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Written Question
Cancer: Alcoholic Drinks
Monday 30th June 2025

Asked by: Cat Smith (Labour - Lancaster and Wyre)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the National Cancer Plan will place a priority on (a) recognising and (b) addressing the cancer risks associated with alcohol.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Alcohol has been identified as a causal factor in more than 200 medical conditions, including mouth, throat, stomach, liver and breast cancers. The Government is committed to reversing the trend on alcohol-specific deaths and shortening the amount of time people spend in ill-health related to due to alcohol-related harm.

Under our Health Mission, the Government is committed to prioritising preventative public health measures to support people to live longer, healthier lives. The Department will continue to work across Government to better understand how we can best reduce alcohol-related harms. Furthermore, the National Cancer Plan will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care- as well as prevention and research and innovation. The plan will build on the shift from sickness to prevention set out by the 10-Year Health Plan and will seek to reduce risk factors.

The United Kingdom Chief Medical Officers’ low-risk drinking guidelines state: “The risk of developing a range of health problems (including cancers of the mouth, throat and breast) increases the more you drink on a regular basis” and that “To keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis”. The low risk drinking guidelines are available at the following link:

https://assets.publishing.service.gov.uk/media/5a80b7ed40f0b623026951db/UK_CMOs__report.pdf


Written Question
Cancer: Screening
Monday 30th June 2025

Asked by: Adam Jogee (Labour - Newcastle-under-Lyme)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if his Department will support the (a) rollout and (b) expansion of testing for (i) hepatitis B, (ii) hepatitis C, (iii) HIV, (iv) other precursor conditions to less survivable cancers and (v) NHS England’s risk-stratified Community Liver Health Check programme.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Testing for hepatitis B, C, and HIV is available through a variety of routes including, primary care, sexual health services and targeted testing to reach groups most at risk of infections. NHS England’s opt-out testing programme operates at several emergency departments and tests all adults blood test for hepatitis B, C, and HIV, unless they opt out. NHS England is exploring whether funding can be identified to allow the programme to continue beyond the current financial year.

The Department supports testing for precursor conditions to less survivable cancers through several programmes. The NHS Cancer Programme works to detect more hepatocellular carcinomas, namely liver cancer, at an early stage. Six-monthly liver ultrasound surveillance for patients with cirrhosis or advanced fibrosis is carried out to identify liver cancers earlier. In 2025/26, community liver health checks will continue to be rolled out across 20 areas to identify patients with cirrhosis or advanced fibrosis.

To speed up diagnosis of cancer, a full roll-out of non-specific symptom pathways has been achieved in England. These introduce a diagnosis route for patients displaying symptoms not aligned to specific cancers. This programme has provided funding to Cancer Alliances in 2023/24 and in 2024/25 to invest in local liver surveillance programmes.


Written Question
Medical Records
Monday 30th June 2025

Asked by: Lord Kamall (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what are the Health Data Research UK projects that access NHS data where specific project independent review was not received from NHS England's Advisory Group for Data, and what is the current status of those projects.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has a Data Sharing Agreement, project identification code DARS-NIC-381078-Y9C5K, with a consortium of academic organisations in the United Kingdom for the purpose of the Health Data Research UK-led, British Heart Foundation Data Science Centre’s CVD-COVID-UK programme.

This agreement was put in place by NHS Digital prior to its merger with NHS England in 2023, and prior to the establishment of NHS England’s Advisory Group for Data (AGD). The AGD was informed of a Senior Information Risk Owner decision to approve an amendment to the agreement on 22 February 2024.

The agreement was subject to reviews by NHS Digital’s Independent Group Advising on the Release of Data (IGARD) on 25 June 2020, 23 July 2020, 15 October 2020, 3 December 2020, 25 February 2021, 29 July 2021, 29 July 2021, 5 May 2022, and 24 November 2022. It was also subject to advice from the Professional Advisory Group on 24 June 2020 and 28 July 2021.

The agreement allowed the data controllers under that agreement to approve access to National Health Service data for individual projects, subject to approval per project by the CVD-COVID-UK oversight committee, which included a representative of NHS Digital/NHS England. Individual projects were not reviewed by IGARD or the AGD.

Under the terms of the agreement, the CVD-COVID-UK oversight committee is required to maintain a list of projects undertaken under the agreement and provide a quarterly report to NHS Digital/NHS England. The following table lists the projects and their current status from the latest report provided in April 2025:

Secure Data Environment research project reference

Current project status

Project title

CCU001

Live - Data in Use

Investigating the effects of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on COVID-19 outcomes

CCU002

Live - Data in Use

SARS-CoV-2 infection and vaccination and the risk of vascular events

CCU003

Live - Data in Use

Direct and indirect effects of the COVID-19 pandemic in individuals with cardiovascular disease (CVD)

CCU004

Live - Data in Use

COVID-19 and CVD risk prediction

CCU005

Live - Data in Use

Data management and analysis methods

CCU007

Live - Data in Use

Impact of COVID-19 pandemic on heart disease patients undergoing cardiac surgery

CCU008

Completed

Evaluating impact of COVID-19 pandemic on the prevalence and management of risk factors

CCU010

Live - Data in Use

In people with CVD and COVID-19, what is the influence of multi-morbidity on risk of poorer outcomes?

CCU013

Live - Data in Use

High-throughput electronic health record phenotyping approaches

CCU014

Live - Data in Use

Assessing the impact of COVID-19 on clinical pathways using a medicines approach

CCU018

Live - Data in Use

COVID-19 infection during pregnancy on CVD and related risk factors

CCU019

Live - Data in Use

Identification and personalised risk prediction for severe COVID-19 in patients with rare disorders impacting cardiovascular health

CCU020

Completed

Evaluation of antithrombotic use and COVID-19 outcomes

CCU022

Live - Data in Use

Genomics of multimorbidity and CVD associated with susceptibility to COVID-19 infection and complications

CCU023

Live - Data in Use

Repurposing medicines used to treat CVD risk to prevent COVID-19

CCU024

Completed

CovPall-Connect. Evaluation of how palliative and end of life care teams have responded to COVID-19: Connecting to boost impact and data assets

CCU028

Live - Data in Use

Coronary revascularisation and outcomes before and after the COVID-19 pandemic

CCU029

Live - Data in Use

Child hospital admission with COVID-19: risk factors; risk groups; and NHS care utilisation

CCU030

Live - Data in Use

Examining potential factors underlying the increased risk of severe COVID-19 experienced by people with intellectual and developmental disabilities

CCU032

Live - Data in Use

The effects of COVID-19 on heart failure subtypes

CCU035

Completed

Are people with COVID-19 and pre-existing respiratory disease at a higher risk of future cardiovascular and venous thromboembolic events compared with COVID-19 patients without pre-existing respiratory disease?

CCU036

Live - Data in Use

The impact of previous exposure to COVID-19 and the safety of COVID-19 vaccination for fertility and pregnancy outcomes

CCU037

Live - Data in Use

Improving methods to minimise bias in ethnicity data for more representative and generalisable models, using CVD in COVID-19 as an example

CCU038

Live - Data in Use

Evaluating the impact of COVID-19 on critical care outcomes

CCU040

Completed

Investigating why some people with diabetes have a greater risk of becoming seriously unwell or dying with COVID-19

CCU043

Live - Data in Use

Investigating new onset diabetes following COVID-19 infection

CCU045

Live - Data in Use

The impact of COVID-19 on heart failure epidemiology, quality of care and outcomes across primary and secondary care

CCU046

Live - Data in Use

Severe mental illness and receipt of acute cardiac care and mortality following myocardial infarction

CCU049

Live - Data in Use

Healthcare utilisation in individuals with Long COVID

CCU051

Completed

Un-vaccination and under-vaccination against SARS-CoV-2 in the UK

CCU052

Live - Data in Use

An observational retrospective cohort study describing the changing epidemiology pre, during and post COVID-19 of asthma, interstitial lung disease, and chronic obstructive pulmonary disease in England

CCU053

Live - Data in Use

Risks and benefits of treatment with SGLT2 inhibitors and the impact of intercurrent illness with COVID-19

CCU056

Completed

Socio-demographic make-up of patients undergoing surgical and transcatheter aortic valve intervention in England and the impact of COVID-19 on this

CCU057

Live - Data in Use

Risks for mortality in people with severe mental illnesses during the COVID-19 pandemic

CCU058

Live - Data in Use

COVID-19 impact on the long-term outcomes of Improving Access to Psychological Therapies in people with long-term cardiovascular conditions

CCU059

Completed

Which combinations of multiple long-term conditions are associated with the greatest risk of hospital admission over the winter season, and to what extent does COVID-19 or influenza vaccination modify this risk?

CCU060

Live - Data in Use

Improving characterisation, prediction and intervention for COVID-19 and influenza-related morbidity and mortality

CCU063

Live - Data in Use

The effect of COVID-19 on maternal and paediatric health among individuals whose first language isn’t English and require an interpreter in England: from preconception to adolescence

CCU064

Live - Data in Use

Impact of COVID-19 clinical care pathway changes on gestational diabetes incidence and pregnancy outcomes in England

CCU066

Live - Data in Use

Changes in acute cardiac care of patients with reduced kidney function during the COVID-19 pandemic

CCU068

Completed

The impact of vaccination on the excess clinical risks of COVID-19 in patients with congenital heart disease

CCU069

Live - Data in Use

RARE-CVD-COVID: To understand COVID-19 impact on intersectional disparity in rare versus common cardiometabolic diseases: CVD and metabolic diseases, including diabetes

CCU070

Live - Data in Use

Supporting novel trial designs using healthcare systems data to mitigate the impact of COVID-19 on diabetes research

CCU071

Live - Data in Use

A regional approach for policy makers to tackle health inequalities in CVD and its risk factors

CCU072

Live - Data in Use

Influence of COVID-19 on British burden of CVD

CCU073

Live - Data in Use

Impact of COVID-19 on the association between Type 2 diabetes and incidence of CVD

CCU074

Live - Data in Use

Improving the accuracy, equity and efficiency of using healthcare systems data for recruitment to a clinical trial involving people with CVD and diabetes mellitus: a simulation study in the “Covid era” using the CVD‑COVID‑UK dataset

CCU075

Live - Data in Use

Impact of the COVID-19 pandemic on corticosteroid use and side effects in Takayasu arteritis and ANCA-associated vasculitis in England

CCU076

Live - Data in Use

The effect of COVID-19 infection on cardiovascular outcomes: an interaction analysis with environmental exposure

CCU077

Live - Data in Use

Risk assessment and long-term outcomes of acute coronary syndrome management strategy in cardio-oncology patients before and after the COVID-19 era

CCU078

On hold

Foresight: a generative artificial intelligence model of patient trajectories across the COVID-19 pandemic

CCU079

Live - Data in Use

Investigating the diagnoses of conditions among children in England following SARS-CoV-2 infections compared to general respiratory infections

CCU080

Live - Data in Use

Impact of COVID-19 on the use of cardiovascular imaging

CCU081

Live - Data in Use

Investigating the impact of COVID-19 on cardiovascular and thromboembolic events in idiopathic inflammatory myopathies and the incidence of connective tissue diseases

CCU082

Live - Data in Use

Pulmonary arterial hypertension in repaired congenital heart disease: impact of the COVID-19 pandemic on prevalence; late diagnosis; and outcomes

CCU083

Live - Data in Use

Trends in choice of management strategy for NSTE-ACS among patients with previous bypass surgery before and after the COVID-19 pandemic

CCU084

Live - Data in Use

Impact of COVID-19 on stroke incidence, severity, aetiology, management, and outcome in younger versus older individuals in England

CCU085

Live - Data in Use

STROKE-IMPACT: What are the long-term consequences of stroke on the patient and to the NHS, and how does COVID-19 contribute to variation?

CCU086

Live - Data in Use

A data landscape review of datasets used in the surveillance of neurological complications of COVID-19

CCU087

Live - Data in Use

The impact of COVID-19 on heart failure outcomes: the moderation roles of diabetes and obesity

CCU088

Live - Data in Use

The impact of COVID-19 on the management of iron deficiency, with or without anaemia, in primary and secondary care

CCU089

Live - Data in Use

The impact of comorbidity, socioeconomic status, and ethnicity on waiting times for surgery before and after the COVID-19 pandemic

CCU090

Live - Data in Use

The impact of cardiac rehabilitation following transcatheter aortic valve implantation before and after the COVID-19 pandemic

CCU092

Live - Data in Use

Simulation modelling of CVD development and management, identifying the extent to which COVID-19 has impacted on the assessment and treatment of CVD.

CCU093

Live - Data in Use

Understanding the relationship between diabetes and the development of multiple long-term conditions in England, Scotland, and Wales during and after the COVID-19 pandemic

CCU094

Live - Data in Use

Identifying preventative opportunities for coronary heart disease and stroke in multi-ethnic patients with non-cardiovascular conditions including COVID-19

CCU095

Live - Data in Use

Quantifying and mitigating bias and health inequalities induced by clinical risk models predicting COVID-19-related risks of people with CVD and diabetes.

CCU096

Live - Data in Use

Impact of COVID-19 on obesity and risks of cardio-renal-metabolic outcomes

CCU097

Live - Data in Use

Drivers, consequences and the COVID-19 pandemic’s effect on severe hyperglycaemia at type 2 diabetes diagnosis

CCU100

Live - Data in Use

Impact of COVID-19 on fatty liver disease and cardiovascular outcomes in England, across ethnicities and social deprivation

CCU101

Live - Data in Use

Lung-Pal-Equity: To identify patterns in use of hospital services in the last year of life for those with advanced lung disease and to examine inequalities by socio-economic group, including before, during and after the COVID-19 pandemic


The status of project CCU078 has been updated to reflect that NHS England paused the project on 29 May. Further detail on the projects is published on the British Heart Foundation Data Science Centre’s website.


Written Question
Eye Cancer: Medical Treatments
Wednesday 25th June 2025

Asked by: John Whittingdale (Conservative - Maldon)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether chemostat can be prescribed by the NHS for the treatment of patients with ocular melanoma.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Chemosaturation therapy, often referred to as chemostat, is used to treat cancer that has spread to the liver arising from ocular melanoma. It is not used to treat ocular melanoma alone.

The National Institute for Health and Care Excellence published guidance in 2021, through its interventional procedures programme, that recommends that chemosaturation can be used for patients with secondary liver metastases resulting from a primary ocular melanoma.

NHS England considered the case for the commissioning of chemosaturation for liver metastases from ocular melanoma in 2016. At that time, NHS England concluded that there was insufficient clinical evidence to support the proposal to make the treatment available for patients with ocular melanoma in the National Health Service.

In December 2024, NHS England announced the roll out of a new treatment across England called tebentafusp, which is now available for patients with uveal melanoma, which is the most common form of ocular melanoma.


Written Question
Carcinogens: Welding
Wednesday 11th June 2025

Asked by: Richard Baker (Labour - Glenrothes and Mid Fife)

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, if she will make it his policy to collect data on the number of workers who work (a) directly and (b) indirectly with welding fume who have received diagnosis of (i) nasal, (ii) septum, (iii) throat, (iv) stomach, (v) bowel, (vi) kidney, (vii) liver, (viii) lung and (ix) bladder cancer.

Answered by Stephen Timms - Minister of State (Department for Work and Pensions)

The Health and Safety Executive (HSE) is responsible for collection of data of workplace injury and illness. The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) provides the national reporting framework for responsible persons (usually employers, the self-employed and people in control of work premises) to report certain cases of injury, diseases and specified dangerous occurrences to the relevant Enforcing Authority (HSE or Local Authority). Regulation 9 of RIDDOR requires the responsible person to report a diagnosis of any cancer attributed to an occupational exposure to a known human carcinogen in their current job.

When reporting, the responsible person must provide details on the affected person's occupation or job title and a description of the work that led to the disease. This would capture whether the person is a welder and/or carries out welding as part of their job. There is also the option to report the specific type of cancer being diagnosed.

HSE also collects data on occupational cancers through the Health and Occupational Reporting (THOR) network. This includes:

  • Lung cancer and mesothelioma data from chest physicians (THOR-SWORD) and
  • Skin cancer data from dermatologists (THOR-EPIDERM)

Where available, occupational information such as job title may be recorded, potentially identifying welders.

However, welders may also be exposed to other carcinogens, such as asbestos, during their work so it is difficult to directly link a diagnosis of cancer specifically to exposure to welding fumes.


Written Question
Neuroendocrine Cancer: Radiotherapy
Friday 16th May 2025

Asked by: Darren Paffey (Labour - Southampton Itchen)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, when he plans to update NHS commissioning policy to include funding for Selective Internal Radiation Therapy for patients with neuroendocrine tumours with liver metastases.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department recognises the need to offer patients the most suitable treatment, including the use of selective internal radiation therapy (SIRT).

NHS England is currently in the early stages of policy development for SIRT as an additional treatment option for patients with neuroendocrine tumours with liver metastases. NHS England, through its specialised commissioning function, is responsible for setting national service standards, and for the development of clinical commissioning policies for prescribed specialised services. Should NHS England’s Clinical Panel consider that the evidence is robust enough to warrant making the treatment routinely available across the National Health Service in England, it will require further consideration through relative prioritisation and investment.


Written Question
Liver Diseases: Sikhs
Thursday 1st May 2025

Asked by: Preet Kaur Gill (Labour (Co-op) - Birmingham Edgbaston)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information his Department holds on the number of Sikhs who have liver disease according to the NHS.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Office for Health Improvement and Disparities publishes mortality data and National Health Service hospital admission rates related to liver disease in England, in public health profiles. There is no data available for the number of Sikhs who have liver disease specifically.


Written Question
Pathways to Work: Impact Assessments
Thursday 1st May 2025

Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, pursuant to the Answer of 7 April 2025 to Question 42060 on Pathways to Work: Impact Assessments, whether her Department’s further programme of analysis will include a disaggregation of data by category of (a) disability and (b) health condition.

Answered by Stephen Timms - Minister of State (Department for Work and Pensions)

A breakdown of the impact of the reforms on disability overall has been published as part of an Equality Analysis of the Spring Statement package of measures (https://www.gov.uk/government/consultations/pathways-to-work-reforming-benefits-and-support-to-get-britain-working-green-paper/spring-statement-2025-health-and-disability-benefit-reforms-equality-analysis).

Data on the health conditions of UC claimants being placed in the LCWRA has been published (https://www.gov.uk/government/collections/universal-credit-work-capability-assessment-statistics) and will continue to be taken into account in the future programme of analysis.

Analysis of those who do not score 4 points in at least one daily living activity for Personal Independence Payment (PIP) has now been undertaken and is provided in the table below. This shows the volume of claimants with the 18 most common disabling conditions in receipt of the PIP daily living component in January 2025, as well as the volume and proportion of these claimants who were awarded less than 4 points in all ten daily living activities.

Health condition category

Volume of PIP Claimants in receipt of Daily Living component

Claimants awarded less than 4 points in all daily living activities

Volume in each condition group

Proportion in each condition group

Cancer

70,000

23,000

33%

Anxiety and Depression

587,000

282,000

48%

Autistic Spectrum Disorders

206,000

13,000

6%

Learning Disabilities

188,000

7,000

3%

ADHD / ADD

75,000

14,000

19%

Psychotic Disorders

112,000

26,000

23%

Other Psychiatric Disorders

90,000

25,000

28%

Arthritis

279,000

214,000

77%

Chronic Pain Syndromes

173,000

118,000

68%

Back Pain

194,000

154,000

79%

Other Regional Musculoskeletal Diseases

136,000

97,000

71%

Cerebrovascular Diseases

56,000

19,000

34%

Epilepsy

36,000

11,000

30%

Multiple Sclerosis and Neuropathic Diseases

80,000

38,000

48%

Cerebral Palsy and Neurological Muscular Diseases

47,000

11,000

24%

Other Neurological Diseases

97,000

35,000

36%

Respiratory Diseases

83,000

45,000

55%

Cardiovascular Diseases

61,000

38,000

62%

All Other Conditions

272,000

126,000

46%

Source: PIP Administrative Data

Notes:

  • Figures are based on the PIP caseload at end January 2025.
  • Data only includes claimants awarded Daily Living component.
  • Data only includes claimants living in regions under DWP policy ownership (England, Wales and Abroad).
  • Data only includes working age claimants
  • Data includes normal rules claimants only and excludes special rules for end of life (SREL) claimants as they typically receive maximum or very high scores.
  • Data may show minor differences to published award level information due to missing or poor quality score data for a small amount of claims.
  • Health condition category is based on primary health condition as recorded on the PIP Computer System at time of latest assessment. Many claimants have multiple health conditions but only primary condition is available for analysis.
  • Only the 18 disabling condition groups which make up the highest proportions of the PIP caseload are displayed in this table.
  • Other disabling condition groups which cover smaller proportions of the PIP caseload are covered in the "Other Conditions" category. This includes:

- Visual Diseases

- Other General Musculoskeletal Diseases

- Endocrine Diseases

- Hearing Disorders

- Gastrointestinal Diseases

- Genitourinary Diseases

- Skin Diseases

- Autoimmune Diseases (Connective Tissue Disorders)

- Infectious Diseases

- Diseases of the Liver, Gallbladder or Biliary Tract

- Haematological Diseases

- Metabolic Diseases

- Multisystem and Extremes of Age

- Diseases of the Immune System

  • Anxiety and Depression includes the following conditions recorded in the PIP Stat Xplore data:

- Anxiety disorders - Other / type not known

- Post traumatic stress disorder (PTSD)

- Stress reaction disorders - Other / type not known

- Generalised anxiety disorder

- Phobia - Specific

- Phobia - Social

- Agoraphobia

- Panic disorder

- Obsessive compulsive disorder (OCD)

- Anxiety and depressive disorders - mixed

- Conversion disorder (hysteria)

- Body dysmorphic disorder (BDD)

- Dissociative disorders - Other / type not known

- Somatoform disorders - Other / type not known

- Depressive disorder

- Bipolar affective disorder (Hypomania / Mania)

- Mood disorders - Other / type not known

  • Figures may not sum due to rounding.
  • Figures are rounded to the nearest 1,000 for volumes and the nearest percentage point for proportions.

Written Question
Neuroendocrine Cancer: Radiotherapy
Wednesday 23rd April 2025

Asked by: Mary Glindon (Labour - Newcastle upon Tyne East and Wallsend)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has had discussions with the National Institute for Health and Social Care on providing guidance on the adoption of selective internal radiation therapy for patients with neuroendocrine tumours .

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department has had no such discussions. In May 2024, the National Institute for Health and Care Excellence (NICE) published interventional procedures guidance that recommends that selective internal radiation therapy can be used as an option for neuroendocrine tumours that have metastasised to the liver, with standard arrangements in place for clinical governance, consent, and audit. The NICE’s interventional procedures make recommendations based on an assessment of safety and efficacy, but do not consider whether the procedure represents a clinically and cost-effective use of National Health Service resources. NHS commissioners are responsible for decisions on whether procedures recommended in the NICE’s interventional procedures guidance should be routinely offered to NHS patients.


Written Question
Clozapine: Side Effects
Tuesday 22nd April 2025

Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential implications for his policies the (a) side effects and (b) long-term health implications of the use of clozapine as a medicament.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines and medicinal products and ensures that the product information for each medicines reflects what is known about the medicine and provides information to support safe use and minimise risks. The product information consists of the Summary of Product Characteristics for healthcare professionals and the patient information leaflet supplied in each pack of medicine.

Clozapine was first authorised in 1989 and is now indicated for treatment-resistant schizophrenic patients and in schizophrenia patients who have severe, untreatable neurological adverse reactions to other antipsychotic agents, including atypical antipsychotics. Treatment resistance is defined as a lack of satisfactory clinical improvement despite the use of adequate doses of at least two different antipsychotic agents, including an atypical antipsychotic agent, prescribed for adequate duration.

Clozapine is also authorised to treat psychotic disorders occurring in patients with Parkinson's disease, in cases where standard treatment has failed. Clozapine is associated with several potentially serious side effects which are outlined in the product information, that require monitoring of various aspects of patient’s health to minimise risks including monitoring: white blood cells, blood pressure, heart function, liver function, body weight, glucose, cholesterol, other medication, falls and for signs of infection.

As clozapine is used when other treatments have failed to manage a patient’s condition, careful monitoring is required to minimise the risks to ensure patients are able to receive effective treatment with clozapine.

The safety of clozapine is continuously monitored by the MHRA to ensure the product information reflects what is known about the medicine. The MHRA is in the process of reviewing the blood monitoring requirements and will be seeking views in the summer from patients, patients’ families and healthcare professionals on methods to improve awareness of the risks associated with clozapine and how to manage them.