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Written Question
Cancer: Health Services
Thursday 14th March 2024

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she has held discussions with NHS England on the need for a dedicated and specific cancer plan.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department works closely with NHS England on a wide range of issues relating to cancer, and to deliver the key priorities on cancer as set out in the NHS Long Term Plan. Current priorities include work on improving cancer survival rates through earlier diagnosis, and reducing cancer treatment waiting times across England, including the time between an urgent general practice referral and the commencement of treatment. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and 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 activity.

On 14 August 2023, the Government published a strategic framework for the Major Conditions Strategy to consider the six conditions, including cancer, that contribute most to morbidity and mortality across the population in England. This is because we recognise that most cancer patients will have at least one other condition, so we are developing a Major Conditions Strategy that will include cancer. The Major Conditions Strategy will apply a geographical lens to each condition, to address regional disparities in health outcomes, supporting the levelling up mission to narrow the gap in healthy life expectancy by 2030.


Written Question
Radiotherapy: Health Professions
Thursday 14th March 2024

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will take steps to recruit an additional 2,000 radiotherapy professionals by 2040.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

In June 2023, NHS England published the NHS Long Term Workforce Plan, which sets out the steps the National Health Service and its partners need to take to deliver a workforce that meets the changing needs of the population, over the next 15 years. The plan recognises the need to increase numbers of allied health professionals (AHPs), including therapeutic and diagnostic radiographers. To address this, we will increase AHP training places from a little over 15,000 in 2021/22 to 17,000 by 2028/89, and then 18,800 by 2031/32, a total increase of approximately 25%. National funding is available to train 150 enhanced practice radiographers a year, to support the diagnosis of cancer and other conditions.

We have already seen increases in the radiotherapy workforce in NHS trusts and other care organisations in England. In November 2023, there were 894 full-time equivalent (FTE) consultants working in the specialty of clinical oncology, an increase of 40, or 4.6%, since November 2022 and 395, or 79.0%, since November 2010. There are also 3,141 FTE therapeutic radiographers, an increase of 133, or 4.4%, since November 2022 and 1,046, or 50.0%, since November 2010. We are also focused on improving cancer treatment, and are supporting advances in radiotherapy, such as using cutting-edge imaging and technology to help target radiation doses at cancer cells more precisely.


Written Question
Radiotherapy: Medical Equipment
Wednesday 13th March 2024

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent discussions she has had with Integrated Care Boards in England on replacement programmes for radiotherapy machinery (LINACS); and what mechanisms are in place to allow her Department to oversee the effectiveness of those replacement programmes.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Since April 2022, the responsibility for investing in new radiotherapy machines has sat with local systems. This is supported by the 2021 Spending Review, which set aside £12 billion in operational capital for the National Health Service, from 2022 to 2025.

The Government and NHS England are already taking steps to ensure that cancer patients can receive high quality radiotherapy treatment across England. This includes supporting advances in radiotherapy, using cutting-edge imaging and technology to help target radiation doses at cancer cells more precisely.


Written Question
Patient Choice Schemes
Monday 15th January 2024

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to her Department's guidance entitled Elective recovery taskforce: implementation plan, published on 4 August 2023, what steps she is taking to ensure equity of access for those unable to use digital platforms.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

In September 2023, NHS England published a framework for action on digital inclusion to help the system design and implement inclusive digital approaches and technologies, including actions to build digital skills and capability among patients and National Health Service staff. This covers all NHS digital platforms. Patients unable to use digital channels will continue to be able to access services via telephone and through face-to-face services.


Written Question
Skin Diseases: Medical Treatments
Tuesday 19th December 2023

Asked by: Peter Dowd (Labour - Bootle)

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 increase access to NICE-approved treatments for patients with inflammatory skin conditions.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The National Institute for Health and Care Excellence (NICE) evaluates all new licensed medicines and licence extensions for existing medicines including any treatments for inflammatory skin conditions and aims to issue guidance on their use close to the time of licensing wherever possible. The National Health Service in England is legally required to fund medicines recommended by NICE, normally within 90 days of the publication of its final guidance. NICE has recommended a number of treatments for inflammatory skin conditions such as eczema, hidradenitis suppurativa and psoriasis that are now routinely available for NHS patients.


Written Question
Dermatitis: Medical Treatments
Tuesday 19th December 2023

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will have discussions with NICE on developing (a) national guidelines and (b) quality standards for the management of severe eczema in adults.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department regularly holds discussions with colleagues in the National Institute for Health and Care Excellence (NICE) about its guidelines programme. NICE has reviewed its guideline portfolio to identify topics that it thinks will add the most value to the health and care system, considering key factors such as clinical benefit, cost effectiveness, the potential to increase productivity and support workforce issues and the potential to address health inequalities.

Atopic dermatitis (eczema) in young people and adults is one of the topics on which NICE will stop work for the time being to allow them to focus on key priorities. Topics that have been stopped will be reconsidered by NICE’s prioritisation board which is being established in Spring 2024 by its chief medical officer.


Written Question
Skin Diseases: Health Services
Tuesday 19th December 2023

Asked by: Peter Dowd (Labour - Bootle)

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 impact of implementing NHS England’s Referral optimisation for people with skin conditions on (i) the cost of treatment and (ii) number of referrals for people with skin conditions in (a) England, (b) Cheshire and Merseyside integrated care system and (c) Mersey Care NHS Foundation Trust.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.

We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.

No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.

The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.

It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.


Written Question
Skin Diseases: Health Services
Tuesday 19th December 2023

Asked by: Peter Dowd (Labour - Bootle)

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 impact of the time taken for patients with inflammatory skin conditions to be referred for specialist care on the cost of treatment for such conditions.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.

We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.

No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.

The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.

It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.


Written Question
Skin Diseases: Health Services
Tuesday 19th December 2023

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help reduce the time taken for patients with inflammatory skin conditions to access (a) specialist care and support and (b) treatment.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure that patients get the care they need when they need it.

We are taking action to recover elective services, including for patients waiting for National Health Service dermatology services, by working towards the targets set out in the Elective Recovery Plan and providing the NHS with record levels of staffing and funding. To facilitate this across the NHS in England, we are: increasing activity, with plans to spend more than £8 billion from 2022/23 to 2024/25; expanding capacity though creating a new network of community diagnostic centres; and maximising all available independent sector capacity. We are managing demand through specialised advice in primary care and giving patients more control over where they receive their care, and we are increasing productivity through transforming outpatient services, developing new surgical hubs to increase theatre productivity and working actively with trusts to support and challenge on their performance.

No specific assessment has been made of the potential impact of implementing NHS England’s referral optimisation for people with skin conditions on the cost of treatment and the number of referrals for people with skin conditions in England, Cheshire and Merseyside Integrated Care System or Mersey Care NHS Foundation Trust.

The aim of referral optimisation is to triage referrals using electronic means, so that those with less serious problems can be offered rapid advice by their general practitioner (GP). This has the potential to create efficiencies by offering people with disabling skin problems rapid treatment to get them back to work and functioning at home quickly. Ensuring only those patients with the most serious conditions are sent to hospital will help to reduce waiting lists and ensure NHS hospital resources are used for those most likely to benefit most.

It is important that integrated care systems work with both GPs and hospitals to monitor referral numbers and ensure that the benefits of electronic triage are not outweighed by increased demand.


Written Question
Skin Diseases: Drugs
Monday 18th December 2023

Asked by: Peter Dowd (Labour - Bootle)

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to page 85 of the Getting it Right First Time report on Dermatology, published by the NHS in August 2021, how many and what proportion of trusts are required to wait for commissioner approval before prescribing (a) NICE-approved biologics for psoriasis and (b) other NICE-approved drugs.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

As advised in the Getting it Right First Time (GIRFT) national report on dermatology, published in August 2021, 56% of trusts reported that they had to wait for commissioner approval before prescribing drugs approved by the National Institute for Health and Care Excellence (NICE), and 12% of trusts said they had been told by clinical commissioning groups that they could not prescribe certain NICE-approved biologics for psoriasis at the time of NHS England’s data questionnaire in 2018/19.

During GIRFT’s subsequent deep dives into the 110 trusts with significant dermatology activity, it became apparent that there was ongoing variation in the way trusts adopt NICE guidelines. While some allow clinicians to prescribe drugs as soon as they are NICE approved, others have processes in place which can produce delays of more than a year in some cases.

GIRFT is aiming to publish trust- and system-level data for dermatology on the Model Health System in early 2024, enabling dermatology clinicians and managers to monitor their variation in provision of care, services, and treatments for skin disorders. Specific metrics for inflammatory skin disorders, including biologic prescribing for psoriasis and eczema, will be included. The aim is to use this data to inform the dermatology element of GIRFT’s Further Faster programme to help target unwarranted variation in care provision for inflammatory skin disease. The Further Faster programme supports providers to deliver rapid clinical transformation to reduce 52-week waits.

There are no plans to introduce specific targets to adopt the NHS England guidance on Referral Optimisation for people with skin conditions. The Outpatient Recovery & Transformation Programme in NHS England will continue to promote the guidance through NHS England regional teams, integrated care boards and directly to provider organisations.

In addition, specific engagement events, such as the webinar delivered on 21 November 2023, will continue to reinforce the need for appropriate and timely referral optimisation across skin care pathways. The programme is working closely with GIRFT and the Further Faster teams to ensure that referral optimisation is seen as a valuable tool to effectively manage the skin care pathway. Through this effort to engage the system combined with the publication of consistent guidance and evidence across the whole skin care pathway, it is hoped that variation can be reduced, across pathway implementation.

It should be recognised that there may be appropriate clinical reasons for some regional or local variation, so it is important to ensure that all patients who need specialist skincare have equal access. The programme will look to review data over the course of the year to understand the impact and consider relevant next steps.