Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the adequacy of myalgic encephalomyelitis/chronic fatigue syndrome services commissioned by (1) Norfolk and Waveney, and (2) Suffolk and North East Essex, Integrated Care Board.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning specialist myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) services that meet the needs of their population subject to local prioritisation and funding. The process of commissioning services should take into account best practice guidance such as the National Institute for Health and Care Excellence guidance on ME/CFS diagnosis and management, published in October 2021. A copy of the guidance is attached.
The Government has been consulting on ‘My Full Reality’, the cross-Government interim delivery plan on ME/CFS, which seeks to improve the experiences and outcomes of people living with this condition. The plan contains a series of actions to improve access to specialist ME/CFS services. The final plan will be published in due course.
The Government has made no assessment of the ME/CFS services commissioned by Norfolk and Waveney, and Suffolk and North East Essex ICBs.
Asked by: Baroness Scott of Needham Market (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 (1) ensure people with myalgic encephalomyelitis (ME) have access to specialist ME/chronic fatigue syndrome services, and (2) increase funding available for such services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning specialist myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) services that meet the needs of their population subject to local prioritisation and funding. The process of commissioning services should take into account best practice guidance such as the National Institute for Health and Care Excellence guidance on ME/CFS diagnosis and management, published in October 2021. A copy of the guidance is attached.
The Government has been consulting on ‘My Full Reality’, the cross-Government interim delivery plan on ME/CFS, which seeks to improve the experiences and outcomes of people living with this condition. The plan contains a series of actions to improve access to specialist ME/CFS services. The final plan will be published in due course.
The Government has made no assessment of the ME/CFS services commissioned by Norfolk and Waveney, and Suffolk and North East Essex ICBs.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to provide a COVID-19 booster programme for the general population in light of new Omicron variants.
Answered by Lord Kamall
On 21 February 2022, the Government accepted advice from the Joint Committee on Vaccination and Immunisation (JCVI) to offer an additional booster dose in spring 2022 to those most vulnerable as a precautionary measure. An additional dose has been offered to all residents in care homes for older adults, individuals aged 12 years old and over who are immunosuppressed and all adults aged 75 years old and over.
On 19 May 2022, the JCVI provided interim advice on an autumn COVID-19 booster programme, which stated that an additional dose should be provided to residents in a care home for older adults and staff; frontline health and social care workers; all those aged 65 years old and over; and adults aged 16 to 64 years old in a clinical risk group. The JCVI continues to review the vaccination of other patient groups and details on the definitions of clinical risk groups. The JCVI will issue further advice if necessary.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they expect general practitioners to use their clinical judgement in including patients with existing diseases in Group 6 for COVID-19 vaccinations if they consider them to be at risk of exacerbation of their underlying disease should they become infected with COVID-19.
Answered by Lord Bethell
Clinicians, including general practitioners (GPs) are able to use their clinical judgement to categorise patients as clinically extremely vulnerable (CEV) because they consider them to be at very high risk of serious illness from COVID-19. Those categorised as CEV are in priority group four of phase one of the vaccination programme. Those who are not categorised as CEV but have underlying conditions that the Joint Committee on Vaccination and Immunisation (JCVI) advises have increased clinical risk from COVID-19 are in priority group six. Within the broad set of clinical conditions within priority group six, GPs and other clinicians are able to add individuals to this group. They are able to use clinical judgement to take into account the risk of COVID-19 exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from the virus itself.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they recommend graded exercise therapy for patients with post COVID-19 symptoms.
Answered by Lord Bethell
On 18 December 2021 the National Institute for Health and Care Excellence, the Royal College of General Practitioners and the Scottish Intercollegiate Guidelines Network published a guideline on the management of the long term effects of COVID-19. A copy of COVID-19 rapid guideline: managing the long-term effects of COVID-19 is attached. In developing the guideline, an expert panel undertook an evidence review into self-pacing and graded forms of exercise.
The panel considered the careful self-pacing of exercise to be an important element of self-management. However, they concluded that in the absence of evidence relating to people with ongoing symptoms from COVID-19, it could not make specific recommendations. A copy of COVID-19 rapid guideline: managing the long-term effects of COVID-19 (NG188). Evidence review 5: interventions is attached. COVID-19 is a new disease and therefore it is not yet clear what the physical, psychological and rehabilitation needs will be for those experiencing long term effects of the virus.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether patients presenting with 'long-COVID' symptoms following (1) diagnosed, or (2) undiagnosed COVID-19, are recommended to participate in the Improving Access to Psychological Therapies programme for medically unexplained symptoms.
Answered by Lord Bethell
Integrating working between mental health and physical health services is an important principle of the treatment and rehabilitation of people with ‘long’ COVID-19. The National Health Service is supporting the establishment of assessment clinics in England for patients with long COVID-19 symptoms who were diagnosed with the virus or who were undiagnosed but suspected of having had COVID-19. This will include specialist physical, cognitive or psychological assessment.
Following assessment, people with persistent mental health problems that involve depression, anxiety or post-traumatic stress disorder should be considered for a referral to an Improving Access to Psychological Therapies (IAPT) service. Where appropriate, people can be referred to IAPT for long term conditions and medically unexplained symptoms service where they exist.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government under which SNOMED code patients with 'long COVID-19' symptoms are categorised.
Answered by Lord Bethell
The SNOMED-CT codes are as follows:
- Acute COVID-19 infection (1325171000000109)
- Ongoing symptomatic COVID-19 (1325181000000106)
- Post-COVID-19 syndrome (1325161000000102)
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the use of steroid inhalers for the prevention of serious symptoms of COVID-19.
Answered by Lord Bethell
The Department has monitored a collection of small studies which have now completed and provided some positive signals on inhaled steroids. This includes the STOIC study at Oxford University which examined the use of inhaled budesonide, a corticosteroid, in the treatment of early COVID-19. STOIC published results which are undergoing peer review. However, larger-scale studies are still needed to confirm the effectiveness and safety of such treatments.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government why Chronic Fatigue Syndrome (CFS) is not listed on the topics covered by the NHS Clinical Knowledge summary; who authorised the decision to combine CFS with “Tiredness/fatigue in adults”; and when that change was made.
Answered by Lord Bethell
The National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summary Tiredness/fatigue in adults was published in October 2009 and there has been no change in the way it is titled over the subsequent period. NICE advises that the inclusion of Chronic Fatigue Syndrome (CFS) within the tiredness/fatigue topic is to ensure that clinicians will consider CFS as a potential diagnosis as early as possible in the course of care of a person presenting with symptoms of tiredness and fatigue.
In 2007 NICE published the guideline, Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management. This is currently being updated and a draft guideline is out for consultation with the final guidance expected in April 2021. The CFS diagnosis and management sections in the Clinical Knowledge Summary on Tiredness/Fatigue are kept in line with NICE guidance on CFS and will be updated following publication of the new guidance if necessary.
Asked by: Baroness Scott of Needham Market (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to reports of the increased risk of serious COVID-19 related illness in the over 60s, what work they are conducting to assess the increased risk of over 60s working in the care system, and in particular, those who have come out of retirement to support services during the pandemic.[T]
Answered by Lord Bethell
We are very grateful to all those working in social care for their incredible commitment to caring for others at this difficult time; we are especially thankful to those who have returned to work or come out of retirement to support services to deliver the best possible care.
We expect every employer to ensure that each employee is undertaking a role that is appropriate to their skills, experience, and personal circumstances. This is the case whether the employee is a permanent member of staff, or somebody who has returned to the sector to help care for and support people during the pandemic. Where, because of their own circumstances, an employee needs to shield themselves, then a social care employer is able to place these staff on furlough.