Karin Smyth

I will continue, if I may. On non-financial redress, the Department is committed to meeting the needs of current patients with clinical requirements via three principal avenues. The first is improving clinical services and treatment to patients, and the second is commissioning further research and development programmes on sodium valproate and pelvic mesh to address the remaining knowledge gaps. I commend my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) for sharing again his personal experiences and for laying bare the deep complexity and the need for more research and development, to which my hon. Friend the Under-Secretary of State is committed. The hon. Member for Leicester South (Shockat Adam), with his clinical knowledge, also added useful experience to the debate. That is absolutely what my hon. Friend will be taking forward. The third avenue is initiating longer-term preventive measures that will help ensure that the system can pick up on adverse trends in patient care and act more quickly in the future. I will take each avenue in turn. On improvement of clinical services, although the number of women up to the age of 54 who have been prescribed sodium valproate has nearly halved since 2018, there is a significant group of patients already affected who have complex and varied needs, and the health system has to ensure that that cohort receives high-quality and tailored care. NHS England has committed to a pilot project on foetal exposure to medicine in the north of England, involving multiple clinical specialties and a wide range of clinical experts, that will undertake a comprehensive review of the service. Eighty patients have been seen as part of the pilot, representing 560 appointments and 650 clinical hours. We have received feedback from patients on the value for their quality of life of being seen by clinical experts and wider multidisciplinary teams. We are considering options to commission this service further nationwide. NHS England has also completed an internal review of mesh centres across England. Mesh centres undoubtedly offer a valuable and impactful service, with nearly 3,000 patients now seen since their introduction. However, as a relatively new service, distinct areas for improvement remain, and we will look closely at the results of the internal review and promptly deliver the necessary improvements. With regard to further research and development, the National Institute for Health and Care Research has been commissioned for a £1.56 million study to develop patient-reported outcome measures for prolapse, incontinence and mesh-complication surgery. In the longer term, those measures will be integrated into the pelvic floor registry, which monitors and improves the safety of mesh patients. Further research is also taking place in this area, and we will ensure that future work takes into account the recommendations of the pilot project and of the mesh centre audit. On longer-term prevention work, recent discussions with NHS England and the Medicines and Healthcare products Regulatory Agency indicate that longer-term improvements in digitisation will help position the UK as a world leader in reducing valproate-exposed births and applying the insights to other teratogenic medicines. The Department will explore increasing centralisation and visibility of the annual risk acknowledgment form across care settings, as highlighted in the Hughes report, and may consider expanding the medicines and pregnancy registry to better link data with research outcomes.