Asked by: Lloyd Russell-Moyle (Labour (Co-op) - Brighton, Kemptown)
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 the adequacy of (a) genitourinary and (b) HIV care for the next five years; and if she will make an estimate of the number of consultants specialising in (i) genitourinary and (ii) HIV care who will be employed in the NHS in 2029.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS workforce statistics show that in November 2023, there were 243 full time equivalent (FTE) consultants working in the specialty of genito-urinary medicine (GUM) in NHS trusts and other core organisations in England, and 133 FTE consultants working in the specialty of community sexual and reproductive health in NHS trusts and other core organisations in England.
NHS England is responsible for providing HIV care and in March 2024 published the NHS England national service specification for adult specialised services for people living with HIV. Specialised adult inpatient and outpatient HIV services aim to provide specialist assessment and ongoing management of HIV, and associated conditions, to support individuals to stay well, remain engaged in care, and to reduce onward transmission. The services will ensure that outcomes, wellbeing, and quality of life are maximised, that they are culturally competent, in recognition of the disproportionate number of people from diverse backgrounds who access HIV care, and that people are central to decisions about the management of their health and social care.
The Department is consulting with NHS England to reform the funding of specialist training in genito-urinary and HIV care, to increase the ability of specialists to train and then practice in areas of greatest need. We are committed to achieving no new HIV transmissions within England by 2030. As part of the plan, we are investing an additional £20 million for new research, which will involve an expansion and evaluation of bloodborne virus opt-out testing in 47 additional emergency departments in areas of England with high HIV prevalence. This is expected to deliver approximately 1.5 million more HIV tests to help us get people with the virus into care. The Department is also allocating over £3.5 million to deliver a National HIV Prevention Programme between 2021 and 2024 to raise awareness of HIV, sexually transmitted infection (STI) testing, and prevention strategies, targeting populations most at risk of HIV, including young people.
We continue to support the delivery of local sexual health services, providing guidance and data through the UK Health Security Agency and the Department. In March 2023 we published the Integrated Sexual Health Service Specification to support local authorities in comprehensive commissioning of services, and providing advice and guidance on managing STIs outbreaks.
Asked by: Lloyd Russell-Moyle (Labour (Co-op) - Brighton, Kemptown)
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 adequacy of the number of sexual and reproductive health professionals in (a) post and (b) training in the context of trends in the level of sexually transmitted infection rates.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS workforce statistics show that in November 2023, there were 243 full time equivalent (FTE) consultants working in the specialty of genito-urinary medicine (GUM) in NHS trusts and other core organisations in England, and 133 FTE consultants working in the specialty of community sexual and reproductive health in NHS trusts and other core organisations in England.
NHS England is responsible for providing HIV care and in March 2024 published the NHS England national service specification for adult specialised services for people living with HIV. Specialised adult inpatient and outpatient HIV services aim to provide specialist assessment and ongoing management of HIV, and associated conditions, to support individuals to stay well, remain engaged in care, and to reduce onward transmission. The services will ensure that outcomes, wellbeing, and quality of life are maximised, that they are culturally competent, in recognition of the disproportionate number of people from diverse backgrounds who access HIV care, and that people are central to decisions about the management of their health and social care.
The Department is consulting with NHS England to reform the funding of specialist training in genito-urinary and HIV care, to increase the ability of specialists to train and then practice in areas of greatest need. We are committed to achieving no new HIV transmissions within England by 2030. As part of the plan, we are investing an additional £20 million for new research, which will involve an expansion and evaluation of bloodborne virus opt-out testing in 47 additional emergency departments in areas of England with high HIV prevalence. This is expected to deliver approximately 1.5 million more HIV tests to help us get people with the virus into care. The Department is also allocating over £3.5 million to deliver a National HIV Prevention Programme between 2021 and 2024 to raise awareness of HIV, sexually transmitted infection (STI) testing, and prevention strategies, targeting populations most at risk of HIV, including young people.
We continue to support the delivery of local sexual health services, providing guidance and data through the UK Health Security Agency and the Department. In March 2023 we published the Integrated Sexual Health Service Specification to support local authorities in comprehensive commissioning of services, and providing advice and guidance on managing STIs outbreaks.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress she has made on delivering the UK 5-year action plan for antimicrobial resistance 2019 to 2024.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
A cross-Government, United Kingdom-wide delivery board monitors and oversees progress in delivering the National Action Plan on antimicrobial resistance (NAP AMR) for 2019 to 2024. The majority of the commitments in the NAP AMR have been assessed as either completed, or as on track for delivery.
Progress against the measurable ambitions in the NAP AMR is collated by the UK Health Security Agency, and reported to the delivery board. Significant progress has been made in further reducing antibiotic use in food producing animals, by 59% since 2014, and in humans, with an 8.8% reduction in overall antibiotic usage from 2014 to 2022. Progress has been slower in other areas, such as reducing the incidence of specific drug-resistant infections, due to the diverse nature of the underlying causes of these infections. Other key achievements from the NAP AMR programme over the past five years include:
- Piloting innovative ways of evaluating and paying for antibiotics on the National Health Service;
- Securing antimicrobial resistance commitments on several ministerial tracks during the UK G7 presidency in 2021; and
- £19.2 million investment into One Health Surveillance through the Pathogen Surveillance in Agriculture, Food and Environment Programme.
The Department has commissioned the Policy Innovation and Evaluation Research Unit (PIRU) at the London School of Hygiene and Tropical Medicine to conduct an evaluation of the 2019 to 2024 NAP AMR, to inform future policy development and implementation. Findings from the PIRU evaluation will be published following the peer-review process.
The forthcoming NAP AMR for 2024 to 2029 is under development, in consultation with a broad range of stakeholders across different sectors, and informed by the findings from the antimicrobial resistance Call for Evidence. This will set us on course for achieving our long-term ambitions, set out in the Government’s 20-year vision to contain, control, and mitigate antimicrobial resistance by 2040.
Asked by: Kevin Brennan (Labour - Cardiff West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department plans to take in the next year to help ensure that children with severe epilepsy can access effective cannabis-based medications through the NHS.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The licensed cannabis-based medicine epidyolex is prescribed routinely for three forms of epilepsy, for patients aged two years old and above. However, clinical guidelines from the National Institute for Health and Care Excellence demonstrate a clear need for more evidence to support routine prescribing and funding decisions for unlicensed cannabis-based medicines.
We continue to call on the manufacturers of these products to conduct research, and we are working with regulatory, research, and National Health Service partners to establish clinical trials to test the safety and efficacy of these products, to enable evidence based prescribing decisions.
Asked by: Justin Madders (Labour - Ellesmere Port and Neston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what her planned timescale is for rolling out the maternal morbidity indicator.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department recognises the importance of monitoring near-misses and severe maternal morbidity, and continues to consider how a maternal morbidity indicator can be implemented. No timescales for a national rollout of the indicator have been set.
NHS England has developed 14 Maternal Medicine Networks (MMN) across England to ensure that all women with chronic and acute medical problems around pregnancy, for instance diabetes or heart disease, have access to specialist management and care from physicians and obstetrics, tackling the biggest contributors to maternal mortality. The Department is in the process of commissioning the National Institute for Health and Care Research’s Policy Research Unit for Maternal and Neonatal Health, to undertake research into developing an MMN-specific maternal morbidity outcome indicator, and provide the prevalence of current morbidity as a baseline for ongoing monitoring.
Asked by: Kate Osamor (Independent - Edmonton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how the additional £95 million investment in dementia care has been allocated.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Dame Barbara Windsor Dementia Mission was launched in August 2022 with £95 million of Government funding. There is now more than £120 million of committed funding to the mission, which will be invested into three key pillars. The first pillar centres on biomarkers and experimental medicine, and will receive £50 million of the funding for the mission, with the intention of securing match funding from industry partners. As part of this pillar, Innovate UK launched a Small Business Research Initiative competition, with the aim of accelerating innovations in clinical biomarker tools and technologies for dementia, where organisations could apply for a share of £6 million of funding out of the allocated £50 million. These technologies will enable the discovery, validation, and implementation of a suite of decision-enabling biomarkers to help transform clinical trials and precision therapies. The competition closed on 4 September 2023, and the recipients awarded a portion of the £6 million will be announced soon.
The second pillar will focus on clinical trial infrastructure and innovation, with two recently announced initiatives to support its delivery. The first of these initiatives is the National Institute for Health and Care Research’s Dementia-Translational Research Collaboration Trials Network, with almost £50 million of funding over five years. This will expand the United Kingdom’s early phase clinical trial capabilities for dementia, speeding up the development of new treatments. The second initiative is the Clinical Trials Delivery Accelerator, focused on dementia, also named the Dementia Accelerator. This was announced in the Autumn Statement 2023, in response to Lord O’Shaughnessy’s independent review into commercial clinical trials in the UK, with up to £20 million of additional funding.
The third pillar will be focused on end-to-end implementation, specifically on aligning translational research, clinical practice, and regulatory frameworks to prepare health-systems for new dementia medicines. The Medicines and Healthcare products Regulatory Agency, the National Institute for Health and Care Excellence, NHS England, the Department, the devolved administrations, and the Dame Barbara Windsor Dementia Mission are already working closely together to plan for the implementation of new dementia medicines, should they gain approval in the UK.
Asked by: Rachel Hopkins (Labour - Luton South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how the £95 million investment in dementia clinical (a) trials and (b) innovative research will be allocated across the Mission’s pillars of (i) innovations in biomarkers, data and digital and imaging technologies, (ii) increasing the number and speed of UK-based clinical trials for research into dementia and neurodegeneration and (iii) end-to-end implementation.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Dame Barbara Windsor Dementia Mission was launched in August 2022 with £95 million of Government funding. There is now more than £120 million of committed funding to the mission, which will be invested into three key pillars. The first pillar centres on biomarkers and experimental medicine, and will receive £50 million of the funding for the mission, with the intention of securing match funding from industry partners. As part of this pillar, Innovate UK launched a Small Business Research Initiative competition, with the aim of accelerating innovations in clinical biomarker tools and technologies for dementia, where organisations could apply for a share of £6 million of funding out of the allocated £50 million. These technologies will enable the discovery, validation, and implementation of a suite of decision-enabling biomarkers to help transform clinical trials and precision therapies. The competition closed on 4 September 2023, and the recipients awarded a portion of the £6 million will be announced soon.
The second pillar will focus on clinical trial infrastructure and innovation, with two recently announced initiatives to support its delivery. The first of these initiatives is the National Institute for Health and Care Research’s Dementia-Translational Research Collaboration Trials Network, with almost £50 million of funding over five years. This will expand the United Kingdom’s early phase clinical trial capabilities for dementia, speeding up the development of new treatments. The second initiative is the Clinical Trials Delivery Accelerator, focused on dementia, also named the Dementia Accelerator. This was announced in the Autumn Statement 2023, in response to Lord O’Shaughnessy’s independent review into commercial clinical trials in the UK, with up to £20 million of additional funding.
The third pillar will be focused on end-to-end implementation, specifically on aligning translational research, clinical practice, and regulatory frameworks to prepare health-systems for new dementia medicines. The Medicines and Healthcare products Regulatory Agency, the National Institute for Health and Care Excellence, NHS England, the Department, the devolved administrations, and the Dame Barbara Windsor Dementia Mission are already working closely together to plan for the implementation of new dementia medicines, should they gain approval in the UK.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the recommendations of the APPG Report Brain Tumours–Pathway to a Cure, and in particular recommendation 6 with reference to paediatric cancer diffuse intrinsic pontine glioma.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department welcomed the All-Party Parliamentary Group report and will continue to work through its recommendations with the Department of Science, Innovation and Technology, UK Research and Innovation, the Medical Research Council, and the National Institute for Health and Care Research (NIHR).
With regards to recommendation six, the NIHR welcomes funding applications for research into any aspect of human health, including childhood brain tumours and paediatric diffuse intrinsic pontine glioma. The usual practice of the NIHR is not to ring-fence funds for specific disease areas, as research proposals in all areas compete for the funding available. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. In all disease areas, the amount of NIHR funding depends on the volume and quality of scientific activity.
We rely on researchers to submit high-quality research proposals. Given the relatively small brain tumour clinical research community, we have been taking action to grow the field. The NIHR is working closely with the Tessa Jowell Brain Cancer Mission in hosting customised workshops for researchers, and training for clinicians, to grow capacity for brain cancer research, attract new researchers, develop the community, and support researchers to submit high-quality research funding proposals.
The NIHR is committed to the involvement, engagement and participation of children and young people in research, supporting researchers and funders, as well as empowering children and young people to lead their own journey with research.
The NIHR, together with the United Kingdom health departments, the Little Princess Trust and Cancer Research UK, jointly fund Experimental Cancer Medicine Centres (ECMCs) to support the most promising innovations into the cancer medicines of tomorrow. For 2023 to 2028, the NIHR is providing £21.6 million in funding for the ECMCs in England, the ECMC Paediatric Network, and the Network Programme Office. Additionally, the NIHR Clinical Research Network cancer portfolio has a dedicated children and young people’s cancer subspecialty, which has a subspecialty lead who promotes and supports research within their local National Health Service trusts.
The Department has also now set up the Children and Young People Cancer Taskforce to progress our mission to deliver world-leading cancer services. This dedicated work focusing on cancers affecting children and young people will explore research and innovation, which may include targeting research funding, reviewing children’s access to clinical trials, gaining greater access to data, and informing future therapies and treatments.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to improve access to new drugs for brain tumour patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department funds research through the National Institute for Health and Care Research (NIHR). The NIHR invests in the research delivery workforce, the facilities, and the capacity to support clinical trials into all disease areas, including brain tumours. The NIHR Clinical Research Facilities and Experimental Cancer Medicine Centres support the delivery of early phase trials, and the NIHR Clinical Research Network and Patient Recruitment Centres support delivery and participation in later phase clinical trials.
The National Institute for Health and Care Excellence (NICE) makes recommendations on whether all new medicines, including for brain tumours, should be routinely funded by the National Health Service based on an assessment of their costs and benefits. NICE is able to recommend medicines for use through the Cancer Drugs Fund, where there is too much uncertainty for NICE to recommend routine use. NICE works closely with the Medicines and Healthcare Products Regulatory Agency to ensure that its appraisal timelines are aligned with the regulatory process. NICE is currently evaluating a number of potential new medicines for brain tumours.
Asked by: Emma Lewell-Buck (Labour - South Shields)
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 implications for her policies of NHS England's publication entitled Cancer Under 16 Patient Experience Survey, published on 8 November 2023.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Cancer is a priority for the Government and the Department continues to take steps to demonstrate this. The Department is taking steps to better understand the landscape of childhood cancer with experts, aided by Dame Caroline Dinenage MP.
Increasing the diagnosis rates of cancers in children and young people is a priority for the Government. Several organisations, including the Department, are taking steps across England to improve cancer diagnosis services in primary health care settings, supporting general practices (GPs) in referring patients, expanding diagnostic capacity, and enabling more precise diagnosis through technology.
NHS England is working to deliver the ambition it set in its Long-Term Plan to diagnose 75% of cancers at stages one and two by 2028. The Department is working to support GPs in improving referrals for suspected cancer. The National Institute for Health and Care Excellence’s guidance underpinning cancer referrals sets out detailed guidance for GPs on the symptoms of cancer in children and young people, recommending very urgent referral, an appointment within 48 hours, for those presenting with a range of potential cancer symptoms including any unexplained lump, bruising or bleeding, neurological symptoms or bone pain. For many of these symptoms, GPs now have direct access to request diagnostic tests including X-ray and ultrasound.
Childhood, young people’s and young adults’ cancers are included within the Department’s work on developing a Major Conditions Strategy. Addressing cancer together with other groups of conditions in a joined-up strategy will allow us to focus on where there are similarities in approach and ensure care is better centered around the patient.
While the Department cannot pre-empt its outcomes or undertake a specific assessment at this stage, the Major Conditions Strategy’s final report will draw on previous work, including submissions from childhood, young people and young adults’ cancer charities and stakeholders in response to our calls for evidence on cancer and on major conditions. The emphasis is on earlier diagnosis, better support to manage conditions, and improved coordination of treatment and care. We are engaging with stakeholders representing babies, children and young people to ensure their views are considered in the development of the strategy.
The Department does not plan to insert any further additions into the strategy development for age appropriate and personalised care. The NHS Long Term Plan states that, where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This is being delivered in line with the NHS Comprehensive Model for Personalised Care, empowering people to manage their care and the impact of their cancer and maximise the potential of digital and community-based support.
In addition, the Under 16 Cancer Patient Experience Survey, commissioned by NHS England, is now in its third year and aims to gather feedback from children and young people and their parents/carers on the cancer care and treatment received.
These surveys provide valuable findings, helping the National Health Service to understand what is good about children, young people’s and adults’ cancer care, and identifying areas for improvements. 75% of children aged between eight and 15 years old reported that they were looked after very well for their cancer or tumour by healthcare staff and 89% of parents/carers rated the overall experience of their child's care as eight or more out of 10. The answers are being used to improve children’s cancer care across England. NHS England is working to review and improve play facilities, including working with the Starlight Foundation Charity on improvements to guidance, and surveying all provision to identify areas for improvement. Work is also underway in improving food quality, including nine larger Children’s Hospital’s NHS Trusts currently piloting better food provision for resident parents.
The Government welcomed Children's Cancer and Leukaemia Group’s Children and Young People’s Cancer Plan. The Department has not made a formal assessment of the recommendations, given the significant amount of work ongoing across NHS England and the Department. Our priorities include improving early diagnosis, delivering more research, and driving progress in genomic medicine.