Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how long her Department has been aware of issues associated with health technology appraisal of combination medicines for blood cancers; and whether her Department is giving additional resources to (a) NICE and (b) NHS England to tackle those issues.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Competition and Markets Authority (CMA) published a statement in November 2023 that clarifies the circumstances under which it will not prioritise enforcement action against drug firms when they implement a specific negotiation framework, to make more combination therapies available on the National Health Service. The statement is available at the following link:
https://www.gov.uk/government/publications/combination-therapies-prioritisation-statement
In the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to launching a consultation on updating the NHS England Commercial Framework for New Medicines, by July of this year. This consultation will reflect the CMA’s statement, and will be used to consider options for transacting a solution for some combination therapies, under specific circumstances.
The National Institute for Health and Care Excellence (NICE) also gave specific consideration to the evaluation of combination therapies in the comprehensive review of its methods and processes for health technology evaluation, that concluded in January 2022. The NICE’s published health technology evaluation manual describes the considerations that will be given to the evaluation of combination therapies where relevant.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help improve pancreatic cancer outcomes in York Central constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Working with NHS England, we are delivering a range of interventions that are expected to increase early diagnosis and improve outcomes for those with pancreatic cancer across England, including the York Central constituency. This includes providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer and diagnose cancers sooner; creating new pathways to support faster referral routes for people with non-specific symptoms that could be linked to a range of cancer types; and increasing direct access for general practitioners to diagnostic tests.
To increase early diagnosis, NHS England is implementing non-symptom specific pathways (NSS) for patients who present with non-specific symptoms, or combinations of non-specific symptoms, to receive the right tests at the right time. There are currently 113 NSS pathways live with the aim to have full national coverage by March 2024.
NHS England is also funding a new audit into pancreatic cancer, the aim of which is to provide regular and timely evidence to cancer service providers of where patterns of care in England may vary, to increase the consistency of access to treatments and to stimulate improvements in cancer treatment and outcomes for patients. The Royal College of Surgeons began work on this audit in October 2022 and a scoping exercise in consultation with key stakeholders has taken place to shape the direction of the audit. The first report is expected in October 2024.
In addition, the Getting It Right First Time team in NHS England is undertaking a deep dive into pancreatic cancer, which will highlight actions National Health Service providers need to take to improve services, as well as gathering examples of good practice to share.
To encourage people to see their general practitioner if they notice symptoms that could be cancer, NHS England runs the Help Us, Help You campaigns, which address the barriers that deter patients from accessing the National Health Service. In addition, the NHS has allocated £10 million to trial innovations that may support earlier and more efficient diagnosis, including a trial for the PinPoint blood test and a new genetic test that may be used as a liquid biopsy for those with suspected pancreatic cancer.
Asked by: Taiwo Owatemi (Labour - Coventry North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she plans to take to help ensure adequacy of funding for cancer research over the next ten years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Research is crucial in tackling cancer, which is why the Department invests over £1 billion per year in health research through the National Institute for Health Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23 and the NIHR spends more on cancer than any other disease group.
In terms of future funding, the NIHR funds research both in response to proposals received from scientists and by identifying areas, like brain cancer, where we want to see more research. It is not usual practice to ring-fence funds for particular topics or conditions. All research applications are subject to peer review and judged in open competition.
Future investment in research and innovation is a priority for the Government. We know developments in areas including genomics and artificial intelligence have the potential to transform the experience of cancer, informed by research. The United Kingdom, with its extensive experience of delivering innovative cancer trials, is well placed to integrate research and treatment for the benefit of cancer patients. Innovative trials such as the Galleri blood test and cancer vaccines are already ongoing, and we are investing in crucial research into new treatments, diagnostics, and medical technologies through the NIHR and research funding partners to transform the future of cancer.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to improve pancreatic cancer diagnosis in South Holland and The Deepings constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is working with NHS England to increase diagnosis of cancer, including pancreatic cancer, across England. This includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis, as set out in the Elective Recovery Plan published in February 2022. In addition, the Government awarded £2.3 billion at the 2021 Spending Review to transform diagnostic services over the next three years, most of which will help increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, prioritising CDCs for cancer services.
The National Health Service introduced the Faster Diagnosis Standard (FDS), which aims to ensure patients have cancer diagnosed or ruled out within 28 days of urgent suspected cancer referral from a general practice (GP) or screening services. To achieve the FDS target NHS England are implementing non symptom specific pathways (NSS) for patients who present with non-specific symptoms, or combinations of non-specific symptoms, to receive the right tests at the right time. There are currently 113 NSS pathways live, with the aim to have full national coverage by 2025.
To encourage people to see their GP if they notice symptoms that could be cancer, NHS England runs the Help Us, Help You campaigns, which address the barriers that deter patients from accessing the NHS. In addition, the NHS has allocated £10 million to trial innovations that may support earlier and more efficient diagnosis, including a trial for the PinPoint blood test and a new genetic test that may be used as a liquid biopsy for those with suspected pancreatic cancer.
Asked by: Peter Gibson (Conservative - Darlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to support the detection of liver disease in Darlington constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Northern Cancer Alliance (NCA) is supporting services to enable the early detection of liver disease across North East and North Cumbria Integrated Care Board (ICB). More than 80% of patients with liver cirrhosis, a type of liver disease, have been invited to monthly ultrasound surveillance. For 2024/25, the NCA has invested over £200k into trusts across the ICB to help improve their monitoring systems for cirrhosis patients. This investment has also included £30,000 for County Durham and Darlington NHS Foundation Trust who will be using their funds to improve systems in relation to call and recall of patients to their six-monthly checks.
The ICB is also enrolled in a Community Liver Health Check pilot in Newcastle, being delivered by the systems Hepatitis C Operational Delivery Networks. This will provide FibroScans in one stop community clinics where patients have relevant blood testing, liver ultrasound and other investigations as required. The pilot has expanded into North Tyneside and when resources allow, they intend to develop clinics elsewhere including Gateshead and Sunderland.
Asked by: Ian Byrne (Labour - Liverpool, West Derby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has plans to invest in diagnostic infrastructure for people with dementia.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
We committed in 2019 to double funding for dementia research to £160 million per year by 2024/25. This will span all areas of research from causes and prevention to treatment and care, delivering evidence to help prevent, diagnose and treat dementia, enabling the best possible care and quality of life for people with dementia.
NHS England is also working with partner agencies to support and inform further research into other diagnostic modalities, including blood-based biomarker and digital tests, which will help improve identification and management of Alzheimer’s disease.
The National Health Service is a world leader in rolling out innovative treatments, including personalised cancer and life-saving gene therapies, and has established a dedicated programme team to prepare the NHS for the potential arrival of new Alzheimer’s treatments that are approved by the Medicines and Healthcare products Regulatory Agency and determined to be clinically and cost-effective by the National Institute for Health and Care Excellence.
The team at NHS England are assessing the additional scanning, treating and monitoring capacity which would be required across the country. This includes securing additional diagnostic capacity including magnetic resonance imaging, lumbar puncture, and positron emission tomography and computed tomography.
Asked by: Andrew Gwynne (Labour - Denton and Reddish)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to NHS England's vaccination strategy, published on 13 December 2023, what guidance her Department plans to provide to Integrated Care Boards (ICBs) to ensure that vaccinators are trained to consider people with blood cancer who have received stem cell transplants when determining who has access to re-vaccination programmes, once ICBs become responsible for training vaccinators.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Eligibility for vaccination programmes is determined by the Joint Committee on Vaccination and Immunisation (JCVI) rather than the National Health Service or individual vaccinators. NHS England or JCVI may issue guidance on administering vaccines to certain groups and individuals including those who are immunocompromised. Training standards in vaccine administration will continue to be set by the UK Health Security Agency, and employers will be responsible for training their staff in accordance with these standards. In line with the vaccination strategy, NHS England will consider which national training and workforce management tools would support integrated care boards and employers to drive innovation in vaccination delivery including ways of supporting different eligible groups.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will formally respond to Cancer Research UK's publication entitled Longer, better lives: A manifesto for cancer research and care, published in November 2023; and if she will make it her policy to accept the recommendations contained in that document.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government welcomes the Cancer Research UK (CRUK) report, Longer, better lives: A manifesto for cancer research and care, which rightly highlights progress made in cancer diagnosis and care. The Department has not made a formal assessment of the recommendations, given the significant amount of work across the cancer programme led by NHS England and supported by the department.
Cancer is a Government and National Health Service priority, demonstrated by the commitment to the ambition of diagnosing 75% of cancers at Stages 1 and 2 by 2028. NHS England has implemented interventions to help achieve this ambition, such as non-specific symptom pathways, and will continue to seek new ways to diagnose cancer earlier and save more lives, for example through the NHS-Galleri blood test trial.
Furthermore, the Department has invested over £100 million into cancer research in 2021/22 through the National Institute for Health and Care Research (NIHR). In January 2023, CRUK, the NIHR and the devolved administrations jointly provided funding of £47.5 million to the Experimental Cancer Medicine Centre network over the next 5 years. The department is working closely with research partners in all sectors, and the Government's continued commitment to cancer research will help to build on that progress, leading to continued improvements for all cancer patients.
Asked by: Derek Twigg (Labour - Halton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has made an assessment of the implications for its policies of the proposals set out in Cancer Research UK's report entitled Longer, better lives: A manifesto for cancer research and care; and what plans she has to fund cancer research in the next 10 years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government welcomes Cancer Research UK’s report, which rightly highlights progress made in cancer diagnosis and care.
Cancer is a Government priority, demonstrated by the commitment to the ambition of diagnosing 75% of cancers at stages 1 and 2 by 2028. NHS England has implemented interventions to help achieve this ambition, such as Non-specific Symptom Pathways, and will continue to seek new ways to diagnose cancer earlier and save more lives, for example through the NHS-Galleri blood test trial.
Furthermore, the Department has invested over £100 million into cancer research in 2021/22 through the National Institute for Health and Care Research (NIHR). In January 2023, Cancer Research UK, NIHR and the devolved administrations jointly provided funding of £47.5 million to the Experimental Cancer Medicine Centre network over the next five years. The Department is working closely with research partners in all sectors, and the Government's continued commitment to cancer research will help to build on that progress, leading to continued improvements for all cancer patients.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken since the 2019 publication of 'Asymptomatic Inflammatory Bowel Disease and Colorectal Cancer Screening Programs' by Farrukh and Mayberry in Gastrointestinal Disorders in respect of its findings of differences and discrimination in the delivery of (1) colorectal screening in healthy people, and (2) care and surveillance of patients with inflammatory bowel disease.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
If someone is detected during bowel screening to have blood in their faeces, then found to have inflammatory bowel disease (IBD) through follow up tests they are referred to the symptomatic service for onward management and surveillance. They are then offered screening every two years along with ongoing monitoring and surveillance, the timeframes of which are detailed below.
The National Institute for Health and Care Excellence (NICE)’s guideline on colorectal cancer prevention was published in March 2011 and updated in September 2022. It recommends using colonoscopy to check for signs of bowel cancer in people aged 18 years old and over with ulcerative colitis or Crohn’s disease. The guidance recommends that follow-up and ongoing colonoscopic surveillance should be arranged at regular intervals for people with IBD and tubular adenoma as follows:
- Low risk: offer colonoscopy at five years;
- Intermediate risk: offer colonoscopy at three years; or
- High risk: offer colonoscopy at one year.
A copy of the guidance is attached.
We expect integrated care boards (ICBs) to have due regard to relevant NICE guidelines when commissioning services. It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, in line with these NICE guidelines.