Question to the Department of Health and Social Care:

To ask His Majesty's Government why there is disparity in the legal prescribing rights of various professions when nurses, pharmacists, physiotherapists, podiatrists, therapeutic and diagnostic radiographers, dietitians and paramedics all undertake prescribing training together, and are assessed in the same way.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Non-medical prescribers must work within their own level of expertise. This, together with the requirements of the roles in which different professions are employed, is reflected in the differences between the legal prescribing responsibilities of these professions. Regulators keep records of which healthcare professionals can prescribe, and employers have a responsibility to ensure that non-medical prescribers undertake the relevant training and development, so that their knowledge and skills remain up to date. This is to ensure clinicians work within their sphere of competence.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when they will respond to the report by the Patient Safety Commissioner The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh, published on 7 February.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government is carefully considering the valuable work done by the Patient Safety commissioner and the resulting Hughes Report, which set out options for redress for those harmed by valproate and pelvic mesh. We will be providing an update to the Patient Safety Commissioner’s Report at the earliest opportunity.

Found: You will remember that Baroness Cumberlege did the “First Do No Harm” report into mesh, Primodos and

Found: Members present: Lord Patel (The Chair); Baroness Blackstone; Viscount Colville of Culross; Baroness Cumberlege

Found: Members present: Lord Patel (The Chair); Baroness Blackstone; Viscount Colville of Culross; Baroness Cumberlege

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Found: 2024 3.50 pm Watch the meeting Members present: Lord Patel (The Chair); Baroness Blackstone; Baroness Cumberlege

Found: 2024 3 pm Watch the meeting Members present: Lord Patel (The Chair); Baroness Blackstone; Baroness Cumberlege

Found: present: Baroness Wyld (In the Chair); Baroness Blackstone; Viscount Colville of Culross; Baroness Cumberlege

Found: Members present: Lord Patel (The Chair); Baroness Blackstone; Viscount Colville of Culross; Baroness Cumberlege

Found: Members present: Lord Patel (The Chair); Baroness Blackstone; Viscount Colville of Culross; Baroness Cumberlege

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential implications for his policies of the report by (a) Baroness Cumberlege entitled Independent Medicines and Medical Devices Safety Review, published 8 July 2020 and (b) Dr Henrietta Hughes entitled Options for redress for those harmed by valproate and pelvic mesh, published on 7 February 2024; and whether he plans to establish a taskforce to improve patient advocacy services for those affected by vaginal mesh implants.

Answered by Andrew Gwynne

The Independent Medicines and Medical Devices Safety Review’s overarching conclusion was that the system failed to listen to patients or put patients at the centre of their care. Subsequent work has focussed on improving how the system listens to and responds to concerns raised by patients, strengthening the evidence base on which decisions are made, including through making sure the right data is collected and used, and improving the safety of medicines and devices.

The Government is carefully considering the valuable work done by the Patient Safety Commissioner and the resulting Hughes Report, which builds on some of the issues identified by Baroness Cumberlege in the IMMDS Review. The Hughes Report sets out options for redress for those harmed by valproate and pelvic mesh, including a proposal on advocacy services. We will be providing an update to the Patient Safety Commissioner’s report at the earliest opportunity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support those impacted by Primodos.

Answered by Andrew Gwynne

Primodos is one of three areas Baroness Cumberlege was asked to look into as part of her Independent Medicines and Medical Devices Review, which reported in 2020. Since the report was published, action has been taken to address the issues identified, including appointing the first Patient Safety Commissioner to champion patient voice in relation to the safety of medicines and medical devices.

Found: The Independent Medicines and Medical Devices Safety Review was chaired by Baroness Cumberlege.

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Found: been highlighted by the 2020 Independent Medicines and Medical Device Safety Review led by Baroness Cumberlege

Found: Baroness Cumberlege has made recommendations and identified actions for improvement in the report ,

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Found: stakeholder inputs, and produce a SG response to the specialist centres recommendation from the Baroness Cumberlege

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Question

What steps is the Cabinet Secretary taking to establish a patient safety commissioner?

Answered by Cabinet Secretary for Health and Social Care

When Baroness Cumberlege first made her recommendation for a Patient Safety Commissioner in the Independent Review of Medicines and Medical Device Safety Report, we were in the process of introducing several patient safety and quality measures, having already strengthened the powers of the Public Services Ombudsman

The range of measures introduced as part of the Health and Social Care (Quality and Engagement) (Wales) Act 2020 included setting up the new citizen voice body – now known as Llais – introducing the Duty of Quality and the Duty of Candour. Taken together these have strengthened patient advocacy and people’s ability to have their voices heard and to be responded to in an open and transparent way.

Llais provides a representative voice and advocacy for people as they use health and social care services and has a role in identifying themes in what people are communicating about services, this includes safety and quality concerns. Llais is developing its role alongside the inspectorates and other assurance functions within Welsh healthcare to ensure these themes are addressed.

The Health and Care Quality Standards (introduced with the Duty of Quality) set out the requirements for safety and quality within the provision of NHS services in Wales.

My officials are keeping the recommendation for a Patient Safety Commissioner under review to understand and learn from the impact of the commissioners in England and Scotland, which operate differently, alongside a review of the impact of those duties and measures implemented in Wales over the last couple of years.

Question

What steps has the Minister taken to ensure that each health board has developed its own services to address the needs of local women experiencing pain or complications due to the use of vaginal synthetic mesh tape and sheets for stress urinary incontinence and pelvic organ prolapse?

Answered by Minister for Climate Change

Since the establishment of the Women’s Health Implementation Group (WHIG) in 2018, a significant proportion of its budget has been spent on resourcing the pelvic floor services in each of the health boards in Wales. These services range from continence support, physiotherapists, nurses and psychological support for pelvic floor dysfunction patients, which include mesh patients, stress urinary incontinence and pelvic organ prolapse patients.

Part of this funding has provided for a network of Pelvic Health and Well-being Coordinators in each health board, to help signpost women to appropriate services and ensure they are supported through appropriate community-based pathways.

Besides its existing work, the WHIG has also been asked to consider the recommendations from the Independent Medicines and Medical Devices Review Chaired by Baroness Cumberlege as they pertain to vaginal mesh.

Historically, the WHIG has established good links with women’s groups, in particular mesh survivors. Indeed, one particular group, Fair Treatment for Women of Wales (FTWW) has sat on the WHIG to offer a perspective from service users. The initial Chair of the WHIG held regular meetings with mesh survivors, allowing their concerns to feed into the work of the group. As the WHIG commences on work in response to Cumberlege Review recommendations in relation to mesh, it will be important that these links continue so as to ensure that the patient voice is heard effectively.

The Pelvic Health and Well-being Coordinators in each health board, which have been funded by the WHIG are in regular contact with mesh survivors in their area. This is particularly true in Swansea Bay University Health Board, as Swansea is the major tertiary centre for mesh removal in Wales.

My officials are engaging with those in UK Government to ensure that mesh removal services in Wales are offered in accordance with the same standards as those in England and that linkages are built across clinical networks to ensure best practice is shared.

I can confirm that clinicians in the tertiary centre in Swansea are working closely with colleagues in England to ensure that the same high standards of care apply to mesh surgery and that officials are working to introduce suitable referral pathways so that women who wish to be treated at mesh centres in other parts of the UK are able to do so.

Question

What progress has been made in Wales in implementing the findings of the Cumberlege review: First do no harm, published in July 2020?

Answered by Minister for Health and Social Services

The Cumberlege recommendations are primarily focused on England but they have implications for Wales. 

I issued a written statement on 15 July about the Cumberlege review: https://gov.wales/written-statement-baroness-cumberleges-announcement-use-surgical-mesh

In that statement, I said the principle of high vigilance to ensure mesh use is restricted until the same conditions Baroness Cumberlege identified in her report are met should also apply in Wales. Her recommendations were consistent with those made by the review panel, which I set up at the end of 2019. 

It is my expectation that sufficient levels of clinical governance, including consent, audit and research are in place in health boards in Wales to ensure all women can be confident that all possible safeguards are in place. 

The evidence we have already of a significant reduction in the use of vaginal mesh procedures in Wales suggests a “pause” is already largely in place, driven by a change in clinical decision making during recent years. However, it is my expectation that these additional restrictions will be the case until the requirements for increased safeguards can be met.

Action has already been taken on some of the recommendations. Specialist mesh centres have been identified in Swansea and Cardiff and work is underway in establishing a UK-wide medical device information system.

In addition, the Women’s Health Implementation Group will be tasked with considering many of the recommendations of the Cumberlege review as they pertain to mesh, as this is consistent with work the group is already doing in this area.

My officials are examining the other recommendations which relate to Wales and are working with the other UK governments to look at those recommendations with a UK remit.  The Medicines and Medical Devices Bill, currently before the House of Lords, will also impact in relevant areas.

I will issue a further statement when officials have completed their assessment of the options available and their implications for the future effectiveness of Wales’ healthcare service.