Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether specialist multidisciplinary teams and designated centres of excellence will be given clear guidance and authority to prescribe off-label treatments supported by genomic evidence and aligned with patient preference for patients with rare cancers.

The Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (NICE) are working to deliver the Government’s ambitions, as set out in the 10-Year Health Plan for England and the Life Sciences Sector Plan, to streamline regulation and market access. This closer collaboration will enable parallel decisions on licensing and value, reducing time to patient access by three to six months.

NICE’s established health technology appraisal processes allow a range of evidence to be considered, and tumour‑agnostic therapies such as pembrolizumab, reference code TA914, have already been licensed and recommended for National Health Service patients. Further treatments are expected to progress through aligned MHRA and NICE pathways.

The Department has commissioned the Royal College of Radiologists to review multidisciplinary team (MDT) working, focusing on practical actions to improve efficiency and speed access to treatment. The review will report in summer 2026, with new guidance to follow in spring 2027.

To improve outcomes for people with rare cancers, Cancer Alliances will assess variation in treatment pathways, including access to specialist MDTs, to support more consistent care and greater use of expertise in centres of excellence. Prescribers remain responsible for treatment decisions, working with patients and using relevant evidence and guidance. Clinicians may prescribe medicines off‑label where this is in the patient’s best interests and subject to local NHS funding arrangements.