Asked by: Lord Rennard (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 ensure that older adults with type 1 diabetes retain access to essential technologies upon entering residential care, and whether they will introduce statutory training and regulatory standards to support safe, consistent and dignified diabetes management in those settings.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for implementing National Institute for Health and Care Excellence (NICE) clinical guidelines and technology appraisals relating to diabetes care and access to diabetes technologies. NHS England supports ICBs by providing supportive funding, data, policy levers, and clinical leadership at national level. Locally, support for people with type 1 diabetes to access and use diabetes technology is provided by diabetes specialists, general practices, and community diabetes teams. Clinical care and support for people in residential care is locally organised.
All health and social care providers must comply with the fundamental standards set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These include requirements that the care provided be centred on the needs of the individual and that providers employ enough suitably qualified, competent, and experienced staff to ensure standards are met.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government what assessment they have made of the benefits of expanding local rail services to local economies, and of increasing rail services into cities to reduce road congestion, improve air quality and reduce carbon emissions.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
Assessments of the benefits of expanding local rail services to local economies, and of increasing rail services into cities, are assessed on a case-by-case basis to reflect local economic conditions, using Transport Analysis Guidance (TAG).
Expanded local rail services can help drive local economic growth by opening up new development opportunities, unlocking housing, reducing costs for businesses and supporting people into work. TAG is used to assess the wider benefits of rail interventions including reduced road congestion, improved air quality and reduced carbon emissions.
The Government recognises the crucial role rail plays in delivering these benefits and is backing rail with the funding needed. The 2025 spending review committed £10.2 billion provided for rail enhancements in the period over the next four years.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
Question to the Department for Transport:
To ask His Majesty's Government whether the mixed use railways team at Network Rail is being dissolved; and if so, what assessment they have made on the impact of that dissolution on the ability of light rail vehicles to operate on parts of the main line rail network.
Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)
Network Rail’s regional teams lead on the development of projects, including light rail proposals. Network Rail has light rail expertise centrally that supports the regions in the operation, design and implementation of light rail projects. The required resource level of this team will be reviewed as the project pipeline develops.
Asked by: Lord Rennard (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 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.
Asked by: Lord Rennard (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 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.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
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.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
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.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
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.
Asked by: Lord Rennard (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 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.
Asked by: Lord Rennard (Liberal Democrat - Life peer)
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.