Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will publish guidance on the safe use of nicotine pouches.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
While there is currently limited research and evidence into the harms and use of nicotine pouches, they are never recommended for children. Nicotine, the active ingredient in pouches, is a highly addictive drug, and we have a duty to protect children and young people from potential harms. Advice on the harms of nicotine can be found on the Talk to Frank website, which is available at the following link:
https://www.talktofrank.com/drug/nicotine
That is why, through the Tobacco and Vapes Bill, we are proposing to introduce age of sale restrictions of 18 years old for nicotine pouches, ban free samples to under 18 year olds, and introduce new packaging, flavours, and point of sale display restrictions.
Whilst the use of nicotine pouches is currently low among adults, it is increasingly popular with younger male audiences. We will continue to monitor the use of these products and update public health guidance and messaging accordingly.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential relationship between nicotine and type II diabetes.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Studies have shown that smokers are 30% to 40% more likely to get type 2 diabetes than people who don’t smoke. Smoking can also make managing the condition more difficult, because high levels of nicotine can lessen the effectiveness of insulin. Such studies have focussed on the impact of nicotine contained within cigarettes, rather than alternative nicotine delivery methods, and the National Health Service recommends that smokers with diabetes should try to quit.
As stated during the Tobacco and Vapes Bill Committee on 14 May 2024, the Department is currently exploring research options to address these evidence gaps in the short, medium, and longer term. I will be setting out further details on this very soon.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will hold discussions with the (a) Medical Schools Council and (b) British Medical Association on the effectiveness of preference-informed allocation for foundation placements for medical graduates.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The UK Foundation Programme Office (UKFPO) manages the national application process for the UK Foundation Programme, on behalf of the four statutory education bodies for the United Kingdom. The UKFPO changed the allocation process for the programme this year to a Preference Informed Allocation method. This consisted of applicants being given a computer-generated rank, and removed the requirement for them to sit the Situational Judgement Test. This change was based on engagement with stakeholders, including the Medical Schools Council, and the British Medical Association.
When confirming the move to the new system last year, the UKFPO set out that once implemented, it would be kept under constant review, to make sure it is working well for applicants. The UKFPO has confirmed that 75% of applicants received their first choice of programme this year, a 4% increase on last year.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the effectiveness of access to (a) specialist care provision and (b) review for asthma patients.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Fewer than 5% of all people with asthma have severe asthma or uncontrolled asthma. For these people, systematic assessment by a specialist multidisciplinary severe asthma team has been shown to improve patient outcomes, for instance with a reduction in exacerbations and oral corticosteroids use, a reduction in health care utilisation, and an improvement in quality of life, regardless of the use of biologic drugs.
Severe asthma services form part of NHS England’s specialised commissioning responsibilities. Specialised respiratory services are subject to joint commissioning or delegation to integrated care boards from April 2024, which will support integrated pathways between specialised and non-specialised services. Recent work contributed to by NHS England, to support capacity within specialised severe asthma services, included the development of a severe asthma toolkit and an Accelerated Access Collaborative on improving pathways for identification and management of patients with severe asthma. Regular asthma reviews, at least annually, are recommended by the National Institute for Health and Care Excellence within its guideline on the diagnosis, monitoring, and chronic management of asthma.
The provision of annual asthma reviews is one of the indicators within the Quality and Outcomes Framework (QOF) for general practices in England. The objective of the QOF is to improve the care patients are given by rewarding practices for the quality of care they provide to their patients, based on several indicators across a range of key areas of clinical care and public health. The latest published data for 2022/23 shows that 62.9% of people on the asthma register received a review in the past 12 months. This has steadily increased since 2020/21, the earliest date from which data is available, as this is when the indicator definition was updated. Further information on the public health profile of patients with asthma is available at the following link:
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to end deaths from asthma.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In the initial report, Major conditions strategy: case for change and our strategic framework, the Department developed a strategic framework on how our approach to health and care delivery can evolve to improve outcomes and better meet the needs of 6 major health conditions, including those with chronic respiratory disease (CRD). As part of the overall strategy for CRD management, we have incentivised primary care, through the general practice contract, to monitor and provide support for those with chronic obstructive pulmonary disease and asthma, including through annual reviews, a personalised action plan, appropriate inhaler optimisation and advice on smoking cessation.
NHS England published the NHS Long Term Plan in 2019, which set out the commitments and objectives for the National Health Service for the next 10 years, in relation to CRD. NHS England is working with a range of partners to improve outcomes across the care pathway. This includes supporting local systems to offer NHS funded tobacco treatment services, building on the £2.3 billion investment in additional diagnostic capacity and the establishment of Community Diagnostic Centres; working with key partners to introduce a range of resources and measures that promote high quality and low carbon inhaler use; publishing a National Bundle of Care for Children and Young People with Asthma to support local systems with the management of asthma care and; widening and making access to specialist care through the delegation of specialist asthma services to ICB commissioning responsibilities.
NHS England is also focused on making more respiratory-specific data available to all regions and systems, ensuring there is greater consistency in the use of data and metrics to enable meaningful comparison, and to identify areas that may need additional support for improvement. NHS England also looks forward to the publication of the updated National Institute for Health and Care Excellence asthma guideline later this year and will promote and support its implementation.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will undertake a review of her strategy on alcohol use through a harm reduction approach.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government takes a wide-ranging approach to reducing alcohol related harms. Several aspects of the Department's work to address alcohol related harms already follows a harm reduction approach. These include the UK Chief Medical Officers’ low-risk drinking guidelines, which recommend that people moderate their drinking to 14 units a week, and guidance from England’s Chief Medical Officer for healthcare professionals, on the consumption of alcohol by young people. The National Health Service’s Better Heath campaign aims to motivate people to take steps to improve their health, including in relation to alcohol use, and the NHS Health Check provides an opportunity for general practitioners to offer advice to reduce alcohol use, if appropriate.
In relation to treatment, the Department is committed to promoting access to alcohol services through our drug strategy. The upcoming UK clinical guidelines for alcohol treatment will include a chapter on taking a harm reduction approach within alcohol treatment, which outlines a flexible service approach. The Department, in partnership with the devolved administrations, will publish these guidelines later this year.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of developing a national strategy for paediatric (a) intensive therapy units and (b) rehabilitative services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department has no current plans to undertake such an assessment. Guidance on the delivery of paediatric critical care services is a matter for NHS England and the relevant professional bodies. Integrated Care Boards are responsible for the commissioning of paediatric rehabilitative services.
An NHS England review of paediatric critical care services was published in 2019, with a further National Specialty Report on Paediatric Critical Care produced in 2022.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help patients with the technological management of asthma.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
There are a range of technologies available to help people manage their asthma. It is important that people are given the necessary support to use technology in managing their conditions, provided these tools have strong levels of evidence, and appropriate regulatory approval, for instance the UK Conformity Assessment, the Conformité Européenne, or compliance with the NHS Digital Technology Assessment Criteria. NHS England and the National Institute for Health and Care Excellence (NICE) are exploring the potential for the platforms for the digital self-management of asthma to be evaluated, although this is dependent on the technology readiness level, which would require good levels of evidence and appropriate regulatory approval. Guidelines developed jointly by the NICE, the Scottish Intercollegiate Guidelines Network, and the British Thoracic Society to harmonise the recommendation from each organisation are ongoing, and have an expected publication date of 30 October 2024.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of surgical hubs on trends in waiting times for elective care.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Several external evaluations of the impact of Elective Surgical Hubs are currently ongoing, and supported by NHS England. The University of York is carrying out a comprehensive evaluation funded by the National Institute of Healthcare Research.
The Health Foundation’s Improvement Analytics Unit has also conducted a quantitative assessment of the impact of surgical hubs, with the results to be published later this month. The Health Foundation’s analysis will indicate the impact surgical hubs have had on the number of procedures undertaken and whether they have increased day-case rates and reduced lengths of stay, all of which supports elective recovery, and reductions in waiting times for elective care.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to promote asthma research through the use of (a) data and (b) AI.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including asthma. The NIHR Respiratory Translational Research Collaboration has a dedicated asthma theme which includes research on diagnostics, monitoring, and digital health interventions to manage asthma. The NIHR has further encouraged research using data science and artificial intelligence approaches through the Artificial Intelligence in Health and Care Award, jointly funded with NHS England and the NHS Accelerated Access Collaborative since 2020.
We also note that the National Institute for Health and Care Excellence’s (NICE’s) guideline committee made several recommendations on diagnosing and monitoring asthma, and for managing chronic asthma when the 2017 guideline was published. A further new recommendation for research was made when the guideline was updated in 2020. It is therefore possible that the NICE will make further recommendations for research when its updated asthma guideline is published later this year.