Asked by: Lord Hunt of Kings Heath (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 NHS England is meeting the Faster Diagnosis Standard for lower gastrointestinal cancer referrals.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is taking steps to achieve the Faster Diagnosis Standard (FDS), which aims to ensure people with cancer or suspected cancer, including lower gastrointestinal (GI) cancers, are diagnosed or have cancer ruled out within 28 days of referral. The Department is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 related backlogs in elective care, which includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment.
To achieve the FDS target specifically, NHS England has implemented a timed pathway for lower GI cancer, by requiring faecal immunochemical testing (FIT) for patients in primary and secondary care settings on a suspected lower GI cancer pathway. FIT testing prevents patients from having unnecessary colonoscopies, freeing up capacity for these procedures and ensuring the most urgent symptomatic patients are seen more quickly. Across 2022/2023 the proportion of lower GI referrals with a related FIT test rose from 24% to 69%.
NHS England is also implementing non symptom specific pathways for patients who present with non-specific symptoms, or combinations of non-specific symptoms, that can indicate several different cancers, including symptoms that may indicate lower GI cancers.
In addition, at the 2021 Spending Review the Government awarded £2.3 billion to transform diagnostic services from 2022 to 2025, most of which will help increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, prioritising CDCs for cancer services. General practice teams have also been given direct access to tests like computed tomography scans, magnetic resonance imaging, and ultrasounds, helping to cut waiting times and speed up the diagnosis of, or ruling out of, cancer. This funding is also being used to expand endoscopy capacity within acute settings and in CDCs.
Asked by: Lord Hunt of Kings Heath (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 level of awareness by doctors of any dangers of the commonly prescribed drug montelukast, as highlighted by the US Food and Drug Administration in March 2020, that the use of the drug resulted in “a wide variety of mental health side effects have been reported, including completed suicides".
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Montelukast remains a safe and effective medicine in the treatment of asthma. Montelukast is indicated for use in the United Kingdom as an add on treatment for asthma patients who are inadequately controlled on inhaled corticosteroid treatment, and can be prescribed for the symptomatic relief of seasonal allergic rhinitis in patients with asthma. There is no licensed indication in the UK for the treatment of allergic rhinitis alone.
Neuropsychiatric effects such as depression have been included in the UK product information for montelukast since 2007. This has been subsequently updated with additional terms based on emerging evidence. This includes the most recent update in 2019, which more fully described the neuropsychiatric effects. In order to remind prescribers of the risk of neuropsychiatric effects with montelukast, a Drug Safety Update article was published by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2019, to accompany the updated warnings.
Following a growing number of Yellow Card reports and queries from patients and caregivers, raising concerns about a potential ongoing lack of awareness of the risk of the neuropsychiatric effects with montelukast, the MHRA is conducting a further review of the current data.
As part of our review, we are evaluating all available evidence, including Yellow Card reports and queries received by the MHRA, literature publications, international regulatory changes, including those made by the United States’ Food and Drug Administration, and are listening to and learning from patients’ experiences. The MHRA has sought advice from our independent expert groups including paediatricians, specialists in mental and respiratory health, as well as experts in medicines safety.
We are considering all relevant regulatory actions that would provide the most effective way of increasing awareness to healthcare professionals, patients, and their caregivers. The MHRA is finalising the review process and will communicate on any further measures to minimise the risk, upon completion of our review.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in relation to the use of montelukast in the UK, what assessment they have made of the US Food and Drug Administration's issuing a “black box warning” in March 2020 about serious mental health side effects of the drug and restricting its use for allergic rhinitis.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Montelukast remains a safe and effective medicine in the treatment of asthma. Montelukast is indicated for use in the United Kingdom as an add on treatment for asthma patients who are inadequately controlled on inhaled corticosteroid treatment, and can be prescribed for the symptomatic relief of seasonal allergic rhinitis in patients with asthma. There is no licensed indication in the UK for the treatment of allergic rhinitis alone.
Neuropsychiatric effects such as depression have been included in the UK product information for montelukast since 2007. This has been subsequently updated with additional terms based on emerging evidence. This includes the most recent update in 2019, which more fully described the neuropsychiatric effects. In order to remind prescribers of the risk of neuropsychiatric effects with montelukast, a Drug Safety Update article was published by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2019, to accompany the updated warnings.
Following a growing number of Yellow Card reports and queries from patients and caregivers, raising concerns about a potential ongoing lack of awareness of the risk of the neuropsychiatric effects with montelukast, the MHRA is conducting a further review of the current data.
As part of our review, we are evaluating all available evidence, including Yellow Card reports and queries received by the MHRA, literature publications, international regulatory changes, including those made by the United States’ Food and Drug Administration, and are listening to and learning from patients’ experiences. The MHRA has sought advice from our independent expert groups including paediatricians, specialists in mental and respiratory health, as well as experts in medicines safety.
We are considering all relevant regulatory actions that would provide the most effective way of increasing awareness to healthcare professionals, patients, and their caregivers. The MHRA is finalising the review process and will communicate on any further measures to minimise the risk, upon completion of our review.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of any dangers to some users of the commonly prescribed asthma drug montelukast.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Montelukast remains a safe and effective medicine in the treatment of asthma. Montelukast is indicated for use in the United Kingdom as an add on treatment for asthma patients who are inadequately controlled on inhaled corticosteroid treatment, and can be prescribed for the symptomatic relief of seasonal allergic rhinitis in patients with asthma. There is no licensed indication in the UK for the treatment of allergic rhinitis alone.
Neuropsychiatric effects such as depression have been included in the UK product information for montelukast since 2007. This has been subsequently updated with additional terms based on emerging evidence. This includes the most recent update in 2019, which more fully described the neuropsychiatric effects. In order to remind prescribers of the risk of neuropsychiatric effects with montelukast, a Drug Safety Update article was published by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2019, to accompany the updated warnings.
Following a growing number of Yellow Card reports and queries from patients and caregivers, raising concerns about a potential ongoing lack of awareness of the risk of the neuropsychiatric effects with montelukast, the MHRA is conducting a further review of the current data.
As part of our review, we are evaluating all available evidence, including Yellow Card reports and queries received by the MHRA, literature publications, international regulatory changes, including those made by the United States’ Food and Drug Administration, and are listening to and learning from patients’ experiences. The MHRA has sought advice from our independent expert groups including paediatricians, specialists in mental and respiratory health, as well as experts in medicines safety.
We are considering all relevant regulatory actions that would provide the most effective way of increasing awareness to healthcare professionals, patients, and their caregivers. The MHRA is finalising the review process and will communicate on any further measures to minimise the risk, upon completion of our review.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are taking steps to ensure that NHS organisations assess the purchase of absorbent continence products and their dispensation to patients based on (1) their impact on patient experience and outcomes, (2) whole-system costs, (3) laundry costs, including energy use, and (4) environmental impact, as well as item price; and what assessment they have made of the savings that would accrue to such organisations in doing so.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The disposable continence tender is due to be issued to the market later this year. To ensure that the National Health Services requirements are considered during the procurement process, the NHS Supply Chain are undertaking significant engagement across the health and social care system. This includes customers in the acute and wider community setting, suppliers, trade associations, professional bodies, and end user reference groups, to understand their requirements from a commercial, value, sustainability, and supply resilience perspective.
The NHS Supply Chain are currently working with suppliers of disposable continence products to understand the value-based procurement and sustainability offerings on the purchase of continence products. The NHS Supply Chain have identified a trust who are committed to supporting us in understanding this value, in the form of a pilot study and potential case study. More information can be provided once these studies have been finalised and confirmed.
To support value-based procurement decisions more broadly across medical technologies, a standard methodology is being developed to assess the value of medical technology beyond upfront cost alone. It is intended that this will support the adoption of products which demonstrate value to the whole system, and ensure the best products are reaching patients.
The Government is working closely with NHS England and wider health partners to develop the methodology and plans for implementation at both a national and local level. The Government is committed to working collaboratively with industry and the procurement community in developing the methodology and will share an initial proposal in due course.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking with NHS England to promote the principles of value-based procurement in the purchase and dispensation of absorbent continence products; and to ensure that pressure on NHS organisations to deliver short-term savings does not undermine the adoption of those principles.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The disposable continence tender is due to be issued to the market later this year. To ensure that the National Health Services requirements are considered during the procurement process, the NHS Supply Chain are undertaking significant engagement across the health and social care system. This includes customers in the acute and wider community setting, suppliers, trade associations, professional bodies, and end user reference groups, to understand their requirements from a commercial, value, sustainability, and supply resilience perspective.
The NHS Supply Chain are currently working with suppliers of disposable continence products to understand the value-based procurement and sustainability offerings on the purchase of continence products. The NHS Supply Chain have identified a trust who are committed to supporting us in understanding this value, in the form of a pilot study and potential case study. More information can be provided once these studies have been finalised and confirmed.
To support value-based procurement decisions more broadly across medical technologies, a standard methodology is being developed to assess the value of medical technology beyond upfront cost alone. It is intended that this will support the adoption of products which demonstrate value to the whole system, and ensure the best products are reaching patients.
The Government is working closely with NHS England and wider health partners to develop the methodology and plans for implementation at both a national and local level. The Government is committed to working collaboratively with industry and the procurement community in developing the methodology and will share an initial proposal in due course.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what assessment they have made of the potential distress caused to spousal pension recipients by Teachers’ Pensions requiring recipients whose spouses retired before January 2007 to confirm annually that they are not living with a new partner; and what assessment they have made of how many such recipients are now living with new partners.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
The beneficiaries of spouses who were members of the Teachers’ Pension Scheme (TPS) who retired before January 2007 are required to complete an annual declaration confirming that they continue to be entitled to receive a survivor’s pension from the Scheme. This process was introduced in 2016 following the identification of a number of cases where entitlement under Scheme rules had ended due to the beneficiary remarrying, entering a civil partnership or living with another person as if married or in a civil partnership. These cases resulted in some significant overpayments needing to be repaid.
The possible impact of the letter on the recipient was considered when the process was established and is subject to discussion with the Teachers’ Pension Scheme Advisory Board, however the department considers that this preventative measure is proportionate and preferable to the alternative. The scheme administrator does not collect information on how many recipients are living with new partners as it is not necessary for the administration of the scheme.
The review referred to in The Guardian on 10 February 2024 was in relation to a separate data exercise where some details of a recipient of TPS benefits match those of a recorded death. This is a standard check carried out by pension scheme administrators to reduce instances of fraud and error leading to overpayments which ultimately cost the taxpayer if they cannot be recovered.
Teachers’ Pensions matches the data of beneficiaries and members who have a pension in payment annually with deaths recorded on the death register. Where there is a sufficiently strong match, the recipient is asked to complete a declaration of ongoing entitlement. The scheme administrator does not record incorrect data about the member from this match and the pension is only suspended if a declaration is not received within 28 days. This is to minimise any potential overpayment.
The review was an internal consideration of the processes and it was concluded that they remain appropriate, but that more detailed guidance on the Teachers’ Pensions website would be helpful for those who may be affected. Updated information is currently being prepared.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what assessment they have made of whether Teachers’ Pensions is incorrectly claiming that some pensioners are dead and stopping their pension payments without cross-checking the death register; and of whether it is complying with its data protection requirements.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
The beneficiaries of spouses who were members of the Teachers’ Pension Scheme (TPS) who retired before January 2007 are required to complete an annual declaration confirming that they continue to be entitled to receive a survivor’s pension from the Scheme. This process was introduced in 2016 following the identification of a number of cases where entitlement under Scheme rules had ended due to the beneficiary remarrying, entering a civil partnership or living with another person as if married or in a civil partnership. These cases resulted in some significant overpayments needing to be repaid.
The possible impact of the letter on the recipient was considered when the process was established and is subject to discussion with the Teachers’ Pension Scheme Advisory Board, however the department considers that this preventative measure is proportionate and preferable to the alternative. The scheme administrator does not collect information on how many recipients are living with new partners as it is not necessary for the administration of the scheme.
The review referred to in The Guardian on 10 February 2024 was in relation to a separate data exercise where some details of a recipient of TPS benefits match those of a recorded death. This is a standard check carried out by pension scheme administrators to reduce instances of fraud and error leading to overpayments which ultimately cost the taxpayer if they cannot be recovered.
Teachers’ Pensions matches the data of beneficiaries and members who have a pension in payment annually with deaths recorded on the death register. Where there is a sufficiently strong match, the recipient is asked to complete a declaration of ongoing entitlement. The scheme administrator does not record incorrect data about the member from this match and the pension is only suspended if a declaration is not received within 28 days. This is to minimise any potential overpayment.
The review was an internal consideration of the processes and it was concluded that they remain appropriate, but that more detailed guidance on the Teachers’ Pensions website would be helpful for those who may be affected. Updated information is currently being prepared.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government when they expect to publish the outcome of their review into the Teachers’ Pensions fraud system for checking whether spouses of recipients who retired before January 2007 are living with a new partner, as outlined in The Guardian on 10 February.
Answered by Baroness Barran - Parliamentary Under-Secretary (Department for Education)
The beneficiaries of spouses who were members of the Teachers’ Pension Scheme (TPS) who retired before January 2007 are required to complete an annual declaration confirming that they continue to be entitled to receive a survivor’s pension from the Scheme. This process was introduced in 2016 following the identification of a number of cases where entitlement under Scheme rules had ended due to the beneficiary remarrying, entering a civil partnership or living with another person as if married or in a civil partnership. These cases resulted in some significant overpayments needing to be repaid.
The possible impact of the letter on the recipient was considered when the process was established and is subject to discussion with the Teachers’ Pension Scheme Advisory Board, however the department considers that this preventative measure is proportionate and preferable to the alternative. The scheme administrator does not collect information on how many recipients are living with new partners as it is not necessary for the administration of the scheme.
The review referred to in The Guardian on 10 February 2024 was in relation to a separate data exercise where some details of a recipient of TPS benefits match those of a recorded death. This is a standard check carried out by pension scheme administrators to reduce instances of fraud and error leading to overpayments which ultimately cost the taxpayer if they cannot be recovered.
Teachers’ Pensions matches the data of beneficiaries and members who have a pension in payment annually with deaths recorded on the death register. Where there is a sufficiently strong match, the recipient is asked to complete a declaration of ongoing entitlement. The scheme administrator does not record incorrect data about the member from this match and the pension is only suspended if a declaration is not received within 28 days. This is to minimise any potential overpayment.
The review was an internal consideration of the processes and it was concluded that they remain appropriate, but that more detailed guidance on the Teachers’ Pensions website would be helpful for those who may be affected. Updated information is currently being prepared.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of international phase 3 clinical trials which suggest that Vorasidenib could offer a new treatment option for low-grade glioma; and whether they intend to make it available to brain tumour patients.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
If the manufacturer applies for a marketing authorisation in the United Kingdom, the Medicines and Healthcare products Regulatory Agency will consider clinical trial evidence in making a licensing decision. Subject to licensing, the National Institute for Health and Care Excellence will consider the clinical trial evidence, when making decisions on whether vorasidenib should be recommended for routine National Health Service funding.