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1123746

registered interest
date	29/04/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antibiotics: Drug Resistance
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of the effectiveness of their 2013–18 antimicrobial resistance strategy at addressing the problem of multi-resistant E. coli-like bacteria; what assessment they have made of recent trends in the number of multi-resistant E. coli-like bacteria in the UK; and what factors inform their view of the balance between efforts to reduce transmission and efforts to reduce the use of antibiotics.
tabling member printed	Baroness Gardner of Parkes
uin	HL15384
answer	answer is ministerial correction date of answer 14/05/2019 answer text <p>While we can count many successes from our 2013-18 Antimicrobial Resistance (AMR) Strategy, resistance has continued to increase. In the United Kingdom we have seen a 35% increase in resistant blood stream infections in humans from 2013-17.</p><p>The number of bloodstream infections (BSIs) is increasing each year. Although the proportion of antibiotic resistant BSIs remain stable year to year, the burden on resistance increases. This is mostly due to increasing prevalence of E.coli bloodstream infections.</p><p>Estimates of the multi-resistant cases can be made, however not all the bacteria are tested against the same antibiotics, so a definitive number of cases cannot be given. The Public Health England Fingertips tool also has an indicator showing the rolling quarterly average proportion of E. coli blood specimens non-susceptible to at least three of the key antimicrobials (gentamicin, ciprofloxacin, piperacillin/tazobactam, 3rd-generation cephalosporins or carbapenems). For England this is 5.5% with little fluctuation over time.</p><p>This is exactly why the UK’s five-year national action plan for AMR, published alongside the UK 20-year vision for AMR on 24 January 2019, includes a strengthened focus on infection prevention and control, renewing our commitment to halve levels of healthcare associated Gram-negative blood stream infections (mostly E.coli) by 2023-24. The plan also sets a world-first target to reduce the actual numbers of resistant infections, with the aim to reduce them by 10% by 2025.</p><p>We are working with the devolved health administrations to develop consistent methodologies for reporting the incidence and mortality of key antibiotic resistant infections and antimicrobial use to allow us to report progress on the ambitions of the AMR national action plan.</p><p>As reductions in inappropriate prescribing also reduces the risk of promoting the growth of antibiotic-resistant bacteria, interventions to reduce antibiotic prescribing or transmission of the bacteria are complementary.</p><p> </p> answering member printed Baroness Blackwood of North Oxford question first answered 14/05/2019 16:29:42 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3596 label Biography information for Baroness Gardner of Parkes

1092659

registered interest
date	21/03/2019
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, with reference to the Tackling antimicrobial resistance 2019–2024: The UK’s five-year national action plan, published on 24 January 2019, what plans he has to fund the (a) design and (b) testing of a new economic model for antibiotics.
tabling member constituency	Cambridge
tabling member printed	Daniel Zeichner
uin	235308
answer	answer is ministerial correction date of answer 29/03/2019 answer text <p>The project to develop and test the feasibility of new models that pay companies for antimicrobials based primarily on a heath technology assessment of their value to the National Health Service as opposed to the volumes used, and to share the learning with international stakeholders, is expected to be established by July this year.</p><p> </p><p>The NHS Long Term Plan, published in January this year, makes the commitment to implement the human health aspects of ‘Tackling Antimicrobial Resistance (2019-2024): the UK’s five-year national action plan’. The project will be led by a central project team resourced by the National Institute for Health and Care Excellence and NHS England and the National Institute for Health Research Policy Research Programme is considering research to support the process.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 29/03/2019 14:35:37 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4382 label Biography information for Daniel Zeichner

884937

registered interest
date	16/04/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what funding his Department has provided for research on tackling antibiotic-resistant bacteria in each of the last three years.
tabling member constituency	Ellesmere Port and Neston
tabling member printed	Justin Madders
uin	135925
answer	answer is ministerial correction date of answer 24/04/2018 answer text <p>The Department has provided the following funding for research on antimicrobial resistance, the majority of which will have been directed at research on tackling antibiotic-resistant bacteria.</p><p> </p><table><tbody><tr><td><p>Financial Year</p></td><td><p>Funding provided</p></td></tr><tr><td><p>2015/16</p></td><td><p>£11,617,633</p></td></tr><tr><td><p>2016/17</p></td><td><p>£17,727,228</p></td></tr><tr><td><p>2017/18</p></td><td><p>£30,565,100</p></td></tr></tbody></table><p><strong> </strong></p><p>It is possible that a small number of programmes or projects on antibiotic-resistant bacteria also include research on other drug-resistant microbes or pathogens; it is not possible to separate out this funding from the above totals.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 24/04/2018 11:17:43 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4418 label Biography information for Justin Madders

828153

registered interest
date	22/01/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the effect of over prescribing antibiotics by GP surgeries on the incidence of anti microbial resistance.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	124113
answer	answer is ministerial correction date of answer 30/01/2018 answer text <p>The English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) run by Public Health England has made a national assessment of prescribing patterns by general practices and clinical commissioning groups, together with an assessment of trends in antibiotic resistance among the most common types of bacteria causing serious infections. ESPAUR publishes annual reports and the most recent report, published in October 2017, is available at the following link:</p><p> </p><p><a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/656280/ESPAUR_executive_summary_2017.pdf" target="_blank">https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/656280/ESPAUR_executive_summary_2017.pdf</a></p><p> </p><p>Antibiotic prescribing is a major driver of antibiotic resistance as antibiotic exposure provides a strong selective pressure for the emergence and spread of resistant bacteria.</p><p> </p><p>This is why the Government is seeking to reduce inappropriate antibiotic prescribing as part of a multi-faceted strategy to reduce antibiotic resistance.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 30/01/2018 14:33:48 answering member 4067 label Biography information for Steve Brine
tabling member	4658 label Biography information for Alex Sobel

778823

registered interest
date	27/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what budget was allocated to combating antibiotic-resistant bacteria (a) before 23 June 2017 and (b) currently.
tabling member constituency	Carshalton and Wallington
tabling member printed	Tom Brake
uin	110154
answer	answer is ministerial correction date of answer 06/11/2017 answer text <p>The UK Five Year Antimicrobial Resistance (AMR) strategy, 2013-2018, published in September 2013, had no associated funding to support implementation. All activity has been supported from within existing business plans of the organisations committed to tackling AMR.</p><p> </p><p>A record of what is spent directly on tackling AMR is not centrally maintained but examples of funded initiatives include NHS England’s use of Quality Premium and Commissioning for Quality and Innovation programmes to drive down inappropriate prescribing and a range of AMR research investments and awareness raising initiatives.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 06/11/2017 11:30:32 answering member 4067 label Biography information for Steve Brine
tabling member	151 label Biography information for Tom Brake

669001

registered interest
date	06/01/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if his Department will take steps to set up a National Antibiotic Register for recording all hospital and community patients who have an antibiotic resistant infection.
tabling member constituency	Thirsk and Malton
tabling member printed	Kevin Hollinrake
uin	58778
answer	answer is ministerial correction date of answer 16/01/2017 answer text <p>Such a system already exists. Hospital microbiology laboratories routinely record the results of testing bacteria isolated from infections for susceptibility or resistance to antibiotics. These data are voluntarily submitted to a national antimicrobial resistance (AMR) database called Second Generation Surveillance System (SGSS) maintained by Public Health England. Currently, 98% of hospital laboratories submit their AMR data to SGSS.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 16/01/2017 16:56:07 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4474 label Biography information for Kevin Hollinrake

669006

registered interest
date	06/01/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if his Department will take steps to record on death certificates antibiotic resistant infection as the patient's cause of death.
tabling member constituency	Thirsk and Malton
tabling member printed	Kevin Hollinrake
uin	58772
answer	answer is ministerial correction date of answer 16/01/2017 answer text <p>There is currently provision for recording resistant infections on death certificates. For example, guidance on recording deaths from MRSA was issued in 2005 by the then Chief Medical Officer. However, it is often the case that by the time someone dies they may have a number of diseases and complications of illness or treatment. It is, therefore, a matter of clinical judgment to decide whether a condition present at or just before death was a primary or secondary cause of a patient’s death.</p><p> </p><p>The World Health Organization is currently working on a revision (ICD 11) of its diagnostic coding system ICD 10. This is due in 2018 and will have a more comprehensive coverage of types of antimicrobial resistance.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 16/01/2017 16:27:56 answering member 4080 label Biography information for David Mowat
tabling member	4474 label Biography information for Kevin Hollinrake

669007

registered interest
date	06/01/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether all blood assay results showing infection or resistance to antibiotics go onto a national register.
tabling member constituency	Thirsk and Malton
tabling member printed	Kevin Hollinrake
uin	58773
answer	answer is ministerial correction date of answer 16/01/2017 answer text <p>Hospital microbiology laboratories routinely record the results of testing bacteria isolated from blood for susceptibility or resistance to antibiotics. Since 1989, Public Health England (and its predecessors, the Public Health Laboratory Service and the Health Protection Agency) have requested that laboratories submit their stored data on resistance in bacteria isolated from blood to a national database called Second Generation Surveillance System (SGSS). Currently, 98% of hospital laboratories submit their antimicrobial resistance data.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 16/01/2017 16:55:14 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4474 label Biography information for Kevin Hollinrake

532958

registered interest
date	05/07/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, with reference to recommendation 9 of the final report of The Review on Antimicrobial Resistance, published in May 2016, whether and within what timescale the Government plans to consider possible changes to its purchase and distribution systems for antibiotics.
tabling member constituency	Thirsk and Malton
tabling member printed	Kevin Hollinrake
uin	41876
answer	answer is ministerial correction date of answer 13/07/2016 answer text <p>The Government will work with the international community to develop and agree a system which encourages the pharmaceutical industry to develop new antibiotics in line with the recommendations made in the final report of the Review on Antimicrobial Resistance. The Department will meanwhile continue its ongoing dialogue with the Association of the British Pharmaceutical Industry on antibiotic pricing and reimbursement in the hope of reaching agreement by the end of the year on a set of potential options for a reimbursement model suitable for piloting in England.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 13/07/2016 09:24:01 answering member 3918 label Biography information for Jane Ellison
tabling member	4474 label Biography information for Kevin Hollinrake

521266

registered interest
date	24/05/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antibiotics: Drug Resistance
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what estimate his Department has made of the potential number of deaths due to drug-resistant bacteria in the UK in each of the next three years.
tabling member constituency	Bolton West
tabling member printed	Chris Green
uin	38143
answer	answer is ministerial correction date of answer 02/06/2016 answer text <p>Specific information on the number of deaths attributable to antimicrobial resistance is not currently available.</p><p>However, a Europe wide study of multi-drug resistance<sup>1</sup> estimated the number of deaths in the European Union, Norway and Iceland, due to multi-drug resistance in five specific bacteria. On the basis of population size, other things being equal, the conclusions reached in the study would imply that around 3,000 deaths per year in the United Kingdom may be due to multi-drug resistance in those specified infections. This is likely to be an underestimate as it omits consideration of large numbers of other bacteria.</p><p><em>Note:</em></p><p><sup>1</sup> European Centre for Disease Prevention and Control/European Medicines Agency Joint Technical Report: <em>The bacterial challenge: time to react</em> 2009</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 02/06/2016 15:32:24 answering member 3918 label Biography information for Jane Ellison
tabling member	4398 label Biography information for Chris Green