Asked by: Yasmin Qureshi (Labour - Bolton South East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of the potential merits of each Integrated care systems having a (a) specialist allergy nurse and (b) dietitian.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The majority of services for people living with allergies are commissioned locally through integrated care boards (ICBs), which are best placed to commission services according to local need. Specialised allergy services are provided for patients with severe and complex allergic conditions, or those who have common allergic conditions for which conventional management has failed and for whom specified specialist treatments are required. In 2023/24, these services are jointly commissioned by NHS England Specialised Commissioning and the ICBs, in line with the published Specialist Allergy Service Specification.
There is an established Clinical Reference Group (CRG), which is responsible for providing national clinical advice and leadership for specialised immunology and allergy services. The CRG uses its expertise to advise NHS England on the best ways to provide specialised services. This includes developing national standards in the form of service specifications and policies. The CRG commenced a review of the current service specification in May 2023, which is expected to be complete by summer 2024. The outcome of the service specification review will be an updated specification which references up-to-date guidance and takes into account the latest evidence base, to clearly define the standards of care for commissioned specialised services.
To help promote awareness of allergies, the National Institute for Health and Care Excellence (NICE) has published guidance on a range of allergy conditions, including food allergy in under 19-year-olds, anaphylaxis, and drug allergy. The NICE promotes its guidance via its website, newsletters, and other media.
To support clinicians in the implementation of clear care pathways, the NICE website has guidance to support diagnosis and treatment of a range of allergy conditions, including how to identify allergies and when to refer to specialist care, and how to ensure allergies are recorded in their medical records. The NICE website also provides primary care practitioners with access to clinical knowledge summaries outlining the current evidence base and practical guidance on a range of skin conditions.
Asked by: Yasmin Qureshi (Labour - Bolton South East)
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 improve allergy awareness in health care settings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The majority of services for people living with allergies are commissioned locally through integrated care boards (ICBs), which are best placed to commission services according to local need. Specialised allergy services are provided for patients with severe and complex allergic conditions, or those who have common allergic conditions for which conventional management has failed and for whom specified specialist treatments are required. In 2023/24, these services are jointly commissioned by NHS England Specialised Commissioning and the ICBs, in line with the published Specialist Allergy Service Specification.
There is an established Clinical Reference Group (CRG), which is responsible for providing national clinical advice and leadership for specialised immunology and allergy services. The CRG uses its expertise to advise NHS England on the best ways to provide specialised services. This includes developing national standards in the form of service specifications and policies. The CRG commenced a review of the current service specification in May 2023, which is expected to be complete by summer 2024. The outcome of the service specification review will be an updated specification which references up-to-date guidance and takes into account the latest evidence base, to clearly define the standards of care for commissioned specialised services.
To help promote awareness of allergies, the National Institute for Health and Care Excellence (NICE) has published guidance on a range of allergy conditions, including food allergy in under 19-year-olds, anaphylaxis, and drug allergy. The NICE promotes its guidance via its website, newsletters, and other media.
To support clinicians in the implementation of clear care pathways, the NICE website has guidance to support diagnosis and treatment of a range of allergy conditions, including how to identify allergies and when to refer to specialist care, and how to ensure allergies are recorded in their medical records. The NICE website also provides primary care practitioners with access to clinical knowledge summaries outlining the current evidence base and practical guidance on a range of skin conditions.
Asked by: Christopher Chope (Conservative - Christchurch)
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 ensure retail food businesses comply with measures in the Food Information Regulations 2014 on providing written allergen information for labels.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The Food Standards Agency (FSA) is responsible for food safety related labelling, including allergens. Local authorities are responsible for enforcing food law in the vast majority of food businesses, including those in the retail and catering sector. As central competent authority, the FSA monitors the delivery of official controls by local authorities.
The FSA produces the statutory Food Law Code of Practice and associated Practice Guidance establishing a set of expectations for the activities local authorities are responsible for under food law, and how these are to be delivered. This is supported by a range of training, advice, and guidance to help food officers discharge their functions. Recent changes to the Food Law Code of Practice will enable a more risk-based and intelligence-driven approach to targeting premises for food standards inspections and carrying out interventions, and includes specific consideration of the risk factor for compliance with providing allergen information.
The FSA also provides support for food businesses, for example through guidance and training, on providing allergen information in line with the requirements of the 2014 Food Information to Consumer Regulations to help drive up compliance and make it easier for people with a food allergy, intolerance, and coeliac disease to make safe choices when eating out.
Asked by: Daisy Cooper (Liberal Democrat - St Albans)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the federated data platform will include functionality to enable the creation of a consolidated national allergy register.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The current use cases for the Federated Data Platform (FDP) are:
- elective recovery, to address the backlog of people waiting for appointments or treatments;
- care coordination, to enable the effective coordination of care between local health and care organisations and services, reducing the number of long stays in hospital;
- vaccination and immunisation, to continue to support the vaccination and immunisation of vulnerable people while ensuring fair and equal access and uptake across different communities;
- population health management, to help integrated care systems proactively plan services that meet the needs of their population; and
- supply chain management, to help the National Health Service put resources where they are needed most, and buy smarter so that we get the best value for money.
The creation of a consolidated national allergy register, or identifiable national clinical data registries, is not in the current scope of the FDP, which will not be processing identifiable patient data at a national level. More products will be developed on the FDP throughout the lifecycle of this programme.
The FDP programme has developed a front door process and demand assessment framework which will be used for new requirements coming into the programme. The assessment framework assesses ideas and requests on the basis of their fit to the core FDP objectives and targeted business case outcomes, as well as assessing against the feasibility of successful delivery when considering things like cost, capacity, wider system dependencies, and other factors. In regard to a consolidated national allergy register, we would expect discussions to be held initially within the National Disease Registry Service.
Alongside the FDP, NHS England are investing in platform modernisation, including the Patient Outcomes and Registries Platform (ORP) which is a unified national registry platform integrated into NHS England’s system data infrastructure for improved data security, flow, linkage, and analysis, and faster pace of registry development.
The ORP’s directions cover all outcome registries, patient-reported outcome measures and patient-reported experience measures, and shared decision-making and data collections across a wide range of conditions, including all surgical and interventional procedures in the NHS and independent sector. A national allergy register or registry may be in the scope for the ORP’s coverage.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department for Environment, Food and Rural Affairs:
To ask the Secretary of State for Environment, Food and Rural Affairs, what steps he is taking to ensure that food businesses adhere to food labelling standards for items (a) containing common allergens and (b) marketed as (i) vegetarian and (ii) vegan.
Answered by Mark Spencer - Minister of State (Department for Environment, Food and Rural Affairs)
The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food so that consumers can have confidence in the food that they buy. All food businesses selling food in the UK must comply with food labelling rules, which include the requirement for specific information to be presented in a specific way. For example, food businesses are under a legal obligation to provide accurate information on the presence of the 14 major allergens in food, so that people who have allergies and intolerances can make safe food choices.
While there are no specific rules covering information on the suitability of food for vegetarians or vegans, the requirement that food information must not mislead consumers applies to such labels as for other voluntary labels.
It is the duty of Local Authorities to enforce food safety and labelling regulations, to help ensure food is safe for people living with a food allergy. The Food Standards Agency have agreements and protocols in place to support local authorities in their work and give guidance to explain the regulations and how they can be applied to food businesses.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department for Education:
To ask the Secretary of State for Education, what recent guidance her Department has provided to (a) schools and (b) other educational institutions on food (i) labelling and (ii) allergens.
Answered by Damian Hinds - Minister of State (Education)
The department provides statutory guidance for schools, ‘Supporting pupils with medical conditions’, which makes clear that schools should ensure they are aware of any pupils with allergies and have processes in place to ensure these can be well managed. The guidance is available at: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3. Further information is available at: https://www.gov.uk/government/publications/school-food-standards-resources-for-schools/allergy-guidance-for-schools.
In early years settings, the Early Years Foundation Stage (EYFS) framework sets the standards that all registered early years providers must meet for the learning, development and care of children from birth to age five. The framework is available at: https://www.gov.uk/government/publications/early-years-foundation-stage-framework--2.
The EYFS states that before a child is admitted to the setting the provider must also obtain information about any special dietary requirements, preferences and food allergies that the child has, and any special health requirements.
The EYFS signposts to the Department of Health and Social Care document ‘Example menus for early years settings in England’ which includes guidance on menu planning, food safety, managing food allergies and reading food labels, which staff preparing food will find helpful in ensuring that children are kept safe. The guidance is available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/658870/Early_years_menus_part_1_guidance.pdf.
The ‘Help for early years providers’ online platform, owned by the department, has a food safety page which also signposts to resources on allergies. This page is available at: https://help-for-early-years-providers.education.gov.uk/safeguarding-and-welfare/food-safety#allergies. The department is also developing nutrition content for the platform which will have a section on allergies and resources such as a common allergies table.
Higher education (HE) institutions and further education institutions are autonomous and it is the responsibility of individual HE institutions to implement and adhere to relevant guidelines with regards to labelling and allergens.
The Food Standards Agency (FSA) promotes its resources including information on allergen labelling and management to all food business operators including schools, nurseries, colleges, and other institutional caterers.
The FSA has published guidance relevant to schools and other educational institutions including sector specific guidance in July 2021 for new allergen labelling legislation which came into force in October 2021. Guidance for institutional caterers (including schools) has been on the FSA website since at least 2017. This has links to training courses offered by allergy charities. In September 2020, the FSA also launched free allergen training which has had over 530,000 users to date, with nearly 75,000 of these being from the education sector.
Asked by: Claire Hanna (Social Democratic & Labour Party - Belfast South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make it his policy to implement Owen's Law in line with the recommendations of the Food Standards Agency.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food. The United Kingdom maintains high standards on the information that is provided on food labels so that consumers can have confidence in the food that they buy.
At the Food Standards Agency’s (FSA’s) December 2023 board meeting, the board agreed a revised policy for provision of allergen information for food businesses selling non-prepacked food, such as coffee shops and restaurants. The new policy sets an expectation for these businesses to provide allergen information in writing as well as having a conversation. The board also agreed their preference would be for written information to be mandatory.
As a non-ministerial department, the FSA cannot make legislation and has written to Ministers in England and Wales, the Executive in Northern Ireland, and Food Standards Scotland for views on these matters.
In the meantime, the FSA will develop guidance to implement this policy and provide support for food businesses on how to provide written allergen information to help drive up compliance and make it easier for people with a food allergy, intolerance or coeliac disease to make safe choices when eating out.
Asked by: Andy Slaughter (Labour - Hammersmith)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent progress the Clinical Reference Group for allergies has made.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England’s Clinical Reference Group (CRG) provides clinical advice and leadership for both Specialised Immunology and Specialised Allergy services.
The CRG advises NHS England on the optimal arrangements for the commissioning of specialised services. This includes developing national standards in the form of service specifications and policies. The CRG commenced a review of the current published Specialist Allergy Service Specification in May 2023, which is expected to be complete by summer 2024. The outcome of the service specification review will be an updated specification which references up to date guidance and takes into account the latest evidence base to clearly define the standards of care for commissioned specialised services.
Asked by: Andy Slaughter (Labour - Hammersmith)
Question to the Cabinet Office:
To ask the Minister for the Cabinet Office, how many deaths from allergies there have been in each year since 2000, by type of allergy.
Answered by John Glen - Paymaster General and Minister for the Cabinet Office
The information requested falls under the remit of the UK Statistics Authority.
A response to the Hon gentleman’s Parliamentary Question of 28 November is attached.
Asked by: Martyn Day (Scottish National Party - Linlithgow and East Falkirk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to adopt Allergy UK's Patient Charter as a plan for patient rights for people living with allergic conditions.
Answered by Will Quince
The majority of allergy services are commissioned locally by integrated care boards, with a small number of specialist allergy services for patients with complex and severe allergies commissioned nationally by NHS England. The service specification specifies that centres provide equity of access to best practice standards for diagnosis and management, based on current national and international guidelines.
The Department and NHS England continue to engage with stakeholders, including Allergy UK, to understand the needs of people with allergies and how services could be improved. This includes patient and public voice membership in NHS England’s clinical reference group which provides clinical advice and leadership on specialised immunology and allergy services.