Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
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 7 February 2024 to Question 12362 on Operating Theatres: Fires, how (a) her Department and (b) NHS England defines the most serious surgical fires and burns; what steps she is taking to ensure the mandatory reporting of such (i) fires and (ii) burns; and how many such (A) fires and (B) burns have been reported by NHS England in each of the last five years.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This can include surgical fires or burns. We are informed that NHS England does not define the severity of harm related to surgical fires or burns specifically. Grading the severity of harm related to a patient safety incident that is recorded on LFPSE, should be done using NHS England’s guidance on recording patient safety events and levels of harm, which asks that near miss events be graded as no harm. The guidance is available at the following link:
If a surgical fire or burn is assessed locally and constitutes a patient safety event, it would fall under the scope of the Care Quality Commission’s (CQC) Regulations 16 or 18, and must be reported to the CQC. This means that the most serious surgical fires or burns which result in serious harm or the death of a service user, are subject to mandatory reporting. NHS trusts can comply with this requirement by recording patient safety events using the LFPSE service, and NHS England shares all such data with the CQC, who are responsible for regulating compliance with CQC regulations. CQC Regulations 16 and 18 are available respectively, at the following links:
https://www.cqc.org.uk/guidance-providers/regulations/regulation-16-notification-death-service-user
Although the recording of wider patient safety events onto LFPSE is a voluntary process, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.
The LFPSE service and its predecessor, the National Reporting and Learning System, do not have specific categories for surgical fires or burns. Determining how many patient safety events related to surgical fires or burns were recorded by National Health Service providers in each of the last five years would require a search of the free text of recorded patient safety events, using key words, and a subsequent expert clinical review of all potential records to determine relevance to the question. This could only be provided at disproportionate cost.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how (a) her Department and (b) NHS England define the severity of (i) a surgical fire, (ii) a surgical burn and (iii) a near miss related to a surgical fire or burn.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This can include surgical fires or burns. We are informed that NHS England does not define the severity of harm related to surgical fires or burns specifically. Grading the severity of harm related to a patient safety incident that is recorded on LFPSE, should be done using NHS England’s guidance on recording patient safety events and levels of harm, which asks that near miss events be graded as no harm. The guidance is available at the following link:
If a surgical fire or burn is assessed locally and constitutes a patient safety event, it would fall under the scope of the Care Quality Commission’s (CQC) Regulations 16 or 18, and must be reported to the CQC. This means that the most serious surgical fires or burns which result in serious harm or the death of a service user, are subject to mandatory reporting. NHS trusts can comply with this requirement by recording patient safety events using the LFPSE service, and NHS England shares all such data with the CQC, who are responsible for regulating compliance with CQC regulations. CQC Regulations 16 and 18 are available respectively, at the following links:
https://www.cqc.org.uk/guidance-providers/regulations/regulation-16-notification-death-service-user
Although the recording of wider patient safety events onto LFPSE is a voluntary process, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.
The LFPSE service and its predecessor, the National Reporting and Learning System, do not have specific categories for surgical fires or burns. Determining how many patient safety events related to surgical fires or burns were recorded by National Health Service providers in each of the last five years would require a search of the free text of recorded patient safety events, using key words, and a subsequent expert clinical review of all potential records to determine relevance to the question. This could only be provided at disproportionate cost.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how her Department records instances of near misses for (a) surgical fires and (b) other patient safety incidences.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This can include surgical fires or burns. We are informed that NHS England does not define the severity of harm related to surgical fires or burns specifically. Grading the severity of harm related to a patient safety incident that is recorded on LFPSE, should be done using NHS England’s guidance on recording patient safety events and levels of harm, which asks that near miss events be graded as no harm. The guidance is available at the following link:
If a surgical fire or burn is assessed locally and constitutes a patient safety event, it would fall under the scope of the Care Quality Commission’s (CQC) Regulations 16 or 18, and must be reported to the CQC. This means that the most serious surgical fires or burns which result in serious harm or the death of a service user, are subject to mandatory reporting. NHS trusts can comply with this requirement by recording patient safety events using the LFPSE service, and NHS England shares all such data with the CQC, who are responsible for regulating compliance with CQC regulations. CQC Regulations 16 and 18 are available respectively, at the following links:
https://www.cqc.org.uk/guidance-providers/regulations/regulation-16-notification-death-service-user
Although the recording of wider patient safety events onto LFPSE is a voluntary process, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.
The LFPSE service and its predecessor, the National Reporting and Learning System, do not have specific categories for surgical fires or burns. Determining how many patient safety events related to surgical fires or burns were recorded by National Health Service providers in each of the last five years would require a search of the free text of recorded patient safety events, using key words, and a subsequent expert clinical review of all potential records to determine relevance to the question. This could only be provided at disproportionate cost.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure that people with lower gastrointestinal cancers are diagnosed in line with the faster diagnosis standard.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is taking steps to achieve the Faster Diagnosis Standard (FDS), which aims to ensure people with cancer or suspected cancer, including lower gastrointestinal (GI) cancers, are diagnosed or have cancer ruled out within 28 days of referral. The Department is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 related backlogs in elective care, which includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment.
To achieve the FDS target specifically, NHS England have implemented a timed pathway for lower GI cancer, by requiring faecal immunochemical testing (FIT) for patients in primary and secondary care settings on a suspected lower GI cancer pathway. FIT testing prevents patients from having unnecessary colonoscopies, freeing up capacity for these procedures, and ensuring the most urgent symptomatic patients are seen more quickly. Across 2022/2023, the proportion of lower GI referrals with a related FIT test rose from 24% to 69%.
NHS England is also implementing non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations of non-specific symptoms that can indicate several different cancers, including symptoms that may indicate lower GI cancers.
In addition, at the 2021 Spending Review the Government awarded £2.3 billion to transform diagnostic services from 2022 to 2025, most of which will help increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, prioritising CDCs for cancer services. General practice teams have also been given direct access to tests like computed tomography scans, magnetic resonance imaging, and ultrasounds helping to cut waiting times and speed up the diagnosis of, or ruling out of, cancer. This funding is also being used to expand endoscopy capacity within acute settings, and in CDCs.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve the rate of early diagnosis of (a) bowel and (b) bowel-related cancers.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is taking steps to improve the rate of early diagnosis for all cancers, including bowel and bowel-related cancers, and is working jointly with NHS England on implementing the delivery plan, for tackling the COVID-19 related backlogs in elective care. This includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment.
NHS England is working to meet the Faster Diagnosis Standard, which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out. To achieve this target NHS England has: streamlined bowel cancer pathways by implementing faecal immunochemical testing triage for patients in primary and secondary care settings on a suspected cancer pathway; implemented non-symptom specific pathways for patients who present with non-specific symptoms, or combinations of non-specific symptoms, that can indicate several different cancers; and has opened community diagnostic centres across England, expanding diagnostic capacity and by prioritising this capacity for cancer services.
In 2023 the NHS England’s Help Us Help You campaign urged people to take up the offer of bowel screening when invited, and the screening offer for the bowel screening programme is being gradually extended from age 60 down to 50 years old by 2025, ensuring more people are screened and potentially diagnosed with bowel cancer at the earliest stage. The National Health Service is also now offering routine preventative bowel cancer screening to thousands of people in England with a genetic condition, Lynch syndrome, that increases their chance of developing bowel cancer and other certain other cancers. This gives the NHS a better chance of finding cancers at a time when they can be more easily and effectively treated.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people in the UK are prescribed anti-depressants.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The most recent data was published on 6 July 2023 and can be found here NHS releases mental health medicines statistics for 2022/2023 in England (nhsbsa.nhs.uk)
Prescriptions do not state the purpose for which they are written, so there may be instances where these medicines are used for other conditions.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help ensure equality in bowel cancer outcomes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Health Service is taking several steps to improve bowel cancer outcomes for patients across England. The NHS is working towards its Long Term Plan’s ambition of diagnosing 75% of all stageable cancers at stage one and two, by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
In 2023, NHS England’s Help Us Help You campaign urged people to take up the offer of bowel screening when invited, while gradually extending the screening offer from those aged 60 down to 50 years old, ensuring more people are diagnosed with bowel cancer at the earliest stage.
The NHS is also now offering routine preventative bowel cancer screening to thousands of people in England with a genetic condition, Lynch syndrome, that increases their chance of developing bowel cancer and certain other cancers. This gives the NHS a better chance of finding cancers at a time when they can be more easily and effectively treated.
Tackling disparities is important in improving all types of cancer outcomes. The Government is committed to its levelling up mission, to narrow the gap in healthy life expectancy by 2030 and increase healthy life expectancy by five years by 2035. Our approach will continue to focus on supporting people to live healthier lives, helping the NHS and social care provide the best treatment and care for patients, and tackling health disparities through national and system interventions such as the NHS’s Core20PLUS5 programme.
The Office for Health Improvement and Disparities was set up to address health inequalities with a range of interventions, including accelerating prevention programmes, reducing digital exclusion, supporting general practice in deprived communities, and improving health literacy.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to increase the number of patients with lower gastrointestinal cancers who receive their first treatment within 62 days of being urgently referred by their GP.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is taking steps to reduce cancer treatment waiting times across England, including the time between an urgent general practice referral and the commencement of treatment for cancer for patients. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 related backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment. Interventions include a pathway re-design to maximise capacity, including comprehensive faecal immunochemical test implementation to detect lower gastrointestinal cancers faster.
In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.
Additionally, the Government published the Major Conditions Strategy Case for Change and Our Strategic Framework on 14 August 2023, which sets out our approach to making the choices over the next five years that will deliver the most value in facing the health challenges of today, and of the decades ahead, including for cancer.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how long her Department has been aware of issues associated with health technology appraisal of combination medicines for blood cancers; and whether her Department is giving additional resources to (a) NICE and (b) NHS England to tackle those issues.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Competition and Markets Authority (CMA) published a statement in November 2023 that clarifies the circumstances under which it will not prioritise enforcement action against drug firms when they implement a specific negotiation framework, to make more combination therapies available on the National Health Service. The statement is available at the following link:
https://www.gov.uk/government/publications/combination-therapies-prioritisation-statement
In the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to launching a consultation on updating the NHS England Commercial Framework for New Medicines, by July of this year. This consultation will reflect the CMA’s statement, and will be used to consider options for transacting a solution for some combination therapies, under specific circumstances.
The National Institute for Health and Care Excellence (NICE) also gave specific consideration to the evaluation of combination therapies in the comprehensive review of its methods and processes for health technology evaluation, that concluded in January 2022. The NICE’s published health technology evaluation manual describes the considerations that will be given to the evaluation of combination therapies where relevant.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to support (a) NICE and (b) NHS England to apply flexibility to appraisal of combination medicines; and whether flexibility will be applied in NICE appraisals for multiple myeloma.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Competition and Markets Authority (CMA) published a statement in November 2023 that clarifies the circumstances under which it will not prioritise enforcement action against drug firms when they implement a specific negotiation framework, to make more combination therapies available on the National Health Service. The statement is available at the following link:
https://www.gov.uk/government/publications/combination-therapies-prioritisation-statement
In the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to launching a consultation on updating the NHS England Commercial Framework for New Medicines, by July of this year. This consultation will reflect the CMA’s statement, and will be used to consider options for transacting a solution for some combination therapies, under specific circumstances.
The National Institute for Health and Care Excellence (NICE) also gave specific consideration to the evaluation of combination therapies in the comprehensive review of its methods and processes for health technology evaluation, that concluded in January 2022. The NICE’s published health technology evaluation manual describes the considerations that will be given to the evaluation of combination therapies where relevant.