Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Lord Evans of Rainow on 14 September (HL Debate, col 241GC), why the “package of prioritised measures to expand the provision of fracture liaison services and improve their current quality” was not mentioned in the Autumn Statement.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Noble Lord's letter of 15 September 2023 following the debate confirmed the position that the Government would continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison services (FLS). A copy of this letter was placed in the House library.
FLS are commissioned by integrated care boards (ICBs) which are well placed to make decisions according to local need. NHS England is also supporting requests from health systems to introduce FLS and other secondary fracture prevention services, including through the Falls and Fragility Fracture Audit Programme.
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. 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.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have any plans to collaborate with media organisations, social media influencers, and public figures including celebrities, to portray accurate and empathetic representations of people living with HIV in order to counteract harmful stereotypes; and, if so, what are their plans.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
HIV Prevention England (HPE) is the national HIV prevention programme for England and is funded at £3.5 million by the Department. The programme aims to support communities who are disproportionately affected by HIV, including gay, bisexual and men who have sex with men and Black African heterosexual men and women. The Department has appointed Terrence Higgins Trust, a national charity who provide services related to sexual heath and HIV, to deliver the programme from 2021 to 2024. HPE delivers a nationally co-ordinated programme of HIV prevention work, including public campaigns such as National HIV Testing Week, that is designed to complement locally commissioned prevention activities in areas of high HIV prevalence. HPE also aims to improve knowledge and understating of HIV transmission and reducing stigma within affected communities.
HPE works with a wide range of models and their network of influencers and develops its strategies based on comprehensive data, audience insight and knowledge from local partners within England which ensure a wide range of patient’s voices and experiences are represented.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are planning to implement comprehensive public education campaigns to raise awareness about HIV transmission and treatment advancements, and to tackle stigma; and, if so, what are their plans.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
HIV Prevention England (HPE) is the national HIV prevention programme for England and is funded at £3.5 million by the Department. The programme aims to support communities who are disproportionately affected by HIV, including gay, bisexual and men who have sex with men and Black African heterosexual men and women. The Department has appointed Terrence Higgins Trust, a national charity who provide services related to sexual heath and HIV, to deliver the programme from 2021 to 2024. HPE delivers a nationally co-ordinated programme of HIV prevention work, including public campaigns such as National HIV Testing Week, that is designed to complement locally commissioned prevention activities in areas of high HIV prevalence. HPE also aims to improve knowledge and understating of HIV transmission and reducing stigma within affected communities.
HPE works with a wide range of models and their network of influencers and develops its strategies based on comprehensive data, audience insight and knowledge from local partners within England which ensure a wide range of patient’s voices and experiences are represented.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many sick days a year are caused by osteoporotic fractures; whether they have conducted any studies into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on this figure; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
23.4 million days were lost due to sickness absence in 2022 where the condition given was a musculoskeletal condition. This represented 12.6% of all days lost to sickness absence and was the third most common reason. Musculoskeletal conditions include back pain, neck and upper limb problems and other musculoskeletal conditions. This may include osteoporosis but sickness absence data for this specific condition is not held by the Department.
The International Osteoporosis Foundation’s report ‘BROKEN BONES, BROKEN LIVES: A roadmap to solve the fragility fracture crisis in Europe’ found that the total number of sick days taken after a fragility fracture in the United Kingdom in 2017 was over 2.5 million days. No studies have been carried out into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on sick days caused by osteoporotic fractures, and there are currently no plans to commission any.
In August 2023, we set out our initial plans for the Major Conditions Strategy within the Case for Change and our Strategic Framework. This initial report sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy. This included, together with NHS England, exploring further supporting the provision of Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have conducted any studies into the savings which would accrue to the NHS from investment to enable universal, high-quality Fracture Liaison Services across England; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We continue to work closely with stakeholders, including the Royal Osteoporosis Society, to further understand the needs of people living with osteoporosis and consider how health and care services can better support them. Fracture Liaison Services are key to prompt diagnosis of osteoporosis and are acknowledged as the world standard for secondary fracture prevention. According to the Royal Osteoporosis Society, for every £1 spend on Fracture Liaison Services in the United Kingdom, £3.26 is saved by the National Health Service.
The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have made any assessment of the impact of fragility fractures caused by undiagnosed osteoporosis on informal care-givers of working age; and what the impact of this is on the labour market.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Unpaid carers play a vital role in our communities, and we all owe them a debt of gratitude. We want unpaid carers to live healthy and fulfilling lives alongside their caring role.
No assessment, specifically on the impact of fragility fractures caused by undiagnosed osteoporosis on informal caregivers of working age; and what the impact of this is on the labour market, has been made. However, the Care Act (2014) requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for unpaid carers. Local authorities are required to undertake a Carer’s Assessment for any unpaid carer who appears to have a need for support and to meet their eligible needs on request from the carer.
In 2023/24, £327 million of funding from the Better Care Fund have been earmarked to provide short breaks and respite services for carers. This also funds additional advice and support to carers and a small number of additional local authority duties.
The enormous contribution made by unpaid carers is reflected throughout the social care reform white paper People at the Heart of Care, published in December 2021, and Next Steps to put People at the Heart of Care, published in April 2023.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to their commitment in the Major Conditions Strategy: case for change and our strategic framework, published on 14 August and updated on 21 August, to set up more fracture liaison services, whether the responsibility for that initiative lies with the Department of Health and Social Care or with NHS England.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
In August 2023, we set out our initial plans for the Major Conditions Strategy within the Case for change and our strategic framework. This initial report sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy. This includes, together with NHS England, exploring further support for the provision of Fracture Liaison Services. This could include identifying people at risk of further osteoporotic fragility fracture and implementing strategies to reduce the risk of future fracture (including falls) and mortality.
The final strategy will be published in early 2024.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of by the scientific accuracy of the Health and Safety Executive's guidance on blood borne virus transmission.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Health and Safety Executive (HSE) is Britain’s national regulator for workplace health and safety. It prevents work-related death, injury and ill health. No assessment has been made, however the HSE guidance on bloodborne virus transmission references current UK Health Security Agency (UKHSA) scientific evidence on risk of transmission of blood-borne viruses.
UKHSA provides advice on management of exposure to blood-borne viruses in occupational settings through its local, regional and national health protection function and through specialist advice from its national team. UKHSA also hosts the UK Advisory Panel for Healthcare Workers living with Bloodborne Viruses which provides advice about the transmission and management of bloodborne viruses among healthcare workers
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government further to the Written Statement by Lord Markham on 8 June (HLWS826), what assessment they have made of the incidence of HIV in (1) women, and (2) heterosexual men, between 2019 and 2021; and what steps they are taking to improve this.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency is currently developing a methodology to estimate incidence among heterosexual men and women based on the methodology currently used to produce estimates of incidence for gay, bisexual and other men who have sex with men. As estimates of incidence are not available for heterosexual men and women, new diagnoses first made in the United Kingdom are used as a proxy and interpreted in context of levels of HIV testing amongst those populations.
Between 2019 and 2021, there was a slight increase in HIV diagnoses and late HIV diagnoses among heterosexuals, whilst HIV testing coverage remained substantially lower in 2021 than in 2019. In addition, the estimated number of undiagnosed people among heterosexual men and women did not decline over the same period. These figures suggest that there was no fall in incidence in this population.
The HIV Action Plan published in 2020 aims to reduce new HIV infections by 80% between 2019 and 2025 and details a range of actions committed to in order to help achieve this ambition.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of opt-out HIV testing in emergency departments in areas of London with high HIV prevalence.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed £20 million in 2022 to 2025 to fund the expansion of HIV opt-out testing in emergency departments (EDs) in areas with extremely high HIV prevalence. The NHS England London region took a decision to include all EDs in the project, which included some of which were in high HIV prevalence areas.
Provisional data from NHS England indicates that this HIV opt-out testing initiative has helped find more than 550 cases of undiagnosed or untreated HIV in the first year of the programme. We are currently considering the results of the first year of HIV opt-out testing and the programme’s contribution to finding cases of undiagnosed or untreated HIV and preventing further HIV transmissions, alongside data on progress towards our ambitions to end new HIV transmissions, AIDS and HIV-related deaths within England by 2030.