National Institute for Health and Care Excellence

Debate between Baroness Morgan of Drefelin and Lord Kamall

Monday 23rd May 2022 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

A key priority for NICE this year is to increase the flexibility and capacity of its technology appraisal programmes through a more proportionate approach to assessments that will enable it to continue to consistently deliver timely guidance on new medicines. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to increasing numbers of new medicines.

[Baroness Morgan of Drefelin (CB)]

I thank the Minister for his Answer and for writing to me on this. NICE does a really important job in our health system and I pay tribute to it for that. However, one thing that I have observed recently is that, in some of the more tricky technology appraisals, sometimes you have a first rejection, then another committee meeting, then possibly another reappraisal. This puts a huge amount of stress on patients, often at the end of life, when they are really worrying about whether they will have access to the treatments under review. Is there anything more that the Government can do to help ease the passage of these interim access agreements that patients can have?

[Lord Kamall (Con)]

I am sure that the noble Baroness appreciates that this was a new process, because of the Orbis trial. In some ways, NICE was not exactly prepared for that. NICE has learned from that lesson and 100% of its guidelines are issued within 90 days of licensing. It has learned the lesson but, sadly, there was a confluence of factors: one was Orbis and the other was that the committee meeting regarding recommendations ran over because there were a number of other cancer drugs that it was trying to look at. It has put this on the agenda for the next meeting.

Mental Health Services for Rough Sleepers

Debate between Baroness Morgan of Drefelin and Lord Kamall

Monday 21st March 2022 Lords Chamber

[Baroness Morgan of Drefelin]

To ask Her Majesty’s Government what assessment they have made of the effectiveness of the £30 million programme to provide specialist mental health services for people sleeping rough, as detailed in the NHS Long Term Plan; and what plans they have to publish an evaluation of the outcomes of that programme.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

This Government are committed to ending rough sleeping by the end of this Parliament. The long-term plan set a target of 20 high-need areas to receive new specialist mental health provision for people sleeping rough by 2023-24. In fact, the NHS has exceeded that target, with 23 sites. There are plans to share learning from these sites to identify the key successes and effective approaches, and NHS England plans to undertake a formal evaluation before the end of the programme.

--- Later in debate ---

[Baroness Morgan of Drefelin (CB)]

I thank the Minister for that Answer and look forward very much to the publication of that work. We know that common mental health conditions are twice as high among people who have experienced homelessness, and psychosis is 15 times as high. Obviously, I commend the Government’s commitment to end rough sleeping. Does the Minister know what figure has been settled on for the number of people sleeping rough with specialist mental health services needs? If one has been settled on, is that the criterion that will be used to review progress with the NHS long-term plan when that is refreshed?

[Lord Kamall (Con)]

I thank the noble Baroness for her Question and for her continued conversations with me on a number of different health-related issues; I am learning quite a lot from those. I understand that the data will be collected at some point, and I hope that that will be done regularly. If the noble Baroness will allow me, I write to her with more details, but I know that the top-level answer to that question is that we are about to get the data.

Cancer Drugs: Licensing and Approval

Debate between Baroness Morgan of Drefelin and Lord Kamall

Monday 8th November 2021 Lords Chamber

[Baroness Morgan of Drefelin (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and declare an interest as chief executive of the charity Breast Cancer Now.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

NICE is committed to publishing draft guidance on cancer drugs around the time of licensing, with final guidance published within three months of licensing wherever possible. The MHRA and NICE work closely together to ensure that licensing procedures and health technology assessments are as streamlined as possible. For cancer drugs, the NHS in England provides funding from the point of draft positive NICE guidance, delivering faster access to promising new cancer treatments.

[Baroness Morgan of Drefelin (CB)]

My Lords, the delay between licensing and NICE technology appraisal has been dealt with in the case of two out of the three drugs approved under Project Orbis, through agreements between NHS England and the drug company concerned. Unfortunately for women with secondary incurable breast cancer, for which there are very few treatment options, no agreement has been made with the drug company Gilead, and this creates a new treatment lottery. Are interim access agreements meant to be the permanent solution, and if not, what can be done to address this lottery and close the gap between Orbis licensing and NICE appraisal?

[Lord Kamall (Con)]

I thank the noble Baroness for her Question. Clearly, there is distress and concern at the delay between MHRA approval and NICE licensing. The drug Trodelvy was licensed by the MHRA for both unresectable locally advanced and metastatic triple-negative breast cancer through Project Orbis. On NICE’s appraisal of Trodelvy to determine its clinical and cost-effectiveness for use in the NHS, NICE hopes to have guidance next year but, in the meantime, NHS England, NHS Improvement and NICE continue to work with the manufacturer to explore options for interim access to Trodelvy.