Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the findings of the first quarterly report of the National Audit of Metastatic Breast Cancer, published on 10 April, what steps they are taking to address gaps in data collection for secondary breast cancer patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
It has not proved possible to respond to this question in the time available before Dissolution. Ministers will correspond directly with the Member.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have for developing a best practice timed pathway for leukaemia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to reduce the rates of emergency diagnosis of leukaemia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve acute myeloid leukaemia survival rates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what cancer waiting times data are being collected regarding leukaemia and its sub-types; and how these data are being published.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
For the Faster Diagnostic Standard (FDS), data regarding leukaemia and its sub-types is collected using the following two categories: suspected acute leukaemia; and suspected haematological malignancies, excluding acute leukaemia. The latter category includes non-acute leukaemia when there is a suspicion. These statistics are published monthly and are available on the NHS Cancer Waiting Times website, in an online only format. Performance against the FDS for suspected acute leukaemia in March 2024 was at 74.1%. Performance against the FDS for suspected haematological malignancies, excluding acute leukaemia, in March 2024 was at 56.8%.
For the 31- and 62-day referral to treatment combined standards, data is collected at an International Classification of Diseases 10 (ICD-10) level, and NHS England publishes data as an aggregation of these reports, to manage the risk of disclosure. Data regarding leukaemia and its sub-types is reported under cancer type ‘Haematological – Other (a)’. These are ICD-10 codes that are haematological, excluding lymphoma, and this aggregation includes ICD-10 codes C91.0 to C96.9, which includes all leukaemia codes. Further information on the ICD-10 classification is available on the NHS England website, in an online only format.
According to NHS England, the 31-day referral to treatment performance for acute leukaemia, testicular, and children’s cancer is no longer published as a separate category, due to the low numbers of patients seen with these cancers. These patients continue to be included within the numerator and denominator of the 31-day and 62-day all cancer National Statistics, published by NHS England.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what proportion of leukaemia patients have received a diagnosis within the 28-day 'faster diagnosis' standard.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
For the Faster Diagnostic Standard (FDS), data regarding leukaemia and its sub-types is collected using the following two categories: suspected acute leukaemia; and suspected haematological malignancies, excluding acute leukaemia. The latter category includes non-acute leukaemia when there is a suspicion. These statistics are published monthly and are available on the NHS Cancer Waiting Times website, in an online only format. Performance against the FDS for suspected acute leukaemia in March 2024 was at 74.1%. Performance against the FDS for suspected haematological malignancies, excluding acute leukaemia, in March 2024 was at 56.8%.
For the 31- and 62-day referral to treatment combined standards, data is collected at an International Classification of Diseases 10 (ICD-10) level, and NHS England publishes data as an aggregation of these reports, to manage the risk of disclosure. Data regarding leukaemia and its sub-types is reported under cancer type ‘Haematological – Other (a)’. These are ICD-10 codes that are haematological, excluding lymphoma, and this aggregation includes ICD-10 codes C91.0 to C96.9, which includes all leukaemia codes. Further information on the ICD-10 classification is available on the NHS England website, in an online only format.
According to NHS England, the 31-day referral to treatment performance for acute leukaemia, testicular, and children’s cancer is no longer published as a separate category, due to the low numbers of patients seen with these cancers. These patients continue to be included within the numerator and denominator of the 31-day and 62-day all cancer National Statistics, published by NHS England.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made in reducing inequalities in outcomes for breast cancer patients from black and minority ethnic backgrounds over the past (1) 10 years, (2) five years, and (3) two years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority 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 for 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 the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve the collection and reporting of ethnicity data for breast cancer patients to support understanding of variations in outcomes and patient experience of NHS care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority 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 for 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 the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what clinical regulation measures are in place to ensure that care and treatments provided by private medical insurers are the most appropriate for a specific patient.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Private medical insurers do not provide care or treatment. However, they do purchase services from independent sector providers who are responsible for delivering healthcare. All providers of healthcare undertaking regulated activities, as defined in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, are regulated by the Care Quality Commission, and follow a set of fundamental standards of safety and quality, while the health and care regulators are responsible for regulating health and care professionals.
Regulations 9 and 12 of the 2014 regulations set out the importance of person-centred care, and safe care and treatment. These regulations have the intention of ensuring that people using a service have care or treatment that is personalised specifically for them, preventing people from receiving unsafe care and treatment, and thereby precluding avoidable harm or risk of harm.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what practical assistance is available for those with a physical or mental condition which prevents them from doing medical tests at home, such as bowel cancer screening, unaided.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are aware of the issues faced by some people with physical or mental health conditions that can make attending a screening appointment, or carrying out a home test, more difficult. Currently, national screening IT systems do not have the facilities to flag conditions for individuals which could make it more difficult to carry out the bowel cancer screening, fecal immunochemical test (FIT) at home. It is therefore recommended that individuals contact their general practice (GP) in these situations, so that GPs can work with the screening provider to arrange further support. For example, carrying out a FIT test at the GP or at home, with the support of a family member or community nurse.
NHS England has started work to improve its national screening IT systems through the Digital Transformation of Screening programme. This will enable screening providers to flag heath issues that may make carrying out a FIT test at home more difficult, and to offer any appropriate support.