Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to publish the Delivery Plan for ME/CFS.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The myalgic encephalomyelitis, also known as chronic fatigue syndrome, final delivery plan will be published shortly. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to provide routine access to circulating tumour DNA blood tests to support the (a) detection and (b) treatment of breast cancer.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department remains committed to improving faster and earlier detection of breast cancer and will work to ensure that patients have timely access to lifesaving, innovative treatments. We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, having now delivered over four million more appointments as the first step to ensuring earlier and faster access to treatment. There are no current plans to provide routine access to circulating tumour DNA blood tests.
The Government’s wider investments into breast cancer research include a £1.3 million project to determine whether an abbreviated form of breast magnetic resonance imaging can detect breast cancers missed by screening through mammography, including lobular breast cancer. We are also proud to have invested £29 million into the Institute of Cancer Research and the Royal Marsden National Institute for Health and Care Research Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, including breast cancer.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much the NHS spends on average per patient with secondary (metastatic) breast cancer; and if he will make a comparative assessment of the average spend per patient with primary breast cancer.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
We are committed to improving the lives of those diagnosed with both primary and secondary breast cancer. The Department does not hold the information to make a comparative assessment of the average spend per patient with primary or secondary breast cancer.
Reducing unwarranted variation in cancer treatment is a strategic priority for the National Health Service. NHS England commissioned new clinical audits on primary and metastatic breast cancer to increase the consistency of access to treatments. On 12 September 2024, the National Cancer Audit Collaborating Centre published their State of the Nation Report on breast cancer. Officials at the Department and NHS England are in the process of considering the audit’s findings and what any next steps could be. To drive up the completeness of data for breast cancer, progesterone receptor status is already collected as part of the NHS Cancer Outcomes and Services Data set. No specific breakdown is available at this time.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether the National Audit of Metastatic Breast Cancer will provide a specific breakdown by (a) breast cancer subtype and (b) hormone receptor status.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
We are committed to improving the lives of those diagnosed with both primary and secondary breast cancer. The Department does not hold the information to make a comparative assessment of the average spend per patient with primary or secondary breast cancer.
Reducing unwarranted variation in cancer treatment is a strategic priority for the National Health Service. NHS England commissioned new clinical audits on primary and metastatic breast cancer to increase the consistency of access to treatments. On 12 September 2024, the National Cancer Audit Collaborating Centre published their State of the Nation Report on breast cancer. Officials at the Department and NHS England are in the process of considering the audit’s findings and what any next steps could be. To drive up the completeness of data for breast cancer, progesterone receptor status is already collected as part of the NHS Cancer Outcomes and Services Data set. No specific breakdown is available at this time.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that the 2013 mandate to accurately collect and collate data on cancer recurrence is being fully implemented.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is committed to ensuring that data on cancer is complete and of sufficiently high quality. The National Disease Registration Service (NDRS) collects recurrence data for non-primary cancers via data submissions as part of the Cancer Outcomes and Services Dataset (COSD). The COSD has been the national standard for reporting cancer in the National Health Service in England since January 2013, and provides a helpdesk and data liaison service to support data completeness.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking is taking to ensure that people diagnosed with invasive lobular breast cancer are routinely offered MRI scans for follow-up monitoring.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Health Service is committed to ensuring that all cancer patients in England, including those with lobular breast cancer, have access to personalised care, including a needs assessment, a care plan, and health and wellbeing information and support.
Treatment for cancer is highly individualised and decisions about cancer treatment, including ongoing monitoring and follow up care, are typically made by clinicians and multidisciplinary teams of healthcare professionals. These decisions are based on medical assessments and what's best for the individual's overall health and well-being.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department (a) has made and (b) plans to make an assessment of the impact of exposure to chemicals on cancer incidence rates.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps NHS England is taking to ensure that NHS Trusts are able to deliver emerging treatments for Duchenne muscular dystrophy when they are needed by patients.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department understands the impact that Duchenne muscular dystrophy has on those living with it and their families, and the urgent need for new treatment options. If new therapies for Duchenne muscular dystrophy are approved by the National Institute for Health and Care Excellence (NICE), then appropriate commissioning plans will be put in place to enable equitable access to treatment through Specialised Neurology Services.
The delivery of timely and equitable access to new treatments for Duchenne muscular dystrophy under company-sponsored early access schemes is not the responsibility of NHS England. Individual pharmaceutical companies may put in place Early Access Programmes (EAPs) to allow early access to new medicines that do not yet have a marketing authorisation. Participation in EAPs is decided at an individual National Health Service trust level, and under these programmes, the cost of the drug is free to both patients taking part in it, and to the National Health Service, although NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP.
There are no common clinical, data, or regulatory standards for company-sponsored EAPs, meaning each one demands a new protocol to be devised and delivered by each participating trust, which can create significant pressures on clinical and financial resources. Companies providing a sponsored EAP also reserve the right to limit or to close registration of new patients at any time, meaning that any financial and clinical investment made by trusts to establish an EAP could be undermined by a commercial decision that would most likely happen in the event of the treatment not being recommended following an appraisal by NICE.
NHS England has published guidance for integrated care systems (ICS) on free of charge (FoC) medicine schemes, including EAPs, providing advice on potential financial, resourcing, and clinical risks.
ICSs should use the guidance to help determine whether to implement any FoC scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with steps NICE on ensuring greater (a) clarity and (b) transparency in relation to how carer quality of life is considered within its medicines appraisal framework.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s (NICE) technology appraisal process allows its independent committees to take all health-related costs and benefits, including health-related quality-of-life for carers, and impacts on personal social services, into account. The NICE’s methods are set out in its published health technology evaluations manual, which is available at the following link:
https://www.nice.org.uk/process/pmg36
Evaluations should consider all health effects for patients, and, when relevant, carers. When presenting health effects for carers, evidence should show when a condition is associated with a substantial effect on a carer’s health-related quality of life, and how the technology affects carers. This applies for all therapies, including therapies for rare diseases. NICE appraisals specifically consider health-related quality of life, for both patients and carers, rather than quality of life as a whole.
Asked by: John Milne (Liberal Democrat - Horsham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with NICE on ensuring that the Single Technology Appraisal process takes into account the health-related quality-of-life impacts on carers for (a) all and (b) rare disease therapies.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence’s (NICE) technology appraisal process allows its independent committees to take all health-related costs and benefits, including health-related quality-of-life for carers, and impacts on personal social services, into account. The NICE’s methods are set out in its published health technology evaluations manual, which is available at the following link:
https://www.nice.org.uk/process/pmg36
Evaluations should consider all health effects for patients, and, when relevant, carers. When presenting health effects for carers, evidence should show when a condition is associated with a substantial effect on a carer’s health-related quality of life, and how the technology affects carers. This applies for all therapies, including therapies for rare diseases. NICE appraisals specifically consider health-related quality of life, for both patients and carers, rather than quality of life as a whole.