Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make it his policy to raise the NHS Improvement tariff for photodynamic therapy to cover the full cost of that procedure; and if he will make a statement.
Answered by Philip Dunne
NHS Improvement and NHS England have no plans to change the national prices for 2017/18 and 2018/19 for photodynamic therapy. However, providers and commissioners can agree to vary national prices where this would be in the best interest of patients. These ‘local variations’ can be agreed in accordance with National Tariff rules on locally-determined prices.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 20 February 2017 to Question 63820, if he will take steps to increase the maximum length of time for which data can be collected on treatments funded from the Cancer Drugs Fund from two to three years.
Answered by Baroness Blackwood of North Oxford
There is no maximum length of time for which data can be collected on treatments funded from the Cancer Drugs Fund (CDF). The duration in the CDF for a cancer drug is determined on an individual basis by the time required for such data development/collection to take place. This will depend on the disease concerned, the data that needs to be examined, the clinical trials that may be already running, and considerations of cancer treatment pathways in England. The time that a drug stays in the CDF is therefore individually assessed and agreed with NHS England, the National Institute for Health and Care Excellence and the company concerned. The timeframe will normally be up to two years, but will be considered on a case by case basis.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will take steps to increase the length of time that data is collected on the evaluation of treatment funded by the Cancer Drugs Fund.
Answered by Baroness Blackwood of North Oxford
NHS England has advised that cancer drugs that are assessed by the National Institute for Health and Care Excellence (NICE) as having both key clinical uncertainties and plausible cost effectiveness can enter the Cancer Drugs Fund (CDF) for evaluation with a view to future NICE re-appraisal once there is sufficient data from continuing clinical trials and/or data collection in the CDF.
The duration in the CDF for a cancer drug is determined on an individual basis by the time required for such data development/collection to take place. This will depend on the disease concerned, the data that needs to be examined, the clinical trials that may be already running, and considerations of cancer treatment pathways in England. The time that a drug stays in the CDF is therefore individually assessed and agreed with NHS England, NICE and the company concerned.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps are being taken to ensure melanoma patients have access to the most clinically effective treatment options if they have (a) brain metastases and (b) previously taken part in a clinical trial.
Answered by Baroness Blackwood of North Oxford
The National Institute for Health and Care Excellence (NICE) has recommended a number of drugs for use in the treatment of melanoma. National Health Service patients have a right in the NHS Constitution to drugs and treatments that have been recommended by NICE, where clinically appropriate.
NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness for drugs and treatments for melanoma into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.
Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.
The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:
https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf
Discussions are taking place with NHS regional and National Cancer Research Institute experts on melanoma on formulating chemotherapy algorithms for the treatment of advanced or metastatic melanoma. These discussions relate in part to the drug treatment of brain metastases and the need to preserve recruitment to clinical trials and whether the qualifications that NHS England has applied in terms of treatment criteria for melanoma drugs within their respective marketing authorisations should be changed.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to prevent NHS England from imposing restrictions on patients' access to NICE-approved treatments for melanoma and other conditions; and if he will make a statement.
Answered by Baroness Blackwood of North Oxford
The Department has placed no restrictions on patients accessing treatments for advanced (stage 4) melanoma.
The National Institute for Health and Care Excellence (NICE) has published guidance on the following treatments for melanoma. National Health Service commissioners are legally required to fund drugs and treatments recommended by NICE for eligible patients within three months of final guidance.
Appraisal number | Year of publication | Technology/condition | Recommendation |
TA268 | 2012 | Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA269 | 2012 | Vemurafenib for locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA319 | 2014 | Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA321 | 2014 | Dabrafenib for unresectable or metastatic BRAF V600 mutation‑positive melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA3571 | 2015 | Pembrolizumab for advanced melanoma after disease progression with ipilimumab | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA3661 | 2015 | Pembrolizumab for advanced melanoma not previously treated with ipilimumab | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA384 | 2016 | Nivolumab for advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation. |
TA396 | 2016 | Trametinib in combination with dabrafenib for unresectable or metastatic melanoma | Recommended in line with marketing authorisation. |
TA400 | 2016 | Nivolumab in combination with ipilimumab for advanced melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA410 | 2016 | Talimogene laherparepvec for unresectable metastatic melanoma | Optimised recommendation for talimogene laherparepvec as an option for treating unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs, only if: - treatment with systemically administered immunotherapies is not suitable; and - the company provides talimogene laherparepvec with the discount agreed in the patient access scheme. |
TA414 | 2016 | Cobimetinib in combination with vemurafenib for unresectable or metastatic BRAF V600 mutation-positive melanoma | At the time of appraisal, the technology was not considered to be an appropriate use of NHS resources based on the data available. |
1 pembrolizumab within its licensed indication was appraised across two separate appraisals.
NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.
Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.
The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:
https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what restrictions have been placed on patients accessing treatments for advanced (stage 4) melanoma by (a) NHS England, (b) his Department and (c) NICE.
Answered by Baroness Blackwood of North Oxford
The Department has placed no restrictions on patients accessing treatments for advanced (stage 4) melanoma.
The National Institute for Health and Care Excellence (NICE) has published guidance on the following treatments for melanoma. National Health Service commissioners are legally required to fund drugs and treatments recommended by NICE for eligible patients within three months of final guidance.
Appraisal number | Year of publication | Technology/condition | Recommendation |
TA268 | 2012 | Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA269 | 2012 | Vemurafenib for locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA319 | 2014 | Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA321 | 2014 | Dabrafenib for unresectable or metastatic BRAF V600 mutation‑positive melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA3571 | 2015 | Pembrolizumab for advanced melanoma after disease progression with ipilimumab | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA3661 | 2015 | Pembrolizumab for advanced melanoma not previously treated with ipilimumab | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA384 | 2016 | Nivolumab for advanced (unresectable or metastatic) melanoma | Recommended in line with marketing authorisation. |
TA396 | 2016 | Trametinib in combination with dabrafenib for unresectable or metastatic melanoma | Recommended in line with marketing authorisation. |
TA400 | 2016 | Nivolumab in combination with ipilimumab for advanced melanoma | Recommended in line with marketing authorisation and following agreement of patient access scheme. |
TA410 | 2016 | Talimogene laherparepvec for unresectable metastatic melanoma | Optimised recommendation for talimogene laherparepvec as an option for treating unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs, only if: - treatment with systemically administered immunotherapies is not suitable; and - the company provides talimogene laherparepvec with the discount agreed in the patient access scheme. |
TA414 | 2016 | Cobimetinib in combination with vemurafenib for unresectable or metastatic BRAF V600 mutation-positive melanoma | At the time of appraisal, the technology was not considered to be an appropriate use of NHS resources based on the data available. |
1 pembrolizumab within its licensed indication was appraised across two separate appraisals.
NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.
Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.
The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:
https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people have been suspended from the Derbyshire Mental Health Trust in the last two years; and for how long those suspensions were active.
Answered by Baroness Blackwood of North Oxford
The information requested is not available centrally. It may be obtained from Derbyshire Healthcare NHS Foundation Trust. We have written to Richard Gregory, Chair of the Trust, informing him of the hon. Member’s enquiry. He will reply shortly and a copy of the letter will be placed in the Library.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what his policy is on ensuring that patients have the right set out in the NHS Constitution to access any NICE-approved treatments that are clinically appropriate for them.
Answered by Baroness Blackwood of North Oxford
National Health Service patients’ right in the NHS Constitution to drugs and treatments recommended in National Institute for Health and Care Excellence (NICE) technology appraisal and highly specialised technology guidance, where clinically appropriate, is underpinned by the legal requirement for NHS commissioners to fund such treatments, normally within three months of NICE issuing its final guidance.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the implications for his policies of the findings in the Clinical Commissioning Group (CCG) Improvement and Assessment Framework data, published in September 2016, which showed that over two-thirds of CCGs have been rated as either needs improvement or greatest need for improvement in diabetes services; and if he will make a statement.
Answered by David Mowat
The Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) contains two recognised evidence-based measures of whether patients with diabetes are being supported to successfully manage their condition. These are the achievement of the National Institute for Health and Care Excellence (NICE) treatment targets, which cover blood sugar, blood pressure and cholesterol control, and participation in structured education programmes.
These measures were selected to reflect matters highlighted by the Public Accounts Committee (PAC) in January 2016 in its report on the management of adult diabetes services. The purpose of the CCG IAF is to highlight the key areas where clinical commissioning groups (CCGs) need to make improvements. The number of CCGs in need of improvement against these two indicators is consistent with the findings of the PAC.
The NHS Operational Planning and Contracting Guidance 2017-2019 included an announcement that NHS England intends to launch a major programme of investment in the treatment and care of people with diabetes. As part of this, CCGs will be able to bid for additional funding of around £40 million per year for priorities which include improvements in relation to the achievement of the treatment targets and attendance at structured education programmes.
Asked by: Pauline Latham (Conservative - Mid Derbyshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to support clinical commissioning groups that need improvement or have the greatest need for improvement for diabetes care under the Clinical Commissioning Group Improvement and Assessment Framework.
Answered by Baroness Blackwood of North Oxford
NHS England will work with health communities/clinical commissioning groups (CCGs) in need of improvement against CCG Improvement and Assessment Framework indicators to mutually identify the nature of the change needed and the type of support required to achieve this. A key focus of improvement will be to support CCGs and providers to locally map their services against nationally recognised best practice diabetes pathways and to identify where local pathways need to change in order to improve outcomes. NHS England is developing plans for additional support to be available from 2017/18 onwards:
- The NHS Operational Planning and Contracting Guidance 2017-2019 included an announcement that NHS England intends to launch a major programme of investment in the treatment and care of people with diabetes, for which CCGs will be able to bid for additional funding of approximately £40 million per year, focused on the key areas of diabetes care where improvements in outcomes will be most beneficial.
- A Diabetes CCG Improvement and Assessment Framework Independent Panel has been developed, chaired by the Chief Executive of Diabetes UK and includes panel members with a wide range of other diabetes clinical expertise. This will consider CCG positions in relation to the diabetes Improvement and Assessment Framework indicators and advise on actions to support improvement.
- Sustainability and Transformation Plans (STPs). As part of supporting the development of STPs, a “How to” guide for diabetes has been issued which sets out advice the actions which CCGs can take to support improvements.
- NHS England regional teams: NHS England has funded diabetes programme leads within each of the National Health Service regions to work with CCGs to support improvement.