Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential merits of allowing a Physician Associate to Junior Doctor conversion course.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There is no training pathway specifically designed for a physician associate to become a doctor in the United Kingdom. To become a doctor in the UK, an individual is required to complete either an undergraduate degree or a graduate-entry programme in medicine from a UK medical school which meets the standards set by the General Medical Council.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to his statement of 6 January 2025 on Health and Social Care Reform, Official Report, columns 595 to 598, what steps he is taking to ensure equal access to healthcare in rural and urban areas.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government recognises the health inequalities faced by rural communities in England, particularly around access to healthcare services. In response, we are working closely across the department, with NHS England and regional Directors of Public Health to develop approaches that address these inequalities so that no person or community is left behind.
The Government is committed to putting patients first, including in both rural and urban areas. This means making sure that all patients are seen on time and ensuring that people have the best possible experience during their care.
On 6 January 2025, NHS England published the new Elective Reform Plan, part of the Government’s Plan for Change, which sets out a whole system approach to hitting the 18-week Referral to Treatment target by the end of this Parliament. The plan sets out the reform and productivity efforts needed to ensure that patients are seen on time and have the best possible experience during their care. A copy of the plan is available at the following link:
https://www.england.nhs.uk/wp-content/uploads/2025/01/reforming-elective-care-for-patients.pdf
We have set an ambition to make progress on the 18-week standard in 2025/26, to 65% nationally and for all trusts to deliver a minimum five percentage point improvement by March 2026. At the end of November 2024, the rate at The Shrewsbury and Telford Hospital NHS Trust was 48.5%.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to his statement of 6 January 2025 on Health and Social Care Reform, Official Report, column 597, what his definition is of working class areas.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department is committed to improving health outcomes across geographies and demographic groups to ensure that there is no two-tier system for healthcare in this country, where those who can afford it pay to go private, and those who cannot are left behind.
The Index of Multiple Deprivation, produced by the Ministry of Housing, Communities and Local Government, is most commonly used as the means to determine the most deprived areas of the country, which are often where health needs are greatest. As an example of targeted support, the Further Faster 20 (FF20) initiative will support 20 trusts with long waits in areas of highest economic inactivity to tackle their waiting lists by improving productivity. Trust teams will work with the FF20 team of clinicians and managers to look at their pathways and ways of working with the aim of improving the way that outpatients, diagnostics, and theatres are run.
On 6 January 2025, NHS England published the new Elective Reform Plan, part of the Government’s Plan for Change, which sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament. The plan sets out the reform and productivity efforts needed to ensure that patients are seen on time and have the best possible experience during their care. The Plan for Change commits that by the end of this parliament, 92% of all patients will wait no longer than 18 weeks for treatment following a referral.
The Elective Reform Plan sets out a range of new measures to address health inequalities, including that people living in disadvantaged areas are 1.8 times more likely to wait over a year than someone living in one of the least deprived areas. This is why the plan commits not only to make progress on the 18-week standard in 25/26, to 65% nationally, but for all trusts to deliver a minimum five percentage point improvement by March 2026, recognising that we must have high expectations for progress across the country.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 improve access to SGLT2 inhibitor treatments for people with chronic kidney disease from underserved communities.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of resources.
The NICE has been able to recommend two SGLT2 inhibitors, empagliflozin and dapagliflozin, for treating chronic kidney disease, subject to specified clinical criteria. The NHS in England is legally required to fund medicines recommended in a NICE appraisal, usually within three months of final guidance, so these treatments should now be available for healthcare professionals to prescribe to NHS patients in line with the NICE’s recommendations.
In September 2024, the NICE added links to the relevant technology appraisal guidance on SGLT-2s, for empagliflozin, which has a NICE reference number of TA942, and for dapagliflozin, which has a NICE reference number of TA775, to the guideline Chronic kidney disease: assessment and management. This is to provide easy access to the relevant appraisal guidance at the right point in the guideline, and to help users find the information more easily. Further information on the guidance for chronic kidney disease, specifically recommendation 1.6.9 on SGLT-2s, is available at the following link:
https://www.nice.org.uk/guidance/ng203/chapter/Recommendations#pharmacotherapy
The NICE publishes a range of resources to support services in putting its recommendations into practice. The NICE has also published a general practice indicator on chronic kidney disease and SGLT2 inhibitors. NICE indicators measure outcomes that reflect the quality of care or processes, and can be used in a number of different settings to support high quality care, including the uptake of NICE-recommended treatments, such as SGLT2 inhibitors.
The responsibility for implementing NICE guidance rests with the relevant commissioner.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 increase uptake of SGLT2 inhibitor treatments for people with chronic kidney disease.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of resources.
The NICE has been able to recommend two SGLT2 inhibitors, empagliflozin and dapagliflozin, for treating chronic kidney disease, subject to specified clinical criteria. The NHS in England is legally required to fund medicines recommended in a NICE appraisal, usually within three months of final guidance, so these treatments should now be available for healthcare professionals to prescribe to NHS patients in line with the NICE’s recommendations.
In September 2024, the NICE added links to the relevant technology appraisal guidance on SGLT-2s, for empagliflozin, which has a NICE reference number of TA942, and for dapagliflozin, which has a NICE reference number of TA775, to the guideline Chronic kidney disease: assessment and management. This is to provide easy access to the relevant appraisal guidance at the right point in the guideline, and to help users find the information more easily. Further information on the guidance for chronic kidney disease, specifically recommendation 1.6.9 on SGLT-2s, is available at the following link:
https://www.nice.org.uk/guidance/ng203/chapter/Recommendations#pharmacotherapy
The NICE publishes a range of resources to support services in putting its recommendations into practice. The NICE has also published a general practice indicator on chronic kidney disease and SGLT2 inhibitors. NICE indicators measure outcomes that reflect the quality of care or processes, and can be used in a number of different settings to support high quality care, including the uptake of NICE-recommended treatments, such as SGLT2 inhibitors.
The responsibility for implementing NICE guidance rests with the relevant commissioner.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 provide (a) comprehensive healthcare guidance on and (b) access to specialised gynaecological support for (i) the management of menstruation, (ii) contraception options, (iii) safe pregnancy care and (iv) other related matters for people with spinal cord injuries.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government will prioritise women’s health, placing women’s equality at the heart of our agenda, and ensuring that women’s health is never neglected again. NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for specialised women’s services that provides clinical advice and leadership for complex obstetrics and maternity, and complex gynaecology and fertility preservation services. Specialist gynaecological services are commissioned in line with the service specification published by the CRG.
Furthermore, there is a CRG for rehabilitation, and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG. The National Institute for Health and Care Excellence also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:
https://www.nice.org.uk/guidance/ng41
Menstrual problems and symptoms, such as heavy or painful periods, are common and can have a significant impact on women and girls’ wellbeing, and their participation in education and the workplace. We also recognise that having a spinal cord injury can create additional challenges for women and girls when it comes to managing their period. A range of treatments are available and can help manage menstrual symptoms and gynaecological conditions. Women and girls should contact their general practice (GP) if menstrual problems are affecting their daily life.
In November 2023, NHS England published a decision support tool for managing heavy periods. This tool supports women’s understanding of their symptoms and appropriate treatment options, to support discussion with clinicians.
The Royal College of General Practitioners (RCGP) has published a Women’s Health Library which brings together educational resources and guidelines on women’s health from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the Faculty of Sexual and Reproductive Healthcare. This resource is continually updated to ensure GPs and other primary healthcare professionals have the most up-to-date advice, to provide the best care for their patients.
We are committed to ensuring that the public receives equitable access to the best possible contraceptive services. Different methods of contraception are available from a range of different settings, including direct from pharmacies, both prescribed and over the counter, from GPs, and from local authority commissioned sexual and reproductive health services.
The NHS Pharmacy Contraception Service was launched in April 2023, enabling pharmacists to issue ongoing supplies of contraception initiated in GP surgeries and sexual health services. The service relaunched in December 2023 to enable community pharmacies to also initiate oral contraception. This service offers greater choice in how people can access contraception services. It will also create additional capacity in GP and sexual health clinics to support meeting the demand for more complex assessments.
The Government will continue to work with the NHS as it delivers its three-year maternity and neonatal plan to grow our maternity workforce, develop a culture of safety, and ensure women and babies receive safe, compassionate care.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 the risks of (a) uterine prolapse and (b) osteoporosis among women with spinal cord injuries through (i) improved access to preventive care, (ii) diagnosis and (iii) long-term management strategies.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government will prioritise women’s health, placing women’s equality at the heart of our agenda, and ensuring that women’s health is never neglected again. Symptoms of uterine prolapse can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed. The National Institute for Health and Care Excellence has produced guidance on the management of pelvic organ prolapse in women, which is available at the following link:
https://www.nice.org.uk/guidance/ng123
For patients who need surgery for uterine prolapse, the NHS England Specialised Commissioning Clinical Reference Group for specialised women’s services has produced a service specification for specialised complex surgery for urinary incontinence and vaginal and uterine prolapse, which is available at the following link:
The implications of musculoskeletal (MSK) conditions, such as osteoporosis, for women’s health cannot not be overlooked. MSK conditions disproportionately impact women. One in three women will experience an osteoporotic fracture in their lifetime, compared to one in five men. Women are more at risk of developing osteoporosis due to hormone changes that happen at the menopause, and directly affect bone density.
For all people, including those with spinal injuries, regular exercise and healthy eating are important factors in preventing osteoporosis. Weight-bearing exercise and resistance exercise are particularly important for improving bone density and helping to prevent osteoporosis. Eating foods rich in calcium and vitamin D, or taking vitamin D supplements, is also an important way people can maintain their bone health and reduce their risk of osteoporosis.
The drug Raloxifene is also recommended by the National Institute for Health and Care Excellence for the primary prevention of osteoporotic fragility fractures in postmenopausal women. In addition, the Government is committed to expanding access to Fracture Liaison Services. Fracture Liaison Services are a globally recognised secondary fracture prevention model for those with osteoporosis, which can reduce the risk of refracture by up to 40%. With NHS England, we are considering a range of options to identify the most effective ways of improving the quality of, and access to, the Fracture Liaison Service model and the interventions it provides.
To support early diagnosis of osteoporosis, including in those with spinal cord injuries, the Government is investing £1.5 billion capital funding in 2025/26 for new surgical hubs and diagnostic scanners to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 ensure that women with spinal cord injuries receive adequate postnatal support including (a) breast feeding assistance and (b) tailored rehabilitation services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government will prioritise women’s health, placing women’s equality at the heart of our agenda and ensuring women’s health is never again neglected. According to NHS England’s guidance, all women who have given birth should be offered a check-up with their general practice six to eight weeks after giving birth. The check-up will cover a range of topics such as mental health, physical recovery, breastfeeding, and support with family planning. NHS England is also rolling out perinatal pelvic health services to reduce rates of perineal tears, and maternal mental health services to provide additional mental health support and improve outcomes for women.
We know that breastfeeding has significant benefits for both mother and baby. The Government is committed to achieving the healthiest generation of children ever, and central to this is our commitment to give every baby the best start in life. This includes helping families to achieve their breastfeeding goals. It is important that all families are supported to make the right choice for them and have prompt and easy access to high-quality advice and services to help them achieve their infant feeding goals.
The Department is working closely with 75 local authorities across England to improve their infant feeding services, including breastfeeding support, through the Family Hubs and Start for Life programme. These services are helping families to access face-to-face and virtual infant feeding support whenever they need it, and in a location that suits them. This could be at home, in their family hub, or in a hospital setting.
We want to build on the actions that local areas are already taking through the Family Hubs and Start for Life programme to improve their infant feeding services. At a national level, families across the United Kingdom can access round-the-clock support and advice on breastfeeding through the National Breastfeeding Helpline.
The Department recognises the profound impact that spinal injuries can have on an individual and their loved ones, and the importance of early access to high-quality neurorehabilitation. The National Institute for Health and Care Excellence has produced guidance on rehabilitation after traumatic injury, which includes specific recommendations regarding rehabilitation for those with spinal injuries. Further information is available at the following link:
https://www.nice.org.uk/guidance/ng211
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 to Question Question 8906 on cancer and with reference to the Plan for Change: Milestones for mission-led government, CP 1210, published on 5 December 2024, whether it remains his policy to meet all NHS cancer waiting time targets within five years.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the importance of, and remains committed to meeting, all three National Health Service cancer waiting time standards across England. These are the 28-day faster diagnosis standard, the 31-day decision to treat to treatment standard, and the 62-day referral to treatment standard.
Lord Darzi’s report has laid bare the true extent of the challenges facing our health service, which is why we have launched our 10 Year Plan to radically reform the NHS and build a health service that is fit for the future.
Following publication of the 10-Year Health Plan, we will publish the new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including improving performance against the cancer waiting time standards.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many hospices there were in England in each year since 2015; and how many of those received Government funding in each of those years.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, and their loved ones.
The Department does not hold specific data regarding hospice funding for each year. Individual ICBs oversee and maintain records of these transactions.
Additionally, the amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on the demand in that ICB area, but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.