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 to improve the (a) detection and (b) treatment of Parkinson's disease.

The National Institute for Health and Care Excellence (NICE) guidance ‘Parkinson’s disease: Diagnosis and management in primary and secondary care’, updated in 2017, sets out best practice for clinicians in the identification and treatment of Parkinson’s disease in line with the latest available evidence. The guidance states that Parkinson's disease should be suspected in people presenting with tremor, stiffness, slowness, balance problems and/or gait disorder, and that, where suspected, patients should be referred promptly to a specialist with expertise in the differential diagnosis of this condition. The guidance covers a range of diagnostic approaches that may be employed to support a diagnosis.

The recommended treatments for Parkinson’s disease are largely drug based. The NICE guidance states that patient preference should be taken into account, once they have been informed of the short- and long-term benefits and drawbacks of the different types of drugs available. The guidance makes it clear that other supportive treatments may also be appropriate. These can include physiotherapy, occupational therapy and speech and language therapy. The NICE guidance can be found at the following link:

www.nice.org.uk/guidance/ng71

NHS England also commissions two treatments for Parkinson’s disease in line with the published suitability criteria, including:

- deep brain stimulation for patients tremor and dystonia;

- Levodopa Carbidopa intestinal gel for patients with severe motor fluctuations; and hyper/dyskinesia when available combinations of medicinal products are unsatisfactory

More information on these commissioning policies can be found on the NHS England website at the following link:

www.england.nhs.uk/commissioning/spec-services/npc-crg/group-d/d04/