Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department has for the role hospices will play in shifting care into the community.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
We have committed to develop a 10-Year Health Plan to deliver an National Health Service fit for the future, by driving three shifts in the way health care is delivered. We will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders as we develop the plan.
One of the three shifts that the plan will deliver is around the Government’s determination to shift more healthcare out of hospitals and into the community. This includes our commitment to trial neighbourhood health centres, to ensure that patients receive personalised care in the most appropriate setting. Palliative and end of life care services, including hospices, will play an important role in our considerations of the services those centres should host. More information about how they can input into the 10-Year Health Plan is available at the following link:
Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
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 (a) increase funding for epilepsy research and (b) improve treatment options for patients with epilepsy.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department funds research into epilepsy via the National Institute for Health and Care Research (NIHR). The NIHR spent almost £19 million on 46 epilepsy research projects in the five years from April 2019 to March 2024. Additionally, over this period, more than 9,500 people were enabled to participate in epilepsy research by the NIHR Clinical Research Network, now the NIHR Research Delivery Network.
The NIHR welcomes funding applications for research into any aspect of human health, including epilepsy. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
The NIHR also works closely with other Government funders, including UK Research and Innovation, which is funded by the Department for Science, Innovation and Technology and includes the Medical Research Council, to fund research into epilepsy to improve treatments and prevent poor health outcomes for patients.
We want a society where every person, including those with long-term conditions such as epilepsy, receives high-quality, compassionate continuity of care, with their families and carers supported. We will change the National Health Service so that it becomes not just a sickness service, but one that is able to prevent ill health in the first place. This will help us be better prepared for the change in the nature of disease, and allow our services to focus more on the management of chronic, long-term conditions, including epilepsy.
At the national level, there are a number of initiatives supporting service improvement and better care for patients with epilepsy, including the RightCare Epilepsy Toolkit and the Getting It Right First Time Programme for Neurology, with further information on both available, respectively, at the following two links:
https://gettingitrightfirsttime.co.uk/academy-resources/population-health/
https://gettingitrightfirsttime.co.uk/medical_specialties/neurology/
NHS England has also established a Neurology Service Transformation Programme, a multi-year, clinically led programme to develop a new model of integrated care for neurology services, including for epilepsy.
Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to roll out NHS-funded Hybrid Close Loop technology to all Type 1 Diabetics in the UK.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
In December 2023, the National Institute for Health and Care Excellence published the Technology Appraisal guidance, and recommended that the National Health Service in England makes Hybrid Closed Loop (HCL) systems available to eligible adults, and all children and young people, those under 19 years old, with type 1 diabetes. The NICE and NHS England agreed on a phased implementation period for HCL over five-years, and without the usual 90-day funding mandate. This is because of a need to build essential workforce competencies within specialist adult services. The NHS England HCL Implementation Strategy, published in January 2024, set out how local systems can meet the needs of the eligible population living with type 1 diabetes. The initial phase of the roll out of HCL systems started earlier this year, in April 2024. Further information on the HCL Implementation Strategy is available at the following link:
https://www.england.nhs.uk/long-read/hybrid-closed-loop-technologies-5-year-implementation-strategy/
Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the introduction of the National Care Institute for Health and Care Excellence severity modifier in 2022 on the (a) appraisal of Enhertu for HER2-low secondary breast cancer and (b) availability of new treatments for secondary breast cancer over the next (i) five, (ii) ten and (iii) twenty years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes it uses in its evaluations independently, and in consultation with stakeholders. The severity modifier that the NICE introduced in 2022 is based on evidence of societal preferences, and was introduced as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement. The severity modifier was designed to be opportunity cost neutral in relation to the end of life modifier that it replaced, and to apply to a broader range of conditions than had benefited from the end of life modifier.
The NICE was unfortunately unable to recommend Enhertu (trastuzumab deruxtecan) for the treatment of HER2-low secondary breast cancer in its final guidance published in July 2024, despite the topic being awarded a severity weighting. Other drugs for advanced cancer, including breast cancer, have been approved using these methods.
No assessment has been made on the likely impact on appraisals of future breast cancer medicines. However, since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines than under the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis and hepatitis D. The NICE is keeping the impact of the severity modifier under review and is scoping further research into society’s preferences on how much additional weighting to give to health benefits for people with severe diseases.
Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make representations to NICE on their decision to no longer offer Enertu for women suffering from metastatic HER2-LOW breast cancer.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Decisions on whether new medicines should be routinely funded by the National Health Service in England are taken by the National Institute for Health and Care Excellence (NICE) on the basis of an evaluation of a treatment’s costs and benefits. NICE’s methods are internationally respected, and have been developed through extensive work with industry, academics and the public to ensure they appropriately capture the costs and benefits, and best reflect social values. These are very difficult decisions to make, and it is important that they are made independently and based on the available evidence.
We understand that despite NICE instigating an exceptional pause in the process to allow for commercial negotiations to take place with the companies, Daiichi Sankyo and AstraZeneca, a deal to enable patient access to this treatment on the NHS in England has not been reached.
We know NICE’s announcement has come as a blow to many women and their families. We understand that NICE and NHS England have already sought to apply as much flexibility as they can in their considerations of Enhertu and have made it clear to the companies that their pricing of the drug remains the main obstacle to access.
Within 16 weeks of the publication of final guidance, companies can also request a rapid review to consider new patient access scheme proposals, with the aim of establishing a pricing agreement that would improve cost-effectiveness and enable patient access to high-cost medicines. The Government wants to see a deal reached to make Enhertu available. NICE and NHS England remain open to considering an improved offer from the companies through the rapid review process, and we strongly encourage the companies to come back to the table.
Asked by: Rachel Gilmour (Liberal Democrat - Tiverton and Minehead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to provide covid-19 vaccinations to the (a) families and (b) carers of patients with immunosuppressant diseases.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
The primary aim of the autumn 2024 COVID-19 vaccination programme remains the prevention of severe illness, hospitalisations, and deaths, arising from COVID-19. On 2 August 2024 the Government accepted the advice of the independent Joint Committee on Vaccination and Immunisation (JCVI) to offer a COVID-19 vaccination to those aged 65 years old or over, those living in care homes for older adults, and those aged between six months and 64 years old who are in a clinical risk group in England this autumn. Additionally, vaccination will be offered to all frontline health and social care workers, as well as staff in care homes for older adults.
There are no plans to offer a COVID-19 vaccination to unpaid carers, including young carers, or the families and household contacts of people with immunosuppression, during the autumn 2024 campaign in England. Unpaid carers and household contacts of those with immunosuppression have previously been offered vaccination on the basis that it indirectly protected those more vulnerable with whom they are in contact. The JCVI advice for autumn 2024 is that in the era of highly transmissible Omicron sub-variants, any protection offered by the vaccines against transmission of infection from one person to another is expected to be extremely limited. The indirect benefits of vaccination in these groups, vaccinating an individual to reduce the risk of severe disease in other people, are therefore less evident than in previous years.