Asked by: Baroness Jenkin of Kennington (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to tackle diet-related ill-health, including type 2 diabetes and heart disease.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We remain committed to promoting a healthy diet for adults and children and are delivering an ambitious programme of work to create a healthier environment to help people make healthy food choices to improve health and to tackle diet related ill health. There are a range of measures in place to support improving diets, promoting physical activity and reducing obesity.
Regulations on out of home calorie labelling for food sold in large businesses, including restaurants, cafes and takeaways, came into force in April 2022. Restrictions on the placement of products high in fat, sugar or salt in key selling locations, came into force on 1 October 2022. We will be implementing restrictions on the sale of less healthy products by volume price such as ‘3 for 2’ and will introduce restrictions on the advertising of less healthy products before 9pm on TV and paid for less healthy product advertising online from 1 October 2025.
We are working with the food industry to make further progress on reformulation and ensure it is easier for the public to make healthier choices. The Food Data Transparency Partnership will help enable and encourage food companies to voluntarily demonstrate progress on the healthiness of their sales.
The Government continues to promote the Eatwell Guide principles through the NHS.UK website and government social marketing campaigns such as Better Health Healthier Families and Start for Life. We are also supporting more than three million children through the Healthy Foods Schemes and helping schools boost physical activity to help children maintain a healthy weight and good overall health through the Primary School PE and Sport Premium and the School Games Organiser Network.
We are continuing to support local authorities to improve the uptake of the NHS Health Check, England's cardiovascular disease prevention programme. The NHS Health Check helps to prevent a range of conditions including heart disease and type 2 diabetes. Each year the programme engages over 1 million people and prevents around 400 heart attacks or strokes.
Asked by: Ashley Dalton (Labour - West Lancashire)
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 the guidance submitted to medical professions on the prescription of semaglutide on the availability of that drug for people suffering from type 2 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has worked intensively with industry to seek commitments from them to address issues with the supply of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide, to expedite deliveries and boost supplies. As a result, the overall supply position in the United Kingdom has improved. Guidance for healthcare professionals now allows for the initiation of new patients on Rybelsus tablets, an oral semaglutide, and provides advice on what to prescribe patients who are unable to obtain their existing GLP-1 RA treatment whilst there continue to be disruptions to the supply of some products, including semaglutide. These disruptions are affecting many countries around the world, and aren’t specific to the UK.
We continue to work with international partners, given the global nature of medical supply chains, collaborating to share best practice and manage and respond to common threats to supply, including on semaglutide and other GLP-1 RAs licensed for treating patients with type 2 diabetes.
Asked by: Ashley Dalton (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is working with her international counterparts to tackle supply issues relating to (a) semaglutide and (b) other glucagon-like peptide-1 receptor agonists licensed for treating patients with type 2 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has worked intensively with industry to seek commitments from them to address issues with the supply of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide, to expedite deliveries and boost supplies. As a result, the overall supply position in the United Kingdom has improved. Guidance for healthcare professionals now allows for the initiation of new patients on Rybelsus tablets, an oral semaglutide, and provides advice on what to prescribe patients who are unable to obtain their existing GLP-1 RA treatment whilst there continue to be disruptions to the supply of some products, including semaglutide. These disruptions are affecting many countries around the world, and aren’t specific to the UK.
We continue to work with international partners, given the global nature of medical supply chains, collaborating to share best practice and manage and respond to common threats to supply, including on semaglutide and other GLP-1 RAs licensed for treating patients with type 2 diabetes.
Asked by: Ashley Dalton (Labour - West Lancashire)
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 with pharmaceutical companies to increase the supply of semaglutide.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has worked intensively with industry to seek commitments from them to address issues with the supply of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide, to expedite deliveries and boost supplies. As a result, the overall supply position in the United Kingdom has improved. Guidance for healthcare professionals now allows for the initiation of new patients on Rybelsus tablets, an oral semaglutide, and provides advice on what to prescribe patients who are unable to obtain their existing GLP-1 RA treatment whilst there continue to be disruptions to the supply of some products, including semaglutide. These disruptions are affecting many countries around the world, and aren’t specific to the UK.
We continue to work with international partners, given the global nature of medical supply chains, collaborating to share best practice and manage and respond to common threats to supply, including on semaglutide and other GLP-1 RAs licensed for treating patients with type 2 diabetes.
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, with reference to NHS England's web page entitled Diabetes treatment and care programme, whether all eight Type 1 diabetes and disordered eating pilots have been commissioned by their Integrated Care Systems to secure services independently of NHS England pilot scheme funding.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The national approach to funding the establishment of Type 1 Diabetes with Disordered Eating services was delivered in two phases. Initial sites in London, Hampshire, and Dorset received national funding between 2018/19 and 2021/22, before the transition of commissioning responsibility to local systems commenced from April 2023. All three of these services did initially secure local funding, independent of the national pilot scheme. More recently, we understand that the status of these sites to be as follows: London services are partially active across London, with local consideration of ongoing funding and delivery arrangements underway; Hampshire services are active and embedded in wider eating disorder specialist services; and Dorset services have been discontinued. The remaining five newer services have been funded from September 2022, and are nationally funded up to March 2025.
Asked by: George Howarth (Labour - Knowsley)
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 discontinuing funding for T1DE pilot schemes on the health and well-being of patients living with type 1 diabetes with disordered eating.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England has provided funding for eight integrated care boards (ICBs) across the country to support the development and establishment of Type 1 Diabetes with Disordered Eating (T1DE) services in every National Health Service region. Funding has been provided on a pump prime basis, and the responsibility for the longer-term sustainable provision of care for these patients sits with the relevant integrated care system.
A nationally commissioned evaluation has shown the positive impact that the provision of T1DE services can have for patients, including reductions in HbA1c, which is linked to reduced rates of diabetes complications, and reduced rates of emergency admissions.
It’s the role of the ICBs to consider the health needs of their populations, in making decisions about the care that is provided. It is expected that ICB leads consider these evaluation findings alongside the risk to patient health and wellbeing of the discontinuation of service provision, as well as other local contextual factors in making decisions about the future provision of T1DE services.
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 she has received representations from (a) healthcare professionals, (b) patient advocacy groups and (c) local authorities on discontinuing Type 1 diabetes and disordered eating services.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
My Rt hon. Friend, the Secretary of State for Health and Social Care engages with a range of external stakeholders, including discussions on Type 1 Diabetes with Disordered Eating (T1DE) services. NHS England is working closely with regional and integrated care board (ICB) level teams to ensure that informed decisions are made about the future provision of T1DE services.
Responsibility for the commissioning of T1DE services sits with the ICBs. It is the role of local ICB decision makers to consider the implications of continuing or discontinuing T1DE services, specific to each location, and including the perspectives of healthcare professionals, patient advocacy groups, and local authorities.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she (a) has made and (b) plans to make an assessment of the potential merits of funding options to ensure the sustainability of T1DE services beyond the pilot phase.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Evaluation by the National Health Service of the initial Type 1 Diabetes with Disordered Eating service (T1DE) pilot sites, in London and Wessex, demonstrated a mean reduction in HbA1c of between 2.3% to 2.5%. Assuming that this level of reduction is maintained, the lifetime quality-adjusted life year gain of these services was estimated at 1.49, which would be cost effective up to a net lifetime cost of £29,800-£44,800.
In response to these initial evaluation findings, NHS England expanded the T1DE programme, supporting provision of new services in an additional five sites from September 2022, expanding coverage to more areas of the country. It is expected that these services will generate further evaluation data to consolidate these early findings, which can be used to inform national and local policy decisions.
NHS England is drawing on learning from existing T1DE services, other emerging evidence and the findings of the recent parliamentary inquiry, to ensure all areas of the country are supported to improve care for those identified as having T1DE. The emergence of these future plans are subject to future spending review settlements for the NHS and level of funding from the NHS England budget allocated to T1DE.
NHS England are also working closely with the first wave of pilot sites including London to ensure that the newer services can benefit from their learning and experience when considering local funding options in advance of March 2025, when the national funding for the five new sites will come to an end.
NHS England is assisting integrated care boards to develop local funding arrangements through the provision of evaluation data, a national programme of support workshops, and an online platform to share learning and good practice.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the potential implications for its policies of the cost-benefit analysis of the T1DE pilot schemes carried out by NHS England.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Evaluation by the National Health Service of the initial Type 1 Diabetes with Disordered Eating service (T1DE) pilot sites, in London and Wessex, demonstrated a mean reduction in HbA1c of between 2.3% to 2.5%. Assuming that this level of reduction is maintained, the lifetime quality-adjusted life year gain of these services was estimated at 1.49, which would be cost effective up to a net lifetime cost of £29,800-£44,800.
In response to these initial evaluation findings, NHS England expanded the T1DE programme, supporting provision of new services in an additional five sites from September 2022, expanding coverage to more areas of the country. It is expected that these services will generate further evaluation data to consolidate these early findings, which can be used to inform national and local policy decisions.
NHS England is drawing on learning from existing T1DE services, other emerging evidence and the findings of the recent parliamentary inquiry, to ensure all areas of the country are supported to improve care for those identified as having T1DE. The emergence of these future plans are subject to future spending review settlements for the NHS and level of funding from the NHS England budget allocated to T1DE.
NHS England are also working closely with the first wave of pilot sites including London to ensure that the newer services can benefit from their learning and experience when considering local funding options in advance of March 2025, when the national funding for the five new sites will come to an end.
NHS England is assisting integrated care boards to develop local funding arrangements through the provision of evaluation data, a national programme of support workshops, and an online platform to share learning and good practice.
Asked by: Matt Western (Labour - Warwick and Leamington)
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 ensure people with diabetes can continue to access the insulin they need.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
We are aware of supply issues with some insulin products, however the vast majority are in stock. Comprehensive management guidance on alternative products has been issued to the National Health Service where needed.
The medicine supply chain is highly regulated, complex, and global. Supply disruption is an issue which affects the United Kingdom, as well as the other countries around the world, and it can have a variety of causes, including manufacturing issues, problems with access to raw ingredients, and sudden spikes in demand.
There is a team within the Department that deals specifically with medicine supply problems. It has well-established tools and processes to manage medicine supply issues, working closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England, and others operating in the supply chain, to help prevent shortages and expedite resupply as soon as possible, to ensure that the risks to patients are minimised.