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1677260

registered interest
date	12/12/2023
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	Skin Diseases: Health Services
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, whether she is taking steps to monitor the effectiveness of NHS England’s guidance on Referral optimisation for people with skin conditions.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6510
answer	answer is ministerial correction date of answer 18/12/2023 answer text <p>As advised in the Getting it Right First Time (GIRFT) national report on dermatology, published in August 2021, 56% of trusts reported that they had to wait for commissioner approval before prescribing drugs approved by the National Institute for Health and Care Excellence (NICE), and 12% of trusts said they had been told by clinical commissioning groups that they could not prescribe certain NICE-approved biologics for psoriasis at the time of NHS England’s data questionnaire in 2018/19.</p><p>During GIRFT’s subsequent deep dives into the 110 trusts with significant dermatology activity, it became apparent that there was ongoing variation in the way trusts adopt NICE guidelines. While some allow clinicians to prescribe drugs as soon as they are NICE approved, others have processes in place which can produce delays of more than a year in some cases.</p><p>GIRFT is aiming to publish trust- and system-level data for dermatology on the Model Health System in early 2024, enabling dermatology clinicians and managers to monitor their variation in provision of care, services, and treatments for skin disorders. Specific metrics for inflammatory skin disorders, including biologic prescribing for psoriasis and eczema, will be included. The aim is to use this data to inform the dermatology element of GIRFT’s Further Faster programme to help target unwarranted variation in care provision for inflammatory skin disease. The Further Faster programme supports providers to deliver rapid clinical transformation to reduce 52-week waits.</p><p>There are no plans to introduce specific targets to adopt the NHS England guidance on Referral Optimisation for people with skin conditions. The Outpatient Recovery &amp; Transformation Programme in NHS England will continue to promote the guidance through NHS England regional teams, integrated care boards and directly to provider organisations.</p><p>In addition, specific engagement events, such as the webinar delivered on 21 November 2023, will continue to reinforce the need for appropriate and timely referral optimisation across skin care pathways. The programme is working closely with GIRFT and the Further Faster teams to ensure that referral optimisation is seen as a valuable tool to effectively manage the skin care pathway. Through this effort to engage the system combined with the publication of consistent guidance and evidence across the whole skin care pathway, it is hoped that variation can be reduced, across pathway implementation.</p><p>It should be recognised that there may be appropriate clinical reasons for some regional or local variation, so it is important to ensure that all patients who need specialist skincare have equal access. The programme will look to review data over the course of the year to understand the impact and consider relevant next steps.</p> answering member constituency Pendle answering member printed Andrew Stephenson grouped question UIN 6511 6512 6513 question first answered 18/12/2023 17:11:22 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677261

registered interest
date	12/12/2023
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	Skin Diseases: Health Services
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, if her Department will set a target for the number of trusts to adopt the NHS England guidance on Referral optimisation for people with skin conditions.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6511
answer	answer is ministerial correction date of answer 18/12/2023 answer text <p>As advised in the Getting it Right First Time (GIRFT) national report on dermatology, published in August 2021, 56% of trusts reported that they had to wait for commissioner approval before prescribing drugs approved by the National Institute for Health and Care Excellence (NICE), and 12% of trusts said they had been told by clinical commissioning groups that they could not prescribe certain NICE-approved biologics for psoriasis at the time of NHS England’s data questionnaire in 2018/19.</p><p>During GIRFT’s subsequent deep dives into the 110 trusts with significant dermatology activity, it became apparent that there was ongoing variation in the way trusts adopt NICE guidelines. While some allow clinicians to prescribe drugs as soon as they are NICE approved, others have processes in place which can produce delays of more than a year in some cases.</p><p>GIRFT is aiming to publish trust- and system-level data for dermatology on the Model Health System in early 2024, enabling dermatology clinicians and managers to monitor their variation in provision of care, services, and treatments for skin disorders. Specific metrics for inflammatory skin disorders, including biologic prescribing for psoriasis and eczema, will be included. The aim is to use this data to inform the dermatology element of GIRFT’s Further Faster programme to help target unwarranted variation in care provision for inflammatory skin disease. The Further Faster programme supports providers to deliver rapid clinical transformation to reduce 52-week waits.</p><p>There are no plans to introduce specific targets to adopt the NHS England guidance on Referral Optimisation for people with skin conditions. The Outpatient Recovery &amp; Transformation Programme in NHS England will continue to promote the guidance through NHS England regional teams, integrated care boards and directly to provider organisations.</p><p>In addition, specific engagement events, such as the webinar delivered on 21 November 2023, will continue to reinforce the need for appropriate and timely referral optimisation across skin care pathways. The programme is working closely with GIRFT and the Further Faster teams to ensure that referral optimisation is seen as a valuable tool to effectively manage the skin care pathway. Through this effort to engage the system combined with the publication of consistent guidance and evidence across the whole skin care pathway, it is hoped that variation can be reduced, across pathway implementation.</p><p>It should be recognised that there may be appropriate clinical reasons for some regional or local variation, so it is important to ensure that all patients who need specialist skincare have equal access. The programme will look to review data over the course of the year to understand the impact and consider relevant next steps.</p> answering member constituency Pendle answering member printed Andrew Stephenson grouped question UIN 6510 6512 6513 question first answered 18/12/2023 17:11:22 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677108

registered interest
date	11/12/2023
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	Skin Diseases: Health Services
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help reduce the time taken for patients with inflammatory skin conditions to access (a) specialist care and support and (b) treatment.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6277
answer	answer is ministerial correction date of answer 19/12/2023 answer text <p>Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.</p><p>We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.</p><p>No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.</p><p>The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.</p><p>It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.</p> answering member constituency Pendle answering member printed Andrew Stephenson grouped question UIN 6278 6279 question first answered 19/12/2023 17:06:31 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677109

registered interest
date	11/12/2023
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	Skin Diseases: Health Services
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential impact of the time taken for patients with inflammatory skin conditions to be referred for specialist care on the cost of treatment for such conditions.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6278
answer	answer is ministerial correction date of answer 19/12/2023 answer text <p>Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.</p><p>We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.</p><p>No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.</p><p>The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.</p><p>It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.</p> answering member constituency Pendle answering member printed Andrew Stephenson grouped question UIN 6277 6279 question first answered 19/12/2023 17:06:31 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677110

registered interest
date	11/12/2023
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	Skin Diseases: Health Services
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential impact of implementing NHS England’s Referral optimisation for people with skin conditions on (i) the cost of treatment and (ii) number of referrals for people with skin conditions in (a) England, (b) Cheshire and Merseyside integrated care system and (c) Mersey Care NHS Foundation Trust.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6279
answer	answer is ministerial correction date of answer 19/12/2023 answer text <p>Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.</p><p>We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.</p><p>No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.</p><p>The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.</p><p>It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.</p> answering member constituency Pendle answering member printed Andrew Stephenson grouped question UIN 6277 6278 question first answered 19/12/2023 17:06:31 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677111

registered interest
date	11/12/2023
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	Skin Diseases: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps NHS England is taking to increase access to NICE-approved treatments for patients with inflammatory skin conditions.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6280
answer	answer is ministerial correction date of answer 19/12/2023 answer text <p>The National Institute for Health and Care Excellence (NICE) evaluates all new licensed medicines and licence extensions for existing medicines including any treatments for inflammatory skin conditions and aims to issue guidance on their use close to the time of licensing wherever possible. The National Health Service in England is legally required to fund medicines recommended by NICE, normally within 90 days of the publication of its final guidance. NICE has recommended a number of treatments for inflammatory skin conditions such as eczema, hidradenitis suppurativa and psoriasis that are now routinely available for NHS patients.</p> answering member constituency Pendle answering member printed Andrew Stephenson question first answered 19/12/2023 16:59:49 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1677112

registered interest
date	11/12/2023
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	Dermatitis: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, if she will have discussions with NICE on developing (a) national guidelines and (b) quality standards for the management of severe eczema in adults.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	6281
answer	answer is ministerial correction date of answer 19/12/2023 answer text <p>The Department regularly holds discussions with colleagues in the National Institute for Health and Care Excellence (NICE) about its guidelines programme. NICE has reviewed its guideline portfolio to identify topics that it thinks will add the most value to the health and care system, considering key factors such as clinical benefit, cost effectiveness, the potential to increase productivity and support workforce issues and the potential to address health inequalities.</p><p>Atopic dermatitis (eczema) in young people and adults is one of the topics on which NICE will stop work for the time being to allow them to focus on key priorities. Topics that have been stopped will be reconsidered by NICE’s prioritisation board which is being established in Spring 2024 by its chief medical officer.</p> answering member constituency Pendle answering member printed Andrew Stephenson question first answered 19/12/2023 17:01:22 answering member 4044 label Biography information for Andrew Stephenson
tabling member	4397 label Biography information for Peter Dowd

1673949

registered interest
date	29/11/2023
answering body	Cabinet Office
answering dept id	53
answering dept short name	Cabinet Office
answering dept sort name	Cabinet Office
hansard heading	Office for Veterans' Affairs
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Minister for the Cabinet Office, what the long term priorities for the Office for Veterans' Affairs are.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	4453
answer	answer is ministerial correction date of answer 08/12/2023 answer text <p>This Government is committed to making the UK the best country in the world to be a veteran.</p><p><strong> </strong></p><p>The Office for Veterans’ Affairs (OVA) sits at the heart of government in the Cabinet Office and is responsible for coordinating and driving forward work across the UK Government to support our veteran community.</p><p><strong> </strong></p><p>In the long term, the OVA is committed to continue transforming and improving services for veterans, making sure veterans and their families have the support and services they need, whilst using data and research to better understand, and deliver for, this community.</p><p><strong> </strong></p><p>The ten-year Strategy for our veterans (2018) sets out the UK Government's vision, and can be accessed online at: <a href="https://www.gov.uk/government/publications/strategy-for-our-veterans" target="_blank">https://www.gov.uk/government/publications/strategy-for-our-veterans</a></p><p> </p> answering member constituency Plymouth, Moor View answering member printed Johnny Mercer question first answered 08/12/2023 14:18:30 answering member 4485 label Biography information for Johnny Mercer
tabling member	4397 label Biography information for Peter Dowd

1673951

registered interest
date	29/11/2023
answering body	Ministry of Defence
answering dept id	11
answering dept short name	Defence
answering dept sort name	Defence
hansard heading	Armed Forces Covenant
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Defence, if he will make it his policy to extend the duty of due regard under the Armed Forces Covenant to (a) UK Government and (b) devolved administrations before the next General Election.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	4454
answer	answer is ministerial correction date of answer 08/12/2023 answer text <p>Since 2011, when the Armed Forces Covenant came into existence in its current form, central and devolved Governments have taken forward many initiatives to the benefit of serving personnel, veterans, and their families. However, we recognise that a clearer public acknowledgement of their role in supporting the Covenant could be beneficial. I have therefore instructed my officials to further explore how central Government and the Devolved Administrations could strengthen their commitment, and to see what more can be done in terms of the Legal Duty. This work will be taken forward over the next year and will also encompass the consideration of widening the scope of the Duty to other policy areas.</p> answering member constituency South West Wiltshire answering member printed Dr Andrew Murrison grouped question UIN 4455 question first answered 08/12/2023 11:46:28 answering member 1466 label Biography information for Dr Andrew Murrison
tabling member	4397 label Biography information for Peter Dowd

1673952

registered interest
date	29/11/2023
answering body	Ministry of Defence
answering dept id	11
answering dept short name	Defence
answering dept sort name	Defence
hansard heading	Armed Forces Covenant
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Defence, if he will make it his policy to extend the duty of due regard under the Armed Forces Covenant to cover (a) social care, (b) employment, (c) pensions, (d) compensation and (e) immigration before the next General Election.
tabling member constituency	Bootle
tabling member printed	Peter Dowd
uin	4455
answer	answer is ministerial correction date of answer 08/12/2023 answer text <p>Since 2011, when the Armed Forces Covenant came into existence in its current form, central and devolved Governments have taken forward many initiatives to the benefit of serving personnel, veterans, and their families. However, we recognise that a clearer public acknowledgement of their role in supporting the Covenant could be beneficial. I have therefore instructed my officials to further explore how central Government and the Devolved Administrations could strengthen their commitment, and to see what more can be done in terms of the Legal Duty. This work will be taken forward over the next year and will also encompass the consideration of widening the scope of the Duty to other policy areas.</p> answering member constituency South West Wiltshire answering member printed Dr Andrew Murrison grouped question UIN 4454 question first answered 08/12/2023 11:46:28 answering member 1466 label Biography information for Dr Andrew Murrison
tabling member	4397 label Biography information for Peter Dowd