Asked by: Peter Bottomley (Conservative - 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 funding for training and professional development for members of the NHS workforce involved in delivering contraceptive care.
Answered by Jo Churchill - Minister of State (Department for Work and Pensions)
Health Education England funds training programmes for obstetrics and gynaecology, community sexual and reproductive health and general practice. However, the training curricula for these specialties are set by other organisations, including the Royal College of Obstetricians and Gynecologists, their Faculty of Sexual and Reproductive Health and the Royal College of General Practitioners. Curricula must meet the standards set by the General Medical Council and be formally approved by them.
No specific assessment has been made around the adequacy of funding for training and professional development. Training and workforce issues for contraception care will be considered in the development of our new Sexual and Reproductive Health Strategy.
Asked by: Peter Bottomley (Conservative - 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 improve awareness of hepatitis C among primary care professionals.
Answered by Seema Kennedy
A variety of initiatives are underway in England to improve hepatitis C awareness and case finding, re-engagement and linkage to care, especially in drug services, primary care, prisons and accident and emergency centres. In addition, NHS England is funding access to new hepatitis C treatments in accordance with guidance from the National Institute for Health and Care Excellence.
Public Health England has developed and shared materials with a range of stakeholders, including the voluntary sector, to help raise awareness of hepatitis C infection and highlight the need for those at risk to seek testing and treatment. The resources and materials available comprise of posters, a quiz, social media videos and social banners in a variety of different languages; all of these resources are available online to download or order by healthcare professionals as well as the public themselves.
Asked by: Peter Bottomley (Conservative - Worthing West)
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 the potential merits of trialling opt-out testing for (a) hepatitis C, (b) HIV and (c) other blood-borne viruses in emergency care settings.
Answered by Seema Kennedy
NHS England specialised commissioning does not run a national programme of opt-out screening within emergency care settings. NHS England is aware of some hospital trusts that have implemented an opt-out screening protocol within emergency care settings, but this is not routine practice in all hospitals. Where opt-out is implemented there are posters on display advising patients, attending the emergency department, that they will be tested unless they tell their attending clinician that they want to opt-out and do not wish to be tested.
Opportunistic testing for blood-borne diseases may also occur in non-traditional healthcare settings frequently used by people who inject drugs (or used to), such as doctors’ surgeries, community pharmacies, prisons and sexual health centres.
Asked by: Peter Bottomley (Conservative - Worthing West)
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 the potential merits of producing a hepatitis C elimination strategy to support the recently announced NHS England deal to help eliminate hepatitis C.
Answered by Seema Kennedy
The Government is committed to meeting the World Health Organization (WHO) target of eliminating hepatitis C by 2030 but there are no plans at this time to publish a strategy to eliminate hepatitis C. A variety of initiatives are underway in England to improve awareness and case finding, re-engagement and linkage to care, especially in drug services, primary care, prisons and accident and emergency centres. In addition, NHS England is funding access to new hepatitis C treatments in accordance with guidance from the National Institute for Health and Care Excellence (NICE).
A summary of progress towards achieving the elimination goal was published in 2017 in Public Health England’s report, ‘Hepatitis C in the UK’ at the following link:
This showed that the United Kingdom is on target to meet the WHO interim goal of reducing hepatitis C mortality by 10% by 2020. Better access to improved treatment has led to the first fall in deaths from severe hepatitis C related liver disease in a decade.
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, on what days the Joint Committee on Vaccinations and Immunisation met in each of the last three years; when the Joint Committee plans to meet in the next two years; at which meetings the Joint Committee discussed gender neutral HPV vaccinations; and what estimate his Department has made of the number of (a) boys and (b) men who remain unprotected against HPV-caused cancers.
Answered by Steve Brine
The Joint Committee on Vaccinations and Immunisation (JCVI) meets on the first Wednesday of February, June and October. The Committee held an extraordinary meeting in August 2016 to discuss influenza. There are no plans to change the current meeting schedule.
Gender neutral human papillomavirus (HPV) vaccination was discussed by JCVI in February and October 2015, June 2016 and October, June and February 2017.
There is no estimate of the number of boys/men who remain unprotected. The indirect protection to males afforded by the adolescent girls HPV programme is considered substantial. JCVI’s Interim Statement on Extending HPV vaccination to adolescent boys is available at:
https://www.gov.uk/government/publications/jcvi-statement-extending-the-hpv-vaccination-programme
The HPV programme for men who have sex with men (MSM), who receive little indirect protection from the girls programme, aims to protect MSM considered at highest risk from HPV infection and disease. The estimated impact and cost-effectiveness of the HPV MSM programme is available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404831/pdf/ciw845.pdf
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what comparative assessment he has made of the change in the rate of babies becoming infected with group B streptococus in the UK relative to the change in the rate in (a) the US, (b) Canada, (c) Germany, (d) France and (e) Spain in the last 10 years.
Answered by Philip Dunne
The UK National Screening Committee (UK NSC) does not recommend screening for group B streptococcus. In the United Kingdom Public Health England laboratory voluntary surveillance reports show that the early onset group B streptococcus (EOGBS) rate has fluctuated with slight increases in recent years and estimate this has increased from 0.37 to 0.44/1000 live births between 2006 and 2015.
The current UK NSC evidence review estimates that the rate in term women is approximately 0.41/1000 live term births. A 2013 report from the USA reported that the rate in term women was 0.21/ 1000 live births.
Comparison of the rate in term women is important as this is the group that will be affected by screening. However it is difficult to make comparision with areas in which screening has been implemented as the majority do no report EOGBS by gestation.
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will take steps to replace the Group B Streptococcus Prevention Strategy which is based on risk factors with offering the enriched culture medium test to all pregnant women on the NHS.
Answered by Philip Dunne
Systematic reviews by National Institute for Health and Care Excellence and the Cochrane Collaboration estimate that intravenous penicillin administered during labour is 80 – 85% effective in preventing early onset group B streptococcus (EOGBS). However both reviews reported that the evidence supporting this was poor. In addition no conclusions could be drawn on the effectiveness of antibiotics in labour in reducing the mortality rate from EOGBS.
Each year there will be about 450 babies affected by EOGBS and about 170,000 women who carry group B streptococcus (GBS) at the point of delivery. Most babies come into contact with GBS during labour and experience no ill effect and are born healthy. The balance of benefit and harm from treating women with preventive antibiotics in labour has not been explored in large studies.
There is currently no GBS Prevention Strategy, The UK National Screening Committee (UK NSC) is actively considering the recommendation on antenatal screening for maternal GBS carriage. A public consultation is currently open and will close on the 25 January 2017. A recommendation is expected in February in 2017. The UK NSC welcomes input onto the consultation.
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment his Department has made of the effectiveness of treating pregnant women who carry the group B streptococcus with antibiotics during pregnancy and childbirth on preventing the transmission of that infection to new-born babies.
Answered by Philip Dunne
Systematic reviews by National Institute for Health and Care Excellence and the Cochrane Collaboration estimate that intravenous penicillin administered during labour is 80 – 85% effective in preventing early onset group B streptococcus (EOGBS). However both reviews reported that the evidence supporting this was poor. In addition no conclusions could be drawn on the effectiveness of antibiotics in labour in reducing the mortality rate from EOGBS.
Each year there will be about 450 babies affected by EOGBS and about 170,000 women who carry group B streptococcus (GBS) at the point of delivery. Most babies come into contact with GBS during labour and experience no ill effect and are born healthy. The balance of benefit and harm from treating women with preventive antibiotics in labour has not been explored in large studies.
There is currently no GBS Prevention Strategy, The UK National Screening Committee (UK NSC) is actively considering the recommendation on antenatal screening for maternal GBS carriage. A public consultation is currently open and will close on the 25 January 2017. A recommendation is expected in February in 2017. The UK NSC welcomes input onto the consultation.
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment his Department has made of the relative effectiveness of the enriched culture medium test and the common all-purpose test in diagnosing group B streptococus infection.
Answered by Philip Dunne
A number of published studies indicate selective enrichment broth culture of vagino-rectal swabs is superior to non selective plate culture to improve the recovery of group B streptococcus (GBS) and avoid the overgrowth by vaginal and rectal flora. Public Health England is not aware of any studies that have compared these tests’ ability to predict early onset GBS infection.
Asked by: Peter Bottomley (Conservative - Worthing West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what cost-benefit assessment he has made of detecting group B streptococcus during pregnancy.
Answered by Philip Dunne
Two cost effectiveness estimates have been made by the health technology assessment. One estimated1 that screening may be cost effective but recommended more research to evaluate the balance of benefit and harm from screening. The second2 estimated that screening was close to current cost effectiveness thresholds. It was uncertain whether screening or risk factor management was the more cost effective option.
The National Institute for Health and Care Excellence3 have been unable to evaluate the cost effectiveness of screening because of a lack of data on key parameters.
Notes:
1 Colbourn et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: cost-effectiveness and expected value of information analyses.2007. HTA. https://www.ncbi.nlm.nih.gov/pubmed/17651659
2 Daniels et al. Cost-effectiveness of rapid tests and other existing strategies for screening and management of early-onset group B streptococcus during labour.2010.HTA.
https://www.ncbi.nlm.nih.gov/pubmed/21078057
3 Antenatal care guideline 2008; https://www.nice.org.uk/guidance/cg62