Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support people with post-polio syndrome.
Answered by Seema Kennedy
There is currently no cure for post-polio syndrome. However, support and a range of treatments are available to help manage symptoms and improve quality of life. Some of the ways in which symptoms may be managed include rest and exercise, mobility aids, weight control and healthy eating, painkilling medication and psychological support.
As set out in the NHS Long Term Plan, NHS England is taking action in a range of areas to improve the care, treatment and support provided to people with long term conditions, including those with post-polio syndrome. This includes rolling out the NHS Comprehensive Model of Personalised Care across the country, reaching 2.5 million people by 2023/24.
Further information on treatment and support available to those affected can be found via the National Health Service website at the following link:
www.nhs.uk/conditions/post-polio-syndrome/treatment/
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions his Department has had with (a) NHS England, (b) manufacturers and (c) NICE on funding arrangements for accessing (a) licensed and (b) unlicensed cannabis-based medicines on the NHS.
Answered by Seema Kennedy
In developing policy on the rescheduling of cannabis-based products for medicinal use, the Government has applied existing arrangements for accessing licensed and unlicensed medicines on the National Health Service. The Department has not had discussions with NHS England, manufacturers or the National Institute for Health and Care Excellence (NICE) on funding arrangements for accessing licensed or unlicensed cannabis-based products, beyond the existing arrangements.
The recent changes to the law to reschedule cannabis-based products for medicinal use, does not impact on the availability of existing licensed cannabis-based medicinal products, such as Sativex and Nabilone. Any medicines which receive a marketing authorisation from the Medicines and Healthcare products Regulatory Agency or European Medicines Agency will be assessed for cost effectiveness by NICE. This is the foundation of NHS decisions about routine funding, and applies to all licensed medicines.
For unlicensed medicines, the normal NHS medicines governance systems apply, as they do to all locally funded unlicensed treatments. These processes support good clinical practice and safe and effective prescribing. Decisions will be taken, at NHS trust level on a case by case basis, based on the needs of the individual patient and the evidence of efficacy and cost effectiveness available.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to his oral contribution of 8 April 2019, Official Report, column 36, what the timetable is for making available a public register of specialist clinicians who can prescribe cannabis-based medicines.
Answered by Seema Kennedy
The law provides that specialist clinicians on the General Medical Council’s ‘Specialist Register’ can prescribe cannabis-based products for medicinal use, where clinically appropriate and in the best interest of patients.
A general practitioner (GP) may make a referral to a specialist clinician on the General Medical Council’s ‘Specialist Register’ once the patient reaches the appropriate point in their treatment pathway.
A list of Registered Medical Practitioners, including specialist clinicians, is available at the following link:
https://www.gmc-uk.org/registration-and-licensing/the-medical-register
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 4 April 2019 to Question 239204 on Ophthalmology, whether the NHS Improvement impact assessment (a) covers changes affecting patient access to combined Minimally Invasive Glaucoma Surgery (MIGS) and cataract operation and (b) recognises the procedure as a common practice; and whether the new tariff price was assessed to cover cataract and MIGS as a single operation.
Answered by Seema Kennedy
In considering the proposed prices for the 2019/20 national tariff, the ophthalmology Clinical Expert Working Group (EWG) specifically stated that minimally invasive glaucoma surgery (MIGS) and cataract activity are commonly done together and it would not usually be in the patient’s best interest to do them separately. The prices assigned to HRG BZ91 in the 2019/20 tariff cover cataract and MIGS as a single operation. The EWG and Royal College of Ophthalmology agreed that the BZ91 prices were appropriate, relative to the prices for other ophthalmology procedures.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 4 April 2019 to Question 239205 on Ophthalmology, if his Department will publish the (a) data and (b) analysis on which NHS Improvement based the assessment that indicates that Minimally Invasive Glaucoma Surgery (MIGS) is cheaper than other glaucoma procedures; and what the difference is in reference costs for MIGS and cataract operation since the last tariff prices were set.
Answered by Seema Kennedy
The current codes do not allow differentiation between minimally invasive glaucoma surgery (MIGS) and non-MIGS activity.
In the development of each national tariff, NHS England and NHS Improvement undertakes an overall assessment of the impact of proposals. This includes consideration of change in expenditure on different types of care in ‘2019/20 National Tariff Payment System – A consultation notice: Impact assessment’. While this provides an overall assessment of impact, detailed feedback on proposed prices for individual Healthcare Resource Groups (units of healthcare) is sought from clinical Expert Working Groups (EWGs). EWGs are managed by the NHS Digital National Casemix Office and comprise clinicians representing specific specialities. This is to ensure that the published tariff supports clinical practice.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the effectiveness of the changes to the NHS tariff for 2019-2020 in the field of ophthalmology on patient access to glaucoma treatment.
Answered by Caroline Dinenage
There has been a significant change in clinical practice in ophthalmology since the last tariff prices were set and reference costs used to calculate prices were collected, with a shift to performing Minimally Invasive Glaucoma Surgery (MIGS) instead of open glaucoma procedures which are frequently combined with cataract extraction.
MIGS are significantly cheaper, and both procedures cannot be differentiated using operating procedure code supplement codes. Open/tube glaucoma procedures are nearly always done with a graft of sclera or tutoplast, which triggers multiple procedures so will receive significantly more under the 2019/20 prices than MIGS procedures, which is appropriate.
NHS Improvement has carried out an impact assessment which shows that the national tariff changes should not affect patient access to glaucoma treatment.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment on the effect of the changes to the NHS tariff for combined cataract and glaucoma surgery on (a) hospital costs and (b) efficiency in the field of ophthalmology.
Answered by Caroline Dinenage
There has been a significant change in clinical practice in ophthalmology since the last tariff prices were set and reference costs used to calculate prices were collected, with a shift to performing Minimally Invasive Glaucoma Surgery (MIGS) instead of open glaucoma procedures which are frequently combined with cataract extraction.
MIGS are significantly cheaper, and both procedures cannot be differentiated using operating procedure code supplement codes. Open/tube glaucoma procedures are nearly always done with a graft of sclera or tutoplast, which triggers multiple procedures so will receive significantly more under the 2019/20 prices than MIGS procedures, which is appropriate.
NHS Improvement has carried out an impact assessment which shows that the national tariff changes should not affect patient access to glaucoma treatment.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many penalty notices were issued by the NHSBSA in Dudley prior to the rollout of universal credit in each year for which information is available.
Answered by Steve Brine
The number of prescription and dental penalty charge notices issued prior to universal credit (UC) rollout in Dudley by calendar year is provided in the following table:
Prior to the rollout of UC in Dudley by calendar year | Prescription penalty charge notice issued | Dental penalty charge notice issued |
2012 | Not held | 51 |
2013 | Not held | 720 |
2014 | 1,018 | 2,570 |
2015 | 4,340 | 2,937 |
2016 | 7,914 | 4,190 |
2017 - until June | 1,939 until June | 2,234 until June |
The number of prescription and dental penalty charge notices issued since the rollout of UC in Dudley by calendar year is provided in the following table:
After the rollout of UC in Dudley by calendar year | Prescription penalty charge notice issued | Dental penalty charge notice issued |
2017 – from July | 6,653 * from July | 2,517 * from July |
2018 | 4,467 | 4,667 |
Notes:
- The following postcodes were used to collate data for the Dudley area: B62, B63, B64, B65, DY1, DY2, DY3, DY4, DY5, DY6, DY7, DY8, DY9, WV1, WV4
- UC commenced roll out in the Dudley area from July 2017 so this date has been used in the data collation. The data represents Penalty Charge Notices sent out against all exemption types ticked by the patient where an exemption could not be verified.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many penalty notices have been issued by the NHSBSA in Dudley since the rollout of universal credit.
Answered by Steve Brine
The number of prescription and dental penalty charge notices issued prior to universal credit (UC) rollout in Dudley by calendar year is provided in the following table:
Prior to the rollout of UC in Dudley by calendar year | Prescription penalty charge notice issued | Dental penalty charge notice issued |
2012 | Not held | 51 |
2013 | Not held | 720 |
2014 | 1,018 | 2,570 |
2015 | 4,340 | 2,937 |
2016 | 7,914 | 4,190 |
2017 - until June | 1,939 until June | 2,234 until June |
The number of prescription and dental penalty charge notices issued since the rollout of UC in Dudley by calendar year is provided in the following table:
After the rollout of UC in Dudley by calendar year | Prescription penalty charge notice issued | Dental penalty charge notice issued |
2017 – from July | 6,653 * from July | 2,517 * from July |
2018 | 4,467 | 4,667 |
Notes:
- The following postcodes were used to collate data for the Dudley area: B62, B63, B64, B65, DY1, DY2, DY3, DY4, DY5, DY6, DY7, DY8, DY9, WV1, WV4
- UC commenced roll out in the Dudley area from July 2017 so this date has been used in the data collation. The data represents Penalty Charge Notices sent out against all exemption types ticked by the patient where an exemption could not be verified.
Asked by: Lord Austin of Dudley (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that (a) nusinersen/Spinraza and (b) other life-saving drugs are made available for people with spinal muscular atrophy.
Answered by Steve Brine
The Government wants National Health Service patients to be able to benefit from effective new medicines in a way that represents value for money to the taxpayer. Through its technology appraisal and highly specialised technologies programmes, the National Institute for Health and Care Excellence (NICE) makes recommendations for the NHS on whether new medicines should be routinely funded by the NHS. NHS organisations are legally required to fund medicines recommended by NICE.
NICE is currently developing technology appraisal guidance on the use of Spinraza for the treatment of spinal muscular atrophy. NICE was unable to recommend Spinraza as an effective use of NHS resources in its draft guidance published in August 2018. Discussions have since been taking place between the manufacturer of Spinraza, Biogen, and NHS England to explore whether there are commercial flexibilities that might enable NICE to recommend the drug as a clinically and cost-effective use of NHS resources. Biogen has now submitted a revised submission and a meeting of NICE’s independent Appraisal Committee took place on 6 March to consider the recommendations. Details from the meeting will made available on the NICE website in due course.