Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the potential effect on the treatment of strokes of withdrawing access to patent foramen ovale closure and left atrial appendage occlusion during the commissioning through evaluation analysis phase.

NHS England’s Commissioning through Evaluation (CtE) programme enables a limited number of patients to access treatments, such as patent foramen ovale closure and left atrial appendage occlusion, which are not routinely funded by the National Health Service. These are usually treatments which show significant promise for the future and enable a small number of patients to access them while new clinical and patient experience data are collected within a formal evaluation programme. This approach ensures that each CtE scheme provides valuable new data, beyond that already available from clinical trials, or where there is no clinical trial data, to inform future commissioning policy decisions.

During the analysis phase, NHS England’s published policy position for the treatment concerned will continue to apply. For patent foramen ovale closure and left atrial appendage occlusion this will mean that these procedures will not be routinely available within the NHS. However, patients already being treated as part of a CtE scheme will continue to receive appropriate follow-up care.

Once the CtE evaluation report is available, or if other significant clinical trial information becomes available more quickly, NHS England’s published policy for the treatment concerned will be reviewed and a decision will be made about whether NHS England will or will not make the treatment available within the NHS.