Lord McColl of Dulwich

The Government recognises that innovation is crucial to drive improvements in clinical care and improved outcomes for people living with sight-threatening conditions. Integrated care boards (ICBs) are responsible for commissioning services to meet local needs. In making commissioning decisions, we would expect ICBs to take into account the National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of glaucoma which NICE keeps under review, to ensure that it reflects developments in medical technology and clinical practice.

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, and this includes independent sector providers. CQC monitors, inspects and regulates services and publish what it finds. Where CQC finds poor care, it can use its enforcement powers to take action. This sits alongside guidance issued by NICE for the treatment of glaucoma and any professional standards issued by the Royal College of Ophthalmologists, which we would expect National Health Service commissioners to have regard to when commissioning services from the independent sector.

NHS England’s Getting It Right First Time Programme is also working with providers across the country to reduce unwarranted variation in care across a range of eyecare subspecialties, including glaucoma.

The Government recognises that innovation is crucial to drive improvements in clinical care and improved outcomes for people living with sight-threatening conditions. Integrated care boards (ICBs) are responsible for commissioning services to meet local needs. In making commissioning decisions, we would expect ICBs to take into account the National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of glaucoma which NICE keeps under review, to ensure that it reflects developments in medical technology and clinical practice.

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, and this includes independent sector providers. CQC monitors, inspects and regulates services and publish what it finds. Where CQC finds poor care, it can use its enforcement powers to take action. This sits alongside guidance issued by NICE for the treatment of glaucoma and any professional standards issued by the Royal College of Ophthalmologists, which we would expect National Health Service commissioners to have regard to when commissioning services from the independent sector.

NHS England’s Getting It Right First Time Programme is also working with providers across the country to reduce unwarranted variation in care across a range of eyecare subspecialties, including glaucoma.

Obesity is a complex problem, and the causes are multi-factorial, including biological; physiological; psycho-social; behavioural; and environmental factors. There are no plans to collect data on the causes of obesity and no specific assessment has been made on the causes of obesity.

Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s national food model, the Eatwell Guide. The Eatwell Guide shows the proportions in which different types of foods should be consumed to have a healthy balanced diet, including average calorie intakes for men and women. The Eatwell Guide principles are communicated through a variety of channels, including the National Health Service website, Government social marketing campaigns, and guidance on healthier catering. For example, the Better Health campaign encourages adults to introduce changes that will help them work towards a healthier weight, including guidance on healthier food choices, calorie intake and portion control.

Obesity is a complex problem, and the causes are multi-factorial, including biological; physiological; psycho-social; behavioural; and environmental factors. There are no plans to collect data on the causes of obesity and no specific assessment has been made on the causes of obesity.

Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s national food model, the Eatwell Guide. The Eatwell Guide shows the proportions in which different types of foods should be consumed to have a healthy balanced diet, including average calorie intakes for men and women. The Eatwell Guide principles are communicated through a variety of channels, including the National Health Service website, Government social marketing campaigns, and guidance on healthier catering. For example, the Better Health campaign encourages adults to introduce changes that will help them work towards a healthier weight, including guidance on healthier food choices, calorie intake and portion control.

Obesity is a complex problem, and the causes are multi-factorial, including biological; physiological; psycho-social; behavioural; and environmental factors. There are no plans to collect data on the causes of obesity and no specific assessment has been made on the causes of obesity.

Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s national food model, the Eatwell Guide. The Eatwell Guide shows the proportions in which different types of foods should be consumed to have a healthy balanced diet, including average calorie intakes for men and women. The Eatwell Guide principles are communicated through a variety of channels, including the National Health Service website, Government social marketing campaigns, and guidance on healthier catering. For example, the Better Health campaign encourages adults to introduce changes that will help them work towards a healthier weight, including guidance on healthier food choices, calorie intake and portion control.

Currently in the United Kingdom, there is no agreed definition for wholegrain or wholegrain foods. Therefore, wholegrain consumption cannot be monitored in the National Diet and Nutrition Survey. At its horizon scan meeting in June 2022 the Scientific Advisory Committee on Nutrition (SACN) agreed that it would be useful to consider a definition for wholegrain and added it to its future work programme due to start Summer 2023.

SACN’s Carbohydrates and Health report published in 2015 provides strong evidence on dietary fibre and positive health outcomes, but for wholegrains and health outcomes the evidence was mixed and SACN has questioned whether any beneficial effect from wholegrain may be due to the fibre content. Fibre is found in a range of foods and is not exclusive to wholegrain foods. Based on SACN’s findings, Government recommends that adults consume 30 grams of dietary fibre each day and that this should be achieved through a variety of food sources.

Government dietary advice, as depicted by the UK’s national food model, the Eatwell Guide, is that we should choose wholegrain or higher fibre versions of starchy carbohydrates wherever possible. This advice aims to increase population intakes of fibre. This is because in the UK, there is no quantitative recommendation for dietary wholegrain consumption, whereas there is a specific Government recommendation for dietary fibre consumption. The Government continues to promote the Eatwell Guide principles through a variety of channels, including the NHS.UK website and our social marketing campaigns, Better Health and Healthier Families.

There are no current plans to introduce a public and private sector partnership aimed at increasing the consumption of wholegrain foods.

Authorised nutrition and health claims related to fibre can be used by food business operators on food products, pursuant to retained Regulation (EC) No 1924/2006, as amended by the Nutrition (Amendment etc.) (EU Exit) Regulations 2019 and the Nutrition (Amendment etc.) (EU Exit) Regulations 2020.

All authorised and rejected nutrition and health claims are included in the Great Britain Nutrition and Health Claims Register (GB NHC Register), other than those health claims authorised on the basis of proprietary data which will be recorded in a separate Annex to the GB NHC Register. The GB NHC Register, and the separate Annex, are available in an online only format.

Currently in the United Kingdom, there is no agreed definition for wholegrain or wholegrain foods. Therefore, wholegrain consumption cannot be monitored in the National Diet and Nutrition Survey. At its horizon scan meeting in June 2022 the Scientific Advisory Committee on Nutrition (SACN) agreed that it would be useful to consider a definition for wholegrain and added it to its future work programme due to start Summer 2023.

SACN’s Carbohydrates and Health report published in 2015 provides strong evidence on dietary fibre and positive health outcomes, but for wholegrains and health outcomes the evidence was mixed and SACN has questioned whether any beneficial effect from wholegrain may be due to the fibre content. Fibre is found in a range of foods and is not exclusive to wholegrain foods. Based on SACN’s findings, Government recommends that adults consume 30 grams of dietary fibre each day and that this should be achieved through a variety of food sources.

Government dietary advice, as depicted by the UK’s national food model, the Eatwell Guide, is that we should choose wholegrain or higher fibre versions of starchy carbohydrates wherever possible. This advice aims to increase population intakes of fibre. This is because in the UK, there is no quantitative recommendation for dietary wholegrain consumption, whereas there is a specific Government recommendation for dietary fibre consumption. The Government continues to promote the Eatwell Guide principles through a variety of channels, including the NHS.UK website and our social marketing campaigns, Better Health and Healthier Families.

There are no current plans to introduce a public and private sector partnership aimed at increasing the consumption of wholegrain foods.

Authorised nutrition and health claims related to fibre can be used by food business operators on food products, pursuant to retained Regulation (EC) No 1924/2006, as amended by the Nutrition (Amendment etc.) (EU Exit) Regulations 2019 and the Nutrition (Amendment etc.) (EU Exit) Regulations 2020.

All authorised and rejected nutrition and health claims are included in the Great Britain Nutrition and Health Claims Register (GB NHC Register), other than those health claims authorised on the basis of proprietary data which will be recorded in a separate Annex to the GB NHC Register. The GB NHC Register, and the separate Annex, are available in an online only format.

Currently in the United Kingdom, there is no agreed definition for wholegrain or wholegrain foods. Therefore, wholegrain consumption cannot be monitored in the National Diet and Nutrition Survey. At its horizon scan meeting in June 2022 the Scientific Advisory Committee on Nutrition (SACN) agreed that it would be useful to consider a definition for wholegrain and added it to its future work programme due to start Summer 2023.

SACN’s Carbohydrates and Health report published in 2015 provides strong evidence on dietary fibre and positive health outcomes, but for wholegrains and health outcomes the evidence was mixed and SACN has questioned whether any beneficial effect from wholegrain may be due to the fibre content. Fibre is found in a range of foods and is not exclusive to wholegrain foods. Based on SACN’s findings, Government recommends that adults consume 30 grams of dietary fibre each day and that this should be achieved through a variety of food sources.

Government dietary advice, as depicted by the UK’s national food model, the Eatwell Guide, is that we should choose wholegrain or higher fibre versions of starchy carbohydrates wherever possible. This advice aims to increase population intakes of fibre. This is because in the UK, there is no quantitative recommendation for dietary wholegrain consumption, whereas there is a specific Government recommendation for dietary fibre consumption. The Government continues to promote the Eatwell Guide principles through a variety of channels, including the NHS.UK website and our social marketing campaigns, Better Health and Healthier Families.

There are no current plans to introduce a public and private sector partnership aimed at increasing the consumption of wholegrain foods.

Authorised nutrition and health claims related to fibre can be used by food business operators on food products, pursuant to retained Regulation (EC) No 1924/2006, as amended by the Nutrition (Amendment etc.) (EU Exit) Regulations 2019 and the Nutrition (Amendment etc.) (EU Exit) Regulations 2020.

All authorised and rejected nutrition and health claims are included in the Great Britain Nutrition and Health Claims Register (GB NHC Register), other than those health claims authorised on the basis of proprietary data which will be recorded in a separate Annex to the GB NHC Register. The GB NHC Register, and the separate Annex, are available in an online only format.

Obesity is a complex problem caused by numerous factors, to which there is no single solution. The National Institute for Health and Care Excellence (NICE) recommends that body mass index (BMI) is used to assess obesity in adults and children. Additionally, it recommends the use of other validated obesity measures, such as waist circumference, to be undertaken alongside BMI for adults when assessing overweightness and obesity in individuals to give a more detailed assessment of an individual’s health risk.

Malnutrition as a broad term refers to deficiency, excess or imbalances of a person’s intake of calories, protein and other nutrients which causes measurable adverse effects on body composition, function or clinical outcome. The full definition of malnutrition therefore includes overnutrition which can lead to obesity, however, in the United Kingdom, the term is more commonly used to refer to a clinical condition involving undernutrition.

NICE advises that nutrition support should be considered in people who are malnourished, as defined by any of the following: a BMI of less than 18.5 kilograms/m²; unintentional weight loss greater than 10% within the last three to six months; or a BMI of less than 20 kilograms/m² and unintentional weight loss greater than 5% within the last three to six months.

Someone can therefore be a healthy weight or have a BMI in the overweight or obese categories but be identified through the NICE definition as potentially requiring nutrition support. The term ‘malnutrition’ is sometimes incorrectly used to refer to a poor diet; although this may put someone at increased risk of malnutrition, this would not necessarily meet the criteria for malnutrition.

Data is not collected on causes of obesity. Data from the Health Survey for England, 2021 and National Child Measurement Programme show obesity prevalence was lowest for those living in the least deprived areas and highest in the most deprived areas.

Obesity is a complex problem caused by numerous factors, to which there is no single solution. The National Institute for Health and Care Excellence (NICE) recommends that body mass index (BMI) is used to assess obesity in adults and children. Additionally, it recommends the use of other validated obesity measures, such as waist circumference, to be undertaken alongside BMI for adults when assessing overweightness and obesity in individuals to give a more detailed assessment of an individual’s health risk.

Malnutrition as a broad term refers to deficiency, excess or imbalances of a person’s intake of calories, protein and other nutrients which causes measurable adverse effects on body composition, function or clinical outcome. The full definition of malnutrition therefore includes overnutrition which can lead to obesity, however, in the United Kingdom, the term is more commonly used to refer to a clinical condition involving undernutrition.

NICE advises that nutrition support should be considered in people who are malnourished, as defined by any of the following: a BMI of less than 18.5 kilograms/m²; unintentional weight loss greater than 10% within the last three to six months; or a BMI of less than 20 kilograms/m² and unintentional weight loss greater than 5% within the last three to six months.

Someone can therefore be a healthy weight or have a BMI in the overweight or obese categories but be identified through the NICE definition as potentially requiring nutrition support. The term ‘malnutrition’ is sometimes incorrectly used to refer to a poor diet; although this may put someone at increased risk of malnutrition, this would not necessarily meet the criteria for malnutrition.

Data is not collected on causes of obesity. Data from the Health Survey for England, 2021 and National Child Measurement Programme show obesity prevalence was lowest for those living in the least deprived areas and highest in the most deprived areas.

Fats are an essential part of a healthy, balanced diet. The Government’s dietary recommendations state that no more than 33% of total energy should come from fats, including no more than approximately 10% of total energy from saturated fats. The advice for the general population is to reduce intakes of saturated fats and replace with more unsaturated fats from sources such as oily fish, rapeseed oil, sunflower oil, nuts and seeds.

Daily physical activity can contribute to maintaining a healthy weight and the prevention and management of certain diseases. This approach should place an emphasis on changing dietary behaviour to reduce calorie intake and support people to self-monitor and manage everyday challenging situations.

NHS England’s adult and paediatric cystic fibrosis service specifications set out national standards, including the importance of access to multidisciplinary teams involving appropriately trained clinical psychologists and social workers. There are regular review meetings between the regional commissioning teams and providers to ensure compliance with service standards across the range of services commissioned.

Health Education England has supported a 60% expansion in the clinical psychology training intake over the past two years. Trainees can undertake specialist placements and upon qualification take up posts across a wide range of settings, including working with adults and children with cystic fibrosis.

The Government committed at least £500 million to develop and support the adult social care workforce over the next three years. We are ensuring a sufficient supply of social workers through measures such as support and development for a post-graduate mental health social work programme, the Education Support Grant and Social Work Bursaries.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

We continue to monitor progress and emerging evidence and will keep the advice under review.

The Department does not recognise the reported figures. Currently, 17 sites are capable of recording overseas vaccinations into the National Immunisation Management System. There is at least one site in each of the seven National Health Service regions in England.

The number of vaccination centres offering this service in England is currently limited due to the rapid expansion of the booster programme. The list of vaccination centres offering this service will be expanded in due course.

99% of the population in England live within 10 miles of at least one COVID-19 vaccination site. UK-wide data is not held centrally.

The Department is continuously monitoring COVID-19 vaccine uptake and assessing ways to increase it further – with accessibility being a key driver. To support vaccine deployment and minimise inequalities in uptake, NHS England and NHS Improvement have developed practical guidance for communities to implement a range of interventions to ensure equitable access to COVID-19 vaccinations.

To ensure that uptake of the COVID-19 vaccine is maximised, there are now more sites in England delivering COVID-19 vaccines than at any other point in the programme, with around 3000 in total. This includes delivery though hospital hubs, vaccination centres, mobile/pop-up facilities, Primary Care Network-led sites, and community pharmacy-led sites. The network of vaccination sites has been designed to deliver the expected vaccine supply as quickly as possible and ensure safe and easy access for the whole population. For those in highly rural areas, where a vaccination site may be more difficult to reach there is a standard operating procedure for roving and other mobile delivery models to go directly to these communities.

The NHS COVID Pass can now be used to demonstrate proof of a booster or third dose for outbound international travel and this record is available through the NHS App and NHS.UK. Booster vaccinations are not required for domestic certification in England.

We have provided a pilot service at selected vaccination centres for residents to request their overseas vaccines are uploaded to the national database. A national service will be launched in December which will support online bookings with further vaccination sites available. AstraZeneca, Pfizer, Moderna and Janssen vaccines in the United States of America, the European Union, the European Economic Area, Canada, Switzerland and Australia regulated by the European Medicines Agency, the Food and Drug Administration, Health Canada, Swissmedic and Therapeutic Goods Administration can generate an NHS COVID Pass. A range of vaccines are administered worldwide and we are working to understand which non-Medicines and Healthcare products Regulatory Agency-approved equivalent vaccines we would be confident to recognise in the NHS COVID Pass.

We are not able to estimate the average additional cost of moving all patients treated in Tier 3 services to management under Tier 4 from existing data. There are currently no national tariffs for Tier 3 specialist weight management services and national tariffs of bariatric surgery vary dependent on the type of procedure.

This data is not routinely collected centrally. NHS England and NHS Improvement are in the process of engaging with trusts to better understand the current position on waiting times. A planned National Obesity Audit will provide information on conversion rates from Tier 3 Specialist Weight Management Services to Tier 4 Specialist Weight Management Services.

This data is not routinely collected centrally. NHS England and NHS Improvement are in the process of engaging with trusts to better understand the current position on waiting times. A planned National Obesity Audit will provide information on conversion rates from Tier 3 Specialist Weight Management Services to Tier 4 Specialist Weight Management Services.

No direct assessment has been made. However, evidence has shown that general practitioners (GP) referrals are effective at encouraging the uptake of weight management services and subsequently result in increased weight loss for those referred. This evidence has informed the decision to invest £20.4 million in the Weight Management Enhanced Service, which financially incentivises GPs to refer individuals to weight management services. We are committed to evaluating the impact of the 2021/22 Weight Management Enhanced Service.

We are working closely with local and national partners from across the sector, including those with dementia and lived experience of the social care system, to ensure that our approach to reform is informed by diverse perspectives.

Together with stakeholders we are considering how we build back fairer to deliver the sustainable improvements to adult social care that we all want to see. We will bring forward proposals for reform later in 2021, including for the social care workforce.

The NHS Long Term Plan commits to the Enhanced Health in Care Homes service model that sets out best practice for dementia care including rehabilitation and reablement.

NHS England and NHS Improvement have also made guidance and resources available to address the rehabilitation needs of people living with dementia, including the ‘Dementia wellbeing in COVID-19’ resource.

In addition, we have commissioned research through the National Institute for Health Research on how to manage or mitigate the impact of COVID-19 on people with dementia and their carers living in the community and concise helpful summary leaflets were produced.

We will be setting out our plans on dementia for England for future years in due course.

NHS England and NHS Improvement have collaborated with the South East Clinical Delivery and Networks to publish guidance for primary care networks and care homes on dementia and older people’s mental health, which includes ways to recognise and support people experiencing behavioural and psychological symptoms of dementia. They have also made guidance and resources available to address the rehabilitation needs of people living with dementia, including the ‘Dementia wellbeing in COVID-19’ resource.

We have commissioned research through the National Institute for Health Research on how to manage or mitigate the impact of COVID-19 on people with dementia and their carers living in the community and concise helpful summary leaflets were produced.

We will be setting out our plans on dementia for England for future years in due course.

The Government has provided a dedicated national discharge fund, managed by the National Health Service, for the first half of 2021/2022 financial year. In tandem with the existing services commissioned by local authorities and clinical commissioning groups, this discharge fund pays for the cost of post-discharge recovery and support services. This includes bed based and home-based rehabilitation and re-ablement care following discharge from hospital and is funded for up to four weeks.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.