Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 incorporate targets to provide asthma sufferers with a Personalised Asthma Action Plan into future iterations of the 10 Year Health Plan for England.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The provision of Personalised Asthma Action Plans is already incentivised by the Quality Outcomes Framework (QOF) indicator AST007. This indicator measures the percentage of patients on the asthma register who have had a review in the past 12 months. This review must include:
- an assessment using a validated asthma control questionnaire;
- a record of the number of exacerbations;
- an assessment of inhaler technique; and
- a written personalised asthma plan.
The latest QOF data shows that for England, the percentage of asthma patients on the register receiving this care has increased from 52.5% in 2021/22 to 64.6% in 2023/24.
Further details on the QOF asthma indicators are available on pages 41 to 46 of NHS England’s 2025/26 QOF guidance, which is available at the following link:
Therefore, there are currently no plans for future iterations of the 10-Year Health Plan for England.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of (a) all people with and (b) children with asthma have a personalised asthma action plan in Birmingham Perry Barr constituency.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE), the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN) published the guideline Asthma: diagnosis, monitoring and chronic asthma management in November 2024, which covers diagnosing, monitoring, and managing asthma in adults, young people, and children. The guideline emphasises the importance of personalised asthma action plans (PAAPs) for effective asthma management.
The Department and NHS England welcome the updated guideline and have been engaging with health system partners to support its implementation across the country, including the use of PAAPs.
NHS England’s National bundle of care for children and young people with asthma aims to support integrated care systems to deliver high quality asthma care and has resources available to support the use of PAAPs in children and young people.
NHS England has also been working jointly with the Health Innovation Networks to form a national respiratory partnership to improve asthma outcomes, including through implementation of the collaborative NICE, BTS, and SIGN asthma guideline.
The Quality and Outcomes Framework (QOF) incentivises use of PAAPs through indicator AST007, which measures the percentage of patients with asthma on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control, a recording of the number of exacerbations, an assessment of inhaler technique, and a written personalised action plan. The latest QOF data shows that for England, the percentage of asthma patients on the register receiving this care has increased from 52.5% in 2021/22 to 64.6% in 2023/24.
According to the QOF data for the end of 2023/24, general practices in the Perry Barr constituency had 5,437 patients on the asthma register. Of these, 4,253 had received an asthma review in the previous 12 months, and 3,361, or 61.8% of patients on the register, had a written personalised asthma plan. Data for this indicator is not broken down by age, and determining these numbers for children would require contacting individual general practices, as they are the data controllers for this patient information.
Further information on the QOF asthma indicators are available on pages 41 to 46 of NHS England’s 2025/26 QOF guidance, which is available at the following link:
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 people with asthma with Personalised Asthma Action Plans.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE), the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN) published the guideline Asthma: diagnosis, monitoring and chronic asthma management in November 2024, which covers diagnosing, monitoring, and managing asthma in adults, young people, and children. The guideline emphasises the importance of personalised asthma action plans (PAAPs) for effective asthma management.
The Department and NHS England welcome the updated guideline and have been engaging with health system partners to support its implementation across the country, including the use of PAAPs.
NHS England’s National bundle of care for children and young people with asthma aims to support integrated care systems to deliver high quality asthma care and has resources available to support the use of PAAPs in children and young people.
NHS England has also been working jointly with the Health Innovation Networks to form a national respiratory partnership to improve asthma outcomes, including through implementation of the collaborative NICE, BTS, and SIGN asthma guideline.
The Quality and Outcomes Framework (QOF) incentivises use of PAAPs through indicator AST007, which measures the percentage of patients with asthma on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control, a recording of the number of exacerbations, an assessment of inhaler technique, and a written personalised action plan. The latest QOF data shows that for England, the percentage of asthma patients on the register receiving this care has increased from 52.5% in 2021/22 to 64.6% in 2023/24.
According to the QOF data for the end of 2023/24, general practices in the Perry Barr constituency had 5,437 patients on the asthma register. Of these, 4,253 had received an asthma review in the previous 12 months, and 3,361, or 61.8% of patients on the register, had a written personalised asthma plan. Data for this indicator is not broken down by age, and determining these numbers for children would require contacting individual general practices, as they are the data controllers for this patient information.
Further information on the QOF asthma indicators are available on pages 41 to 46 of NHS England’s 2025/26 QOF guidance, which is available at the following link:
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 1 July 2025 to Question 62448 on Asthma: Medical Equipment, whether his Department has made an assessment of the potential impact of prescription charges on the health outcomes of people with asthma.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No assessment has been made of the potential impact of prescription charges on the health outcomes of people with asthma. However, the National Institute for Health and Care Excellence, the British Thoracic Society, and the Scottish Intercollegiate Guideline Network published a new collaborative guideline for asthma in November 2024. The guideline covers diagnosing, monitoring, and managing asthma in adults, young people, and children. It aims to improve the accuracy of diagnosis, help people to control their asthma, and reduce the risk of asthma attacks. The recommendations offer the opportunity to simplify diagnostic processes and improve the treatment of people with asthma, and NHS England is working with specialist groups and partners to encourage a joined-up approach to implementation. Through its national respiratory programme and focused work on children and young people with asthma, NHS England is already supporting systems to improve outcomes for people with asthma.
While there are no plans to amend the criteria for eligibility for free prescriptions, approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place for which those with asthma may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.
People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three month and 12-month certificates available, and PPCs can be paid for in instalments.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 the affordability of prescriptions for people with asthma in Birmingham Perry Barr constituency.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No assessment has been made of the potential impact of prescription charges on the health outcomes of people with asthma. However, the National Institute for Health and Care Excellence, the British Thoracic Society, and the Scottish Intercollegiate Guideline Network published a new collaborative guideline for asthma in November 2024. The guideline covers diagnosing, monitoring, and managing asthma in adults, young people, and children. It aims to improve the accuracy of diagnosis, help people to control their asthma, and reduce the risk of asthma attacks. The recommendations offer the opportunity to simplify diagnostic processes and improve the treatment of people with asthma, and NHS England is working with specialist groups and partners to encourage a joined-up approach to implementation. Through its national respiratory programme and focused work on children and young people with asthma, NHS England is already supporting systems to improve outcomes for people with asthma.
While there are no plans to amend the criteria for eligibility for free prescriptions, approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place for which those with asthma may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.
People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three month and 12-month certificates available, and PPCs can be paid for in instalments.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 3 July 2025 to Question 62444 on Asthma: Medical Equipment, what recent discussions his Department has had with pharmaceutical companies on encouraging them to become marketing authorisation holders for dosage counters in emergency inhalers.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) has not approached any pharmaceutical company to encourage them to become a marketing authorisation holder (MAH) for short-acting beta agonist (SABA) pressurised metered-dose inhalers (pMDIs) with integrated dose counters. As the United Kingdom’s independent regulator for medicines and medical devices, the MHRA does not have the remit to proactively approach pharmaceutical companies with requests to become MAHs for specific products.
However, the MHRA provides scientific and regulatory advice to support any pharmaceutical company that wishes to develop and seek authorisation for SABA pMDIs that incorporate integrated dose counters. Through scientific advice meetings and regulatory interactions, the MHRA can offer support on the design, development, and licensing requirements for these products.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential benefits of amending the Human Medicines (Amendment) (No. 2) Regulations 2014 to require (a) colleges, (b) nurseries, and (c) universities to hold emergency asthma inhalers.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
There are no plans to amend these regulations to require colleges and universities to hold emergency inhalers. These are not controlled environments like schools, which require parents to inform them if their children need an inhaler. Colleges and universities typically have much larger enrolment numbers than schools, with their students having greater freedom of movement than schools. Colleges and universities also have students of adult age who are responsible, as adults, for ensuring both have and properly use their inhalers.
Emergency inhalers in schools are a back-up and not a substitution for a child having their own inhaler to hand. The emergency inhaler is for use in the event a child’s inhaler is empty, broken or unavailable.
By virtue of the wording of the School Standards and Framework Act 1998, the Human Medicines (Amendment) (No. 2) Regulations 2014 also apply to maintained nursery schools, namely state-funded early years settings, controlled and funded by the local authority.
Evidence has not been presented that suggests it is necessary to extend the regulations to all non-state-run nurseries in England. Parents of children with asthma attending nursery should ensure that their child, or the nursery, has the child’s inhaler available.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
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 people with asthma in Birmingham Perry Barr constituency.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Birmingham and Solihull Integrated Care System (BSol ICS) is working to enhance asthma care, which includes access to diagnostics in the community, across the city and the borough. Improved rates of diagnosis will allow early intervention and prevention, supporting patients to manage their condition more effectively at home or in the community, and preventing emergency hospital admissions.
In primary care, adults, children, and young people can access support from their general practice (GP) for diagnosis and ongoing management of the condition, treatment of mild exacerbations, and asthma annual reviews to optimise treatment and prevent exacerbations.
Adults, children, and young people have access to outpatient reviews by community respiratory specialist nurses through GP referrals to the Birmingham Community Healthcare NHS Foundation Trust. These reviews are for patients requiring specialist support, where their condition is not severe enough to require secondary care.
In December 2024, the BSol ICS’s Community Care Collaborative launched a Respiratory Same Day Emergency Care Service at Washwood Health and Wellbeing Centre. The service is in particular responding to the issue that 40% of those admitted to Birmingham Heartlands Hospital have respiratory illness. The service is for patients aged 17 years old and over from any part of Birmingham and Solihull who have chronic respiratory conditions, including chronic obstructive pulmonary disease, asthma, pneumonia, respiratory failure, bronchiectasis, and interstitial lung disease. Patients who access the service are then either discharged, followed-up with a GP, admitted to a virtual ward, also known as hospital at home, or referred to a community respiratory service.
For children and young people, the Birmingham Women’s and Children’s NHS Foundation Trust’s Department of Respiratory Medicine and Cystic Fibrosis treats children and young people aged between zero and 18 years old with asthma, including 40 to 50 with difficult asthma, who are receiving specialised treatments.
The BSol ICS has also established a Paediatric Asthma Network which has been leading a number of workstreams focused on improving asthma education, training, post-asthma attack management, and the creation of a novel risk stratification tool to identify children with high risk of asthma attacks. The BSol ICB has also provided funding to support the creation of new asthma clinics, specialist asthma nurses, and asthma-friendly school initiatives. 75% of children who had a second review at these clinics showed significant improvement in their asthma control test, suggesting improved disease control. 100% of children who attended the clinics had a reduction in asthma-related hospital accident and emergency department visits over the subsequent six months.
Asked by: Simon Opher (Labour - Stroud)
Question to the Ministry of Defence:
To ask the Secretary of State for Defence, whether he plans to review the criteria for which applications to join the British Army are rejected on medical grounds.
Answered by Luke Pollard - Minister of State (Ministry of Defence)
This Government inherited a recruitment crisis, with targets being missed every year for the past 14 years, and is taking decisive action to get recruitment back on track. This has included the largest pay rise to personnel in decades and scrapping 100 outdated policies that slow recruitment down.
Defence is committed to a diverse workforce and is seeking to ‘select in’ rather than ‘select out’ and is focused on work to review the current policies for Armed Forces recruiting.
An update to Joint Service Publication (JSP) 950 Leaflet 6-7-7, which outlines the medical entry standard for the Armed Forces, was published in August 2024 following an intensive period of review undertaken by clinical experts, Defence personnel staff and the recruiting agencies. Recent updates to policy include; new regulations for a range of conditions including asthma and eczema, and candidates with Autism Spectrum Disorder may now be able to join the Armed Forces providing they meet certain criteria.
Asked by: Ayoub Khan (Independent - Birmingham Perry Barr)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential merits of mandating the installation of dosage counters in all NHS-provided emergency asthma inhalers.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) understands the term “emergency asthma inhalers” in this context to refer to reliever inhalers containing short-acting beta agonist (SABA) licensed for the rapid relief of symptoms during acute asthma attacks or bronchospasm, as well as for the prevention of exercise-induced bronchospasm. The MHRA is aware of ongoing safety concerns associated with the absence of integrated dose counters on SABA pressurised metered dose inhalers (pMDIs), particularly the risk that patients may unknowingly use inhalers that are empty or near empty during an asthma attack.
The MHRA has assessed the potential merits of mandating the inclusion of dose counters on SABA pMDIs. As part of this review, the MHRA has actively engaged with external national healthcare stakeholders and pharmaceutical industry to explore the feasibility of the integration. While the safety case for improved dose visibility is recognised, it is equally important to consider the potential impact of the product design change on supply resilience. The United Kingdom market for SABA pMDIs is currently limited to a small number of market authorisation holders and introducing a regulatory requirement without fully considering implementation timelines, material and personnel resources, and manufacturing capabilities could risk destabilising the supply of these critical medicines.
Rather than mandating dose counters on SABA pMDIs, the MHRA is currently pursuing a more flexible, proportionate approach to strongly recommend the inclusion of dose counters. This strategy seeks to improve patient safety outcomes while avoiding the risk of unintended supply disruption. The MHRA remains committed to working closely with industry and other stakeholders to ensure that any changes are introduced within a robust and pragmatic framework and timeline that safeguards patient access to essential respiratory medicines.