Written questions by Smith.

If he will make an assessment of the potential merits of allowing community pharmacists to substitute prescription medication for generic alternatives in cases of medicine shortages.

If the generic name is written on the prescription, pharmacists can dispense any supplier’s version of that product. However, where the prescription is written for a brand or a supplier, then the pharmacist is required to supply that specific product. Generic substitution was consulted on in 2010 but the proposals were not progressed following concerns about the potential impact on patient safety. Currently, Serious Shortages Protocols (SSPs) are a tool that has been used in recent years to manage and mitigate medicine and medical device shortages. An SSP enables community pharmacists to supply a specified alternative medicine or device, with the patient’s consent, and without needing to seek authorisation from the prescriber. SSPs are developed with the input of clinical experts and are a safe, effective way to ensure medicines continue to be available for everyone who needs them.

What assessment he has made of the impact of the Soft Drinks Industry Levy on children's (a) oral health and (b) associated dental care.

No specific assessment has been made. Sugar consumption is the main risk factor for tooth decay. Reducing consumption of foods and drinks that contain sugar, alongside adequate exposure to fluoride, including daily toothbrushing with fluoride toothpaste, has a positive effect on children’s oral health and associated dental care.

Whether he has made an assessment of the adequacy of the nutritional content of commercial infant and baby foods.

An evidence review on commercial baby food and drink, published in June 2019, showed that young children are eating too much sugar and salt, and energy intakes are exceeding requirements. Some baby foods, particularly finger foods, had added sugar or salt or contained ingredients that are high in sugar or salt. More information on this review is available at the following link:https://www.gov.uk/government/publications/commercial-infant-and-baby-food-and-drink-evidence-reviewMore recent evidence considered by the independent Scientific Advisory Committee on Nutrition (SACN), for their report on Feeding Young Children aged 1 to 5 years, published in July 2023, reported that among children aged 12 to 18 months old who consumed commercial baby food and drinks, these products provided around 20% of free sugars intakes. Free sugar intakes are above recommendations for children at all ages where recommendations have been set.SACN recommended in this report that foods, including snacks that are high in salt, free sugars, saturated fat, or are energy dense, should be limited in the diets of children aged one to five years and that commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet nutrition requirements.We face a childhood obesity crisis and the Government is committed to raising the healthiest next generation. Under our health mission and shift to prevention we are considering what action is needed to respond to the SACN commercial baby food recommendations to establish healthy habits as early as possible.

How many and what proportion of community pharmacies have dispensed medications at a loss in each of the last three years.

We do not hold this information. Community pharmacy reimbursement arrangements do not aim to ensure that every pharmacy is paid as much or more than it paid for every product, but aims overall to reimburse as much as they were bought for, plus the allowed medicine margin. The medicine margin is the difference between the product price reimbursed by the National Health Service and the price at which pharmacies buy them. As part of the Community Pharmacy Contractual Framework (CPCF) in 2023/24, pharmacies were allowed to retain £850 million from the medicine margin, on top of what they are paid for the medicines they purchase as part of providing NHS services. The Department assesses the medicines margin retained through a quarterly margin survey, which has found that more than the amount agreed as part of the CPCF has been delivered in total across the previous four financial years.

What steps he is taking to help increase referrals from GP surgeries to community pharmacies under the Pharmacy First service.

In August 2024, approximately 71% of general practices (GPs) in England made at least one referral into the Pharmacy First Service. To help increase uptake, NHS England is working closely with the integrated care boards (ICBs), GP stakeholders, and the community pharmacy sector to improve referral pathways. Funding has been provided to ICBs to recruit Primary Care Network engagement leads who will be well placed to support GP teams to refer into the service.Digital systems are being improved to integrate the referral process, and most pharmacies can now receive Pharmacy First referrals from GPs straight into their NHS England assured pharmacy IT systems. NHS England is continuing to promote the Pharmacy First service to increase public awareness and knowledge around accessing community pharmacy services. This will include a targeted public communications campaign with associated media materials.