Manchester North

Noted (AI summary) The Department acknowledges the coroner's concerns but refers to the BSG's opinion that a national stent registry is not required and NICE's view that existing guidance remains appropriate. It also mentions the Pennine Acute Hospitals NHS Trust established an ERCP biliary stent oversight meeting, and that NHS Improvement has brought the concerns in the report to the GIRFT clinical lead for gastroenterology. The BSG is in discussion with JAG about adding a stent planning/recall database to key performance indicators and incorporating it into the ISREE programme, with a formal discussion planned for the BSG Endoscopy Committee in October. It also mentions that reduction in variation in practice is an objective of the Get It Right First Time (GiRFT) initiative.

Noted (AI summary) The Department of Health acknowledges the concerns regarding access to NHS records and services for individuals with co-occurring mental health and substance misuse conditions. They reference existing guidance and reviews on information sharing and integrated care pathways, highlighting the responsibility of local commissioners and providers.

Noted (AI summary) Bury Council, as Highway Authority, states that all Highway Inspectors are scheduled to undergo specific training and competency checks to ensure they understand how to undertake their role under the new Code of Practice. There will be regular evidence based reviews of the new Code of Practice and monitoring. The Department for Transport acknowledges the concerns but notes that local highway authorities have a duty to maintain the highways network in their area and that Central Government has no powers to override local decisions in these matters. They endorse a code of practice, issued by the UK Roads Liaison Group, providing guidance to highway authorities on how to maintain and manage their highways.

Noted (AI summary) Takeda believes the existing patient information leaflet adequately addresses the issue of damaged patches, and they have requested a review to determine if changes are needed; the MHRA also reviewed product information for fentanyl patches in April 2015.

Noted (AI summary) The RCOG acknowledges the concerns but refers to their guideline which aligns with the National Screening Committee's recommendation against routine screening for GBS. NICE acknowledges the concerns but refers to the UK National Screening Committee's current position that screening for GBS is not supported by the evidence, and that NICE's guideline does not recommend routine screening for GBS. The Department of Health acknowledges concerns about GBS screening but states that the UK National Screening Committee does not currently support universal screening due to insufficient evidence. They note that the NSC will be reviewing the evidence in 2015/16.

Noted (AI summary) The Department of Health acknowledges the concerns but states that the issues raised are most appropriately addressed at a local level, while also noting national investment in psychological therapies and access targets.

Noted (AI summary) The council provides contextual information about commissioned substance misuse services and describes the services available, but does not outline specific changes in response to the concerns.

Noted (AI summary) The Trading Standards Institute states that it is a professional body without powers to get involved and that the matter is for local authority trading standards departments. It highlights a workforce survey demonstrating severe cuts to trading standards services. Oldham Council will ensure the trader concerned is visited and spoken to by officers on the safety/health implications and moral obligations related to addictions, and about sales to minors of age-restricted products. Public Health England has been working with the Department of Health to restrict access to volatile substances, has refined information collected on VSA as part of the National Treatment Monitoring System, and is looking to improve national collection of drug-related mortality data. The Department of Health acknowledges the concerns and refers to the response from Public Health England, expressing full support for their views and advice.