Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to reform NHS dental contracts to ensure that they prioritise prevention.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
From 1 April 2023, the responsibility for commissioning primary care dentistry to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England. This included the transfer of all funding, Units of Dental Activity, and the management responsibility for National Health Service dentistry.
The current NHS dental contract already requires dental services to provide preventative care and treatment. To support dentists with this, NHS England and the Office for Health Improvement and Disparities have produced a comprehensive toolkit for dentists, providing evidence-based interventions and advice on how dental health professionals can improve and maintain their patient’s oral health. This guidance is available on the GOV.UK website, in an online-only format.
As set out in Our plan to recover and reform NHS dentistry, we are working on further reforms to the 2006 contract, in discussion with the dental profession, to properly reflect the care needed by different patients, and more fairly remunerate practices. We expect to develop options for consultation with the dental profession in advance of a further announcement later this year. Any changes would be phased in from 2025 onwards. The plan also includes a range of measures which will prevent poor oral health, particularly in the youngest children, including dental teams providing preventative advice and treatment to reception-age children in the most under-served areas, and a new Smile for Life programme which will provide education and advice for nurseries and other early years settings.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to ensure that dental services are represented in the governance structures of integrated care systems.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
From 1 April 2023, the responsibility for commissioning primary care dentistry to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England.
ICBs are required to publish their constitution, which includes a list of ICB board members, in accordance with the Health and Care Act 2022. ICBs have made board member information, including members’ expertise and knowledge, publicly available on their websites.
The Health and Care Act 2022 sets out membership requirements of the ICBs that include representatives from NHS trusts, primary care, and local authorities. However, the local areas can go beyond the legislative minimum requirements in order to address their local needs. Most ICBs have used this discretion, and appointed additional members such as members for public health, voluntary, community and social enterprise representatives, and others based on their local area needs.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to allow specialist orthoptists independent prescribing responsibilities, thereby obviating glaucoma patients' requirement for a duplicate appointment with an ophthalmologist for eye drop prescriptions, and avoiding unnecessary delay in treatment for these patients and others.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Prescribing is a high-risk activity, and it is widely agreed that it should only be carried out in a regulatory context. There is a process in place for making changes to prescribing responsibilities, to ensure those changes are safe and beneficial for patients. NHS England leads on developing clinical cases for change, in collaboration with the professional bodies, and the Commission on Human Medicines reviews proposals and provides advice. If proposals are progressed, changes must be made to the Human Medicines Regulations 2012, using the powers in the Medicines and Medical Devices Act 2021, and this requires a public consultation and regulations to be laid and debated in both Houses of Parliament and the Northern Ireland Assembly.
Regulated orthoptists are currently able to supply and administer certain medicines via exemptions or patient group directions. There are no plans to extend this to independent prescribing at this time.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to enable faster registration tracks for dentists who have been trained in other countries.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Currently, to be entered into the dentists register, an individual must hold a recognised United Kingdom dentistry qualification; a European Economic Area (EEA) or Swiss qualification recognised under European Union exit standstill arrangements; or they must pass the Overseas Registration Exam or License in Dental Surgery exam. Prior to January 2001, the General Dental Council (GDC) also recognised dentistry qualifications from a limited number of dental schools in specific countries outside the EEA, which is published on the GDC’s website in an online-only format.
Under legislative changes that came into force in March 2023, the GDC now has greater flexibility to amend routes to registration for dentists with overseas qualifications, including the power to recognise qualifications as sufficient for registration without further assessment. We will continue to discuss with the GDC how they can best utilise this new flexibility to enable suitably qualified dentists to enter the workforce as quickly and efficiently as possible.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the Community Pharmacy Contractual Framework remains fit for purpose, given that it was negotiated before the COVID-19 pandemic.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Community Pharmacy Contractual Framework (CPCF) 2019-24 five-year deal commits £2.592 billion per year to the sector and outlines a joint vision for how community pharmacy will be more integrated into the National Health Service, deliver more clinical services and become the first port of call for minor illnesses. The Government continues to support this ambition.
Each year of the CPCF is negotiated separately between the Department, NHS England, and the Pharmaceutical Services Negotiating Committee. In September last year, following a joint review of the CPCF, we announced the agreement for the remainder of the five-year deal, which included a further one-off investment in the sector of £100 million.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to consult on a new NHS dental contract to provide access to general dentistry; and what steps they will take to ensure that local commissioners work with providers to make existing contracts sustainable.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is holding discussions and consulting with the British Dental Association (BDA) and the wider dental sector for additional reforms of the National Health Service (NHS) Dental System, planned for 2023. NHS England is responsible for commissioning primary care dentistry to meet the needs of the local population, with many of these functions transferring to integrated care boards (ICBs) from April 2023. They will work with commissioners and providers, supported by NHS England’s Assurance Framework.
‘Our plan for patients’, announced in September 2022 and available in an online-only format, outlines how we will meet oral health needs and increase access to NHS dental care. This includes improving the 2006 contract to ensure fairer remuneration for practices providing complex treatment as well as enabling dentists to make better use of dental teams to deliver NHS treatment. These changes were discussed with stakeholders and implemented through regulations that came into effect on 25 November 2022, improving access to general dentistry and making the NHS contract more attractive and sustainable to dentists and their teams.
The Department also worked with NHS England and the BDA to introduce a minimum Unit of Dental Activity value in October 2022, the implementation of which will support commissioners to work closely with providers in ensuring NHS dental contracts are sustainable.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to collect data regarding a dental workforce to improve the (1) recruitment, and (2) retention, of dentists.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has committed to publishing a workforce plan next year, which will include independently verified forecasts for the number of healthcare professionals, including dental professionals, required in future years. This will take into account improvements in retention and productivity and will make use of available data sources.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to speed up referrals for people diagnosed with pancreatic cancer, given the pace at which the disease progresses and the need for treatment to begin quickly.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service is implementing non-specific symptom (NSS) pathways for patients presenting with vague and non-site specific symptoms which do not clearly align to a tumour type, such as pancreatic cancer. As of November 2022, there were 98 NSS pathways and approximately 60,000 referrals have been made. By March 2024, we expect these NSS pathways to be available throughout England. This will also support the NHS to meet the Faster Diagnosis Standard for all patients referred for the investigation of suspected cancer to receive an outcome within 28 days.
NHS England’s ‘Help Us, Help You’ campaign addresses the barriers to patients seeking advice for symptoms for all cancer types. The current campaign focuses on abdominal and urological symptoms, which can be related to pancreatic cancer.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the ambition in the NHS Long Term Plan which states that "by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients", when they will commence Phase 2 to include a wider range of tests that will involve dialogues with (1) GPs, (2) Integrated Care Boards, and (3) key stakeholders.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
While there are no plans to add a specific second phase, we are committed to the NHS Long Term Plan’s ambition of diagnosing 75% of cancers at stage 1 or 2 by 2028.
Patients will benefit from earlier diagnostic tests closer to home, with 91 community diagnostic centres (CDCs) already up and running. Investment in up to 160 CDCs will deliver up to 17 million tests by March 2025. As of November 2022, existing CDCs have delivered more than 2.4 million additional checks.
In addition, the NHS-Galleri trial is currently evaluating a test for blood to identify cancer risk, which can detect signs of more than 50 different cancers, including those where no screening programmes currently exist. The trial has recruited the target of 140,000 participants and interim results are expected in late 2023. If successful, the NHS has committed to deploying one million Galleri tests in 2024 and 2025. The clinical trial is currently planned to conclude in 2025.
Asked by: Baroness Redfern (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to commission further research into smoking related health disparities.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
While there are no specific plans to do so, we continue to work with researchers on smoking related health disparities. The Office for Health Improvement and Disparities is a partner in the SPECTRUM research consortium, which undertakes research on unhealthy products such as tobacco, alcohol and food and health disparities.