Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend to use the NHS Planning Guidance to direct integrated care boards to establish and maintain high-quality Fracture Liaison Services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Patients around the country, including those suffering from osteoporosis, are waiting too long for care and treatment. Our Plan for Change will get the health service back on its feet and make it fit for the future.
My Rt Hon. Friend, the Secretary of State for Health and Social Care has confirmed that planning guidance will be published in the new year.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they intend to publish a roll-out plan for Fracture Liaison Services in England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Fracture Liaison Services (FLS) are a globally recognised care model for secondary fracture prevention. The Government is committed to expanding access to these important preventative services.
FLS provision is ultimately a matter for integrated care boards, who are best placed to make commissioning decisions according to local need. The Department is continuing to work closely with NHS England to develop plans to ensure better quality and access to these important preventive services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many deaths in the UK there have been from AIDS-related illnesses in each of the last 10 years for which figures are available.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
While the information is not collected in the format requested, the following table shows the most recent HIV Action Plan monitoring and evaluation framework report, where UKHSA presented an estimated number of HIV-related deaths (30% of all-cause mortality in people with HIV) in England. Below is a summary table:
| 2019 | 2020 | 2021 | 2022 |
Total number of deaths (all-cause mortality) | 571 | 741 | 732 | 603 |
Estimated number of HIV-related deaths (30% of all-cause mortality) | 171 | 222 | 220 | 181 |
An in-depth analysis of 2022 deaths showed that 25% (103) of the 402 deaths from known causes were HIV related or possibly HIV related and 14% (55 deaths) included an AIDS-related condition as primary cause of death.
HIV is a priority for the government and, as set out in the Labour manifesto, the government have committed to commissioning a new plan to end new HIV transmissions within England by 2030. Ministers have commissioned officials for advice including engaging stakeholders from across the system to build upon the work of the previous Plan.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to improve women’s health, and whether they are committed to implementing the Women’s Health Strategy for England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to prioritising women’s health, and will be considering how to take forward the Women’s Health Strategy for England in due course.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Lord Evans of Rainow on 14 September (HL Debate, col 241GC), why the “package of prioritised measures to expand the provision of fracture liaison services and improve their current quality” was not mentioned in the Autumn Statement.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Noble Lord's letter of 15 September 2023 following the debate confirmed the position that the Government would continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison services (FLS). A copy of this letter was placed in the House library.
FLS are commissioned by integrated care boards (ICBs) which are well placed to make decisions according to local need. NHS England is also supporting requests from health systems to introduce FLS and other secondary fracture prevention services, including through the Falls and Fragility Fracture Audit Programme.
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. This strategy will explore how we can tackle the key drivers of ill-health in England, reduce pressure on the National Health Service and reduce ill-health related labour market inactivity. The Strategy will focus on six major groups of conditions including musculoskeletal conditions, such as osteoporosis.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have any plans to collaborate with media organisations, social media influencers, and public figures including celebrities, to portray accurate and empathetic representations of people living with HIV in order to counteract harmful stereotypes; and, if so, what are their plans.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
HIV Prevention England (HPE) is the national HIV prevention programme for England and is funded at £3.5 million by the Department. The programme aims to support communities who are disproportionately affected by HIV, including gay, bisexual and men who have sex with men and Black African heterosexual men and women. The Department has appointed Terrence Higgins Trust, a national charity who provide services related to sexual heath and HIV, to deliver the programme from 2021 to 2024. HPE delivers a nationally co-ordinated programme of HIV prevention work, including public campaigns such as National HIV Testing Week, that is designed to complement locally commissioned prevention activities in areas of high HIV prevalence. HPE also aims to improve knowledge and understating of HIV transmission and reducing stigma within affected communities.
HPE works with a wide range of models and their network of influencers and develops its strategies based on comprehensive data, audience insight and knowledge from local partners within England which ensure a wide range of patient’s voices and experiences are represented.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are planning to implement comprehensive public education campaigns to raise awareness about HIV transmission and treatment advancements, and to tackle stigma; and, if so, what are their plans.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
HIV Prevention England (HPE) is the national HIV prevention programme for England and is funded at £3.5 million by the Department. The programme aims to support communities who are disproportionately affected by HIV, including gay, bisexual and men who have sex with men and Black African heterosexual men and women. The Department has appointed Terrence Higgins Trust, a national charity who provide services related to sexual heath and HIV, to deliver the programme from 2021 to 2024. HPE delivers a nationally co-ordinated programme of HIV prevention work, including public campaigns such as National HIV Testing Week, that is designed to complement locally commissioned prevention activities in areas of high HIV prevalence. HPE also aims to improve knowledge and understating of HIV transmission and reducing stigma within affected communities.
HPE works with a wide range of models and their network of influencers and develops its strategies based on comprehensive data, audience insight and knowledge from local partners within England which ensure a wide range of patient’s voices and experiences are represented.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many sick days a year are caused by osteoporotic fractures; whether they have conducted any studies into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on this figure; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
23.4 million days were lost due to sickness absence in 2022 where the condition given was a musculoskeletal condition. This represented 12.6% of all days lost to sickness absence and was the third most common reason. Musculoskeletal conditions include back pain, neck and upper limb problems and other musculoskeletal conditions. This may include osteoporosis but sickness absence data for this specific condition is not held by the Department.
The International Osteoporosis Foundation’s report ‘BROKEN BONES, BROKEN LIVES: A roadmap to solve the fragility fracture crisis in Europe’ found that the total number of sick days taken after a fragility fracture in the United Kingdom in 2017 was over 2.5 million days. No studies have been carried out into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on sick days caused by osteoporotic fractures, and there are currently no plans to commission any.
In August 2023, we set out our initial plans for the Major Conditions Strategy within the Case for Change and our Strategic Framework. This initial report sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy. This included, together with NHS England, exploring further supporting the provision of Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have conducted any studies into the savings which would accrue to the NHS from investment to enable universal, high-quality Fracture Liaison Services across England; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We continue to work closely with stakeholders, including the Royal Osteoporosis Society, to further understand the needs of people living with osteoporosis and consider how health and care services can better support them. Fracture Liaison Services are key to prompt diagnosis of osteoporosis and are acknowledged as the world standard for secondary fracture prevention. According to the Royal Osteoporosis Society, for every £1 spend on Fracture Liaison Services in the United Kingdom, £3.26 is saved by the National Health Service.
The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have made any assessment of the impact of fragility fractures caused by undiagnosed osteoporosis on informal care-givers of working age; and what the impact of this is on the labour market.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Unpaid carers play a vital role in our communities, and we all owe them a debt of gratitude. We want unpaid carers to live healthy and fulfilling lives alongside their caring role.
No assessment, specifically on the impact of fragility fractures caused by undiagnosed osteoporosis on informal caregivers of working age; and what the impact of this is on the labour market, has been made. However, the Care Act (2014) requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for unpaid carers. Local authorities are required to undertake a Carer’s Assessment for any unpaid carer who appears to have a need for support and to meet their eligible needs on request from the carer.
In 2023/24, £327 million of funding from the Better Care Fund have been earmarked to provide short breaks and respite services for carers. This also funds additional advice and support to carers and a small number of additional local authority duties.
The enormous contribution made by unpaid carers is reflected throughout the social care reform white paper People at the Heart of Care, published in December 2021, and Next Steps to put People at the Heart of Care, published in April 2023.