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, with reference to NHS England's web page entitled Diabetes treatment and care programme, whether all eight Type 1 diabetes and disordered eating pilots have been commissioned by their Integrated Care Systems to secure services independently of NHS England pilot scheme funding.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The national approach to funding the establishment of Type 1 Diabetes with Disordered Eating services was delivered in two phases. Initial sites in London, Hampshire, and Dorset received national funding between 2018/19 and 2021/22, before the transition of commissioning responsibility to local systems commenced from April 2023. All three of these services did initially secure local funding, independent of the national pilot scheme. More recently, we understand that the status of these sites to be as follows: London services are partially active across London, with local consideration of ongoing funding and delivery arrangements underway; Hampshire services are active and embedded in wider eating disorder specialist services; and Dorset services have been discontinued. The remaining five newer services have been funded from September 2022, and are nationally funded up to March 2025.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of discontinuing funding for T1DE pilot schemes on the health and well-being of patients living with type 1 diabetes with disordered eating.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England has provided funding for eight integrated care boards (ICBs) across the country to support the development and establishment of Type 1 Diabetes with Disordered Eating (T1DE) services in every National Health Service region. Funding has been provided on a pump prime basis, and the responsibility for the longer-term sustainable provision of care for these patients sits with the relevant integrated care system.
A nationally commissioned evaluation has shown the positive impact that the provision of T1DE services can have for patients, including reductions in HbA1c, which is linked to reduced rates of diabetes complications, and reduced rates of emergency admissions.
It’s the role of the ICBs to consider the health needs of their populations, in making decisions about the care that is provided. It is expected that ICB leads consider these evaluation findings alongside the risk to patient health and wellbeing of the discontinuation of service provision, as well as other local contextual factors in making decisions about the future provision of T1DE services.
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 she has received representations from (a) healthcare professionals, (b) patient advocacy groups and (c) local authorities on discontinuing Type 1 diabetes and disordered eating services.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
My Rt hon. Friend, the Secretary of State for Health and Social Care engages with a range of external stakeholders, including discussions on Type 1 Diabetes with Disordered Eating (T1DE) services. NHS England is working closely with regional and integrated care board (ICB) level teams to ensure that informed decisions are made about the future provision of T1DE services.
Responsibility for the commissioning of T1DE services sits with the ICBs. It is the role of local ICB decision makers to consider the implications of continuing or discontinuing T1DE services, specific to each location, and including the perspectives of healthcare professionals, patient advocacy groups, and local authorities.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she (a) has made and (b) plans to make an assessment of the potential merits of funding options to ensure the sustainability of T1DE services beyond the pilot phase.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Evaluation by the National Health Service of the initial Type 1 Diabetes with Disordered Eating service (T1DE) pilot sites, in London and Wessex, demonstrated a mean reduction in HbA1c of between 2.3% to 2.5%. Assuming that this level of reduction is maintained, the lifetime quality-adjusted life year gain of these services was estimated at 1.49, which would be cost effective up to a net lifetime cost of £29,800-£44,800.
In response to these initial evaluation findings, NHS England expanded the T1DE programme, supporting provision of new services in an additional five sites from September 2022, expanding coverage to more areas of the country. It is expected that these services will generate further evaluation data to consolidate these early findings, which can be used to inform national and local policy decisions.
NHS England is drawing on learning from existing T1DE services, other emerging evidence and the findings of the recent parliamentary inquiry, to ensure all areas of the country are supported to improve care for those identified as having T1DE. The emergence of these future plans are subject to future spending review settlements for the NHS and level of funding from the NHS England budget allocated to T1DE.
NHS England are also working closely with the first wave of pilot sites including London to ensure that the newer services can benefit from their learning and experience when considering local funding options in advance of March 2025, when the national funding for the five new sites will come to an end.
NHS England is assisting integrated care boards to develop local funding arrangements through the provision of evaluation data, a national programme of support workshops, and an online platform to share learning and good practice.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the potential implications for its policies of the cost-benefit analysis of the T1DE pilot schemes carried out by NHS England.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Evaluation by the National Health Service of the initial Type 1 Diabetes with Disordered Eating service (T1DE) pilot sites, in London and Wessex, demonstrated a mean reduction in HbA1c of between 2.3% to 2.5%. Assuming that this level of reduction is maintained, the lifetime quality-adjusted life year gain of these services was estimated at 1.49, which would be cost effective up to a net lifetime cost of £29,800-£44,800.
In response to these initial evaluation findings, NHS England expanded the T1DE programme, supporting provision of new services in an additional five sites from September 2022, expanding coverage to more areas of the country. It is expected that these services will generate further evaluation data to consolidate these early findings, which can be used to inform national and local policy decisions.
NHS England is drawing on learning from existing T1DE services, other emerging evidence and the findings of the recent parliamentary inquiry, to ensure all areas of the country are supported to improve care for those identified as having T1DE. The emergence of these future plans are subject to future spending review settlements for the NHS and level of funding from the NHS England budget allocated to T1DE.
NHS England are also working closely with the first wave of pilot sites including London to ensure that the newer services can benefit from their learning and experience when considering local funding options in advance of March 2025, when the national funding for the five new sites will come to an end.
NHS England is assisting integrated care boards to develop local funding arrangements through the provision of evaluation data, a national programme of support workshops, and an online platform to share learning and good practice.
Asked by: Matt Western (Labour - Warwick and Leamington)
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 ensure people with diabetes can continue to access the insulin they need.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
We are aware of supply issues with some insulin products, however the vast majority are in stock. Comprehensive management guidance on alternative products has been issued to the National Health Service where needed.
The medicine supply chain is highly regulated, complex, and global. Supply disruption is an issue which affects the United Kingdom, as well as the other countries around the world, and it can have a variety of causes, including manufacturing issues, problems with access to raw ingredients, and sudden spikes in demand.
There is a team within the Department that deals specifically with medicine supply problems. It has well-established tools and processes to manage medicine supply issues, working closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England, and others operating in the supply chain, to help prevent shortages and expedite resupply as soon as possible, to ensure that the risks to patients are minimised.
Asked by: Mary Glindon (Labour - North Tyneside)
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 ensure that Tier 2 weight management services are sufficiently (a) resourced and (b) integrated with (i) primary care networks, (ii) community health hubs and (iii) other relevant providers to offer comprehensive support for people living with obesity.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service and local government provide a range of free tier two weight management services (WMS), to help eligible people living with obesity to lose weight. These are multi-component programmes, including dietary approaches and physical activity, with behaviour change support. The length of support can vary, but guidance from the National Institute of Health and Care Excellence suggests these should last at least three months.
The NHS offers the NHS Digital Weight Management Programme, which is a tier two service aimed at adults living with obesity, who also have type 2 diabetes or hypertension, or both, as well as NHS staff living with obesity. The 12-week programme is directly commissioned and managed by NHS England nationally, and is available via direct referral from any general practice or Community Pharmacy
Local authorities are able to spend funding from the Public Health Grant on weight management services in line with local population need. They may be delivered as a standalone service or as part of an integrated service, for example with smoking cessation support. Where local authorities commission these services, they are responsible for determining the required resourcing and interaction with other services, along with weight management service providers
Local authorities are part of integrated care systems (ICSs), which are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. ICS membership also includes the NHS, social care providers, charities, and other organisations. Being a member of the ICS will help local authorities to work more closely with partner organisations and offer integrated support for people living with obesity.
Asked by: Mary Glindon (Labour - North Tyneside)
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 access to weight management services in areas of socioeconomic deprivation.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Local authorities and the National Health Service provide weight management services to support their communities to achieve and maintain a healthier weight. These range from behavioural weight management programmes to specialist services for those living with obesity and associated co-morbidities.
Local authorities are able to spend funding from the Public Health Grant on behavioural weight management services in line with local population need, including in areas of socioeconomic deprivation. Integrated care boards are responsible for commissioning NHS specialist weight management services in line with local population need, as well as determining the criteria for access to these services in line with relevant guidance.
NHS England commissions the Digital Weight Management Programme nationally for people living with obesity and an existing comorbidity of either diabetes, or hypertension, or both. The 12-week programme is available via direct referral from any general practice or Community Pharmacy.
The programme provides three levels of intervention at varying intensities, and patients less likely to complete a behavioural programme of this nature, for instance those of a younger age, from ethnic minority backgrounds, from a more deprived area, or who are male, are offered a higher level of intervention and support to retain their engagement on the programme. Approximately 50% of total referrals are from the two most deprived socioeconomic quintiles.
Asked by: Earl of Dundee (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what incentives they are offering to medical partnerships to assist type two diabetes sufferers through research into both stem-cell and non-stem-cell treatments for diabetes type one sufferers.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is delivering improvements as part of the Vision for the Future of UK Clinical Research Delivery to make the United Kingdom a world leader in clinical research, attracting investment from commercial companies to deliver cutting edge research in a range of disease areas, including diabetes. For example, we introduced the National Contract Value Review to standardise costing and contracting for commercial research in the National Health Service.
This has reduced set up times for clinical research by a third which makes running research in the UK more efficient for commercial companies.
The National Institute for Health and Care Research’s (NIHR) Clinical Research Network (CRN) supports conduct of clinical research in the NHS, providing tailored support for both non-commercial organisations and the life sciences industry. The CRN has a Diabetes Speciality Group to support research across key priorities in diabetes.
The NIHR works in partnership with Diabetes UK to deliver the joint UK Strategy for Clinical and Applied Diabetes Research. The NIHR also funds a Global Health Research Unit on Diabetes and Cardiovascular Disease in South Asia, creating partnerships between research organisations in Bangladesh, India, Pakistan, Sri Lanka and the UK.
Asked by: Earl of Dundee (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what incentives they are offering to commercial operators to form medical partnerships to advance stem-cell and non-stem-cell treatments for diabetes type one sufferers.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is delivering improvements as part of the Vision for the Future of UK Clinical Research Delivery to make the United Kingdom a world leader in clinical research, attracting investment from commercial companies to deliver cutting edge research in a range of disease areas, including diabetes. For example, we introduced the National Contract Value Review to standardise costing and contracting for commercial research in the National Health Service.
This has reduced set up times for clinical research by a third which makes running research in the UK more efficient for commercial companies.
The National Institute for Health and Care Research’s (NIHR) Clinical Research Network (CRN) supports conduct of clinical research in the NHS, providing tailored support for both non-commercial organisations and the life sciences industry. The CRN has a Diabetes Speciality Group to support research across key priorities in diabetes.
The NIHR works in partnership with Diabetes UK to deliver the joint UK Strategy for Clinical and Applied Diabetes Research. The NIHR also funds a Global Health Research Unit on Diabetes and Cardiovascular Disease in South Asia, creating partnerships between research organisations in Bangladesh, India, Pakistan, Sri Lanka and the UK.