Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government on what basis, if any, the NHS Mandate requires that investment in NICE-recommended treatments for hepatitis C be limited to avoid disinvestment in other health services.
Answered by Lord Prior of Brampton
The NHS Mandate requires healthcare expenditure to be limited to the resources made available by the government. The range of potential treatments which could improve patients health exceeds the funding made available to the National Health Service, therefore increased investment in one area has an opportunity cost on the ability to invest in other areas. NHS England is investing in the rollout of Hepatitis C treatment in full accordance with National Institute of Health and Care Excellence guidance, with an expected doubling of the number of patients benefiting from new treatment to 10,000s in the coming year.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the breakdown of the patient treatment capacity for each Operational Delivery Network for hepatitis C, broken down by hub and spoke.
Answered by Lord Prior of Brampton
NHS England does not hold this information. NHS England is not the responsible commissioner for all services in which the treatment of people with hepatitis is undertaken.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the breakdown of run rates assigned to each Operational Delivery Network for hepatitis C, broken down by hub and spoke.
Answered by Lord Prior of Brampton
Operational Delivery Networks (ODNs) lead organisations in collaboration with the local NHS England commissioning team are responsible for approving the organisations involved in the ODN. The ODN lead provider is responsible for working with its partners in determining how the patient numbers will be managed across its network. NHS England does not hold this information.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government which current policy document or guidance, if any, specified a five-year rollout for the prioritised treatment of hepatitis C patients.
Answered by Lord Prior of Brampton
NHS England has already published its planning approach to implement National Institute for Health and Care Excellence (NICE) recommended treatment during 2016/17. NHS England has committed to produce an operational framework for hepatitis C during 2016/17. This will set out NHS England’s commitment to improving outcomes in hepatitis C across England. The publication date for the document has not been set but we anticipate work to continue during the late spring and early summer.
NICE Technology Appraisals (TA) 363, 364 and 365 require Operational Delivery Networks to prioritise treatment for patients with the highest unmet clinical need. The National Health Service commitment to 10,000 treatments in 2016/17 reflects the multi-year modelling used by NICE and published in conjunction with the recommendations for TA 364. The NICE recommendations note that treatment decisions are influenced by clinical characteristics such as level of liver damage, genotype, treatment history and comorbidities. The recommendations also record the advice of clinical experts to the committee that a realistic estimate of patients accessing treatment each year is between 7-10,000.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government when NHS England expects to publish its operational framework for hepatitis C.
Answered by Lord Prior of Brampton
NHS England has already published its planning approach to implement National Institute for Health and Care Excellence (NICE) recommended treatment during 2016/17. NHS England has committed to produce an operational framework for hepatitis C during 2016/17. This will set out NHS England’s commitment to improving outcomes in hepatitis C across England. The publication date for the document has not been set but we anticipate work to continue during the late spring and early summer.
NICE Technology Appraisals (TA) 363, 364 and 365 require Operational Delivery Networks to prioritise treatment for patients with the highest unmet clinical need. The National Health Service commitment to 10,000 treatments in 2016/17 reflects the multi-year modelling used by NICE and published in conjunction with the recommendations for TA 364. The NICE recommendations note that treatment decisions are influenced by clinical characteristics such as level of liver damage, genotype, treatment history and comorbidities. The recommendations also record the advice of clinical experts to the committee that a realistic estimate of patients accessing treatment each year is between 7-10,000.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what impact assessment they made of the introduction of CQUIN scheme <i>BI1 Improving HCV Treatment Pathways through ODNs</i>, and whether they will publish a copy of that assessment.
Answered by Lord Prior of Brampton
The National Institute for Health and Care Excellence specifically requires Operational Delivery Networks to prioritise hepatitis C patients on the basis of clinical need, as part of a progressive rollout of treatments over the next five years and the Commissioning for Quality and Innovation scheme (CQUIN) enables and ensures this take place. There is no separate assessment of impact. NHS England recognises that there is a very significant improvement in inequalities as a result of roll-out treatment for hepatitis C.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether NHS England's decision to treat 10,000 hepatitis C patients represents a cap on the number of patients the NHS can treat in 2016–17.
Answered by Lord Prior of Brampton
NHS England’s approach paces the roll-out of hepatitis C treatment in accordance with the National Institute for Health and Care Excellence (NICE) recommendation for prioritisation and the modelling assumptions which informed the NICE recommendations.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether patients who meet the eligibility criteria for NICE-approved medicines for hepatitis C will have access to treatment in line with their rights under the NHS Constitution in 2016–17, even if more than 10,000 patients have already been treated.
Answered by Lord Prior of Brampton
NHS England’s approach paces the roll-out of hepatitis C treatment in accordance with the National Institute for Health and Care Excellence (NICE) recommendation for prioritisation and the modelling assumptions which informed the NICE recommendations. These are in line with patients’ rights under the NHS Constitution.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government on which specific NICE guidance NHS England based its decision to restrict access to new treatments for hepatitis C to 10,000 patients in 2016–17.
Answered by Lord Prior of Brampton
The planning approach for hepatitis C is set out in the National Institute for Health and Care Excellence (NICE) Technology Appraisals 363, 364 and 365 which require Operational Delivery Networks to prioritise treatment for patients with the highest unmet clinical need. We understand from NHS England that the figure of 10,000 patients reflects NICE modelling used for its recommendations and published alongside the guidance.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to ensure that the objectives of the hepatitis C improvement framework can still be achieved.
Answered by Lord Prior of Brampton
NHS England has been rapidly working on their plans for access to treatment during 2016/17 following enactment of the National Institute for Health and Care Excellence technical appraisal guidance and has committed to produce an operational framework for the treatment of hepatitis C during 2016/17. This will set out NHS England’s commitment to improving outcomes in hepatitis C across England.