Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of the National Institute for Health and Care Excellence’s severity modifier on the prescribing of cancer medicines.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) published its updated manual for health technology evaluations in January 2022, and has introduced a number of changes to make its methods and processes fairer, faster, and more consistent.
This includes the introduction of a broader severity modifier in place of the end-of-life modifier. NICE has been monitoring the impact of the changes that it introduced and analysis carried out by NICE for the first year of the updated manual’s implementation shows that NICE’s committee accepted 11 out of 13 cases where the company applied for a severity modifier, with eight of these being for cancer medicines.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to adopt a new immunisation programme and ensure that there is high uptake of this programme.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is advised by the independent Joint Committee on Vaccination and Immunisation (JCVI). The JCVI considers the disease’s burden on society, vaccine safety and efficacy, and the impact and cost effectiveness of immunisation strategies, before making a recommendation as to whether a new immunisation programme should be developed. This advice is then considered by the Department and, subject to that consideration, the Department works with partners, including the National Health Service and the UK Health Security Agency, to ensure the effective implementation of this advice. This includes work to ensure vaccine uptake of any implemented programmes is high. Numerous methods are used to ensure high uptake, including targeted communications, ensuring vaccine accessibility and availability.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how they plan to assess the impact of new immunisation programmes for infant respiratory syncytial virus on (1) hospitalisations, and (2) health inequality.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency (UKHSA) monitors national immunisation programmes in England. The UKHSA’s Severe Acute Respiratory Infection Watch surveillance system collects weekly information on admissions to hospital with Respiratory Syncytial Virus (RSV), to monitor admission rates in each RSV season. If a programme is introduced, monitoring of its effectiveness would include thorough analysis of immunisation records, both infant or maternal, and laboratory results for patients needing healthcare for RSV-like illness. The UKHSA can also monitor RSV admissions by deprivation and ethnicity, using routine National Health Service records, when these become available following the RSV season. The UKHSA will also monitor inequalities in uptake of the RSV immunisation programmes, through its routine uptake data collections.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how they plan to assess the wider productivity and economic benefits of any new immunisation programmes for infant respiratory syncytial virus.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The independent Joint Committee for Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation. The JCVI’s evaluation of the cost-effectiveness of a respiratory syncytial virus (RSV) programme was based on the health benefits of an infant RSV programme, and the potential healthcare cost savings from preventing cases and hospitalisations.
The Department did not ask the JCVI to complete an assessment of the wider productivity and economic benefits when determining the cost-effectiveness of a vaccination programme, and the Department did not assess this separately for RSV.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what information they have on countries currently implementing immunisation programmes for infant respiratory syncytial virus with regard to (1) acceptance and uptake, and (2) hospitalisations.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
In the United States, as of 31 January 2024, maternal immunisation was 17.9%. By February 2024, 43% of infants under eight months old had received a dose of nirsevimab.
In Galicia, Spain, 92.9% of 5,357 infants born from 25 September 2023 to 4 February 2024 had nirsevimab, as well as 79.7% of 5,823 infants included in a catch-up programme. The peak of the hospitalisation rate in infants under six months old was 102 per 100,000 in 2023/24, during the week starting 27 November 2023. This is compared to a median of 776 for 2017/18, 2018/19 and 2019/20, peaking during the first week of the January.
In Luxembourg, 84% of 1524 infants born in hospital between early October and mid-December 2023 received nirsevimab. Luxembourg observed a decrease in hospitalisation in infants under six months old of 69%, between the 2022/23 and 2023/24 respiratory syncytial virus seasons.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they will decide on the tender for the Respiratory Syncytial Virus immunisation for infants and young adults.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has engaged the market on its requirements for products that would enable respiratory syncytial virus vaccination programmes to be implemented for infants and older adults, as advised by the Joint Committee on Vaccination and Immunisation. Final decisions on these programmes have not yet been taken. There are no plans for a respiratory syncytial virus vaccination programme for young adults.
The Invitation to Offer was published on 24 January 2024, and closed on 29 February. Bids received will now be evaluated based on cost-effectiveness. Following this, a full business case will be developed for the Government’s approval this spring.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the finding by the NHS Confederation that there has been a 26 per cent cut to the public health grant per person in real terms since 2015–16; and what plans they have to ensure that every baby and young child in England can receive the full Healthy Child Programme.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
At the 2021 Spending Review, we considered the need for local government public health funding, and have provided cash growth in the Public Health Grant to local authorities each year over the settlement period. In 2024/25 the total Public Health Grant to local authorities will be £3.603 billion, providing local authorities with an average 2.1% cash increase compared to 2023/24.
In addition to the Public Health Grant, we have provided additional targeted investment to local authorities in England for drug and alcohol addiction treatment and recovery, and services that support the best start in life. From April 2024 we will also double current spend on stop smoking services, in support of our commitment to deliver a smoke-free generation. This overall funding package will deliver a real term increase of more than 4%, over the two years 2023/24 and 2024/25, in Department funding allocated for local authority public health functions.
Local authorities are responsible for using their Public Health Grant to provide a Healthy Child Programme that best meet the needs of their local populations. In addition, the health visiting workforce is fundamental to enabling successful delivery of this programme, and as part of the NHS Long Term Workforce Plan, we will be expanding training places by 74% to over 1,300 by 2031/32. To support progress towards this expansion, training places for health visitors will grow by 17% by 2028/29.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the additional £165 million of annual funding provided by NHS England to improve maternity and neonatal care, which will rise to £186 million a year this year, and how this will directly improve babies’ health and development outcomes.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The investment within maternity and neonatal services supports the delivery of NHS England's three-year delivery plan, which will make maternity and neonatal care safer, more personalised, and more equitable for women and babies.
The plan outlines the investment we are making in listening to women and families, growing, retaining, and supporting our workforce, developing, and sustaining a culture of safety, and underpinning more personalised and equitable care. The plan sets out success measures for trusts, integrated care systems, and NHS England, to monitor the impacts and improvements at every level.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to tackle problems of recruitment and retention of midwives in England to enable every expectant parent and baby to receive the continuity of care model.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Since 2021 we have invested an additional £165 million a year to improve maternity and neonatal care, rising to an additional £186 million from April 2024. This is improving the quality of care for mothers and babies, and increasing the number of midwifery posts available.
As of December 2023, there are 23,361 full time equivalent midwives working in National Health Service trusts and other core organisations in England, an increase of 3,707, or 18.9%, compared to 2010. The Long Term Workforce Plan sets an ambitious increase in midwifery training places, to 58,000 by 2031/32. We will work towards achieving this by increasing places to over 44,000 by 2028/29.
NHS England have introduced measures focused on recruitment and retention, in-line with their three-year maternity delivery plan. This includes establishing a nursing and midwifery retention programme, supporting organisations in assessing themselves against the NHS People Promise, and developing a local retention plan. NHS England is also implementing enhanced continuity of carer for midwifery to ensure safe, consistent, and personalised care in the areas of highest need.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many children have required NHS care as a result of (1) tooth decay, (2) Type 2 diabetes, and (3) musculoskeletal conditions, in the past 12 months for which data is available.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Whilst data on musculoskeletal conditions is not held in the form requested, the below table shows published data for 2022/23 where the main reason the patient was admitted to hospital was for dental caries or Type 2 diabetes mellitus.
Primary diagnosis | Age 0 | Age 1-4 | Age 5-9 | Age 10-14 | Age 15 | Age 16 | Age 17 |
Dental caries | 2 | 4,669 | 19,560 | 7,802 | 782 | 671 | 503 |
Type 2 diabetes mellitus | 0 | 0 | 18 | 88 | 38 | 39 | 24 |
Source: Hospital Episode Statistics Inpatient Data (Diagnosis Annex) from 2022-23
Notes