Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help improve the knowledge of GPs on the symptoms of young onset dementia.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
We want all general practitioners to have received appropriate training, in order to provide high quality care to people with dementia, regardless of the person’s age or individual needs.
The standard of training for health care professionals is the responsibility of the health care independent statutory regulatory bodies who set the outcome standards expected at undergraduate level and approve courses and Higher Education Institutions to write and teach the curricula content that enables their students to meet the regulators outcome standards.
Whilst not all curricula may necessarily highlight a specific condition, they all nevertheless emphasize the skills and approaches a Health Care Practitioner must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients, including for dementia.
The NHS Long Term Workforce Plan, published on 30 June 2023, sets out NHS England’s commitment to improving training for workers caring for people with dementia.
The Long Term plan also sets out the plan for there to be more healthcare staff working in and with GP practices, which will mean people will be able to get an appointment with the right professional depending on their needs. This means that those with dementia will be able to access the most appropriate support more quickly.
The plan will include more GPs, nurses and 20,000 additional pharmacists, physiotherapists, paramedics, physician associates and social prescribing link. These bigger teams of staff will work with other local services to make sure people, including those with dementia, get better access to a wider range of support for their needs.
We are seeing more people from younger cohorts with multimorbidity. Multimorbidity challenges the specialised approach to medicine, which has improved our ability to successfully treat single diseases. The Long Term Plan also addresses the increased need for medical and other clinical professionals with generalist and core skills to manage and support patients with seemingly unrelated diseases.
There are also a variety of resources available on the NHS England E-learning for Health platform, including a programme on dementia care, designed to enhance the training and education of the health and social care workforce.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential merits of (a) 3D mammography and (b) other new screening technologies to support the early diagnosis of breast cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The UK National Screening Committee (UK NSC) is aware of research into the use of three-dimensional (3D) mammography and the growing interest to use artificial intelligence (AI) in the National Health Service breast screening programme. Guidance has been published on GOV.UK on the use of Tomosynthesis 3D imaging in a clinical trial setting as part of the NHS breast screening programme.
The UK NSC had also worked with Health Technology Assessments to design an evaluation of existing AI in a prospective study to look at whether it could be used to read breast screening mammograms.
There are currently no plans to adopt these technologies, but evidence to inform a UK NSC decision on the use of 3D mammography and AI in the NHS breast screening programme will be reviewed by the Committee when available.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment her Department has made of the potential merits of introducing (a) a risk assessment and (b) a breast density assessment during a women's first breast cancer screening appointment.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The UK National Screening Committee (UK NSC) plans to review the evidence for risk stratification in breast screening, to tailor it more closely to an individual’s risk of cancer, rather than the current population-based approach.
In 2019, the UK NSC reviewed the benefit of additional screening with ultrasound after a negative mammography screening, for women with dense breasts. The Committee concluded that there was insufficient evidence to recommend additional ultrasound screening at that time.
The Breast Screening Risk Adaptive Imaging for Density trial is looking into the use of supplementary imaging techniques for women within the standard breast screening programme, who are found to have radiographically dense breast tissue. The UK NSC will review this evidence when it becomes available.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of (a) lowering the breast cancer screening age to 40 and (b) including a breast cancer risk assessment in the first appointment.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The UK National Screening Committee (UK NSC) currently recommends that all women aged 50 years old to 71 years old are invited for breast screening every three years. A trial, AgeX is looking at the impact of increasing or decreasing, or both, the screening age for the breast screening programme. When the results from this trial are available, the UK NSC will review the findings. The UK NSC plans to review the evidence for risk stratification in breast screening to tailor it more closely to an individual’s risk of cancer, rather than the current population-based approach.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the dementia diagnosis rate was for people aged under 65 who had developed symptoms on 23 February 2024; and if she will publish a monthly estimate of this rate within national primary care dementia data.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The dementia diagnosis rate is not calculated for patients aged under 65 years old. This is because the numbers of patients known to have dementia in the sample population age groups comprising those aged between zero and 64 years old are not large enough for reliable estimates to be made.
The dementia diagnosis rate for patients aged 65 years old and over is calculated and published monthly via the Primary Care Dementia Data publication, which is available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/primary-care-dementia-data
This publication does include a monthly count of the number of patients aged 65 years old and under who do have a dementia diagnosis on their patient record; this is expressed as a raw count and as a percentage of registered patients aged between zero and 64 years old.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if her Department will take steps to require every Integrated Care Board to develop a young onset dementia pathway to (a) standardise and (b) improve dementia (i) care and (ii) support for people of working age.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence guidelines.
The Dementia Well Pathway includes diagnosing well, living/ supporting well and dying well, and highlights that services need to be integrated, commissioned, monitored, and aligned with NICE standards for each component of the pathway. It makes it clear that the needs, wishes and preferences of each individual, including those of working age, should be taken into account in planning and providing their care.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the effectiveness of the national ambition for dementia diagnosis rates at ensuring that people under 65 receive (a) a timely dementia diagnosis and (b) appropriate post-diagnostic support.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The dementia diagnosis rate is not calculated for patients aged under 65 years old. This is because the numbers of patients known to have dementia in the sample population age groups comprising the zero to 64-year-old age range, are not large enough for reliable estimates to be made. Nonetheless, NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care.
As part of the spending review settlement in 2021/22, £17 million was allocated to the National Health Service to address dementia waiting lists and to increase the number of diagnoses, which had been adversely impacted by the pandemic. NHS England will share reporting on the impact of this funding and examples of good practice with dementia clinical networks in March 2024.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the availability of genomic testing.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Genomic Test Directory defines which genomic tests must be delivered by the NHS Genomic Laboratory Hubs in England, as well as who is eligible for genomic testing. The directory currently covers testing for over 3,200 rare diseases and over 200 cancer clinical indications. NHS England regularly updates the directory, through a robust and evidence-based test evaluation process, to keep pace with scientific and technological advances, and to ensure that genomic testing is available for all patients for whom it would be of clinical benefit. Testing is available for all eligible patients across England.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the implications for her policies of variations in access to genetic and genomic testing for cancer through the NHS Genomics Medicine Service; and what steps her Department is taking to reduce these variations.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The seven NHS Genomic Medicine Service Alliances raise awareness of genomics among healthcare professionals and support delivery of equitable access to genomic testing, clinical genetics, and genomic counselling services. NHS England has also established the NHS Genomics Ethics, Equity and Legal Advisory Group to ensure that the NHS Genomic Medicine Service (NHS GMS) provides equitable access to all patients. The group will identify and review appropriate datasets to inform health inequalities analysis of the NHS GMS, and identify actions to address inequalities.
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the impact of trends in average waiting times for biomarker and genomic testing on waiting times for cancer treatment.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England has implemented capturing of Patient Level Contract Monitoring data across the National Health Service Genomic Laboratory Hubs (GLHs) to facilitate a national approach to reporting and validating activity data and turnaround times. This will enable NHS England to understand activity volumes, detect any backlogs, and institute recovery. NHS England undertakes a quarterly assurance process with each of the NHS GLHs to monitor improvements in turnaround times to ensure these are being met in every region and for all patients.
NHS England is also undertaking a programme of work alongside clinical experts, including the Medical Royal Colleges, to establish clinically relevant cancer turnaround times across diagnosis, prognosis, treatment determining clinical use cases and optimising cancer pathways to ensure genomic test results are provided in a clinically relevant timeframe.