Department of Health and Social Care

The NHS Long Term Plan committed to reduce mortality and long term disability from stroke, including enhanced diagnostic support in the community, better personalised planning and increasing access to rehabilitation. This will help prevent up to 150,000 heart attacks, strokes and dementia cases by 2029.

Due to training requirements, thrombectomies are restricted to Interventional Neuroradiologists in England. The General Medical Council (GMC) is working with the Royal College of Radiologists to develop a medical credential in interventional neuroradiology, or acute stroke, which addresses mechanical thrombectomy. The GMC and the Royal College are ensuring the credential has the right scope to meet the needs of health services across the United Kingdom.

The National Health Service is committed to increasing the delivery of mechanical thrombectomy from 1% to 10%. The latest data shows that 2.3% of patients are now receiving a thrombectomy following a stroke. In early 2022, the NHS will undertake a quality review with each of the seven regions to increase this rate.

NHS England and NHS Improvement advise that this is a new technology which offers an alternative for balloon-based catheter ablation for atrial fibrillation. At present, further research on a wider cohort of patients is required to provide more data and evidence for its use.

NHS England and NHS Improvement developed the RightCare Falls and Fragility Fractures Pathway in collaboration with National Health Service professionals, Public Health England, National Osteoporosis Society to provide commissioners with resources to prevent falls, detect and manage osteoporosis and support patients following fragility fractures. NHS England and NHS Improvement plan to refresh this programme in partnership with the Best Musculoskeletal Pathway Improvement Programme within the next 12 months.

One Departmental Minister travelled to COP26 by airplane on the outward leg of the journey and train for the return leg. Any unavoidable carbon emissions from COP26 will be offset, including those associated with travel.

We have not made a specific assessment. Information on such costs is not collected in the format requested.

The Department funds research through the National Institute for Health Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS). However, it is not usual practice to ring-fence funds for particular topics or conditions. 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. We will continue to work with stakeholders to consider how best to support continued research into ME/CFS.

The Getting It Right First Time (GIRFT) speciality report on renal medicine, published September 2021, recommended that all renal centres provide a minimum of 20% of patients with dialysis services at home within 12 months.

NHS England and NHS Improvement’s Renal Services Transformation Plan (RSTP) has established 11 regional clinical networks to meet this recommendation. Of 51 renal centres, 16 units have met or exceeded this minimum level, with several centres achieving more than 30% of patients receiving dialysis at home. NHS England and NHS Improvement have asked renal networks to ensure units continue to develop home therapies and increase levels of dialysis at home. Providers, integrated care systems and regional commissioners will monitor progress via the UK Renal Registry and NHS England Renal datasets.

The GIRFT report set a deadline for all centres to establish the required staffing model by September 2022. NHS England and NHS Improvement are encouraging clinicians and centres to consider the GIRFT recommendations in their work and the individual sites will evaluate how best to implement them.

The Getting It Right First Time (GIRFT) speciality report on renal medicine, published September 2021, recommended that all renal centres provide a minimum of 20% of patients with dialysis services at home within 12 months.

NHS England and NHS Improvement’s Renal Services Transformation Plan (RSTP) has established 11 regional clinical networks to meet this recommendation. Of 51 renal centres, 16 units have met or exceeded this minimum level, with several centres achieving more than 30% of patients receiving dialysis at home. NHS England and NHS Improvement have asked renal networks to ensure units continue to develop home therapies and increase levels of dialysis at home. Providers, integrated care systems and regional commissioners will monitor progress via the UK Renal Registry and NHS England Renal datasets.

The GIRFT report set a deadline for all centres to establish the required staffing model by September 2022. NHS England and NHS Improvement are encouraging clinicians and centres to consider the GIRFT recommendations in their work and the individual sites will evaluate how best to implement them.

On 3 November 2021, we published the Workforce Recruitment and Retention Fund on GOV.UK, which includes £349,004 for Slough and £22,676,944 for South East across 19 local authorities, to help bolster adult social care workforce capacity over winter, including filling vacancies.

Local authority grant allocations can be found at the following link: https://www.gov.uk/government/publications/workforce-capacity-fund-for-adult-social-care/annex-c-grant-allocations

While no formal assessment has been made, local authorities have a duty under the Care Act 2014 to provide carers an assessment of and support for their needs, where eligible. This includes a duty to promote an individual’s wellbeing and consider the impact of the role as a carer. We continue to work with carers’ organisations to assess and understand carers’ needs and how best to support them.

During the pandemic, we have provided carers with guidance on their health and wellbeing; funding to Carers UK to extend their support phoneline; funding to the Carers Trust for grants to provide support to unpaid carers experiencing loneliness during the pandemic; and we have worked with the Social Care Institute for Excellence to publish guidance on reopening day services, providing respite to unpaid carers.

In addition, we have published our Mental Health Recovery Action Plan, supported by an additional £500 million in 2021/22, to ensure we have the right support in place, including for unpaid carers. We are working with key stakeholders, including unpaid carers, to develop our plans and will publish further detail in our white paper on social care reform shortly.

While no formal assessment has been made, local authorities have a duty under the Care Act 2014 to provide carers an assessment of and support for their needs, where eligible. This includes a duty to promote an individual’s wellbeing and consider the impact of the role as a carer. We continue to work with carers’ organisations to assess and understand carers’ needs and how best to support them.

During the pandemic, we have provided carers with guidance on their health and wellbeing; funding to Carers UK to extend their support phoneline; funding to the Carers Trust for grants to provide support to unpaid carers experiencing loneliness during the pandemic; and we have worked with the Social Care Institute for Excellence to publish guidance on reopening day services, providing respite to unpaid carers.

In addition, we have published our Mental Health Recovery Action Plan, supported by an additional £500 million in 2021/22, to ensure we have the right support in place, including for unpaid carers. We are working with key stakeholders, including unpaid carers, to develop our plans and will publish further detail in our white paper on social care reform shortly.

The data requested is not held centrally.

The Health and Care Bill transfers clinical commissioning groups’ current requirements to manage conflicts of interest to integrated care boards. This includes maintaining and publishing a register of members’ interests and arrangements for the management of conflicts or potential conflicts of interest.

No recent assessment has been made. While national contracts were used to secure appropriate inpatient capacity and other resource in England, on 31 March 2021 these contracts came to an end. From 1 April 2021, NHS England and NHS Improvement returned to local commissioning arrangements and as such this information is not held centrally.

We have announced £2 billion this year through the Elective Recovery Fund and £8 billion in the following three years to tackle the elective backlog. This will enable National Health Service commissioners and trusts to secure the capacity required locally.

Through the introduction of the Tobacco and Related Products Regulations 2016, we have introduced e-cigarette product and safety standards, along with a duty to notify a product to be placed on the United Kingdom market to the Medicines and Healthcare products Regulatory Agency (MHRA). Non-compliant products are subject to local trading standards enforcement. The Department continues to work closely with the MHRA, Trading Standards and other regulatory enforcement agencies to ensure that products sold in the UK comply with regulations for all e-cigarette products and the non-compliant products are removed from the market. Central funding is provided to local authorities for local trading standards activity, including illicit e-cigarettes.

Through the introduction of the Tobacco and Related Products Regulations 2016, we have introduced e-cigarette product and safety standards, along with a duty to notify a product to be placed on the United Kingdom market to the Medicines and Healthcare products Regulatory Agency (MHRA). Non-compliant products are subject to local trading standards enforcement. The Department continues to work closely with the MHRA, Trading Standards and other regulatory enforcement agencies to ensure that products sold in the UK comply with regulations for all e-cigarette products and the non-compliant products are removed from the market. Central funding is provided to local authorities for local trading standards activity, including illicit e-cigarettes.

Evidence from clinical trials of ivermectin as a treatment for COVID-19 is inconclusive at this stage. We will continue to monitor the data from clinical trials continuing worldwide, including the Government-funded PRINCIPLE trial, to expand the evidence base for ivermectin. We recognise the need to make treatments for COVID-19 available to patients once proven as safe and effective. The RAPID-C19 group was established to accelerate the process between the completion of clinical trials and patient access. Ivermectin will be considered for marketing authorisation in the United Kingdom as a treatment for COVID-19 should an application be received from a manufacturer.

The information is not held in the format requested. While the number of scans of the prostate is collected, this does not represent the number of patients or whether the purpose of the scan was for suspected cancer.

We will publish the Women’s Health Strategy in due course. We are currently analysing the responses to the call for evidence which will inform the priorities, content and actions in the Strategy. Within the call for evidence, the online survey included questions on menstrual health.

The UK Health Security Agency is working with a range of partners, such as the University College of London, to monitor the effectiveness of COVID-19 vaccinations in clinical risk groups, including those with immunosuppression. The VirusWatch study is underway to monitor antibody response following vaccination among individuals with immunosuppression.

As part of the COVID-19 Immunity National Core Study, the UK Research and Innovation OCTAVE study is examining the effectiveness of vaccines in clinically at-risk groups. This includes vaccine responses in patients with certain immunosuppressed conditions.

The Health and Care Bill transfers clinical commissioning groups’ current requirements to manage conflicts of interest to integrated care boards (ICBs), which includes maintaining and publishing a register of members’ interests and arrangements for the management of conflicts or potential conflicts of interest.

The ICB chair can also veto members of the board if they are unsuitable and NHS England can issue guidance to ICBs in relation to appointments. In order to manage conflicts of interest of board membership, we have also brought forward an amendment to the Bill to prevent individuals from the membership of boards where there are significant interests or views that could undermine its independence.

National contracts were used to secure all appropriate inpatient capacity across England, which came to an end on 31 March 2021. However, these contracts related to hospital capacity, not bed capacity. Total spend on hospital capacity and health services from private sector providers from March 2020 to March 2021 is not currently available as these contracts are undergoing a reconciliation exercise. It is expected that this will be completed by the end of 2021/22. However, information is being collated at independent provider level, rather than by specific area or region. From 1 April 2021, NHS England and NHS Improvement returned to local commissioning arrangements and as such this information is not held centrally.

We replied to the hon. Member on 22 November.

As of 16 November 2021, 173 applications for COVID-19 test device products have been subject to desktop review by the UK Health Security Agency. As of 16 November, 108 suppliers have submitted information as part of the desktop review validation process. However, in order to be triaged for desktop review, every application must submit accompanying data in the first instance regarding their product. There are currently 93 COVID-19 test device product applications which are ‘pending information’, where further information has been requested from the supplier.

As of 16 November 2021, 173 applications for COVID-19 test device products have been subject to desktop review by the UK Health Security Agency. As of 16 November, 108 suppliers have submitted information as part of the desktop review validation process. However, in order to be triaged for desktop review, every application must submit accompanying data in the first instance regarding their product. There are currently 93 COVID-19 test device product applications which are ‘pending information’, where further information has been requested from the supplier.

We replied to the hon. Member on 30 November 2021.

The following table shows the gene affected and the mutation in the 26 patients licensed as eligible for mitochondrial donation treatment, the date each application was made and then approved by the Human Fertilisation and Embryology Authority (HFEA) Statutory Approvals Committee.

HFEA Application reference Gene affected by mutation Mutation Date received Date approved by the HFEA Statutory Approvals Committee

M0001 MT-TK Details omitted to protect patient identity 28 June 2017 31 August 2017

M0002 MT-TK Details omitted to protect patient identity 4 September 2017 26 October 2017

M0007 MT-ND1 m.3460 G>A 13 March 2018 24 May 2018

M0003 MT-TL1 Details omitted to protect patient identity 25 September 2017 26 July 2018

M0005 MT-TL1 m.3243 A>G 5 December 2017 26 July 2018

M0008 MT-TL1 m.3243 A>G 15 March 2018 26 July 2018

M0004 MT-TK Details omitted to protect patient identity 4 December 2017 30 August 2018

M0006 MT-TS1 Details omitted to protect patient identity 9 January 2018 30 August 2018

M0009 MT-TI m.4300 A>G 28 June 2018 27 September 2018

M0010 MT-TI m.4300 A>G 11 July 2018 27 September 2018

M0013 MT-ND4 m.11778 G>A 14 July 2018 25 October 2018

M0012 MT-ND1 m.3460 G>A 13 July 2018 25 October 2018

M0014 MT-ND4 m.11778 G>A 23 November 2018 31 January 2019

M0015 MT-ND4 m.11778 G>A 23 November 2018 31 January 2019

M0011 MT-ND4 m.11778 G>A 12 July 2018 29 August 2019

M0016 MT-TK m.8344 A>G 5 July 2019 26 September 2019

M0017 MT-ND4 m.11778 G>A 22 August 2019 31 October 2019

M0018 MT-TL1 Details omitted to protect patient identity 10 December 2019 26 March 2020

M0019 MT-TL1 Details omitted to protect patient identity 10 December 2019 26 March 2020

M0020 MT-TL1 Details omitted to protect patient identity 30 March 2020 25 June 2020

M0021 MT-ND1 Details omitted to protect patient identity 30 March 2020 25 June 2020

M0022 MT-ND1 Details omitted to protect patient identity 26 June 2020 24 September 2020

M0024 MT-ND4 Details omitted to protect patient identity 9 December 2020 29 July 2021

M0025 MT-ND4 Details omitted to protect patient identity 9 December 2020 29 July 2021

M0026 MT-ND4 Details omitted to protect patient identity 7 June 2021 4 October 2021

M0027 MT-ND1 Details omitted to protect patient identity 7 June 2021 4 October 2021

Source: HFEA

All tests are robustly assessed through laboratory validation, as precursor to procurement. To improve the quality of lateral flow tests The UK Health Security Agency (UKHSA) has recently introduced additional criteria that devices must meet to be accepted for validation. The criteria focus on improvements to the usability, sustainability and performance of lateral flow antigen tests, compared to devices currently available. In addition, the UKHSA works with suppliers to improve the sustainability and usability of lateral flow devices, such as reducing the amount of packaging.

The Wade-Gery Review was published on 23 November. The Goldacre Review will be published early in 2022, which is likely to be after Committee stage of the Bill in the House of Lords.

The interim clinical policy for Ronapreve (casirivimab and imdevimab) was expanded on 4 November. The clinical policy prioritises the most vulnerable hospitalised patients for whom this treatment will provide the most benefit. Patients are eligible to be considered for Ronapreve if they are hospitalised for management of symptoms of confirmed COVID-19 and negative for COVID-19 antibodies. This is based on clinical trial evidence of efficacy in this group.

Patients are also eligible for Ronapreve if they have hospital-onset COVID-19 and are at high risk of progression to severe illness or if the virus presents a material risk of destabilising a pre-existing condition or compromising recovery. These patients do not need to be negative for COVID-19 antibodies. These conditions are for both immunocompromised and non-immunocompromised patients and reflect clinical trial evidence of efficacy and available supply.

We are unable to provide the information requested as it is commercially sensitive.

The Department published a Prior information Notice in Find a Tender Service on 5 October 2021 inviting suppliers to submit an Expression of Interest on neutralising antibody treatments they are developing for treating and preventing COVID-19. The engagement enables the Department to monitor development of all neutralising monoclonal antibodies for treatment and prevention of COVID-19.

We are considering all evidence submitted to the Government’s public consultation on whether to make permanent the temporary measure allowing for home use of both pills for early medical abortion, including evidence from ambulance services. The consultation asked questions on whether other NHS services had been affected by the temporary measure. We will publish our response in due course.

We continue to monitor the emerging data for AstraZeneca’s long-acting antibody therapy, AZD7442. AstraZeneca are discussing potential approval for the therapy with the Medicines and Healthcare products Regulatory Agency.

We anticipate that further neutralising monoclonal antibody treatments will be submitted for evaluation for a marketing authorisation by the MHRA in the next few months. These treatments could become available for community treatment or preventative use.

On 20 August 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) approved Ronapreve (casirivimab and imdevimab) as the first monoclonal antibody combination product indicated for use in the prevention and treatment of acute COVID-19 infection.

The current supply of Ronapreve is limited globally, therefore the clinical policy prioritises the most vulnerable hospitalised patients for whom this treatment will provide the most benefit, which is supported by the clinical evidence. There are no current plans to make Ronapreve available for prophylaxis. We also anticipate that further neutralising monoclonal antibody treatments will be submitted for evaluation for a marketing authorisation by the MHRA in the next few months. If approved, these could become available for community treatment or prevention use.

Following the outcome of the Spending Review 2021, plans for individual budgets for 2022/23 to 2024/25, including funding for training the cancer workforce, will be subject to a detailed financial planning exercise and finalised in due course.

The NHS Long Term Plan committed to reduce mortality and long term disability from stroke, including enhanced diagnostic support in the community, better personalised planning and increasing access to rehabilitation. This will help prevent up to 150,000 heart attacks, strokes and dementia cases by 2029.

Due to training requirements, thrombectomies are restricted to Interventional Neuroradiologists in England. The General Medical Council (GMC) is working with the Royal College of Radiologists to develop a medical credential in interventional neuroradiology, or acute stroke, which addresses mechanical thrombectomy. The GMC and the Royal College are ensuring the credential has the right scope to meet the needs of health services across the United Kingdom.

The National Health Service is committed to increasing the delivery of mechanical thrombectomy from 1% to 10%. The latest data shows that 2.3% of patients are now receiving a thrombectomy following a stroke. In early 2022, the NHS will undertake a quality review with each of the seven regions to increase this rate.

I refer the hon. Member to the answer of 30 November to Question 60499.

There is currently no planned date for publication of a strategy to deliver the dementia moonshot.

However, we have committed to invest £375 million in neurodegenerative disease research over the next five years to fund projects into a range of diseases, including dementia. A new dementia strategy, which will set out our plans in England for future years, including on research, will be published in 2022.

Local authority commissioned public health services in England are funded through a ring-fenced Public Health Grant, which has been maintained in the Chancellor’s Financial Statement.

Local authorities are best placed to make individual funding decisions based on local need. We will continue to work with the Local Government Association and professional bodies to share evidence and guidance that allows councils to make the best decisions to meet local need.

Each local authority must submit a return to the Department for Levelling Up, Housing and Communities, setting out how the Grant has been spent at the end of each financial year.

It is not possible to reliably estimate the average waiting time for children to complete an assessment for autism in Coventry, the West Midlands and England from the data currently collected by NHS Digital. Children and young people are largely out of scope of the current data collection. Available data shows that during Quarter 4 of 2020/21, there were a total of 9,055 new referrals for suspected autism among under 18 year olds recorded in England. Of these, approximately 12% or 1,060 received a first appointment in 13 weeks or less and 4% or 360 received a first appointment between 13 and 26 weeks.

To reduce diagnosis waiting times for children and young people across England, we are investing an additional £10.5 million in 2021/22 as part of the COVID-19 Mental Health and Wellbeing Recovery Action Plan and the NHS Long Term Plan. Local systems are using this funding to improve different diagnostic pathways. In addition, through our new autism strategy, we are funding an early identification pilot in which healthcare and education staff working together to assess children who may be autistic more quickly within schools.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.