Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when she expects a funding decision for the Early Aortic Repair in patients Needing Endovascular/Open Surgery for Type B Aortic Dissection (EARNEST) randomised trial, following a favourable opinion from the National Institute for Health Research in February 2023.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Research commissioned the Early Aortic Repair in patients Needing Endovascular/Open Surgery for Type B Aortic Dissection (EARNEST) trial to test the effectiveness of a surgical treatment for aortic dissection. NHS England received an Excess Treatment Cost funding request for this trial, and at the end of February 2024 they confirmed this funding in principle with the trial team. This will now enable the trial team to continue to progress the set-up phase for the study, and to subsequently begin recruitment.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of regional variations in the provision of molecular radiotherapy.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Molecular radiotherapy is currently commissioned alongside brachytherapy via a national service specification. There are currently 38 trusts in England that are commissioned to deliver these services however, given the spectrum of treatments available under this service specification, there is some variation in what each provider offers.
For this reason, NHS England is developing a standalone molecular radiotherapy service specification. This will clarify the service model and review demand and access arrangements. The service specification will also take into account any future developments in treatment technologies and recommendations made by the National Institute for Health and Care Excellence.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will include provisions in the NHS workforce plan to increase the nuclear medicines workforce; and what steps he is taking to ensure the adequacy of supply of that workforce to meet future demand for (a) molecular radiotherapy and (b) other treatments.
Answered by Will Quince
The Government has committed to publishing the Long-Term Workforce Plan shortly. This will include projections for the number of doctors, nurses and other professionals that will be needed, taking full account of improvements in retention and productivity. This plan will help ensure that we have the right numbers of staff, with the right skills, to transform and deliver high quality services fit for the future.
NHS England are currently leading work to revise the Brachytherapy and Molecular Radiotherapy Service Specification and to understand current service readiness to expand access to new molecular radiotherapy treatments, should they be approved by National Institute for Health and Care Excellence.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
What steps he is taking to improve (a) health outcomes and (b) early diagnosis for people with aortic dissections.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
In March 2022, NHS England launched an Aortic Dissection Toolkit to support the implementation of robust clinical pathways to identify and manage both Type A and Type B aortic dissection.
All English regions are working with the Cardiac Pathways Improvement Programme to improve diagnosis and treatment.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
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 reduce waiting times at emergency departments for (a) patients and (b) ambulances with patients in (i) England and (ii) the University Hospitals of Derby and Burton NHS Foundation Trust.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England’s Urgent and Emergency Care Recovery 10 Point Action Plan includes an increased role for NHS 111 as the first point of triage, measures to improve patient flow through hospitals and reduce pressure on emergency departments and ensuring medically fit patients can be discharged as soon as possible.
University Hospitals of Derby and Burton NHS Foundation Trust is extending its same day emergency care service to seven days a week and reducing demand on accident and emergency through expanding community rapid intervention services and collaborating with the local health and care system to increase primary care capacity. The Trust plans to develop its medical workforce, establish a frailty assessment area for elderly patients and maximise the use of its urgent treatment centre.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
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 research funding into aortic dissection.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department funds research through the National Institute for Health Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including aortic dissection.
In December 2020, the Department convened a multidisciplinary group of experts and patient representatives together to identify high-priority research questions for aortic dissection. In response to an outcome paper from this workshop, the NIHR launched a call on ‘Early endovascular repair in type b uncomplicated sub-acute aortic dissection’ and is currently exploring the development of a brief to cover outstanding questions and signal the NIHR’s desire to commission research in this important area.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what evidence has been provided to Ministers on the comparative effectiveness of (a) mandatory self-isolation and (b) a mandatory testing regime for arrivals into the UK from amber destinations for managing the risk to public health from covid-19.
Answered by Jo Churchill - Minister of State (Department for Work and Pensions)
We are unable to provide the evidence provided to Ministers as it relates to the formulation of ongoing border policy and its release could prejudice decision making.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether (a) he and (b) officials in his Department have had discussions with counterparts in the Department for Transport on permitting the use of NHS lateral flow tests for mandatory covid-19 testing for arrivals into the UK from (i) amber and (ii) green list destinations.
Answered by Jo Churchill - Minister of State (Department for Work and Pensions)
Officials in the Department of Health and Social Care and the Department for Transport have discussed options for reducing the cost of travel testing, including whether National Health Service lateral flow tests could be used by arrivals from ‘amber’ and ‘green list’ countries. However, lateral flow tests are not permitted for most international arrivals as they are not suitable for identifying variants. Polymerase chain reaction testing of inbound travellers and genome sequencing of positive samples are crucial for disease surveillance and identification of potentially harmful variants.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the potential merits of establishing fluoroquinolone toxicity as a diagnosis in response to (a) tendon injury, (b) mitochondrial dysfunction and (c) oxidative stress attributed by some patients to the use of that drug.
Answered by Nadine Dorries
The Yellow Card Scheme is the system used in the United Kingdom for reporting adverse drug reactions (ADRs). This acts as an early warning system for the identification of previously unrecognised adverse reactions and also provides valuable information on recognised ADRs, allowing the Commission on Human Medicines and Medicines and Healthcare products Regulatory Agency (MHRA) to identify and refine the understanding of risk factors that may affect the clinical management of patients.
The following table shows spontaneous suspected ADR reports for fluoroquinolones in association with tendon injury, mitochondrial dysfunction and oxidative stress to 25 May 2021 in the UK.
Reaction | Number of reports |
Tendon disorders* | 1,381 |
mitochondrial cytopathy, mitochondrial toxicity, mitochondrial myopathy acquired | 1 |
Oxidative stress | 2** |
Source: MHRA Sentinel database for Adverse Drug Reactions.
Notes:
*Tendon disorders includes 21 different relevant reaction terms.
**These reports are duplicates and have been subsequently merged on the database.
The frequency of tendonitis range from 1 in 100 to less than 1 in 10,000, depending on the specific fluoroquinolone medicine. For the products that provide an estimate of the frequency of tendon rupture, this is listed as less than 1 in 10,000. Mitochondrial dysfunction and oxidative stress are among the possible mechanisms that might lead to tendon injury or other ADRs caused by fluoroquinolones, but this association is not fully understood and mitochondrial dysfunction and oxidative stress are not listed as ADRs in the product information for fluoroquinolones.
The MHRA continues to review information about the safety of all medicines, including fluoroquinolones, and will take appropriate regulatory action as appropriate on the basis of new safety information. Serious side effects of fluoroquinolone antibiotics can be varied, potentially affecting several different parts of the body. An assessment of the potential merits of fluoroquinolone toxicity as a clinical diagnosis in response to tendon injury, mitochondrial dysfunction or oxidative stress has not been made.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of patients who are prescribed fluoroquinolone antibiotics suffer adverse reactions in the form of (a) tendon injury, (b) mitochondrial dysfunction and (c) oxidative stress.
Answered by Nadine Dorries
The Yellow Card Scheme is the system used in the United Kingdom for reporting adverse drug reactions (ADRs). This acts as an early warning system for the identification of previously unrecognised adverse reactions and also provides valuable information on recognised ADRs, allowing the Commission on Human Medicines and Medicines and Healthcare products Regulatory Agency (MHRA) to identify and refine the understanding of risk factors that may affect the clinical management of patients.
The following table shows spontaneous suspected ADR reports for fluoroquinolones in association with tendon injury, mitochondrial dysfunction and oxidative stress to 25 May 2021 in the UK.
Reaction | Number of reports |
Tendon disorders* | 1,381 |
mitochondrial cytopathy, mitochondrial toxicity, mitochondrial myopathy acquired | 1 |
Oxidative stress | 2** |
Source: MHRA Sentinel database for Adverse Drug Reactions.
Notes:
*Tendon disorders includes 21 different relevant reaction terms.
**These reports are duplicates and have been subsequently merged on the database.
The frequency of tendonitis range from 1 in 100 to less than 1 in 10,000, depending on the specific fluoroquinolone medicine. For the products that provide an estimate of the frequency of tendon rupture, this is listed as less than 1 in 10,000. Mitochondrial dysfunction and oxidative stress are among the possible mechanisms that might lead to tendon injury or other ADRs caused by fluoroquinolones, but this association is not fully understood and mitochondrial dysfunction and oxidative stress are not listed as ADRs in the product information for fluoroquinolones.
The MHRA continues to review information about the safety of all medicines, including fluoroquinolones, and will take appropriate regulatory action as appropriate on the basis of new safety information. Serious side effects of fluoroquinolone antibiotics can be varied, potentially affecting several different parts of the body. An assessment of the potential merits of fluoroquinolone toxicity as a clinical diagnosis in response to tendon injury, mitochondrial dysfunction or oxidative stress has not been made.