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Written Question
Medicine: Education
Thursday 12th January 2023

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many medical students are studying in the UK.

Answered by Will Quince

The information requested is not held centrally.


Written Question
Black Country Integrated Care System: General Practitioners
Wednesday 2nd November 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many GPs who had been previously working in Black Country Integrated Care System area have left the profession over the last three years.

Answered by Neil O'Brien

This information is not collected in the format requested.


Written Question
Fungi: Infectious Diseases
Tuesday 1st November 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to his answer of 22 September 2022 to Question 45706 on Fungi: Infectious Diseases, and with reference to the World Health Organisation's fungal priority pathogens list to guide research, development and public health action of 25 October, if he will make his policy to increase funding for research in this area.

Answered by Will Quince

The National Institute for Health and Care Research (NIHR) is supporting the ‘UK 5-year action plan for antimicrobial resistance 2019 to 2024’, which commits to undertake research on antifungal resistance. In the last five years, the NIHR has invested more than £6 million in research into fungal infection and anti-microbial resistance is a priority for future research. However, it is not usual practice to ring-fence funds for particular topics or conditions. The Department works with other Government departments and funding agencies as well as the World Health Organization on the approach to antifungal resistance.


Written Question
Black Country Integrated Care System: General Practitioners
Wednesday 26th October 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to improve GP retention in the Black Country ICS area.

Answered by Will Quince

We are working with NHS England, Health Education England and the profession to increase the general practice workforce in England, including in the Black Country Integrated Care System area. This includes measures to improve recruitment, address the reasons why doctors leave the profession and encourage them to return to practice.

The updated GP Contract Framework announced a number of new schemes, alongside continued support for existing recruitment and retention schemes for the general practice workforce. This includes the GP Retention Scheme, the GP Retention Fund, the National GP Induction and Refresher, the Locum Support Scheme, the New to Partnership Payment and the Supporting Mentors Scheme.


Written Question
Black Country Integrated Care System: General Practitioners
Tuesday 25th October 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much funding was allocated to Black Country integrated care system to support GP retention in 2022-23; and how much was spent in 2021-22.

Answered by Will Quince

The Black Country Integrated Care System received £711,000 in 2021/22 for local general practitioner retention initiatives and new to practice fellowships. Its indicative allocation for 2022/23 is £1.176 million, which includes funding for retention initiatives and fellowships.


Written Question
Black Country Integrated Care System: Labour Turnover
Tuesday 25th October 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment her Department has made of the adequacy of the provision of local retention initiatives in the Black Country Integrated Care System area.

Answered by Robert Jenrick

No specific assessment has been made. However, the NHS People Plan sets out a range of actions to improve staff retention through strengthening measures to address health and wellbeing, equality and diversity, culture and leadership and flexible working. NHS England also support systems to develop tailored health and wellbeing offers to meet the needs of the local workforce. This includes the mental health hubs in each integrated care system (ICS) and occupational health services which are being supported through the Growing Occupational Health and Wellbeing programme.

The Black Country ICS is implementing national retention initiatives in addition to a dedicated pensions portal and collaboration with organisations such as Timewise to support flexible working within clinical areas. Targeted assessments of the general practitioner workforce are made and reported via a monthly partnership board.


Written Question
Fungi: Infectious Diseases
Tuesday 27th September 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the current level of funding for research into fungal infections is; and what the projected budget for such research is for the next five years.

Answered by Robert Jenrick

The Department’s National Institute for Health and Care Research (NIHR) welcomes funding applications for research into any aspect of human health, including fungal infection research. However, it is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality. In the last five years, the NIHR has invested more than £6 million in research into fungal infection.


Written Question
Fungi: Infectious Diseases
Thursday 22nd September 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential risks posed by treatment resistant fungal infections.

Answered by Caroline Johnson

Misuse and overuse of antimicrobials, such as fungal agents, is a factor in the development of drug-resistant pathogens. NHS England’s national pharmacy and prescribing clinical lead is supported by seven regional antimicrobial stewardship (AMS) leads. These AMS leads collaborate with regional National Health Service stakeholders and partner organisations, including infection prevention and control, patient safety, diagnostics and sepsis teams, the Department, the UK Health Security Agency (UKHSA), Health Education England and the Care Quality Commission, to contribute to multi-professional endeavours to mitigate the threat of antimicrobial resistance (AMR).

NHS England’s AMR diagnostics team advise that high-level research has been undertaken to understand the need for optimal fungal diagnostics and resistance testing. This has highlighted opportunities for improvement in data collection regarding the use of diagnostics, surveillance and consistent access to diagnostics.

The UKHSA reports on antifungal resistance against systemic antifungals utilised in the treatment of candidaemia, in the English Surveillance Programme for Antimicrobial Utilisation and Resistance report. Resistance to the key antifungals, amphotericin B, caspofungin and fluconazole, appears to have been decreasing in all Candida species. Fluconazole resistance decreased from 8.2% of Candida blood isolates tested in 2016 to 3.2% in 2020. Resistance to amphotericin B and caspofungin decreased slightly from 2016 to 2020, by 1.3% to 1.1%, and 3.4% to 3.3% respectively.


Written Question
Fungi: Infectious Diseases
Thursday 22nd September 2022

Asked by: John Spellar (Labour - Warley)

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 estimate of the number of (a) patients admitted to hospital and (b) patients receiving medical treatment following a fungal infection in each of the last 3 years.

Answered by Caroline Johnson

This information is not held in the format requested. However, the following table shows the number of person IDs with a primary diagnosis of fungal infection and finished admission episodes (FAEs) and finished consultant episodes (FCEs) where a main procedure took place in 2019/20 and 2020/21 in English National Health Service hospitals and English NHS commissioned activity in the independent sector.

Year

Number of person IDs with a primary diagnosis

Number of person IDs with a primary diagnosis with a procedure

2019/20

7,638

5,483

2020/21

5,224

3,674

Source: NHS Digital

Notes:

  1. Person IDs. The Master Person Service (MPS) person identifier. This is a unique identifier for each individual patient, generated via the MPS. This identifier replaces the HESID field and allows an individual’s care to be tracked across years and continuous periods to be identified.
  2. Primary Diagnosis. The primary diagnosis is the first of up to 20 (14 from 2002/03 to 2006/07 and seven prior to 2002/03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.
  3. ICD-10 coding and description. The following ICD-10 codes are indexed under the term ‘fungal infection’:

- B49.X Unspecified mycosis

- B20.5 HIV disease resulting in other mycoses

- B35.0 Tinea barbae and tinea capitis

- B35.1 Tinea unguium

- B35.2 Tinea manuum

- B35.3 Tinea pedis

- B35.6 Tinea cruris

- B36.9 Superficial mycosis, unspecified

- B48.7 Opportunistic mycoses

Research indicates that fungal infections are also known as mycosis, therefore the ICD-10 block B35-B49 Mycoses may be pertinent and has also been included in the data. It should be noted that there may be other codes within the ICD-10 classification which maybe applicable to the condition.

  1. A FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.
  2. A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which it ends. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
  3. Main procedure. The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, for example, time waited, while a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures. It should be noted that some patients are treated for a fungal infection condition during an outpatient appointment. However, diagnoses are extremely seldom recorded in outpatient records, therefore it is not possible to provide useful data from the outpatient data set.
  4. HES figures are available from 1989/90 onwards. Changes to the figures over time should be interpreted in the context of improvements in data quality and coverage particularly in earlier years, improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

Data is also held on total systemic antifungal prescribing in NHS hospital trusts recorded as defined daily doses (DDDs) per 1,000 admissions per day in 2020. The total consumption of antifungals in NHS acute trusts in 2020 was 0.63 DDDs per 1,000 admissions per day. This is a 21% increase in the rate of prescribing from 2019. The collection of the NHS England’s antifungal commissioning for quality and innovation data was interrupted by COVID-19.


Written Question
Operose Health: Staff
Thursday 23rd June 2022

Asked by: John Spellar (Labour - Warley)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of the report by Panorama that Operose Health have used less qualified staff to consult with patients without supervision.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

Physician associates (PAs) are not a substitute for a general practitioner. The use of PAs in primary care is detailed in the Network Contract Directed Enhanced Service, which describes the role and the tasks a PA funded by the Additional Role Reimbursement Scheme (ARRS) would be expected to undertake. It also references the expectation of the supervision of PAs. NHS England and NHS Improvement have committed to review the ARRS by the end of 2023.