Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps have been taken by NHS England to commission access to molecular diagnostic tests for (a) melanoma, (b) lung cancer, (c) colorectal cancer, (d) breast cancer and (e) all paediatric cancers.

The independent Cancer Taskforce recognised the need for more accessible molecular diagnostic provision in its report, Achieving World-Class Cancer Outcomes: A Strategy for England 2015-2020, published in July 2015.

Following this, in September 2015, we confirmed a commitment from NHS England to implement the recommendations on molecular diagnostics. This will mean that around 25,000 additional people a year will have their cancers genetically tested to identify the most effective treatments. NHS England worked with partners across the healthcare system to produce an implementation plan, Achieving World-Class Cancer Outcomes: Taking the strategy forward, which was published on 12 May 2016.

Also in September 2015, the NHS England Board approved the development of a Personalised Medicine Strategy for the National Health Service, to be discussed at the NHS England Board in the summer. This work will build on the 100,000 Genomes Project, in which the NHS is a key delivery partner. The Project will sequence whole genomes from eligible patients with rare diseases and cancers. It is moving the NHS to a new model of diagnosis and treatment based on understanding of underlying genetic causes and drivers of disease and a comprehensive phenotypic characterisation of the disease (rather than deduction from symptoms and individual diagnostic tests). This will be critical in guiding the approach to molecular diagnostics.

In addition, changes to the section 118 guidance implemented in the national tariff payment system for molecular diagnostics which were implemented from April 2016 will support clinical change and practice and have been broadly welcomed by industry bodies. This means molecular genetic tests which are companion diagnostics being funded separately by commissioners for the first three years before being incorporated into national prices for treatment episodes. There are six tests routinely commissioned in this way in their first three years which have been funded in this way with effect from April, and an annual process for ensuring that new tests which are clinically and cost-effective and adopted as commissioning policy by NHS England or mandated by the National Institute for Health and Care Excellence, are reflected in ongoing arrangements.