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 many fully qualified GPs have been recruited since the general election (1) under the Additional Roles Reimbursement Scheme, and (2) through any other route; and whether they have set a target for the number of full-time equivalent GPs per 1,000 population in England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Information on the number of recently qualified general practitioners (GPs) for which primary care networks are claiming reimbursement via the Additional Roles Reimbursement Scheme is currently being collated. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published. Between 31 July 2024 and 30 November 2024, the headcount of fully qualified GPs increased by 831.
There is no NHS England recommendation for how many patients a GP should have assigned, or the ratio of GPs or other practice staff to patients. The demands each patient places on their GP are different and can be affected by many different factors, including rurality and patient demographics. It is necessary to consider the workforce for each practice as a whole, not only GPs but also the range of health professionals available who are able to respond to the needs of their patients.
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 align the use of chlorhexidine in healthcare and consumer products with the recommendation in the Joint Royal College of Surgeons of England and Medicines and Healthcare products Regulatory Agency Statement on use of Topical Chlorhexidine for Skin Preparation Prior to Surgery, calling for the use of licensed medicinal products over unregulated biocidal forms to prevent antimicrobial resistance and safeguard patient safety.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency, as the regulator for medicines and medical devices in the United Kingdom, continues to recommend the use of licensed medicines to prepare the skin prior to surgery. Use of an appropriately authorised product for its specific intended use, in accordance with the manufacturer’s instructions for use, is the only way to ensure the benefit-risk balance remains favourable.
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 letter of 22 October signed by the Covid Airborne Transmission Alliance addressed to the chief nursing officers of the four nations about expert evidence provided to the Covid-19 Inquiry, particularly about the airborne transmission of the virus and other respiratory viruses; and when they expect a response to the letter to be issued.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Chief Nursing Officer for England has stated that a range of evidence on the issue of routes of transmission of COVID-19 was presented to the COVID-19 Inquiry during their examination of the impact of the pandemic on healthcare systems across the United Kingdom.
A response from the UK Chief Nursing Officers to the letter from the Covid Airborne Transmission Alliance will be sent shortly.
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 have taken to ensure that the NHS and other services are following the prescribing standards stating that, from 13 December 2024, healthcare professionals working in designated physician associate or anaesthesia associate roles should not prescribe medicines, even if they hold prescribing rights from a previous profession or have previously been authorised to prescribe by their employer.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The physician associate (PA) and anaesthesia associate (AA) professions do not have prescribing responsibilities. Prescribing responsibilities are conferred upon specific professions by the Human Medicines Regulations 2012 and are not transferable to another regulated role or profession.
NHS Employers has recently published guidance which sets out information for employers on the PA and AA roles and how they fit within the National Health Service. This includes setting out information about prescribing and the supply and administering of medicines.
Subject to locally determined governance arrangements, a PA or AA may administer medicines under a patient specific direction (PSD). A PSD is a written instruction, signed by an authorised prescriber, for medicine or medicines to be administered to a named person after the prescriber has assessed the patient.
As the regulator of PAs and AAs, the General Medical Council has also published information on its website confirming that the roles are not able to prescribe.
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 many physician associates currently working in the NHS or in private healthcare have not passed the Physician Associate National Examination; and whether they plan to ensure that physician associates currently working have passed it before the deadline for registering with the General Medical Council in December 2026.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold data on how many Physician Associates (PAs) currently working in the National Health Service or in private healthcare have not passed the Physician Associate National Examination (PANE).
Statutory regulation of PAs and Anaesthesia Associates (AAs) by the General Medical Council (GMC) has begun. The GMC has made it a mandatory registration requirement for all PAs to have passed the PANE. Under the Anaesthesia Associate and Physician Associate Order, PAs and AAs must join the GMC register or cease practising by December 2026.
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 they plan to ensure that medical schools have integrated antimicrobial stewardship competencies into undergraduate curriculums, to help meet the aims of the five-year antimicrobial resistance action plan; and whether the Department of Health and Social Care is primarily responsible for coordinating this with the General Medical Council and the Department for Education.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The standard of medical training is the responsibility of the General Medical Council (GMC), which is an independent statutory body. The GMC has the general function of promoting high standards of education and co-ordinating all stages of education to ensure that medical students and newly qualified doctors are equipped with the knowledge, skills, and attitudes essential for professional practice.
Each individual medical school sets its own undergraduate medical curriculum. This has to meet the standards set by the GMC, who then monitor and check to make sure that these standards are maintained. Whilst curricula do not necessarily highlight specific conditions for doctors to be aware of, they instead emphasise the skills and approaches that a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.
The NHS England Antimicrobial Resistance Programme, a prescribing workstream, has collaborated with the Workforce Training and Education directorate to co-produce, with stakeholders from university schools of pharmacy, an indicative curriculum and competency framework for antimicrobial resistance and antimicrobial stewardship, as a part of the new initial education and training programme for United Kingdom pharmacists who will graduate with independent prescribing rights from 2025/26. The prescribing workstream has plans to make contact with the GMC and the Nursing and Midwifery Council during 2025/26 to establish how antimicrobial stewardship is taught and examined in undergraduate medical and nursing courses in England, and to support improvement as required.
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 whether the independent review of physician associate and anaesthesia associate professions, led by Professor Gillian Leng CBE, will consider the impact of physician and anaesthetist associates on the availability of training places for junior doctors, the nature and structure of junior doctor training programmes, and the levels of remuneration for junior doctors.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the published Terms of Reference, the Leng review will be an end-to-end review of the Physician Associate and Anaesthesia Associate professions, covering selection and recruitment, training, day to day work, scope of practice, oversight, supervision, and professional regulation.
As part of the deal agreed between the Government and the British Medical Association (BMA) Resident Doctors Committee, the Government has committed to work in partnership with the BMA and other health organisations to review the current system of training and rotational placements for resident doctors. This work is being taken forward outside the Leng Review.
The levels of remuneration for resident doctors are not in scope of the review, as the Review Body on Doctors' and Dentists' Remuneration advises the Government on rates of pay for doctors and dentists.
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 whether they are funding or part-funding the General Medical Council's defence against the legal challenge to the registration of anaesthetist and physician associates; and if so, why.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is funding the General Medical Council (GMC) to undertake the work required to introduce regulation for Anaesthesia Associates (AAs) and Physician Associates (PAs), to avoid doctors paying for this through their registrant fees.
A longstanding principle underpinning the introduction of statutory regulation for new professions is that all related-costs, including legal challenges to that work, should be funded by the Government, to avoid other professions cross-subsidising the work involved.
Once regulation of AAs and PAs becomes self-funding, the Government will cease funding the GMC.
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 encourage the uptake of antimicrobial stewardship (AMS) principles into undergraduate education across medical, nursing, veterinary and allied health professional degrees; and what steps they will take to engage with academic institutions to ensure future prescribers are equipped to advocate and implement AMS practices effectively.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS England antimicrobial resistance prescribing workstream has collaborated with the Workforce Training and Education directorate to co-produce, with stakeholders from university schools of pharmacy, an indicative curriculum and competency framework for antimicrobial resistance and antimicrobial stewardship, as a part of the new initial education and training programme for United Kingdom pharmacists who will graduate with independent prescribing rights from 2025/26. The prescribing workstream has plans to make contact with the General Medical Council and Nursing and Midwifery Council during 2025/26 to establish how antimicrobial stewardship is taught and examined in undergraduate medical and nursing courses in England, and to support improvement as required.
The UK Health Security Agency has recently updated the antimicrobial prescribing and stewardship competency framework, which is applicable for health students and prescribing courses. The goal of the antimicrobial prescribing and stewardship competency framework is to improve the quality of antimicrobial treatment and stewardship, and therefore reduce the risks of inadequate, inappropriate, and adverse effects of antimicrobial treatment.
The Veterinary Medicines Directorate (VMD) visits the vet schools annually to provide training to undergraduate students on antibiotic stewardship and the responsible use of medicines. The VMD also works with the Vet Schools Council, who are keen to promote antimicrobial research, and raises veterinary student awareness of the importance of the appropriate prescribing of antibiotics. As an example of this, they recently produced a white paper highlighting the importance of collecting and using farm level antibiotic use data to support responsible use of antibiotics.
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 plans they have to integrate work to increase public awareness and understanding of antimicrobial resistance and responsible antimicrobial use into the 2024 to 2029 five-year action plan for antimicrobial resistance.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency (UKHSA) assisted in the development of an antimicrobial resistance (AMR) public awareness target in the 2024 to 2029 National Action Plan (NAP). The target states that ‘by 2029, we aim to increase UK public and healthcare professionals’ knowledge on AMR by 10%, using 2018 and 2019 baselines, respectively’.
The UKHSA will continue to survey the public across the five-year NAP to identify any fluctuations in knowledge from the 2019 baseline. Knowledge on antibiotic use and AMR is lowest amongst 18 to 34-year-olds, therefore we aim to: