Asked by: Caroline Lucas (Green Party - Brighton, Pavilion)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make a comparative assessment of the adequacy of the reasons the (a) National Institute for Health and Care Excellence has been unable and (b) Scottish Medicines Consortium has been able to recommend Enhertu for use on the NHS.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) makes authoritative, evidence-based recommendations for the National Health Service in England on whether new licensed medicines should be routinely funded by the NHS, based on an assessment of their costs and benefits. Decisions on the availability of medicines in Scotland are a matter for the devolved administration.
The NICE published guidance in 2021 and 2023 recommending Enhertu, also known as trastuzumab deruxtecan, for the treatment of NHS patients with HER2-positive breast cancer through the Cancer Drugs Fund, and it is now available to eligible NHS patients in England in line with the NICE’s recommendations.
The NICE is currently evaluating Enhertu for the treatment of metastatic HER2-low breast cancer, and has not yet published final guidance. Stakeholders have had an opportunity to appeal against the NICE’s draft recommendations, and the NICE will consider any appeals through the established process and publish final guidance in due course.
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, whether NICE is taking steps to make Enhertu available to the National Health Service to treat incurable HER2-low secondary breast cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is currently developing guidance for the National Health Service on whether Enhertu can be recommended for routine NHS funding, based on an assessment of the costs and benefits. The NICE was unfortunately unable to recommend Enhertu as a clinically and cost-effective use of NHS resources in its final draft guidance published on 5 March 2024. Stakeholders have had an opportunity to appeal against the NICE’s draft recommendations, and the NICE will consider any appeals through the established process, and will publish final guidance in due course.
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 estimate she has made of the timeline for meeting cancer screening uptake targets for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
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 increase the uptake of screening for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
Asked by: Jason McCartney (Conservative - Colne Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to then Answer of 30 January 2024 to Question 11063 on Cancer and Public Health, whether the Minister of State for Health and Secondary Care participates in NHS Public Health Functions Agreement accountability meetings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is currently held to account for the delivery of National Health Service public health functions through Director General-led accountability meetings, supplemented with an annual ministerial accountability meeting.
The annual ministerial NHS public health functions accountability meeting with NHS England is chaired by the minister with responsibility for public health. Other Department ministers with responsibility for relevant programmes are invited to attend, or to feed views into the discussion via the lead minister.
As the Minister of State for Health and Secondary Care, I now have responsibility for screening, and engage with the national screening programme performance outside these meetings.
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, what assessment she has made of the adequacy of the uptake of the cervical cancer vaccine.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The routine human papillomavirus (HPV) vaccination programme for adolescents offers a life-saving vaccine to all children in Year 8, to protect them against strains of HPV that can cause some cancers including cervical, anal, head, and neck. High-risk HPV DNA is found in over 99% of all cervical cancers. The UKHSA monitors uptake of the adolescent HPV vaccination programme, and publishes annual statistics for England and the United Kingdom, with further information available at the following link:
This data is used by local NHS Screening and Immunisation Teams to develop local plans to improve uptake and reduce inequalities, in collaboration with key partners such as directors of public health, and their teams in local authorities. Publication of statistical data also generates national communication activity, to raise awareness and improve uptake.
Asked by: Jason McCartney (Conservative - Colne Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 January 2024, how frequently the Minister of State for Health and Secondary Care and the Parliamentary Under Secretary of State for Public Health, Start of for Life and Primary Car meet to discuss arrangements under section 7A for cancer screening; and on what date they last discussed that matter.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Arrangements under the section 7A agreement are negotiated at an official level. Health ministers are sighted in these arrangements, and have the opportunity to steer the process, usually feeding in through their private offices.
Asked by: Jason McCartney (Conservative - Colne Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 January 2024 to Question 11063 on Cancer and Public Health, what steps the Minister of State for Health and Secondary Care can take in the event that key deliverables on cancer screening under section 7A are not being delivered.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
As the Minister of State for Health and Secondary Care, I have the ability to request improvement plans, trajectories, and regular meetings with NHS England, where key deliverables on any screening programme are not met.
Asked by: Stephanie Peacock (Labour - Barnsley East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent discussions she has had with NHS England on ensuring that cancer is (a) diagnosed and (b) treated as quickly as possible.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department engages in ongoing discussions with NHS England, and is taking steps to reduce cancer diagnosis and treatment waiting times across England. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.
Recently, following ministerial approval, NHS England consolidated the cancer waiting times standards on 1 October 2023. This followed the clinically led review of standards across the National Health Service, which recommended consolidating cancer waiting times from 10 standards into three. The three standards are: the Faster Diagnosis Standard (FDS), ensuing a maximum 28-day wait for communication of a definitive cancer or non-cancer diagnosis for patients referred urgently, or those identified by NHS cancer screening; a maximum 62-day wait to first treatment from urgent general practitioner referral, NHS cancer screening, or consultant upgrade; and a maximum 31-day wait from the decision to treat to any cancer treatment starting, for all cancer patients.
To achieve the FDS target and early diagnosis, NHS England has implemented a non-symptom specific pathway for patients who present with non-specific symptoms, or combinations of non-specific symptoms, that can indicate several different cancers, and a Best Timed Practice Pathway to ensure patients are diagnosed or told that cancer is ruled out within 28 days of an urgent referral.
Asked by: Jason McCartney (Conservative - Colne Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department plans to take to increase breast screening uptake; how much funding she plans to make available for the breast screening uptake improvement plan developed by NHS England; and what recent assessment her Department has made of the effectiveness of the breast screening programme.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in the NHS Breast Screening Programme (NHS BSP), and is working with NHS England on the development of the breast screening improvement plan.
At this time, NHS England has not requested any additional funding to support the delivery of the breast screening improvement plan. Assessment of the effectiveness of the NHS BSP is made through the regular accountability meetings, under the Public Health Functions Section 7A Agreement.