Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to promote (1) the NHS Low Income Scheme to chronically ill patients, including Hidradenitis suppurativa patients, and (2) the use of pre-payment prescription certificates to chronically ill patients, including Hidradenitis suppurativa patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Business Services Authority and the National Health Service promote the NHS Low Income Scheme and prescription pre-payment certificates (PPCs) to professionals and patients. It does this through social media, online resources, media releases and healthcare bulletins.
Our extensive arrangements to help people afford NHS prescription charges, means that almost 89% of prescription items in England are already provided free of charge. For those not exempt from charges, PPCs can be used to cap costs at approximately £2 a week for regular prescriptions.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what consideration they have given to including Hidradenitis suppurativa (HS) to the list of specified medical conditions qualifying for free prescriptions, given the high out-of-pocket costs for HS patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
While we are not considering adding this or other conditions to the list of exemptions for free prescriptions, there are extensive arrangements currently in place to ensure that prescriptions are affordable for patients with hidradentis suppurativa.
Around 89% of prescriptions are dispensed free of charge and extensive arrangements are already in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how integrated care boards assess the initial and continuing financial stability of private companies from which NHS services are commissioned, and what assessment they have made of the overall financial stability of private companies providing NHS services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) assess the financial stability of companies subject to the current rules on procurement, including the Public Contract Regulations 2015. ICBs are responsible for their own due diligence and governance surrounding procurement, the award of contracts, and the assessment of suppliers for those purposes.
The Department has not made a central assessment of the overall financial stability of private companies providing services to the National Health Service.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, following the decision by One Norwich Practices to stop providing services to the NHS, including a walk-in centre, because of financial problems, whether they will conduct an investigation into the board of that company and its management of services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Norfolk and Waveney Integrated Care Board (ICB) and One Norwich Practices have been working constructively to identify appropriate alternative providers and develop plans to transfer services and staff. The ICB’s immediate priorities are to ensure that disruption to patient care is minimised and to protect the wellbeing of staff at One Norwich Practices. Once these immediate priorities are addressed, the ICB will be in a position to undertake its own internal review of the circumstances that may have contributed to One Norwich Practices’ insolvency.
As a commissioner, the ICB is not in receipt of the financial information of its contractors, and the ICB is not responsible for the financial viability of any organisation, nor any subsequent arrangements, financial or otherwise, within a wider group of companies or partners with whom the ICB does not directly commission services.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they plan to take to resolve the shortages of more than 100 medicines, as reported by the British Generic Manufacturers Association.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Medicine supply problems can occur for several reasons. For example, they can be due to manufacturing difficulties, regulatory problems, problems with the supply of raw materials, sudden demand spikes or from issues which are related to the distribution of the product. The production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Occasionally, the National Health Service experiences temporary shortages of specific medicines.
We know how frustrating and distressing the possibility of shortages can be and we acknowledge that there have been challenges recently with access to a limited number of medicines. We want to assure patients that the Department has well-established processes to prevent, manage and mitigate medicine shortages and works with the pharmaceutical industry, the Medicines and Healthcare products Regulatory Agency, NHS England, the devolved governments and others operating in the supply chain to help ensure patients have access to the treatments they need.
The Department routinely shares information about medicine supply issues directly with the NHS so they can put management plans in place to mitigate the risk of the shortage impacting patients and inform their patients about what it might mean for them. If any patient is concerned about their treatment, they should discuss this with their pharmacist or general practitioner.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of Nolan and Ormondroyd’s systematic review published on 30 March in Clinical Genetics, setting out the consequences for consumers and health services of direct-to-consumer genetic testing and how it relates to equitable healthcare; and what assessment they have made of the regulation of direct-to-consumer genetic testing.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Whilst no specific assessment has been made of Nolan and Ormondroyd’s systematic review published in March 2023 or Emma Wilkinson’s article published in October 2022, the Government recognises both the opportunities and risks raised by direct-to-consumer genomic tests and is committed to ensuring effective and proportionate regulation.
In consideration of the regulation of direct-to-consumer genetic and health testing, the Medicines and Healthcare products Regulatory Agency is working to develop a robust, world-leading regulatory regime for such medical devices that prioritises patient safety.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of Emma Wilkinson’s article published in October 2022 in The BMJ on the impact of direct-to-consumer testing on the public and the NHS, and of how this relates to the regulation of direct-to-consumer health testing.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Whilst no specific assessment has been made of Nolan and Ormondroyd’s systematic review published in March 2023 or Emma Wilkinson’s article published in October 2022, the Government recognises both the opportunities and risks raised by direct-to-consumer genomic tests and is committed to ensuring effective and proportionate regulation.
In consideration of the regulation of direct-to-consumer genetic and health testing, the Medicines and Healthcare products Regulatory Agency is working to develop a robust, world-leading regulatory regime for such medical devices that prioritises patient safety.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made towards introducing the recording of antimicrobial resistance as a cause of death on death certificates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Medical practitioners are expected to state the cause of death on death certificates to the best of their knowledge and belief, including where a resistant infection was a contributory factor. Consistently citing antimicrobial resistance (AMR) as a cause of death on the Medical Certificate of Cause of Death (MCCD) could provide better data on the scale and impact of AMR and improve public awareness of the issue.
In November 2022, as part of the National Medical Examiner’s “Good Practice Series”, the Royal College of Pathologists published a paper to help medical examiner offices align with the UK AMR National Action Plan, and support surveillance of antimicrobial resistance. The paper asks medical examiners to encourage and educate those writing MCCDs to accurately record the organism responsible for the infection, whether it was resistant to microbial therapy, and whether the infection was hospital- or community-associated, where this is known. A copy of the paper is attached.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure the safety of NHS England’s plan to allow community pharmacists to prescribe certain antibiotics.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Pharmacists with an additional prescribing qualification are already allowed to prescribe medicines within their competence, including antibiotics. These skills are already being used in general practice and hospitals where many pharmacists have a prescribing qualification. Changes have been made to the initial training and education of pharmacists so that from 2026 all pharmacists will qualify with a prescribing qualification.
As part of the Delivery plan for recovering access to primary care, an additional investment up to £645 million will support a new Pharmacy First service which will allow community pharmacists to assess patients and provide treatments, including the supply of certain antibiotics. These will be supplied against Patient Group Directions (PGDs) which have been designed following extensive input from expert clinicians across the National Health Service to mitigate against the risk of increased antimicrobial resistance. The PGDs will be informed by the latest National Institute for Health and Care Excellence guidance to embed best practice and the new service will be closely monitored to ensure treatments, including antibiotics, are being supplied appropriately. In addition, a separate evaluation of the service will be commissioned by the National Institute for Health and Care Research.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the quality and safety of (1) imported, and (2) home produced generic drugs; and whether they plan to step up testing following the decision of the US military to introduce a new testing programme.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Before a medicine can be placed onto the market in the United Kingdom, it must first receive approval from the Medicines and Healthcare products Regulatory Agency (MHRA) via the granting of a Marketing Authorisation, commonly known as a product licence. Each medicinal product is assessed for its safety, quality, and efficacy. For a generic medicine, an assessment of whether the medicinal product is equivalent to the proprietary medicine will also be performed.
Manufacturers of all medicines, including generics, are required to perform testing for each batch before it is released to market to ensure that it meets the specifications as set out in the product licence. There are currently no plans to amend these testing processes. If the UK product is manufactured in a third country there is an additional requirement for testing after importation i.e., after shipping, but before release to the market. This extra control measure is not a requirement for supply to the market in the United States of America.
It should be noted that medicines, including generics, must comply with the same Good Manufacturing Standards which are applicable for domestic and third country manufacturers. The MHRA’s medicines inspectorate conduct inspections to ensure that those manufacturing medicines meet these stringent Good Manufacturing Practice standards. These standards are also applicable to the testing facilities, which are also the subject of inspections to ensure the appropriate standards are being met.