One of the Healthcare Missions set out in my Rt. Hon. Friend the Prime Minister’s Life Sciences Vision is the prevention and treatment of cardiovascular disease and its major risk factors, including obesity. Government has announced that £95m will be provided to support the deployment and use of innovative treatments to deliver these Healthcare Missions. Work will now commence with a wide range of partners to develop and deliver this mission.

Alongside this, the National Institute for Health Research (NIHR) funds, enables and delivers world-leading health and social care research and focusses their work on early translational research, clinical research and applied health and social care research.

The NIHR welcomes funding applications for research into any aspect of human health, including diabetes and related heart conditions; it is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

The information requested is not available.

The Department’s National Institute for Health Research (NIHR) was established in 2006 to increase the volume of applied health research for the benefit of patients and the public, drive faster translation of basic science discoveries into tangible benefits for patients and the economy, and develop and support the people who conduct and contribute to applied health research. The NIHR spent £30.8 million on research relating to metabolic and endocrine disease in 2014/15 (the latest available figure). Most of this investment (£24.4 million in 2014/15) is in infrastructure for research in metabolic and endocrine disease where spend on specific disease areas such as type 1 diabetes cannot be separated from total infrastructure expenditure. This infrastructure including NIHR biomedical research centres and the NIHR Clinical Research Network.

The NIHR funds a wide range of research relating to type 1 diabetes and in 2014/15 the NIHR CRN supported 49 studies in this disease area.

The NIHR Efficacy and Mechanism Evaluation programme is currently seeking to commission research on immunotherapy for type 1 diabetes.

Medical devices are required to be CE marked under the European Union medical devices Directives and may not be placed on the market until this process is complete.

The Department has not commissioned nor assessed specific research on this topic.

Appropriate drugs for the treatment of cancer should be prescribed as part of a wider pathway of care coordinated by a multidisciplinary team. This should include specialists in other relevant long term conditions such as diabetes.

Because of the possibility of complex interactions with drugs for different conditions, the multi-disciplinary team should also have access to advice from an experienced cancer pharmacist.

The evidence considered by the National Institute for Health and Care Excellence (NICE) in the development of its guidance is available on the NICE website.

The evidence for NICE’s draft clinical guideline on type 1 diabetes is available at:

www.nice.org.uk/guidance/indevelopment/gid-cgwaver122/documents and the evidence for NICE’s draft clinical guideline type 2 diabetes is available at:

www.nice.org.uk/guidance/indevelopment/gid-cgwave0612/documents

We have had no recent discussions with the National Institute for Health and Care Excellence (NICE) about the updated draft clinical guidelines currently in development on types 1 and 2 Diabetes in adults. The Department is a stakeholder in the development of all NICE guidance and, in common with other stakeholders, is able to comment on NICE’s guidance at several stages of the guidance development process. The Department has received one piece of correspondence concerning NICE’s updated guideline on type 2 Diabetes. NICE is an independent body and its guidance is based on a thorough and transparent assessment of the available evidence and is developed through wide consultation with stakeholders.

There have been no discussions between my Rt. hon. Friend the Secretary of State for Health and the Royal Colleges about the use of Kisspeptin to treat infertility or diabetes.

Information about the prescription charge exemption arrangements, including the requirement to hold valid exemption certificate to claim a medical exemption, is included on NHS Choices. Long-standing arrangements are also in place to make available to general practitioner (GP) practices leaflets to put on display for patients containing details about the exemption rules and requirements. The declaration on the prescription form that patients are required to sign to claim a medical exemption from the charge also makes clear the requirement for a certificate.

Additionally, in October 2014 as part of the centralisation of the prescription exemption checking process within the NHS Business Services Authority (NHSBSA), the NHSBSA sent all English pharmacies and GP practices a supply of posters and booklets entitled ‘Claiming free prescriptions?’ to make available to patients. The poster warns patients of the consequences of claiming free prescriptions incorrectly and directs them to the booklet for more information on eligibility, which states that medical exemption certificates are valid for five years. The poster and booklet are also published on the NHSBSA website:

http://www.nhsbsa.nhs.uk/PrescriptionServices/4666.aspx.

The NHSBSA is currently planning further communications work to build on this initial activity.

The Prescription Exemption Checking Service is delivered by the NHS Business Services Authority (NHSBSA) as commissioned by NHS England. NHSBSA assumed the responsibility for this service from 17 September 2014.

From 17 September 2014 to 20 February 2015 a total of 13,779 patients have paid a penalty charge in full for claiming free prescriptions without a valid exemption certificate with a further 5,504 patients opting to pay the penalty charge in instalments.

From 17 September 2014 to 20 February 2015 a total of 610 patients have paid a penalty charge in full for claiming free prescriptions without a valid maternity exemption certificate with a further 474 patients opting to pay the penalty charge in instalments.

Data is not available to indicate the number of diabetic patients who have been fined.

Commissioners and providers should make insulin pumps available for those people with Type 1 diabetes who meet the criteria in the National Institute for Health and Care Excellence’s technology appraisal guidance on continuous subcutaneous insulin infusion for the treatment of diabetes mellitus (TA151) as well as ensuring that relevant structured patient education is provided to support people newly diagnosed with diabetes and at appropriate points in their life as their condition progresses.

Information on the number of people using insulin pumps is not collected centrally.

The United Kingdom Insulin Pump Audit, published in May 2013, collected data from across the United Kingdom. The audit demonstrated that 6% of adults with Type 1 diabetes and 19% of children with Type 1 diabetes were being treated with insulin pumps. The audit’s findings are available at:

www.diabetes.org.uk/Documents/News/The_United_Kingdom_Insulin_Pump_Audit_May_2013.pdf

Researchers at the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health published findings in 2010 in the British Journal of Psychiatry that diabetes mellitus increases not only the risks of dementia and mild cognitive impairment but also the risk of progression from such impairment to dementia.

The NIHR is currently investing nearly £0.3 million in systematic reviews of interventions which target modifiable risk factors for dementia. This evidence synthesis will encompass vascular risk factors such as diabetes.

In England, it is for commissioners to make funding decisions based on the health needs of their local populations.

In 2013-14, the latest year available, the net ingredient cost of insulin dispensed in primary care was £328.3 million and in secondary care the cost was £8.1 million. Insulin has been defined as all medicines included in British National Formulary section 6.1.1 Insulins.

Prescriptions are a matter for individual clinicians. There are no national restrictions on the prescribing of blood glucose testing strips to patients with diabetes. It is for local commissioners and clinicians to make decisions on how these strips should feature in the provision of diabetes services for their local populations. A variety of brands of blood glucose testing strips are listed in the Drug Tariff for general practitioners to prescribe for their patients as required. We have no plans to issue guidance to general practitioners on this issue.

Prescriptions are a matter for individual clinicians. There are no national restrictions on the prescribing of blood glucose testing strips to patients with diabetes. It is for local commissioners and clinicians to make decisions on how these strips should feature in the provision of diabetes services for their local populations. A variety of brands of blood glucose testing strips are listed in the Drug Tariff for general practitioners to prescribe for their patients as required. We have no plans to issue guidance to general practitioners on this issue.

Prescriptions are a matter for individual clinicians. There are no national restrictions on the prescribing of blood glucose testing strips to patients with diabetes. It is for local commissioners and clinicians to make decisions on how these strips should feature in the provision of diabetes services for their local populations. A variety of brands of blood glucose testing strips are listed in the Drug Tariff for general practitioners to prescribe for their patients as required. We have no plans to issue guidance to general practitioners on this issue.

Prescriptions are a matter for individual clinicians. There are no national restrictions on the prescribing of blood glucose testing strips to patients with diabetes. It is for local commissioners and clinicians to make decisions on how these strips should feature in the provision of diabetes services for their local populations. A variety of brands of blood glucose testing strips are listed in the Drug Tariff for general practitioners to prescribe for their patients as required. We have no plans to issue guidance to general practitioners on this issue.

Oral medications are widely used to control high blood glucose levels in patients with type 2 diabetes, leading to reductions in long-term complications of diabetes such as heart and kidney disease. The risk of hypoglycaemia associated with these drugs is well-known and is evaluated in detail both at the time of marketing authorisation approval and in the post-marketing period.

The Patient Information Leaflet provided with all oral diabetes treatments contains advice on the risk of hypoglycaemia while driving. Patients are instructed to take appropriate precautions or to avoid driving completely if affected by hypoglycaemia.

In addition, the Driver and Vehicle Licensing Agency’s ‘At a glance guide to the current medical standards of fitness to drive’ (May 2014) provides detailed advice to healthcare professionals on the management of patients receiving oral diabetes therapies who wish to drive.

The Medicines and Healthcare products Regulatory Agency keeps the safety of medicines under continual review and is in regular discussion on relevant issues with the DVLA and the Department for Transport, most recently regarding the development of public communications for the new offence of driving with certain drugs taken above specified limits, which is due to come into force in March 2015. The new offence mainly involves illegal drugs and those with sedative effects and does not include treatments for diabetes.

The National Institute for Health and Care Excellence (NICE) is responsible for regularly reviewing its guidance to ensure that it reflects the latest available evidence. Ministers have had no such discussions with NICE on its guidance.

NHS England is now responsible for referring new topics for development through NICE’s clinical guideline work programme.

We understand that NICE plans to publish an updated clinical guideline on the management of type 2 diabetes in adults in 2015. The scope for this clinical guideline update was developed in consultation with stakeholders and states that it will not consider the management of hypoglycaemia, unless this is as a consequence of pharmacological interventions for hyperglycaemia. The final scope for the clinical guideline update is available at:

www.nice.org.uk/guidance/gid-cgwave0612/documents/type-2-diabetes-final-scope2