Question to the Department of Health and Social Care:

To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 9 July (HL16592), what is their view of the proportion of each of the resulting illness, deaths and costs that could be prevented by new efforts to prevent transmission; and what are the costs of new measures introduced in 2019 to prevent transmission of carbapenem-resistant Enterobacteriaceae.

Public Health England (PHE) has prioritised collecting the necessary data across the National Health Service to enable estimation and monitoring of the proportion of cases, deaths and costs attributable to carbapenemase-resistant Enterobacteriaceae.

In May 2015 PHE implemented an enhanced surveillance system of all carbapenemase-producing Gram negative bacteria, which was modified in 2019 to maximise efficiency. The health burden of cases, estimated from these data, will be published in the English Surveillance Programme for Antimicrobial Utilisation Report in November 2019.

The few published reports of outbreaks have estimated costs of at least £1 million, and up to £5 million, all indicating multi-model control measures are required, as outlined in the PHE toolkit for prevention and control of carbapenemase-producing Enterobacteriaceae which is currently being updated.

Using national surveillance and patient administration data to develop mathematical models, work is ongoing to estimate the reduction in levels of illness and death when specified detection and control measures are applied by 2020. Developed models will enable associated costs incurred to be estimated and the cost-effectiveness of control measures to be established by 2021.