The FCDO is leading coordination of the cross-government international response to the monkeypox virus (MPX). Through our multilateral and bilateral health programmes, working closely with the World Health Organization, we have been supporting Ministries of Health in partner countries to strengthen their preparedness, prevention and response, including through strengthened surveillance, contact-tracing and case management.

To help strengthen testing, the UK is funding partners such as the Wellcome Trust to support a network of UK and international institutions on research into monkeypox antiviral testing and treatments in selected countries, including in West and Central Africa. To help strengthen treatment, we are supporting the UK Public Health Rapid Support Team, in partnership with Oxford University, to work with Nigeria CDC to understand the clinical features and outcomes of MPX in Nigeria and develop effective care and management strategies. They are also supporting laboratory system strengthening,and we continue to share UK surveillance data and experience on monkeypox to inform the global response.

The Department has published guidance on testing in adult social care settings, including respite services. Individuals accessing respite care through a care home should test before admission, to reduce the risk of bringing infection into the home and given the high-risk nature of these settings and vulnerabilities of residents. Based on public health advice, testing is not required if accessing care through other adult social care services, such as day care centres and domiciliary care.

For individuals who may be unable to test due to a disability, a risk assessment should be undertaken and a decision may determine whether it is in their best interests to be tested. In all instances, guidance on infection prevention and control measures should be followed in all adult social care services where individuals may access respite care to prevent transmission of COVID-19.

The National Institute for Health and Care Excellence (NICE) guidance has provided guidance for clinicians to improve the diagnosis, treatment and management of urinary tract infections (UTIs), which includes advice on self-care and pain management. In October 2018, NICE published ‘Urinary tract infection (recurrent): antimicrobial prescribing’ in order to improve treatment, which is available at the following link:

https://www.nice.org.uk/guidance/ng112

NHS England and NHS Improvement and the Accelerated Access Collaborative are working with NICE and the National Institute for Health and Care Research to identify the technologies which could potentially be accelerated into adoption in the National Health Service in England.

In addition, NHS England and NHS Improvement’s RightCare Programme have developed a dashboard incorporating metrics relevant to monitoring the quality of care of patients with UTIs. This dashboard supports senior leaders in integrated care systems in assurance and oversight of UTI care and health professionals with quality improvement. NHS England and NHS Improvement’s UTI workstream focuses on developing a co-ordinated pathway-based approach to improving the prevention, diagnosis, treatment and management of UTIs.

Health Education England’s e-learning for healthcare has also added a new session to the Antimicrobial Resistance and Infections eLearning programme, which is available at the following link:

https://www.e-lfh.org.uk/new-session-on-antimicrobial-prescribing-for-urinary-tract-infections-now-available/

The National Health Service has been asked to restore asthma and chronic obstructive pulmonary disease (COPD) registers and spirometry checks for adults and children to pre-pandemic levels in 2022/23. The Quality Outcomes Framework for 2022/23 includes respiratory indicators for the diagnosis of asthma and COPD, which was re-instated in April 2022.

Through the GP Contract, general practitioners are incentivised to maintain a register of patients with asthma aged six years old or over. This includes a record of spirometry and one other objective test, such as FeNO or reversibility or variability, between three and six months after diagnosis and within six months of registration for those newly registered with a diagnosis of asthma but no record of objective tests performed at the date of registration.

NHS England and NHS Improvement have established 13 respiratory clinical networks to support pharmacists in Primary Care Networks to undertake a range of medicine reviews. This includes advising patients on the correct use of inhalers and contributing to multidisciplinary working.

There are no current plans to use point-of-care testing in care homes to support the assessment of multiple respiratory illnesses. Asymptomatic, symptomatic and outbreak testing for COVID-19 continues to be provided for staff and residents in care homes and on admission to prevent transmission. We will continue to review testing arrangements in adult social care in line with the latest clinical advice.

No specific assessment has been made. Visitors to care homes are asked to take precautions to keep themselves and their loved ones safe, in line with guidance for the rest of the population. While the guidance no longer requires most visitors to test before entering care settings in England, for those who wish to do so a range of tests are available from providers such as high street pharmacies at various price points. For those residents who require support with personal care, these visitors should test in line with the Government’s guidance for care staff using free lateral flow device tests provided by the care setting.

We keep the testing policies under review. Current data shows that rates of infection, illness and death among care home residents continue to decline. However, symptomatic testing continues to be available for those in social care settings. While the guidance no longer requires most visitors to test before entering care settings in England, for those who wish to do so a range of tests are available from providers such as high street pharmacies at various price points. For those residents who require support with personal care, these visitors should test in line with the Government’s guidance for care staff using free lateral flow device tests provided by the care setting.

Patients with a blood test which suggests a possible diagnosis of coeliac disease are usually referred for gastroscopy by their general practitioner. The British Society of Gastroenterology and the National Institute for Health and Care Excellence have recommended standards for how patients with gastrointestinal symptoms are initially investigated in primary care, which includes testing for coeliac disease.

There is no nationally recommended screening programme for dementia in the United Kingdom. The UK National Screening Committee (UK NSC) reviewed the available evidence and found no screening test which could identify people with dementia before the onset of symptoms. The UK NSC also found there was no evidence that current treatments for dementia are effective. The UK NSC is due to the review the evidence for screening for dementia in 2022/23.

The UK Health Security Agency continues to work with commercial partners to procure sufficient test kits and ensure a continuous supply to care homes. Care homes can order rapid lateral flow device (LFD) tests for regular asymptomatic testing, symptomatic testing of staff and residents and LFD and polymerase chain reaction (PCR) testing in the case of outbreaks. A courier booking service remains available to all care homes for completed PCR test kits in during outbreaks.

We have published guidance on infection prevention and control in adult social care settings which encourages visitors to take necessary precautions. This includes wearing face masks and staying away from the care home if they are symptomatic or test positive for COVID-19. Visitors providing personal care are advised to test themselves up to twice weekly before entering the care home, with free asymptomatic testing available.