Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what discussions his Department has had with NHS England and relevant Integrated Care Boards on the funding of specialist orthotist posts required to deliver vacuum bell therapy at NHS pectus and chest wall surgical centres; and whether he has made an assessment of the potential impact on patient care of surgical services being available but non-surgical alternatives being unavailable.

The factors that determine whether a service is a prescribed specialised service are: the number of individuals who require the service; the cost of providing the service or facility; and the number of people able to provide the service or facility.

Vacuum bell therapy for pectus excavatum is not designated as a prescribed specialised service. Non surgical management of pectus excavatum is considered a pathway based intervention better managed through local medical pathways. Responsibility for commissioning therefore sits with integrated care boards (ICBs) rather than NHS England or the Department. There are no current plans to change this approach.

NHS England will continue to encourage ICBs to prioritise commissioning non surgical medical treatments for patients with pectus excavatum as part of an integrated pathway. In addition, through the National Institute for Health and Care Research, the Department is funding the RESTORE trial, which will inform future commissioning decisions in relation to surgery. More information on the RESTORE trial is available at the following link:

https://www.fundingawards.nihr.ac.uk/award/NIHR158749