Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many multiple sclerosis specialist nurses work in the NHS; and what plans they have, if any, to ensure all people with multiple sclerosis have access to a specialist nurse.
Answered by Lord Kamall
Data on the number of multiple sclerosis (MS) specialist nurses working in the National Health Service is not held centrally. Services for adults with MS are part of local neurology services commissioned by clinical commissioning groups. NHS England is leading a programme to develop optimal neurology pathways including, MS services. The MS pathway includes access to specialist nurses for all patients diagnosed with MS.
NHS England commissions a highly specialised service for children with MS across seven centres. All children with MS have access to a specialist paediatric nurse with an expertise in paediatric MS. The National Institute for Health and Care Excellence advises a multidisciplinary approach and recommends the involvement of professionals to best meet the needs of the patient, including MS nurses.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made on the impact of COVID-19 on the rehabilitation needs of people living with neurological conditions such as multiple sclerosis; and what plans they have to work with NHS England on a long term strategy for delivering (1) physiotherapy, (2) speech and language therapy, and (3) occupational therapy to people with neurological conditions to help them maintain their wellbeing.
Answered by Lord Bethell
On 23 December 2020, NHS England outlined priorities for the remainder of 2020-2021, including maximising capacity to treat non-COVID-19 patients. This capacity includes services to people with neurological diseases, for example physiotherapy, occupational therapy and speech and language therapy. The provision of rehabilitation support in England is a local matter, and local commissioners are best placed to provide services according to local need.
NHS England and NHS Improvement have commenced work on updating their guidance for clinical commissioning groups on commissioning accessible, high quality rehabilitation services. This has included engagement with professional bodies’ clinicians, alongside other stakeholders, societies and third sector organisations who represent the patient voice.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made about the barriers to prescribing Sativex to treat spasticity in people with multiple sclerosis; and what plans they have to work with NHS England and organisations such as the MS Society to address any such barriers.
Answered by Lord Bethell
The Department has made no recent assessment. However, Departmental officials regularly engage with stakeholders and organisations such as the MS Society, to discuss a range of issues, including concerns relating to access to treatments.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of what additional NHS services, including rehabilitation, will be required as a result of the neurological complications seen in inpatients with COVID-19.
Answered by Lord Bethell
COVID-19 is a new disease with many new and unexpected complications. Clinicians in the National Health Service have adapted rapidly to this evolving situation and rehabilitation programs for COVID-19 have been developed in many parts of the NHS, providing rehabilitation both in hospital and in the community.
On 29 April, Sir Simon Stevens and Amanda Pritchard published a letter on the second phase of the NHS response to COVID-19, and recommended actions for the next phase including preparing to support the increase in patients who have recovered from COVID-19 and who having been discharged from hospital need ongoing community health support.
The NHS also published guidance on 5 June entitled After-care needs of inpatients recovering from COVID-19, which supports primary care and community health services to meet the immediate and longer-term care needs of patients discharged following an acute episode of COVID-19, by describing the typical expected health care needs of patients post-discharge. These include neuromuscular and neuro-psychological, amongst others.
Copies of the NHS letter and guidance are attached.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many (1) outpatient neurology appointments have been cancelled to date, and (2) neurology inpatients were sent home from hospital early in England, as a result of COVID-19.
Answered by Lord Bethell
NHS England and NHS Improvement have advised that this information is not collected.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the impact of COVID-19 on the delivery of NHS secondary care services to people with neurological conditions.
Answered by Lord Bethell
No specific assessment has been made.
In co-operation with the Royal College of Physicians and the Chief Medical Officer’s team, the Association of British Neurologists (ABN) published COVID-19 specific guidance for patients with neurological conditions, as well as clinicians, on 22 March 2020. The guidance identified patient groups at increased risk from COVID-19 and those for whom shielding was recommended. Early in the pandemic, the ABN recommended a reduction in face to face appointments for non-emergency care in services such as neurology, while maintaining essential care to protect patients. NHS England and NHS Improvement advised the system that in-person consultations should quickly be phased out and “should only take place when absolutely necessary”.
During the pandemic, digital and remote general practitioner consultations and outpatient appointments as means to support patients have become the norm across England. Providers have been rolling out remote consultations using video, telephone, email and text message services as a priority, including for those with neurological conditions. NHS England and NHS Improvement have also published a range of guidance for primary and community health service to identify, support and engage people, such as those with neurological conditions, during the COVID-19 outbreak, including:
- the NHS England and NHS Improvement Novel coronavirus (COVID-19) standard operating procedure: Community Health Services; and
- the NHS England and NHS Improvement Guidance and standard operating procedures General practice in the context of coronavirus (COVID-19).
Copies of these as well as the ABN guidance Association of British Neurologists Guidance on COVID-19 for people with neurological conditions, their doctors and carers are attached.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the impact of COVID-19 on the sustainability of charities working to support people with neurological conditions.
Answered by Lord Bethell
The Government is aware of the impact of the COVID-19 pandemic on a range of sectors, including charities.
To support charities in dealing with the COVID-19 pandemic, there was an announcement by the Chancellor of the Exchequer on 8 April 2020, of a funding package of £750 million for the wider voluntary and charity sector. Of this, £370 million will support charities working with vulnerable people. In England, £200 million of this support will be provided through the National Lottery’s Coronavirus Community Support Fund, to which charities can apply for funding. Applicants will be assessed on the extent to which they meet the objectives of the fund, which are to reduce temporary closures of essential charities and to reduce the burden on the public services, including the National Health Service.
In addition, charities can access the Coronavirus Job Retention Scheme and the Coronavirus Business Interruption Loan Scheme and are able to benefit from the three-month VAT deferral scheme. Charity shop premises will benefit from the new enhanced retail rate relief at 100%.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure the long-term sustainability of charitable organisations providing support to people with neurological conditions.
Answered by Lord Bethell
The Government is aware of the impact of the COVID-19 pandemic on a range of sectors, including charities.
To support charities in dealing with the COVID-19 pandemic, there was an announcement by the Chancellor of the Exchequer on 8 April 2020, of a funding package of £750 million for the wider voluntary and charity sector. Of this, £370 million will support charities working with vulnerable people. In England, £200 million of this support will be provided through the National Lottery’s Coronavirus Community Support Fund, to which charities can apply for funding. Applicants will be assessed on the extent to which they meet the objectives of the fund, which are to reduce temporary closures of essential charities and to reduce the burden on the public services, including the National Health Service.
In addition, charities can access the Coronavirus Job Retention Scheme and the Coronavirus Business Interruption Loan Scheme and are able to benefit from the three-month VAT deferral scheme. Charity shop premises will benefit from the new enhanced retail rate relief at 100%.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of (1) advances in treatments for multiple sclerosis for NHS patients, including the recently approved first short course oral treatment, cladribine tablets; and (2) the extent to which new treatments will help to reduce burdens on NHS services.
Answered by Lord O'Shaughnessy
The Department has made no such assessment.
Through its technology appraisal programme, the National Institute for Health and Care Excellence (NICE) makes recommendations on whether selected drugs and treatments represent a clinically and cost effective use of National Health Service resources, taking into account the impact on the health service of a product.
NICE is currently developing guidance on the use of cladribine for treating multiple sclerosis and expects to publish final guidance in December.
Asked by: Lord Dubs (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to improve NHS patient access to the latest innovative cost-effective medicines for multiple sclerosis.
Answered by Lord O'Shaughnessy
Through its technology appraisal programme, the National Institute for Health and Care Excellence (NICE) makes authoritative, evidence-based recommendations for the National Health Service on the clinical and cost effective use of drugs and other treatments. Wherever possible, NICE aims to publish draft guidance on significant new drugs as soon as possible after licensing. NICE has recommended a number of drugs as treatments for multiple sclerosis.
Commissioners are legally required to fund drugs and treatments recommended in NICE technology appraisal guidance within three months of its final guidance being issued. This is reflected in the NHS Constitution as a right to NICE approved drugs.