Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many rheumatoid arthritis patients received a biologic in each of the last three years.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
This information is not collected in the format requested.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, If he will include metrics on the uptake of biologics for severe asthma in the update to the NHS Long Term Plan.
Answered by Gillian Keegan - Secretary of State for Education
The Department and NHS England are currently reviewing delivery of the commitments made in the NHS Long Term Plan, including those relating to respiratory outcomes. The update to the NHS Long Term Plan will be published later this year.
There are no current plans to include metrics measuring uptake of biologics in the NHS Long Term Plan update. However, pathways to biologic therapy are being streamlined, including through the Accelerated Access Collaborative’s work to improve the identification of patients in primary and secondary care settings for referrals to assess suitability to receive biologic treatment.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to amend the respiratory outcomes section in the update of the NHS Long Term Plan.
Answered by Gillian Keegan - Secretary of State for Education
The Department and NHS England are currently reviewing delivery of the commitments made in the NHS Long Term Plan, including those relating to respiratory outcomes. The update to the NHS Long Term Plan will be published later this year.
There are no current plans to include metrics measuring uptake of biologics in the NHS Long Term Plan update. However, pathways to biologic therapy are being streamlined, including through the Accelerated Access Collaborative’s work to improve the identification of patients in primary and secondary care settings for referrals to assess suitability to receive biologic treatment.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he has plans to include measures to promote an increase in treatment reviews of chronic obstructive pulmonary disease patients who are risk of exacerbation within CORE20+5.
Answered by James Morris
There are no plans to do so. However, Core20PLUS5 supports increasing the uptake of COVID-19, flu and pneumonia vaccines to reduce infective exacerbations and potential emergency hospital admissions.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent estimate he has made of the number of patients who have received all components of the discharge bundle included in the Best Practice Tariff for chronic obstructive pulmonary disease in the last 12 months.
Answered by James Morris
No specific estimate has been made. Compliance with the Best Practice Tariff criteria is measured by the National COPD Audit Programme’s secondary care audit.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he has plans to include incentives within the Quality and Outcomes Framework or Investment and Impact Fund to help ensure that chronic obstructive pulmonary disease (COPD) patients receive a proactive review of their care after a prescription of oral corticosteroid for a COPD exacerbation.
Answered by James Morris
We have no specific plans to do so. However, the Quality and Outcomes Framework and the Investment and Impact Fund are reviewed to ensure alignment with the latest clinical guidance and best practice.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what alternatives to oral corticosteroids treatment are available for asthma and COPD patients.
Answered by Gillian Keegan - Secretary of State for Education
While the National Institute of Health and Care Excellence’s (NICE) guideline ‘Asthma: diagnosis, monitoring and chronic asthma management’ does not specifically make recommendations on oral corticosteroids, NICE is working with the British Thoracic Society and the Scottish Intercollegiate Guidelines Network to produce United Kingdom-wide guidance to update and replace this guideline. Evidence on pharmacological management, including the use of oral corticosteroids, will be reviewed during this process.
The 2022/23 Quality and Outcomes Framework incentivises general practitioners to assess asthma control through a questionnaire, which records of the number of exacerbations, an assessment of inhaler technique and a written personalised action plan, to monitor potential over-prescribing. The Impact and Investment Fund currently contains two indicators which aim to improve the care of people with asthma, including recognising Primary Care Networks which reduce in the percentage of patients receiving six or more Short-Acting Beta Agonists (SABAs) prescriptions per year.
NICE’s guidelines for asthma and its guideline ‘Chronic obstructive pulmonary disease in over 16s: diagnosis and management’ recommend oral corticosteroids and alternatives. For adults with asthma, these include SABAs, leukotriene receptor antagonists and long-acting beta2 agonists. For chronic obstructive pulmonary disease (COPD), NICE recommends smoking cessation, SABAs and short-acting muscarinic antagonists, Theophylline tablets, oral mucolytic therapy, oral anti-oxidant therapy, oral anti-tussive therapy, oral prophylactic antibiotic therapy, long-term oxygen therapy, ambulatory oxygen therapy, short-burst oxygen therapy, non-invasive ventilation and pulmonary rehabilitation. NICE has also published technology appraisal guidance on biologics for those with severe asthma, such as Omalizumab for treating severe persistent allergic asthma.
No specific assessment has been made of the cost of caring for and treating adverse events in patients prescribed frequent or maintenance prescriptions of oral corticosteroids. However, in developing its guidelines, NICE has recommended a number of medicines for patients with severe asthma, such as mepolizumab, which considered the costs and benefits relating to a potential reduction in the use of corticosteroids.
NHS England and NHS Improvement’s Severe Asthma Collaborative is developing capacity in severe asthma centres to streamline patient pathways to biologic therapies and reduce variation in prescribing and patient management. A toolkit has been produced to support clinical teams.
The Royal College of General Practitioners’ guidance on long term condition recovery asks clinicians to consider all high-risk patients with COPD and asthma who have not received a review for more than 12 months and have been prescribed either three or more SABAs in the last 12 months; those aged five years old and over not on the asthma or COPD register who have received two or more courses of oral steroids in 12 months; and those on the asthma or COPD register to be prioritised for review.
Asked by: Yvonne Fovargue (Labour - Makerfield)
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 encourage primary care clinicians to monitor potential over-prescribing of oral corticosteroids.
Answered by Gillian Keegan - Secretary of State for Education
While the National Institute of Health and Care Excellence’s (NICE) guideline ‘Asthma: diagnosis, monitoring and chronic asthma management’ does not specifically make recommendations on oral corticosteroids, NICE is working with the British Thoracic Society and the Scottish Intercollegiate Guidelines Network to produce United Kingdom-wide guidance to update and replace this guideline. Evidence on pharmacological management, including the use of oral corticosteroids, will be reviewed during this process.
The 2022/23 Quality and Outcomes Framework incentivises general practitioners to assess asthma control through a questionnaire, which records of the number of exacerbations, an assessment of inhaler technique and a written personalised action plan, to monitor potential over-prescribing. The Impact and Investment Fund currently contains two indicators which aim to improve the care of people with asthma, including recognising Primary Care Networks which reduce in the percentage of patients receiving six or more Short-Acting Beta Agonists (SABAs) prescriptions per year.
NICE’s guidelines for asthma and its guideline ‘Chronic obstructive pulmonary disease in over 16s: diagnosis and management’ recommend oral corticosteroids and alternatives. For adults with asthma, these include SABAs, leukotriene receptor antagonists and long-acting beta2 agonists. For chronic obstructive pulmonary disease (COPD), NICE recommends smoking cessation, SABAs and short-acting muscarinic antagonists, Theophylline tablets, oral mucolytic therapy, oral anti-oxidant therapy, oral anti-tussive therapy, oral prophylactic antibiotic therapy, long-term oxygen therapy, ambulatory oxygen therapy, short-burst oxygen therapy, non-invasive ventilation and pulmonary rehabilitation. NICE has also published technology appraisal guidance on biologics for those with severe asthma, such as Omalizumab for treating severe persistent allergic asthma.
No specific assessment has been made of the cost of caring for and treating adverse events in patients prescribed frequent or maintenance prescriptions of oral corticosteroids. However, in developing its guidelines, NICE has recommended a number of medicines for patients with severe asthma, such as mepolizumab, which considered the costs and benefits relating to a potential reduction in the use of corticosteroids.
NHS England and NHS Improvement’s Severe Asthma Collaborative is developing capacity in severe asthma centres to streamline patient pathways to biologic therapies and reduce variation in prescribing and patient management. A toolkit has been produced to support clinical teams.
The Royal College of General Practitioners’ guidance on long term condition recovery asks clinicians to consider all high-risk patients with COPD and asthma who have not received a review for more than 12 months and have been prescribed either three or more SABAs in the last 12 months; those aged five years old and over not on the asthma or COPD register who have received two or more courses of oral steroids in 12 months; and those on the asthma or COPD register to be prioritised for review.
Asked by: Yvonne Fovargue (Labour - Makerfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will make recurrent oral corticosteroids prescriptions from primary care a trigger for referral to secondary or tertiary care for asthma patients.
Answered by Gillian Keegan - Secretary of State for Education
While the National Institute of Health and Care Excellence’s (NICE) guideline ‘Asthma: diagnosis, monitoring and chronic asthma management’ does not specifically make recommendations on oral corticosteroids, NICE is working with the British Thoracic Society and the Scottish Intercollegiate Guidelines Network to produce United Kingdom-wide guidance to update and replace this guideline. Evidence on pharmacological management, including the use of oral corticosteroids, will be reviewed during this process.
The 2022/23 Quality and Outcomes Framework incentivises general practitioners to assess asthma control through a questionnaire, which records of the number of exacerbations, an assessment of inhaler technique and a written personalised action plan, to monitor potential over-prescribing. The Impact and Investment Fund currently contains two indicators which aim to improve the care of people with asthma, including recognising Primary Care Networks which reduce in the percentage of patients receiving six or more Short-Acting Beta Agonists (SABAs) prescriptions per year.
NICE’s guidelines for asthma and its guideline ‘Chronic obstructive pulmonary disease in over 16s: diagnosis and management’ recommend oral corticosteroids and alternatives. For adults with asthma, these include SABAs, leukotriene receptor antagonists and long-acting beta2 agonists. For chronic obstructive pulmonary disease (COPD), NICE recommends smoking cessation, SABAs and short-acting muscarinic antagonists, Theophylline tablets, oral mucolytic therapy, oral anti-oxidant therapy, oral anti-tussive therapy, oral prophylactic antibiotic therapy, long-term oxygen therapy, ambulatory oxygen therapy, short-burst oxygen therapy, non-invasive ventilation and pulmonary rehabilitation. NICE has also published technology appraisal guidance on biologics for those with severe asthma, such as Omalizumab for treating severe persistent allergic asthma.
No specific assessment has been made of the cost of caring for and treating adverse events in patients prescribed frequent or maintenance prescriptions of oral corticosteroids. However, in developing its guidelines, NICE has recommended a number of medicines for patients with severe asthma, such as mepolizumab, which considered the costs and benefits relating to a potential reduction in the use of corticosteroids.
NHS England and NHS Improvement’s Severe Asthma Collaborative is developing capacity in severe asthma centres to streamline patient pathways to biologic therapies and reduce variation in prescribing and patient management. A toolkit has been produced to support clinical teams.
The Royal College of General Practitioners’ guidance on long term condition recovery asks clinicians to consider all high-risk patients with COPD and asthma who have not received a review for more than 12 months and have been prescribed either three or more SABAs in the last 12 months; those aged five years old and over not on the asthma or COPD register who have received two or more courses of oral steroids in 12 months; and those on the asthma or COPD register to be prioritised for review.
Asked by: Yvonne Fovargue (Labour - Makerfield)
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 the effectiveness of home administration of biologics for severe asthma; and whether he has plans to extend that treatment.
Answered by Gillian Keegan - Secretary of State for Education
The NHS England and NHS Improvement Accelerated Access Collaborative (AAC) on Improving Access to Biologic Therapy estimates that approximately 200,000 or 5% of patients with asthma have severe asthma. Of these patients, the AAC estimates that between 50,000 to 100,000 may be eligible for biologic therapy, with approximately 11,000 patients receiving this treatment. The AAC aims to improve the identification of these patients in primary and secondary care settings, to allow referrals to specialist severe asthma centres to determine their suitability for biologic treatment.
No specific estimate of the number of patients awaiting an appointment at a severe asthma centre has been made as this information is not collected in the format requested. No specific assessment has been made of the effectiveness of home administration of biologics for severe asthma. The National Institute for Health and Care Excellence’s COVID-19 rapid guideline on severe asthma promoted the use of home administration for biologic treatments to maintain access and reduce risks to patients of COVID-19 exposure. While we are ensuring that patients who are eligible for this treatment are able to access it, there are no plans to extend the eligibility criteria.