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
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, if he will request that NHS England review its policy on individual funding requests.
Answered by George Freeman
We have no such plans. We understand that NHS England is currently reviewing its generic policies, including its interim commissioning policy on individual funding requests.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what proportion of people on the Work Programme who have been subject to benefit sanctions have been identified as suffering from mental health problems.
Answered by Esther McVey - Minister without Portfolio (Cabinet Office)
The information requested is not readily available and could only be provided at disproportionate cost.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what comparative assessment he has made of job outcomes of those people transferred from incapacity benefit to the fit to work groups who have (a) mental health and (b) other health issues.
Answered by Mark Harper - Secretary of State for Transport
We do not hold information on job outcomes for Incapacity Benefit Reassessment claimants who are found fit for work.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what proportion of people on the Work Programme have been indentified as having mental health problems; and what the employment outcomes have been for those people since the beginning of that programme.
Answered by Esther McVey - Minister without Portfolio (Cabinet Office)
Information is available which shows the number of ESA claimants who participate on the Work Programme and achieve a Job Outcome. This information also shows where a mental and behavioural disorder has been identified as the primary health condition by these participants. Information is available at:
http://tabulation-tool.dwp.gov.uk/WorkProg/tabtool.html
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what research he has commissioned into the mental health needs of people claiming jobseeker's allowance.
Answered by Mark Harper - Secretary of State for Transport
We recognise that mental health is a mainstream issue for employment support and are committed to supporting people with common mental health conditions into employment. That is why the Department commissioned research into the effects that unemployment has on the mental health and wellbeing of Jobseeker’s Allowance (JSA) claimants. In 2012 we published The Mental health in context: the national study of work-search and wellbeing report which examined the mental health and wellbeing of JSA claimants.
We also commissioned RAND Europe to undertake research to examine the existing evidence on mental health interventions and propose new approaches to develop the evidence base for future policy development. The report suggested a range of approaches to improve the alignment of mental health and employment services for people with common mental health conditions.
With the Department of Health we took forward a number of feasibility pilots based on the recommendations put forward in the report Psychological Wellbeing and Work: Improving Service Provision and Outcomes to explore the most promising and evidence-based approaches to supporting individuals with mental health conditions.
These pilots will contribute to a better evidence base for action and will inform our thinking about next steps not only for government, but for all who have a role to play including employers, commissioners, service providers and individuals.
We will expand these pilots from summer 2015 and use the learning from the early pilots to support the delivery of the next phase.
Asked by: Paul Burstow (Liberal Democrat - Sutton and Cheam)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what the recorded primary medical condition was of each incapacity benefit reassessment claimant, where the outcome of the assessment was fit for work, since September 2013; and if he will make a statement.
Answered by Mark Harper - Secretary of State for Transport
The information requested is shown in the table below.
Number of Incapacity Benefits Reassessments with a Fit for Work outcome split into International Classification of Diseases (2010) Condition Groups: 01 October 2013 to 31 March 2014
| |
Disabling condition groups | Fit for Work decisions |
Certain Infectious and Parasitic Diseases | - |
Neoplasms | - |
Diseases of the Blood and Blood forming organs and certain diseases involving the immune mechanism | - |
Endocrine, Nutritional and Metabolic Diseases | - |
Mental and Behavioural Disorders | 800 |
Diseases of the Nervous System | 100 |
Diseases of the Eye and Adnexa | - |
Diseases of the Ear and Mastoid Process | - |
Diseases of the Circulatory System | 100 |
Diseases of the Respiratory System | - |
Diseases of the Digestive System | - |
Diseases of the Skin and Subcutaneous System | - |
Diseases of the Musculoskeletal system and Connective Tissue | 500 |
Diseases of the Genitourinary System | - |
Pregnancy, Childbirth and the Puerperium | - |
Congenital Malformations, Deformations and Chromosomal Abnormalities | - |
Symptoms, Signs and Abnormal Clinical and Laboratory findings, not elsewhere classified | 300 |
Injury, Poisoning and certain other consequences of external causes | 100 |
Factors influencing health status and contact with health services | - |
Total | 2,000 |
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Source: Data in the tables above is derived from administrative data held by the DWP and assessment data provided by Atos Healthcare. | |
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Notes: |
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1. Figures are rounded to the nearest 100. “-“denotes nil or under 50. 2. Totals may not sum due to the rounding method used. | |
3. March 2014 is the latest data available. |
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4. The outcome recorded is the final DWP Decision Maker’s decision or the recommendation made by the Atos Healthcare Professional where the Decision Maker’s decision is not yet available. | |
5. The data presented above comes from benefit claims data held by the Department for Work and Pensions. In October 2008, ESA replaced IB for new claims. Starting with a trial in October 2010 and reaching a full scale national roll-out in April 2011, existing IB claims began to be phased out, with claimants reassessed to see if they qualify for ESA instead. | |
Special points to note
This is a follow on to PQ207639 answered on 1 September 2014 where we gave the data requested up to September 2013. We are now providing the data from October 2013 to March 2014 for IBR cases found fit for work, by disabling condition.