Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to the announcement by NHS England of 11 April 2017 on mechanical thrombectomy, what estimate he has made of the savings in long-term health and social care costs from those stroke patients who receive a mechanical thrombectomy each year.
Answered by Steve Brine
NHS England agreed to fund thrombectomy for stroke in April 2017.
Progression to full implementation will need to take place on a phased basis to ensure the service providers can put in place the necessary staffing and working arrangements. In the short term there will be an interim set of arrangements.
Initially the procedure will be undertaken in neuroscience centres which are currently being assessed to ensure that they meet the standards set out in the service specification that is currently out for public consultation. This information will be used by a national oversight group and regional commissioning teams to assess who is able to provide the service in this interim period and will not be published. Further work with the providers of this service will be completed with regional commissioners and the services directly to establish clear action plans which will lead to full implementation.
It is anticipated that there will be some 1,000 cases completed by the end of March 2018; and that, by 2023, about 10% of stroke admissions in England (8,000 cases) will be treated with thrombectomy annually. NHS England have not undertaken an independent cost benefit analysis of thrombectomy but there have been research studies published such as Jean Ganesalingam et al – “Cost-Utility Analysis of Mechanical Thrombectomy Using Stent Retrievers”, in Acute Ischemic Stroke 2015;46:2591-2598. This showed that it is a highly cost effective treatment, particularly when the longer term health and social care costs are taken into account.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the number of interventional neuroradiologists in England; and whether he plans to increase that number.
Answered by Philip Dunne
Health Education England (HEE) is responsible for the planning and funding of post-registration medical education. HEE works directly with a number of partners, including National Health Service trusts, to assess demand and supply for clinical staff, and commissions programmes of education accordingly. HEE’s investment in training reflects the relative priorities the NHS and HEE have to develop the future workforce, including Radiology.
HEE is working with the Royal College of Radiologists and other stakeholders to explore options for developing the necessary competencies in Interventional Radiology specialists, including those who currently do not have the required Interventional Neuroradiology experience; including Neurosurgeons and Cardiologists.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to the Independent Mental Health Taskforce report entitled Five Year Forward View on Mental Health published in February 2016, what the timetable is for the establishment of a care pathway for autism.
Answered by Jackie Doyle-Price
An indicative timeline for the development of care pathways was set out in the Five Year Forward View for Mental Health. The precise timetable for the establishment of a care pathway for autism will be confirmed by NHS England in due course.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how much funding was allocated by NHS England to the learning disability GP annual health check scheme in 2015-16.
Answered by David Mowat
In 2015/16, spend on General Practitioner Learning Disabilities Directed Enhanced Services (DES) was £12.376 million. Under the DES, patients aged 14 and over with learning disabilities are offered an annual health check, which includes producing a health action plan.
The National Audit Office has recently estimated that the annual cost of supporting a person with challenging behaviour and learning disabilities, autism or both within an assessment and treatment unit is £180,000.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the average annual cost to the public purse of supporting a person with challenging behaviour and learning disabilities, autism or both within an assessment and treatment unit.
Answered by David Mowat
In 2015/16, spend on General Practitioner Learning Disabilities Directed Enhanced Services (DES) was £12.376 million. Under the DES, patients aged 14 and over with learning disabilities are offered an annual health check, which includes producing a health action plan.
The National Audit Office has recently estimated that the annual cost of supporting a person with challenging behaviour and learning disabilities, autism or both within an assessment and treatment unit is £180,000.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what policy proposals the Clinical Priority Advisory Group assigned priority level (a) 1, (b) 2, (c) 3, (d) 4 and (e) 5 to the specialised commissioning re-prioritisation process for 2016-17, announced on 4 December 2016.
Answered by David Mowat
Information on the annual prioritisation process for specialised treatments was announced by NHS England on 4 December 2016. This can be found here:
https://www.england.nhs.uk/2016/12/hiv-prevention-pregramme/
The final outcomes of the 2016-17 prioritisation were as follows:
Recommended for routine commissioning | Not recommended for routine commissioning |
- Pegvisomant for acromegaly as a third-line treatment for adults | - Eculizumab for treatment of recurrence of C3 glomerulopathy post-transplant |
- Auditory brainstem implants for congenital abnormalities of the auditory nerves or cochleae | - Riociguat for pulmonary arterial hypertension |
- Haematopoietic stem cell transplant for Lymphoplasmacytic lymphoma /Waldenstrom’s Macroglobulinaemia (adults) | - Second allogeneic haematopoietic stem cell transplant for relapsed disease |
- Everolimus for subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex |
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- Rituximab for immunoglobulin-G4 related disease (IgG4-RD) |
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- Microprocessor controlled prosthetic knees |
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- Tolvaptan for hyponatraemia secondary to the Syndrome of Inappropriate Antidiuretic Hormone (SIADH) for patients who require cancer chemotherapy |
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- Ivacaftor for children (2-5 years) with cystic fibrosis (named mutations) |
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- Sodium oxybate for symptom control for narcolepsy with cataplexy (children) |
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- Pasireotide for Cushing’s Disease |
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Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the timetable is for the NHS England 2018-19 specialised commissioning annual prioritisation process; and if he will make a statement.
Answered by David Mowat
NHS England expects to publish its prioritisation decisions for specialised services for the financial year 2017/18 in the spring of 2017.
Clinical policy propositions that were not funded on grounds of affordability in the 2016/17 prioritisation round will have the opportunity to be considered again alongside new proposals being put forward for prioritisation in 2017/18.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to ensure that the autism referral to treatment pathway announced in the Five Year Forward View on Mental Health is being developed; and for what reasons it was not included in NHS England's implementation plan for the Five Year Forward View.
Answered by David Mowat
NHS England’s Implementation Plan for the Five Year Forward View for Mental Health was published in July 2016. It described the national programme of work that will be taken forward to deliver the recommendations of the Mental Health Task Force. This will include work to develop an evidence based treatment pathway for people who have co-occurring mental health needs and neurodevelopmental conditions such as autism. In parallel, the Department plans to work with partners to improve tracking of referral to assessment times for an autism diagnosis.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will list the members of the neuroscience clinical reference group of NHS England.
Answered by David Mowat
Clinical Reference Groups (CRG) are currently undertaking a process of recruitment. Once all appointments have been made, a full list of members for each CRG will be published on NHS England’s website. However, for the Specialised Neurosciences CRG, the Chair and Lead CRG Commissioner have been confirmed as Adrian Williams and Jacquie Kemp respectively.
Asked by: Cheryl Gillan (Conservative - Chesham and Amersham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when he plans to publish Christine Lenehan's review of children's services and learning disabilities.
Answered by Baroness Blackwood of North Oxford
Dame Christine Lenehan is in the final stages of completing her report into the co-ordination of care, support and treatment for children and young people with complex needs (and behaviour that challenges) involving mental health problems and learning disabilities and/or autistic spectrum condition.