Written questions by McVey.

What steps he is taking to increase the efficiency of supplying medication at hospital discharge to ensure faster discharge.

The Department and NHS England recognise the need for patients who are ready to go home to be discharged as quick as possible, both for their benefit and to improve the efficiency of hospitals. Information on the average wait time for hospital patients to be provided with medication at the point of discharge is not held centrally by NHS England, and it is the responsibility of individual trusts to monitor discharge and medication efficiency. To support hospitals on improving processes, guidance has been published, which is available at the following link:https://www.england.nhs.uk/urgent-emergency-care/improving-hospital-discharge/

What the average wait time is for hospital patients to be provided with medications at discharge.

The Department and NHS England recognise the need for patients who are ready to go home to be discharged as quick as possible, both for their benefit and to improve the efficiency of hospitals. Information on the average wait time for hospital patients to be provided with medication at the point of discharge is not held centrally by NHS England, and it is the responsibility of individual trusts to monitor discharge and medication efficiency. To support hospitals on improving processes, guidance has been published, which is available at the following link:https://www.england.nhs.uk/urgent-emergency-care/improving-hospital-discharge/

What steps he plans to take to make the hospital discharge process more efficient.

The Government will improve hospital discharge processes, to tackle delayed discharges, and to make sure people do not spend longer than necessary in hospital, freeing up hospital beds.We will do so by developing local partnerships, working between the National Health Service and social care, making sure people get the right support from health and social care services to return home as soon as possible. Currently, every acute hospital has access to a care transfer hub, which brings together professionals from the NHS and local authorities to manage discharges for people with more complex needs, and collaboration between integrated care boards and local authorities will continue to be supported by the Better Care Fund framework through 2025/26.

Pursuant to the Answer of 18 November 2024 to Question 12696 on Primodos: Research, when the minutes and outcome of the November Commission on Human Medicines discussion will be published.

The Medicines and Healthcare products Regulatory Agency (MHRA), together with the wider Government, have committed to reviewing any new scientific evidence which comes to light.The new publication by Danielsson et al has been reviewed by the MHRA and advice has been sought from the Government’s independent advisory body, the Commission on Human Medicines (CHM), who have provided their independent expert advice on our assessment of whether the findings of the latest publication justify a further review. The MHRA will consider the recommendations given by the CHM before deciding whether any further action is warranted.The minutes of the November CHM meeting will be made publicly available through the GOV.UK website at the earliest opportunity.

Pursuant to the Answer of 21 November 2024 to Question 13772 on Cardiovascular Diseases: Emergency Calls, if he will provide this data for the period between March 2015 and March 2021; and what assessment he has made of potential impact of the (a) ageing population and (b) number of patients with multiple comorbidities on trends in the number of category one incidents.

Information on ambulance service demand is published by NHS England, including, as of April 2018, the monthly total number of cardiac arrests responded to by ambulance services. The following table shows the total number of cardiac arrests each month from April 2018 to June 2024:MonthTotal cardiac arrestsApril 20186,345May 20186,587June 20186,005July 20186,792August 20186,136September 20185,887October 20186,761November 20186,623December 20187,225January 20197,670February 20196,522March 20196,642April 20196,345May 20196,037June 20195,724July 20196,373August 20196,100September 20196,135October 20196,783November 20197,152December 20198,737January 20208,145February 20207,008March 20208,607April 202010,208May 20207,639June 20206,838July 20206,748August 20207,168September 20206,889October 20207,727November 20207,684December 20209,259January 202110,724February 20217,699March 20217,473Source: the data is published by NHS England, and is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/The increasing aging population and complexity that comes with more patients with multiple comorbidities may be reflected in the trend of rising in category 1 incidents.

What guidance his Department issues to hospitals on visiting times for friends and family.

Contact with family and friends is fundamental to the health and wellbeing of residents in care homes and people in hospital. We have worked with NHS England and the Care Quality Commission (CQC) to develop the policy options to strengthen the expectation for care providers and hospitals in England to allow visiting. This included introducing secondary legislation to amend CQC regulations. Further information on CQC regulations, specifically Regulation 9A: Visiting and accompanying in care homes, hospitals and hospices, is available at the following link:https://www.cqc.org.uk/guidance-providers/regulations/regulation-9a-visiting-and-accompanying

Pursuant to the Answer of 18 November 2024 to Question 13773 on the Vaccine Damage Payment Scheme, how much his Department spent on legal fees defending against appeals.

Between 1 November 2021 and 1 December 2024, the total spent by the NHS Business Services Authority on behalf of the Department on legal fees to defend against appeals within the Vaccine Damage Payment Scheme was £50,608.

Pursuant to the Answer of 18 November 2024 to Question 13773 on the Vaccine Damage Payment Scheme, how many claims have waited over a year for a decision; and what support his Department provides to claimants.

As of 1 December 2024, 1,107 claims have been waiting over a year for a resolution. All claims are managed on a case-by-case basis and there are several factors that may impact processing times. This includes time spent awaiting medical records from healthcare providers, or appropriate legal identification documentation, or awaiting consent from claimants for access to their medical records

Pursuant to the Answer of 18 November 2024 to Question 13773 on the Vaccine Damage Payment Scheme, how many people were (a) assessed and (b) successful in each of those financial years; and what the (i) mean, (ii) median and (iii) range of awards was.

In the financial year (FY) 2022/23, 1,298 applications were assessed, and 72 applications were successful. In the FY 2023/24, 3,806 applications were assessed, and 99 applications were successful. In the FY 2024/25, 4,664 applications have been assessed, and 27 applications have been successful. We are unable to disclose the specific number of applications that were successful in the 2021/22 FY, as that number is fewer than or equal to five, and could lead to individuals being identified. For the FYs 2022/23 to 2024/25, the mean average number of successful applications is 66, the median average is 72, and the range is 72. The mean average, median average, and range do not include numbers for the 2021/22 FY, as including this information could lead to individuals being identified. The payment amount for successful claims is fixed at £120,000.

How much has been spent on (a) reviewing applications to the Vaccine Damage Payment Scheme and (b) reviewing cases where a patient has challenged a decision in each of the last 5 years.

The Vaccine Damage Payment Scheme transferred from the Department for Work and Pensions to the NHS Business Services Authority (NHSBSA) in November 2021. We cannot provide any costings for the scheme during the period in which it was operated by the Department for Work and Pensions. Since the NHSBSA took over operation of the scheme, the following costs have been incurred for the medical assessments of the claims:in the financial year 2021/22, no costs were incurred, as the claims assessment did not begin until May 2022;in the financial year 2022/23, the total cost of the medical assessments was £5,018,638.73;in the financial year 2023/24, the total cost of the medical assessments was £10,500,029.88; andin the current financial year, up to 1 November 2024, the total cost of the medical assessments is £9,616,394.02.These are annual totals since we do not separate the budgets for initial assessments and mandatory reversals, the review of claims already assessed.

With reference to section 4.2 of NHS key statistics: England, HC 07281, published on 25 October 2024, (a) what assessment he has made of the causes of the increase in life threatening ambulance calls since Spring 2021 and (b) what percentage of the calls each month were cardiac related.

The rise in category 1 incidents reflects an increase in the proportion of patients’ ambulance services that have been determined to require an immediate face-to-face response. This may reflect a long-term trend of rising pressures on the health services from an increasing aging population, and complexity that comes with more patients with multiple comorbidities. Information on increases in ambulance service demand is published by NHS England. The total number of cardiac arrests that ambulance services responded to is published by month, however this information does not include other cardiac incidents, for example heart attack or angina, and the information is not disaggregated by incident category. The following table shows the total number of cardiac arrests each month from March 2021 to June 2024:MonthTotal cardiac arrestsMarch 20217,473April 20216,982May 20217,085June 20216,944July 20217,592August 20217,135September 20217,442October 20218,307November 20218,483December 20219,227January 20218,936February 20217,466March 20218,216April 20228,043May 20227,781June 20227,407July 20227,959August 20227,408September 20227,349October 20228,118November 20228,440December 202211,988January 20229,832February 20227,682March 20228,599April 20238,049May 20237,298June 20236,921July 20236,611August 20236,753September 20236,668October 20237,941November 20238,259December 20239,554January 20249,471February 20248,045March 20248,309May 20247,544June 20247,344Source: The data is published by NHS England, and is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

Pursuant to the Answer of 1 November 2024 to Question 9445 on Department of Health and Social Care: Public Appointments, what interests Alan Milburn has declared since being appointed as a Lead Non-Executive Board Member.

The usual process of declarations of interest and agreement of appropriate mitigations for non-executive board member (NEBM) appointments was carried out, overseen by the Permanent Secretary. He is content that the process has been carried out, that appropriate declarations have been made, and that appropriate mitigations for any conflicts arising have been put in place. NEBMs are contracted to work for two to three days a month and therefore it is not unusual for them to hold multiple other positions and interests. Their declarations of interest are published each year in the Register of Interests in the Department’s Annual Report and Accounts, and will also be published on GOV.UK website as per the new guidance on NEBM declarations of interest, that will be published soon. These declarations will be published at the earliest opportunity.

Pursuant to the Answer of 31 October 2024 to Question 11248 on Coronavirus: Vaccination, what discussions the MHRA has had with industry safety regulators on the potential implications of the Pfizer study abstract entitled Post Conditional Approval Active Surveillance Study Among Individuals in Europe Receiving the Pfizer-BioNTech Coronavirus Disease 2019 (COVID-19) Vaccine dated 12 March 2024 on an assessment of individuals’ medical fitness to operate safety critical systems.

The study abstract has been reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA), as part of its continuous post approval safety monitoring procedures for the Pfizer-BioNTech COVID-19 Vaccine (Comirnaty). The abstract is available at the following link:https://catalogues.ema.europa.eu/system/files/2024-06/C4591021%20Interim%205%20Study%20Report%20Abstract%20_0.pdfThe MHRA does not consider that any regulatory action is warranted at this time, therefore has not discussed this study abstract with industry safety regulators. The MHRA will review the final study report, when it is made available by Pfizer, as part of safety monitoring procedures.The MHRA continues to closely monitor the safety of all COVID-19 vaccines and will take any regulatory action necessary should any new safety concerns be identified.

Pursuant to the Answer of 13 September 2024 to Question 4203 on Primodos: Research, when he expects the Medicines and Healthcare products Regulatory Agency to complete that review; and what steps he is taking to (a) manage potential conflicts of interest and (b) ensure transparency during the review process.

The Medicines and Healthcare products Regulatory Agency (MHRA), together with the wider Government, are committed to reviewing any new scientific evidence since the conclusions of the 2017 independent Expert Working Group, convened by the Commission on Human Medicines (CHM).As per the commitment to reviewing any new scientific evidence, the MHRA has reviewed the publication by Danielsson et al. For full transparency, the MHRA will present their review at the November 2024 CHM meeting. The meeting will have a number of invited experts, including the papers authors, who are invited to give a presentation on their paper and address any questions from the CHM. Mrs Marie Lyon has also been invited to participate as an expert patient, as a representative of the Association For Children Damaged by Hormone Pregnancy Tests. The CHM will give their opinion, and the MHRA will then act upon the CHM’s advice if required. Both the MHRA and the CHM have codes of conduct in order to manage potential conflicts of interest.The MHRA have a Dealing with Staff Conflicts of Interest Policy, where staff must declare all relevant interests on appointment, when they arise and annually, so that they can be discussed, mitigated, or disposed of, or both, as required. Staff cannot hold direct financial interests in the pharmaceutical industry or healthcare, specifically medical device, industries.The CHM has a Code of Practice on conflicts of interest which applies to chairs, members, co-opted members, and invited observers and experts. The annual declaration of interests made by all chairs and members are published on GOV.UK website. Declarations from members for the day, invited experts, and patient experts are published in the same way as permanent members of the CHM, on the GOV.UK website, and in the committee minutes for transparency reasons. Further information is available on the GOV.UK website, at the following link:https://www.gov.uk/government/publications/human-medicines-regulations-2012-advisory-bodies-annual-report-2023The minutes and outcome of the November CHM discussion will be communicated and made publicly available through the GOV.UK website, at the earliest opportunity.

Pursuant to the Answer of 14 October 2024 to Question 6194 on Coronavirus: Vaccination, whether the Medicines and Healthcare products Regulatory Agency has made an assessment of the potential implications for future medical decisions of the Pfizer study abstract entitled, Post Conditional Approval Active Surveillance Study Among Individuals in Europe Receiving the Pfizer-BioNTech Coronavirus Disease 2019 (COVID-19) Vaccine, dated 12 March 2024; and when he plans to publish the full study.

The study abstract has been reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA), as part of its continuous post approval safety monitoring procedures for the Pfizer-BioNTech COVID-19 Vaccine (Comirnaty). The abstract is available at the following link:https://catalogues.ema.europa.eu/system/files/2024-06/C4591021%20Interim%205%20Study%20Report%20Abstract%20_0.pdfThe MHRA does not consider that any regulatory action is warranted at this time and will review the final study report, when it’s made available by Pfizer, as part of safety monitoring procedures.The MHRA does not publish study reports for company studies, and further publications of results are the responsibility of Pfizer-BioNTech. The MHRA continues to closely monitor the safety of all COVID-19 vaccines and will take any regulatory action necessary should any new safety concerns be identified.

What his policy is on allowing people with financial interests in the private healthcare sector to be (a) employed in and (b) non executive directors at his Department.

All Department employees are subject to the Department’s policy on the Declaration and Management of Outside Interests. The policy is in alignment with the model Cabinet Office guidance in this area for Civil Servants, published on the GOV.UK website, which sets out how staff can identify when a perceived, potential, or actual conflict of interest arises, and what action must be taken in those circumstances. This includes a discussion between the employee and manager to determine whether there is a conflict of interest in the first instance, or perceived conflict of interest, such that the employee should be excluded from the activity, or that the employee may continue with the activity but must implement actions to mitigate any risk. Further information is available at the following link:https://www.gov.uk/government/publications/declaration-and-management-of-outside-interests-in-the-civil-service/declaration-and-management-of-outside-interests-in-the-civil-servicePrior to appointment and throughout their term of office, non-executive board members are required to declare all relevant interests, and for any areas where a potential conflict of interest could be seen to arise, mitigations are required to be put in place and approved by the Department. Declarations of interest are published each year in the Register of Interests in the Department’s Annual Report and Accounts.

On what dates Alan Milburn has attended Departmental meetings.

Central Government Corporate Transparency Commitments require Government Departments to publish details of Ministers and Senior Officials meetings with external individuals or organisations on a quarterly basis. We will be publishing the meetings that Alan Milburn attended, in accordance with the transparency guidelines.

Whether he has made an assessment of the potential implications for his policies of the study entitled Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-analysis of self-controlled case series studies, published on 3 August 2023.

All vaccines used in the United Kingdom are only authorised once they have met the robust standards of effectiveness, safety, and quality set by the UK’s independent regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).The monitoring of vaccine safety does not stop once a vaccine has been approved. Whilst no specific assessment has been made of this study, the MHRA continuously monitors safety data from a range of sources including Yellow Card reports, interim and final study reports for clinical trials, post-authorisation safety studies, and data from scientific literature.

What information his Department holds on the cost to the public purse for hospital food in each of the last five years.

The following table shows the cost of inpatient food services, as well as other patient food services, in England over the last five years:YearInpatient food service costsOther patient food service costs2022/23£750,600,000£126,000,0002021/22£660,200,000£89,700,0002020/21£617,800,000£35,300,0002019/20£630,500,000N/A2018/19£633,800,000N/ASource: the NHS Digital Estates Return Information Collection, published December 2023, available at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/england-2022-23