Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 exposure to Diethylstilbestrol on children of women who took that drug while pregnant.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicine and Healthcare products Regulatory Agency continuously assesses the benefit and risk balance of all medicines, at the time of initial licensing and throughout their use in clinical practice, carefully evaluating any emerging evidence on their benefits and risks.
In 1971, a US study identified that diethylstilbestrol (DES) could cause a distinct type of cancer in the daughters of women who took DES in early pregnancy. It was subsequently contraindicated in pregnancy, pre-menopausal women, children, and young adults. The issue of DES and vaginal carcinoma in the daughters of women who took DES in pregnancy was reviewed by the predecessor to the Commission on Human Medicines, the Committee on Safety of Medicines (CSM) in the early 1970s. In 1973, the CSM wrote to all doctors to inform them of the results of the US study and the absence of identified cases in the UK.
A small increased risk of breast cancer in women who received DES whilst pregnant was first identified in the 1980s and confirmed in further studies in the 1990s, when a longer follow up of women who had taken DES was available. No increased risk of other cancers has been established, including endometrial cancer or ovarian cancer.
Since 1992, the National Cancer Institute at the US National Institutes of Health has been conducting the DES Follow-up Study of more than 21,000 mothers, daughters, and sons exposed in the womb during the mother’s pregnancy, to better understand the long-term health effects of exposure to DES. The findings of this follow up have been published in scientific literature.
Daughters of individuals exposed to DES are at increased risk of clear cell cancer of the cervix and vagina. The current advice from the UK Health Security Agency, formerly Public Health England, is that routine cervical screening is appropriate for those who believed they were exposed to DES in utero. Further information on the UK Health Security Agency’s advice is available at the following link:
Participation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will provide regular screening for people exposed to Diethylstilbestrol in utero.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK National Screening Committee (UK NSC), which advises the Government on screening programmes, has never been asked to consider the evidence for screening people exposed to diethylstilbestrol in utero.
Any individual or organisation can submit a topic to the UK NSC to consider a new screening programme via the UK NSC’s annual call, with further information available at the following link:
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 ensure that NHS Data Security and Protection Toolkit (a) guidance and (b) training is adequate to ensure that NHS staff are compliant with the UK General Data Protection Regulation when working (i) at their place of work and (ii) remotely.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The main source of the UK General Data Protection Regulation (UK GDPR) and information governance (IG) guidance and advice for health and care is the NHS England IG portal, which is available at the following link:
https://transform.england.nhs.uk/information-governance/
The Data Security and Protection Toolkit (DSPT) includes IG elements to ensure that organisations meet UK GDPR standards. Accompanying DSPT guidance created for small and large health and social care organisations signposts to the IG portal, with further information for both small and large health and social care organisations available, respectively, at the following two links:
The IG portal guidance is produced on behalf of NHS England, the Department, and key national stakeholders. It is approved by the Information Commissioner’s Office, the United Kingdom’s regulatory authority for data protection, and the National Data Guardian, the independent advisory body for ensuring people’s confidential data is safe.
The IG portal provides guidance on a range of topics, including when working remotely, as, for example, it includes guidance on video conferencing and frequently asked questions on accessing information when working from home, with further information on both video conferencing and the frequently asked questions available, respectively, at the following two links:
To comply with the DSPT training requirements, the vast majority of health organisations use the centrally provided NHS England Data Security Awareness (DSA) course. NHS England reviews the DSA training on an annual basis to ensure that it reflects current best practice for using, sharing, and protecting information.
In addition, the Joint Cyber Unit of NHS England and the Department provides online IG training modules, including simple and engaging training for front line staff on information sharing, with further information available at the following link:
https://portal.e-lfh.org.uk/Component/Details/750310
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 help support hospitals to (a) recruit and (b) retain clinical staff in Oxfordshire.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Decisions about recruitment are matters for individual National Health Service trusts. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.
That said, we are committed to training the staff the NHS needs, including clinical staff, and ensuring that the NHS remains an attractive place to work for our staff across the country. NHS England already has an extensive retention programme which is addressing matters that are important to staff, such as good occupational health support, options for working more flexibly, and better culture and leadership.
This summer we will publish a refreshed Long Term Workforce Plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many vacancies for (a) administrative staff, (b) clinical staff and (c) managers there are in the Oxford University Hospitals NHS Foundation Trust; and what the average time was for a vacancy to be open in (i) Oxfordshire and (ii) the UK in the last five years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department does not hold information on trust level vacancies by staff groups, or information on the lengths of time that vacancies have been open at a local or national level.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 increase the number of certified Auditory Verbal Therapists.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Audiology services in the National Health Service, including provision of therapies for children with hearing loss, are locally commissioned.
In summer 2025, we will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade and treat patients on time again.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
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 help ensure that ICBs are providing clear and consistent guidance on help for deaf children in developing language and communication skills.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local populations, including services for non-hearing children. NHS England supports ICBs to make informed decisions about the provision of audiology services so that they can provide consistent, high quality, and integrated care to non-hearing children.
In 2019, NHS England, with input from the National Deaf Children’s Society, produced a guide for commissioners and providers who support children and young people with hearing loss. The guide provides practical advice on ensuring non-hearing children receive the support they need. In July 2016, NHS England published Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning Groups. This framework supports ICBs to make informed decisions about what is good value for the populations they serve and to provide more consistent, high quality, integrated care, including for children with hearing loss. It also addresses inequalities in access and outcomes between hearing services.
The National Institute of Health and Care Excellence’s (NICE) prioritisation board considered childhood hearing loss as a potential guideline topic last August, but concluded that there is limited evidence available in this area and that the NHS England Action Plan on Hearing Loss addresses care for this population. Later this year, the NICE’s prioritisation board will consider if it should develop a guideline on paediatric audiology following a topic suggestion. It will also consider if the NICE should update its technology appraisal guidance on cochlear implants for children and adults.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of the adequacy of the guidance on services for children with hearing loss.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local populations, including services for non-hearing children. NHS England supports ICBs to make informed decisions about the provision of audiology services so that they can provide consistent, high quality, and integrated care to non-hearing children.
In 2019, NHS England, with input from the National Deaf Children’s Society, produced a guide for commissioners and providers who support children and young people with hearing loss. The guide provides practical advice on ensuring non-hearing children receive the support they need. In July 2016, NHS England published Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning Groups. This framework supports ICBs to make informed decisions about what is good value for the populations they serve and to provide more consistent, high quality, integrated care, including for children with hearing loss. It also addresses inequalities in access and outcomes between hearing services.
The National Institute of Health and Care Excellence’s (NICE) prioritisation board considered childhood hearing loss as a potential guideline topic last August, but concluded that there is limited evidence available in this area and that the NHS England Action Plan on Hearing Loss addresses care for this population. Later this year, the NICE’s prioritisation board will consider if it should develop a guideline on paediatric audiology following a topic suggestion. It will also consider if the NICE should update its technology appraisal guidance on cochlear implants for children and adults.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to issue Severe Shortage Protocols for (a) methylphenidate, (b) dexamfetamine, (c) atomoxetine, (d) lisdexamfetamine, (e) guanfacine, (f) oestrogel, (g) buproprion and (h) lamotrigine.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Serious Shortage Protocols (SSPs) enable community pharmacists to supply a specified medicine or device in accordance with a protocol rather than a prescription, with the patient’s consent, and without needing to seek authorisation from the prescriber. SSPs are additional tools that have been used in recent years, alongside a range of other mechanisms, to manage and mitigate medicine and medical devices shortages. SSPs are not introduced unless sufficient supplies of the alternative product to be supplied in accordance with the SSP are available to support the market.
Furthermore, SSPs are not suitable for all medicines and patients. For example, patients with complex health needs may not be considered suitable for a supply in accordance with an SSP. In these cases, patients would always be referred back to the prescriber for any decision about their treatment before any therapeutic or generic alterative is supplied. SSPs are not issued for controlled drugs in Schedule II, such as methylphenidate, except under very restricted circumstances.
The Department is aware of a supply issue affecting methylphenidate prolonged-release tablets. These supply issues are taking longer to resolve than the Department originally anticipated, and the Department is working with the respective suppliers to further improve the United Kingdom’s supply for the short and long-term as soon as possible. There are no plans to issue a SSP for methylphenidate.
The Department is currently unaware of any medicine supply issues affecting dexamfetamine, atomoxetine, lisdexamfetamine, guanfacine, oestrogel, bupropionand, lamotrigine. Therefore, there are no plans to issue SSPs for these medicines.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what information his Department holds on companies involved in supplying PPE which was subsequently marked as do not supply due to being unsuitable for use in the NHS.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department holds all pertinent contractual detail on those companies who provided personal protective equipment (PPE) products that were considered unsuitable for use. Between 1 November 2023 and 30 September 2024, approximately 432,700 pallets of unusable PPE have been disposed of.
It currently costs approximately £200,000 per week to store PPE unsuitable for National Health Service use. The figure is dynamic because the stock is reducing. NHS Supply Chain manages PPE product supply and logistics and they lease storage for PPE from the following companies GXO and Visku (Bis Henderson).
A programme of work is underway to reduce our excess stock. This work will significantly reduce the cost of our storage network and is due to be complete by January 2025 through sales, donations, recycling, and energy from waste.