Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent discussions her Department has had with (a) BEIS, (b) NIHR and (c) the MHRA about the UK’s ability to host large multi-site clinical trials for dementia.
Answered by Neil O'Brien
The Department of Health and Social Care is working with the Department for Business, Energy and Industrial Strategy and the National Institute for Health and Care Research to support the delivery of the Dame Barbara Windsor Dementia Mission, led by the Office for Life Sciences. The Mission will accelerate the development of novel ‘precision’ treatments in neurodegeneration and increase the number of clinical trials, including large multi-site clinical trials. The Office for Life Sciences has had held initial discussions with the Medicines and Healthcare products Regulatory Agency on the Mission.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
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 health and care staff have the training required to support (a) people who are dying and (b) the families and friends of those people.
Answered by Neil O'Brien
I refer the hon. Member to the answer given to the hon. Member for West Ham (Ms Lyn Brown) on 26 July 2022 to Question UIN 38579.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to support increases in auscultation using a stethoscope in primary and community care settings to detect heart murmurs characteristic of heart valve disease.
Answered by Will Quince
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what services breathlessness clinics will provide to support the early detection of heart valve disease; and whether those clinics will refer patients for auscultation using a stethoscope in primary care or community diagnostic centres.
Answered by Will Quince
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to support the increased use of stethoscopes in (a) primary care settings and (b) CDCs for the detection of heart valve disease.
Answered by James Morris
NHS England has assessed that clinical auscultation using a stethoscope is insufficiently sensitive to identify the presence and clinical significance of heart valve disease. Clinicians are expected to consider the history of the patient and undertake an examination to ensure the appropriate test is requested, which would normally include auscultation of the heart, with other assessments such as blood pressure. While some community diagnostic centres may have facilities to examine patients, its aims are to provide diagnostics tests such as echocardiograms.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
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 tackle (a) the number of preventable deaths caused by heart valve disease and (b) the variation in quality of diagnostic services for CVDs.
Answered by James Morris
People with heart failure will be supported by multi-disciplinary teams in Primary Care Networks and greater access to echocardiography within community diagnostic centres (CDCs). This will improve the investigation of those with breathlessness and the early detection of heart failure and heart valve disease. NHS England is working with the British Heart Foundation to raise awareness of heart valve disease to ensure earlier diagnosis, enable patients to receive treatment and prevent avoidable deaths.
We have committed £2.3 billion to launch at least 100 CDCs by 2024/25, increase the volume of diagnostic activity and further reduce waiting times for patients with cardiovascular disease. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment to end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of how breathlessness clinics will support the (a) the detection of and (b) referral into CDCs for diagnosis of heart valve disease.
Answered by James Morris
People with heart failure will be supported by multi-disciplinary teams in Primary Care Networks and greater access to echocardiography within community diagnostic centres (CDCs). This will improve the investigation of those with breathlessness and the early detection of heart failure and heart valve disease. NHS England is working with the British Heart Foundation to raise awareness of heart valve disease to ensure earlier diagnosis, enable patients to receive treatment and prevent avoidable deaths.
We have committed £2.3 billion to launch at least 100 CDCs by 2024/25, increase the volume of diagnostic activity and further reduce waiting times for patients with cardiovascular disease. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment to end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Stickels June 2022 BMJ paper on aortic stenosis waiting times, what steps his Department plans to take to facilitate the conversion of SAVR to TAVI for aortic stenosis treatment for the purposes of expediting the recovery of the heart valve disease backlog.
Answered by James Morris
The National Institute for Health and Care Excellence (NICE) makes recommendations on interventions for aortic stenosis in its guideline ‘Heart valve disease presenting in adults: investigation and management’. It has no current plans to review or update this guideline. For adults unsuited to heart valve surgery, NHS England recommends transcatheter aortic valve implantation (TAVI) to treat aortic stenosis.
We have committed £2.3 billion to launch at least 100 community diagnostic centres by 2024/25 to increase diagnostic activity and reduce waiting times for patients with heart valve disease, such as aortic stenosis. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidence based, clinically led, whole pathway approach to improving prevention, diagnosis, treatment and end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the findings of the Stickels, June 2022 BMJ paper on recovering aortic stenosis waiting lists, whether his Department has plans to use those findings to inform best practice guidance on reducing mortality from that disease.
Answered by James Morris
The National Institute for Health and Care Excellence (NICE) makes recommendations on interventions for aortic stenosis in its guideline ‘Heart valve disease presenting in adults: investigation and management’. It has no current plans to review or update this guideline. For adults unsuited to heart valve surgery, NHS England recommends transcatheter aortic valve implantation (TAVI) to treat aortic stenosis.
We have committed £2.3 billion to launch at least 100 community diagnostic centres by 2024/25 to increase diagnostic activity and reduce waiting times for patients with heart valve disease, such as aortic stenosis. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidence based, clinically led, whole pathway approach to improving prevention, diagnosis, treatment and end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the adequacy of existing guidance to support the diagnosis and management of Huntington's disease.
Answered by James Morris
There are no national guidelines for the diagnosis and management of Huntingdon’s disease. The Department has made no assessment on the clinical guideline on care for people who have Huntington's disease. However, the neuropsychiatry service specification is in development, which when finalised, will outline the multi-disciplinary approach to caring for patients with complex neurological conditions including Huntington’s Disease who require specialised assessment and mental health support.
NHS England’s neuroscience transformation programme (NSTP) is developing a number of optimal pathways for neurology services which includes Huntington's disease. Following extensive stakeholder engagement, the NSTP is developing a new definition for ‘specialised’ neurology and a model for neurology services. This will make it easier for integrated care systems (ICSs) to reduce the inequalities of access and bring specialist knowledge and skills into the patient pathway much earlier. It will help speed up the process for initial diagnosis for patients and whenever specialist interventions are indicated along a patient journey, enable that to be made available closer to the patient rather than predominantly at the specialist centres.
The Government remains committed to achieving parity between mental and physical health services and to reducing mental health inequalities with investment in National Health Service mental health services continuing to increase from almost £11 billion in 2015/16 to £15 billion in 2021/22. While no assessment has been made for people with Huntington’s disease, there is work underway to review the Clinical Genomic Service Specification which includes the need to strengthen access to mental health support services. The revised specification will be subject to public consultation before receiving final approval. The NSTP includes developing optimal pathways for neurology services, which also includes common principles regarding access to appropriate timely mental health support.
In the last five years, the National Institute for Health and Care Research (NIHR) has funded two studies into Huntington’s disease with a total award value of £316,267 and supported the delivery of 39 studies relating to Huntington’s disease via the Clinical Research Network infrastructure. The Government has also committed to invest at least £375 million in neurodegenerative disease research over the next five years to fund projects into a range of diseases, including Huntington’s disease.