Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government which drugs have been delisted from the Cancer Drugs Fund; how many patients are currently being treated with each drug; and what steps they are taking to develop a new system for prescribing each drug.
Answered by Lord Prior of Brampton
Details of the drugs removed from the national Cancer Drugs Fund (CDF) list following re-prioritisation are shown in tables 1 and 2. The latest version of the list is available on NHS England’s website at: www.england.nhs.uk/ourwork/pe/cdf/. A copy is attached.
Table 1: Confirmation of previously notified drugs and indications delisted on 12 March 2015 | |
Drug | Indication removed |
Aflibercept | 2nd line in combination with irinotecan-based combination chemotherapy for metastatic colorectal cancer |
Bendamustine | Treatment of patients with indolent non-Hodgkin’s lymphoma who are refractory to rituximab |
Bevacizumab | 1st line in combination with oxaliplatin–based combination chemotherapy for metastatic colorectal cancer |
Bevacizumab | 1st line in combination with irinotecan–based combination chemotherapy for metastatic colorectal cancer |
Bevacizumab | 1st line in combination with single agent fluoropyrimidine–based chemotherapy for metastatic colorectal cancer. |
Bevacizumab | In combination with carboplatin and gemcitabine chemotherapy for recurrent platinum sensitive ovarian cancer |
Bortezomib | Re-treatment in patients with relapsed myeloma |
Bortezomib | Treatment of patients with relapsed Waldenstrom’s macroglobulinaemia |
Bortezomib | Treatment of patients with relapsed mantle cell lymphoma |
Bosutinib | Treatment of blast phase chronic myeloid leukaemia |
Cetuximab | 2nd line in combination with irinotecan chemotherapy for metastatic colorectal cancer in patients with RAS wild type (non-mutated) tumours |
Dasatinib | Treatment of the lymphoid blast phase of chronic myeloid leukaemia |
Everolimus | Treatment of progressive unresectable or metastatic well differentiated neuroendocrine tumour of the pancreas |
Lapatinib | In combination with capecitabine chemotherapy for HER-2 receptor positive locally advanced or metastatic breast cancer |
Ofatumumab | Treatment of relapsed or refractory chronic lymphatic leukaemia |
Pazopanib | Treatment of previously treated metastatic non-adipocytic soft tissue sarcomas |
Pegylated liposomal doxorubicin | 1st or 2nd line chemotherapy of angiosarcoma |
Pegylated liposomal doxorubicin | Chemotherapy of primary malignant sarcomas of the heart and great vessels |
Source: National Cancer Drugs Fund List Ver 6.0 | |
Table 2: Confirmation of previously notified drugs and indications delisted on 4 November 2015 | |
Drug | Indication removed |
Albumin bound Paclitaxel | First line treatment of advanced adenocarcinoma of the pancreas in combination with Gemcitabine |
Bendamustine | 2nd or subsequent line treatment of chronic lymphatic leukaemia for patients whom fludarabine combination therapy is not a therapeutic option |
Bendamustine | 2nd and subsequent line of treatment of mantle cell lymphoma in patients who have not received previous Bendamustine |
Bevacizumab | Treatment of patients with triple negative metastatic breast cancer and/or prior Taxane therapy |
Bevacizumab | 2nd or 3rd line treatment of metastatic colorectal cancer in combination with standard chemotherapy in patients who have not previously received Bevacizumab |
Bosutinib | Treatment of chronic phase CML refractory to Nilotinib or Dasatinib |
Bosutinib | Treatment of accelerated phase CML refractory to Nilotinib or Dasatinib |
Bosutinib | Treatment of accelerated phase CML where there is significant intolerance to Dasatinib and Nilotinib. |
Cetuximab | 3rd and subsequent line treatment of metastatic colorectal cancer as a single agent |
Cetuximab | 3rd and subsequent line treatment of metastatic colorectal cancer as a single agent in patients not treated to progression under NICE TA176 |
Dasatinib | Treatment of adults with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukaemia (ALL) with resistance or intolerance to prior therapy including Imatinib |
Everolimus | 2nd or 3rd line treatment of metastatic renal cell carcinoma where disease has progressed on or after treatment with VEGF-targeted therapy |
Lenalidomide | 2nd line treatment of multiple myeloma in patients who have contraindications to the use of Bortezomib |
Panitumumab | 3rd and subsequent line treatment of metastatic colorectal cancer as a single agent |
Panitumumab | 3rd and subsequent line treatment of metastatic colorectal cancer as a single agent in patients not treated to progression under NICE TA176 |
Pegylated Liposomal Doxorubicin | 2nd line treatment of Fibromatosis |
Peptide Receptor Radionucleotide Therapy (Lutetium177 Octreotate or Yttrium90 Octreotide/Octreotate) | Treatment of advanced neuro-endocrine tumours i.e. for pNETS after Sunitinib/chemotherapy, for mid-gut carcinoid, after octreotide/somatostatin therapies. |
Pomalidomide | Treatment of relapsed and refractory multiple myeloma in patients who have received at least 2 prior treatment regimens, including both lenalidomide and bortezomib, and have demonstrated disease progression on the last therapy |
Source: National Cancer Drugs Fund List Ver 6.0 | |
NHS England publishes information on the number of patient applications for particular drugs/indications contained on the national CDF list on a quarterly basis. This information also includes the number of applications approved through the individual CDF request process. The latest information isattached as it is too long to be included in this answer. It is also available at:
www.england.nhs.uk/ourwork/pe/cdf/ and a copy of this is also attached.
The Government is committed to the CDF and is working with NHS England and the National Institute for Health and Care Excellence on the future arrangements for the Fund.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress has been made in implementing the recommendations of the 2014 report of the UK Stem Cell Strategy Oversight Committee on the future of unrelated donor stem cell transplantation in the United Kingdom.
Answered by Lord Prior of Brampton
The Government continues to take forward work to deliver the recommendations in the 2014 report. We remain committed to improving stem cell transplantation services and doing all we can to help those in need of a transplant to find a suitable donor.
Since 2011, the Department has provided its delivery partners, NHS Blood and Transplant and the Anthony Nolan, a total of £16 million in additional, new funding to improve stem cell transplantation services in the United Kingdom. A further £3 million investment was announced in March 2015.
This funding has led to a tangible improvement in the availability of stem cells in the UK and the achievements include:
- More UK patients received a stem cell transplant in 2014 than ever before;
- Over 60% of black, Asian and minority ethnic (BAME) patients are now able to find a well matched donor compared to only 40% in 2010;
- A single unified bone marrow donor registry has been created streamlining the provision of stem cells and reducing the time to provide cells from adult donors;
- The proportion of patients receiving cord blood from UK donors has significantly increased; and
- An increase in UK patients receiving a transplant from 802 in 2010/11 to 1,060 in 1013/14. The increased use of UK-sourced stem cells has meant that more donors than ever are available to donate leading to a significant cost saving by reducing the need to import stem cells.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is their assessment of each of the recommendations to the Department of Health in the report <i>Bridging the Gap between Academics and Policy Makers</i> by researchers from Buckinghamshire New University and the University of Bristol, published on 20 April.
Answered by Lord Prior of Brampton
We have made no assessment.
NHS England, and all National Health Service organisations, have a duty to have due regard to the need to reduce health inequalities in access to health services and health outcomes achieved, as well as having regard to the different needs of groups with characteristics protected under the Equality Act 2010.
As part of its contractual arrangements for provision of healthcare in prisons, NHS England expects that care planning and delivery of services must be equitable for all prisoners and take into consideration the diversity of the prison population. This would include Gypsies, Travellers and the Roma communities.
The Equality Delivery System (EDS) for the NHS helps all NHS organisations, in discussion with local partners and patients, to review and improve their performance for people with characteristics protected under the Equality Act. By using the EDS, NHS organisations can ensure they are delivering on the public sector Equality Duty.
Every person entering a place of detention will have an initial health screen at reception where health needs are assessed and where appropriate referrals are made to other services, including substance misuse services.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what were the dates of meetings ministers and officials from the Department of Health had with public health representatives to discuss the health impacts of potential cuts in alcohol duty between 1 November 2014 and 17 March 2015.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Ministers and officials in the alcohol policy team meet with public health representatives and experts on a regular basis in the course of their normal activities. Discussions on the general evidence base for the impacts of changes in alcohol duty may have been raised during these meetings. There have been no discussions on specific changes in alcohol duty.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what were the dates of meetings ministers and officials from the Department of Health had with (1) the Portman Group, (2) Drinkaware, (3) Diageo, (4) the Wine and Spirits Trade Association, (5) the British Beer and Pub Association, and (6) SABMiller, between 1 November 2014 and 17 March 2015.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Dates of meetings attended by the Parliamentary Under Secretary of State for Public Health and officials from the Department:
- 5 November 2014 – Responsibility Deal alcohol network meeting, attendance included the Portman Group, Diageo, the Wine and Spirits Trade Association, the British Beer and Pub Association and SABMiller;
- 18 November 2014 – Responsibility Deal Plenary Group meeting, attendance included the Portman Group; and
- 3 March 2015 – The All-Party Parliamentary Beer Group reception promoting lower alcohol beers and wines. Attendance included Portman Group, the Wine and Spirits Trade Association, the British Beer and Pub Association and SABMiller.
Details of meetings held by Ministers and the Permanent Secretary with external organisations are also published quarterly in arrears and can be found at:
https://www.gov.uk/government/collections/ministerial-gifts-hospitality-overseas-travel-and-meetings
Dates of meetings attended by officials from the Department only:
- 14 November 2014 – Meeting with industry on the EU alcohol strategy, attendance included the Wine and Spirits Trade Association, the British Beer and Pub Association and the Portman Group;
- 4 December 2014 – Drinkaware medical panel meeting;
- 21 January 2015 – Meeting with the Portman Group;
- 3 February 2015 – Drinkaware Board meeting;
- 5 February 2015 – Meeting with the Wine and Spirits Trade Association;
- 16 February 2015 – Meeting with the Portman Group;
- 17 February 2015 – Meeting with the Portman Group;
- 19 February 2015 – Meeting with SABMiller;
- 25 February 2015 – Meeting with the Portman Group;
- 26 February 2015 – Meeting with SABMiller; and
- 26 February 2015 – Meeting with Drinkaware.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what were the results of their consultation with Public Health England on how the refurbishment plans for short-term holding facilities at Heathrow might be delivered.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Public Health England (PHE) and the Border Force have agreed arrangements to release accommodation space at London Heathrow in order to provide temporary holding room space for Border Force. These changes do not compromise current screening operations which continue to be delivered through close and effective working between PHE, Border Force and Heathrow Airport Limited.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether, in the light of the containment of the ebola epidemic in West Africa, they intend to review the ebola screening arrangements at Heathrow.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Screening arrangements at London Heathrow and the other ports remain under constant review.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have plans to work with NHS England to ensure that a clinical audit is carried out into services for people with advanced liver disease from all causes.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
NHS England, Public Health England (PHE) and the Department of Health are working jointly with stakeholders to make sure that patients with liver disease, including those who may develop hepatic encephalopathy, are supported. PHE is also working with stakeholders to develop a liver disease framework.
There are currently no plans to carry out a clinical audit into services for people with advanced liver disease for all causes. However, liver cancer outcomes for the specialised services which NHS England commissions are currently audited and a national audit of outcome dimensions for the treatment of hepatitis C will be established by NHS England in due course. In addition, PHE is working with the Lancet Commission on Liver Disease to use routine data to investigate elements of care for people with advanced liver disease.
We are also taking action to prevent people developing liver disease in the first place by tackling two of the main causes of liver disease – obesity and alcohol misuse. This includes:
- our Call to Action on Obesity, which sets out two national ambitions for a downward trend in level of excess weight in children and adults by 2020; and
- our Alcohol Strategy, which aims to cut the number of people drinking above the lower-risk guidelines.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking to improve care and treatment for patients with hepatic encephalopathy.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
NHS England, Public Health England (PHE) and the Department of Health are working jointly with stakeholders to make sure that patients with liver disease, including those who may develop hepatic encephalopathy, are supported. PHE is also working with stakeholders to develop a liver disease framework.
There are currently no plans to carry out a clinical audit into services for people with advanced liver disease for all causes. However, liver cancer outcomes for the specialised services which NHS England commissions are currently audited and a national audit of outcome dimensions for the treatment of hepatitis C will be established by NHS England in due course. In addition, PHE is working with the Lancet Commission on Liver Disease to use routine data to investigate elements of care for people with advanced liver disease.
We are also taking action to prevent people developing liver disease in the first place by tackling two of the main causes of liver disease – obesity and alcohol misuse. This includes:
- our Call to Action on Obesity, which sets out two national ambitions for a downward trend in level of excess weight in children and adults by 2020; and
- our Alcohol Strategy, which aims to cut the number of people drinking above the lower-risk guidelines.
Asked by: Lord Avebury (Liberal Democrat - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, following the introduction of enhanced screening arrangements for ebola at the United Kingdom’s main ports of entry for people travelling from the affected regions, what advice they have received from the Chief Medical Inspector about arrangements at ports of entry for quarantining suspected ebola patients and for providing trained staff and equipment to move those patients to isolation units in hospitals.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Public Health England (PHE) is leading on arrangements for enhanced screening for Ebola which is being rolled out at Heathrow, Gatwick and St Pancras (Eurostar), and Birmingham and Manchester airports thereafter. This screening will be for passengers that Border Force officers identify as having travelled from Sierra Leone, Guinea and Liberia or for those passengers who identify themselves to staff.
Screening is being implemented by PHE staff, who follow official protocols. PHE has issued guidance to its staff and for professionals across other sectors, about how to deal with a suspected case of Ebola. There are established and tested procedures for transporting patients with highly infectious diseases to hospitals when required.