Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the total cost of treating patients who are obese and overweight; and what are the associated costs of treating (1) type 2 diabetes, (2) cardiovascular disease, (3) cerebrovascular disease, (4) musculoskeletal diseases including joint replacers, (5) cancer, and (6) dementia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The department has reviewed and uses cost estimates published by Frontier Economics in 2022.
A study by Frontier Economics estimated that in 2021 obesity related ill-health cost the National Health Service £6.5 billion annually. This estimate includes costs associated with the following obesity related diseases: colorectal cancer; oesophageal cancer; kidney cancer; ovarian cancer; pancreatic cancer; coronary heart disease; stroke; type 2 diabetes; hypertension; knee osteoarthritis; endometrial cancer, and breast cancer.
The disease costs associated with obesity are calculated from the total annual costs per case, as shown in the following table:
Disease | Cost per case per year (2021) |
(1) Type 2 diabetes | £ 827.33 |
(2) Cardiovascular disease - Coronary heart disease (CHD) | £ 1,557.25 |
(2) Cardiovascular disease - Stroke | £ 247.55 |
(2) Risk of Cardiovascular disease - Hypertension | £ 453.91 |
(4) Musculoskeletal disease - Knee Osteoarthritis | £ 27,798.40 |
(5) Cancer - Colorectal cancer | £ 520.13 |
(5) Cancer - Oesophageal cancer | £ 545.06 |
(5) Cancer - Kidney cancer | £ 1,662.88 |
(5) Cancer - Ovarian cancer | £ 14,990.93 |
(5) Cancer - Pancreatic cancer | £ 7,447.27 |
(5) Cancer - Endometrial cancer | £ 520.13 |
(5) Cancer - Breast cancer | £ 545.06 |
The annual costs per case includes direct health-care costs including hospital care (both inpatient and outpatient), primary care, and medication, and they are not exclusively related to obesity associated cases. Indirect and social care costs are not included, which means the exclusion of these costs will probably underestimate total costs of disease events overall.
Asked by: Baroness Wheeler (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how they plan to ensure the sustainability of the stroke rehabilitation innovations developed through the Stroke Quality Improvement in Rehabilitation (SQuIRe) projects to ensure that every stroke survivor has the best chance of recovery.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is prioritising implementation of the National Service Model for an Integrated Community Stroke Service (ICSS), which includes delivery of specialist stroke rehabilitation at home and in care homes, improving life after stroke support, and six month follow-up reviews, by working closely with the voluntary sector. The ICSS model is vital to support physical, cognitive, and psychological recovery, return to work, and quality of life.
The ICSS model includes provision of tailored and patient centred reablement care, through joint work between the National Health Service and social care. Provision of peer support and six months reviews, information, and longer-term support in the community is also achieved through integrated and collaborative working with the voluntary sector.
The National Stroke Quality Improvement in Rehabilitation (SQuIRe) programme is driving implementation of the ICSS model in England. NHS England funds SQuIRe posts in each NHS region, to work with integrated care boards (ICBs) in improving provision of community-based stroke rehabilitation, promoting stroke recovery, and improving patient outcomes. ICBs also receive a separate funding allocation to support prevention services, which include stroke rehabilitation.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
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 increase public awareness of links between heart disease in women and alcohol consumption.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check is England’s cardiovascular disease prevention programme. It aims to prevent heart disease, stroke, diabetes, and kidney disease, and some cases of dementia among adults aged 40 to 74 years old. Each year the programme engages over one million people, including women, and prevents approximately 400 heart attacks or strokes. The provision of an alcohol risk assessment, and brief advice about alcohol harm, is a requirement in the NHS Health Check. The guidance to practitioners sets out that people identified as drinking at higher-risk levels should be referred for a liver check, as recommended by the National Institute for Health and Care Excellence. In addition, the United Kingdom’s Chief Medical Officer’s Low risk drinking guidelines and National Health Service guidance highlight that alcohol use is a risk factor for heart disease.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
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 increase public awareness of the potential merits of regular exercise in reducing the effects of insomnia.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Being active can help prevent and manage chronic conditions and diseases, including coronary heart disease, stroke, type 2 diabetes, obesity, cancer, depression, and musculoskeletal conditions. It is also important for a range of other things, including energy balance, to maintain a healthy body weight, cognitive functioning, and sleep.
Our current focus is supporting people who are the most inactive to become more active, as this is where the greatest health gains can be achieved. This includes promoting easy and fun ways to get active through the Better Health social marketing campaign, including Couch to 5k, and Active 10 apps.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department (a) has taken and (b) plans to take steps to (a) monitor the incidence of depression among stroke survivors and (b) improve interventions to enhance (i) aftercare and (ii) quality of life for those people.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Depression affects approximately one third of people with stroke, and stroke services in the National Health Service are very aware of the impact this can have on the quality of life and level of independence of people who experienced a stroke, and the importance of understanding through measurement which people are affected, to support appropriate management.
The National Clinical Guideline for Stroke 2023 recommends that people with stroke should be routinely screened for anxiety and depression using standardised tools, the results of which should be used alongside other sources of information to inform clinical formulation of treatment and support needs.
The latest published Sentinel Stroke National Audit Programme (SSNAP) data, from October to December 2023, showed that 92.4% of stroke patients were screened for mood disturbances, including depression, in hospital. 75% of stroke patients who were followed up at six months post stroke also had a mood screen, with 53% of patients receiving the psychological support needed.
NHS England is driving implementation of the National Service Model for an Integrated Community Stroke Service (ICSS) with a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work, and improved quality of life. From July 2024, the SSNAP will record the amount of psychological rehabilitation provided to patients, and measure changes in quality of life over time.
Asked by: Lord Bishop of Chelmsford (Bishops - Bishops)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in view of the expected growth in the supply of physician associates (PAs) to 10,000 by 2036–37 under the NHS Long Term Workforce Plan, how many PAs are expected to work in each setting.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Physician Associates (PAs) currently work in over 40 specialties across primary, secondary, and community care, each determined by local needs and decisions. The largest proportion of the PA workforce works with doctors and other colleagues in primary care, followed by emergency and acute medicine. Other specialties include geriatrics, stroke, community, dermatology, and ear, nose, and throat. We have not made a central assessment of where we expect PAs to work in 2036/37. PAs' work must be undertaken within local clinical governance rules, and under the supervision or oversight of a senior doctor.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government where the overall responsibility for patients with facial palsy sits within the NHS.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Care for people with facial palsy may be delivered by a number of specialties, depending on its cause. Facial palsy will often present in primary care, and if there are additional concerning features, the patient may be referred directly to the hospital as an emergency, where they may be looked after by medical or stroke teams. Rehabilitation professionals may be needed to support recovery.
Facial palsy without additional features is often managed in general practice. If time and treatment does not result in a satisfactory outcome, then the patient should be referred to a hospital, to be reviewed by a neurologist and other members of the team as needed, for example speech and language therapists, psychologists, or neurosurgeons.
Asked by: John Whittingdale (Conservative - Maldon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many patients received stroke rehabilitation inpatient care in St Peter's Hospital Maldon in each year since 2000.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Over the years, St Peter’s Hospital has provided valuable capacity for patients across Mid and South Essex to receive inpatient stroke rehabilitation in community beds. The volume of beds, and therefore patients treated on site, has changed over the years due to shifting demand and, in recent years, the impact of the pandemic.
In 2022/23, 118 patients received inpatient stroke rehabilitation care at St Peter’s Hospital. However, there are currently no inpatient stroke rehabilitation beds at St Peter’s hospital in Maldon, as the 16 stroke rehabilitation beds that were on site were moved to Brentwood Community Hospital in October 2023, to ensure the safe provision of care through this winter.
The current consultation being undertaken by Mid and South Essex Integrated Care Board has set out options to increase community inpatient stroke rehabilitation capacity from 24 to 27, which would total 50 beds across the system. This increase is based on data that shows around 2,000 people in Mid and South Essex have a stroke each year, of which around 500 need a stay in a community hospital for specialist rehabilitation support.
Asked by: Feryal Clark (Labour - Enfield North)
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 improve treatment for individuals aged over 65 with low blood pressure in (a) Enfield North constituency, (b) the London Borough of Enfield, and (c) London.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards in London are responsible for arranging healthcare services that meet the needs of their local populations, including for patients over the age of 65 years old in the Enfield North Constituency, the London Borough of Enfield, and London.
The NHS Health Check, offered every five years to eligible people aged 40 to 74 years old, aims to prevent heart disease, stroke, type 2 diabetes and kidney disease, and some cases of dementia. People can also now have their blood pressure tested in many community pharmacies and over 7,500 pharmacies have delivered nearly two million blood pressure checks in just over two years, and we are working with NHS England to expand this service by investing up to £50 million over this and next year. In both services people will be referred to their general practice for further assessment and clinical treatment if required, including those with low blood pressure. Further information on the management of hypotension, low blood pressure, is available at the following website:
https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
Asked by: Paulette Hamilton (Labour - Birmingham, Erdington)
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 merits of publishing a dedicated cancer strategy.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
On 24 January 2023, the Government announced plans to publish the Major Conditions Strategy, which will focus on tackling the six major conditions groups: cancers, mental ill-health, cardiovascular disease including stroke and diabetes, dementia, chronic respiratory diseases, and musculoskeletal disorders, that account for around 60% of ill-health and early death in England. Addressing cancer together with other major conditions will allow the Department and NHS England to focus on similarities in approach, ensuring care is better centred around the patient.
Following the call for evidence for a 10-year cancer plan in 2022, the Department received over 5,000 submissions. These findings are being fed into the development of the Major Conditions Strategy.