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Written Question
Fungi: Infectious Diseases
Tuesday 27th September 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the current level of funding for research into fungal infections is; and what the projected budget for such research is for the next five years.

Answered by Robert Jenrick

The Department’s National Institute for Health and Care Research (NIHR) welcomes funding applications for research into any aspect of human health, including fungal infection research. However, 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. In the last five years, the NIHR has invested more than £6 million in research into fungal infection.


Written Question
Fungi: Infectious Diseases
Thursday 22nd September 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential risks posed by treatment resistant fungal infections.

Answered by Caroline Johnson - Shadow Minister (Health and Social Care)

Misuse and overuse of antimicrobials, such as fungal agents, is a factor in the development of drug-resistant pathogens. NHS England’s national pharmacy and prescribing clinical lead is supported by seven regional antimicrobial stewardship (AMS) leads. These AMS leads collaborate with regional National Health Service stakeholders and partner organisations, including infection prevention and control, patient safety, diagnostics and sepsis teams, the Department, the UK Health Security Agency (UKHSA), Health Education England and the Care Quality Commission, to contribute to multi-professional endeavours to mitigate the threat of antimicrobial resistance (AMR).

NHS England’s AMR diagnostics team advise that high-level research has been undertaken to understand the need for optimal fungal diagnostics and resistance testing. This has highlighted opportunities for improvement in data collection regarding the use of diagnostics, surveillance and consistent access to diagnostics.

The UKHSA reports on antifungal resistance against systemic antifungals utilised in the treatment of candidaemia, in the English Surveillance Programme for Antimicrobial Utilisation and Resistance report. Resistance to the key antifungals, amphotericin B, caspofungin and fluconazole, appears to have been decreasing in all Candida species. Fluconazole resistance decreased from 8.2% of Candida blood isolates tested in 2016 to 3.2% in 2020. Resistance to amphotericin B and caspofungin decreased slightly from 2016 to 2020, by 1.3% to 1.1%, and 3.4% to 3.3% respectively.


Written Question
Fungi: Infectious Diseases
Thursday 22nd September 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an estimate of the number of (a) patients admitted to hospital and (b) patients receiving medical treatment following a fungal infection in each of the last 3 years.

Answered by Caroline Johnson - Shadow Minister (Health and Social Care)

This information is not held in the format requested. However, the following table shows the number of person IDs with a primary diagnosis of fungal infection and finished admission episodes (FAEs) and finished consultant episodes (FCEs) where a main procedure took place in 2019/20 and 2020/21 in English National Health Service hospitals and English NHS commissioned activity in the independent sector.

Year

Number of person IDs with a primary diagnosis

Number of person IDs with a primary diagnosis with a procedure

2019/20

7,638

5,483

2020/21

5,224

3,674

Source: NHS Digital

Notes:

  1. Person IDs. The Master Person Service (MPS) person identifier. This is a unique identifier for each individual patient, generated via the MPS. This identifier replaces the HESID field and allows an individual’s care to be tracked across years and continuous periods to be identified.
  2. Primary Diagnosis. The primary diagnosis is the first of up to 20 (14 from 2002/03 to 2006/07 and seven prior to 2002/03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.
  3. ICD-10 coding and description. The following ICD-10 codes are indexed under the term ‘fungal infection’:

- B49.X Unspecified mycosis

- B20.5 HIV disease resulting in other mycoses

- B35.0 Tinea barbae and tinea capitis

- B35.1 Tinea unguium

- B35.2 Tinea manuum

- B35.3 Tinea pedis

- B35.6 Tinea cruris

- B36.9 Superficial mycosis, unspecified

- B48.7 Opportunistic mycoses

Research indicates that fungal infections are also known as mycosis, therefore the ICD-10 block B35-B49 Mycoses may be pertinent and has also been included in the data. It should be noted that there may be other codes within the ICD-10 classification which maybe applicable to the condition.

  1. A FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.
  2. A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which it ends. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
  3. Main procedure. The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, for example, time waited, while a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures. It should be noted that some patients are treated for a fungal infection condition during an outpatient appointment. However, diagnoses are extremely seldom recorded in outpatient records, therefore it is not possible to provide useful data from the outpatient data set.
  4. HES figures are available from 1989/90 onwards. Changes to the figures over time should be interpreted in the context of improvements in data quality and coverage particularly in earlier years, improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

Data is also held on total systemic antifungal prescribing in NHS hospital trusts recorded as defined daily doses (DDDs) per 1,000 admissions per day in 2020. The total consumption of antifungals in NHS acute trusts in 2020 was 0.63 DDDs per 1,000 admissions per day. This is a 21% increase in the rate of prescribing from 2019. The collection of the NHS England’s antifungal commissioning for quality and innovation data was interrupted by COVID-19.


Written Question
Operose Health: Staff
Thursday 23rd June 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of the report by Panorama that Operose Health have used less qualified staff to consult with patients without supervision.

Answered by Maria Caulfield

Physician associates (PAs) are not a substitute for a general practitioner. The use of PAs in primary care is detailed in the Network Contract Directed Enhanced Service, which describes the role and the tasks a PA funded by the Additional Role Reimbursement Scheme (ARRS) would be expected to undertake. It also references the expectation of the supervision of PAs. NHS England and NHS Improvement have committed to review the ARRS by the end of 2023.


Written Question
NHS: Protective Clothing
Wednesday 26th January 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what was the cost of personal protective equipment purchased by the NHS in 2021; and how much and what proportion of that equipment was manufactured in the UK.

Answered by Edward Argar

The vast majority of personal protective equipment was supplied under contracts agreed in 2020, with deliveries into 2021 and 2022. Payments authorised in 2021 show a total of 1.36 billion items at a purchase price of £795 million. Of those, 846 million items or 62% were supplied by United Kingdom manufacturers at a purchase price of £704 million.


Written Question
Medical Equipment and Protective Clothing: Imports
Tuesday 11th January 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department has taken to prevent imports of medical goods and personal protective equipment produced by forced labour.

Answered by Edward Argar

The Department published its Modern Slavery statement in October 2021 which is available at the following link:

https://www.gov.uk/government/organisations/department-of-health-and-social-care/about/modern-slavery-statement

Contracts are normally placed in line with Departmental terms and conditions which include clauses requiring Good Industry Practice to ensure that there is no slavery or human trafficking in supply chains. Suppliers appointed to NHS Supply Chain framework contracts, which provide the majority of medical goods and services to the National Health Service, must comply with the Labour Standards Assurance System or they can be removed from consideration for future procurement.

The Department was aware that the direct, urgent sourcing and purchasing of personal protective equipment in 2020 involved higher risks in ethical and business practices and had a number of mitigations in place. The Department of Health and Social Care engaged with NHS Supply Chain, the Home Office and the Foreign and Commonwealth Development Office regarding modern slavery concerns in awarding contracts. Additional training and guidance was distributed to strengthen buying professionals’ knowledge of modern slavery risks specific to the pandemic.


Written Question
Coronavirus: Protective Clothing
Tuesday 11th January 2022

Asked by: Lord Spellar (Labour - Life peer)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the oral contribution of the Parliamentary Under-Secretary of State for Health and Social Care, on 11 November 2020, Official Report, column 1022, regarding the production of PPE in the UK, what was the percentage of PPE produced in the UK in the most recent month for which figures are available.

Answered by Edward Argar

This information is not available in the format requested. However, of 36.4 billion items ordered by 6 December 2021, 3.9 billion were ordered from United Kingdom manufacturers.


Speech in Commons Chamber - Mon 13 Dec 2021
Covid-19 Update

"It is clear from the Secretary of State’s statement that he is a considerable improvement on his predecessor, so I am sure that he accepts that covid is now endemic and variants will probably emerge for years, if not decades. In that case, surely by now, instead of the erratic …..."
Lord Spellar - View Speech

View all Lord Spellar (Lab - Life peer) contributions to the debate on: Covid-19 Update

Speech in Commons Chamber - Tue 23 Nov 2021
Oral Answers to Questions

"7. What assessment he has made of the viability of the community pharmacy sector. ..."
Lord Spellar - View Speech

View all Lord Spellar (Lab - Life peer) contributions to the debate on: Oral Answers to Questions

Speech in Commons Chamber - Tue 23 Nov 2021
Oral Answers to Questions

"That is a welcome response from the Minister, and shows that she and the Department now seem to recognise our pharmacies for their magnificent efforts during the pandemic, providing frontline primary care and delivering and encouraging vaccination. Will she further recognise their expertise and dedication, and push rapidly forward with …..."
Lord Spellar - View Speech

View all Lord Spellar (Lab - Life peer) contributions to the debate on: Oral Answers to Questions