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 consideration is being given to specialised dermatology, immunology and allergy services as part of NHS England’s review of commissioning, including services for patients living with chronic spontaneous urticaria.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.
In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.
A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.
The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.
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 increase capacity in specialist dermatology services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.
In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.
A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.
The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.
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 consideration has been given to the use of AI algorithms to help triage patients in primary care settings, particularly in relation to patients presenting with dermatological symptoms that can be mistaken as allergy, such as patients living with chronic spontaneous urticaria.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.
To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.
The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.
Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.
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 improve awareness of chronic spontaneous urticaria among clinicians, particularly in primary care settings, to help reduce delays to diagnosis.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.
To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.
The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.
Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.
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 benefits of introducing a comprehensive breast cancer risk assessment for all women, including younger pre-screening age women.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In England, breast screening is offered to women under the age of 50 years old according to nationally recommended guidelines, based on their assessed risk of developing breast cancer. These can be found on the National Institute for Health and Care Excellence’s website in an online-only format.
Women younger than 50 years old are not routinely screened for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 years old tend to have denser breasts. The denseness of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.
Due to this and other factors, there is a risk of over-treatment and distress for women who do not have breast cancer but would be subjected to invasive and painful medical treatments and diagnostic tests. Therefore, the Government does not currently plan to introduce comprehensive breast cancer risk assessments for women under 50 years old, although the UK National Screening Committee keeps age brackets under review.
Some women have an increased chance of developing breast cancer because of their genes. Five to 10 out of 100, or 5% to 10% of, all breast cancers happen because of an inherited tendency, also called a genetic predisposition.
National Health Service breast cancer risk assessments in England are undertaken to identify the risk of having an inherited tendency of developing breast cancer. It is up to integrated care boards to commission breast cancer risk assessment services locally in line with national clinical guidance.
The NHS website has a webpage that raises awareness of checking breasts for potential symptoms of breast cancer in all age groups. The NHS Breast Screening Programme produced a five-point plan for being breast aware. The plan sets out that individuals should know what's normal for them, look at and feel their breasts, know what changes to look for, report any changes to a general practitioner without delay and attend routine screening when invited.
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 extend breast cancer risk assessment to women under 50 years of age.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In England, breast screening is offered to women under the age of 50 years old according to nationally recommended guidelines, based on their assessed risk of developing breast cancer. These can be found on the National Institute for Health and Care Excellence’s website in an online-only format.
Women younger than 50 years old are not routinely screened for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 years old tend to have denser breasts. The denseness of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.
Due to this and other factors, there is a risk of over-treatment and distress for women who do not have breast cancer but would be subjected to invasive and painful medical treatments and diagnostic tests. Therefore, the Government does not currently plan to introduce comprehensive breast cancer risk assessments for women under 50 years old, although the UK National Screening Committee keeps age brackets under review.
Some women have an increased chance of developing breast cancer because of their genes. Five to 10 out of 100, or 5% to 10% of, all breast cancers happen because of an inherited tendency, also called a genetic predisposition.
National Health Service breast cancer risk assessments in England are undertaken to identify the risk of having an inherited tendency of developing breast cancer. It is up to integrated care boards to commission breast cancer risk assessment services locally in line with national clinical guidance.
The NHS website has a webpage that raises awareness of checking breasts for potential symptoms of breast cancer in all age groups. The NHS Breast Screening Programme produced a five-point plan for being breast aware. The plan sets out that individuals should know what's normal for them, look at and feel their breasts, know what changes to look for, report any changes to a general practitioner without delay and attend routine screening when invited.
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 regional variations in access to specialist care for chronic spontaneous urticaria, and what steps they are taking to address those variations.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England’s Getting It Right First Time (GIRFT) programme addresses regional variations in healthcare by identifying areas of unwarranted variation and working with local teams to implement improvements and reduce differences. Through GIRFT’s Further Faster programme, hospital trust clinicians and operational teams are being brought together with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.
A Further Faster handbook for dermatology, which covers conditions like chronic spontaneous urticaria, has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.
In addition, NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.
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, if any, to include personalised breast cancer risk assessments in the NHS Health Check programme for women under 50 years of age.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Some women have an increased risk of developing breast cancer because of their genetics. NHS breast cancer risk assessments are undertaken to identify women under the age of 50 years old at higher risk and offer them breast screening according to national guidelines.
The NHS Health Check, a core component of England’s cardiovascular disease prevention programme, assesses risk factors for cardiovascular disease in people aged 40 to 74 years old and refers them to behavioural support services and clinical management where appropriate.
For these reasons, the Department does not have plans to include personalised breast cancer risk assessments for women under 50 years old in the NHS Health Check Programme.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Foreign, Commonwealth & Development Office:
To ask His Majesty's Government what assessment they have made of the advisory opinion of the International Court of Justice on 19 July 2024 regarding the legal consequences arising from the policies and practices of Israel in the Occupied Palestinian Territory; and when they expect to publish their analysis of that advisory opinion and its policy implications.
Answered by Lord Collins of Highbury - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)
The UK respects the independence of the International Court of Justice, and we are considering its Advisory Opinion of 19 July 2024 with the seriousness and rigour it deserves. We have been clear that many aspects of the Opinion are already government policy: Israeli settlements are illegal under international law, and Israel should end its presence in the Occupied Palestinian Territories as swiftly as possible.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department for Energy Security & Net Zero:
To ask His Majesty's Government what plans they have to work with Ofgem to publish updated planning and grid connection guidance for digital infrastructure to prevent bottlenecks in the grid connections queue and to ensure that other sectors are not deprioritised in favour of data centres.
Answered by Lord Wilson of Sedgefield - Lord in Waiting (HM Household) (Whip)
As announced in the Industrial Strategy, my department is developing measures to accelerate the connection of high-value strategic demand projects in a wide range of sectors, while continuing to support all users to connect to the grid more quickly through broader grid upgrades.
The Department is also working with Ofgem on its End-to-End Review of the obligations and incentives pertaining to network companies in the delivery of grid connections. This will improve customer communications and ensure high levels of service for all customers. This complements ongoing, fundamental reforms to the connections process that will significantly reduce congestion and bottlenecks.