Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, if he will investigate the reasons why NHS England is instructing hospitals with patients presenting as clinically urgent to treat such patients with innovative radiotherapy at the hospital's financial risk while it decides whether to fund the patient; and if he will issue guidelines on how hospitals which have followed that instruction will receive reimbursement for such expenditure if NHS England subsequently refuses to fund the treatment.

University College Hospitals London (UCHL) did not apply to be a contracted provider of gamma knife services for NHS England. For this reason it has not been formally assessed against the service specification. The gamma knife referred to is owned and operated by Queen’s Square Radiotherapy Centre (QSRC) Ltd, a private company wholly owned by Medical Equipment Solutions Limited, in premises owned by UCLH under a commercial agreement with UCLH.

As the National Health Service was going through a major transition in 2013-14 it was decided at that time that there should be no new market entrants for stereotactic radiotherapy services. Therefore only existing commissioned providers were asked to identify the services that they considered themselves to be providing, and UCLH did not express an interest in respect to gamma knife treatment. QSRC Ltd is not an existing NHS England commissioned provider and therefore was not assessed against the service specification.

All patients need to be treated in accordance with the prescribed clinical pathways and in line with contractual agreements with providers. If providers treat outside the required contractual agreements then they do so at their own financial risk, and this is why NHS England instructs hospitals to this effect where no contractual arrangement is in place.