Asked by: Beccy Cooper (Labour - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to update guidance to Integrated Care Boards (ICBs) on the need to offer gluten free staples on NHS prescription for people with coeliac disease.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
NHS England has no plans to update the guidance. The Department undertook a national consultation in 2017 on the prescribing of gluten-free (GF) foods in primary care. The rationale for this was the increased availability of these products in supermarkets and other food outlets at a time when the annual cost to the National Health Service of prescribing such items was £15.7 million. The first of these proposed changes to prescribing arrangements resulted in the Government’s decision to restrict NHS prescribing of such foods to only bread and mixes.
NHS England’s guidance, Prescribing Gluten-Free Foods in Primary Care, was developed to communicate to local commissioners, now integrated care boards (ICBs), the changes in legislation. Wording is included in the guidance which states that commissioners may further restrict the prescribing of GF foods by selecting bread or mixes only, or may choose to end the prescribing of GF foods altogether if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and provided they have regard to reducing health inequalities. In NHS England’s guidance, there are no limits on the amount of bread or mixes that can be prescribed. This guidance is available at the following link:
Decisions about the commissioning and funding of local health services are the responsibility of local ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practice. The guidance does not remove the clinical discretion of prescribers in accordance with their professional duties.
Asked by: Beccy Cooper (Labour - Worthing West)
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 assessment of the potential merits of ensuring people with lung conditions are given an annual (a) review and (b) medication check.
Answered by Andrew Gwynne
Annual reviews, including reviews of medication, play a key role in the ongoing management of people with respiratory diseases, such as asthma and chronic obstructive pulmonary disorder (COPD). They are recommended by the National Institute for Health and Care Excellence (NICE), playing a core part in its guidance for the diagnosis and management of asthma and COPD. Further information on the NICE’s guidance for the diagnosis and management asthma and COPD is available respectively at the following two links:
https://www.nice.org.uk/guidance/ng80
https://www.nice.org.uk/guidance/ng115
The majority of patients with COPD and asthma are managed by general practitioners and members of the primary care team, with onward referrals to secondary care where required, and so the provision of annual reviews is incentivised in primary care through the Quality and Outcomes Framework. There are specific indicators for annual reviews for both COPD and asthma within this framework, specifically sections COPD010 and AST007. The Quality and outcomes framework guidance for 2024/25 is available at the following link:
https://www.england.nhs.uk/publication/quality-and-outcomes-framework-guidance-for-2024-25/
The NICE is currently reviewing its guideline for the diagnosis, monitoring, and management of chronic asthma, and an updated version is due to be published in November 2024. Based on the draft that has been published for consultation, we anticipate annual reviews will remain a recommended core component of the ongoing management of people with asthma.
Asked by: Beccy Cooper (Labour - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will commission a review into the adequacy of adult liver services across the NHS.
Answered by Andrew Gwynne
There are currently no plans for a review into the adequacy of adult liver services across the National Health Service. The commissioning of services for liver disease is generally the responsibility of integrated care systems (ICS). ICS are responsible for decisions on commissioning health services and reviewing those services to ensure they best meet the needs of their local population.
NHS England has a Hepatobiliary and Pancreas Clinical Reference Group (CRG) which provides clinical advice to NHS England in support of the commissioning of specialised services. By working in partnership with key stakeholders, the CRG helps drive improvements in the quality, equity, experience, efficiency, and outcomes of specialised services. The CRG is currently reviewing its service specification in relation to liver and pancreatic care, which is scheduled for completion before the end of the current financial year.
Asked by: Beccy Cooper (Labour - Worthing West)
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 impact of physical advertising for unhealthy food products on levels of child obesity.
Answered by Andrew Gwynne
No assessment has been made of the potential impact of outdoor physical advertising for less healthy food and drink products on levels of child obesity. However, the Government welcomes recent action at a local level to ban junk food marketing across public transport networks and public spaces that are controlled locally.
Supporting people to stay healthier for longer is at the heart of the Government’s Health Mission. This includes taking bold action to tackle the childhood obesity crisis and create the healthiest generation of children ever.
The Government has committed to implementing the advertising restrictions set out in the Communications Act 2003 on less healthy food and drink products without further delay. The regulations introduce a 9:00pm watershed for the advertisement of less healthy food or drink products on television, and a total restriction of paid-for advertising of these products online, which will come into force United Kingdom-wide on 1 October 2025.
Evidence shows that these restrictions will have a direct impact on childhood obesity by reducing children’s exposure to advertising of less healthy products. We estimate that these restrictions will remove up to 7.2 billion calories from children’s diets per year in the UK, and reduce the number of children living with obesity by 20,000.
Asked by: Beccy Cooper (Labour - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the timeframe is for implementation of the review by Lord Darzi entitled Independent Investigation of the National Health Service in England, published on 12 September 2024.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Lord Darzi’s full report has laid bare the true extent of the challenges facing our health service, giving us the frank assessment necessary to face these problems honestly and properly and do the hard work required to fix them. Lord Darzi’s findings will inform our 10-year plan to radically reform the National Health Service and build a health service that is fit for the future.
The plan will consider the change needed to meet the three health mission goals; a fairer system where everyone lives well for longer, an NHS that is there when people need it, and fewer lives lost to the biggest killers. This is a long-term challenge and will take time to deliver, and so the plan will consider both what immediate actions are needed to get the NHS back on its feet and bring waiting lists down, as well as the longer-term changes needed to make the health service fit for the future.
Alongside the 10-year health plan we are also taking action to address immediate challenges in the health service, such as hiring a thousand more general practitioners and ending junior doctor strikes. We have also committed to cut NHS waiting times with 40,000 more appointments every week, double the number of cancer scanners, develop a new Dentistry Rescue Plan, hire 8,500 additional mental health staff, and ensure the return of the family doctor.
Asked by: Beccy Cooper (Labour - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to increase the numbers of (a) health visitors and (b) school nurses.
Answered by Andrew Gwynne
We are committed to creating the healthiest generation of children ever. To achieve this, we must ensure that families have the support they need to give their babies and children the best start and the building blocks for a healthy life.
The child health workforce, including health visitors and school nurses, is central to how we support families to give their child the best start in life. Their contact with parents, carers and children of all ages provides vital advice and support and helps ensure that health, development, and safeguarding needs are identified early.
We are committed to training the staff we need to ensure patients, their carers and their families are cared for by the right professional, when and where they need it. We will want to assure ourselves, and the National Health Service, that the current plan will deliver the reform needed. We will need to do this in light of the 10 Year Plan.
Asked by: Beccy Cooper (Labour - Worthing West)
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 adequacy of pathways for the earlier detection of non-alcohol related fatty liver disease.
Answered by Andrew Gwynne
There are 10 community diagnostic centres (CDC) currently providing ultrasound liver elastography, otherwise known as a fibroscan. NHS England has plans to understand the diagnostic pathways for liver disease and how CDCs can further support this.
The pathway for assessing liver disease should start with blood tests taken in primary care, with FIB-4 liver tests available at National Health Service trusts.
Asked by: Beccy Cooper (Labour - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce the prevalence of non-alcohol related fatty liver disease in children.
Answered by Andrew Gwynne
NHS England is assessing the role of screening for non-alcoholic fatty liver disease in children as part of the initial 30 Complication from Excess Weight clinics. Children and young people are assessed within these clinics for a range of physical and mental health problems associated with excess weight with the intention to provide early interventions. The efficacy of this approach is currently being evaluated by the National Institute for Health and Care Research.
Asked by: Beccy Cooper (Labour - Worthing West)
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 assessment of the potential merits of allowing parents to buy first-stage baby formula using (a) loyalty points, (b) grocery vouchers, (c) food bank vouchers and (d) other cash-equivalent methods.
Answered by Andrew Gwynne
Infant formula legislation sets robust nutritional and compositional standards to ensure that all infant formula meets the nutritional needs of babies for healthy growth and development, irrespective of brand or price. The legislation also restricts the marketing and promotion of infant formula so as not to discourage breastfeeding. This is in line with our international commitments to support the World Health Organisation International Code of Marketing of Breastmilk Substitutes to promote breastfeeding.
The Department has published guidance on infant and follow-on formula and food for special medical purposes, including specialist infant formulas, which advises businesses on the implementation of the regulations. Loyalty and reward card schemes vary between retailers, and it is for businesses to ensure that their activities are in compliance with the regulations on a case by case basis.
The Competition and Markets Authority (CMA) is undertaking a market study into competition in the infant formula sector in the United Kingdom. It is gathering evidence on: consumer behaviour, the drivers of choice, and the information and advice available to consumers to support their decisions; the role of the regulatory framework and its enforcement in influencing market outcomes; and the supply-side features of the market such as barriers to entry and expansion. The CMA’s market study is expected to publish an interim report in October 2024. We look forward to the CMA’s interim report into this issue and we will carefully consider any findings and recommendations for the regulatory framework for infant formula.
Asked by: Beccy Cooper (Labour - Worthing West)
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 establish a health mission board.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
My Rt. Hon. Friend, the Secretary of State for Health and Social Care, chairs a cross-government Health Mission Board to oversee and drive delivery of the health mission to ‘build a health and social care system fit for the future'.