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 encourage (a) clinical commissioning groups and (b) primary care clinicians to tackle variations in access to transcatheter aortic valve implantation procedures throughout England.

NHS England commissions transcatheter aortic valve implantation (TAVI) and has a published policy which is consistent with National Institute for Health and Care Excellence (NICE) guidance, and access to TAVI is increasing year on year since it was first commissioned by NHS England.

Whilst clinical commissioning groups (CCGs) do not commission TAVI, they do play a part in encouraging primary and secondary care services to increase rates of diagnosis for aortic stenosis and refer onwards for management as appropriate.

In addition, NHS England is working in collaboration with NHS Improvement’s Getting It Right First Time team on a range of topics including TAVI. The review will consider current and potential future demand, waiting times, and pathway optimisation. As part of this process, a clinical lead has been identified to head up a policy working group which will review NHS England’s current policy for TAVI commissioning, in light of a number of new randomised control trials and updated guidance from national and international bodies.

Furthermore, NICE has been asked to develop a guideline on the management of valvular heart disease which should increase awareness of these conditions, including aortic stenosis.