Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 17 February (HL5559), whether individuals who do not have (1) a BMI of less than 18.5 kilograms/m2, (2) unintentional weight loss greater than 10 per cent within the last three to six months, or (3) a BMI of less than 20 kilograms/m2 and unintentional weight loss greater than five per cent within the last three to six months, are therefore not defined as malnourished or undernourished; and whether there are any other scientific measurements or criteria that would justify obese individuals not being defined as malnourished or undernourished.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
There is no agreed scientific nor universal definition of overnutrition, however the National Health Service refers to overnutrition as getting more nutrients than needed. Excess intake of macronutrients will mean an excess intake of energy, leading to weight gain and obesity. Excess intake of individual micronutrients may be associated with specific adverse health outcomes depending on the vitamin or mineral. Population prevalence of obesity is monitored by the Health Survey for England and data on population average energy and nutrient intakes are collected by the National Diet and Nutrition Survey. However, at an individual level, healthcare professionals may assess and monitor a patient’s weight and/or nutritional status depending on clinical need.
Although there is no formal assessment of malnutrition at a population-level, NHS Digital collects data on finished hospital admission episodes of malnutrition in England, based on International Classification of Disease (ICD-10) codes. The cause of malnutrition is not presented in the Hospital Episode Statistics.
The criteria referred to are from the National Institute for Health and Care Excellence (NICE) clinical guidelines CG32 ‘Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ and are recommended as indications for when nutrition support should be considered. This NICE guideline also states that nutrition support should be considered in people at risk of malnutrition, defined as those who have eaten little or nothing for more than 5 days and/or are likely to eat little or nothing for 5 days or longer; a poor absorptive capacity and/or high nutrient losses; and/or increased nutritional needs from causes such as catabolism. Healthcare professionals might use other screening or assessment tools, or their own clinical judgement regarding additional signs and symptoms, to assess whether someone is at risk of malnutrition.
In the NICE guideline CG32, the term malnutrition is not used to cover excess nutrient provision (overnutrition). However, someone can be a healthy weight or have a body mass index in the overweight or obese categories but be identified through the NICE definition as potentially requiring nutrition support. Hospital Episode Statistics (HES) are also reported for scurvy and rickets, conditions which result from nutrient deficiencies, but these are reported separately to the HES for malnutrition.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 17 February (HL5559), how many people in England are deemed to be malnourished; and what proportion of those are caused by (1) undernutrition, and (2) overnutrition.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
There is no agreed scientific nor universal definition of overnutrition, however the National Health Service refers to overnutrition as getting more nutrients than needed. Excess intake of macronutrients will mean an excess intake of energy, leading to weight gain and obesity. Excess intake of individual micronutrients may be associated with specific adverse health outcomes depending on the vitamin or mineral. Population prevalence of obesity is monitored by the Health Survey for England and data on population average energy and nutrient intakes are collected by the National Diet and Nutrition Survey. However, at an individual level, healthcare professionals may assess and monitor a patient’s weight and/or nutritional status depending on clinical need.
Although there is no formal assessment of malnutrition at a population-level, NHS Digital collects data on finished hospital admission episodes of malnutrition in England, based on International Classification of Disease (ICD-10) codes. The cause of malnutrition is not presented in the Hospital Episode Statistics.
The criteria referred to are from the National Institute for Health and Care Excellence (NICE) clinical guidelines CG32 ‘Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ and are recommended as indications for when nutrition support should be considered. This NICE guideline also states that nutrition support should be considered in people at risk of malnutrition, defined as those who have eaten little or nothing for more than 5 days and/or are likely to eat little or nothing for 5 days or longer; a poor absorptive capacity and/or high nutrient losses; and/or increased nutritional needs from causes such as catabolism. Healthcare professionals might use other screening or assessment tools, or their own clinical judgement regarding additional signs and symptoms, to assess whether someone is at risk of malnutrition.
In the NICE guideline CG32, the term malnutrition is not used to cover excess nutrient provision (overnutrition). However, someone can be a healthy weight or have a body mass index in the overweight or obese categories but be identified through the NICE definition as potentially requiring nutrition support. Hospital Episode Statistics (HES) are also reported for scurvy and rickets, conditions which result from nutrient deficiencies, but these are reported separately to the HES for malnutrition.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 17 February (HL5559), what is the scientific definition of overnutrition; and how this is measured and monitored in obese individuals.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
There is no agreed scientific nor universal definition of overnutrition, however the National Health Service refers to overnutrition as getting more nutrients than needed. Excess intake of macronutrients will mean an excess intake of energy, leading to weight gain and obesity. Excess intake of individual micronutrients may be associated with specific adverse health outcomes depending on the vitamin or mineral. Population prevalence of obesity is monitored by the Health Survey for England and data on population average energy and nutrient intakes are collected by the National Diet and Nutrition Survey. However, at an individual level, healthcare professionals may assess and monitor a patient’s weight and/or nutritional status depending on clinical need.
Although there is no formal assessment of malnutrition at a population-level, NHS Digital collects data on finished hospital admission episodes of malnutrition in England, based on International Classification of Disease (ICD-10) codes. The cause of malnutrition is not presented in the Hospital Episode Statistics.
The criteria referred to are from the National Institute for Health and Care Excellence (NICE) clinical guidelines CG32 ‘Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ and are recommended as indications for when nutrition support should be considered. This NICE guideline also states that nutrition support should be considered in people at risk of malnutrition, defined as those who have eaten little or nothing for more than 5 days and/or are likely to eat little or nothing for 5 days or longer; a poor absorptive capacity and/or high nutrient losses; and/or increased nutritional needs from causes such as catabolism. Healthcare professionals might use other screening or assessment tools, or their own clinical judgement regarding additional signs and symptoms, to assess whether someone is at risk of malnutrition.
In the NICE guideline CG32, the term malnutrition is not used to cover excess nutrient provision (overnutrition). However, someone can be a healthy weight or have a body mass index in the overweight or obese categories but be identified through the NICE definition as potentially requiring nutrition support. Hospital Episode Statistics (HES) are also reported for scurvy and rickets, conditions which result from nutrient deficiencies, but these are reported separately to the HES for malnutrition.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure equity in the provision of glaucoma care (1) across the country, and (2) in different health settings.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Government recognises that innovation is crucial to drive improvements in clinical care and improved outcomes for people living with sight-threatening conditions. Integrated care boards (ICBs) are responsible for commissioning services to meet local needs. In making commissioning decisions, we would expect ICBs to take into account the National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of glaucoma which NICE keeps under review, to ensure that it reflects developments in medical technology and clinical practice.
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, and this includes independent sector providers. CQC monitors, inspects and regulates services and publish what it finds. Where CQC finds poor care, it can use its enforcement powers to take action. This sits alongside guidance issued by NICE for the treatment of glaucoma and any professional standards issued by the Royal College of Ophthalmologists, which we would expect National Health Service commissioners to have regard to when commissioning services from the independent sector.
NHS England’s Getting It Right First Time Programme is also working with providers across the country to reduce unwarranted variation in care across a range of eyecare subspecialties, including glaucoma.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve glaucoma care in independent sector treatment centres.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Government recognises that innovation is crucial to drive improvements in clinical care and improved outcomes for people living with sight-threatening conditions. Integrated care boards (ICBs) are responsible for commissioning services to meet local needs. In making commissioning decisions, we would expect ICBs to take into account the National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of glaucoma which NICE keeps under review, to ensure that it reflects developments in medical technology and clinical practice.
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, and this includes independent sector providers. CQC monitors, inspects and regulates services and publish what it finds. Where CQC finds poor care, it can use its enforcement powers to take action. This sits alongside guidance issued by NICE for the treatment of glaucoma and any professional standards issued by the Royal College of Ophthalmologists, which we would expect National Health Service commissioners to have regard to when commissioning services from the independent sector.
NHS England’s Getting It Right First Time Programme is also working with providers across the country to reduce unwarranted variation in care across a range of eyecare subspecialties, including glaucoma.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to increase the use of innovative medical technology in the treatment of glaucoma.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Government recognises that innovation is crucial to drive improvements in clinical care and improved outcomes for people living with sight-threatening conditions. Integrated care boards (ICBs) are responsible for commissioning services to meet local needs. In making commissioning decisions, we would expect ICBs to take into account the National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of glaucoma which NICE keeps under review, to ensure that it reflects developments in medical technology and clinical practice.
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, and this includes independent sector providers. CQC monitors, inspects and regulates services and publish what it finds. Where CQC finds poor care, it can use its enforcement powers to take action. This sits alongside guidance issued by NICE for the treatment of glaucoma and any professional standards issued by the Royal College of Ophthalmologists, which we would expect National Health Service commissioners to have regard to when commissioning services from the independent sector.
NHS England’s Getting It Right First Time Programme is also working with providers across the country to reduce unwarranted variation in care across a range of eyecare subspecialties, including glaucoma.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Ministry of Housing, Communities and Local Government:
To ask His Majesty's Government what plans they have to reinforce a fair market by ensuring that fees, and particularly increases in fees, charged by property management companies are transparent and justified to their customers.
Answered by Baroness Scott of Bybrook - Shadow Minister (Housing, Communities and Local Government)
By law, variable service charges must be reasonable and, where costs relate to work or services, the work or services must be of a reasonable standard. Leaseholders may make an application to the appropriate tribunal to challenge the reasonableness of their service charges.
We are committed to protecting and empowering leaseholders by giving them more information on what their costs pay for. We will legislate to ensure service charges are transparent and communicated effectively, removing barriers to challenge when things go wrong. This will help leaseholders more effectively challenge their landlord if they consider their fees are unreasonable. We are due to bring forward further leasehold reforms later in this parliament.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department for Environment, Food and Rural Affairs:
To ask His Majesty's Government whether they have set a target for the time between a local authority agreeing that noise from residential premises constitutes a statutory nuisance and the cessation of such noise.
Answered by Lord Benyon - Lord Chamberlain (HM Household)
Defra is responsible for the domestic legislation covering statutory nuisances, although local authority environmental health departments are the main enforcers of the statutory noise regime under the Environmental Protection Act, 1990.
Sources of noise nuisance are highly individual, and while some can be dealt with swiftly and straightforwardly, others will require works to be carried out or other steps to be taken which may be more complex and time consuming. As such, the Government considers that decisions around the timeframe for complying with a noise abatement order must be a matter for local authorities to decide within individual situations.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Home Office:
To ask His Majesty's Government, further to the National Referral Mechanism data for January to March 2023, what is the breakdown of positive reasonable grounds decisions for adults and children by (1) month, (2) the number of British nationals, and (3) the number of non-British nationals.
Answered by Lord Murray of Blidworth
The Home Office publishes quarterly and annual statistics regarding the National Referral Mechanism (NRM). The Q1 2023 statistics can be found here;
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1154119/modern-slavery-national-referral-mechanism-statistics-uk-quarter-1-2023-january-to-march-tables.ods
The data shows the number of duty to notify notices (DTN) received from January to March 2023 and the number of reasonable grounds decisions made per quarter.
Further disaggregated data which shows nationality and whether the potential victim was an adult or child at the time of exploitation is published via the UK Data Service.
The DTN data related to April 2023 will be part of the Q2 statistics which is due to be published in August 2023.
Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Home Office:
To ask His Majesty's Government how many duty-to-notify notices were received for potential victims of modern slavery between 7 March and 30 April this year compared to the same period in 2022.
Answered by Lord Murray of Blidworth
The Home Office publishes quarterly and annual statistics regarding the National Referral Mechanism (NRM). The Q1 2023 statistics can be found here;
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1154119/modern-slavery-national-referral-mechanism-statistics-uk-quarter-1-2023-january-to-march-tables.ods
The data shows the number of duty to notify notices (DTN) received from January to March 2023 and the number of reasonable grounds decisions made per quarter.
Further disaggregated data which shows nationality and whether the potential victim was an adult or child at the time of exploitation is published via the UK Data Service.
The DTN data related to April 2023 will be part of the Q2 statistics which is due to be published in August 2023.