Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the consequences for patients with mantle cell lymphoma of NICE’s decisions not to recommend (1) brexucabtagene autoleucel, and (2) acalabrutinib with bendamustine and rituximab; and what steps they plan to take to resolve the uncertainties identified in the evidence to support the use of brexucabtagene autoleucel, given that its use has not been recommended, and it will therefore not add to further data.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is an independent body and develops its recommendations in line with its established processes on the basis of an assessment of clinical and cost effectiveness. It is right that these decisions are made independently on the basis of the available evidence, and the Government has no plans to intervene in NICE’s decisions. Companies may, however, bring forward further evidence or revised commercial proposals for future consideration through NICE’s established processes.
The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients with mantle cell lymphoma will be concerning for patients and their families, but it is important to note that final guidance has not yet been published and an appeal is ongoing. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.
NICE has recently consulted on its draft guidance that does not recommend acalabrutinib in combination with bendamustine and rituximab for the treatment of untreated mantle cell lymphoma. NICE will take the comments received in response to the consultation fully into account in developing its final guidance.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether high-impact therapies that are the last line of curative potential for rare cancers are disadvantaged by standard appraisal models; and what plans they have to establish a dedicated review mechanism for such treatments.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has no current plans to establish a dedicated review mechanism for rare cancer treatments. Most medicines, including for rare cancers, are assessed through the National Institute for Health and Care Excellence’s (NICE) standard technology appraisal programme, with a small number of treatments for very rare and severe conditions considered through the highly specialised technologies programme, which applies a higher cost effectiveness threshold.
NICE’s methods are suitable for evaluating treatment for rare cancers where prices are set fairly. NICE completed eight technology appraisals of medicines for the treatment of rare cancers between April 2025 and April 2026 and was able to recommend them all for some or all the eligible patient population.
We are also investing approximately 25% more in innovative treatments through an increase to NICE’s cost-effectiveness threshold and changes to how health benefits are valued. This will support access to medicines delivering significant health benefits, including for rare diseases, that may previously have been declined on cost-effectiveness grounds.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of NICE not recommending treatment options around expanding access to innovative therapies for rare cancer patients.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has no current plans to establish a dedicated review mechanism for rare cancer treatments. Most medicines, including for rare cancers, are assessed through the National Institute for Health and Care Excellence’s (NICE) standard technology appraisal programme, with a small number of treatments for very rare and severe conditions considered through the highly specialised technologies programme, which applies a higher cost effectiveness threshold.
NICE’s methods are suitable for evaluating treatment for rare cancers where prices are set fairly. NICE completed eight technology appraisals of medicines for the treatment of rare cancers between April 2025 and April 2026 and was able to recommend them all for some or all the eligible patient population.
We are also investing approximately 25% more in innovative treatments through an increase to NICE’s cost-effectiveness threshold and changes to how health benefits are valued. This will support access to medicines delivering significant health benefits, including for rare diseases, that may previously have been declined on cost-effectiveness grounds.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government in light of the proposal contained in the National Cancer Plan for England for the appointment of a national lead for rare cancers, what is the name of (1) the employing body and paymaster, and (2) the governance body responsible for the appointment; what is the expected management line of the post-holder by job title; whether the role is to be full-time or part-time: and what are the expected contracted or Full-Time Equivalent weekly hours.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Cancer Plan, published on 4 February 2026, sets out several commitments and ambitions, to be delivered within the next 10 years.
This includes appointing a national clinical lead for rare cancers, to sit on the National Cancer Board and advise on delivery of actions in the rare cancers chapter of the plan, and a National Institute for Health and Care Research National Specialty Lead for Rare Cancers to support delivery of research on rare cancers, as part of implementation of the Rare Cancers Act.
Responsibility for supporting the role of the national clinical lead for rare cancers, including governance and renumeration, will reside with the Department and NHS England.
Selecting the national clinical lead for rare cancers requires an appropriate appointment process. NHS England and Department officials are following public appointment procedures, including drafting a job specification, determining contract length, weekly hours, renewal and review details, probation terms, and line management.
Until the appointment is made, NHS England’s Clinical Advisory Group has leads for specific rare cancers.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in relation to proposed appointment of a national lead for rare cancers, what is the expected term length of the appointment in months; what are the proposed the contract start and end dates; and what are the details of any renewal, review, or probation points with corresponding dates.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Cancer Plan, published on 4 February 2026, sets out several commitments and ambitions, to be delivered within the next 10 years.
This includes appointing a national clinical lead for rare cancers, to sit on the National Cancer Board and advise on delivery of actions in the rare cancers chapter of the plan, and a National Institute for Health and Care Research National Specialty Lead for Rare Cancers to support delivery of research on rare cancers, as part of implementation of the Rare Cancers Act.
Responsibility for supporting the role of the national clinical lead for rare cancers, including governance and renumeration, will reside with the Department and NHS England.
Selecting the national clinical lead for rare cancers requires an appropriate appointment process. NHS England and Department officials are following public appointment procedures, including drafting a job specification, determining contract length, weekly hours, renewal and review details, probation terms, and line management.
Until the appointment is made, NHS England’s Clinical Advisory Group has leads for specific rare cancers.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what are the interim leadership arrangements until the national lead for rare cancers takes up their post, including the name or title of the accountable post holder and the start date.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Cancer Plan, published on 4 February 2026, sets out several commitments and ambitions, to be delivered within the next 10 years.
This includes appointing a national clinical lead for rare cancers, to sit on the National Cancer Board and advise on delivery of actions in the rare cancers chapter of the plan, and a National Institute for Health and Care Research National Specialty Lead for Rare Cancers to support delivery of research on rare cancers, as part of implementation of the Rare Cancers Act.
Responsibility for supporting the role of the national clinical lead for rare cancers, including governance and renumeration, will reside with the Department and NHS England.
Selecting the national clinical lead for rare cancers requires an appropriate appointment process. NHS England and Department officials are following public appointment procedures, including drafting a job specification, determining contract length, weekly hours, renewal and review details, probation terms, and line management.
Until the appointment is made, NHS England’s Clinical Advisory Group has leads for specific rare cancers.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in the light of the report by the Health Services Safety Investigations Body Insulin: supporting safe self-administration for patients in the community with a mental health problem, published on 26 February, what steps they plan to take to ensure that vulnerable patients are appropriately supported to administer insulin safely after discharge from hospital.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is considering the Health Services Safety Investigations Body’s report and will respond to the recommendation in the report in due course.
To reduce insulin related harm, the NHS Getting It Right First Time (GIRFT) programme published guidance in April 2025 to support trusts to establish Diabetes Safety Boards. GIRFT is also undertaking a pilot across 20 integrated care systems as part of a Community and District Nurse Insulin Programme, which works to empower community diabetes nurses and district nursing teams to support patients at home requiring insulin administration.
To further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the neighbourhood health framework will support the early identification and prevention of chronic kidney disease.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Neighbourhood Health Framework is designed to provide clarity and consistency to integrated care boards (ICBs), local authorities, and their partners, in developing and scaling neighbourhood health.
It is important that reforms are locally led, as ICBs and local authorities are best placed to design services that make sense for their local populations. Local systems can choose to go further than the minimum aims set out in the framework, and this could include a focus on chronic kidney disease.
Early diagnosis of chronic kidney disease is supported through widespread access to blood and urine tests across the National Health Service, including in primary care and community diagnostic services.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in the light of the report by the Health Services Safety Investigations Body Insulin: supporting safe self-administration for patients in the community with a mental health problem, published on 26 February, what assessment they have made of the risks to patient safety of inadequate assessment of a patient's ability to self-administer insulin prior to discharge from hospital
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is considering the Health Services Safety Investigations Body’s report and will respond to the recommendation in the report in due course.
To reduce insulin related harm, the NHS Getting It Right First Time (GIRFT) programme published guidance in April 2025 to support trusts to establish Diabetes Safety Boards. GIRFT is also undertaking a pilot across 20 integrated care systems as part of a Community and District Nurse Insulin Programme, which works to empower community diabetes nurses and district nursing teams to support patients at home requiring insulin administration.
To further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of the NHS Health Check programme in identifying chronic kidney disease; and what steps they are taking to increase uptake of that programme.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Blood pressure is a risk factor for chronic kidney disease (CKD) and cardiovascular disease (CVD). Each year, the NHS Health Check, which is a core component of England’s CVD prevention programme, engages over 1.4 million people and identifies over 340,000 cases of high blood pressure.
Individuals who are identified with high blood pressure during their NHS Health Check are referred to their general practice for further clinical investigation who determine whether an individual should be tested for CKD. Data is currently not collected on the number of individuals who are subsequently tested for CKD.
To improve access and engagement with the NHS Health Check, we are developing the NHS Health Check Online service that people can use at home, at a time convenient to them, to understand and act on their CVD risk. The NHS Health Check Online is being piloted in multiple local authorities across England.