Respiratory Syncytial Virus: Immunisation Programme
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow
Baroness Ritchie of Downpatrick
To ask His Majesty’s Government what assessment they have made of the budget implications of implementing the recent statement of the Joint Committee on Vaccination and Immunisation recommending a respiratory syncytial virus immunisation programme to protect (1) infants, and (2) older adults.
Lord Evans of Rainow (Con)
My Lords, officials across the Department of Health and Social Care, the UK Health Security Agency and National Health Service England are developing policy options based on the joint committee advice regarding an expanded immunisation programme to protect infants and older adults. As the expanded programme has yet to go to tender, the department is unable to confirm any budget implications at this moment.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I thank the Minister for his Answer. The JCVI stated in its previous minutes that there is a long lead-in time for procuring vaccines and getting a programme set up, so there needs to be sufficient time in place between a policy decision being finalised and a programme being ruled out. In view of that, will it be possible with the current infrastructure, or are new additions required? Can the Minister give us a little more detail about discussions on funding measures, and what funding measures have been identified in the budget to execute implementation of the RSV vaccination programme? Will that vaccine be available for the 2024 winter season for infants and older adults?
Lord Evans of Rainow (Con)
My Lords, I pay tribute to the noble Baroness for her doughty campaigning on this subject. The UK system is responsive and agile in setting up new immunisation programmes, as demonstrated in the response to Covid-19. The Government are progressing rapidly with operational and other relevant planning to develop policy options for infant and adult RSV programmes. It is not appropriate to commit to a definite timeline at present; however, planning is continuing at pace. Remaining challenges include the availability and price of potential immunisation products, along with their licensing. The department is engaging with HM Treasury to seek support for a potential programme, and it is working with UKHSA and NHS England to identify and mitigate against any potential barriers to implementation.
The moment I have any news to answer the noble Baroness’s question about 2024, she will certainly be one of the first to know about it.
Dementia Diagnosis
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow
Lord Evans of Rainow (Con)
My noble friend raises a very important point. It is important that junior doctors and others come to some agreement and do not continue with their strikes. I understand that there are strong feelings on all sides, but we all have to work together—carers and healthcare professionals—to do what we can for people suffering from this dreadful disease.
Baroness Ritchie of Downpatrick (Lab)
My Lords, one of the important points that emerged from the report was on the importance of workforce training. In many instances, the first point of contact for anybody with such symptoms is their GP. Can the Minister outline what steps the Government can take to ensure that GPs are trained to identify dementia symptoms and differentiate between types of dementia?
Lord Evans of Rainow (Con)
The noble Baroness is absolutely right. There are different types of dementia at different stages depending on the individual and their age. Unfortunately, it can start very early on, in their 30s and 40s. In my experience, GPs and their practices are very well trained and knowledgeable in such matters. If the noble Baroness has any specific concerns in her area I can certainly look into them, but GP services do a very good job overall. We also have on our high streets things such as dementia awareness, where retailers and other public services recognise the early signs of dementia to make sure that people get the services they require.
Metastatic and Secondary Breast Cancer
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow
Baroness Ritchie of Downpatrick
To ask His Majesty’s Government what assessment they have made of level of compliance of NHS Trusts in submitting data on metastatic and secondary breast cancer to the National Cancer Registration and Analysis Service as mandated from 1 January 2013.
Lord Evans of Rainow (Con)
My Lords, the cancer outcomes and services dataset is collected by the National Disease Registration Service. It captures data about the patient at the time they are diagnosed for each tumour. Compliance with the data standard is improving, as reflected in the increasing number of instances of disease progression and recurrence submitted to the dataset. The National Disease Registration Service continues to support all trusts to improve the quality and completeness of their data submissions.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I thank the Minister for his Answer, but I will probe a little further. A clinical audit for metastatic secondary breast cancer was commissioned by NHS England in May 2021. What is the progress of this clinical audit? Given the compelling importance of working across the jurisdictions of the UK, what is the incidence of metastatic and secondary breast cancer data held by cancer registries in England, Scotland, Wales, and Northern Ireland, notwithstanding devolution responsibilities?
Lord Evans of Rainow (Con)
I am most grateful to the noble Baroness, and I pay tribute to her long-standing work on this subject. Data is very important, as it allows us to look at best practice in the various areas of the United Kingdom and how we can learn from that. It is all about the quality of data.
The Royal College of Surgeons began scoping for the audit commissioned by NHS England in October 2022. Key stakeholders will be consulted over the scoping period to determine the audit’s quality improvement goals. The scoping period concludes in September 2023 and a state of the nation report will be published in September 2024.
The noble Baroness will welcome that Cancer Focus Northern Ireland announced a £60,000 commitment to fund a two-year research audit into secondary breast cancer in Northern Ireland in February 2023. We look forward to the findings of this audit to see where we can improve our services here in England.
Secondary Metastatic Breast Cancer
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow
Baroness Ritchie of Downpatrick
To ask His Majesty’s Government what assessment they have made of the incidence of secondary metastatic breast cancer in England.
Lord Evans of Rainow (Con)
My Lords, the latest cancer registration data shows that secondary breast cancer accounted for 14% of the 39,871 recorded diagnoses of female breast cancers. NHS England is funding a new clinical audit on breast cancer, including metastatic breast cancer, to provide evidence for cancer service providers of where patterns of care may vary, in order to increase the consistency of access to treatments and help stimulate improvements in outcomes for patients. The first outputs are expected next year.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I thank the Minister for his Answer. Given the anticipated rise in cancer incidence, what steps are the Government taking to increase the NHS’s capacity to deliver innovative radiotherapy treatments for cancer—including molecular radiotherapies, which have additional infrastructure requirements? Also, what access to clinical trials and medicines are the Government providing for those diagnosed with metastatic secondary breast cancer? While I welcome the audit, will it be made permanent?
Lord Evans of Rainow (Con)
My Lords, the Healthcare Quality Improvement Partnership commissions, develops and manages the National Clinical Audit and Patient Outcomes Programme on behalf of NHS England, NHS Wales and the other devolved nations. This includes five national clinical audits focused on priority cancers, such as prostate, lung, breast, oesophageal, gastric and bowel cancers. These audits have been introduced to reduce variation in treatment by demonstrating where care is being provided in line with standards, and where a service is doing well or could be improved. Five additional new clinical audits were announced in May 2021, one of which will focus on metastatic breast cancer. I would be very happy to update the House on the metastatic breast cancer audit once it is in a form that I can share.
Respiratory Syncytial Virus Immunisation
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow
Baroness Ritchie of Downpatrick
To ask His Majesty’s Government what discussions they have had with the NHS and vaccine manufacturers regarding expanding the Respiratory Syncytial Virus immunisation programme for winter 2023/24, and the potential for making a universal offer of that vaccine.
Lord Evans of Rainow (Con)
My Lords, the Joint Committee on Immunisation and Vaccination has advised that the existing targeted RSV immunisation offer should move to a more effective and longer-lasting monoclonal antibody. The Government are in conversation with the manufacturer and the NHS to support this change in time for the 2023-24 winter season. The JCVI is actively reviewing the evidence around other available products and the potential for universal RSV offers as soon as practicable.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I thank the Minister for his Answer. He will be aware that the Joint Committee on Vaccination and Immunisation has recently recognised the importance of a universal immunisation programme to help protect all infants from RSV. There is an issue around the budget, so will the Minister clarify for your Lordships’ House what discussions he and his colleagues have had with the Chancellor about the budget for a universal RSV immunisation programme for the 2023-24 winter programme?
Lord Evans of Rainow (Con)
My Lords, I have not discussed the universal RSV immunisation programme for 2023-24 with the Chancellor. However, the independent expert committee, the JCVI, provides the Government with advice on all immunisation programmes, including RSV. For the current year, this advice is to improve the existing targeted programme for children at high risk. Once the JCVI has concluded its robust review of evidence for an expanded or universal programme, I will support the implementation of any changes advised as soon as practicable. This would include talking to the Chancellor to seek budgetary support for a potential programme. I offer the noble Baroness a meeting with the relevant officials following this Question to discuss this important matter further, if that would be helpful.
Immunisation: Winter 2023-24
Debate between Baroness Ritchie of Downpatrick and Lord Evans of Rainow(1 year, 2 months ago)
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Baroness Ritchie of Downpatrick
To ask His Majesty’s Government when they expect the Joint Committee on Vaccinations and Immunisations (JCVI) will announce the national immunisation programme for respiratory viruses for the winter season 2023/2024.
Lord Evans of Rainow (Con)
My Lords, there are many viruses that cause mild and severe respiratory tract infections, with vaccination programmes against influenza and Covid-19 and a target immunisation offer against respiratory syncytial virus for children at high risk in England. The Joint Committee on Vaccination and Immunisation has recently published advice on influenza and Covid-19 for 2023-24, and is reviewing new products for potentially improving and expanding the RSV immunisation offer. The Government will announce those in due course.
Baroness Ritchie of Downpatrick (Lab)
I thank the Minister for his Answer, but obviously I am looking for a little more on a time and a date for that vaccination programme for next winter, which could see the introduction of several new immunisations for RSV. Indeed, I understand that one vaccine received its licence from the MHRA last November. What are the Government doing to ensure that the Joint Committee on Vaccination and Immunisation is able to rapidly access these new technologies in time for the next winter season, and thus help to mitigate the problems faced by the National Health Service?
Lord Evans of Rainow (Con)
I thank the noble Baroness for her question and pay tribute to the work that she does on behalf of us all as the allergy champion in Parliament. In line with the JCVI recommendation, the NHS currently offers a targeted monoclonal antibody programme to a small number of infants at high risk of severe complications from RSV infection. However, there are potential changes to this programme: a new monoclonal antibody which provides longer-term protection than the one currently used has been developed, and the JCVI is reviewing this in time for the 2023-24 season. The new monoclonal antidotes and vaccines are being reviewed by the JCVI for potential expansion of the current programme, including a universal offer. The JCVI is expected to conclude advice on this later in 2023. I assure the noble Baroness that I have asked for a specific date, and once I receive one I will certainly notify her.