Asked by: Dawn Butler (Labour - Brent Central)
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 help ensure the Major Conditions Strategy improves breast cancer outcomes for ethnic minority women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women, including black women, is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including metastatic breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in operational planning guidance for the health system. The Core20PLUS5 approach for adults has been rolled out as an NHS England framework to focus action on reducing inequalities on issues within the National Health Services’ direct influence, which are major contributors to inequalities in life expectancy through major conditions like cancer, cardiovascular disease, respiratory disease, and others, or Long-Term Plan priorities where stark inequalities are evident, such as maternity or severe mental illness.
The key actions for systems as highlighted in NHS England’s planning guidance for 2024/25 is to continue to deliver against the five strategic priorities for tackling health inequalities. Additionally, by the end of June 2024, NHS England aims to publish joined-up action plans to address health inequalities, and implement the Core20PLUS5 approach.
Improving earlier diagnosis of cancers, including breast cancer, is also a priority for the Government. The NHS has an ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, which will help tens of thousands of people live for longer. Additionally, the new cancer standards developed and supported by cancer doctors and implemented in October 2023, will ensure patients are diagnosed faster, and that treatment starts earlier. In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support the delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.
Whilst the Major Conditions Strategy does not seek to describe everything that is being done, or could be done, to meet the challenges of individual conditions in silo, it instead focuses on the changes likely to make the most difference across the six groups of major conditions, including cancer.
Asked by: Andrew Rosindell (Conservative - Romford)
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 tackle the recent increase in cases of tuberculosis.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
To support tuberculosis (TB) control in England, the UK Health Security Agency (UKHSA) and NHS England launched a collaborative TB Action Plan in July 2021. This has specific actions and measurable objectives to improve the prevention, detection, and control of TB in England. This action plan is available at the following link:
https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england
The UKHSA and NHS England continue their work with partners to raise awareness of TB among vulnerable communities and healthcare professionals, to support early detection and diagnosis of TB. The measures identified in the action plan are currently being reviewed in the light of the current increase in cases, to ensure resources are focused on the actions with the highest benefit.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
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 benefits of introducing more flexible working arrangements for maternity staff in NHS services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Flexible working arrangements, or We work flexibly, is one of the elements contained in the NHS People Promise, with a commitment to deliver for staff, including midwives, by 2024/25. NHS England has created and shared flexible working arrangement resources, and delivered bespoke webinars and workshops on the issue. They have also brought together midwifery leaders from across the system to share good practice, foster collaboration, and support the implementation of flexible working across maternity services.
In September 2021, contractual changes took effect for employees covered by the NHS Terms and Conditions of Service Handbook, which includes the right to request flexible working from day one, without the need to provide a justification.
Flexible working is one of the key pillars of improving staff experience and retention, as set out in the Long Term Workforce Plan. It will contribute to the aim of retaining up to 130,000 more staff over the course of the plan. However, no assessment of the benefits of introducing more flexible working arrangements specifically for maternity staff has been made.
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 assessment she has made of the impact of air quality on the health of residents in Warwick and Leamington constituency.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The fraction of mortality attributable to particulate air pollution indicator, measured as PM2.5, represents the percentage of annual deaths from all causes in those aged 30 years old and older, attributed to PM2.5. In 2022, the latest year from which published data is available, the fraction of mortality attributable to particulate air pollution was 5.5% for Warwickshire, and 5.5% for Warwick.
The UK Health Security Agency (UKHSA) produces the estimates of the fraction of mortality attributable to particulate air pollution in English local authorities and regions, as an indicator within the Public Health Outcomes Framework for England, published by the Office for Health Improvement and Disparities. This framework is available at the following link:
The UKHSA provides the scientific secretariat to the Committee on the Medical Effects of Air Pollutants, an expert committee of the Department, which advises the Government on matters concerning the health effects of air pollutants. Further information on this committee is available at the following link:
https://www.gov.uk/government/groups/committee-on-the-medical-effects-of-air-pollutants-comeap
Asked by: Baroness Burt of Solihull (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to introduce better perioperative practices into the NHS to reduce the number of surgical cancellations, complications, and extended stays in hospital.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
In May 2023, NHS England published guidance in an online-only format setting out five core perioperative care requirements relating to the care of adult patients awaiting planned inpatient surgery. Implementation of these core requirements will reduce post-surgery complications and length of stay and reduce the likelihood of short notice postponement or cancellations occurring for avoidable clinical reasons. The NHS England National Elective Recovery and Outpatients programme is working with NHS England regional teams to help oversee and support compliance and will continue to do so throughout 2024/25. Beyond these requirements, we are encouraging the adoption of practices such as enhanced recovery initiatives, which minimise length of stay and reduce complications, using the Commissioning for Quality and Innovation framework as a financial incentive, and maximising day surgeries where clinically appropriate to minimise risk of cancellation from bed pressures.
Asked by: Baroness Gale (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is their assessment of the impact of the NHS long-term workforce plan upon the number of specialists such as Parkinson’s nurses in the NHS.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
In June 2023, we published the Long Term Workforce Plan which sets out the steps the National Health Service and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years.
The Plan commits to double the number of medical places, taking the total number of places to 15,000 by 2031/32 and including a commensurate increase in specialty training places that meets the demands of the NHS in the future. It also commits to increasing adult nursing places by 92%, taking the number of total places up to nearly 38,000 by 2031/32.
There are a record number of nurses working in the NHS and we have reached our target of 50,000 additional nurses, meaning we have delivered on our commitment six months early. In January 2024 there are over 363,000 nurses working across the NHS, representing over 62,000 more than in September 2019.
Asked by: Janet Daby (Labour - Lewisham East)
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 work with local authorities to increase access to support services for people with autism.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Our national autism strategy, published in July 2021, acknowledges the importance of autistic people being able to access community support, including social care, and that this support should be available at the right time, and tailored to autistic people’s needs. We are currently updating the Autism Act Statutory Guidance to support the National Health Service and local authorities in delivering improved outcomes for autistic people. This will include setting out what local authorities must and should be doing to support autistic adults.
Under the Care Act 2014, it is the responsibility of local authorities to assess individuals’ care and support needs, including those of autistic adults, and, where eligible, to meet those needs. A new duty for the Care Quality Commission (CQC), to assess local authorities’ delivery of their Care Act 2014 duties, went live on 1 April 2023, and the formal assessment period has started. The CQC will examine how well local authorities deliver their Care Act duties, including those that apply to autistic people with care and support needs. This will increase transparency and accountability and, most importantly, drive improved outcomes for people who draw on care and support.
Each integrated care board (ICB) must have an Executive Lead for learning disability and autism, to support them in delivering care and support for autistic people in their area. NHS England has published statutory guidance on these Executive Lead roles. Key areas of the Executive Lead role include, but are not limited to: supporting the board in developing a strategic plan for people with a learning disability and autistic people, with local authorities and wider partners; using joint commissioning principles to work together to facilitate appropriate community support, care, and housing; and enabling people to live well at home. It also includes working with local authorities, primary care networks, place-based partnerships, provider collaboratives, health care providers, and wider partners to address inequalities in health outcomes for people with a learning disability and autistic people.
Asked by: Lord Turnberg (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact on the mental health of medical practitioners of withdrawing NHS Practitioner Health services for new applicants.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We recognise that the NHS Practitioner Health service is valued by many doctors. NHS England is reviewing the service as part of a wider review of its mental health and wellbeing offer to National Health Service staff. It was confirmed on 15 April 2024 that the service will continue to accept new patients from primary and secondary care whilst this review is undertaken over the next 12 months. NHS England will confirm future arrangements once the review has been completed.
Asked by: Henry Smith (Conservative - Crawley)
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 genomics testing for bowel cancer patients.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
A National Health Service testing programme is helping to diagnose thousands of people with a genetic condition, Lynch Syndrome, that increases the chance of developing certain cancers including bowel cancer. The national programme ensures all people diagnosed with bowel cancer are offered genomic testing, with a diagnosis for Lynch Syndrome not only helping to guide more personalised cancer treatment but enabling their families and relatives to be offered testing too. Relatives who receive a diagnosis of Lynch Syndrome can be referred to genetic services to discuss regular testing options to help catch any cancers as early as possible, as well as to consider preventive options such as taking aspirin or undergoing risk-reducing surgery.
Genomic testing in the NHS in England is provided through the NHS Genomic Medicine Service (GMS) and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory (NGTD) which outlines the full range of genomic testing offered by the NHS in England including tests for 3,200 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The NGTD sets out the eligibility criteria for patients to access testing as well as the genomic targets to be tested and the method that should be used, including testing for bowel cancer patients.
The NHS GMS cancer genomic testing strategy has facilitated a move to a consolidated laboratory network through the seven NHS GLHs delivering more extensive panel testing using cutting edge high throughput Next Generation Sequencing (NGS) technology. For patients, including those with bowel cancer, this technology enables testing for a larger number of genetic variations to give a more precise diagnosis, identify biomarkers to target treatment and opportunities to access innovative medicines, and can support enrolment into molecularly stratified clinical trials.
Testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional (for example, their general practitioner or other healthcare professional if they are already being seen in a relevant service) whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS clinical genomics service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.
The 17 NHS Clinical Genomic Services (NHS CGSs), commissioned by NHS England, deliver a comprehensive clinical genomic and counselling service that directs the diagnosis, risk assessment and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a rare genetic or genomic condition. As part of the NHS CGS, the patient and their family will access diagnosis, and management relevant to their particular condition, but also receive support and guidance so that they are able to understand their condition, its implications, and their options in relation to reproduction, screening, prevention and clinical management.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of the shortage of the psychotropic medication Olanzapine, and what steps they are taking to ensure that such shortages do not affect the health and safety of patients, and wider public safety.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are aware that there have been supply constraints with olanzapine 210 milligram, 300 milligram, and 405 milligram powder and solvent for prolonged release suspension for injection. We worked with manufacturers to uplift production, and the issues were resolved in February 2024. We worked with NHS England to issue national communications containing advice on how to manage patients whilst there was a disruption to supply. We are not aware of any supply issues affecting oral presentations of olanzapine, or of any supply issues with any risperidone or haloperidol products.