Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department is taking to encourage clinical commissioning groups to increase access to cough-assist machines for people with muscle-wasting conditions, such as muscular dystrophy.

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 for local populations, taking into account the available evidence and individual circumstances as appropriate.

Currently, the evidence base to support the routine use of cough assist machines in muscle-wasting conditions is not well established. NHS England 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.