The Secretary of State has not requested a recommendation about immunisation against pneumococcal disease from the Joint Committee on Vaccination and Immunisation (JCVI) under the terms of the Health Protection (Vaccination) Regulations 2009 in the last five years.

Departmental officials requested advice from the JCVI in early 2014 about the use of pneumococcal conjugate vaccine (PCV). At its meeting on 4 June 2014, the minutes of which are available on GOV.UK, the JCVI concluded that PCV13 should remain the pneumococcal conjugate vaccine of choice for infants in the United Kingdom at this time. We have accepted this advice.

The Joint Committee on Vaccination and Immunisation concluded a review of the adult pneumococcal vaccination programme in 2012. The Committee started a new review at its meeting on 28 January, taking into account the latest information on the epidemiology, cost-effectiveness and impact of adult pneumococcal vaccination. It is anticipated that the review will take six months to complete, subject to the availability of the necessary evidence.

The Secretary of State has not requested a recommendation about immunisation against pneumococcal disease from the Joint Committee on Vaccination and Immunisation (JCVI) under the terms of the Health Protection (Vaccination) Regulations 2009.

We will consider carefully any advice received from the JCVI about immunisation against pneumococcal disease in due course.

The information requested is shown in the following table.

Notes

1. This programme is being phased in with 71-79 year-olds being offered shingles vaccines on a “catch-up” basis alongside the routine cohort of 70 year-olds. In 2013, vaccine was offered to 70 and 79 year-olds.

2. This programme is to protect at-risk pre-term infants for whom RSV infection is likely to cause serious illness or death. It is not managed centrally but commissioned through specialised commissioning. Guidance was provided to the National Health Service in “Immunisation against Infectious Disease” following this recommendation in 2010.

3. The extension programme for children will be phased in over a number of years. This extension began in 2013-14 with all two and three year-olds being offered vaccination through general practitioner surgeries, and 5-11 year old children in seven areas being offered vaccination through pilot programmes.

One of the underpinning principles of the NHS Outcomes Framework is to ensure that it encourages the promotion of equality in line with the Equality Act 2010.

The Domain 1 premature mortality indicators in the NHS Outcomes Framework and Clinical Commissioning Groups Outcomes Indicator Set are capped at age 75 because the attribution of the cause of death is more vexed for older people, who often have co-morbidities. Therefore, including those aged 75 and above could lead these indicators to become misleading.

However, to ensure all age groups are covered equally, ‘Life Expectancy at 75’ is an overarching indicator in Domain 1 of the NHS Outcomes Framework. This indicator captures ages 75 and over and all conditions.

The above information is contained in the NHS Outcomes Framework 2011-12 Equalities Impact Assessment and the NHS Outcomes Framework 2011-12, both of which have already been placed in the Library.

Health and Wellbeing Boards in each upper-tier Local Authority are responsible for the development of Joint Strategic Needs Assessments to identify the current and future health and wellbeing needs of the local population and a Joint Health and Wellbeing Strategy that sets the strategic direction for local commissioning decisions. This may include assessment of the prevalence and impact of dementia, and appropriate actions for prevention, diagnosis and care.

The healthcare provided is inclusive of all types of dementia including frontotemporal dementia.

The annual cost to the National Health Service in England of cold housing is reported to be between £850 million¹ and £1.36 billion².This does not include additional spending by social services, or economic losses through absences from work. Total costs to the NHS and the country are unknown³.

The Cold Weather Plan for England ³ is a framework intended to protect the population from harm to health from cold weather, including vulnerable older people. It aims to prevent the major avoidable effects on health during periods of cold weather in England by alerting people to the negative health effects of cold weather, and enabling them to prepare and respond appropriately.

Help is available through Cold Weather Payments which provide more targeted support for vulnerable low-income groups. The Government has permanently increased Cold Weather Payments from £8.50 to £25 for the duration of this Parliament for each qualifying period of cold weather.

This winter over 2 million low income households, including over 1.4 million poorer pensioners, will receive a discount of £140 off their electricity bill through the Warm Home Discount scheme.

Winter Fuel Payments also provide assurance to older people, who may suffer the worst impacts of a progressive condition, so that they can keep warm during the winter months. In addition, around 482,000 low income and vulnerable homes have received energy efficiency measures under Energy Companies Obligation.

The Department of Energy and Climate Change have commissioned work that will allow them to model the potential cost-savings to health and social care services from energy efficiency measures and other interventions.

Notes:

1. Department of Health (2010) ‘Winter kills’, in 2009 Annual Report of the Chief Medical Officer

2. The Cost of Cold: Why we need to protect the health of older people in winter

3. Public Health England (2014) The Cold Weather Plan for England. Making the case: why long-term strategic planning for cold weather is essential to health and wellbeing

The impact of cold homes on the health of older people has been discussed internally within the Department (DH) during the development of policy initiatives to prevent major avoidable effects on health during periods of cold weather. These initiatives include the The Cold Weather Plan for England, Keep Warm Keep Well leaflet and the Get Ready For Winter campaign hosted by the Met Office.

Further discussions were held at the Annual Cold Weather Plan seminar – this stakeholder event brings together colleagues from the DH, Local Government Association, NHS England, Public Health England, academia and the voluntary and community sector to discuss issues around the cold weather plan and how to best support local action. In addition, discussions were held at the Health officials working group – this is a regular meeting attended by the Department of Energy and Climate Change, DH and Public Health England. The aim of this group is to share information on cold weather, fuel poverty and health impacts with a view to ensure the fuel poverty strategy is aligned with health policy.

There are currently no plans to explore the feasibility of replicating the Liverpool STARS programme for people at the end of life elsewhere in England. This is a local initiative and it is for commissioners in other localities to determine how best to improve the provision of end of life care services in their areas, based on the needs of their populations.

NHS England is responsible for improving end of life care services nationally and has established, and is supporting, palliative care networks across England. Through these networks and the work of NHS Improving Quality, NHS England is continuing to support improvements in palliative care services and sharing of good practice. The Transforming End of Life Care in Acute Hospitals programme is also helping to drive improvements for people in hospitals.

The Secretary of State for Health, Jeremy Hunt MP, announced the Government’s intention to maintain a stable Mandate for 2015-16 at the same time as publishing the first Annual Assessment of NHS England. The Annual Assessment, and NHS England’s first Annual Report, describe an organisation that has established itself and made progress, but has more to do to deliver all of its objectives. The decision to propose a stable Mandate for 2015-16 was taken in view of the importance of continuity of purpose for NHS England in the final year of the current spending review cycle. The priorities for the National Health Service remain those described in the current Mandate for 2014-15, and the Government wants NHS England to make further progress still on the ambitious agenda already set.

As set out in my Written Ministerial Statement on 22 July (HL Deb, column WS124-5), the Department is engaging with key stakeholders on its proposed approach over the summer. The Government will consider views expressed before finalising the Mandate for publication in the autumn.

Hospital Episode Statistics (HES) data does not separately identify those cases of lymphoedema that are associated with cancer from those that are not, and is unable to identify cases of lipoedema as there is no coding available for this condition, based on the tenth revision of the International Classification of Diseases (ICD).

Further to this, HES data is not linked to costing information and therefore this information cannot be provided.

In the following table we have provided the number of finished admission episodes (FAEs) for patients with a primary diagnosis of lymphoedema from 2010-11 to 2012-13.

Note:

An FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission

Hospital Episode Statistics (HES) data does not separately identify those cases of lymphoedema that are associated with cancer from those that are not, and is unable to identify cases of lipoedema as there is no coding available for this condition, based on the tenth revision of the International Classification of Diseases (ICD).

Further to this, HES data is not linked to costing information and therefore this information cannot be provided.

In the following table we have provided the number of finished admission episodes (FAEs) for patients with a primary diagnosis of lymphoedema from 2010-11 to 2012-13.

Note:

An FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission

Hospital Episode Statistics (HES) data does not separately identify those cases of lymphoedema that are associated with cancer from those that are not, and is unable to identify cases of lipoedema as there is no coding available for this condition, based on the tenth revision of the International Classification of Diseases (ICD).

Further to this, HES data is not linked to costing information and therefore this information cannot be provided.

In the following table we have provided the number of finished admission episodes (FAEs) for patients with a primary diagnosis of lymphoedema from 2010-11 to 2012-13.

Note:

An FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission

The Government's Mandate to NHS England sets out the ambitions for the health service for the next two years, which includes an objective to make measurable progress towards making the National Health Service among the best in Europe at supporting people with ongoing health problems to live healthily and independently, with much better control over the care they receive. This includes people with bowel and bladder illnesses.

It is for NHS England to determine how it seeks to achieve the objectives set out in the Mandate; the Government will hold it to account for the outcomes it achieves, including in relation to long-term conditions such as bowel and bladder illnesses.

Recently, we launched a consultation on refreshing the Mandate to NHS England to ensure it remains relevant and up to date. In this consultation we propose taking forward all existing objectives and adding one new objective relating to the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. We welcome views on our approach to the refresh of the Mandate.

More information about this consultation can be found at:

www.gov.uk/government/consultations/refreshing-the-nhs-mandate

My Lords, the Government fully recognise the importance of addressing sepsis—a potentially life-threatening condition. We support the overall thrust of the World Sepsis Declaration. We have taken a range of actions to address sepsis, focusing on those interventions directly relevant to England—for example, the training of healthcare professionals in the awareness of sepsis. I commend the Global Sepsis Alliance for its initiative in raising the profile of this serious condition.

The information requested is provided in the following table.

This information is collected through the personal social services expenditure and unit cost (PSSEX1) return, completed by local authorities and collected annually by the National Health Service Information Centre.

Source; NHS Information Centre, PSSEX1 final return, 2010-11 report

Net expenditure on adult social care in 2010-11 was £14,605 million. This is the latest year for which data are available.