Information is not available in the format requested. However, the following table shows the number of admissions with a primary diagnosis related to vibrio, campylobacter, and pseudomonas, from 2019/20 to 2023/24:

Source: Hospital Admitted Patient Care Activity, available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity

The above data does not record the underlying causation, including any illness associated with United Kingdom bathing waters.

In the March 2024 response to the Science, Innovation and Technology Committee’s report on bacteriophages, the government acknowledged the challenges in developing phage therapy in the United Kingdom, including the requirement to meet Good Manufacturing Practice (GMP) standards. GMP is the minimum standard that a medicines manufacturer must meet in their production processes. To meet GMP, products must:

- be of consistent high quality;

- be appropriate to their intended use; and

- meet the requirements of the marketing authorisation or product specification.

In the response, the Government committed to considering the case for a UK-based GMP facility to support phage innovators and reduce reliance on imports. The UK Health Security Agency is also exploring phage production options in accordance with GMP, working with partners nationally and internationally.

The new Life Sciences Sector Plan, part of the upcoming Industrial Strategy, to be published in late spring 2025, will outline the Government’s growth strategy for the sector. Within this, domestic manufacturing, including for bacteriophage production, is a priority and projects can be supported via applications to the Life Sciences Innovative Manufacturing Fund.

In parallel, the Medicines and Healthcare products Regulatory Agency will be publishing draft guidance on phage product licensing, developed with researchers and industry, to clarify regulatory and manufacturing requirements.

The Medicines and Healthcare products Regulatory Agency (MHRA) is preparing the draft guidance, Regulatory considerations for therapeutic use of bacteriophages in the United Kingdom, which will be published in the second quarter of 2025.

Regulation of medicines in the UK is undertaken by the MHRA in accordance with the Human Medicines Regulations 2012 (SI 2012/1916) (as amended), thereby ensuring compliance with statutory obligations relating to the manufacture, distribution, sale, labelling, advertising, and promotion of medicines.

The purpose of the guidance is to address regulatory considerations applicable to the use, in the UK, of bacteriophages for therapeutic purposes in humans, whether as licensed or unlicensed medicinal products.

In its March 2024 response to the Science, Innovation and Technology Committee’s report on bacteriophages, the Government acknowledged the challenges in manufacturing phage materials in the United Kingdom, including the requirement to meet Good Manufacturing Practice (GMP) standards. The principles of GMP are considered necessary to ensure the medicines are of the appropriate quality, safety, and efficacy. The Government committed to considering the case for the development of a UK-based GMP facility to support phage innovators.

In parallel, the Government is engaging with professional regulators and the specialist pharmacy service to clarify how existing regulations address liability for the use of non-GMP produced phages. Unlicensed phages can currently be used in the UK for compassionate cases with appropriate controls. The Medicines and Healthcare products Regulatory Agency will be publishing regulatory considerations for therapeutic use of bacteriophages in the UK in the second quarter of 2025, which will offer guidance on these matters.

The United Kingdom’s regulatory framework supports patient access to phage therapy and is in line with many other national regulatory authorities. We continue to keep the regulatory framework for phage therapies under review, aligning where necessary with regulatory frameworks internationally, in order to support continued patient access via phage sharing between countries.

The Medicines and Healthcare products Regulatory Agency is planning to publish draft guidance on phage product licensing, developed with researchers and industry, to clarify regulatory and manufacturing requirements.

In March 2024, the Government’s response to the Science, Innovation and Technology Committee’s report on bacteriophages highlighted the potential role of phage therapy as one of a range of tools to tackle antimicrobial resistance.

To support clinical use, the Medical and Healthcare Products Regulatory Agency plans to publish non-mandatory guidance on the quality, safety, and efficacy data required to license phage products for both proactive and reactive National Health Service use to treat common infections, and the National Institute for Health and Care Excellence will assess new phage-based treatments alongside other medicines.

In the March 2024 response to the Science, Innovation and Technology Committee’s report on bacteriophages, the Government acknowledged the challenges of requiring United Kingdom-produced phages to meet Good Manufacturing Practice (GMP) standards, which is essential for clinical use.

To address this, the Government committed to exploring the case for a dedicated GMP facility to support phage innovators, working with key stakeholders, including funders and research organisations, to strengthen the UK’s phage manufacturing capabilities and thereby improve patient access to these therapies.

I thank the hon. Member for raising this, and he knows our support for Ukraine is ironclad. We are funding NHS doctors and nurses to work closely with their Ukrainian counterparts to share best practice, including how to prevent the spread of infections and AMR. Through the World Health Organisation, we are also strengthening Ukraine’s health system to provide better care, and we will continue to do so.

Q2

.

Dr Danny Chambers (Winchester) (LD):

The Russian invasion of Ukraine has led to the emergence of bacteria that are severely resistant to multiple antibiotics, and this is now seriously delaying the return of injured soldiers to the frontline. We know that, just like Mr Putin, these superbugs do not respect national borders. It is only a matter of time until we start to detect them in our NHS hospitals, and we know that antimicrobial resistance is a huge challenge facing us at the moment. Will the Prime Minister consider supporting the Ukrainian war effort by providing rapid diagnostic tests that can be used in the field and in civilian hospitals, which would not only enable us to diagnose and treat these resistant infections more quickly, returning soldiers back to the frontline more quickly, but provide valuable surveillance data to help global public health and protect our NHS from these dangerous bacteria?

The Government is committed to supporting innovation and the development of new, safe, and effective medicines. Officials in the Department are working closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to explore the use of bacteriophages, also known as phages.

Although there are currently no licensed bacteriophage medicines in the United Kingdom, patients may still access them as part of a clinical trial, as unlicensed medicines, or as medicines prepared under the supervision of a pharmacist.

The MHRA is actively developing non-binding, regulator-agnostic information to help innovators understand what type of quality, safety, and efficacy data is needed by regulators to evaluate phage products for market authorisation.

The control of oral diseases is essential to prevent and manage bacteraemia. Raising awareness of oral health in general can help to reduce the risk of sepsis and infective endocarditis.

The latest version of Delivering better oral health: an evidence-based toolkit for prevention published by the Office for Health Improvement and Disparities supports dental teams to improve the oral and general health of their patients. The guidance includes advice on how to prevent and treat oral diseases like dental caries and periodontitis, and is available at the following link:

https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention

The UK Health Security Agency coordinates the ‘e-Bug’ health education programme, which aims to promote positive behaviour change amongst children and young people to support infection prevention and control efforts. Oral hygiene features in e-Bug lesson plans aimed at children from ‘early years’ to key stage 2 or equivalent. More information on the programme is available at the following link:

https://www.e-bug.eu/

The Government continues to work with the UK Sepsis Trust which plays a pivotal role in influencing public awareness of sepsis through wide ranging campaigns, online resources, and events, including its dental sepsis campaign.

The Department invests over £1 billion a year through the National Institute for Health and Care Research (NIHR). Since 2017, the NIHR has funded 14 research projects on sepsis diagnosis and management, with a combined total funding value of over £27 million.

The Department continues to invest heavily in research and development of new tools to aid in the detection and management of sepsis and bacterial infections with the guidance of the National Institute for Health and Care Excellence (NICE). Laser therapies for sepsis and bacterial infections are still in their infancy, but the Department will continue to work closely with NICE to ensure that when they mature, their efficacy is proven and, subject to NICE recommending their use, they may become available to the National Health Service.

The Department invests over £1 billion per year through the National Institute for Health and Care Research (NIHR). Since 2017, the NIHR has funded 14 research projects on sepsis diagnosis and management, with a combined total funding value of over £27 million.

The Department continues to invest heavily in research and development of new tools to aid in the detection and management of sepsis and bacterial infections with the guidance of the National Institute for Health and Care Excellence (NICE).

Laser therapies for sepsis and bacterial infections are still in their infancy, but the Department will continue to work closely with NICE to ensure that when they mature, their efficacy is proven and, subject to NICE recommending their use, they may become available to the National Health Service.

The National Health Service has published advice on treatment of dental abscesses caused by infection which can be found at the following link:

https://www.nhs.uk/conditions/dental-abscess/.

The National Dental Survey Programme also provides information on oral health improvement with further resources, including on dental antimicrobial stewardship which can be found at the following link:

https://www.gov.uk/government/collections/oral-health.

I thank the hon. Lady for raising what seems like an awful case. My heart goes out to the family involved. If she would like to write to me about it, I will make sure that she gets a full answer and a meeting with a Minister if that is required.

Q9

.

Wendy Chamberlain (North East Fife) (LD):

A little girl in my constituency, only nine years old, developed a bacterial infection just before Christmas. Thereafter, very distressing symptoms occurred, such as obsessive compulsive disorder and intrusive thoughts. She has not washed, dressed or properly eaten since Christmas. We believe this to be PANS and PANDA—paediatric acute-onset neuropsychiatric syndrome and paediatric acute-onset neuropsychiatric disorders associated with streptococcus. Although health is devolved and I am seeking support for her, part of the reason for the lottery and the antipsychotic medication that is often given for this condition—despite the fact that broad-based antibiotics have been proven to work—is that no part of the UK has implemented the World Health Organisation’s ICD 11. Will the Government commit to looking at this, so that other children across the UK do not need to suffer in such a way?

The Healthcare Safety Investigations Branch (HSIB) is studying the safety of oxygen systems in relation to COVID-19 but NHS England and NHS Improvement are not aware of any current safety incidents related to Pseudomonas or Legionella type bacteria. Each healthcare provider is expected to have a water safety policy and plan, covering both Legionella and Pseudomonas aeruginosa, which is monitored by their water safety group. This group should include infection prevention and control subject matter experts as part of its membership.

These water safety policies and plans will specify the requirements for the design, installation and commissioning of equipment and water testing which includes a risk stratification for clinical areas based upon national guidance. The guidance is available at the following link:

https://www.gov.uk/government/publications/hot-and-cold-water-supply-storage-and-distribution-systems-for-healthcare-premises

This draws together and updates the previous guidance and includes recommendations for the safe management of water systems and how to manage and minimise the risks to health from various aspects including those presented by Pseudomonas and Legionella bacteria.

There has been a global effort to tackle antimicrobial resistance and, in particular, to reduce the use of antibiotics in agriculture, especially the critically important antibiotics. The UK is a leader in that and has adopted farm husbandry that has made it possible to reduce the use of antibiotics. We have also worked with international partners, including the United States, to assist them to achieve the same.