Question to the Department of Health and Social Care:

To ask His Majesty's Government what discussions they have held with social media companies on the moderation of pro-eating disorder material and misinformation relating to diabetes and body image.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Under the Government’s Online Safety Act, all in-scope services are now required to protect their users from illegal content, and platforms likely to be accessed by children need to prevent their users from accessing eating disorder content.

No discussions have been held with social media companies. However, we are working closely with the Department for Science, Innovation and Technology, Ofcom and others as the Online Safety Act takes effect. This includes exploring further opportunities to address harmful pro-eating disorder material and misinformation shared on social media and websites.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the Yorkshire Cancer Research’s ROSE model for research funding; and whether this model will be included the National Cancer Plan.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Cancer Plan will seek to ensure equitable access to the benefits of health research, as set out by Yorkshire Cancer Research’s ROSE model. The Department invests in research through its research delivery arm, the National Institute for Health and Care Research (NIHR). NIHR welcomes funding applications for research into any aspect of human health and care including cancer. These applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.

Welcoming applications on cancer to all NIHR programmes enables maximum flexibility both in terms of amount of research funding a particular area can be awarded, and the type of research which can be funded. In line with prior commitments, the Department has increased funding for NIHR research infrastructure schemes delivering cancer research outside the Greater South East, including biomedical research centres, clinical research facilities, and HealthTech research centres.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will require integrated care boards to provide sustainable funding for successful pilot projects on type 1 diabetes and eating disorders to enable them to become regional centres of excellence.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has provided up to £1.5 million a year for the five current Type 1 Disordered Eating pilots for three years. This funding is transferred to integrated care boards on an annual basis and in 2025/26 has been ringfenced.

Decisions on funding for future years have yet to be taken.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to raise awareness of type 1 diabetes and eating disorders (T1DE) among healthcare professionals in diabetes and eating disorder services; and whether they plan to establish a national framework for preventing T1DE, including risk screening tools for use in clinical practice.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England is currently funding five Type 1 Disordered Eating (T1DE) Pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.

Pilot sites are delivering a national high level service specification alongside testing local novel approaches to improving care including to awareness raising of the condition amongst both diabetes and eating disorder health care professionals.

A national evaluation is currently underway to assess the impact of the five current pilot services. NHS England will review the evaluation findings to understand further opportunities to promote awareness of Type 1 disordered eating amongst healthcare professionals.

NHS England works alongside its partners to support the delivery of key messages around diabetes education and awareness. This includes through a digital diabetes platform which is developing educational resources for T1DE.

No assessment has been made of the merits of creating a national framework.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will support the creation of an international symposium of experts on type 1 diabetes and eating disorders to share best practice and guidance on diagnosis and treatment.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

No assessment has been made of the merits of creating an international symposium of experts on type 1 diabetes and eating disorders. NHS England is currently funding five Type 1 Disordered Eating (T1DE) pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.

A national evaluation is currently underway to assess the impact of the five current pilot services. NHS England will review the evaluation findings to understand further opportunities to promote awareness of T1DE amongst healthcare professionals.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will work with diabetes and eating disorder charities to support national campaigns aimed at reducing stigmatisation of type 1 diabetes and eating disorders (T1DE) in the media, drawing on NHS England's Language Matters guidance.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The national diabetes programme works closely with charity partners including Diabetes UK who take a multi-pronged approach to reducing stigma experienced by those with all types of diabetes. This includes raising awareness of the complex and serious nature of type 1 diabetes, including type 1 disordered eating (T1DE), providing support to those that experience stigma, and supporting research into stigma and how it can be reduced or prevented.

NHS England is partnering with the National Institute for Health and Care Research to deliver a qualitative evaluation of the five current T1DE pilot sites. A core element of this approach has been engagement with service users to understand their experiences of having the condition, both before and during their involvement with the T1DE service.

The National Diabetes Experience Survey led by NHS England is a further mechanism for understanding the experiences of those living with type 1 diabetes including T1DE to inform national and local approaches to improvement.

In response to feedback on the experiences of people of all ages who live with diabetes, NHS England published the document, Language Matters: language and diabetes, a guide for health care professionals which sets out the good practice principles for interactions with people living with diabetes including around reducing stigma. The guide is available on the NHS website in an online-only format.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to improve training for healthcare practitioners in recognising and managing type 1 diabetes and eating disorders, including provision for GPs.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The standard of training for healthcare professionals is the responsibility of the independent professional regulators, who set the outcome standards expected at undergraduate level, and who approve the courses and curricula that universities write and teach in order to enable their students to meet these outcome standards.

The curricula for postgraduate medical specialty training are set by individual royal colleges and faculties. For general practice, it is set by the Royal College of General Practitioners. The General Medical Council approves the curricula and assessment systems for each training programme.

Whilst not all curricula may necessarily highlight a specific condition, they all emphasise the skills and approaches a healthcare practitioner must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients, including for type 1 diabetes with disordered eating.

Employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver appropriate treatment for patients.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the NHS Long Term Workforce Plan will include measures to recruit, train and retain mental health professionals with specialism in type 1 diabetes and eating disorders.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. To support this, the Department and NHS England will be engaging with key stakeholders to ensure that the particular needs of different patient groups and relevant health professionals are reflected in this work.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to scope and support the development of peer support networks for people living with type 1 diabetes and eating disorders, including moderated online and in-person models.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Diabetes Audit is the primary mechanism for collecting data in England on the care and outcomes of people living with diabetes, helping to inform healthcare practice and policy.

The National Diabetes Audit could serve as a registry for type 1 diabetes with disordered eating (T1DE) in the future. An agreed definition of T1DE supported by National Institute for Health and Care Excellence (NICE) will be important to enable diagnosis, data recording, and establishing data collection processes.

NHS England works closely with NICE to understand emerging areas for consideration in national guidance and has committed to sharing the current pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes. NICE is responsible for producing clinical guidelines and quality standards for diabetes care.

The current NICE guideline for type 1 diabetes diagnosis and management, a copy of which is attached, states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management, and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management.

NHS England works in close partnership with national charities and organisations that support people living with type 1 diabetes, including by facilitating and supporting peer support opportunities.

For example, NHS England has collaborated with Diabetes UK, Breakthrough Type 1 Diabetes, and people with lived experience to produce The Six Principles of Good Peer Support for People Living with Type 1 Diabetes statement, which aims to promote the standards required for peer support to both clinicians and to those who are looking to access peer support opportunities. Further information on the statement is available on the NHS.UK website, in an online only format.

Diabetes UK also runs the Together Type 1 Programme which aims to create a supportive environment where young people can connect with others who understand the challenges of living with type 1 diabetes. Further information is available on the Together Type 1 Programme on Diabetes UK’s website, in an online only format. Diabetes UK also has a network of regional teams that facilitate local peer support groups and activities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether NHS England will create a dedicated registry for type 1 diabetes that includes a specific category for type 1 diabetes and eating disorders to improve prevalence data and patient support.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Diabetes Audit is the primary mechanism for collecting data in England on the care and outcomes of people living with diabetes, helping to inform healthcare practice and policy.

The National Diabetes Audit could serve as a registry for type 1 diabetes with disordered eating (T1DE) in the future. An agreed definition of T1DE supported by National Institute for Health and Care Excellence (NICE) will be important to enable diagnosis, data recording, and establishing data collection processes.

NHS England works closely with NICE to understand emerging areas for consideration in national guidance and has committed to sharing the current pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes. NICE is responsible for producing clinical guidelines and quality standards for diabetes care.

The current NICE guideline for type 1 diabetes diagnosis and management, a copy of which is attached, states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management, and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management.

NHS England works in close partnership with national charities and organisations that support people living with type 1 diabetes, including by facilitating and supporting peer support opportunities.

For example, NHS England has collaborated with Diabetes UK, Breakthrough Type 1 Diabetes, and people with lived experience to produce The Six Principles of Good Peer Support for People Living with Type 1 Diabetes statement, which aims to promote the standards required for peer support to both clinicians and to those who are looking to access peer support opportunities. Further information on the statement is available on the NHS.UK website, in an online only format.

Diabetes UK also runs the Together Type 1 Programme which aims to create a supportive environment where young people can connect with others who understand the challenges of living with type 1 diabetes. Further information is available on the Together Type 1 Programme on Diabetes UK’s website, in an online only format. Diabetes UK also has a network of regional teams that facilitate local peer support groups and activities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether NHS England plans to add a mental health assessment as an annual care check for people with type 1 diabetes.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Diabetes Audit is the primary mechanism for collecting data in England on the care and outcomes of people living with diabetes, helping to inform healthcare practice and policy.

The National Diabetes Audit could serve as a registry for type 1 diabetes with disordered eating (T1DE) in the future. An agreed definition of T1DE supported by National Institute for Health and Care Excellence (NICE) will be important to enable diagnosis, data recording, and establishing data collection processes.

NHS England works closely with NICE to understand emerging areas for consideration in national guidance and has committed to sharing the current pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes. NICE is responsible for producing clinical guidelines and quality standards for diabetes care.

The current NICE guideline for type 1 diabetes diagnosis and management, a copy of which is attached, states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management, and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management.

NHS England works in close partnership with national charities and organisations that support people living with type 1 diabetes, including by facilitating and supporting peer support opportunities.

For example, NHS England has collaborated with Diabetes UK, Breakthrough Type 1 Diabetes, and people with lived experience to produce The Six Principles of Good Peer Support for People Living with Type 1 Diabetes statement, which aims to promote the standards required for peer support to both clinicians and to those who are looking to access peer support opportunities. Further information on the statement is available on the NHS.UK website, in an online only format.

Diabetes UK also runs the Together Type 1 Programme which aims to create a supportive environment where young people can connect with others who understand the challenges of living with type 1 diabetes. Further information is available on the Together Type 1 Programme on Diabetes UK’s website, in an online only format. Diabetes UK also has a network of regional teams that facilitate local peer support groups and activities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans NHS England has to embed mental health support into all diabetes clinics to support emotional wellbeing for patients with type 1 diabetes.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Diabetes Audit is the primary mechanism for collecting data in England on the care and outcomes of people living with diabetes, helping to inform healthcare practice and policy.

The National Diabetes Audit could serve as a registry for type 1 diabetes with disordered eating (T1DE) in the future. An agreed definition of T1DE supported by National Institute for Health and Care Excellence (NICE) will be important to enable diagnosis, data recording, and establishing data collection processes.

NHS England works closely with NICE to understand emerging areas for consideration in national guidance and has committed to sharing the current pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes. NICE is responsible for producing clinical guidelines and quality standards for diabetes care.

The current NICE guideline for type 1 diabetes diagnosis and management, a copy of which is attached, states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management, and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management.

NHS England works in close partnership with national charities and organisations that support people living with type 1 diabetes, including by facilitating and supporting peer support opportunities.

For example, NHS England has collaborated with Diabetes UK, Breakthrough Type 1 Diabetes, and people with lived experience to produce The Six Principles of Good Peer Support for People Living with Type 1 Diabetes statement, which aims to promote the standards required for peer support to both clinicians and to those who are looking to access peer support opportunities. Further information on the statement is available on the NHS.UK website, in an online only format.

Diabetes UK also runs the Together Type 1 Programme which aims to create a supportive environment where young people can connect with others who understand the challenges of living with type 1 diabetes. Further information is available on the Together Type 1 Programme on Diabetes UK’s website, in an online only format. Diabetes UK also has a network of regional teams that facilitate local peer support groups and activities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network to work together to review and update clinical guidelines on type 1 diabetes and eating disorders, including guidance on diagnosis and treatment.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) have a shared interest to improve quality of care for patients through the development of clinical guidelines. SIGN works together with NICE in several areas, including identifying and undertaking joint initiatives to reduce duplication of effort and improve efficiency in their respective guideline development programmes and providing joint solutions to issues affecting guideline development in the United Kingdom.

NICE has published guidelines on the diagnosis and management of Type 1 diabetes in adults and in children, namely NG17 and NG18. Both include recommendations on dietary management and NG17 has recommendations on managing complications, including eating disorders. NICE has also published a guideline on the recognition and treatment of eating disorders, namely NG69. This guideline includes recommendations for people with diabetes and physical and mental health comorbidities, including eating disorders. Copies of guidelines NG17 and NG69 are attached.

NICE intends to carry out focussed updates to all diabetes guidance to take account of changes in insulin availability but has no current plans for further updates to NG17 and NG18, either alone or in collaboration with SIGN. NICE takes a proactive approach to surveillance, monitoring for changes in the evidence base that may impact on its recommendations. Topics for new or updated guidance are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by an integrated, cross-organisational prioritisation board, chaired by NICE’s chief medical officer.