Asked by: Lisa Smart (Liberal Democrat - Hazel Grove)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that patients experiencing mental health problems are provided with comprehensive information on (a) potential side effects, (b) interactions with other medications and (c) the long-term implications of any medication they are advised to take.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Any decision to prescribe a medicine should be made following a conversation between the prescriber and patient. This is known as shared decision making and should involve discussing with the patient the risks, benefits and possible consequences of different options, along with the prescriber’s clinical judgement.
NHS England has recently published decision support tools on depression and bipolar to help individuals to compare possible treatment options, and a leaflet on the safer use of valproate. Unless the information is on the pack, all dispensed medicines must include a patient information leaflet, which provides information on using the medicine safely. Specialist mental health pharmacists are available at the majority of mental health trusts to discuss medication options with patients, and the Medicines A-Z website and NHS App provide information about medicines and mental health.
The Mental Health Bill extends access to advocacy support, currently only available to patients detained under the Mental Health Act, to all patients in mental health inpatient settings. Advocates support patients to understand and exercise their rights. The bill also introduces measures to encourage people to create an Advance Choice Document while they are well. This is a written record of their wishes, including their preferences on medication, so that these can later inform decisions during a mental health crisis. The bill also raises the threshold on when compulsory medication can be administered to a patient, by requiring that there must be a compelling reason to override the patient’s refusal, whether made at the time or in advance. Urgent and compulsory medication and electroconvulsive therapy can also only be given under a more limited set of circumstances. These measures aim to better balance patient autonomy and the ability to administer treatment at a time of mental health crisis.
Asked by: Lisa Smart (Liberal Democrat - Hazel Grove)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to help support patients with mental health problems in exercising their right to refuse medication in NHS settings.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Any decision to prescribe a medicine should be made following a conversation between the prescriber and patient. This is known as shared decision making and should involve discussing with the patient the risks, benefits and possible consequences of different options, along with the prescriber’s clinical judgement.
NHS England has recently published decision support tools on depression and bipolar to help individuals to compare possible treatment options, and a leaflet on the safer use of valproate. Unless the information is on the pack, all dispensed medicines must include a patient information leaflet, which provides information on using the medicine safely. Specialist mental health pharmacists are available at the majority of mental health trusts to discuss medication options with patients, and the Medicines A-Z website and NHS App provide information about medicines and mental health.
The Mental Health Bill extends access to advocacy support, currently only available to patients detained under the Mental Health Act, to all patients in mental health inpatient settings. Advocates support patients to understand and exercise their rights. The bill also introduces measures to encourage people to create an Advance Choice Document while they are well. This is a written record of their wishes, including their preferences on medication, so that these can later inform decisions during a mental health crisis. The bill also raises the threshold on when compulsory medication can be administered to a patient, by requiring that there must be a compelling reason to override the patient’s refusal, whether made at the time or in advance. Urgent and compulsory medication and electroconvulsive therapy can also only be given under a more limited set of circumstances. These measures aim to better balance patient autonomy and the ability to administer treatment at a time of mental health crisis.
Asked by: Tom Gordon (Liberal Democrat - Harrogate and Knaresborough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department are taking to improve procedures for processing gestational diabetes blood glucose tests to improve the accuracy of diagnosis.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence is responsible for setting clinical guidelines. For diabetes in pregnancy, including testing for gestational diabetes, the relevant clinical guideline is NG3 - Diabetes in pregnancy: management from preconception to the postnatal period, which is available at the following link:
https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#gestational-diabetes
The Department provides funding to the National Institute for Health and Care Research for research to help improve procedures around gestational diabetes, such as the DOMINO study, with further information available at the following link:
https://fundingawards.nihr.ac.uk/award/NIHR134628
Asked by: James Naish (Labour - Rushcliffe)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has decided on the future availability of the Complex Cancer Late Effects Rehabilitation Service provided by Royal United Hospitals Bath NHS Foundation Trust.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate National Health Service commissioning body. NHS England commissions the Royal United Hospitals Bath NHS Foundation Trust’s Complex Cancer Late Effects Rehabilitation Service. NHS England has no immediate plans to decommission the rehabilitation service.
Asked by: Blake Stephenson (Conservative - Mid Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will publish an impact assessment on the proposed creation of a Bedfordshire, Milton Keynes, Cambridgeshire, Peterborough and Hertfordshire ICB.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) should engage with all other organisations within their integrated care partnership, including with local authorities, to ensure they are involved where there are boundary changes.
Clustering ICBs remain separate organisations and so must necessarily continue to duplicate some activities, which is unwieldy. Mergers allow those inefficiencies to be removed and brings stability for leaders, staff, and partners. It is not possible to estimate the difference in savings between clusters and mergers because these may vary in footprints, in starting points, and in transition arrangements.
When NHS England decides on ICB mergers, it must take into account its wider duties, including duties relating to value for money and equalities. These will be considered in decision making, but NHS England is not required to publish impact assessments.
Asked by: Blake Stephenson (Conservative - Mid Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what engagement he has had with local authorities in Bedfordshire on plans for ICB re-organisation in the East of England.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) should engage with all other organisations within their integrated care partnership, including with local authorities, to ensure they are involved where there are boundary changes.
Clustering ICBs remain separate organisations and so must necessarily continue to duplicate some activities, which is unwieldy. Mergers allow those inefficiencies to be removed and brings stability for leaders, staff, and partners. It is not possible to estimate the difference in savings between clusters and mergers because these may vary in footprints, in starting points, and in transition arrangements.
When NHS England decides on ICB mergers, it must take into account its wider duties, including duties relating to value for money and equalities. These will be considered in decision making, but NHS England is not required to publish impact assessments.
Asked by: Al Pinkerton (Liberal Democrat - Surrey Heath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of including British citizens who studied medicine abroad in NHS specialty training prioritisation policies in Surrey Heath constituency.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
British doctors who obtained their medical degree abroad need to meet the requirements of the General Medical Council, the independent regulator of the medical profession, to practise medicine in the United Kingdom. These doctors are then able to apply for jobs in the National Health Service on the same basis as UK medical graduates.
As set out in our 10-Year Health Plan, published on 3 July, we will work across the Government to prioritise UK medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the NHS for a significant period for specialty training. We will set out further details in due course.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to take steps to promote the (a) recruitment and (b) retention of UK medical graduates over international applicants.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
British doctors who obtained their medical degree abroad need to meet the requirements of the General Medical Council, the independent regulator of the medical profession, to practise medicine in the United Kingdom. These doctors are then able to apply for jobs in the National Health Service on the same basis as UK medical graduates.
As set out in our 10-Year Health Plan, published on 3 July, we will work across the Government to prioritise UK medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the NHS for a significant period for specialty training. We will set out further details in due course.
Asked by: Caroline Dinenage (Conservative - Gosport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many cancer patients have access to radiotherapy in (a) Gosport, (b) the South East and (c) England.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
All cancer patients have access to radiotherapy treatment. Decisions about cancer treatment are typically made by clinicians and multidisciplinary teams of healthcare professionals.
Asked by: Joe Robertson (Conservative - Isle of Wight East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of brand-specific prescribing on the availability of medication at pharmacies.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has made no assessment of the potential impact of brand-specific prescribing on the availability of medication at pharmacies.
Decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers must always satisfy themselves that the medicines that they consider appropriate for their patients can be safely prescribed and that they take account of appropriate national guidance on clinical effectiveness, as well as the local commissioning decisions of their respective integrated care boards.
Prescribers can normally prescribe a medicine by brand or by the generic name, and in primary care, where a prescription specifies a branded medicine, that product must be dispensed, whereas for a generic prescription, any manufacturer’s product can be dispensed. For some medicines or some conditions, switching between manufacturers’ products carries additional clinical risks and guidance regarding the appropriateness of brand or generic prescribing for specific medicines or conditions might be issued.
To assist with the management of supply issues with certain medicines for attention deficit hyperactivity disorder, clinical experts with input from the Medicines and Healthcare products Regulatory Agency and the Department developed guidance on prescribing methylphenidate generically. This guidance was issued to provide prescribers with information on how to switch between methylphenidate products. This is a guidance document and as such there is no requirement for prescribers to follow it unless they deem it necessary and suitable for their patients.