Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what progress has been made on the commitment made in the NHS Long Term Plan to “improve patient pathways to ensure timely assessment and treatment that reduces the risk of death and disability” for severe asthma attacks.
Answered by Lord Bethell
The NHS Long Term Plan commitment to reduce death and disability from severe asthma attacks by ensuring timely assessment and treatment has been taken forward within the scope of the Clinical Review of Standards. This was requested by the Prime Minister in June 2018 and is led by Professor Stephen Powis, Medical Director of NHS England.
The review seeks to promote safety and outcomes; drive improvements in patients experience; are clinically meaningful, accurate and practically achievable; ensure the sickest and most urgent patients are given priority; ensure patients get the right service in the right place; are simple and easy to understand for patients and the public; and not worsen inequalities.
An interim report was published in March 2019 and testing at 14 different hospitals began in May 2019. This included a commitment to collect data to examine the feasibility of measuring how fast critically ill or injured patients arriving at accident and emergency receive a package of tests and care developed with clinical experts
Asked by: Alex Norris (Labour (Co-op) - Nottingham North)
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 (a) people with severe asthma can access specialist centres for investigations and diagnosis and (b) severe asthma patients who are shielding during the covid-19 outbreak retain access to biologic therapies.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Specialist respiratory services for severe asthma have continued during the COVID-19 outbreak; in most cases people with severe asthma have been able to receive their biologic medication at home instead of having to attend hospital. Given the pivotal role of respiratory medicine in treating patients with COVID-19, the ability of some centres to commence patients receiving biologic therapies may have been impacted at the peak of the surge.
The National Institute for Health and Care Excellence COVID-19 rapid guideline on severe asthma provides guidance on starting or continuing on biological treatments, for people with severe asthma during the COVID-19 outbreak. The rapid guideline is available at the following link:
https://www.nice.org.uk/guidance/ng166
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to address any variation in the number of emergency admissions to hospital for asthma and severe asthma across Clinical Commissioning Groups.
Answered by Lord Bethell
Respiratory disease is a clinical priority within the NHS Long Term Plan. The respiratory interventions proposed in the NHS Long Term Plan include early and accurate diagnosis of respiratory conditions, which help prevent avoidable emergency admissions for asthma.
The Quality Outcomes Framework (QOF) ensures all practices establish and maintain a register of patients with an asthma diagnosis in accordance with National Institute for Health and Care Excellence guidance. An update to the General Practitioner contract includes an improved QOF asthma domain which incorporates aspects of care positively associated with better patient outcomes and self-management. NHS England also commissions the national asthma audit programme that provides data on a range of indicators to show improvements and opportunities in asthma outcomes. Audit data are then used by providers to assess the quality of their services and to support quality improvement.
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps the Department for Health and Social Care is taking to address the rate of emergency adult admissions to hospital for asthma and severe asthma at NHS Harrogate and Rural District Clinical Commissioning Group.
Answered by Lord Bethell
Respiratory disease is a clinical priority within the NHS Long Term Plan. The respiratory interventions proposed in the NHS Long Term Plan include early and accurate diagnosis of respiratory conditions, which help prevent avoidable emergency admissions for asthma.
The Quality Outcomes Framework (QOF) ensures all practices establish and maintain a register of patients with an asthma diagnosis in accordance with National Institute for Health and Care Excellence guidance. An update to the General Practitioner contract includes an improved QOF asthma domain which incorporates aspects of care positively associated with better patient outcomes and self-management. NHS England also commissions the national asthma audit programme that provides data on a range of indicators to show improvements and opportunities in asthma outcomes. Audit data are then used by providers to assess the quality of their services and to support quality improvement.
Asked by: Rosie Cooper (Labour - West Lancashire)
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 people with (a) asthma, (b) COPD and (c) other lung conditions (i) receive timely diagnoses and (b) access emergency and routine care during the covid-19 lockdown.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Specialist respiratory services for severe asthma, along with urgent and emergency treatment for other serious complaints, have continued throughout the COVID-19 outbreak. In most cases people with severe asthma have been able to receive their medication at home instead of having to attend hospital.
Whilst routine treatments were suspended to provide capacity to treat COVID-19 patients, we are now working closely with the National Health Service and other partners to restart these in a safe way, with excellence in infection prevention and control as a key principle. Guidance has already been issued on this, and approaches are being tailored at local level according to local capacity and local demand, with the most urgent services being restarted first.
Asked by: Alex Norris (Labour (Co-op) - Nottingham North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, until what date the recommendations in the NICE COVID-19 rapid guideline: severe asthma will remain in place.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence is unable to confirm a date on which the recommendations in the COVID-19 rapid guideline on severe asthma [NG166] will cease to be in place at this time.
COVID-19 rapid guidelines, and their individual recommendations, will be kept under review and may be considered for withdrawal:
- If the guideline or recommendations are no longer needed or become redundant/obsolete because service delivery has changed (e.g. normal services have resumed), or the recommendations are likely to have limited relevance for the service beyond the timeframe of the current crisis;
- If there are safety issues, for example, the recommendations may harm patients, service users or health and social care practitioners; and
- To remove duplication of recommendations if guideline content or certain recommendations within the COVID-19 suite are merged.
Asked by: Alex Norris (Labour (Co-op) - Nottingham North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many patients began biologic therapies for severe asthma in each month in 2020; and how many patients in total were prescribed biologic therapies for severe asthma in each of those months.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The following table shows the number of patients with severe asthma each month where biologic drug costs have been reimbursed to centres providing severe asthma services.
. | January 2020 | February 2020 | March 2020 |
Total patients | 4,906 | 4,732 | 4,444 |
New Starters | 152 | 91 | 63 |
Asked by: Alex Norris (Labour (Co-op) - Nottingham North)
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 effect of the covid-19 outbreak on the access of severe asthma patients to (a) specialist care in severe asthma centres and (b) biologic therapies.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Specialist respiratory services for severe asthma have continued during the COVID-19 outbreak; in most cases people with severe asthma have been able to receive their biologic medication at home instead of having to attend hospital. Given the pivotal role of respiratory medicine in treating patients with COVID-19, it is likely that the ability of some centres to commence patients on biologics may have been impacted at the peak of the surge.
The National Institute for Health and Care Excellence COVID-19 rapid guideline on severe asthma provides guidance on starting or continuing on biological treatments, for people with severe asthma during the COVID-19 outbreak. The guideline is available at the following link:
https://www.nice.org.uk/guidance/ng166
Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he has taken to monitor oral corticosteroid use by asthma patients who have not been able to access specialist respiratory services during the covid-19 outbreak.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence COVID-19 rapid guideline on severe asthma provides guidance on the use of oral corticosteroids and starting or continuing on biological treatments, which aim to minimise oral corticosteroid exposure, for people with severe asthma during the COVID-19 outbreak. The guideline is available at the following link:
https://www.nice.org.uk/guidance/ng166
Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to (a) monitor and (b) tackle over-reliance by asthma patients on reliever inhalers during the covid-19 outbreak.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The monitoring and prescribing of asthma medication are performed in accordance with guidance from the National Institute for Health and Care Excellence to manage the condition. The guidance is available at the following link:
https://www.nice.org.uk/guidance/ng80/chapter/Recommendations#self-management
The NHS England and NHS Improvement clinical guide for the management of respiratory patients during the COVID-19 pandemic states that the majority of community respiratory services should be switched to telephone or virtual consultation. Routine annual reviews should continue virtually to reassure patients and ensure they are happy with their management plans to avoid hospital attendance. The clinical guide is available at the following link: