Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the research article by University College London entitled Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis, published on 19 March 2024, if she will ban advertising for vapes.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government’s position on vaping remains unchanged, if you don’t smoke, don’t vape, and children should never vape. Studies are important in helping to better understand the long-term health risks associated with vaping, but the mentioned study, that was carried out by University College London, corroborated by Cancer Research UK, does not demonstrate a causal relationship between vaping and cancer.

Overall, studies on the effects of vaping have so far shown that vapes are less harmful than smoking and can help people quit, although the long-term risks are unknown. Vaping is never recommended for children, and carries potential harms of future addiction while their lungs and brains are still developing. There is a lack of research on the potential long-term harms from vaping, and we are exploring future opportunities with the United Kingdom’s research councils.

Otherwise, I refer the hon. Member to the answer I gave on 6 February 2024 to Question 12629, as our position on the advertising of vapes remains unchanged.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate her Department has made of the number of adult vapers that may return to tobacco products as a result of the disposable vapes ban.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The health advice on vaping is clear, vaping can play a role in helping adult smokers to quit, but if you don’t smoke, don’t vape, and children should never vape. However, youth vaping has tripled in the last three years, and one in five children have now used a vape. We know that disposable vapes have played a significant role in this rise, with 69% of 11 to 17-year-olds who vape now using disposables, compared to just 7% in 2021. Disposable vapes also cause significant environmental harm, with five million disposable vapes thrown away every week.

To protect children and the environment, the Government has taken the decision to ban the sale and supply of disposable vapes.

The Impact Assessment on the disposable vape ban, published by the Department for Food, Environment and Rural Affairs on 11 March 2024, states that it is difficult to quantify the number of people switching either between different types of vapes, disposable to reusable, switching from vaping to smoking cigarettes, or stopping vaping or smoking altogether, as a result of a ban on disposable vapes.

However, reusable and refillable vapes will still be available for adult smokers to use as a quit aid and as a more affordable option than smoking. Therefore, it will not be necessary for adult vapers to return to tobacco products because refillable vapes will remain easily available to them, at a small cost relative to most tobacco products.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she has commissioned research into cellular changes in lung tissue for those who vape to assess the risks of future cancer.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government’s position on vaping remains unchanged, if you don’t smoke, don’t vape, and children should never vape. Studies are important in helping to better understand the long-term health risks associated with vaping, but the mentioned study, that was carried out by University College London, corroborated by Cancer Research UK, does not demonstrate a causal relationship between vaping and cancer.

Overall, studies on the effects of vaping have so far shown that vapes are less harmful than smoking and can help people quit, although the long-term risks are unknown. Vaping is never recommended for children, and carries potential harms of future addiction while their lungs and brains are still developing. There is a lack of research on the potential long-term harms from vaping, and we are exploring future opportunities with the United Kingdom’s research councils.

Otherwise, I refer the hon. Member to the answer I gave on 6 February 2024 to Question 12629, as our position on the advertising of vapes remains unchanged.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the NHS plans to expand the use of System One computer software.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The procurement of electronic patient record systems is conducted at an integrated care board or trust level, following specific procurement criteria. Consequently, decisions regarding software adoption and expansion will be made by National Health Service trusts. All procurement activity for patient record systems is conducted in compliance with regulations, which means that the outcome of future procurements cannot be known at this point.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to her Department's press release entitled £5 million fund to tackle fatal drug deaths across the UK, published on 29 August 2023, how this funding will be distributed; and what criteria her Department is using to select projects for this funding.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

As part of the Reducing Drug Deaths Innovation Challenge, which aims to reduce drug-related deaths across the United Kingdom, the Department is investing in 12 projects to develop technologies aimed at improving detection, response, or intervention in potential drug-related deaths.

Applicants submitted proposals, and these were assessed by an independent panel. Detailed assessment criteria were worked up by NHS Fife, and then moderated before awards were made. They included how well the project met the challenge described in the competition scope, the main technical challenges addressed, what similar products were available and how the proposal differentiated from them, project plan and milestones, expertise, cost, and commercial potential. We awarded funding to 12 projects, with further information available at the following link:

https://www.gov.uk/government/news/5-million-fund-to-tackle-fatal-drug-deaths-across-the-uk

This funding supports wider Government initiatives to tackle drug misuse in society. The UK’s drugs strategy, published in December 2021, has a key objective to prevent 1,000 drug deaths in England by 2025. This aligns with work within and across the four nations of the UK to improve systems of support and reduce drug-related deaths.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to provide public health interventions for people at risk of overdosing on (a) naloxone and (b) other synthetic opioids.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department is actively monitoring, and responding to, the continued threat posed by the growing levels of potent synthetic opioids such as nitazenes and illicit fentanyl in the United Kingdom. A core part of this response is expanding access to naloxone, which is a lifesaving medicine that reverses the effects of an opioid overdose. The Government recently consulted on proposed amendments to the Human Medicines Regulations 2012 so that more professionals and services can give out take-home supplies of naloxone to those at-risk of an overdose, as well as their friends and family. This consultation closed on 6 March 2024, and we will publish the next steps in due course.

For those using opiates, treatment is the safest place to be. The Government is investing an additional £780 million over three years, through to 2024/25, to create a world-class treatment and recovery system, the largest ever single increase in treatment and recovery funding in England. £532 million is being invested specifically to improve drug and alcohol treatment and recovery services. This funding is in addition to the Public Health Grant, and will grow the capacity and quality of the drug treatment system.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to improve how it collects data on non-fatal overdoses involving synthetic opioids.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department has a longstanding surveillance system in place to collect information on the nature and location of novel drug use, drug markets, and reports alerting us to drug harms experienced. We continue to monitor the threat posed by synthetic opioids, and are working to improve drug surveillance on synthetic opioids through development of an early warning system. The early warning system dashboard will pull together overdose-response data from ambulances, toxicology labs, and other key sources, so we know in near-real time where to target responses.

We know that most overdoses take place when individuals are alone or accompanied by others also using drugs. This means they are largely transitory and hidden events with no opportunity for sampling. A key indicator, therefore, are those who do come into contact with first responders, who are administered the lifesaving opioid reversal drug naloxone, or who are admitted to hospital. Ambulance data represents an opportunity for rapidly identifying local spikes in overdoses and, for this purpose, we are establishing data feeds with ambulance trusts in England on callouts where naloxone has been administered.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure that Tier 2 weight management services are sufficiently (a) resourced and (b) integrated with (i) primary care networks, (ii) community health hubs and (iii) other relevant providers to offer comprehensive support for people living with obesity.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service and local government provide a range of free tier two weight management services (WMS), to help eligible people living with obesity to lose weight. These are multi-component programmes, including dietary approaches and physical activity, with behaviour change support. The length of support can vary, but guidance from the National Institute of Health and Care Excellence suggests these should last at least three months.

The NHS offers the NHS Digital Weight Management Programme, which is a tier two service aimed at adults living with obesity, who also have type 2 diabetes or hypertension, or both, as well as NHS staff living with obesity. The 12-week programme is directly commissioned and managed by NHS England nationally, and is available via direct referral from any general practice or Community Pharmacy

Local authorities are able to spend funding from the Public Health Grant on weight management services in line with local population need. They may be delivered as a standalone service or as part of an integrated service, for example with smoking cessation support. Where local authorities commission these services, they are responsible for determining the required resourcing and interaction with other services, along with weight management service providers

Local authorities are part of integrated care systems (ICSs), which are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. ICS membership also includes the NHS, social care providers, charities, and other organisations. Being a member of the ICS will help local authorities to work more closely with partner organisations and offer integrated support for people living with obesity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many people under the age of 18 were diagnosed with ADHD in the last 12 months.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

Data on the number of children diagnosed with attention deficit hyperactivity disorder (ADHD) is not held centrally, but may be held locally by individual National Health Service trusts or commissioners.

The Department is exploring options for improving data collection and reporting on waiting times for ADHD assessments and diagnoses, to help improve access to ADHD assessments in a timely way and in line with the National Institute for Health and Care Excellence’s guidelines. In line with this, the National Institute for Health and Care Research has commissioned a research project to provide initial insights into local ADHD assessment waiting times data collection, and NHS England is currently scoping a national programme of work on ADHD, to understand more about the issues relating to ADHD service provision across the country.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure adequate oversight of how primary care settings deliver equitable access to weight management services in line with NICE Guidance.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Local authorities and the National Health Service provide a range of Weight Management Services (WMS) to support their communities to achieve and maintain a healthier weight. Generally, WMS delivered in the community are behavioural services provided by local authorities or the NHS Digital Weight Management Programme, rather than in primary care.

Local commissioners and WMS providers are expected to take National Institute for Health and Care Excellence (NICE) guidelines into account, alongside the individual needs, preferences, and values of their patients or service users. The NICE’s guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. It is not mandatory to apply the recommendations, although health and care commissioners are expected to take them fully into account.

Although primary care services are not a main provider of WMS, general practice (GP) is an important source of referrals to WMS. The Department funds the GP Weight Management Enhanced Service, which incentivises GPs to develop and implement a proactive approach to identifying and engaging with patients living with obesity, including the referral to WMS where appropriate. The service delivery specification for this enhanced service includes minimum standards such as undertaking training to have sensitive conversations about weight, and the review and restoration of the practice obesity register.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve access to weight management services in areas of socioeconomic deprivation.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Local authorities and the National Health Service provide weight management services to support their communities to achieve and maintain a healthier weight. These range from behavioural weight management programmes to specialist services for those living with obesity and associated co-morbidities.

Local authorities are able to spend funding from the Public Health Grant on behavioural weight management services in line with local population need, including in areas of socioeconomic deprivation. Integrated care boards are responsible for commissioning NHS specialist weight management services in line with local population need, as well as determining the criteria for access to these services in line with relevant guidance.

NHS England commissions the Digital Weight Management Programme nationally for people living with obesity and an existing comorbidity of either diabetes, or hypertension, or both. The 12-week programme is available via direct referral from any general practice or Community Pharmacy.

The programme provides three levels of intervention at varying intensities, and patients less likely to complete a behavioural programme of this nature, for instance those of a younger age, from ethnic minority backgrounds, from a more deprived area, or who are male, are offered a higher level of intervention and support to retain their engagement on the programme. Approximately 50% of total referrals are from the two most deprived socioeconomic quintiles.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will take steps to help raise awareness of careers in (a) medical physics and (b) clinical engineering.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Promoting healthcare science careers is a vital part of our NHS Health Careers team’s work, covering 350 careers in the National Health Service. Almost 240,000 people accessed information on healthcare science careers over the last 12 months.

As part of National Careers Week and Healthcare Science Week, an estimated 10,000 students heard directly from a range of NHS staff, including an apprentice Clinical Engineer and other healthcare scientists, as their stories were shown in classrooms across the country.

We will continue to promote all healthcare science careers, including Medical Physics and Clinical Engineering, as part of our work to raise awareness of all careers in the NHS, and encouraging people to join the NHS workforce. There are several case studies promoting careers in Medical Physics and Clinical Engineering on the National School of Healthcare Science website.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has she made of the potential implications for her policies of the findings of the research article by University College London entitled Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis, published on 19 March 2024.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government’s position on vaping remains unchanged, if you don’t smoke, don’t vape, and children should never vape. Studies are important in helping to better understand the long-term health risks associated with vaping, but the mentioned study, that was carried out by University College London, corroborated by Cancer Research UK, does not demonstrate a causal relationship between vaping and cancer.

Overall, studies on the effects of vaping have so far shown that vapes are less harmful than smoking and can help people quit, although the long-term risks are unknown. Vaping is never recommended for children, and carries potential harms of future addiction while their lungs and brains are still developing. There is a lack of research on the potential long-term harms from vaping, and we are exploring future opportunities with the United Kingdom’s research councils.

Otherwise, I refer the hon. Member to the answer I gave on 6 February 2024 to Question 12629, as our position on the advertising of vapes remains unchanged.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 7 December 2023 to Question 4959 on Respiratory Diseases: Health Services, how many Acute Respiratory Infection hubs were operating in winter 2023/24.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

During winter 2022/23, 363 Acute Respiratory Infection (ARI) hubs were implemented by integrated care systems (ICSs). The Department does not hold recorded information on the number of ARI hubs in 2023/24, as this information is held instead by local health bodies. The ambition in the recovery plan for urgent and emergency care is that each local area that would benefit from an ARI hub, has one in place ahead of winter. Evaluations from NHS England suggest that ARI hubs may save general practitioner appointments and accident and emergency attendances.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of making access to Bacillus Calmette-Guérin vaccinations available to farming and agricultural families that regularly interact with livestock.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

The Bacillus Calmette-Guérin (BCG) vaccination is not usually recommended for people aged over 16 years old, unless the risk of exposure is great. The vaccination can be offered to veterinary staff and those who handle animals or animal materials, for instance abattoir workers, which could be infected with tuberculosis (TB). Based on the current available evidence, only a very small subset of farmers may be at high risk of TB exposure and therefore eligible for vaccination. This does not include farmer’s household contacts or children who would not constitute a risk sufficiently high enough to warrant a recommendation for the vaccine. If the level of risk should increase, then the Joint Committee on Vaccination and Immunisation could be asked to review this.

Eligibility for the BCG vaccination as an occupational health vaccine should be based on an individual risk assessment. Those eligible would need to access the vaccine through a private occupational health provider, and may seek further advice from the National Farmers Union. Non-National Health Service providers can charge for this service.

Under the Control of Substances Hazardous to Health Regulations (COSHH), all new employees, including farmers, should undergo a pre-employment health assessment, which should include a review of immunisation needs. The COSHH risk assessment will indicate which pathogens staff are exposed to in their workplace, such as bovine TB. Staff considered to be at risk of exposure to pathogens should be offered routine pre-exposure immunisation as appropriate. This decision should also take into account the safety and efficacy of available vaccines.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will take steps to (a) recruit and (b) train more (i) medical physicists and (ii) clinical engineers.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The number of Scientist Training Programme (STP) trainees in Medical Physics and Clinical Engineering has tended to increase, with larger increases in recent years. The number of Higher Specialist Scientist Training (HSST) trainees has remained fairly constant. The following two tables show the number of trainees in the Medical Physics and Clinical Engineering STP each year since 2011, and the number of Medical Physics and Clinical Engineering trainees in HSST each year since 2014, respectively:

Note: The data for 2024 is subject to change, and without the Wales numbers.

Notes:

- the data for 2024 is subject to change, and without the Wales numbers; and

- data is not available for the year 2022.

The NHS Long Term Workforce Plan sets out the future National Health Service workforce requirements, and includes healthcare science figures, though this is not broken down into Medical Physics and Clinical Engineering workforce targets. The plan assesses that education and training places for healthcare scientists need to increase by 20 to 34%, reaching between 930 and 1,039 places by 2033/34. The ambition set out in this plan is to increase training places for healthcare scientists by 32%, to over 1,000 places, by 2031/32. We will work towards achieving this ambition by increasing training places by 13%, to over 850, by 2028/29.

The workforce plan also sets out the ambition to retain up to 130,000 more staff across the NHS over the next 15 years, through measures to improve staff’s experience of working in the NHS. This applies to all NHS staff groups, including medical physicists and clinical engineers.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many full-time equivalent qualified school nurses are working in a public health-commissioned (a) school nursing service, (b) zero to 19 service and (c) five to 19 healthy child programme in each local authority area.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Since April 2013, local authorities have held responsibility for commissioning public health services for school-aged children. These services may be commissioned from a range of providers both inside and outside of the National Health Service. NHS England publishes monthly workforce data which includes information on the number of school nurses directly employed by NHS trusts and other core NHS organisations in England. This data will not represent the total number of school nurses delivering local authority commissioned services, as it will excludes places where services are commissioned outside of the NHS. It is not possible to identify the specific service or programme that these staff are working within.

While data is not available at a local authority level, the following table shows full-time equivalent (FTE) school nurses working within NHS trusts and other core organisations in England by Government Office Region, as of November 2023:

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they have taken to ensure that patient records and personal data are only accessible to those who need to view them, and to ensure connections between software systems in health facilities include suitable control measures for this risk.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

National IT systems must ensure that users can be identified correctly, and are given appropriate access. This is achieved using identity verification capabilities, including creating a national digital identity for each authorised user.

Each local National Health Service organisation which requires access to the national IT systems is required to set up its own local Registration Authority (RA) which consists of people and processes who are trained to create identities and grant access for their staff to the national IT systems. NHS England has published the RA Policy requirements with which every local NHS organisation that has an RA must comply. This reflects current best practice for identity and access management as informed by the National Cyber Security Centre (NCSC) guidance.

The RA Policy also allows non-NHS health and care organisations providing direct care to run their own RA service. RA hosting is subject to meeting requirements and assessment criteria, which are soon to be published.

The RA process includes the use of RA codes, assigned to professional users’ smartcards to give them access to the correct information within national IT systems.

The RA codes which are assigned for a specific user will allow that user to create and process referrals appropriately depending on their job role.

Local organisations which have an RA function are required to have an RA audit policy and conduct annual audits on NHS Smartcard usage as part of their RA governance. RA Managers (those responsible for administering the RA function within an organisation) must implement a process to run the RA reports on a regular basis.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made, in each of the past five years, of the economic costs of the effects of post-operative cancer treatments.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department is working jointly with NHS England and Cancer Alliances to ensure every person receives personalised care and support from cancer diagnosis onwards, including post-treatment. As outlined in the NHS Long Term Plan for cancer, where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. After treatment, the person will move to a follow-up pathway that suits their needs, and ensures they can get rapid access to clinical support, where they are worried that their cancer may have recurred.

Post-operative cancer treatments encompass a wide variety of care, depending on the type and stage of cancer, the treatment the patient has had, and the patient’s needs. Follow-up care often includes regular check-ups, blood tests, scans, and procedures. It may also involve further treatments to deal with late and long-term side effects, including chemotherapy or radiotherapy to reduce the risk of cancer coming back. These highly individualised treatments have varying economic costs.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 25 March (HL2978), why they have specified how physician associates (PAs) are to be used, specifically with undifferentiated patients, rather than allowing GP practices to make their own decisions about the use of PAs.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Physician Associates (PAs) work within a defined scope of practice and limits of competence. NHS England has provided recent guidance on the use of PAs in general practice (GP) teams. As set out in the Network Contract Directed Enhanced Service, PAs should be adequately supervised by a GP when providing care for undifferentiated patients.

In terms of employment choices, GPs are self-employed contractors to the National Health Service, and it is largely up to employers to determine how best to staff their primary care network or GP, to best meet the needs of their population.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to adopt a new immunisation programme and ensure that there is high uptake of this programme.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department is advised by the independent Joint Committee on Vaccination and Immunisation (JCVI). The JCVI considers the disease’s burden on society, vaccine safety and efficacy, and the impact and cost effectiveness of immunisation strategies, before making a recommendation as to whether a new immunisation programme should be developed. This advice is then considered by the Department and, subject to that consideration, the Department works with partners, including the National Health Service and the UK Health Security Agency, to ensure the effective implementation of this advice. This includes work to ensure vaccine uptake of any implemented programmes is high. Numerous methods are used to ensure high uptake, including targeted communications, ensuring vaccine accessibility and availability.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when they intend to publish feedback to the Licensing of non-surgical cosmetic procedures consultation, which ran from 2 September to 28 October 2023.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

We are currently analysing the feedback received during the consultation, and intend to publish the Government’s response later in the spring.

Question to the Department of Health and Social Care:

To ask His Majesty's Government further to the Written Answers by Lord Markham on 27 February 2023 (HL5458) and 14 March 2023 (HL5916), whether they will place in the Library of the House a copy of the YAML, R and Python code exportable from NHS England's Federated Data Platform for (1) the Ambulance Dataset Dashboard, and (2) the COVID Monitoring Reporting and Publication Dashboard.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England will from time to time publish examples of code and specifications that are deemed useful to the wider community and industry, including where appropriate, the sharing of code within the NHS GitHub.

To ensure that NHS England is creating a vibrant marketplace for both end users and for industry, it aims to publish the Canonical Data Model structures as well as the metadata, in line with the Tech Code of Practice.

The Federated Data Platform (FDP) Programme is developing a sustainable way to publish examples of specifications and code for specific FDP products. The programme is working through a set of core principles to help determine how they will publish analysis code publicly. This includes making sure that there is appropriate explanatory information surrounding the code, that will help to provide additional context for those viewing the information.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how they plan to assess the impact of new immunisation programmes for infant respiratory syncytial virus on (1) hospitalisations, and (2) health inequality.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The UK Health Security Agency (UKHSA) monitors national immunisation programmes in England. The UKHSA’s Severe Acute Respiratory Infection Watch surveillance system collects weekly information on admissions to hospital with Respiratory Syncytial Virus (RSV), to monitor admission rates in each RSV season. If a programme is introduced, monitoring of its effectiveness would include thorough analysis of immunisation records, both infant or maternal, and laboratory results for patients needing healthcare for RSV-like illness. The UKHSA can also monitor RSV admissions by deprivation and ethnicity, using routine National Health Service records, when these become available following the RSV season. The UKHSA will also monitor inequalities in uptake of the RSV immunisation programmes, through its routine uptake data collections.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how they plan to assess the wider productivity and economic benefits of any new immunisation programmes for infant respiratory syncytial virus.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The independent Joint Committee for Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation. The JCVI’s evaluation of the cost-effectiveness of a respiratory syncytial virus (RSV) programme was based on the health benefits of an infant RSV programme, and the potential healthcare cost savings from preventing cases and hospitalisations.

The Department did not ask the JCVI to complete an assessment of the wider productivity and economic benefits when determining the cost-effectiveness of a vaccination programme, and the Department did not assess this separately for RSV.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will take steps to develop tools on social media to improve health literacy for (a) men and (b) women.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The National Health Service website and the NHS App are our main digital tools available to citizens, to support them in accessing services and making decisions about their health.

These are supported by the Department and NHS social media channels through a range of proactive media campaigns to help citizens make and sustain healthy behaviour changes, as well as receive the care they need by accessing the NHS at the right time, in the right way.

Clinicians across the NHS also support patients’ health literacy by providing clear information, increasing patients’ knowledge, and sharing decision making on their care.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what information they have on countries currently implementing immunisation programmes for infant respiratory syncytial virus with regard to (1) acceptance and uptake, and (2) hospitalisations.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

In the United States, as of 31 January 2024, maternal immunisation was 17.9%. By February 2024, 43% of infants under eight months old had received a dose of nirsevimab.

In Galicia, Spain, 92.9% of 5,357 infants born from 25 September 2023 to 4 February 2024 had nirsevimab, as well as 79.7% of 5,823 infants included in a catch-up programme. The peak of the hospitalisation rate in infants under six months old was 102 per 100,000 in 2023/24, during the week starting 27 November 2023. This is compared to a median of 776 for 2017/18, 2018/19 and 2019/20, peaking during the first week of the January.

In Luxembourg, 84% of 1524 infants born in hospital between early October and mid-December 2023 received nirsevimab. Luxembourg observed a decrease in hospitalisation in infants under six months old of 69%, between the 2022/23 and 2023/24 respiratory syncytial virus seasons.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what criteria apply to NHS hospitals when requesting patients to sign a 'do not resuscitate' form.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

There are no set criteria applied to National Health Service hospitals when requesting patients sign do not resuscitate forms. Doctors are required to make do not attempt cardiopulmonary resuscitation (DNACPR) decisions based on the individual circumstances of a patient, and with the involvement of the person concerned or, where the person lacks capacity, their family, or any other legally recognised advocate.

Patient facing guidance setting out how DNACPR decisions should be made, and how individuals or their families can get support about a DNACPR, is provided on the NHS website, in an online only format.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 16 February (HL2398), whether they have increased the maximum funding for medical degree apprentices from £50,000 to £150,000 over the term of the course.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The funding of £150,000 to be provided by NHS England per medical degree apprentice is an increase of the funding of £50,000 for medical degree apprentices announced by Health Education England in January 2023.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many 'do not resuscitate' forms have been signed in each of the past five years.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold this data.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will encourage the National Institute for Health and Care Research to rigorously evaluate existing research efforts and review how they can further prioritise and drive research investment for pancreatic cancer and other less survivable cancers.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Research is crucial in the fight against cancer, which is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121 million for 2022/23.

In terms of establishing targeted funding into pancreatic cancer, the NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

The Government, through the NIHR, is committed to improving research into pancreatic cancer and cancers with the poorest survival rates by funding high quality, timely research that leads to improved outcomes for patients and the public, and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including those with pancreatic cancer and other less survivable cancers.

In 2023, the Government awarded £2 million to new interdisciplinary research teams tackling hard to treat cancers, via the Medical Research Council, which hosted a two-day cancer sandpit strategic funding opportunity, focused on technological innovation for understanding cancers with the poorest survival rates.

The NIHR has funded seven research projects for pancreatic cancer for the period 2019 to 2023, with a total committed spend of approximately £3.6 million. The NIHR also supports the delivery of pancreatic cancer research funded by those in the charity and public sectors. For example, since 2019, the NIHR Clinical Research Network has supported over 70 pancreatic cancer-related studies.

The NIHR continues to encourage and welcome applications for research into any aspect of human health, including pancreatic cancer. All applications are assessed for funding by peer review committees. The level of research spend in a particular area is driven by factors including the quality of the proposals and their scientific potential. All applications for research into pancreatic cancer and other less survivable cancers made through open competition have been funded.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will establish targeted funding to prioritise and drive research investment into pancreatic cancer and the other less survivable cancers.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Research is crucial in the fight against cancer, which is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121 million for 2022/23.

In terms of establishing targeted funding into pancreatic cancer, the NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

The Government, through the NIHR, is committed to improving research into pancreatic cancer and cancers with the poorest survival rates by funding high quality, timely research that leads to improved outcomes for patients and the public, and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including those with pancreatic cancer and other less survivable cancers.

In 2023, the Government awarded £2 million to new interdisciplinary research teams tackling hard to treat cancers, via the Medical Research Council, which hosted a two-day cancer sandpit strategic funding opportunity, focused on technological innovation for understanding cancers with the poorest survival rates.

The NIHR has funded seven research projects for pancreatic cancer for the period 2019 to 2023, with a total committed spend of approximately £3.6 million. The NIHR also supports the delivery of pancreatic cancer research funded by those in the charity and public sectors. For example, since 2019, the NIHR Clinical Research Network has supported over 70 pancreatic cancer-related studies.

The NIHR continues to encourage and welcome applications for research into any aspect of human health, including pancreatic cancer. All applications are assessed for funding by peer review committees. The level of research spend in a particular area is driven by factors including the quality of the proposals and their scientific potential. All applications for research into pancreatic cancer and other less survivable cancers made through open competition have been funded.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they have taken to ensure that NHS trusts are made aware of (1) insourcing arrangements as a route to reducing local waiting lists, and (2) the benefits of insourcing for (a) patients, and (b) NHS trusts.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Independent sector providers have a significant role to play in supporting the National Health Service as trusted partners, to recover elective services. The Elective Recovery Taskforce was launched in 2022 to consider how capacity across the system could be best utilised, including how insourcing could be used to meet the ambitions on long waits. The taskforce concluded its work by publishing an implementation plan in August 2023, which sets out a series of actions that have either been delivered, or will be delivered, over the coming months.

Local systems are best placed to consider how to utilise insourcing as part of their delivery plans, in a way which works for their areas. To support the system, NHS England produced Guidance for trusts on the use of insourcing and NHS Shared Business Services produced the Insourcing of Clinical Services Framework Agreement.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what recent assessment they have made regarding the potential for insourcing to tackle NHS waiting lists.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Independent sector providers have a significant role to play in supporting the National Health Service as trusted partners, to recover elective services. The Elective Recovery Taskforce was launched in 2022 to consider how capacity across the system could be best utilised, including how insourcing could be used to meet the ambitions on long waits. The taskforce concluded its work by publishing an implementation plan in August 2023, which sets out a series of actions that have either been delivered, or will be delivered, over the coming months.

Local systems are best placed to consider how to utilise insourcing as part of their delivery plans, in a way which works for their areas. To support the system, NHS England produced Guidance for trusts on the use of insourcing and NHS Shared Business Services produced the Insourcing of Clinical Services Framework Agreement.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what deficiency in NHS England’s Secure Data Environment was described in paragraph 5.1.10 of the minutes from the 29 February meeting of the Advisory Group for Data, and what steps are being taken to rectify that deficiency.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The point made in the meeting was unrelated to any deficiency within the Secure Data Environment (SDE). The requirement from the Home Office is for specific statistical models and systems to be applied across the dataset requested, which is made up of aggregated data. This specific functionality is available from within the Home Office’s own technical environment, and not from within the SDE. There are no plans at this time to migrate this functionality within the SDE.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how much research funding the National Institute for Health and Care Research and the Medical Research Council have invested in biomedical studies of the causes and treatment of myalgic encephalomyelitis (ME) and non-biomedical studies of ME since 2019.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department funds research through the National Institute for Health and Care Research (NIHR). Since 2019, the NIHR has awarded £1.9 million for research into myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The Medical Research Council (MRC), part of UK Research and Innovation (UKRI), has invested £3.6 million since 2019.

This funding includes the NIHR and UKRI co-funded DecodeME study, a £3.2 million study into the genetic underpinning of ME. The study will analyse samples from 25,000 people with ME, to search for genetic differences that may indicate underlying causes or an increased risk of developing the condition. This study aims to increase our understanding of the disease, and therefore contribute to the research base on diagnostic tests and targeted treatments for ME.

In 2020, the NIHR, the Chief Scientist Office in Scotland, and the MRC also funded the James Lind Alliance Priority Setting Partnership for ME, facilitated by the charity Action for ME. The report sets out the top 10 research priorities for ME. These recommendations have been co-produced through a process led by a steering group of people living with ME, carers, and clinicians.

In the interim delivery plan on ME, the Department recognised that there has been a relatively low amount of biomedical research funded on ME, compared with disease burden. The NIHR and MRC welcome applications for further biomedical research into ME. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. In all disease areas, the amount of funding depends on the volume and quality of scientific activity.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what recent assessment they have made of the role of insourcing as a solution to eliminating waiting list backlogs for elective procedures.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Independent sector providers have a significant role to play in supporting the National Health Service as trusted partners, to recover elective services. The Elective Recovery Taskforce was launched in 2022 to consider how capacity across the system could be best utilised, including how insourcing could be used to meet the ambitions on long waits. The taskforce concluded its work by publishing an implementation plan in August 2023, which sets out a series of actions that have either been delivered, or will be delivered, over the coming months.

Local systems are best placed to consider how to utilise insourcing as part of their delivery plans, in a way which works for their areas. To support the system, NHS England produced Guidance for trusts on the use of insourcing and NHS Shared Business Services produced the Insourcing of Clinical Services Framework Agreement.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress they have made on the funding of biomedical research into myalgic encephalomyelitis (ME) since the then Parliamentary Under Secretary of State for Health and Social Care stated on 24 January 2019 that “there have not been good enough research proposals in the ME space, partly because of the stigma … and partly because of the division in the medical community”.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department funds research through the National Institute for Health and Care Research (NIHR). Since 2019, the NIHR has awarded £1.9 million for research into myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The Medical Research Council (MRC), part of UK Research and Innovation (UKRI), has invested £3.6 million since 2019.

This funding includes the NIHR and UKRI co-funded DecodeME study, a £3.2 million study into the genetic underpinning of ME. The study will analyse samples from 25,000 people with ME, to search for genetic differences that may indicate underlying causes or an increased risk of developing the condition. This study aims to increase our understanding of the disease, and therefore contribute to the research base on diagnostic tests and targeted treatments for ME.

In 2020, the NIHR, the Chief Scientist Office in Scotland, and the MRC also funded the James Lind Alliance Priority Setting Partnership for ME, facilitated by the charity Action for ME. The report sets out the top 10 research priorities for ME. These recommendations have been co-produced through a process led by a steering group of people living with ME, carers, and clinicians.

In the interim delivery plan on ME, the Department recognised that there has been a relatively low amount of biomedical research funded on ME, compared with disease burden. The NIHR and MRC welcome applications for further biomedical research into ME. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. In all disease areas, the amount of funding depends on the volume and quality of scientific activity.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact of the National Institute for Health and Care Excellence’s severity modifier on the prescribing of cancer medicines.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Institute for Health and Care Excellence (NICE) published its updated manual for health technology evaluations in January 2022, and has introduced a number of changes to make its methods and processes fairer, faster, and more consistent.

This includes the introduction of a broader severity modifier in place of the end-of-life modifier. NICE has been monitoring the impact of the changes that it introduced and analysis carried out by NICE for the first year of the updated manual’s implementation shows that NICE’s committee accepted 11 out of 13 cases where the company applied for a severity modifier, with eight of these being for cancer medicines.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the extent to which the 2021 NICE guidance for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has been implemented (1) in general, and (2) in relation to the training health and social care professionals on how to employ the new recommendations, (a) establishing a UK-wide network of hospital-based ME/CFS specialist services, (b) making all NHS services accessible and capable of providing personalised ongoing care and support to those with ME/CFS, and (c) ensuring social care provision for ME/CFS is monitored and regularly reviewed.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

No formal assessment has been made of the extent to which the 2021 National Institute for Health and Care Excellence (NICE) guidance for myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), has been implemented.

NHS England does not centrally commission services for ME. Services to support people living with ME are commissioned by integrated care boards (ICBs) to meet the needs of their local population, and are not reviewed or assessed by NHS England centrally. In October 2023, the British Association of Clinicians in ME published their ME/CFS National Services Survey 2023. This survey provides insight on the services being delivered for adults, and children and young people, living with ME. A copy of the survey is attached.

In relation to the training of health and social care professionals, it is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes. This has involved feedback and input from the ME Research Collaborative (MERC) Patient Advisory Group. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.

The Department published My full reality: an interim delivery plan for ME/CFS in August 2023, which sets out a number of actions to improve the experiences and outcomes for people living with the condition, including better education of professionals and improvements to service provision. More information about the interim plan is available on the GOV.UK website, in an online only format.

Alongside the publication of the interim delivery plan, we ran a public consultation to build a picture of how well the plan meets the needs of the ME community, and to understand if there are any gaps where further action may be necessary. The Department is currently analysing over 3,000 responses to the consultation on the interim delivery plan on ME, and will publish a final delivery plan later this year.

In relation to the monitoring of social care provision for individuals with ME, the Department has made a landmark shift in how we hold local authorities to account for their adult social care duties, through a new Care Quality Commission (CQC) assessment. The CQC will examine how well local authorities deliver their Care Act duties, increasing transparency and accountability and, most importantly, driving improved outcomes for people, including those with ME, who draw on care and support. The CQC completed five pilot assessments and is now rolling out assessment to all local authorities.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information her Department holds on the number of operations that were (a) cancelled and (b) delayed by more than two months due to the industrial action by junior doctors in 2023.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The number of operations that were cancelled due to the industrial action by junior doctors in 2023, was 157,570. Data is not held regarding operations delayed by more than two months. The National Health Service is prioritising urgent, emergency, and cancer care, and will continue to do its best to maintain appointments and elective procedures wherever possible. Cancelled appointments that need to be rescheduled, will be done so as a priority. Data on the impact of industrial action is available here:

https://www.england.nhs.uk/publication/preparedness-for-potential-industrial-action-in-the-nhs/#heading-3

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will publish a breakdown of the allocation of £3million government funding for Operation Joseph.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Operation Joseph was established to enforce the rules on vaping, and tackle illicit vapes and underage sales. It supplements work being undertaken by local authorities using existing local government funding. The £3 million of funding has been allocated over two years, from 2023/24 to 2024/25. A grant was provided to the National Trading Standards to commission specific areas of work, and to support local authorities. The following table shows the budget of each work area as of February 2024, as well as the total allocated:

Note: The figures shown are based on allocations in February 2024, and may be subject to change.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many incidents of patient records or personal data being accessed without due cause have been recorded in the most recent year for which figures are available.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Health and care organisations are required to submit data breach reports within 72 hours of an incident. Data breach incidents are reported to the Information Commissioners Office (ICO), who then investigate and decide what action to take. Notifiable breaches are those that are likely to result in a high risk to the rights and freedoms of the individual, referred to as the data subject. NHS England publishes the number of incidents reported through the Data Security and Protection Toolkit on its website. In 2023, 996 incidents were reported to the ICO, but not all of these would have involved patient details being accessed without due cause. The ICO publishes details on its website of incidents where it takes enforcement action.

Question to the Department of Health and Social Care:

To ask His Majesty's Government why NHS England has decided to allow the prescription of gender affirming hormones as a routine commissioning treatment option for young people from around their 16th birthday after only a literature review and without consulting medical and other specialists, or taking note other countries’ experience of such hormones.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has not adopted a new policy for gender-affirming hormones since 2016. NHS England made a consequential amendment to their gender-affirming hormones policy to bring it into alignment with the new puberty suppressing hormones policy. This planned update was set out in the puberty suppressing hormones policy consultation documents.

NHS England has put additional safeguards on the use of cross-sex hormones, including that any prescription to young people aged between 16 to 18 must be approved by a national multi-disciplinary team.

NHS England will continue to review the gender affirming hormone policy in line with the latest clinical advice and take note of recommendations set out once the Cass Review has delivered its final report.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 9 February (HL2216), why the information mentioned in the Answer on government expenditure is commercially sensitive.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

At the time of answering, the Department was engaged in commercial negotiations with NHS Supply Chain and their sub-contractors, relating to ongoing storage requirements for the COVID Strategic Intensive Care Unit. In December 2023, the average per pallet per week cost for equipment in the COVID Strategic Intensive Care Unit was £5.52.

The Department currently makes payments to NHS Supply Chain in relation to storage of personal protective equipment (PPE). At end of December 2023 there were 492,259 pallets, or 5.1 billion items, of COVID-19 PPE remining in storage. This includes both business as usual and excess stock.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many children of which biological sex were prescribed puberty blockers in each year since 2010.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

Gonadotropin-releasing hormone agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These include precocious puberty, some forms of cancer, endometriosis and gender dysphoria. Information on biological sex is not held in the format requested.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many non-compliant disposable vaping products have been seized through Operation Joseph.

Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)

Data on the number of illicit vapes seized through Operation Joseph in the financial year 2023 to 2024 will be published shortly.

Operation Joseph has identified that in the year before the Operation, 2.1 million illicit vapes were seized across England by Trading Standards from 2022 to 2023.

Question to the Department of Health and Social Care:

To ask His Majesty's Government why the National Institute for Health and Care Excellence 2020 evidence review of gender-affirming hormones for children and adolescents with gender dysphoria was not referenced in the list of resources which informed NHS England’s decision on the prescription of gender-affirming hormones for children and adolescents.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has not adopted a new policy for gender-affirming hormones. NHS England made a consequential amendment to their gender-affirming hormones policy to bring it into alignment with the new puberty suppressing hormones policy. This planned update was set out in the puberty suppressing hormones policy consultation documents.

NHS England has put additional safeguards on the use of cross-sex hormones, for instance that any prescription to young people aged between 16 and 18 years old must be approved by a national multi-disciplinary team.

NHS England will continue to review the gender affirming hormone policy in line with the latest clinical advice, and will take note of recommendations set out in the Cass Review, once the final report has been delivered.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what contracts NHS England and the Department of Health and Social Care have with The Phoenix Partnership and for what services; and what assessment they have made of the appropriateness of it providing such services.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department is the contracting authority for two consecutive framework agreements on which The Phoenix Partnership (TPP) has been appointed as a supplier, and awarded call-off contracts. These frameworks are the GP Systems of Choice (GPSoC), from 2014, and the GP IT Futures framework agreement (GPITF FA), which succeeded the GPSoC in 2020. The GPITF FA is the main contractual framework to supply IT systems and services to general practices (GPs) and associated organisations in England. The GPITF FA is operationally managed by NHS England, and the relevant contracting authorities under the call-off contracts are the individual integrated care boards, who contract on behalf of GPs.

In addition to managing the GPITF FA on behalf of the Department, NHS England is the contracting authority on three active contracts with TPP for: GP IT development and compliance; provision of Point of Care services to the NHS England Vaccination Programme; and provision of IT services to residential places of detention under the Health and Justice Information Systems contract.

The UK Health Security Agency (UKHSA) has a statutory requirement to report on the performance of the national immunisation programmes, and in June 2022, TPP was awarded a contract to extract this data directly from GPs' systems for the UKHSA, with a successor contract being awarded for the same work in October 2023. All Government contracts are awarded fairly and transparently, in line with the Public Contracts Regulations 2015. All decisions on contracts are rigorously scrutinised to assess a company’s ability to perform and deliver the best value for money for the taxpayer.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance her Department issues on the (a) adoption by and (b) use in the NHS of System One computer software.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Decisions on the procurement, adoption, and use of SystmOne are made locally as part of standard procurement procedures, which adhere to compliant procurement guidelines. No additional guidance has been provided by the Department on the adoption or usage of SystmOne in the National Health Service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what action they are taking to help the mental health of boys who were impacted by the lockdown restrictions.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

We want to ensure that all children and young people get the mental health support they need, including boys.

By the end of 2023/24 the overall spending on mental health has increased by more than £4.7 billion in cash terms since 2018/19 (before the COVID-19 lockdown restrictions were introduced).

There are now around 400 mental health support teams in place across England, covering 3.4 million children or around 35% of pupils in schools and colleges. We estimate this will increase to 44% by April 2024 and we are working to increase this coverage to 50% of pupils by March 2025.

There are also currently around 65 locally funded early support hubs in England. These hubs are open to those aged 11 to 25 years old and, importantly, they are for anyone who may not meet the threshold to receive National Health Service support. Following a competitive commercial process from hubs across the country, the government is now providing up to £8 million to 24 existing hubs to provide even more support. This means children and young people, including boys, who are experiencing feelings of anxiety or stress will have a physical space to go to in their community when their problems first emerge, without the need for a referral.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact of the Abortion Act 1967 on UK birth rates.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

No assessment has been made of the impact of the Abortion Act 1967 on United Kingdom birth rates. Parliament decided the circumstances under which abortion can legally be undertaken. Under the act, women have access to safe, legal, regulated abortion services.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact on the UK of the global decline in fertility rates.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

No such assessment has been made.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have reviewed the decision of the Care Quality Commission to approve the registration of Gender Plus Healthcare in east London, which runs the private Gender Plus hormone clinic set up by former Tavistock Gender Identity Development Service specialist Dr Aidan Kelly, and which can refer patients aged 16 to 18 for cross-sex hormone treatment.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Care Quality Commission (CQC) is the independent regulator of health and social care in England, and one of its statutory responsibilities is to assess and register providers of regulated activity, as set out in schedule one of the Health and Social Care Act 2008. Gender Plus Healthcare is a United Kingdom based private gender clinic offering a range of treatment options, including hormone treatment, for those aged 16 years old and over.

In January 2024 the CQC approved Gender Plus Healthcare’s registration to carry out the regulated activity of treatment of disease, disorder, or injury, with the provider having met the CQC’s requirements for registration. The registration by the CQC was on the condition that the provider must not carry out the regulated activity of treatment of disease, disorder, or injury, on those under the age of 16 years old, at any location.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when the major conditions strategy will be published.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Our intention is to publish the Major Conditions Strategy in the summer of this year.

Make the chickenpox vaccine part of the routine childhood immunisation schedule, which is delivered by the NHS, and introduce a catch-up programme.

We want the Government to increase education in schools on allergies, provide funding for schools, restaurants, hotels, etc to have emergency epipens, and provide funding for additional support through the NHS for people with allergies, including for advice and support from dietitians.

Group B strep is very common in pregnant women and can spread to the baby and make them ill, with potentially fatal consequences. We want the Government to provide funding so that all pregnant women can be offered regular screening for Group B strep.

I want the Government to provide dedicated and adequate funding for smaller GP surgeries, to ensure that these services remain open.

The Queen awarded the George Cross to the NHS in 2021. We believe incorporating the award appropriately into the NHS logo will provide all NHS workers with a constant reminder of the high esteem their role is held by the nation.

We want the Government to revise who is eligible for free flu jabs to extend these to early years workers in nurseries, so that this group, which is at high risk of being exposed to the flu, can easily access protection.

Provide more funding to ensure the NHS provide 3 rounds of IVF for every person who wants to start a family, no matter where they live. According to NICE, women aged under 40 should be offered 3 cycles of IVF treatment on the NHS if they meet certain criteria. We want funding to ensure this happens.

We want the government to support free eye tests for all ages to help increase the early detection and enable treatment of brain cancer and serious eye diseases and disorders.

A Public Inquiry must be urgently held to investigate the impact of the Covid-19 pandemic on people with Autism. I don't think that people with Autism were considered and supported correctly by the Government throughout the Covid-19 pandemic so lessons need to be learnt.

Allow patients that are prescribed cannabis to grow their own cannabis at home with a restriction of 6 plants per household. This is to assist people with financial difficulty who may not be able to afford a private prescription.

Take action to make changes for glioblastoma patients, and ensure there is enough funding for research and clinical trials. We also want the Government to promote any clinical trials to make these as accessible as possible.

I am concerned that the Bill would restrict access to gender affirming care for trans children, such as hormone therapy. It would mean that healthcare professionals who provide this care could be prosecuted.

Many people are able to access vital life-saving drugs for free on the NHS, such as drugs for diabetes. Anaphylaxis sufferers have to carry an Epipen throughout their life. This is undoubtedly a life-saving medication and we believe it should be free to anaphylaxis suffers.

The current age of breast cancer screening for women is 50-70 year olds however research suggests there has been a rise in breast cancer in younger ages. I think it would be great if we offered screening to 28-70 year olds, to catch this disease at a much earlier stage.

We think the Government should make it mandatory for all employers and employees working within care and teaching to be required to take regular random drug tests.

The Covid pandemic proved that rough sleeping can be prevented and support can be given for those in need. I believe our failure to continue with this support is a disgrace. The Government should provide more funding, like it did during the pandemic to get all rough sleepers into accommodation.

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Found: of Health and Social Care (DHSC), the public, healthcare providers and our NHS colleagues.

Found: of Health and Social Care (DHSC), the public, healthcare providers and our NHS colleagues.

Found: of Health and Social Care Group Accounting Manual (GAM) 2021-22.

Found: of Health and Social Care Group Accounting Manual (GAM) 2021-22.

Found: Noting the only indirect contact he is aware of was via an official from DHSC, a representative from

Found: The MHRA is an executive agency of the Department of Health and Social Care.

Found: The MHRA is an executive agency of the Department of Health and Social Care.

Found: Stakeholder engagement UK Health Security Agency (UKHSA) NHS Supply Chain Department of Health

Found: The MHRA is an executive agency of the Department of Health and Social Care.

Found: RPC -DHSC -5316(1) 1 04 April 2024 Tobacco and Vapes Bill Lead department Department for Health

Found: From: Office for Life Sciences, Department of Health and Social Care, and Department for Science, Innovation

Found: behind her question, I can say that my department, the DWP, is working ever more closely with the DHSC

Found: ://www.legislation.gov.uk/ukpga/1998/46/schedule/5Radiation is a reserved matter and there is an UK Department