Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they expect to provide a response to The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh, published on 4 February 2024 by the Patient Safety Commissioner before parliament rises for the summer; and if not, on what timeframe they expect to provide a response.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report in due course.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many prescriptions were given to women between the ages of 18–52 for sodium valproate in 2024, and what improvements have been made to the information provided to midwives to help them prepare expectant mothers with epilepsy.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The number of prescription items prescribed in England to women between the ages of 18 to 52 years old for sodium valproate in 2024 was 201,834.
Valproate must not be prescribed to women under the age of 55 years old who are able to have children, unless two specialists independently consider and document that there is no other effective or tolerated treatment, and the patient fulfils the conditions of a Pregnancy Prevention Programme (PPP). As part of the PPP, healthcare professionals should discuss the risks of valproate in pregnancy with the patient and the need to take effective contraception. The number of women who become pregnant while on valproate is very small and is monitored. Pregnant women with epilepsy should only be treated with valproate if there are no other treatment options.
The Medicines and Healthcare products Regulatory Agency has recently updated its guidance to assist healthcare professionals, including midwives, in supporting all women, especially those who are pregnant or planning a pregnancy. This updated guidance is readily available online.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what consideration they have given to providing controls on the use of the terms non-toxic and quasi-ceramic in cookware.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Food Standards Agency recognises the importance of clear and accurate labelling in relation to food contact materials. Under the Materials and Articles in Contact with Food Regulations 2012, all materials intended for contact with food must be safe and must not transfer substances to food in quantities that could endanger human health. This requirement applies regardless of the terminology used in marketing.
The terms “non-toxic” and “quasi-ceramic” are not defined or recognised as official terms under current food contact materials regulations. There are no plans to introduce specific definitions for them. Their use is instead subject to general consumer protection laws, which prohibit false or misleading claims.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 14 May (HL6764), whether (1) the Department of Health and Social Care, and (2) NHS England’s Workforce, Training and Education Directorate, either (a) hold data on the number of individual applicants for medical speciality training places, or (b) can extract such data from their existing systems.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England holds data based on the application process for medical specialty training, which allows for the identification of unique applicants. The following data is part of management information systems summarising information supplied in historic medical specialty training cycles and has not been quality assured for routine publication purposes. Applicants may have chosen to only apply to one specialty programme or may have made multiple applications within any year. The following table shows the data held on the number of unique applicants in rounds one and two of medical specialty training for each of the years 2020 to 2024 across the United Kingdom:
Entry year | Round one unique applicants | Round two unique applicants | Total number of unique applicants in rounds one plus unique applicants in round two |
2020 | 13,901 | 6,457 | 20,358 |
2021 | 17,154 | 6,685 | 23,839 |
2022 | 18,260 | 6,134 | 24,394 |
2023 | 20,297 | 6,081 | 26,378 |
2024 | 26,203 | 7,179 | 33,382 |
Source: NHS England Medical Specialty Programme Applications Data.
Round one of the medical specialty application process includes applications to first year specialty training and core training programmes, often referred to as ST1 and CT1, and some ‘higher’ medical specialty training programmes, usually at year three, often referred to as ST3. Round two is for entry to most ‘higher’ medical specialty training programmes, often referred to as ST3 or ST4. There will be a limited number of doctors who apply in a year to both rounds one and two, and therefore they will appear twice in the aggregated final column of this data.
The Department also has access to information held in the UK Medical Education Database (UKMED) which is managed jointly by the General Medical Council and the Medical Schools Council. NHS England submits specialty medical recruitment data to the UKMED. This includes more information on individual historical applications to medical specialty training, which underpins the data presented above.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the number of doctors who have applied for specialty training across all 65 medical specialties in terms of (1) individual applicants, and (2) numbers of applications, in each of the past five years; and what is the number of training places available per year in the same time period.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the total number of applications across all medical specialties for recruitment rounds from 2020 to 2024 in the United Kingdom, alongside the total number of posts available:
Entry year | Number of applications across all specialty training pathways | Number of posts cross all specialty training pathways |
2020 | 28,124 | 11,779 |
2021 | 31,890 | 11,579 |
2022 | 36,563 | 12,105 |
2023 | 42,794 | 12,680 |
2024 | 59,698 | 12,743 |
Source: NHS England, Medical Specialty Training Competition Ratios.
This data covers all round one and round two specialty training pathway programmes. The Department does not hold information on the number of individual, or unique, applicants that this comprises of. Data for individual specialties is published annually by NHS England and can be found on the NHS.UK website, in an online only format.
We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. This is central to the vision in our 10 Year Plan.
We will ensure that the number of medical specialty training places meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the number of general practices which have stopped offering prescriptions for hormones for transgender patients; and what steps, if any, they are taking to ensure that these prescriptions are available to all patients within a reasonable reach of their home.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold this data centrally. NHS England is currently carrying out a review of adult gender services, chaired by Dr David Levy, with the aim of producing an updated service specification. The review will examine the model of care and operating procedures of each service, and will carefully consider experiences, feedback, and outcomes from clinicians and patients. It will also look at how to overcome the challenges that some individuals face in accessing a timely prescription.
NHS England has also increased the number of adult gender dysphoria clinics in England from seven to 12, with the rollout of five new pilot adult clinics since July 2020. The rollout of these new clinics is helping to tackle long waiting times.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the number of NHS Trusts in England allowing physician associates to prepare recommended summary plan for emergency care and treatment (ReSPECT) forms and apply do not resuscitate orders; and whether they consider this practice to be legal and appropriate.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department and NHS England do not hold data on individual Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions at National Health Service trusts in England.
ReSPECT is a process which records personalised recommendations for a person’s clinical care and treatment for a future emergency in which they are not able to make decisions or to express wishes. These recommendations, including a cardiopulmonary resuscitation (CPR) decision, are developed through conversations between a person and the health care professionals involved with their care. Recommendations are recorded on a non-legally binding form.
The Resuscitation Council UK has produced guidance for organisations and healthcare professionals using the ReSPECT process. CPR decision policies are determined locally by organisations providing NHS care.
The Resuscitation Council UK, the British Medical Association, and the Royal College of Nursing have jointly produced guidance on decisions about CPR. It states that the overall clinical responsibility for decisions about CPR, including DNACPR decisions, rests with the most senior clinician responsible for the person’s care as defined explicitly by local policy.
The Government has commissioned Professor Gillian Leng CBE to lead an independent review of the physician and anaesthesia associate professions. It will consider the safety of the roles and their contribution to multidisciplinary healthcare teams. The conclusions of the review will inform the workforce plan to deliver the 10-Year Health Plan.
The review will consider the approach that was adopted in England to support the safe introduction, employment, and deployment of these new roles.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they have taken towards achieving no antibiotic prescription without diagnostic confirmation by 2027, as recommended by the World Innovation Summit for Health, and what future plans they have towards that aim.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing unnecessary antimicrobial prescriptions by supporting clinicians to prescribe the right antimicrobials only to those who need them is a core undertaking of the Government’s 2024 to 2029 antimicrobial resistance (AMR) national action plan (NAP). The NAP highlights the importance of accurate diagnostic testing to guide effective antibiotic use to help tackle AMR. Specifically, outcome four of the NAP commits to strengthening antimicrobial and diagnostic stewardship by improved targeting of antimicrobials and diagnostic tools. Furthermore, outcome six relates to supporting the development of diagnostics for infection.
The NAP includes targets to achieve a 5% reduction in total antibiotic use in human populations by 2029 from the 2019 baseline, and to ensure 70% of antibiotics used across the human healthcare system are from the ‘Access’ category, a new United Kingdom category, by 2029. The Department continues to work with cross Government bodies, including NHS England and the UK Health Security Agency, to deliver the outcomes and commitments outlined in the NAP.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to manage the NHS provision of biologic medications and other high-cost treatments, particularly to avoid inequality between patients under different integrated care boards.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) makes evidence-based recommendations for the National Health Service in England on whether new medicines, including biologics, should be routinely funded by the NHS based on an assessment of their clinical and cost-effectiveness.
The NICE evaluates all new medicines and significant licence extensions for existing medicines, and NHS England and the integrated care boards are legally required to fund the medicines recommended in a NICE appraisal, usually within three months of final guidance. The NICE’s evaluations and the associated funding requirement ensures that patients are consistently able to benefit from clinically and cost-effective medicines wherever they live in England.
Asked by: Baroness Bennett of Manor Castle (Green Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to ensure the future of the Greener NHS programme following the abolition of NHS England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds.