Asked by: Yasmin Qureshi (Labour - Bolton South East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve allergy awareness in health care settings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The majority of services for people living with allergies are commissioned locally through integrated care boards (ICBs), which are best placed to commission services according to local need. Specialised allergy services are provided for patients with severe and complex allergic conditions, or those who have common allergic conditions for which conventional management has failed and for whom specified specialist treatments are required. In 2023/24, these services are jointly commissioned by NHS England Specialised Commissioning and the ICBs, in line with the published Specialist Allergy Service Specification.
There is an established Clinical Reference Group (CRG), which is responsible for providing national clinical advice and leadership for specialised immunology and allergy services. The CRG uses its expertise to advise NHS England on the best ways to provide specialised services. This includes developing national standards in the form of service specifications and policies. The CRG commenced a review of the current service specification in May 2023, which is expected to be complete by summer 2024. The outcome of the service specification review will be an updated specification which references up-to-date guidance and takes into account the latest evidence base, to clearly define the standards of care for commissioned specialised services.
To help promote awareness of allergies, the National Institute for Health and Care Excellence (NICE) has published guidance on a range of allergy conditions, including food allergy in under 19-year-olds, anaphylaxis, and drug allergy. The NICE promotes its guidance via its website, newsletters, and other media.
To support clinicians in the implementation of clear care pathways, the NICE website has guidance to support diagnosis and treatment of a range of allergy conditions, including how to identify allergies and when to refer to specialist care, and how to ensure allergies are recorded in their medical records. The NICE website also provides primary care practitioners with access to clinical knowledge summaries outlining the current evidence base and practical guidance on a range of skin conditions.
Asked by: Yasmin Qureshi (Labour - Bolton South East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of the potential merits of each Integrated care systems having a (a) specialist allergy nurse and (b) dietitian.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The majority of services for people living with allergies are commissioned locally through integrated care boards (ICBs), which are best placed to commission services according to local need. Specialised allergy services are provided for patients with severe and complex allergic conditions, or those who have common allergic conditions for which conventional management has failed and for whom specified specialist treatments are required. In 2023/24, these services are jointly commissioned by NHS England Specialised Commissioning and the ICBs, in line with the published Specialist Allergy Service Specification.
There is an established Clinical Reference Group (CRG), which is responsible for providing national clinical advice and leadership for specialised immunology and allergy services. The CRG uses its expertise to advise NHS England on the best ways to provide specialised services. This includes developing national standards in the form of service specifications and policies. The CRG commenced a review of the current service specification in May 2023, which is expected to be complete by summer 2024. The outcome of the service specification review will be an updated specification which references up-to-date guidance and takes into account the latest evidence base, to clearly define the standards of care for commissioned specialised services.
To help promote awareness of allergies, the National Institute for Health and Care Excellence (NICE) has published guidance on a range of allergy conditions, including food allergy in under 19-year-olds, anaphylaxis, and drug allergy. The NICE promotes its guidance via its website, newsletters, and other media.
To support clinicians in the implementation of clear care pathways, the NICE website has guidance to support diagnosis and treatment of a range of allergy conditions, including how to identify allergies and when to refer to specialist care, and how to ensure allergies are recorded in their medical records. The NICE website also provides primary care practitioners with access to clinical knowledge summaries outlining the current evidence base and practical guidance on a range of skin conditions.
Asked by: Daisy Cooper (Liberal Democrat - St Albans)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the federated data platform will include functionality to enable the creation of a consolidated national allergy register.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The current use cases for the Federated Data Platform (FDP) are:
- elective recovery, to address the backlog of people waiting for appointments or treatments;
- care coordination, to enable the effective coordination of care between local health and care organisations and services, reducing the number of long stays in hospital;
- vaccination and immunisation, to continue to support the vaccination and immunisation of vulnerable people while ensuring fair and equal access and uptake across different communities;
- population health management, to help integrated care systems proactively plan services that meet the needs of their population; and
- supply chain management, to help the National Health Service put resources where they are needed most, and buy smarter so that we get the best value for money.
The creation of a consolidated national allergy register, or identifiable national clinical data registries, is not in the current scope of the FDP, which will not be processing identifiable patient data at a national level. More products will be developed on the FDP throughout the lifecycle of this programme.
The FDP programme has developed a front door process and demand assessment framework which will be used for new requirements coming into the programme. The assessment framework assesses ideas and requests on the basis of their fit to the core FDP objectives and targeted business case outcomes, as well as assessing against the feasibility of successful delivery when considering things like cost, capacity, wider system dependencies, and other factors. In regard to a consolidated national allergy register, we would expect discussions to be held initially within the National Disease Registry Service.
Alongside the FDP, NHS England are investing in platform modernisation, including the Patient Outcomes and Registries Platform (ORP) which is a unified national registry platform integrated into NHS England’s system data infrastructure for improved data security, flow, linkage, and analysis, and faster pace of registry development.
The ORP’s directions cover all outcome registries, patient-reported outcome measures and patient-reported experience measures, and shared decision-making and data collections across a wide range of conditions, including all surgical and interventional procedures in the NHS and independent sector. A national allergy register or registry may be in the scope for the ORP’s coverage.
Asked by: Marquess of Lothian (Conservative - Life peer)
Question to the Department for Environment, Food and Rural Affairs:
To ask His Majesty's Government what steps they are taking, in light of recent research by University College London, to ensure that ultra-processed foods, particularly meat-alternative products, are (1) clearly labelled, and (2) not categorised in the green ‘healthy’ category of the traffic-light food labelling system.
Answered by Lord Douglas-Miller - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)
The UK maintains high standards on the information that is provided on food labels so that consumers can have confidence in the food that they buy. The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food. Prepacked food has to show: (1) a list of ingredients; (2) the net quantity of the food; (3) the quantity of certain ingredients used; (4) ingredients causing allergies or intolerances; (5) a best before or use by date; (6) any special storage conditions and/or conditions of use; (7) country of origin where required; (8) origin of the primary ingredient (where required); (9) instructions for use where necessary and (10) other labelling as required.
In addition, the name of the food (or of any ingredients) should be accompanied by details of the physical condition of the food or the specific treatment which it has undergone (for example, powdered, refrozen, freeze-dried, quick-frozen, concentrated, smoked) in all cases where omission could mislead the purchaser. This means that consumers are able to examine the label on any food and determine whether it meets their particular requirements.
While nutrition labelling is mandatory on most prepacked food, front of pack 'traffic light' nutrition labelling remains voluntary, and it is for the individual business to decide on which foods the information will be most useful to consumers. Manufacturers and retailers are encouraged to provide front of pack nutrition labelling on as many of their products as possible where the information is meaningful for consumers. Research has shown that consumers expect to find front of pack nutrition labelling on pre-prepared convenience foods, ready meals and other processed products.
The Department of Health and Social Care published guidance in 2013 on applying voluntary front of pack nutrition labelling. The traffic light score for each product is set against thresholds for ‘green’, ‘amber’ and ‘red’, and should be applied on an individual basis relating to the nutritional content and are used to represent whether a product is ‘high’ (red), ‘medium’ (amber) or ‘low’ (green) in specific, individual nutrients (total fat, saturated fat, total sugars and salt). The guidance can be found here and attached.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department for Environment, Food and Rural Affairs:
To ask the Secretary of State for Environment, Food and Rural Affairs, what steps he is taking to ensure that food businesses adhere to food labelling standards for items (a) containing common allergens and (b) marketed as (i) vegetarian and (ii) vegan.
Answered by Mark Spencer - Minister of State (Department for Environment, Food and Rural Affairs)
The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food so that consumers can have confidence in the food that they buy. All food businesses selling food in the UK must comply with food labelling rules, which include the requirement for specific information to be presented in a specific way. For example, food businesses are under a legal obligation to provide accurate information on the presence of the 14 major allergens in food, so that people who have allergies and intolerances can make safe food choices.
While there are no specific rules covering information on the suitability of food for vegetarians or vegans, the requirement that food information must not mislead consumers applies to such labels as for other voluntary labels.
It is the duty of Local Authorities to enforce food safety and labelling regulations, to help ensure food is safe for people living with a food allergy. The Food Standards Agency have agreements and protocols in place to support local authorities in their work and give guidance to explain the regulations and how they can be applied to food businesses.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department for Education:
To ask the Secretary of State for Education, what recent guidance her Department has provided to (a) schools and (b) other educational institutions on food (i) labelling and (ii) allergens.
Answered by Damian Hinds - Minister of State (Education)
The department provides statutory guidance for schools, ‘Supporting pupils with medical conditions’, which makes clear that schools should ensure they are aware of any pupils with allergies and have processes in place to ensure these can be well managed. The guidance is available at: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3. Further information is available at: https://www.gov.uk/government/publications/school-food-standards-resources-for-schools/allergy-guidance-for-schools.
In early years settings, the Early Years Foundation Stage (EYFS) framework sets the standards that all registered early years providers must meet for the learning, development and care of children from birth to age five. The framework is available at: https://www.gov.uk/government/publications/early-years-foundation-stage-framework--2.
The EYFS states that before a child is admitted to the setting the provider must also obtain information about any special dietary requirements, preferences and food allergies that the child has, and any special health requirements.
The EYFS signposts to the Department of Health and Social Care document ‘Example menus for early years settings in England’ which includes guidance on menu planning, food safety, managing food allergies and reading food labels, which staff preparing food will find helpful in ensuring that children are kept safe. The guidance is available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/658870/Early_years_menus_part_1_guidance.pdf.
The ‘Help for early years providers’ online platform, owned by the department, has a food safety page which also signposts to resources on allergies. This page is available at: https://help-for-early-years-providers.education.gov.uk/safeguarding-and-welfare/food-safety#allergies. The department is also developing nutrition content for the platform which will have a section on allergies and resources such as a common allergies table.
Higher education (HE) institutions and further education institutions are autonomous and it is the responsibility of individual HE institutions to implement and adhere to relevant guidelines with regards to labelling and allergens.
The Food Standards Agency (FSA) promotes its resources including information on allergen labelling and management to all food business operators including schools, nurseries, colleges, and other institutional caterers.
The FSA has published guidance relevant to schools and other educational institutions including sector specific guidance in July 2021 for new allergen labelling legislation which came into force in October 2021. Guidance for institutional caterers (including schools) has been on the FSA website since at least 2017. This has links to training courses offered by allergy charities. In September 2020, the FSA also launched free allergen training which has had over 530,000 users to date, with nearly 75,000 of these being from the education sector.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to help improve the (a) clarity and (b) accuracy of allergen information on food labelling.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food. The United Kingdom maintains high standards on the information that is provided on food labels, so that consumers can have confidence in the food they buy. The Food Standards Agency (FSA) is responsible for food safety and food hygiene in England, Wales, and Northern Ireland, including food allergen labelling.
All food businesses are under a legal obligation to provide information on the presence of the 14 major allergens in food, so that people who have allergies and intolerances are able to make safe food choices. The FSA carries out a range of research to ensure that this information is clear and accurate. It has recently carried out an evaluation of the prepacked for direct sale food labelling requirements introduced in 2021, and updated food labelling technical guidance for businesses following a consultation with consumers and food businesses on the application and understanding of allergen labelling.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she will make an assessment of the adequacy of food labelling for people with allergies.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The fundamental principle of food labelling rules is that information provided to the consumer must not mislead and must enable the safe use of food. The United Kingdom maintains high standards on the information that is provided on food labels, so that consumers can have confidence in the food they buy. The Food Standards Agency (FSA) is responsible for food safety and food hygiene in England, Wales, and Northern Ireland, including food allergen labelling.
All food businesses are under a legal obligation to provide information on the presence of the 14 major allergens in food, so that people who have allergies and intolerances are able to make safe food choices. The FSA carries out a range of research to ensure that this information is clear and accurate. It has recently carried out an evaluation of the prepacked for direct sale food labelling requirements introduced in 2021, and updated food labelling technical guidance for businesses following a consultation with consumers and food businesses on the application and understanding of allergen labelling.
Asked by: John Healey (Labour - Wentworth and Dearne)
Question to the Ministry of Defence:
To ask the Secretary of State for Defence, how many people were rejected from joining the Armed Forces due to (a) anaphylaxis and (b) allergies in each year since 2010.
Answered by Andrew Murrison - Parliamentary Under-Secretary (Ministry of Defence)
This information is not held centrally and could be provided only at disproportionate cost.
Asked by: Richard Foord (Liberal Democrat - Tiverton and Honiton)
Question to the Department for Education:
To ask the Secretary of State for Education, whether she is taking steps to ensure the provision of non-dairy milk products in (a) schools and (b) other early-years learning environments.
Answered by Damian Hinds - Minister of State (Education)
The government’s School Food Standards (SFS) regulate the food and drink provided at both lunchtime and other times of the school day. Although schools are required to make milk available, the SFS (Schedule 1) also enables schools to provide a variety of other drinks including plain soya, rice or oat drinks enriched with calcium and combination, and flavoured variations of these drinks to suit particular medical, dietary and cultural needs. School food policies work best when schools discuss them with parents and pupils, so that parents can raise pupils’ particular dietary needs.
There is a requirement within the early years foundation stage (EYFS) statutory framework that all registered early years settings must ensure that: ‘where children are provided with meals, snacks and drinks, they must be healthy, balanced and nutritious’. The EYFS also states that before a child is admitted to the setting the provider must also obtain information about any special dietary requirements, preferences and food allergies that the child has, and any special health requirements.
The department believes that schools and early year settings are best placed to make decisions about their food policies, taking into account local circumstances and the needs of their children. In doing so, the department expects settings to make reasonable adjustments for children with particular requirements, for example to reflect dietary and cultural needs.