury trials resumed on 18 May.

HM Courts & Tribunals Service has comprehensively assessed the risk to its staff and users. We have published and implemented safety controls to help prevent the spread of Covid-19.

Face coverings are available on request for staff, judges and jurors. Personal protective equipment (PPE) is available to staff where local assessments show that this is necessary. In line with Government guidance, PPE will be reserved for those most at risk of close contact through their workplace, such as security officers involved in interventions, fire-marshals and first-aiders.

We are keeping the use and distribution of PPE under close review and we will continue to ensure that we comply with Government guidance.

Published data on violence is only available until September 2019, and the only prisons with PAVA for the duration of this period were the four pilot sites: HMPs Hull, Wealstun, Preston and Risley.

There was an increase in the average number of assaults in prisons in across England and Wales between January 2018 to September 2019, which is the timeframe that PAVA has been in available in these four prisons.

When comparing the 21 months prior to January 2018, HMPs Hull, Wealstun and Preston had a slightly lower increase in violence compared to the wider estate.

We have been rolling out PAVA incapacitant spray to all band 3-5 staff in the adult male estate. Staff need appropriate training to use PAVA and only prisons that have implemented the key worker scheme – which is vital in building relationships between offenders and staff – will receive it.

PAVA has not been introduced as a violence reduction measure, it is intended to help protect staff and prisoners from incidents where there is serious violence, or an imminent or perceived risk of serious violence. It has been introduced alongside a range of other measures aimed to improve safety.

We have no plans to release prisoners or to use prison ships in response to the Covid-19 outbreak.

HMPPS is doing everything it can to prevent the spread of COVID-19, based on the very latest scientific and medical advice. We are working closely with Public Health England, the NHS and the Department of Health and Social Care to manage the challenges we face.

In line with broader clinical advice, HMPPS has introduced a procedure for the protective isolation of individuals in prison custody when it is considered that they may be potentially infected with the virus.

Our capacity to isolate prisoners varies across the estate depending on the type of establishment, its configuration and the category of prisoner held. Each establishment has in place local contingency plans setting out how it will manage should isolation of prisoners be necessary.

People in prison custody who become unwell have the benefit of on-site NHS healthcare services which provide the first line assessment and treatment response. HMPPS has worked closely with our partners in the NHS to make arrangements for transfer to hospital should an individual be sufficiently unwell to require hospital admission, building on our business as usual procedures for access to healthcare.

We have no plans to release prisoners or to use prison ships in response to the Covid-19 outbreak.

HMPPS is doing everything it can to prevent the spread of COVID-19, based on the very latest scientific and medical advice. We are working closely with Public Health England, the NHS and the Department of Health and Social Care to manage the challenges we face.

In line with broader clinical advice, HMPPS has introduced a procedure for the protective isolation of individuals in prison custody when it is considered that they may be potentially infected with the virus.

Our capacity to isolate prisoners varies across the estate depending on the type of establishment, its configuration and the category of prisoner held. Each establishment has in place local contingency plans setting out how it will manage should isolation of prisoners be necessary.

People in prison custody who become unwell have the benefit of on-site NHS healthcare services which provide the first line assessment and treatment response. HMPPS has worked closely with our partners in the NHS to make arrangements for transfer to hospital should an individual be sufficiently unwell to require hospital admission, building on our business as usual procedures for access to healthcare.

PAVA spray is being provided to all band 3-5 staff in the adult male estate and it is currently being rolled out across the estate. Staff need appropriate training to use PAVA and only prisons who have the key worker scheme – which is vital in building relationships between offenders and staff – will receive it.

The following uses of PAVA have been recorded in the last 12 months;

Rigid bar handcuffs are being rolled out to all band 3-5 staff in the adult male estate.

Data on the number of times that rigid bar handcuffs have been used is recorded locally. As we do not currently hold this information centrally, we are unable to provide the number of times that these have been used in prisons. However, we are piloting the use of a Digital Tool for establishments to record this and other Use of Force data, which will improve our ability to interrogate and extract any relevant data, such as this.

Rigid bar handcuffs are only one of the tools we are giving prison officers to help them do their job more safely. This also includes body worn cameras and PAVA spray.

We are giving staff the tools they need to do the job safely – rolling out PAVA incapacitant spray, and investing £100 million, as part of a wider £2.75 billion package, to fund tough airport-style security that will clamp down on the illicit items which fuel violence and hinder rehabilitation.

The Ministry of Justice is actively engaged with the Prison Service Pay Review Body in support of their evidence gathering process and we look forward to receiving their considered recommendations later this year. To maintain the integrity of this independent process we will not be commenting on any material that will not be formally published. The document referred to is not a published document.

We are giving staff the tools they need to do the job safely – rolling out PAVA incapacitant spray, and investing £100 million, as part of a wider £2.75 billion package, to fund tough airport-style security that will clamp down on the illicit items which fuel violence and hinder rehabilitation.

The Ministry of Justice is actively engaged with the Prison Service Pay Review Body in support of their evidence gathering process and we look forward to receiving their considered recommendations later this year. To maintain the integrity of this independent process we will not be commenting on any material that will not be formally published. The document referred to is not a published document.

We are giving staff the tools they need to do the job safely – rolling out PAVA incapacitant spray, and investing £100 million, as part of a wider £2.75 billion package, to fund tough airport-style security that will clamp down on the illicit items which fuel violence and hinder rehabilitation.

The Ministry of Justice is actively engaged with the Prison Service Pay Review Body in support of their evidence gathering process and we look forward to receiving their considered recommendations later this year. To maintain the integrity of this independent process we will not be commenting on any material that will not be formally published. The document referred to is not a published document.

We are giving staff the tools they need to do the job safely – rolling out PAVA incapacitant spray, and investing £100 million, as part of a wider £2.75 billion package, to fund tough airport-style security that will clamp down on the illicit items which fuel violence and hinder rehabilitation.

The Ministry of Justice is actively engaged with the Prison Service Pay Review Body in support of their evidence gathering process and we look forward to receiving their considered recommendations later this year. To maintain the integrity of this independent process we will not be commenting on any material that will not be formally published. The document referred to is not a published document.

We are giving staff the tools they need to do the job safely – rolling out PAVA incapacitant spray, and investing £100 million, as part of a wider £2.75 billion package, to fund tough airport-style security that will clamp down on the illicit items which fuel violence and hinder rehabilitation.

The Ministry of Justice is actively engaged with the Prison Service Pay Review Body in support of their evidence gathering process and we look forward to receiving their considered recommendations later this year. To maintain the integrity of this independent process we will not be commenting on any material that will not be formally published. The document referred to is not a published document.

PAVA spray is being provided to all band 3-5 staff in the adult male estate and it is currently being rolled out across the estate. We are able to provide the number of establishments who have completed their training activity and therefore in a position to issue PAVA to their staff.

1 January 2019, 4 pilot prisons

1 April 2019, 4 pilot prisons

1 July 2019 4 pilot prisons

1 October 2019, 6 establishments (inclusive of the 4 pilot prisons)

1 January 2020, 7 establishments (inclusive of the 4 pilot prisons)

We are giving prison officers body worn cameras, rigid bar handcuffs and PAVA spray to help them do their job more safely.

Staff need appropriate training to use PAVA and only prisons who have rolled out the key worker scheme – which is vital in building relationships between offenders and staff – will receive it.

Rigid Bar handcuffs are being provided to all band 3-5 prison officers in the adult male estate. Establishments will be required to train their staff prior to issuing them therefore exact figures of staff equipped is not available. Instead we are able to provide the number of establishments who have commenced their training for the dates requested:

1 January 2019, None

1 April 1 2019, None

1 July 2019, None

1 October 2019: 2 establishments commenced training

1 January 2020: 16 establishments actively delivering training

Rigid bar handcuffs are only one of the tools we are giving prison officers to help them do their job more safely; others include body worn cameras and PAVA spray.