Select Committee · Health and Social Care Committee

Prevention in health and social care

Status: Closed Opened: 18 Jan 2023 Closed: 30 May 2024 14 recommendations 11 conclusions 2 reports

The Health and Social Care Committee has announced ten themes to be examined in its major new inquiry into preventing ill-health. The subjects, ranging from early years and childhood to alcohol and gambling, were chosen after MPs received more than 600 submissions from researchers and organisations involved in preventative healthcare. The inquiry will examine social …

Reports

2 reports
Title HC No. Published Items Response
First Report - Prevention in health and social care: health… HC 484 19 Jan 2024 15 Responded
Tenth Report - Prevention in health and social care: vaccin… HC 1764 27 Jul 2023 10 Responded

Recommendations & Conclusions

25 items
2 Conclusion Tenth Report - Prevention in health and… Accepted

Address practical challenges of time and location preventing vaccination access.

Vaccination is the one of the greatest success stories when it comes to preventing infection. Its impact is transformative. This makes it all the more concerning that England did not reach the 95% target for any routine childhood immunisations in 2021/22. The Government and NHS England should constantly strive to …

Government response. NHS England, in collaboration with partners, is developing and will publish a vaccination and immunisation delivery strategy later in 2023, aimed at improving uptake and coverage, reducing inequalities, and delivering locally tailored services with targeted outreach.
Department of Health and Social Care
3 Conclusion Tenth Report - Prevention in health and… Deferred

Covid-19 vaccine rollout success demonstrates benefits of mission-based approach for immunisation.

The incredible success of the Covid-19 vaccine rollout showed what can be achieved with a mission-based attitude from Government, which involved making it as easy as possible for everybody to receive the vaccine. Fundamental to that success was the wide range of people that were mobilised to deliver the vaccination, …

Government response. The government deflected the recommendation, focusing instead on its efforts to improve commercial clinical trials, clinical research delivery, and partnerships for vaccine innovation, rather than routine immunisation delivery.
Department of Health and Social Care
4 Recommendation Tenth Report - Prevention in health and… Deferred

Consult on amending regulations to give students and retired staff roles in immunisation.

To ensure that nobody misses out on vital vaccine protection because of practical challenges such as convenient times or locations, a more flexible delivery model, that makes the most of the wide range of healthcare professionals, is needed. We recommend that the Government carries out a consultation on whether to …

Government response. The government deflected the recommendation, responding by referencing Lord O’Shaughnessy's review of commercial clinical trials and outlining commitments to improve their speed, instead of addressing a consultation on routine immunisation delivery.
Department of Health and Social Care
5 Conclusion Tenth Report - Prevention in health and… Accepted

Empower local ICS leaders to take ownership of improving vaccination uptake.

We agree that there is a need for national oversight of vaccination programmes and the value of this was clear during the Covid-19 pandemic. However, with routine immunisation programmes, the role of the Government and, in particular, NHS England must be limited to the more strategic, national level. Local ICS …

Government response. The government described existing national oversight roles (DHSC, UKHSA, JCVI) and processes for new immunisation products. It stated it is working with JCVI and UKHSA to support resources for outbreak response and improvement of existing programmes, and mentioned funding for …
Department of Health and Social Care
6 Recommendation Tenth Report - Prevention in health and… Accepted

Provide Government commitment and support to NHS England's vaccination and immunisation strategy.

We welcome NHS England’s intention to set out an integrated vaccination and immunisation strategy. This strategy will be vital if England is to meet the 95% target for all childhood vaccinations and to address the variations in uptake across routine immunisation programmes. The strategy must receive the commitment and support …

Government response. The government confirms that NHS England, in collaboration with partners, is developing an integrated vaccination and immunisation delivery strategy to improve uptake and coverage, which will be published later in 2023.
Department of Health and Social Care
7 Recommendation Tenth Report - Prevention in health and… Accepted

Require NHS England's strategy to address access, professional roles, local empowerment, and communication.

The NHS England integrated vaccination and immunisation strategy must: a) have a strong focus on the action that is needed to tackle the practical challenges that limit access to vaccination; b) set out how to make best use of the wide range of healthcare professionals able to administer vaccinations; c) …

Government response. The government states NHS England is developing an integrated vaccination and immunisation delivery strategy, due for publication later in 2023, which will address the committee's points by focusing on local empowerment, diverse healthcare professionals, and targeted outreach.
Department of Health and Social Care
8 Conclusion Tenth Report - Prevention in health and… Accepted

Decline in UK clinical trial activity threatens global leadership position.

We are deeply concerned to hear about the decline in clinical trial activity and the risk to the UK’s position as a global leader in this area. The challenges highlighted by witnesses, particularly around the administrative aspects of running a trial, are clearly fixable and it is vital that they …

Government response. The government notes the concerns about clinical trial decline but highlights an increase in participants since 2018 and the impact of the pandemic. It details existing efforts like the Research Reset programme and the 'Future of UK Clinical Research Delivery' …
Department of Health and Social Care
9 Recommendation Tenth Report - Prevention in health and… Accepted

Swiftly implement O’Shaughnessy review recommendations for clinical trials and patient engagement.

We welcome Lord O’Shaughnessy’s review of commercial clinical trials, which chimed with a lot of the evidence that we heard in this part of our inquiry. The Government’s positive response to the recommendations is encouraging. We especially endorse the following recommendations and will be keeping a watching brief on the …

Government response. The government accepts the recommendations in principle, noting it has made five headline commitments backed by £121 million to improve commercial clinical trials and will provide an implementation update in the autumn outlining progress and responding in full to the …
Department of Health and Social Care
10 Recommendation Tenth Report - Prevention in health and… Accepted in Part

Prepare regulatory and delivery systems for future personalised preventative healthcare innovations.

Exciting innovations are on the horizon and have the potential to transform preventative healthcare. While the timeframe for such innovations, like a personalised cancer vaccine, is unknown, future planning must be done on the assumption that personalised therapeutics will become available. NHS England, and the MHRA and JCVI, need to …

Government response. The government outlines existing effective regulatory and delivery processes for new medicines and states it monitors partner organizations. It highlights £10 million funding allocated to MHRA to accelerate bringing innovative medicines to UK patients, aligning with the goal of faster …
Department of Health and Social Care
11 Recommendation Tenth Report - Prevention in health and… Accepted in Part

Require DHSC and NHS England to submit plan for regulatory readiness and resourcing.

The Department of Health and Social Care and NHS England must lay before Parliament a plan for how they intend to ensure all relevant regulatory and delivery systems are ready to assess and deliver these new innovations to patients. As part of that plan, the JCVI and the MHRA must …

Government response. The government describes existing regulatory processes and monitoring for new medicines, detailing how it supports JCVI's modelling capabilities and allocates £10 million over two years to MHRA for accelerating innovative medicine delivery, but does not commit to laying a formal …
Department of Health and Social Care
1 Conclusion First Report - Prevention in health and… Accepted

Place of residence significantly impacts health, driving preventable health inequalities in disadvantaged areas.

The places where people live—homes, communities and neighbourhoods—affect their health and wellbeing substantially. Place, health inequalities and the likelihood of developing preventable health conditions are inextricably linked. People from less well-off groups, and those who live in less well-off neighbourhoods, have a much higher likelihood of developing life-limiting health conditions …

Government response. The government is extending the Decent Homes Standard (DHS) to the private rented sector through the Renters (Reform) Bill and aims to halve non-decent rented homes by 2030. They have engaged with stakeholders, commissioned analysis, and intend to publish a …
Department of Health and Social Care
2 Conclusion First Report - Prevention in health and… Accepted

Lack of progress developing "healthy places" despite strong evidence, impacting NHS sustainability.

The evidence base on the importance of place in protecting good health is stronger than it has ever been. But as we discuss in the next chapter, we have known about the relationship between health and place for decades, if not longer. It is frustrating that more progress has not …

Government response. The government has introduced 'Awaab’s Law' via the Social Housing (Regulation) Act 2023 to mandate social landlords to address hazards like damp and mould within a fixed timeframe. The Renters (Reform) Bill will also introduce a Decent Homes Standard for …
Department of Health and Social Care
3 Conclusion First Report - Prevention in health and… Accepted

Poor quality private rented housing burdens NHS, lacking promised minimum quality standard.

Homes in the private rented sector contribute disproportionately to both the total number of poor quality homes and the costs that poor housing causes to the NHS. The existence of a statutory minimum standard for housing in the social rented sector is not enough on its own to protect tenants …

Government response. The government highlights existing measures such as the Nationally Described Space Standard, requirements for Permitted Development Rights, and design codes as mechanisms to maintain design quality. They conclude that further consultation on design or space standards is not necessary at …
Department of Health and Social Care
4 Recommendation First Report - Prevention in health and… Deferred

Require Government to update and implement Decent Homes Standard for all rented sectors promptly.

We recommend the Government proceeds without delay in the consultation necessary to update the Decent Homes Standard for the social rented sector and in implementing a Decent Homes Standard for the private rented sector. It should set out a timetable for doing so in response to this report.

Government response. The government deflected the recommendation by discussing the role of the National Planning Policy Framework in creating healthy communities and stating they are not looking to extend the list of statutory planning consultees, rather than providing a timetable for updating …
Department of Health and Social Care
5 Recommendation First Report - Prevention in health and… Deferred

Expedite Awaab's Law implementation and extend safeguards against health hazards to private tenants.

It is welcome that the Government’s has proposed measures to protect social sector tenants from the worst impacts of unhealthy homes, via the implementation of “Awaab’s law”. We recommend that the Government act quickly on the outcome of its consultation on this topic for social sector tenants. It should also …

Government response. The government deflected the recommendation by discussing the growth and delivery of social prescribing initiatives and related targets, rather than providing an update on 'Awaab’s Law' consultation outcomes or considering extending housing hazard safeguards to the private rented sector.
Department of Health and Social Care
6 Recommendation First Report - Prevention in health and… Deferred

Voluntary quality standards for housing development fail to adequately protect residents' health.

An absence of hazards is not enough on its own to ensure that housing protects residents’ health. Space, design and location matter, and these should not be the preserve of those who are able to afford more expensive housing. Several standards exist to support the development of housing that is …

Government response. The government deflected the recommendation by discussing the roles of local directors of public health and Integrated Care Boards, stating there are no plans to alter ICB membership requirements, rather than addressing housing quality standards, space, design, or developer requirements …
Department of Health and Social Care
7 Recommendation First Report - Prevention in health and… Accepted

Consult on making health-related design and space standards mandatory for all new dwellings.

We recommend the Government consult on both the content of existing design and space standards as they relate to health, and on the implications of making such standards mandatory for new dwellings—both for developments requiring standard planning consent, and for both householder and change of use PDR developments.

Government response. The government acknowledges the importance of healthy places and is committed to the Levelling Up mission, highlighting existing cross-government work and initiatives, but does not commit to the recommended consultation on making design and space standards mandatory for new dwellings.
Department of Health and Social Care
8 Conclusion First Report - Prevention in health and… Accepted

National Planning Policy Framework fails to sufficiently prioritise health promotion in local planning.

Local authorities and councils necessarily consider a wide range of criteria in assessing planning applications. This, alongside pressures on their resources and skills, makes it difficult for them to prioritise ensuring that planning promotes health. The lack of changes to requirements relating to health in the revised National Planning Policy …

Government response. The government agrees that places where people live, work and age is critical to our health and describes actions being taken to ensure health, wellbeing and action to tackle disparities are embedded across new active travel policies and programmes.
Department of Health and Social Care
9 Recommendation First Report - Prevention in health and… Accepted

Lack of clarity and integration post-PHE hinders health promotion in planning applications.

The former Public Health England’s Healthy Places team had a clear remit to support healthy development. Following PHE’s dissolution and the division of its responsibilities, there is a lack of clarity over which part of DHSC is now responsible for this role, and a lack of formal integration between DHSC …

Government response. The government states that the former Public Health England's Healthy Places team transferred to the Office for Health Improvement and Disparities (OHID) within DHSC, where officials continue their work to improve public health through the built and natural environment.
Department of Health and Social Care
10 Recommendation First Report - Prevention in health and… Rejected

Make OHID a statutory consultee for all new large housing developments.

We recommend that OHID be made a statutory consultee for new large housing developments, building on role already accorded to Active Travel England in supporting inclusive, effective and health-protecting development.

Government response. The government rejects the recommendation to make OHID a statutory consultee for new housing developments, citing concerns about justifying new consultees, slowing down the application process, and value for money, and states it is not currently extending the list of …
Department of Health and Social Care
11 Conclusion First Report - Prevention in health and… Rejected

GPs lack confidence in social prescribing, leading to underutilisation for underserved groups.

Frontline health and social care staff do not only deal with immediate medical needs. People also present to the health service with issues that relate to unmet social needs, which can in turn, over time, develop into medical needs. Increased use of social prescribing can both relieve pressure on clinical …

Government response. The government declines the recommendation, stating that national ambitions for the delivery of social prescribing have been set out in the NHS Long Term Plan and that social prescribing has grown significantly across England since 2019, exceeding NHS Long Term …
Department of Health and Social Care
12 Recommendation First Report - Prevention in health and… Rejected

Establish national social prescribing strategy to improve practitioner confidence and youth engagement.

We recommend DHSC work with NHS England and existing networks and providers to develop a national strategy for social prescribing. This should aim to improve understanding amongst frontline clinical practitioners of the benefits of social prescribing and to improve their confidence in offering social and community-based solutions to unmet social …

Government response. The government rejects the recommendation for a new national social prescribing strategy, stating that national ambitions are already set in the NHS Long Term Plan, significant progress has been made, and existing guidance provides strategic direction for its integration into …
Department of Health and Social Care
13 Conclusion First Report - Prevention in health and… Accepted

Short-term health pressures undermine long-term prevention strategies for creating healthy places.

Integrated Care Systems aim to enable a stronger focus on prevention, and on the specific approaches needed in different communities to help ensure that they are “healthy places”. But this is a long-term agenda. The mixed longer-term outcomes of initiatives such as Healthy New Towns demonstrate that building communities that …

Government response. The government agrees that much of what keeps us healthy lies outside the NHS and social care system and that creating healthy places and ensuring good health for all is essential to Levelling Up. DHSC is collaborating with DfT and …
Department of Health and Social Care
14 Recommendation First Report - Prevention in health and… Rejected

Reconsider mandating public health representatives on Integrated Care Boards to prioritise prevention

We have previously recommended that all ICBs should include a public health representative, such as a public health director, and that DHSC considers making this a mandatory requirement. In response, the Department said it agreed that prevention needs to be a priority, but emphasised the importance of protecting ICS autonomy. …

Government response. The government rejects the recommendation to reconsider mandating public health representatives on ICBs, stating it has no plans to alter the Health and Care Act 2022 and emphasizing ICB autonomy and existing duties for local authorities to provide public health …
Department of Health and Social Care
15 Conclusion First Report - Prevention in health and… Accepted

Healthy places are vital for population health, requiring long-term whole-Government commitment and coordination

Healthy places are vital to protecting people’s physical and mental health from both direct and indirect consequences and in turn, to building a sustainable health service. “Healthy places” include both the built environment—homes, communities and neighbourhoods—and wider environmental factors, such as air quality and emission levels. The benefits of building …

Government response. The government accepts the committee's conclusion, stating it is already committed to creating healthy places through the Levelling Up mission, the Green Infrastructure Framework, and collaborations with other departments on active travel and public health initiatives.
Department of Health and Social Care

Oral evidence sessions

9 sessions
Date Witnesses
20 May 2024 Adrian Chiles, TV presenter and author of The Good Drinker, Ailsa Rutter OBE · Fresh and Balance, Alice Wiseman · Association of Directors of Public Health, Sir Ian Gilmore · Alcohol Health Alliance View ↗
6 Feb 2024 Andy Tighe · The British Beer and Pub Association, Asma Khalil · The Royal College of Obstetricians and Gynaecologists (RCOG), Hazel Cheeseman · Action Against Smoking, Karen Tyrell · Drinkaware, Matt Lambert · The Portman Group, Professor Peter Hajek · Wolfson Institute of Population Health Barts and The London School of Medicine and Dentistry Queen Mary University of London, Sandra Ionno Butcher · The National Organisation for FASD View ↗
5 Feb 2024 Professor Javed Khan OBE · Equi View ↗
18 Oct 2023 Chris Naylor · The King's Fund, Dr Mark Green · University of Liverpool, Julia Thrift · Town and Country Planning Association, Simon Reeve · Office for Health Improvement and Disparities View ↗
5 Sep 2023 David Finch · The Health Foundation, Dr Henry Burridge · Imperial College London, Dr Jill Stewart · University of Greenwich, Helen Garrett · Building Research Establishment View ↗
11 Jul 2023 Chris Boardman · Active Travel England, Mark Lawrie · StreetGames, Tom Hollingsworth · Sport England View ↗
23 May 2023 Dr Nikki Kanani · NHS England, Maria Caulfield · Department of Health and Social Care View ↗
18 Apr 2023 Ben Lucas · The Association of the British Pharmaceutical Industry (ABPI), Doctor Mary Ramsay · UK Health Security Agency, Professor Dame Jenny Harries · UK Health Security Agency, Professor Sir Andrew Pollard · Joint Committee on Vaccination and Immunisation, Rebecca Catterick · Sanofi Vaccines UK & Ireland, Stuart Carroll · Moderna View ↗
21 Feb 2023 Dr Jeanelle De Gruchy, Deputy Chief Medical Officer for England · Department for Health and Social Care, Jonathan Marron · Department for Health and Social Care, Professor Sir Chris Whitty, Chief Medical Officer for England View ↗

Correspondence

4 letters
DateDirectionTitle
18 Oct 2023 Correspondence from the Secretary of State, Steve Barclay MP, on a Smokfree Gen…
18 Oct 2023 Correspondence from the Parliamentary Under Secretary of State, Neil O' Brien M…
18 Oct 2023 Correspondence from Diabetes UK on consideration of obesity in the prevention i…
5 Sep 2023 Correspondence from the Chief Executive of Sport England, Tim Hollingsworth fol…