Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what recent assessment his Department has made of the appropriate frequency with which people with pernicious anaemia should receive vitamin B12 replacement injections; what the guidelines are for GPs on granting requests by individual patients for injections to be administered more frequently than prescribed; and if he will make a statement.

Pernicious anaemia is a particular type of anaemia caused by lack of vitamin B12. When pernicious anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners (GPs). It is for clinicians, not the Department, to specify regimes of clinical care.

The Department has made no specific assessment of the benefits of allowing easier access to vitamin B12. Any patients with pernicious anaemia who have concerns about their treatment should discuss this matter with their GP.

The treatment of pernicious anaemia is well established and reported in the British Committee for Standards in Haematology (BCSH) document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders, which was updated in May 2014. The BCSH operates independently of Department and NHS England. Cobalamin status is the recommended first line diagnostic test and is widely available. The guidance states that the clinical picture is the most important factor in assessing the significance of the test results. The guidelines can be found at the following link: www.bcshguidelines.com

Current clinical practice within the United Kingdom is to treat pernicious anaemia with Vitamin B12 intramuscular injections. The BCSH produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom.