Asked by: Dawn Butler (Labour - Brent Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve breast cancer outcomes amongst Black women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women, including black women, is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including metastatic breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in operational planning guidance for the health system. The Core20PLUS5 approach for adults has been rolled out as an NHS England framework to focus action on reducing inequalities on issues within the National Health Services’ direct influence, which are major contributors to inequalities in life expectancy through major conditions like cancer, cardiovascular disease, respiratory disease, and others, or Long-Term Plan priorities where stark inequalities are evident, such as maternity or severe mental illness.
The key actions for systems as highlighted in NHS England’s planning guidance for 2024/25 is to continue to deliver against the five strategic priorities for tackling health inequalities. Additionally, by the end of June 2024, NHS England aims to publish joined-up action plans to address health inequalities, and implement the Core20PLUS5 approach.
Improving earlier diagnosis of cancers, including breast cancer, is also a priority for the Government. The NHS has an ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, which will help tens of thousands of people live for longer. Additionally, the new cancer standards developed and supported by cancer doctors and implemented in October 2023, will ensure patients are diagnosed faster, and that treatment starts earlier. In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support the delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.
Whilst the Major Conditions Strategy does not seek to describe everything that is being done, or could be done, to meet the challenges of individual conditions in silo, it instead focuses on the changes likely to make the most difference across the six groups of major conditions, including cancer.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much funding was provided for (a) dementia and (b) cancer research in the 2022-23 financial year.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Government responsibility for delivering dementia research and dementia research funding is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research (NIHR), and the Department for Science Innovation and Technology, with research delivered via UK Research and Innovation.
In 2022/23, we estimate that total Government spend on dementia research was £99.9 million, with £35.1 million of this being via the NIHR. The Department of Health and Social Care spends £1.3 billion per year on health research through the 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.
The NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. The NIHR welcomes funding applications for research into any aspect of human health, including all cancers and dementia types. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
Asked by: Henry Smith (Conservative - Crawley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help improve genomics testing for bowel cancer patients.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
A National Health Service testing programme is helping to diagnose thousands of people with a genetic condition, Lynch Syndrome, that increases the chance of developing certain cancers including bowel cancer. The national programme ensures all people diagnosed with bowel cancer are offered genomic testing, with a diagnosis for Lynch Syndrome not only helping to guide more personalised cancer treatment but enabling their families and relatives to be offered testing too. Relatives who receive a diagnosis of Lynch Syndrome can be referred to genetic services to discuss regular testing options to help catch any cancers as early as possible, as well as to consider preventive options such as taking aspirin or undergoing risk-reducing surgery.
Genomic testing in the NHS in England is provided through the NHS Genomic Medicine Service (GMS) and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory (NGTD) which outlines the full range of genomic testing offered by the NHS in England including tests for 3,200 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The NGTD sets out the eligibility criteria for patients to access testing as well as the genomic targets to be tested and the method that should be used, including testing for bowel cancer patients.
The NHS GMS cancer genomic testing strategy has facilitated a move to a consolidated laboratory network through the seven NHS GLHs delivering more extensive panel testing using cutting edge high throughput Next Generation Sequencing (NGS) technology. For patients, including those with bowel cancer, this technology enables testing for a larger number of genetic variations to give a more precise diagnosis, identify biomarkers to target treatment and opportunities to access innovative medicines, and can support enrolment into molecularly stratified clinical trials.
Testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional (for example, their general practitioner or other healthcare professional if they are already being seen in a relevant service) whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS clinical genomics service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.
The 17 NHS Clinical Genomic Services (NHS CGSs), commissioned by NHS England, deliver a comprehensive clinical genomic and counselling service that directs the diagnosis, risk assessment and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a rare genetic or genomic condition. As part of the NHS CGS, the patient and their family will access diagnosis, and management relevant to their particular condition, but also receive support and guidance so that they are able to understand their condition, its implications, and their options in relation to reproduction, screening, prevention and clinical management.
Asked by: Navendu Mishra (Labour - Stockport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment her Department has made of the adequacy of bowel cancer diagnosis services in (a) Stockport and (b) Greater Manchester.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department continues to take steps to improve early diagnosis for all cancers, which encompasses bowel cancer, and in all areas, including Stockport and Greater Manchester. The Department is working jointly with NHS England on implementing the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care, which 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 and treatment.
NHS England is working to meet the Faster Diagnosis Standard (FDS), which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out. To achieve this target, NHS England has: streamlined bowel cancer pathways by implementing faecal immunochemical testing (FIT) triage for patients in primary and secondary care settings; implemented non-symptom specific pathways for patients; and opened community diagnostic centres across England, prioritising this capacity for cancer services. The latest published data from February 2024 shows FDS performance was 78.1% nationally. More specifically to bowel cancer, the latest published data shows that at a national level, the number of people diagnosed with bowel cancer has risen to 41,596 in 2021, compared to 37,702 diagnosed in 2019. Since the FIT kit was introduced into the bowel cancer screening programme in April 2019, national uptake has increased from 59.2% to 67.8%. the latest data for the North-West region shows that 64.3% of 60 to 74-year-olds completed their bowel screening in the first quarter of 2023/24.
In 2023 the NHS England’s Help Us Help You campaign urged people to take up the offer of bowel screening when invited, and the screening offer for the bowel screening programme is being gradually extended from age 60 down to 50 years old by 2025, ensuring more people are screened and potentially diagnosed with bowel cancer at the earliest stage. NHS England is also now offering routine preventative bowel cancer screening to people with Lynch syndrome, with 94% of people on average receiving the test between 2021 and 2023, up from 47% in 2019.
Asked by: Luke Evans (Conservative - Bosworth)
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 women with a genetic history of breast cancer to access screening services in (a) England and (b) Leicestershire.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In Leicestershire and nationwide, women with a very high risk (VHR) of breast cancer due to family history may be offered screening earlier and more often, as part of the NHS Breast Screening Programme.
Women formally identified as eligible for VHR breast screening are referred to the National Health Service breast screening service associated with their general practice. They are eligible to be screened from the age of 25 years old upwards, and should be invited every year. The diagnostic screen includes mammography or magnetic resonance imaging, depending on age and risk criteria, and is therefore not the same as the routine breast screening service. To support screening of VHR women, a new central database is planned to ensure all referrals reach NHS breast screening services.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to prioritise research into variation of the prevalence of prostate cancer among different ethnic groups.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department welcomes the recently announced TRANSFORM trial which aims to save thousands of men each year by finding the best way to screen for prostate cancer across all ethnic groups. It will be spread across the United Kingdom, although final decisions on specific locations are yet to be taken. Men will be invited to participate via their general practices. This study, led by Prostate Cancer UK and supported by the Government among others, will also aim to address some of the inequalities that exist in prostate cancer diagnosis today by ensuring that one in ten of the trial participants will be black men, who are three times overrepresented compared to the population of men aged between 45 and 75 years old as based on 2021 census data.
More broadly, the National Institute for Health and Care Research (NIHR) funds research in response to proposals received from scientists and commissioned calls rather than allocating funding to specific disease areas. It welcomes funding applications for research into any aspect of human health, including prostate cancer. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.
In addition, to raise awareness of prostate cancer in this group, Leicester’s Centre for BME Health has developed a toolkit in partnership with the NIHR with guidance on how to start conversations about prostate cancer and overcome barriers to diagnosis.
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: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will encourage the National Institute for Health and Care Research to rigorously evaluate existing research efforts and review how they can further prioritise and drive research investment for pancreatic cancer and other less survivable cancers.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Research is crucial in the fight against cancer, which is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121 million for 2022/23.
In terms of establishing targeted funding into pancreatic cancer, the NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
The Government, through the NIHR, is committed to improving research into pancreatic cancer and cancers with the poorest survival rates by funding high quality, timely research that leads to improved outcomes for patients and the public, and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including those with pancreatic cancer and other less survivable cancers.
In 2023, the Government awarded £2 million to new interdisciplinary research teams tackling hard to treat cancers, via the Medical Research Council, which hosted a two-day cancer sandpit strategic funding opportunity, focused on technological innovation for understanding cancers with the poorest survival rates.
The NIHR has funded seven research projects for pancreatic cancer for the period 2019 to 2023, with a total committed spend of approximately £3.6 million. The NIHR also supports the delivery of pancreatic cancer research funded by those in the charity and public sectors. For example, since 2019, the NIHR Clinical Research Network has supported over 70 pancreatic cancer-related studies.
The NIHR continues to encourage and welcome applications for research into any aspect of human health, including pancreatic cancer. All applications are assessed for funding by peer review committees. The level of research spend in a particular area is driven by factors including the quality of the proposals and their scientific potential. All applications for research into pancreatic cancer and other less survivable cancers made through open competition have been funded.
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 whether they will establish targeted funding to prioritise and drive research investment into pancreatic cancer and the other less survivable cancers.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Research is crucial in the fight against cancer, which is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121 million for 2022/23.
In terms of establishing targeted funding into pancreatic cancer, the NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
The Government, through the NIHR, is committed to improving research into pancreatic cancer and cancers with the poorest survival rates by funding high quality, timely research that leads to improved outcomes for patients and the public, and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including those with pancreatic cancer and other less survivable cancers.
In 2023, the Government awarded £2 million to new interdisciplinary research teams tackling hard to treat cancers, via the Medical Research Council, which hosted a two-day cancer sandpit strategic funding opportunity, focused on technological innovation for understanding cancers with the poorest survival rates.
The NIHR has funded seven research projects for pancreatic cancer for the period 2019 to 2023, with a total committed spend of approximately £3.6 million. The NIHR also supports the delivery of pancreatic cancer research funded by those in the charity and public sectors. For example, since 2019, the NIHR Clinical Research Network has supported over 70 pancreatic cancer-related studies.
The NIHR continues to encourage and welcome applications for research into any aspect of human health, including pancreatic cancer. All applications are assessed for funding by peer review committees. The level of research spend in a particular area is driven by factors including the quality of the proposals and their scientific potential. All applications for research into pancreatic cancer and other less survivable cancers made through open competition have been funded.
Asked by: Charles Walker (Conservative - Broxbourne)
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 level of NHS funding for brain tumour research compared to research into other cancers; and if she will provide the quantum of NHS research funding into brain tumours for each of the last five financial years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department invests over £1 billion per year into health research, through the National Institute for Health Research (NIHR), whose research spending for all cancers was £121.8 million in 2022/23. Funding for the delivery of brain cancer studies in the National Health Service cannot be disaggregated from other studies, but to indicate scale, in 2022/23 the NIHR Clinical Research Network supported 61 brain cancer studies and recruited 4,317 participants to these studies.
Over the past five financial years, the NIHR has spent over £11.3 million in funding for brain cancer research. The following table shows the amount of funding awarded for brain cancer research, from 2018/19 to 2022/23:
Financial Year | Funding amount |
2018/19 | £2.9 million |
2019/20 | £150,000 |
2020/21 | £2.2 million |
2021/22 | £5.3 million |
2022/23 | £750,000 |
Total | £11.3 million |
Note: the amount of funding awarded will differ to actual spend in a given year, as total spending will include that of multi-year awards made in previous years.
The NIHR funds research in response to proposals received from scientists, rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
To increase the quality, diversity, and number of brain cancer research proposals, the NIHR is working with the Tessa Jowell Brain Cancer Mission and the research community, to develop research capacity in the brain cancer community.