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, how many and what proportion of patients with type 1 diabetes use real time continuous glucose monitoring to manage their diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Standard care for type 1 diabetes involves regularly measuring blood glucose levels by self-monitoring, blood testing, or by using a continuous glucose monitor, real-time or intermittently scanned.
The NHS Long Term Plan committed that 20% of people with type 1 diabetes would benefit from life changing flash glucose monitors. Data to quarter three of 2022/23 shows that 73% of people with type 1 diabetes were prescribed flash glucose monitoring, against the 20% target. As a result of the recent National Institute for Health and Care Excellence guidance that also recommended that insulin dependent patients with type 2 diabetes should benefit from flash or continuous glucose monitoring devices, we are now starting to see a growth in prescribing within the type 2 diabetes patient group.
Asked by: Lloyd Russell-Moyle (Labour (Co-op) - Brighton, Kemptown)
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 impact of off-label prescriptions of Victoza, Luraglutide, for the purpose of weight loss from private healthcare providers on the level of supply of that drug for type 2 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
While the position has improved, there continues to be a global supply issue with glucagon-like peptide-1 receptor agonists (GLP-1 RA), including Victoza (liraglutide). We have issued updated guidance to healthcare professionals in the form of a National Patient Safety Alert on 3 January 2024, on how to manage patients requiring these medicines.
Our guidance is clear that GLP-1 RAs that are solely licensed to treat type 2 diabetes should only be used for that purpose and should not be routinely prescribed for weight loss. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines.
We know how distressing and frustrating medicine supply issues can be, and the Department will continue to help ensure that these critical medicines reach diabetes patients. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
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 help stop disruption of the supply of (a) Ozempic, (b) Trulicity and (c) similar medicines.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
While the position has improved, there continues to be a global supply issue with glucagon-like peptide-1 receptor agonists (GLP-1 RA), including Trulicity (dulaglutide) and Ozempic (semaglutide). We have issued updated guidance to healthcare professionals in the form of a National Patient Safety Alert on the 3 January 2024, on how to manage patients requiring these medicines.
Our guidance is clear that GLP-1 RAs that are solely licensed to treat type 2 diabetes should only be used for that purpose, and should not be routinely prescribed for weight loss. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and the Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines.
We know how distressing and frustrating medicine supply issues can be, and the Department will continue to help in ensuring that these critical medicines reach diabetes patients. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
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 support patients affected by shortages of Trulicity.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
While the position has improved, there continues to be a global supply issue with glucagon-like peptide-1 receptor agonists (GLP-1 RA), including Trulicity (dulaglutide) and Ozempic (semaglutide). We have issued updated guidance to healthcare professionals in the form of a National Patient Safety Alert on the 3 January 2024, on how to manage patients requiring these medicines.
Our guidance is clear that GLP-1 RAs that are solely licensed to treat type 2 diabetes should only be used for that purpose, and should not be routinely prescribed for weight loss. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and the Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines.
We know how distressing and frustrating medicine supply issues can be, and the Department will continue to help in ensuring that these critical medicines reach diabetes patients. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
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 help ensure the supply of Trulicity.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
While the position has improved, there continues to be a global supply issue with glucagon-like peptide-1 receptor agonists (GLP-1 RA), including Trulicity (dulaglutide) and Ozempic (semaglutide). We have issued updated guidance to healthcare professionals in the form of a National Patient Safety Alert on the 3 January 2024, on how to manage patients requiring these medicines.
Our guidance is clear that GLP-1 RAs that are solely licensed to treat type 2 diabetes should only be used for that purpose, and should not be routinely prescribed for weight loss. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and the Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines.
We know how distressing and frustrating medicine supply issues can be, and the Department will continue to help in ensuring that these critical medicines reach diabetes patients. If any patient is concerned about their treatment, they should discuss this with their clinician at the earliest opportunity.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend to commission further research into the accuracy of BMI thresholds for (1) adults, and (2) children.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) recommends that Body Mass Index (BMI) for adults and BMI centile, adjusted for age and sex, for children and young people should be used as a practical measure for estimating and defining adiposity, the measure of fatty tissue. In September 2022, NICE reviewed evidence on the most accurate methods and thresholds for assessing the risk associated with overweight and obesity in adults, children and young people, which included BMI.
The Government accepts NICE’s evidence review and recommendations on BMI, including that: BMI is used as a practical measure of overweight and obesity in both adults and children and young people but needs to be interpreted with caution because it is not a direct measure of central adiposity, the accumulation of excess fat in the abdominal area which directly relates to health risks such as type 2 diabetes, hypertension and cardiovascular disease; in adults with a BMI below 35 kilograms per metre squared, waist-to-height ratio should be measured and used as well as BMI, as a practical estimate of central adiposity; in children or young people with a BMI on or above the 91st centile, waist to height ratio should be measured to estimate the degree of central adiposity to help identify or predict future health risks; and a child’s BMI centile should always be plotted on the Royal College of Paediatrics and Child Health UK-World Health Organization growth charts and BMI charts.
NICE also recommended further research, for adults as well as children and young people, on the most accurate and suitable measurements and boundary values to assess the health risks associated with overweight, obesity and central adiposity in people of different ethnicities, particularly those from black, Asian and minority ethnic family backgrounds.
The Department have noted NICE’s recommendations for research. The Department delivers research through the National Institute for Health and Care Research, which funds and supports research across all areas of health and social care, including obesity. Research proposals in all areas compete for the funding available, with awards made on the basis of scientific quality, value for money, and importance of the topic to patients and the health and care system.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what recent assessment they have made of the accuracy of BMI thresholds for (1) adults, and (2) children.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) recommends that Body Mass Index (BMI) for adults and BMI centile, adjusted for age and sex, for children and young people should be used as a practical measure for estimating and defining adiposity, the measure of fatty tissue. In September 2022, NICE reviewed evidence on the most accurate methods and thresholds for assessing the risk associated with overweight and obesity in adults, children and young people, which included BMI.
The Government accepts NICE’s evidence review and recommendations on BMI, including that: BMI is used as a practical measure of overweight and obesity in both adults and children and young people but needs to be interpreted with caution because it is not a direct measure of central adiposity, the accumulation of excess fat in the abdominal area which directly relates to health risks such as type 2 diabetes, hypertension and cardiovascular disease; in adults with a BMI below 35 kilograms per metre squared, waist-to-height ratio should be measured and used as well as BMI, as a practical estimate of central adiposity; in children or young people with a BMI on or above the 91st centile, waist to height ratio should be measured to estimate the degree of central adiposity to help identify or predict future health risks; and a child’s BMI centile should always be plotted on the Royal College of Paediatrics and Child Health UK-World Health Organization growth charts and BMI charts.
NICE also recommended further research, for adults as well as children and young people, on the most accurate and suitable measurements and boundary values to assess the health risks associated with overweight, obesity and central adiposity in people of different ethnicities, particularly those from black, Asian and minority ethnic family backgrounds.
The Department have noted NICE’s recommendations for research. The Department delivers research through the National Institute for Health and Care Research, which funds and supports research across all areas of health and social care, including obesity. Research proposals in all areas compete for the funding available, with awards made on the basis of scientific quality, value for money, and importance of the topic to patients and the health and care system.
Asked by: Caroline Lucas (Green Party - Brighton, Pavilion)
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 (a) monitor the availability, (b) notify relevant stakeholders of shortages and (c) help ensure adequate supply of (i) Victoza and (ii) other medications for patients with diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
We are aware of global supply issues with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) including Victoza (liraglutide), which are licensed for treating patients with type 2 diabetes. We have issued guidance in the form of a Medicine Supply Notification, addressing all GLP-1 RAs advising healthcare professionals on how to manage patients requiring these medicines. Further guidance has been issued through a National Patient Safety Alert which provides further background and clinical information and actions for providers. This guidance was futher updated on 3 January 2024.
Our guidance is clear that GLP-1 RA medicines that are solely licensed to treat type 2 diabetes should only be used for that purpose and should not be routinely prescribed for weight loss.
The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines. We have also added some of these products to the list of medicines that cannot be exported from, or hoarded in, the United Kingdom.
We are continuing to work closely with manufacturers and others working in the supply chain to help ensure the continued supply of these medicines for UK patients, for example by asking suppliers to expedite deliveries. Supplies of Rybelsus (semaglutide) have been boosted to support demand from new patients with type 2 diabetes, alongside patients switching from Victoza injections.
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 the report entitled Let’s talk kidneys: Opportunities for early intervention in chronic kidney disease, published by Kidney Care UK on 13 December 2023, if she will ensure that the Major Conditions Strategy includes (a) increased testing for chronic kidney disease in primary care settings for those most at risk by virtue of having (i) diabetes and (ii) cardiovascular disease, (b) the incorporation of evidence-based interventions into chronic kidney disease care strategies which aim to delay disease progression and (c) other actions on chronic kidney disease.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s guidance, Chronic kidney disease: Assessment and management [NG203], updated in November 2021, sets out the best practice for clinicians in the diagnosis and management of chronic kidney disease (CKD). The guidance covers monitoring for those patients at risk as well as pharmacological management and referral, where appropriate, and is available at the following link:
https://www.nice.org.uk/guidance/ng203
In addition to evidence-based guidance to support clinicians in diagnosing problems of the kidney, we are also working to detect people at risk of kidney disease through the NHS Health Check Programme. The programme, which is available for everyone between the ages of 40 and 74 years old who are not already on a chronic disease register, assesses people’s health and risk of developing certain health problems. Using this information, patients are supported in making behavioural changes and accessing treatment which helps to prevent and detect kidney disease earlier.
We are investing in new delivery models for the NHS Health Check, including nearly £17 million for the development and roll-out of an innovative new national and digital NHS Health Check, which will be rolled out this spring, and will give people a choice about where and when to have a check.
The UK National Screening Committee (UK NSC) reviewed CKD and glomerulonephritis in 2011 and concluded that a population-wide screening programme would not be recommended, and has not looked at the evidence for a targeted programme. The UK NSC can be alerted to any new peer-reviewed evidence published which may suggest the case for a new screening programme. Proposals to change or review a topic early can be submitted via the UK NSC’s annual call, which will open in July 2024.
Asked by: Steve McCabe (Labour - Birmingham, Selly Oak)
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 adequacy of the availability of continuous glucose monitoring for people with type-1 diabetes; and if she will make an assessment of the potential merits of taking steps to increase access to that monitoring.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The NHS Long Term Plan made a commitment that 20% of people with type 1 diabetes would benefit from life changing flash glucose monitors. Data up to the third quarter of 2022/23 shows that 73% of people with type 1 diabetes were prescribed flash glucose monitoring, against the 20% target. As a result of the recent National Institute for Health and Care Excellence guidance that also recommended that insulin dependent patients with type 2 diabetes should benefit from flash or continuous glucose monitoring devices, we are now starting to see a growth in prescription within the type 2 diabetes patient group.
Variation ratio in prescribing between the most and least affluent Indices of Multiple Deprivation (IMD) quintiles has been monitored on a quarterly basis. Variation between these IMD quintiles has reduced in every English region. When the programme started, Flash was twice as likely to be prescribed to patients living in the most affluent areas. The current ratio between most and least affluent geographies is now at a ratio of 1 to 1.02, meaning there is virtually parity between the most and least deprived patient groups across England.