Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, following their response to the consultation on the extent of the impact on inward investment of higher payments under the statutory scheme to control the costs of branded medicines, what assessment they have made of the sensitivity analysis used to assess that impact; and whether they are proposing changes to that analysis.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department has received materials from pharmaceutical industry Trade Associations and from individual companies about the impact of changes to the voluntary and statutory schemes for branded medicines prices.
These include responses to the assessments made by the Department in the draft impact assessment that accompanies our recent consultation on increased rates in the statutory scheme. We will be considering this evidence over the coming weeks and will publish our response alongside the final impact assessment.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what evidence they have received from industry of the impending impact on UK Research and Development investment of rising payment rates under the voluntary and statutory schemes for branded medicines.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department has received materials from pharmaceutical industry Trade Associations and from individual companies about the impact of payment percentages under the voluntary and statutory schemes.
These include responses to the assessment made by the Department in the draft impact assessment that accompanies our recent consultation on increased rates in the statutory scheme. We will be considering this evidence over the coming weeks and will publish our response alongside the final impact assessment.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what consideration they have given to the impact assessment for the Statutory Scheme for controlling the costs of branded health service medicines, which states that the proposed rebates pose a remote risk to the supply of medicines to the NHS.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The impact assessment published in December 2022 on the impact of proposed changes to payment percentages in the statutory scheme for branded medicines pricing considered matters relevant to the risk to the supply of medicines of any changes.
We have little evidence to suggest that, given the available mitigations, changes to volume-based payment rates will lead to supply issues.
We work closely with suppliers, NHS England, Medicines and Healthcare products Regulatory Agency, the devolved Governments and other stakeholders to ensure patients continue to have access to the treatments they need.
Asked by: Lord Warner (Crossbench - 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 changes to the rebate in the Voluntary Scheme for Branded Medicines Pricing and Access, and to the accompanying Statutory Scheme, on (1) foreign direct investment into the UK Research and Development, (2) employment levels in the life sciences industry in the UK, and (3) medicines launches in the UK.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
An impact assessment was published in December 2022 as part of the consultation on the impact of changes to the statutory scheme for branded medicines. The Department has received materials from pharmaceutical industry Trade Associations and from individual companies about a wide range of issues relevant to both the voluntary and statutory schemes for branded medicines pricing. We will be considering this evidence over the coming weeks and will publish our response alongside the final impact assessment.
Asked by: Lord Warner (Crossbench - 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 the mechanisms for pricing schemes for innovative medicines in the UK, and those in comparative countries such as (1) Germany, (2) Spain, and (3) Ireland.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
No assessment has been made.
The Government is open to ideas about how a successor to Voluntary Scheme for Branded Medicines Pricing and Access should operate from 2024 onwards and will work with industry and apply learning from approaches in the United Kingdom and internationally to agree a mutually beneficial successor that that supports better patient outcomes; ensures the sustainability of National Health Service spend on branded medicines; and enables a strong UK life sciences industry.
Asked by: Lord Warner (Crossbench - 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 the real terms decline in medicines spend since 2019 on (1) patient outcomes, and (2) foreign direct investment into UK research and development.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
An impact assessment was published in December 2022 as part of the consultation on the impact of changes to the Statutory Scheme for Branded Medicines. The Department has received materials from pharmaceutical industry Trade Associations and from individual companies about a wide range of issues relevant to both the voluntary and statutory schemes for branded medicines pricing. We will be considering this evidence over the coming weeks and will publish our response alongside the final impact assessment.
The latest data published by the NHS Business Services Authority on prescribing costs in hospitals and the community for 2021/22 shows spending on medicines increased from £15.74 billion in 2019/20 to £17.78 billion in 2021/22, which is also an increase in real terms.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to identify the range of costs among NHS acute hospital providers for (1) routine (a) hip, (b) knee, and (c) cataract, operations, (2) routine (a) CT, (b) MRI scans, and (c) x-rays, and (3) routine pathology tests; and whether they will publish such information as an aid to holding NHS providers to account for public expenditure.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England collects and publishes ‘National Cost Collection for the NHS’ annually in an online only format. This data is collected by Healthcare Resource Groups (HRGs), which are standard groupings of clinically similar treatments using similar levels of healthcare resources.
This data will show HRGs for hip, knee, cataract procedures and outpatient computerised tomography (CT) or magnetic resonance imaging (MRI) when the relevant clinical coding has been documented in the patient’s record. A cost for the activity will then be assigned by the relevant National Health Service trust. However, where a CT or MRI has been undertaken during an inpatient episode or attendance in accident and emergency, this will be included in the composite cost of the HRG and will not be separately identifiable.
While information on x-rays and pathology testing is collected, this is for direct access for general practitioners (GPs). The report of an x-ray or result of a pathology test is returned to the GP rather than a hospital clinician or consultant. Where this procedure is undertaken at the request of a hospital clinician or consultant, it is not reported separately.
Additionally, data on costs is also made available to NHS providers through Patient Level Information Costing System (PLICS) dashboards, the Model Hospital and Getting It Right First Time programmes, which support health providers to improve patient treatment and productivity. The PLICS dashboards allow trusts to examine data to understand the difference between costs incurred in comparison to other similar organisations. NHS England uses this information and other performance data to hold NHS organisations to account.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what, if any, central contracts have been let by NHS England with independent care providers to increase NHS (1) diagnostic, and (2) elective surgery, capacity; and what guidance has been given by NHS England to local commissioners to use independent service providers in order to reduce the backlog of NHS patients awaiting (a) diagnosis, and (b) treatment.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The majority of commissioning between independent sector providers and the National Health Service takes place locally. While central contracts were regularly used by NHS England during the pandemic, in 2022/23 there have been no central contracts between NHS England and independent care providers to increase diagnostic or elective surgery capacity.
In February 2022, NHS England published the Delivery plan for tackling the COVID-19 backlog of elective care, which sets out how the National Health Service will recover and expand elective services over the next three years. It advises that effective use of the independent sector should be encouraged to increase capacity and reduce waiting times. A copy of the plan is attached.
In January 2022, NHS England published the 2022/23 priorities and operational planning guidance, which states that independent sector should be considered to manage winter pressures and increase capacity, including through virtual wards. A copy of the guidance is attached.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the independent sector was invited to participate in the selection of (1) NHS diagnostic and treatment hubs, or (2) elective surgical hubs; and if so, whether this was on the basis of a specific volume of service contracts or spot purchases.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
A table showing surgical hubs and community diagnostic centres (CDCs) established in 2022, with the services provided, the National Health Service region, the relevant integrated care system and NHS trust, the name of the hub and the date of opening, is attached due to the size of the data. Information on the selection criteria for each CDC and surgical hub is not held centrally.
Local systems undertake an evaluation of the most appropriate locations for CDCs, including consideration of accessibility, affordability and addressing inequality and deprivation. Business cases are scrutinised by a national approvals panel with clinical and diagnostic experts to assess feasibility prior to approval. CDC locations are also subject to Ministerial approval. Surgical hub locations have been selected by a clinically-led process to ensure that sites are connected to the appropriate services to deliver high quality outcomes for patients and to consider health inequalities. The independent sector were not invited to participate in the selection of CDCs or surgical hubs.
NHS England has engaged with patient forums and undertaken a public awareness campaign on the expansion of services. The Department and NHS England are working with general practitioners (GPs), cancer charities and patient representatives to expand direct GP access to diagnostic scans for those with concerning symptoms which do not align with the two-week cancer referral target to see a specialist.
Asked by: Lord Warner (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what arrangements they have put in place to advise (1) GPs, and (2) patients, on their ability to use diagnostic and surgical hubs as an alternative to waiting for treatment at their local hospital.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
A table showing surgical hubs and community diagnostic centres (CDCs) established in 2022, with the services provided, the National Health Service region, the relevant integrated care system and NHS trust, the name of the hub and the date of opening, is attached due to the size of the data. Information on the selection criteria for each CDC and surgical hub is not held centrally.
Local systems undertake an evaluation of the most appropriate locations for CDCs, including consideration of accessibility, affordability and addressing inequality and deprivation. Business cases are scrutinised by a national approvals panel with clinical and diagnostic experts to assess feasibility prior to approval. CDC locations are also subject to Ministerial approval. Surgical hub locations have been selected by a clinically-led process to ensure that sites are connected to the appropriate services to deliver high quality outcomes for patients and to consider health inequalities. The independent sector were not invited to participate in the selection of CDCs or surgical hubs.
NHS England has engaged with patient forums and undertaken a public awareness campaign on the expansion of services. The Department and NHS England are working with general practitioners (GPs), cancer charities and patient representatives to expand direct GP access to diagnostic scans for those with concerning symptoms which do not align with the two-week cancer referral target to see a specialist.