Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what recent assessment they have made of the accuracy of BMI thresholds for (1) adults, and (2) children.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) recommends that Body Mass Index (BMI) for adults and BMI centile, adjusted for age and sex, for children and young people should be used as a practical measure for estimating and defining adiposity, the measure of fatty tissue. In September 2022, NICE reviewed evidence on the most accurate methods and thresholds for assessing the risk associated with overweight and obesity in adults, children and young people, which included BMI.
The Government accepts NICE’s evidence review and recommendations on BMI, including that: BMI is used as a practical measure of overweight and obesity in both adults and children and young people but needs to be interpreted with caution because it is not a direct measure of central adiposity, the accumulation of excess fat in the abdominal area which directly relates to health risks such as type 2 diabetes, hypertension and cardiovascular disease; in adults with a BMI below 35 kilograms per metre squared, waist-to-height ratio should be measured and used as well as BMI, as a practical estimate of central adiposity; in children or young people with a BMI on or above the 91st centile, waist to height ratio should be measured to estimate the degree of central adiposity to help identify or predict future health risks; and a child’s BMI centile should always be plotted on the Royal College of Paediatrics and Child Health UK-World Health Organization growth charts and BMI charts.
NICE also recommended further research, for adults as well as children and young people, on the most accurate and suitable measurements and boundary values to assess the health risks associated with overweight, obesity and central adiposity in people of different ethnicities, particularly those from black, Asian and minority ethnic family backgrounds.
The Department have noted NICE’s recommendations for research. The Department delivers research through the National Institute for Health and Care Research, which funds and supports research across all areas of health and social care, including obesity. Research proposals in all areas compete for the funding available, with awards made on the basis of scientific quality, value for money, and importance of the topic to patients and the health and care system.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of why their target for sugar reduction in food and drink has not been met.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Assessments have been made of why the overall 20% reduction ambition for the voluntary sugar reduction programme has not been delivered. The progress monitoring for retailers and manufacturers for the sugar reduction programme, which is what is being referred to, uses sales weighted averages. These are calculated by weighting mean sugar levels by total volume sales. This gives more weight to products with higher volume sales.
Between 2015 and 2020, good levels of reduction were seen in sales weighted average sugar levels in some categories included in the programme for retailers and manufacturers, including reductions of approximately 15% in breakfast cereals, 13.5% in yogurt and fromage frais, and 7.2% in ice creams, lollies and sorbets.
However, increases were seen in the volume sales of higher sugar products included in the programme, for retailers and manufacturers between 2015 and 2020, including a 32% increase in sweet spreads and sauces and a 27.8% increase in chocolate confectionery. When calculating the overall, sales weighted average sugar reduction figure of 3.5%, these increase in sales negate the reductions made in breakfast cereals and other categories included in the programme.
It is also more difficult for some products included in the programme to reduce sugar levels. Some of these categories have instead taken action to reduce calorie levels, with sales weighted average calorie levels for retailers and manufacturers reducing by 7.1% in ice creams, lollies and sorbets, 4.3% in cakes and 3.2% in chocolate confectionery. These are not included in the overall assessment of sugar reduction achieved to date of 3.5%.
Due to limitations with the data, it is not possible to produce sales weighted average figures for the eating out of home sector, so changes made to products sold in these businesses are not covered in the data above.
The Major Conditions Strategy: case for change and strategic framework, included a commitment to continue to work with stakeholders and industry to reduce levels of sugar, calories and salt, including in baby food and drink.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are considering using the new screening technology, developed by OsteoSight, for estimating bone mineral density from routine X-rays that has been approved by the Food and Drug Administration in the United States to give earlier diagnosis of osteoporosis.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
OsteoSight is not a registered product with the Medicines and Healthcare Products Regulatory Agency, therefore the Government is not currently considering the use of this technology. However, we will continue to explore areas where artificial intelligence can be deployed in health and care to support clinicians, transform patient experience and improve outcomes.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government why fracture liaison services were not included in the ‘Delivery plan for tackling the COVID-19 backlog of elective care’ published in February 2022; how much of the £8 billion committed to support elective recovery under that plan has been allocated to fracture liaison services; and, if none, what were the reasons for that.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The allocation of funding from the Elective Recovery Fund (ERF) would be a local decision for providers applying the guidance, so we are unable to provide a national picture of spending specifically on fracture liaison services (FLS). FLS’ may be included in, and have benefited from, the ERF if those community providers submit to the Secondary Uses Service outpatient activity, and if the activity falls under an ERF treatment function.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have plans to set up an expert steering group on fracture liaison services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value of quality-assured secondary fracture prevention services, including fracture liaison services (FLS). Over 3 million people are estimated to have osteoporosis in the United Kingdom, and over 500,000 patients present with fragility fractures to hospitals each year.
On the 24 January 2023, we announced our plan to publish the Major Conditions Strategy: Case for change and our strategic framework. This strategy will explore how we can tackle the key drivers of ill-health in England, reduce pressure on the National Health Service and reduce ill-health related labour market inactivity. The strategy will focus on six major groups of conditions including musculoskeletal conditions, such as osteoporosis. Aligning work across several groups of conditions will allow us to focus on where there are similarities in approach and ensure care is better centred around the patient.
As per the strategy, the Government will, together with NHS England, explore supporting the provision of fracture liaison services. This includes ongoing engagement with NHS England on musculoskeletal conditions such as osteoporosis as well as preventative interventions such as FLS. In addition, we engage with a range of groups and organisations across musculoskeletal conditions and those with lived experience.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the correlation between the deprivation and availability of fracture liaison services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has not made an assessment on the correlation between the deprivation and availability of fracture liaison services (FLS). The Fracture Liaison Service Database Annual Report 2023 examines differences in FLS performance based on age, gender and care home residence for 2021, a copy of which is attached. The Falls and Fragility Fracture Audit Programme is also planning to report on social deprivation and ethnicity in the future.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1798), in what circumstances the economic benefits of improved healthcare are assessed.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Economic assessment is undertaken in support of Governmental decision-making, particularly where significant new or existing public resources are required. HM Treasury’s Green Book provides detail of this and sets out guidance on appraising the impacts of government policy. These include employment and productivity effects, environmental impacts and changes in risks to life or health.
The Green Book guidance covers spending control processes, including the development of business cases, as well as regulatory control processes, including regulatory impact assessments.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1798), why there are no timescales for reaching the achievable target of 80 per cent for breast cancer screening.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has developed an internal national plan in collaboration with key stakeholders to improve uptake within the breast screening programme from 2023 and beyond. This plan will encompass a series of evaluative projects which are expected to report by April 2024
There is currently no intention of publishing the internal plan, but it is available on the NHS Futures Platform. This is a collaboration platform that empowers everyone working in health and social care to safely connect, share and learn across boundaries.
NHS England and the Department are working in collaboration to establish a set of improvement objectives. Rather than a timescale for reaching the target of 80%, each region has a local improvement plan and are working to reach the agreed efficiency standard following restoration of services post COVID-19 pandemic. It was agreed that a quantified focus on reducing variation was preferable to setting timescales.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1800), why the improvement plan for the NHS breast screening programme is not set to be published.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has developed an internal national plan in collaboration with key stakeholders to improve uptake within the breast screening programme from 2023 and beyond. This plan will encompass a series of evaluative projects which are expected to report by April 2024
There is currently no intention of publishing the internal plan, but it is available on the NHS Futures Platform. This is a collaboration platform that empowers everyone working in health and social care to safely connect, share and learn across boundaries.
NHS England and the Department are working in collaboration to establish a set of improvement objectives. Rather than a timescale for reaching the target of 80%, each region has a local improvement plan and are working to reach the agreed efficiency standard following restoration of services post COVID-19 pandemic. It was agreed that a quantified focus on reducing variation was preferable to setting timescales.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government what is the incidence over the last 24 months of spouses or partners who use their spouse's or partner's NHS records in custody and other disputes.
Answered by Lord Bellamy - Parliamentary Under-Secretary (Ministry of Justice)
The information requested could only be obtained at disproportionate cost.
The data readily available to the Government does not enable the Government to determine whether, and if so to what extent, spouses or partners have used their spouses’ or partners’ NHS records in custody or other disputes. The use of NHS data in such circumstances without consent would in normal circumstances constitute a breach of patient confidentiality.