Asked by: Lord McColl of Dulwich (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the total cost of treating patients who are obese and overweight; and what are the associated costs of treating (1) type 2 diabetes, (2) cardiovascular disease, (3) cerebrovascular disease, (4) musculoskeletal diseases including joint replacers, (5) cancer, and (6) dementia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The department has reviewed and uses cost estimates published by Frontier Economics in 2022.
A study by Frontier Economics estimated that in 2021 obesity related ill-health cost the National Health Service £6.5 billion annually. This estimate includes costs associated with the following obesity related diseases: colorectal cancer; oesophageal cancer; kidney cancer; ovarian cancer; pancreatic cancer; coronary heart disease; stroke; type 2 diabetes; hypertension; knee osteoarthritis; endometrial cancer, and breast cancer.
The disease costs associated with obesity are calculated from the total annual costs per case, as shown in the following table:
Disease | Cost per case per year (2021) |
(1) Type 2 diabetes | £ 827.33 |
(2) Cardiovascular disease - Coronary heart disease (CHD) | £ 1,557.25 |
(2) Cardiovascular disease - Stroke | £ 247.55 |
(2) Risk of Cardiovascular disease - Hypertension | £ 453.91 |
(4) Musculoskeletal disease - Knee Osteoarthritis | £ 27,798.40 |
(5) Cancer - Colorectal cancer | £ 520.13 |
(5) Cancer - Oesophageal cancer | £ 545.06 |
(5) Cancer - Kidney cancer | £ 1,662.88 |
(5) Cancer - Ovarian cancer | £ 14,990.93 |
(5) Cancer - Pancreatic cancer | £ 7,447.27 |
(5) Cancer - Endometrial cancer | £ 520.13 |
(5) Cancer - Breast cancer | £ 545.06 |
The annual costs per case includes direct health-care costs including hospital care (both inpatient and outpatient), primary care, and medication, and they are not exclusively related to obesity associated cases. Indirect and social care costs are not included, which means the exclusion of these costs will probably underestimate total costs of disease events overall.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of findings from the Royal College of Radiologists, published in May, showing a regional disparity in wait times for cancer treatment in 2023, with 11 per cent of patients in England waiting more than 31 days for treatment after the decision to treat had been confirmed, compared to 19 per cent of patients in the North East and Yorkshire.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
According to the latest data, of those 10,328 cancer patients referred for first or subsequent treatment for radiotherapy in March 2024, 89.7% were treated within 31 days. The proportion of patients waiting more than 31 days for radiotherapy treatment in March 2024 was therefore 10.3%. This has decreased by 4.5% since January 2024.
We are aware of regional disparities in wait times for cancer treatment through NHS England’s data, and are considering the findings made by the Royal College of Radiologists. Tackling inequalities in outcomes, experience, and access of cancer diagnostics, including regional disparities, is a key focus of the Government. NHS England has commissioned six new cancer clinical audits in breast cancer, both primary and metastatic, as well as ovarian, pancreatic, non-Hodgkin lymphoma, and kidney cancer. These 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. The first outcomes of these audits are expected in September 2024.
The Department is working closely with NHS England to make sure we have the right workforce with the right skills up and down the country. In 2023/24, NHS England invested an additional £50 million to increase the number of cancer and diagnostic specialists.
The Government is also backing the NHS Long Term Workforce Plan, with over £2.4 billion over the next five years to fund additional education and training places. The plan sets out an aim to double the number of medical school places in England to 15,000 places a year by 2031/32, and to work towards this expansion by increasing places by a third, to 10,000 a year, by 2028/29.
We are building our cancer workforce. In January 2024 there were over 35,200 full-time equivalent (FTE) staff in the cancer workforce, an increase of over 13,300, or 60.7% since January 2010. Regarding clinical oncology specifically, as of January 2024, there are currently over 1,600 FTE doctors working in the speciality of clinical oncology in National Health Service trusts and other core organisations in England. This is over 30, or 2.2%, more than last year, over 300, or 27.7%, more than 2019, and over 600, 66.5%, more than in 2010. This includes over 900 FTE consultants. This is over 40, or 5.1%, more than last year, over 100, 22.0%, more than in 2019, and over 400, 80.2%, more than in 2010.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that the 15 per cent shortfall in clinical oncologists, as estimated in the Royal College of Radiologists workforce census, does not impact the operational performance of radiotherapy services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
According to the latest data, of those 10,328 cancer patients referred for first or subsequent treatment for radiotherapy in March 2024, 89.7% were treated within 31 days. The proportion of patients waiting more than 31 days for radiotherapy treatment in March 2024 was therefore 10.3%. This has decreased by 4.5% since January 2024.
We are aware of regional disparities in wait times for cancer treatment through NHS England’s data, and are considering the findings made by the Royal College of Radiologists. Tackling inequalities in outcomes, experience, and access of cancer diagnostics, including regional disparities, is a key focus of the Government. NHS England has commissioned six new cancer clinical audits in breast cancer, both primary and metastatic, as well as ovarian, pancreatic, non-Hodgkin lymphoma, and kidney cancer. These 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. The first outcomes of these audits are expected in September 2024.
The Department is working closely with NHS England to make sure we have the right workforce with the right skills up and down the country. In 2023/24, NHS England invested an additional £50 million to increase the number of cancer and diagnostic specialists.
The Government is also backing the NHS Long Term Workforce Plan, with over £2.4 billion over the next five years to fund additional education and training places. The plan sets out an aim to double the number of medical school places in England to 15,000 places a year by 2031/32, and to work towards this expansion by increasing places by a third, to 10,000 a year, by 2028/29.
We are building our cancer workforce. In January 2024 there were over 35,200 full-time equivalent (FTE) staff in the cancer workforce, an increase of over 13,300, or 60.7% since January 2010. Regarding clinical oncology specifically, as of January 2024, there are currently over 1,600 FTE doctors working in the speciality of clinical oncology in National Health Service trusts and other core organisations in England. This is over 30, or 2.2%, more than last year, over 300, or 27.7%, more than 2019, and over 600, 66.5%, more than in 2010. This includes over 900 FTE consultants. This is over 40, or 5.1%, more than last year, over 100, 22.0%, more than in 2019, and over 400, 80.2%, more than in 2010.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the proportion of cancer patients currently waiting more than 31 days for radiotherapy treatment.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
According to the latest data, of those 10,328 cancer patients referred for first or subsequent treatment for radiotherapy in March 2024, 89.7% were treated within 31 days. The proportion of patients waiting more than 31 days for radiotherapy treatment in March 2024 was therefore 10.3%. This has decreased by 4.5% since January 2024.
We are aware of regional disparities in wait times for cancer treatment through NHS England’s data, and are considering the findings made by the Royal College of Radiologists. Tackling inequalities in outcomes, experience, and access of cancer diagnostics, including regional disparities, is a key focus of the Government. NHS England has commissioned six new cancer clinical audits in breast cancer, both primary and metastatic, as well as ovarian, pancreatic, non-Hodgkin lymphoma, and kidney cancer. These 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. The first outcomes of these audits are expected in September 2024.
The Department is working closely with NHS England to make sure we have the right workforce with the right skills up and down the country. In 2023/24, NHS England invested an additional £50 million to increase the number of cancer and diagnostic specialists.
The Government is also backing the NHS Long Term Workforce Plan, with over £2.4 billion over the next five years to fund additional education and training places. The plan sets out an aim to double the number of medical school places in England to 15,000 places a year by 2031/32, and to work towards this expansion by increasing places by a third, to 10,000 a year, by 2028/29.
We are building our cancer workforce. In January 2024 there were over 35,200 full-time equivalent (FTE) staff in the cancer workforce, an increase of over 13,300, or 60.7% since January 2010. Regarding clinical oncology specifically, as of January 2024, there are currently over 1,600 FTE doctors working in the speciality of clinical oncology in National Health Service trusts and other core organisations in England. This is over 30, or 2.2%, more than last year, over 300, or 27.7%, more than 2019, and over 600, 66.5%, more than in 2010. This includes over 900 FTE consultants. This is over 40, or 5.1%, more than last year, over 100, 22.0%, more than in 2019, and over 400, 80.2%, more than in 2010.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department plans to shorten the diagnostic pathway for ovarian cancer by allowing the CA125 blood test and ultrasound to be undertaken at the same time.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is supporting NHS England in developing Best Practice Timed pathways, to support the ongoing improvement effort to shorten diagnosis pathways, reduce variation, improve patient experience of care, and meet the Faster Diagnosis Standard. This standard ensures patients are told they have cancer, or that cancer is ruled out, within 28 days of urgent cancer referral from general practice or screening service.
In March 2023, NHS England published guidance for local health and care systems to implement a timed gynaecological cancer diagnostic pathway, including for ovarian cancer. The gynaecological pathway ensures that at day zero, when presenting with symptoms, an ultrasound and a minimum data set is obtained, which includes a full blood count. For patients with suspected ovarian cancer, the minimum dataset should also include tumour marker CA125, with confirmation of suspicious features of ovarian cancer on ultrasound.
The guidance further ensures that patients with persistent abdominal symptoms, raised CA125, and a normal pelvic scan should be referred through the non-specific symptoms rapid diagnostic centre pathway. Women over 50 years old with elevated CA125 and palpable mass or ascites, or both, or with a previous ultrasound with risk of malignancy, should be referred straight to a computed tomography scan.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
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 reduce regional variations in early diagnosis of ovarian cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Reducing inequalities and variation in cancer treatment is a priority for the Government, as is increasing early cancer diagnosis, as both are key contributors to reducing cancer health inequalities. The National Health Service is improving cancer pathways to get people diagnosed faster once referred, and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single urgent cancer referral pathway, but who are at risk of being diagnosed with cancer. This will help support faster ovarian cancer diagnosis. 113 NSS pathways are currently operational, with more in development.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to tackle regional variations in early diagnosis of ovarian cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is taking a wide range of activity to increase awareness and early diagnosis of, as well as tackle regional variations in, ovarian cancer. Since 2020 NHS England has run several Help Us Help You campaigns, that have included a focus on abdominal symptoms which, amongst other abdominal cancers, can be indicative of ovarian cancer.
NHS England relaunched the Help Us Help You cancer campaign on the 8 January 2024, to encourage people to get in touch with their general practitioner if they notice, or are worried about, symptoms that could be cancer. The campaign address barriers to people coming forward with suspected signs of cancer in general, and is not specific to ovarian cancer.
Raising awareness and improving early diagnosis of cancers, including ovarian cancer, remains a priority across all regions in England. NHS England is working towards the NHS Long Term Plan ambition of diagnosing 75% of stageable cancers at stage one and two by 2028. Achieving this will mean that, from 2028, around 55,000 more people each year will survive their cancer for at least five years after diagnosis.
To help increase cancer diagnosis rates, as of February 2024, there are 154 community diagnostic centres (CDCs) open with over six million checks carried out, with the aim of having 160 CDCs open by March 2025. We also plan to transform the way the National Health Service provides elective care, by increasing activity at dedicated and protected surgical hubs. These will help separate elective care facilities from urgent and emergency care, including for ovarian cancer. At present, the surgical hubs are focusing on a number of specialities, including gynaecology.
The NHS is improving pathways to get people diagnosed faster once they are referred, and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single urgent cancer referral pathway, but who are at risk of being diagnosed with cancer. This will help support faster ovarian cancer diagnosis. 108 NSS pathways are currently operational, with more in development.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to increase awareness of ovarian cancer symptoms.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is taking a wide range of activity to increase awareness and early diagnosis of, as well as tackle regional variations in, ovarian cancer. Since 2020 NHS England has run several Help Us Help You campaigns, that have included a focus on abdominal symptoms which, amongst other abdominal cancers, can be indicative of ovarian cancer.
NHS England relaunched the Help Us Help You cancer campaign on the 8 January 2024, to encourage people to get in touch with their general practitioner if they notice, or are worried about, symptoms that could be cancer. The campaign address barriers to people coming forward with suspected signs of cancer in general, and is not specific to ovarian cancer.
Raising awareness and improving early diagnosis of cancers, including ovarian cancer, remains a priority across all regions in England. NHS England is working towards the NHS Long Term Plan ambition of diagnosing 75% of stageable cancers at stage one and two by 2028. Achieving this will mean that, from 2028, around 55,000 more people each year will survive their cancer for at least five years after diagnosis.
To help increase cancer diagnosis rates, as of February 2024, there are 154 community diagnostic centres (CDCs) open with over six million checks carried out, with the aim of having 160 CDCs open by March 2025. We also plan to transform the way the National Health Service provides elective care, by increasing activity at dedicated and protected surgical hubs. These will help separate elective care facilities from urgent and emergency care, including for ovarian cancer. At present, the surgical hubs are focusing on a number of specialities, including gynaecology.
The NHS is improving pathways to get people diagnosed faster once they are referred, and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single urgent cancer referral pathway, but who are at risk of being diagnosed with cancer. This will help support faster ovarian cancer diagnosis. 108 NSS pathways are currently operational, with more in development.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
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 early diagnosis of ovarian cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is taking a wide range of activity to increase awareness and early diagnosis of, as well as tackle regional variations in, ovarian cancer. Since 2020 NHS England has run several Help Us Help You campaigns, that have included a focus on abdominal symptoms which, amongst other abdominal cancers, can be indicative of ovarian cancer.
NHS England relaunched the Help Us Help You cancer campaign on the 8 January 2024, to encourage people to get in touch with their general practitioner if they notice, or are worried about, symptoms that could be cancer. The campaign address barriers to people coming forward with suspected signs of cancer in general, and is not specific to ovarian cancer.
Raising awareness and improving early diagnosis of cancers, including ovarian cancer, remains a priority across all regions in England. NHS England is working towards the NHS Long Term Plan ambition of diagnosing 75% of stageable cancers at stage one and two by 2028. Achieving this will mean that, from 2028, around 55,000 more people each year will survive their cancer for at least five years after diagnosis.
To help increase cancer diagnosis rates, as of February 2024, there are 154 community diagnostic centres (CDCs) open with over six million checks carried out, with the aim of having 160 CDCs open by March 2025. We also plan to transform the way the National Health Service provides elective care, by increasing activity at dedicated and protected surgical hubs. These will help separate elective care facilities from urgent and emergency care, including for ovarian cancer. At present, the surgical hubs are focusing on a number of specialities, including gynaecology.
The NHS is improving pathways to get people diagnosed faster once they are referred, and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single urgent cancer referral pathway, but who are at risk of being diagnosed with cancer. This will help support faster ovarian cancer diagnosis. 108 NSS pathways are currently operational, with more in development.
Asked by: Chloe Smith (Conservative - Norwich North)
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 potential impact of the rollout of community diagnostic centres on the time taken to diagnose less survivable cancers.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is taking steps through NHS England to improve outcomes for cancer patients, including those cancers mentioned by the Less Survivable Cancer Taskforce, namely lung, liver, brain, oesophageal, pancreatic and stomach. Diagnostic checks are a key part of cancer pathways and the 150 community diagnostic centres (CDCs) opened by the Government will give earlier diagnostic tests, benefitting millions of patients including those who are referred with suspected less survivable cancers. National Health Service systems have been asked to prioritise CDC capacity towards their most challenged cancer pathways, where this is clinically appropriate, and these centres have delivered over six million additional tests for all elective activity since July 2021. The CDC programme is on track to meet its target to open up to 160 CDCs by March 2025, with many due to open ahead of schedule.
In November 2022, the NHS also announced an expansion of direct access to diagnostic scans across all general practices, to help cut waiting times and speeding up cancer diagnosis, or all-clear for patients. The NHS is now looking to widen the clinical pathways for which this is offered.
Making improvements across different cancer types is critical to helping achieve the NHS Long Term Plan ambition of diagnosing 75% of patients at an early stage by 2028 and reducing inequalities in cancer survival. NHS England has commissioned new cancer clinical audits covering six cancer types, some of which are less survivable: pancreatic cancer, ovarian cancer, non-Hodgkin lymphoma, kidney cancer and primary and metastatic breast cancer. All six audits will cover care delivered in England and Wales.