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 adequacy of funding and provision by clinical commissioning groups of cough assist machines for people with (a) muscular dystrophy and (b) neuromuscular conditions on the quality of care for people with those conditions.

The provision of cough assist machines is a matter for local clinical commissioning groups (CCGs). CCGs have the independence and autonomy to make commissioning decisions and policies for local populations, taking into account the available evidence and individual circumstances as appropriate.

The evidence base to support the routine use of cough assist machines in muscle-wasting conditions over other cough assist methods is not well established. NHS England previously worked with Muscular Dystrophy UK through its Bridging the Gap project to address areas of concern raised by patients and their representatives, one of which was the provision of cough assist machines. Through this work, a number of CGGs developed commissioning policies which set out the circumstances in which to consider these devices. In addition, in February 2016 the National institute for Health and Care Excellence published new guidance on the assessment and management of motor neurone disease, recommending that cough assist machines should be considered if assisted breath stacking is not effective, and/or during a respiratory tract infection.