Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many plastic spacers for asthma inhalers (1) have been prescribed, and (2) at what cost, in each of the last five years; what guidance there is on how often such spacers need to be replaced; when such guidance was given to providers in the NHS; and what assessment they have made of the cost to the NHS of the implementation of this guidance.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the total number of prescription items, quantities and Net Ingredient Cost (NIC) of spacer/holding chamber devices that were dispensed in England regardless of where prescribed from January 2019 to November 2024:
Calendar Year | Total Items | Total Quantity | Total NIC (£) |
2019 | 1,857,744 | 1,974,051 | 11,960,224.48 |
2020 | 1,437,840 | 1,525,746 | 9,091,373.81 |
2021 | 1,652,145 | 1,752,204 | 10,847,694.23 |
2022 | 1,825,426 | 1,944,489 | 12,241,335.04 |
2023 | 1,900,533 | 2,037,113 | 12,843,890.18 |
2024 Jan-Nov (11 months) | 1,777,964 | 1,918,473 | 11,924,830.03 |
Total | 10,451,652 | 11,152,076 | 68,909,347.77 |
Source: NHS Business Services Authority (NHS BSA)
Notes:
Information on how to look after a spacer device is included in the patient information leaflet that is provided to patients with their device. This can be found in the section on how to look after the device and includes cleaning and storage instructions as well as advice on when the device should be replaced. The general advice for the spacers available in the United Kingdom is that they should be replaced after one year.
Guidance for patients on device replacement can also be found on patient support websites such as Asthma and Lung UK which includes similar advice: ‘You should replace your spacer at least every year, especially if you use it daily, but some may need to be replaced sooner – ask your GP, nurse or pharmacist if you’re unsure.’
Guidance for healthcare professionals can be found on the Right Breath website and on the NHS clinical guidance page which recommend that all spacers should be replaced annually while the British National Formulary which provides healthcare professionals with up-to-date information about the use of medicines recommends that spacer devices should be replaced every six to 12 months.
NHS England is not aware of any additional clinical guidance it has issued, other than that contained in the product information, about replacing spacers.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the average number of hours spent by doctors and nurses in statutory and mandatory training; and what is the cost to the NHS of the time they spend undertaking such training.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The exact amount of statutory and mandatory training completed varies, depending on which organisation they work for, their role or roles, and the frequency of their movement between organisations, for instance resident doctors rotating between organisations may have to repeat some of the training.
On average, it is estimated that nationally defined statutory and mandatory training takes up to eight hours or one day per person per year and locally mandated training will add to this. This considerable investment of time has to be balanced against the fact that this training is both important, for instance safety training and emergency preparedness training, and often required by law.
In early 2024, NHS England commenced work in partnership with the Department, the Care Quality Commission, the Health Services Safety Investigations Branch, and NHS Resolution to reform statutory and mandatory training through a programme to optimise, rationalise, and redesign.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what assessment they have made of the number of road accidents in England in the last 10 years where potholes and poor-quality road surfaces were a cause.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
Statistics on reported road injury collisions in Great Britain are published based on data reported by police via the data collection known as STATS19.
Within STATS19, reporting police officers can assign up to 6 factors which they believe may have contributed to the collision, including ‘poor or defective road surface’. Contributory factors are assigned based on the opinions of the reporting officer at the scene or within a short time of the collision, rather than a detailed investigation.
The number of collisions in each of the last 10 years with the factor ‘poor or defective road surface’ assigned is published in table RAS0701 on gov.uk and reproduced below:
Year | Reported road collisions in England with ‘poor or defective road surface’ assigned as a contributory factor |
2014 | 660 |
2015 | 544 |
2016 | 519 |
2017 | 465 |
2018 | 446 |
2019 | 437 |
2020 | 376 |
2021 | 429 |
2022 | 432 |
2023 | 532 |
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what assessment they have made of the finding by the RAC in February 2024 that council road maintenance in England dropped by 45 per cent in 2022–23 compared to the five years previously; and whether road maintenance levels have improved since then.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
The Department’s officials meet regularly with local authority representatives and other experts in the road maintenance industry to discuss best practice. Ministers have also met with key stakeholder groups, including the Pothole Partnership which comprises organisations representing road users and industry.
The Department agrees that local highway authorities should focus on preventative rather than reactive maintenance activities, and this advice is set out in the Code of Practice on Well Managed Highway Infrastructure, which is available online. The Department is committed to updating this guidance and has begun work to scope out urgently which parts need updating and how. The Department strongly advocates a risk-based whole lifecycle asset management approach to local authority highways maintenance programmes, and encourages authorities to consider all parts of the highway network, such as bridges, cycleways, and lighting columns, and not just the fixing of potholes or resurfacing of roads.
Decisions on how much to spend on their local highway networks each year are matters for local highway authorities, who have a duty under Section 41 of the Highways Act 1980 to maintain the public highway network in their area. The Department for Transport collects and publishes on gov.uk each year data on authorities’ capital and revenue expenditure on their highway maintenance activities. The data shows that, at a national level, total spending on local road maintenance in the financial year 2022/23 was broadly similar to total spend in each of the previous five years.
This Government recognises the importance of well-maintained roads and has provided an additional £500m for highway maintenance for the year 2025/26 – a near 50% uplift on the current baseline. This has resulted in an 36% increase on average to individual local highway authority allocations, as well as providing highway maintenance funding top-ups to London authorities and mayoral areas already receiving City Region Sustainable Transport Settlements. These allocations can be found on gov.uk.
In addition, the Department is taking a number of steps to improve its understanding of the condition of local roads. It worked with the British Standards Institute and the highway sector to develop a new road condition data standard for local highway authorities, which was published last year. This will enable them to utilise new technologies, including AI, to identify potholes and other defects in their highway network more promptly.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what steps they are taking to improve their understanding of the condition of local roads; and what plans they have to support local authorities to use exploit AI technologies that make it faster and easier to identify potholes.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
The Department’s officials meet regularly with local authority representatives and other experts in the road maintenance industry to discuss best practice. Ministers have also met with key stakeholder groups, including the Pothole Partnership which comprises organisations representing road users and industry.
The Department agrees that local highway authorities should focus on preventative rather than reactive maintenance activities, and this advice is set out in the Code of Practice on Well Managed Highway Infrastructure, which is available online. The Department is committed to updating this guidance and has begun work to scope out urgently which parts need updating and how. The Department strongly advocates a risk-based whole lifecycle asset management approach to local authority highways maintenance programmes, and encourages authorities to consider all parts of the highway network, such as bridges, cycleways, and lighting columns, and not just the fixing of potholes or resurfacing of roads.
Decisions on how much to spend on their local highway networks each year are matters for local highway authorities, who have a duty under Section 41 of the Highways Act 1980 to maintain the public highway network in their area. The Department for Transport collects and publishes on gov.uk each year data on authorities’ capital and revenue expenditure on their highway maintenance activities. The data shows that, at a national level, total spending on local road maintenance in the financial year 2022/23 was broadly similar to total spend in each of the previous five years.
This Government recognises the importance of well-maintained roads and has provided an additional £500m for highway maintenance for the year 2025/26 – a near 50% uplift on the current baseline. This has resulted in an 36% increase on average to individual local highway authority allocations, as well as providing highway maintenance funding top-ups to London authorities and mayoral areas already receiving City Region Sustainable Transport Settlements. These allocations can be found on gov.uk.
In addition, the Department is taking a number of steps to improve its understanding of the condition of local roads. It worked with the British Standards Institute and the highway sector to develop a new road condition data standard for local highway authorities, which was published last year. This will enable them to utilise new technologies, including AI, to identify potholes and other defects in their highway network more promptly.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what plans they have to meet experts in the road maintenance industry, including the RAC, Road Surface Treatments Association, the Road Emulsion Association, and the Asphalt Industry Alliance, to discuss best practice.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
The Department’s officials meet regularly with local authority representatives and other experts in the road maintenance industry to discuss best practice. Ministers have also met with key stakeholder groups, including the Pothole Partnership which comprises organisations representing road users and industry.
The Department agrees that local highway authorities should focus on preventative rather than reactive maintenance activities, and this advice is set out in the Code of Practice on Well Managed Highway Infrastructure, which is available online. The Department is committed to updating this guidance and has begun work to scope out urgently which parts need updating and how. The Department strongly advocates a risk-based whole lifecycle asset management approach to local authority highways maintenance programmes, and encourages authorities to consider all parts of the highway network, such as bridges, cycleways, and lighting columns, and not just the fixing of potholes or resurfacing of roads.
Decisions on how much to spend on their local highway networks each year are matters for local highway authorities, who have a duty under Section 41 of the Highways Act 1980 to maintain the public highway network in their area. The Department for Transport collects and publishes on gov.uk each year data on authorities’ capital and revenue expenditure on their highway maintenance activities. The data shows that, at a national level, total spending on local road maintenance in the financial year 2022/23 was broadly similar to total spend in each of the previous five years.
This Government recognises the importance of well-maintained roads and has provided an additional £500m for highway maintenance for the year 2025/26 – a near 50% uplift on the current baseline. This has resulted in an 36% increase on average to individual local highway authority allocations, as well as providing highway maintenance funding top-ups to London authorities and mayoral areas already receiving City Region Sustainable Transport Settlements. These allocations can be found on gov.uk.
In addition, the Department is taking a number of steps to improve its understanding of the condition of local roads. It worked with the British Standards Institute and the highway sector to develop a new road condition data standard for local highway authorities, which was published last year. This will enable them to utilise new technologies, including AI, to identify potholes and other defects in their highway network more promptly.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what assessment they have made of the extent to which local authorities in England undertook preventative road maintenance, such as surface dressing roads to prevent potholes forming, in the last year; and what steps they intend to take to increase the amount of preventative road maintenance undertaken.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
The Department’s officials meet regularly with local authority representatives and other experts in the road maintenance industry to discuss best practice. Ministers have also met with key stakeholder groups, including the Pothole Partnership which comprises organisations representing road users and industry.
The Department agrees that local highway authorities should focus on preventative rather than reactive maintenance activities, and this advice is set out in the Code of Practice on Well Managed Highway Infrastructure, which is available online. The Department is committed to updating this guidance and has begun work to scope out urgently which parts need updating and how. The Department strongly advocates a risk-based whole lifecycle asset management approach to local authority highways maintenance programmes, and encourages authorities to consider all parts of the highway network, such as bridges, cycleways, and lighting columns, and not just the fixing of potholes or resurfacing of roads.
Decisions on how much to spend on their local highway networks each year are matters for local highway authorities, who have a duty under Section 41 of the Highways Act 1980 to maintain the public highway network in their area. The Department for Transport collects and publishes on gov.uk each year data on authorities’ capital and revenue expenditure on their highway maintenance activities. The data shows that, at a national level, total spending on local road maintenance in the financial year 2022/23 was broadly similar to total spend in each of the previous five years.
This Government recognises the importance of well-maintained roads and has provided an additional £500m for highway maintenance for the year 2025/26 – a near 50% uplift on the current baseline. This has resulted in an 36% increase on average to individual local highway authority allocations, as well as providing highway maintenance funding top-ups to London authorities and mayoral areas already receiving City Region Sustainable Transport Settlements. These allocations can be found on gov.uk.
In addition, the Department is taking a number of steps to improve its understanding of the condition of local roads. It worked with the British Standards Institute and the highway sector to develop a new road condition data standard for local highway authorities, which was published last year. This will enable them to utilise new technologies, including AI, to identify potholes and other defects in their highway network more promptly.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what assessment they have made of the extent to which local authorities in England divert money from their roads budgets to fund other policy areas.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
The Department for Transport allocates capital funding to local highways authorities to enable them to maintain and improve their respective networks, based on their local knowledge, circumstances, and priorities. The funding is paid out as a grant under section 31 of the Local Government Act 2003, and is unringfenced. It is up to each authority to decide how best to spend it to fulfil its statutory duty under section 41 of the Highways Act 1980.
Revenue funding for highway maintenance is provided to local authorities each year by the Ministry of Housing, Communities and Local Government as part of the Local Government Finance Settlement. This funding is also unringfenced.
The Department publishes maintenance expenditure on local roads on gov.uk each year based on local authority outturn receipts. These show that capital expenditure on the local highway network is consistently higher than the funding provided by the Department for highway maintenance activities, which suggests that generally local authorities are not using the capital funding provided by the Department for other purposes.
The Department intends to introduce new reporting requirements on local highway authorities for the 2025/26 financial year, which will require them to provide further information to ensure residents can see how they intend to use the funding provided by the Government.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what percentage of adults in England currently receive prescriptions for anti-depressants.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines Used in Mental Health statistical release includes information about prescribing in England for medicines classified within the British National Formulary section 0403, as antidepressant drugs. There were 6,873,381 total identified patients, aged 18 years old and over, in quarter two of 2024/25.
The Office of National Statistics (ONS) publishes population statistics for England on the ONS website. The estimated mid-year population for people aged 18 years old and over in England in 2023 was 45,691,677.
Based on the latest published data, the number of adults, those aged 18 years old and over, in England who received a prescription for antidepressant drugs in the quarterly period of July to September 2024 was 15% of the estimated 2023 mid-year population.
Asked by: Lord Mawson (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what was the cost to the NHS of anti-depressants in each of the past ten years; and how many they prescribed in each of those years.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Prescription Cost Analysis (PCA) provides the total number of prescription items of each medicine dispensed in the community in England. The following table shows the total number of items prescribed, based on information within the PCA and using British National Formulary Section 0403 for antidepressant drugs that have been dispensed in England regardless of where prescribed, as well as their net ingredient cost (NIC), for each calendar year from 2014 to 2023, and from January to November 2024:
Calendar year | Total number of items | Total NIC |
2014 | 57,149,109 | £265,008,698.97 |
2015 | 61,021,662 | £284,746,655.27 |
2016 | 64,703,639 | £266,562,024.17 |
2017 | 67,530,457 | £235,076,089.51 |
2018 | 70,873,979 | £202,526,719.66 |
2019 | 74,814,621 | £201,729,659.16 |
2020 | 78,866,866 | £352,682,885.77 |
2021 | 82,620,542 | £288,099,249.84 |
2022 | 85,404,864 | £224,648,497.13 |
2023 | 88,469,803 | £230,013,659.86 |
2024 | 84,251,563 | £207,585,360.44 |
Total | 815,707,105 | £2,758,679,499.78 |
The NHS Business Services Authority does not hold a single cost to the National Health Service. Total NIC is the amount that would be paid using the basic price of the prescribed medicine and the quantity prescribed, before any discounts, dispensing costs, or fees. It also does not include other costs to the NHS, such as those associated with purchasing or storing these medicines. The basic price is given either in the Drug Tariff or is determined from prices published by manufacturers, wholesalers, or suppliers.