Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, when the NHS Commissioning Board Special Health Authority first issued a public consultation on funding for Duodopa; what the outcome of that consultation was; and if he will make a statement.
Answered by George Freeman
NHS England has advised that it has not conducted a formal consultation process yet but has engaged with stakeholders during the process of developing its draft commissioning policy on the treatment of advanced Parkinson’s disease with Duodopa (co-careldopa) that is awaiting prioritisation later this year.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, on what dates in the last five years NHS England or its predecessor organisations have taken a decision to consult on whether to make Duodopa available for routine use on the NHS (a) internally and (b) externally.
Answered by George Freeman
Duodopa has never been routinely commissioned by NHS England.
NHS England assumed responsibility for directly commissioning specialised services in April 2013 and prior to this, responsibility for commissioning specialised services rested with the national NHS Specialised Services and the 10 regional specialised commissioning groups. Details of any consultations and commissioning decisions are not held centrally.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether the specialised services circular issued by NHS England on 30 September 2013, ID SSC1315, on Individual Funding Requests for Clinically Urgent Treatment Outside Established Policy, remains in force; whether individual requests for treatments for which a cohort policy is in development will not be funded without evidence of clinical exceptionality; how many individual funding requests for (a) all treatment and (b) Duodopa were (i) approved and (ii) not approved under the (A) critical clinically urgent criteria and (B) urgent non-clinical criteria in each month in which that circular has been in force; if all requests made under the urgent non-clinical criteria received expert opinion from the Chair of the relevant clinical reference group within two weeks; and if he will make a statement.
Answered by George Freeman
NHS England has confirmed that, to be successful, any individual funding request (IFR) for Duodopa must demonstrate exceptionality against the cohort of patients with Parkinson's disease in NHS England’s draft commissioning policy.
Although it does not routinely commission Duodopa for the treatment of advanced Parkinson’s disease, NHS England has advised that, it will consider funding this treatment in exceptional clinical circumstances. Clinicians can submit IFRs for this treatment to NHS England on behalf of their patients.
NHS England has IFRs for all treatments/interventions were received by NHS England through the standard IFR process. 238 of these were considered by an NHS England IFR panel.
21 requests for Duodopa were received as shown in the table.
IFR team | Indication | Number of IFRs received | Approved | Not Approved |
Midlands and East | Duodopa | 3 | 0 | 3 |
North | Duodopa | 5 | 0 | 5 |
London | Duodopa | 11 | 0 | 11 |
South | Duodopa | 2 | 0 | 2 |
Source: NHS England
NHS England is unable to provide monthly figures due to the small volume of requests as this could lead to the identification of individual patients.
NHS England has advised that the SSC1315 on Individual Funding Requests for Clinically Urgent Treatment Outside Established Policy has officially expired but has been maintained whilst a review is taking place regarding how such cases will be handled in the future.
It has confirmed that not all non-clinical IFRs require an expert opinion. This is only sought when it is felt that further expert opinion is required. It should be noted that Duodopa became NHS England’s responsibility from April 2014. Prior to then cases were considered by clinical commissioning groups.
Details of IFRs processed under specialised services circular SSC1315 for the period 1 October 2013 to 24 February 2015 are shown in the table:
IFR team | Indication | Number of IFRs received | Approved | Not Approved | ||
critical clinically urgent | urgent non-clinical | critical clinically urgent | urgent non-clinical | |||
Midlands & East | All | 11 | 5 | 6 | 0 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
North | All | 13 | 12 | 0 | 1 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
London | All | 37 | 31 | 3 | 3 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
South | All | 18 | 10 | 1 | 3 | 4 |
Duodopa | 6 | 0 | 0 | 0 | 0 | |
Source: NHS England
Further information about NHS England’s IFR process is available at:
www.england.nhs.uk/wp-content/uploads/2013/04/cp-03.pdf
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what information NHS England collects on the status of individual funding requests for treatment.
Answered by George Freeman
NHS England has advised that it collects monthly data on individual funding requests (IFRs) received relating to specialised services. The data include the number of such IFRs received nationally and by each NHS England region and the programmes of care they relate to.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what treatments are currently due for consideration through NHS England's specialised commissioning prioritisation process; what communications his Department has received on each treatment from (a) hon Members and (b) other interested parties; whether each treatment is (i) routinely and (ii) not routinely available on the NHS in England pending the outcome of the prioritisation process; what the estimated annual eligible population is for each such treatment; and if he will make a statement.
Answered by Jane Ellison
The list of treatments that are currently due for consideration through NHS England’s specialised commissioning prioritisation process and the expected number of patients to be treated each year for each such treatment is attached.
The communications the Department has received on each such treatment from hon. Members and other interested parties since April 1 2013 is also attached.
NHS England has confirmed that all the treatments listed are not routinely available on the NHS in England pending the outcome of the prioritisation process.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether NHS England is continuing to consider whether to publish the minutes of meetings of the Clinical Priorities Advisory Group; what factors it is taking into consideration before making that decision; and if he will make a statement.
Answered by Jane Ellison
NHS England has advised that it is planning to publish the Clinical Priorities Advisory Group (CPAG) minutes for the meeting which took place in February. It plans to publish these minutes and others following the current NHS England consultation on the principles underpinning prioritisation in specialised services. The consultation closes on 27 April 2015 and can be found at:
www.engage.england.nhs.uk/consultation/investing-in-specialised-commissioning
NHS England has advised that it intends to routinely publish minutes of CPAG meetings in the future, and is considering how to make available minutes of previous meetings.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, for what reasons NHS England has established screening groups to consider individual funding requests (IFRs) before a formal review by an IFR panel can take place; what information IFR screening groups require before making a decision on whether to submit a request to an IFR panel; whether decisions made by IFR screening groups can be appealed; how many IFR screening groups are in operation; what information is collected on decisions taken by IFR screening groups; and if he will make a statement.
Answered by George Freeman
NHS England has advised that screening panels are in place to ensure that individual funding requests (IFRs) not appropriate for its IFR panel to consider are screened out (e.g. those for services commissioned by clinical commissioning groups or those where the treatment is already commissioned by NHS England). For the screening to take place, a fully completed IFR request form must be submitted. The IFR request form is available at:
www.england.nhs.uk/commissioning/policies/gp/
An appeal cannot be made against the decision of a screening panel unless further information pertinent to the request becomes available. Screening panels take place every week in the four NHS England regions.
NHS England collects data centrally on the numbers of IFRs screened but this is not broken down to individual drug level.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, on what basis NHS England's Clinical Priorities Advisory Group has recommended that Duodopa should not be routinely commissioned by NHS England; what factors NHS England's Clinical Priorities Advisory Group took into consideration in reaching that recommendation; what advice NHS England's Clinical Priorities Advisory Group sought from patient representatives in reaching that decision; what process NHS England follows to allow interested parties to appeal recommendations by the Clinical Priorities Advisory Group; and if he will make a statement.
Answered by George Freeman
NHS England has advised that its Neuroscience Clinical Reference Group (CRG) carefully reviewed the clinical evidence for the treatment of advanced Parkinson’s disease with Duodopa (co-careldopa) and made a recommendation to the Clinical Priorities Advisory Group (CPAG).
CPAG accepted the CRG’s recommendation that Duodopa should not be routinely commissioned for treatment of this condition and, in turn, made this recommendation to the Directly Commissioned Services Committee of the NHS England Board. The Board committee endorsed the recommendation in June 2014.
Both patients and carers were involved in the decision-making process. There are four patient /carer representatives on the CRG, and patient and public stakeholders registered with the CRG were given an opportunity to feed in their views before the Group made its recommendations to CPAG. CPAG’s membership includes a lay chair and four patient representatives.
Further work has been undertaken on Duodopa since NHS England’s Board endorsed CPAG’s decision in June 2014 and NHS England will reconsider whether or not to commission this treatment, alongside a number of other specialised treatments, later this year.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether the existence of the draft NHS England commissioning policy on Duodopa for a cohort of patients with Parkinson's disease means that any successful individual funding requests for Duodopa must demonstrate exceptionality against that cohort.
Answered by George Freeman
NHS England has confirmed that, to be successful, any individual funding request (IFR) for Duodopa must demonstrate exceptionality against the cohort of patients with Parkinson's disease in NHS England’s draft commissioning policy.
Although it does not routinely commission Duodopa for the treatment of advanced Parkinson’s disease, NHS England has advised that, it will consider funding this treatment in exceptional clinical circumstances. Clinicians can submit IFRs for this treatment to NHS England on behalf of their patients.
NHS England has IFRs for all treatments/interventions were received by NHS England through the standard IFR process. 238 of these were considered by an NHS England IFR panel.
21 requests for Duodopa were received as shown in the table.
IFR team | Indication | Number of IFRs received | Approved | Not Approved |
Midlands and East | Duodopa | 3 | 0 | 3 |
North | Duodopa | 5 | 0 | 5 |
London | Duodopa | 11 | 0 | 11 |
South | Duodopa | 2 | 0 | 2 |
Source: NHS England
NHS England is unable to provide monthly figures due to the small volume of requests as this could lead to the identification of individual patients.
NHS England has advised that the SSC1315 on Individual Funding Requests for Clinically Urgent Treatment Outside Established Policy has officially expired but has been maintained whilst a review is taking place regarding how such cases will be handled in the future.
It has confirmed that not all non-clinical IFRs require an expert opinion. This is only sought when it is felt that further expert opinion is required. It should be noted that Duodopa became NHS England’s responsibility from April 2014. Prior to then cases were considered by clinical commissioning groups.
Details of IFRs processed under specialised services circular SSC1315 for the period 1 October 2013 to 24 February 2015 are shown in the table:
IFR team | Indication | Number of IFRs received | Approved | Not Approved | ||
critical clinically urgent | urgent non-clinical | critical clinically urgent | urgent non-clinical | |||
Midlands & East | All | 11 | 5 | 6 | 0 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
North | All | 13 | 12 | 0 | 1 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
London | All | 37 | 31 | 3 | 3 | 0 |
Duodopa | 0 | 0 | 0 | 0 | 0 | |
South | All | 18 | 10 | 1 | 3 | 4 |
Duodopa | 6 | 0 | 0 | 0 | 0 | |
Source: NHS England
Further information about NHS England’s IFR process is available at:
www.england.nhs.uk/wp-content/uploads/2013/04/cp-03.pdf
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many attendees at each National Institute for Health and Care Excellence appraisal committee meeting convened in each of the last three years were (a) industry representatives, (b) doctors, (c) other health professionals, (d) health economists, (e) researchers, (f) patient representatives, (g) lay representatives and (h) other.
Answered by George Freeman
The National Institute for Health and Care Excellence (NICE) has advised that it does not classify information about appraisal committee attendees in the format requested.
Based on NICE’s assessment of attendees’ job titles, the breakdown of attendees across its four committees responsible for developing technology appraisals for the years 2012-14 was as follows:
industry representatives 6
doctors (general practitioners) 13
other health professionals 76
health economists 29
researchers 0
patient representatives 0
lay representatives 15
other 11