Speeches by Beales.

“This Wednesday marked Holi, a festival celebrated by millions around the world and here in the UK. Last year, I had the privilege of celebrating Holi with Hindu cultural groups in West Drayton and Uxbridge. We threw colourful paint and played traditional games, and children described what the first Holi festival that t…”

“It is a pleasure to serve under your chairmanship, Dr Murrison. I thank my hon. Friend the Member for Rugby (John Slinger) for securing this important and timely debate. Social cohesion can feel like quite an abstract, nebulous term, but we all know, and have heard today, that the practice of social cohesion and how it…”

“Should the NHS take the same approach to pharmaceutical interventions as well? Obviously the NHS is contracting Lilly and others around injectables. Rather than a simple price-based approach, should there be an outcomes-focused approach? I think Susan talked about the requirement that the private sector develop wraparo…”

“So you are actively finding the most in need.”

“I am not necessarily mandating either one. I am just asking whether you believe a referral-based payment system is the right approach. Whether it is a primary care-based incentive, a provider incentive or an incentive for the ICB, do you think that a more outcomes-focused incentive approach is a better way of using the…”

“I guess that QOF does different things, though. For example, in the diabetes world, you can refer someone to book a diabetes education course, and there is a QOF for that. I guess that QOF was changed to attendance at a course to encourage a good referral and actively ensure that the GP service played a role in making …”

“Does anyone else on the panel want to talk? Susan, you wanted to come in.”

“We touched before on GP-based payments. Following on from that point, Claudia, do you think the payment system needs to have a more graduated focus that heavily incentivises the most in need, rather than a blanket payment approach for referrals? Do we need a smarter payment system that looks at outcomes as well as refe…”

“How do you deal with the capacity issues that you touched on earlier as being the priority, as opposed to incentivising referrals. We know that there are capacity issues to get people into services. If you are proactively going out and finding people, and we are already struggling as a system to deal with the people wh…”

“Is that via primary care, secondary care or local authority public health?”

“Where you do believe that would sit in the system best, in terms of outreach and proactive engagement?”

“That is helpful.”

“But you would potentially get no wraparound support? If I went to Pharmacy4U or something and ordered an injectable, I would not necessarily get any contact from my GP, a health professional or a health hub. But if I went on an app, felt I needed something and referred myself to a programme, or share my interest in it,…”

“You said that is a complex picture that varies from area to area in terms of what services may or may not be available or commissioned by the NHS, local authorities and, potentially, voluntary sector provision. Is there a role for digital in ensuring that clinicians and patients understand better what is available in t…”

“Susan, in some of your earlier discussions you talked about taking a whole-systems approach rather than a programmatic approach to delivery. Has one of the challenges in moving to such a model been that, ultimately, we need evidence-based interventions, and it is easier to test an intervention than a system approach? Y…”

“Do you not see private prescriptions as self-referral by another means? We know most people who are using injectable treatments are self-referring themselves to private provision. That is happening anyway, so would it better if self-referral or self-supported access was happening through an NHS supported platform rathe…”

“Let me turn to the role of digital service delivery, which some of the panellists have already touched on—Emily, I think you touched on it in the evidence you gave about some of the evidence of weight loss. To what extent is that desirable in and of itself or is it a way of dealing with backlogs or resource shortages? …”

“On the hub model, you talked about one of the challenges of testing as being the ICB-based commissioning model of local need. You touched on that a bit in today’s session. That is a complete departure, I suppose, from the rationale of commissioning care locally. Why should this, and not any other aspect of care, be com…”

“That is really clear, thank you. Is there a risk of bypassing GPs, as they are currently the gatekeepers to the system? As I think you mentioned, obviously these individuals often have to have multimorbidity to get on to these programmes; it is not just obesity that they are facing. They are potentially facing diabetes…”

“A specialist weight management hub.”