Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to instruct NHS England to increase the baseline number of specialty training places in clinical oncology in order to progressively eliminate workforce shortfalls and reduce delays in cancer care.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government committed in the 10-Year Health Plan to create 1,000 new specialty training posts over the next three years with a focus on specialties where there is the greatest need. Further information on which specialties will receive these places and when will be announced in due course.
Alongside this, the Government will publish a 10 Year Workforce Plan later this spring. It will set out a clear roadmap to improve working lives in the National Health Service, through better treatment of staff, higher-quality training, and more fulfilling roles.
In addition, the Department will also use training more directly as a lever to support improvements in operational performance, prioritising training places in trusts, often those in rural or coastal areas, where vacancy rates are higher and performance is lower.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether any of the 1,000 new specialty training places announced in the 10 Year Health Plan will be available for recruitment rounds this year; and if so, whether clinical radiology and clinical oncology will receive any of the additional posts.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government committed in the 10-Year Health Plan to create 1,000 new specialty training posts over the next three years with a focus on specialties where there is the greatest need. Further information on which specialties will receive these places and when will be announced in due course.
Alongside this, the Government will publish a 10 Year Workforce Plan later this spring. It will set out a clear roadmap to improve working lives in the National Health Service, through better treatment of staff, higher-quality training, and more fulfilling roles.
In addition, the Department will also use training more directly as a lever to support improvements in operational performance, prioritising training places in trusts, often those in rural or coastal areas, where vacancy rates are higher and performance is lower.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of which specialities will receive new specialty training places from the 1,000 new training posts announced in the 10 Year Health Plan.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government committed in the 10-Year Health Plan to create 1,000 new specialty training posts over the next three years with a focus on specialties where there is the greatest need. Further information on which specialties will receive these places and when will be announced in due course.
Alongside this, the Government will publish a 10 Year Workforce Plan later this spring. It will set out a clear roadmap to improve working lives in the National Health Service, through better treatment of staff, higher-quality training, and more fulfilling roles.
In addition, the Department will also use training more directly as a lever to support improvements in operational performance, prioritising training places in trusts, often those in rural or coastal areas, where vacancy rates are higher and performance is lower.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what mechanisms are in place to ensure that integrated care boards adhere to the National Institute for Health and Care Excellence guideline that body mass index should not be used to exclude patients from referral for joint replacement surgery.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
National Institute for Health and Care Excellence guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice, and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.
It is the responsibility of individual integrated care boards to determine policies for their local area. As with all surgery, Body Mass Index (BMI) should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that the integrated care boards' use of body mass index threshold criteria for joint replacement surgery is in line with their commitments to reduce health inequalities, particularly in regions with lower life expectancy and higher burden of obesity and musculoskeletal conditions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.
The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.
As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.
No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to issue guidance to integrated care boards to stop the exclusive use of body mass index thresholds in restricting access to joint replacement surgery.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.
The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.
As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.
No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.
Asked by: Baroness Ritchie of Downpatrick (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 of body mass index-based restrictions on waiting times, pain, mobility and disease progression among patients awaiting joint replacement surgery.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of individual integrated care boards (ICBs) to determine policies for their local area, including that of the body mass index (BMI) threshold criteria for joint replacement surgery.
The National Institute for Health and Care Excellence has developed guidelines for BMI thresholds by experts based on a thorough assessment of the available evidence and through extensive engagement with interested parties. They are not mandatory but represent best practice and National Health Service organisations are expected to take them fully into account in ensuring that local services meet the needs of their populations.
As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.
No specific assessment has been made of the impact of BMI based restrictions on waiting times, pain, mobility, and disease progression among patients awaiting joint replacement surgery, and there are no current plans for the Department to issue guidance to ICBs on this matter.
Asked by: Baroness Ritchie of Downpatrick (Labour - 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 16 February (HL14349), on what evidence they base the conclusion that including wider societal benefits in vaccination appraisals would disadvantage programmes unable to evidence such benefits; and whether they have carried out a recent assessment of those benefits.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Our approach to decisions about vaccination programmes is informed by expert recommendations and advice from the Joint Committee on Vaccination and Immunisation (JCVI). Working closely with the UK Health Security Agency‑based JCVI secretariat, the Department ensures that the cost-effectiveness methodology for assessing vaccination programmes enables the committee to advise on programmes that deliver the greatest health benefit to the greatest number of people.
Understanding the wider impacts of vaccination beyond health benefits is important in making the broader case for investment in vaccines and in encouraging uptake of vaccines amongst those who are offered them, and can be considered in exceptional cases in addition to the cost effectiveness assessment. In recognition of this, the Department strives to remain abreast of work demonstrating the benefits of vaccination to the wider economy.
However, changing the cost-effectiveness methodology itself to consider a broader range of costed benefits runs the risk of unintended consequences for vaccination programmes which cannot robustly demonstrate these benefits.
That is because decisions are required on how best to spend public funds. If wider socio-economic benefits can be robustly demonstrated for some vaccination programmes but not others due to data availability, there is a risk that changing the cost-effectiveness methodology to include wider benefits could result in programmes with high-quality data being considered more valuable. These programmes could therefore be prioritised for funding over other vaccination programmes, not because they deliver greater overall benefit, but because the data on their wider economic impact is more complete.
The potential impact of this, and potential consequences for the vaccine supply market, including vaccine price, would need to be carefully considered and risks properly evaluated, before any systematic change to methodology.
Asked by: Baroness Ritchie of Downpatrick (Labour - 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 5 February (HL13800), whether they plan to conduct periodic reviews of the Joint Committee on Vaccination and Immunisation's cost-effectiveness methodology to ensure that it remains up-to-date and appropriate.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We have one of the most comprehensive vaccination programmes in the world. Our approach to evaluating vaccination programmes is informed by expert recommendations and advice from the Joint Committee on Vaccination and Immunisation (JCVI). Working closely with the UK Health Security Agency‑based JCVI secretariat, the Department ensures that the cost-effectiveness methodology for assessing vaccination programmes continues to enable the committee to advise on programmes that deliver the greatest health benefit to the greatest number of people.
The Department maintains oversight of this methodology on an ongoing basis, with particular focus when the range of available evidence and underlying evidence landscape changes over time. Those changes may arise from time to time at irregular intervals, and so it is unlikely to be helpful to review the methodology at fixed and regular intervals.
Asked by: Baroness Ritchie of Downpatrick (Labour - 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 5 February (HL13800), what assessment they have made of whether a health-systems focus on the benefits of vaccines and immunisations may disadvantage prevention within the health technology appraisals process.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The cost-effectiveness methodology used by the Joint Committee on Vaccination and Immunisation (JCVI) ensures that decisions are objective, consistent, and based on high-quality data on health benefits and costs. This approach is not understood to disadvantage vaccinations and immunisations as a form of prevention when compared with treatments, therapeutic health measures, or other forms of prevention.
This is because, similar to the JCVI, the National Institute for Health and Care Excellence also applies a health‑sector perspective when appraising preventative and treatment interventions. Beyond vaccines, many other health interventions can generate wider societal or economic benefits, and so applying an appraisal approach across the health system which is consistently focused on health benefits does not uniquely disadvantage vaccinations or immunisations.