Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what guidance his Department gives to clinical commissioning groups on commissioning breast cancer services.

The majority of treatments for cancer such as radiotherapy and chemotherapy (for all cancers), and services for rarer cancers are commissioned nationally by NHS England. Commissioning is informed by a range of clinical reference groups established as a primary source of advice on best practice, service standards for commissioned providers, and forward strategy and innovation.

National Institute for Health and Care Excellence (NICE) quality standards define clinical best practice for the diagnosis and treatment of breast cancer to help clinicians ensure that patients are given information about the treatment options available and help in choosing the best option to suit them.

The Health and Social Care Act (2012) places a duty on NHS England to have regard to NICE quality standards. NHS England would expect clinical commissioning groups (CCGs) to take into account NICE quality standards when commissioning breast cancer services.

No assessment has been made of the performance of services against the breast cancer quality standard. However, compliance with quality standards generally could be monitored through a range of mechanisms depending on the specific quality standard, for example, the 30 national clinical audits funded by NHS England, the Best Practice Tariff, Commissioning for Quality Improvement Initiatives arrangements and the CCG Outcome Indicator Set. These levers are designed to drive quality improvement in the National Health Service using quality standards where appropriate. NHS England's National Clinical Directors actively promote existing NICE quality standards.

At the request of NHS England, the Healthcare Quality Improvement Partnership will shortly begin commissioning a new national breast cancer clinical audit. There is an expectation that national clinical audits, where appropriate, support the implementation of NICE clinical guidelines and quality standards. The new national clinical audit will be in place by the end of 2014-15.