Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what plans he has to nationally commission (a) minor ailments services and (b) minor eye conditions services.
Answered by George Freeman
There are no plans to commission either service at a national level. Those with a minor ailment may visit a pharmacy, walk in centre or practice nurse for treatment and those concerned they may have a minor eye condition can visit their general practitioner, optical practice or pharmacy.
Services for minor ailments are commissioned by clinical commissioning groups who are also able to commission services from local optometrists to provide treatment for minor eye conditions. This ensures that services are commissioned to reflect local need.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how he plans to ensure that an additional 20,000 patients a year will have their cancers genetically tested as part of the Government's Cancer Taskforce strategy; and what data he plans to collect on those people who are tested.
Answered by Jane Ellison
The independent Cancer Taskforce recognised the need for more accessible molecular diagnostic provision in its report, Achieving World-Class Cancer Outcomes: A Strategy for England 2015-2020, published in July 2015.
Following this, in September 2015, we confirmed a commitment from NHS England to implement the recommendations on molecular diagnostics. This will mean that around 25,000 additional people a year will have their cancers genetically tested to identify the most effective treatments. NHS England is currently working with partners across the healthcare system to produce an implementation plan to determine how best to take forward the Taskforce’s recommendations.
Regional Genetic Laboratories are central to all NHS Genomic Medicine Centres and have been the focal point for adoption of genomic technologies into healthcare for over 40 years. These laboratories are currently the focus of an NHS England Specialised Commissioning intended re-procurement exercise, the invitation to tender for which is due to be launched towards the end of the year. The re-procurement aims to create a new genomic laboratory infrastructure for the National Health Service in England based on centralised and local genomic laboratory hubs to support rare, inherited and acquired disease, as well as the future personalised medicine requirements inclusive of molecular diagnostics in stratified medicine.
In September 2015, the NHS England Board approved the development of a Personalised Medicine Strategy for the NHS, to be discussed at the NHS England Board in the summer.
This work will build on the 100,000 Genomes Project, in which the NHS is a key delivery partner. The Project will sequence whole genomes from eligible patients with rare diseases and cancers. It is moving the NHS to a new model of diagnosis and treatment based on understanding of underlying genetic causes and drivers of disease and a comprehensive phenotypic characterisation of the disease (rather than deduction from symptoms and individual diagnostic tests). This will be critical in guiding the approach to molecular diagnostics.
In addition, changes to the section 118 guidance implemented in the national tariff payment system for molecular diagnostics from April will support clinical change and practice. This includes a number of molecular diagnostic tests to be funded separately by commissioners for the first three years before being incorporated into national prices for treatment episodes.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when the UK Genetics Testing Network plans to update its data on UK molecular genetic test activity rates.
Answered by George Freeman
The UK Genetic Testing Network has been working closely with the Health and Social Care Information Centre (HSCIC) and NHS England to re-establish the national data collection for molecular genetic test activity rates. They are in the final stages of implementing a HSCIC national dataset and collection process for United Kingdom data. Data collection is expected to have been completed by the summer of 2016 with a full update prepared by the end of the year.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many women were tested for the BRCA1/2 gene mutation in each of the last five years.
Answered by George Freeman
NHS England offers BRCA testing to individuals with a greater than 10% chance of carrying the mutation, using a model based on the individual’s personal and family history of cancers. Data is not collected centrally on reasons for women choosing to take a test for the BRCA1/2 gene mutation.
The UK Genetic Testing Network is working with NHS England, the devolved administrations and the Health and Social Care Information Centre to collect and publish United Kingdom-wide data on molecular genetic testing activity. Data collection is expected to have been completed by the summer of 2016 with a full update prepared for publication by the end of the year. However, it is not intended that this will include specific data for BRCA1 and BRCA2 mutation testing activity.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what information his Department holds on the reasons for women choosing to take a test for the BRCA1/2 gene mutation.
Answered by George Freeman
NHS England offers BRCA testing to individuals with a greater than 10% chance of carrying the mutation, using a model based on the individual’s personal and family history of cancers. Data is not collected centrally on reasons for women choosing to take a test for the BRCA1/2 gene mutation.
The UK Genetic Testing Network is working with NHS England, the devolved administrations and the Health and Social Care Information Centre to collect and publish United Kingdom-wide data on molecular genetic testing activity. Data collection is expected to have been completed by the summer of 2016 with a full update prepared for publication by the end of the year. However, it is not intended that this will include specific data for BRCA1 and BRCA2 mutation testing activity.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when the UK Genetics Testing Network plans to conduct an evaluation of genetic testing for BRCA1/2 mutations.
Answered by George Freeman
NHS England offers BRCA testing to individuals with a greater than 10% chance of carrying the mutation, using a model based on the individual’s personal and family history of cancers. Data is not collected centrally on reasons for women choosing to take a test for the BRCA1/2 gene mutation.
The UK Genetic Testing Network is working with NHS England, the devolved administrations and the Health and Social Care Information Centre to collect and publish United Kingdom-wide data on molecular genetic testing activity. Data collection is expected to have been completed by the summer of 2016 with a full update prepared for publication by the end of the year. However, it is not intended that this will include specific data for BRCA1 and BRCA2 mutation testing activity.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will place in the Library a list of all public appointments made by his Department between 1 January 2015 and 1 May 2015.
Answered by Jane Ellison
Under the Code of Practice for Ministerial Appointments to Public Bodies April 2012, government departments are required to publicise successful appointments. Public Appointments made by the Department of Health are published at:
https://www.gov.uk/government/publications/dh-non-executive-appointments
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many instances of Stevens-Johnson Syndrome and toxic epidermal necrolysis have been reported in each of the last five years; and in how many of those cases were (a) paracetamol, (b) codeine and (c) other drugs were assessed to be the cause.
Answered by George Freeman
Reports of suspected adverse drug reactions (ADRs) are collected by the Medicines and Healthcare products Regulatory Agency (MHRA) and Commission for Human Medicines (CHM) through the spontaneous reporting scheme; the Yellow Card Scheme. The scheme collects ADR reports from across the United Kingdom on all medicines, including those from prescriptions, over-the-counter or general retail sales. Reports are also received for herbal medicines and other unlicensed medicines. Reporting to the Yellow Card Scheme is voluntary for healthcare professionals and members of the public, there is also a legal obligation for pharmaceutical companies to report all serious ADRs for their products that they are made aware of.
There is an unknown and variable level of under-reporting to the Yellow Card Scheme meaning that data collected cannot be used to calculate incidence. We are unable to calculate this because neither the total number of reactions occurring in the population, nor the number of patients using the drug is known.
Up to 22 June 2015, the MHRA has received a total of 262 UK spontaneous suspected ADR reports of Stevens-Johnson Syndrome (SJS) and 135 UK spontaneous suspected ADR reports of Toxic Epidermal Necrolysis (TEN) between 1 January 2011 and 31 December 2014.
The table below shows the total number of UK spontaneous Stevens-Johnson Syndrome ADR reports received by the MHRA between 1 January 2011- 22 June 2015 associated with paracetamol, codeine and all other drugs.
Year | Paracetamol | Codeine | Other drugs not containing paracetamol or codeine |
2011 | 0 | 0 | 50 |
2012 | 3 | 0 | 50 |
2013 | 0 | 0 | 68 |
2014 | 0 | 0 | 65 |
2015 | 0 | 0 | 26 |
The table below shows the total number of UK spontaneous Toxic Epidermal Necrolysis ADR reports received by the MHRA between 1 January 2011- 22 June 2015 associated with paracetamol, codeine and all other drugs.
Year | Paracetamol | Codeine | Other drugs not containing paracetamol or codeine |
2011 | 0 | 0 | 19 |
2012 | 0 | 0 | 43 |
2013 | 1* | 1* | 26 |
2014 | 0 | 1 | 36 |
2015 | 0 | 0 | 9 |
*Refers to a case with co-codamol, so appears in both columns
It is important to note that Yellow Card reports are not proof of a side effect occurring but only a suspicion by the reporter that the medicine may have caused the side effect. Yellow Card reports may therefore relate to true side effects of the medicine, or they may be due to coincidental illnesses that would have occurred in the absence of medicine.
Asked by: Margaret Hodge (Labour - Barking)
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 NHS staff are aware of the symptoms and treatment of Stevens-Johnson Syndrome and toxic epidermal necrolysis.
Answered by George Freeman
There are between 6,000 and 8,000 recognised rare diseases and an estimated 1 in 17 people will be affected by a rare disease at some point in their lifetime. The Government continues to work hard to raise awareness of, and take action on, rare diseases.
In 2013, the Department published the UK Strategy for Rare Diseases. As part of its implementation, the Department has funded the production of two videos on rare diseases, the first from the viewpoint of the patient and their family and the second directed at healthcare professionals. The videos can be viewed on the Department’s website at:
https://www.gov.uk/government/collections/rare-diseases
The Deputy Chief Medical Officer for England, Dr Gina Radford, a rare disease champion, raises the profile of rare diseases and their importance in healthcare planning. The Department is also working with Public Health England which is leading the establishment of the first UK Rare Disorders Register. This will eventually register all cases of rare disease in the United Kingdom.
British National Formulary publishes guidance on Stevens Johnson Syndrome, including details of specific genetic testing.
Asked by: Margaret Hodge (Labour - Barking)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the average waiting time in accident and emergency was (a) in Barking, Havering and Redbridge University Hospitals NHS Trust, (b) in Queen's Hospital, (c) in King George Hospital, (d) across London and (e) in England in each of the last four (i) quarters and (ii) years.
Answered by Jane Ellison
The National Health Service Health and Social Care Information Centre (HSCIC) Hospital Episode Statistics (HES) measure accident and emergency waiting times from arrival to assessment, treatment and departure. A table showing the mean and median waiting times for 2010-11 to 2013-14 and quarters 1 to 4 of 2013-14 is below. Data for individual hospital sites are not published.
Duration to Assessment | Duration to Treatment | Duration to Departure | |||||
Year | Mean (minutes) | Median (minutes) | Mean (minutes) | Median (minutes) | Mean (minutes) | Median (minutes) | |
Barking, Havering and Redbridge University Hospitals NHS Trust | 2010-11 | 37.5 | 13 | 96.3 | 88 | 195.1 | 188 |
2011-12 | 21.7 | 14 | 98.6 | 90 | 198.6 | 188 | |
2012-13 | 19.7 | 13 | 100.2 | 90 | 201.6 | 186 | |
2013-14 | 21.5 | 14 | 93.8 | 83 | 196.6 | 182 | |
Quarter 1 2013-14 | 21.7 | 14 | 96.9 | 85 | 195.0 | 180 | |
Quarter 2 2013-14 | 21.2 | 14 | 92.0 | 82 | 186.5 | 177 | |
Quarter 3 2013-14 | 20.6 | 14 | 87.4 | 76 | 197.4 | 181 | |
Quarter 4 2013-14 | 22.6 | 15 | 98.5 | 88 | 207.6 | 189 | |
London | 2010-11 | 89.8 | 11 | 143.6 | 86 | 161.6 | 152 |
2011-12 | 38.9 | 11 | 89.6 | 67 | 150.8 | 143 | |
2012-13 | 29.4 | 11 | 81.6 | 62 | 155.8 | 146 | |
2013-14 | 58.8 | 11 | 86.5 | 61 | 166.9 | 146 | |
Quarter 1 2013-14 | 53.9 | 11 | 88.1 | 63 | 163.1 | 145 | |
Quarter 2 2013-14 | 54.4 | 11 | 85.2 | 60 | 158.6 | 142 | |
Quarter 3 2013-14 | 60.2 | 12 | 84.6 | 60 | 168.8 | 146 | |
Quarter 4 2013-14 | 66.6 | 13 | 88.0 | 63 | 177.0 | 152 | |
England | 2010-11 | 64.5 | 10 | 98.4 | 58 | 145.7 | 130 |
2011-12 | 33.1 | 8 | 75.4 | 52 | 138.2 | 125 | |
2012-13 | 30.3 | 8 | 74.0 | 53 | 141.4 | 128 | |
2013-14 | 38.2 | 9 | 70.2 | 51 | 144.6 | 129 | |
Quarter 1 2013-14 | 35.7 | 9 | 70.8 | 52 | 143.2 | 127 | |
Quarter 2 2013-14 | 37.4 | 8 | 69.5 | 50 | 139.5 | 125 | |
Quarter 3 2013-14 | 39.3 | 8 | 69.3 | 50 | 145.5 | 130 | |
Quarter 4 2013-14 | 40.4 | 9 | 71.0 | 52 | 150.3 | 132 | |
Source: HES, HSCIC.
Notes:
1. Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.
2. Mean and Median: The mean (average) and median (middle in ranking when all values are sorted in order) duration in minutes to assessment, treatment or duration.
3. Duration to assessment: This is the total amount of time in minutes between the patients’ arrival and their initial assessment in the accident and emergency (A&E) department. This is calculated as the difference in time from arrival at A&E to the time when the patient is initially assessed.
4. Duration to treatment: This is the total amount of time in minutes between the patients’ arrival and the start of their treatment. This is calculated as the difference in time from arrival at A&E to the time when the patient began treatment.
5. Duration to departure: This is total amount of time spent in minutes in an A&E department. This is calculated as the difference in time from arrival at A&E to the time when the patient is discharged from A&E care. This includes being admitted to hospital, dying in the department, discharged with no follow up or discharged and referred to another specialist department.
6. London area: For years 2011-12 and 2012-13, this data covers all trusts within the London Strategic Health Authority. For 2013-14, all trusts located within the London Area Team are included.
7. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage and changes in NHS practice.