Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 14 October 2024 on Enzyme Replacement Therapy: Drugs, what progress his Department has made in tackling shortages of (a) ADHD medication, (b) Creon and (c) other medications used in the management of (i) enzyme deficiency disorders and (ii) cystic fibrosis.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has continued to work hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.
We are continuing to work to resolve medicine supply issues, where they remain, for some strengths of methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term.
In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinions for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.
The Department is also continuing to engage with suppliers of Creon and other pancreatic enzyme replacement therapies (PERT) to boost production to mitigate the supply issue. The supplier of Creon expects to receive increased quantities for 2025. Suppliers of alternative PERT and specialist importers of unlicensed medicines continue to supply increased volumes to assist in covering the gap in the market. In December, the Department issued further management advice to healthcare professionals. This directs clinicians to unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure local mitigation plans are implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice, including advice on preserving the available stock of alternative PERT for certain patient cohorts.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase the supply of GLP-1 receptor agonist medications for diabetic patients in Shipley constituency.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are ongoing global supply issues with some medications used to treat diabetes, and we continue to work closely with industry partners to improve the situation. Supplies of Rybelsus, which is an oral semaglutide available in tablet form, have been boosted to support demand from new patients with type 2 diabetes, as well as those unable to obtain their existing treatment. The Medicines and Healthcare products Regulatory Agency’s regulatory approval of Mounjaro, an injectable medicine for adults with type 2 diabetes, has brought an additional treatment option to the United Kingdom’s market. We have provided advice for healthcare professionals on how to manage patients requiring these medicines whilst there are shortages, and are keeping this under review as the situation evolves. The Department has also added some of these products to the list of medicines that cannot be exported from, or hoarded in, the UK.
The guidance is clear that medications licensed to treat type 2 diabetes should not be prescribed for weight loss, except where specifically licenced for this use. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.
The Department monitors and manages medicine supply at a national level, so that stocks remain available to meet regional and local demand. Information on stock levels within individual pharmacies is not held centrally.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure the McCloud remedy is implemented for affected NHS workers by April 2025.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The NHS Business Services Authority (NHSBSA) is implementing the McCloud remedy for impacted members of the NHS Pension Scheme. Remedy implementation is a complex and large-scale undertaking. The core element of the remedy will provide members with a choice of benefits at retirement for the period the discrimination identified by the McCloud judgment was effective. Approximately 350,000 retired members will be offered this choice retrospectively.
The Department expects that the majority of impacted retired members will not receive their choice until after April 2025.Whilst the majority of impacted retired members are likely to already be in receipt of their most beneficial set of benefits, the Department is working with the NHSBSA to accelerate the provision of this choice, particularly for members for whom there would be an immediate financial impact. The NHSBSA will communicate revised timelines with members once these are confirmed.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help support the financial sustainability of community pharmacies.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Pharmacies play a vital role in our healthcare system. Previous plans did not go far enough. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists.
The consultation with Community Pharmacy England on the national funding and contractual framework arrangements for 2024/25 has not yet been concluded, and we are looking into this as a matter of urgency.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to prevent the sale of the CellAED personal defibrillator.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for regulating the United Kingdom’s medical devices market and works to protect and promote public health and patient safety. We undertake safety and market surveillance of all medical devices in the UK to monitor both performance and safety. We also designate Approved Bodies to undertake conformity assessments of medical devices and award a UK conformity assessed marking to sell products.
The MHRA acts on evidence and takes prompt action where necessary to protect public health. We communicate any actions taken to healthcare professionals and patients as appropriate. We encourage all users of medical devices to report any problems to us via the Yellow Card Scheme.
We are aware of issues raised by stakeholders regarding the CellAED device and we are investigating these concerns with the manufacturer.
Typically, when concerns are identified we have a number of regulatory options available to protect the public including, but not limited to, working with manufacturers to address safety concerns, negotiating a voluntary suspension of sales pending the conclusion of a safety and performance investigation, producing safety communications, or taking compliance action to prevent sales when required.
Interactions between medical device manufacturers and the MHRA are confidential. This is to promote transparent, accurate and timely flow of information to allow appropriate regulatory decisions to be made from evidence provided.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase access to diagnosis for children with (a) ADHD and (b) autism in the context of applications for school places.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The Department is currently considering next steps to improve access to autism and attention deficit hyperactivity disorder (ADHD) assessments.
It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism and ADHD assessment services, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines.
On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people and adults referred to an autism assessment service. In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.
In respect of ADHD, we are supporting a cross-sector taskforce that NHS England has launched to look into challenges in ADHD service provision, to help provide a joined-up approach, including with education, in response to concerns around rising demand.
Local authorities must ensure there are sufficient school places for all pupils, including those with special educational needs (SEN) and disabilities. The Children and Families Act 2014 requires local authorities to keep the provision for children and young people with SEN and disabilities under review including its sufficiency, working with parents, young people, and providers. There is no requirement for a formal medical diagnosis to be made before requesting an Education Health and Care needs assessment.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of instructing NICE to review it's infant head circumference measurement guidelines, in the context of improving the diagnosis and treatment of (a) hydrocephalus and (b) other long term related complications.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) develops its guidance independently and keeps its published guidelines under active surveillance so that it is able to update its recommendations in light of any significant new evidence. Decisions on updates to existing guidance are made by NICE’s Prioritisation Board in line with NICE’s published common prioritisation framework.
NICE’s guideline on “suspected neurological conditions: recognition and referral” includes recommendations on head circumference measurement. We understand that NICE is currently reviewing its recommendations to consider if any update to its recommendation is warranted.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help reduce waiting times for access to CAMHS support.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
It is unacceptable that too many children and young people are not receiving the mental health care they deserve, and we know that waits for mental health services are far too long. We are determined to change that.
As part of our mission to build a National Health Service that is fit for the future and that is there when young people need it, this Government will recruit 8,500 additional mental health workers across children and adult mental health services and introduce a specialist mental health professional in every school. This will mean mental health conditions, such as anxiety and depression, can be identified early on and prevented from developing into more serious conditions in later life.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his department is taking to tackle shortages in (a) ADHD medication, (b) Creon and (c) medications used in the management of enzyme deficiency disorders and cystic fybrosis.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules and guanfacine prolonged-release tablets are now available.
We are continuing to work to resolve medicine supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the UK from October 2024 onwards.
In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance which includes offering rapid response to primary care teams seeking urgent advice/opinion for the management of patients including those known to be at a higher risk of adverse impact because of these shortages.
The Department has also been working with suppliers to address current supply issues with Creon which is used by patients with conditions such as cystic fibrosis and certain cancers including pancreatic cancer. The supply issues with Creon are impacting countries throughout Europe and have been caused by limited availability of raw ingredients and manufacturing capacity constraints to produce volumes needed to meet demand. These issues have resulted in knock-on supply disruptions of alternative pancreatic enzyme replacement therapy (PERT) medications. The Department is continuing to work with all suppliers of PERT to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets and increase production.
The supplier of Creon has advised that they expect to have regular supplies released each month going forward and are working to increase the quantities released. Serious Shortage Protocols are in place for Creon 10,000 and 25,000 capsules which pharmacists can use to restrict supply to one month at a time to ensure more patients have access to it whilst stock is limited.
We have issued comprehensive guidance to healthcare professionals about these supply issues, which provides advice on how to manage patients whilst there is disruption to supply. This guidance is being kept under review and updates will be made, as necessary.
Asked by: Anna Dixon (Labour - Shipley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will review the tapered annual allowance threshold for NHS pensions.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Tax policy is a matter for my Rt Hon. Friend, the Chancellor of the Exchequer. The tapered annual allowance threshold applies universally and restricts the amount of tax-free pension saving available to the wealthiest in society.