Cancer: Screening

(asked on 12th January 2015) - View Source

Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what steps they are taking to standardise access to funding for cancer-related molecular testing.


Answered by
Earl Howe Portrait
Earl Howe
Deputy Leader of the House of Lords
This question was answered on 26th January 2015

Improving Outcomes: a Strategy for Cancer (Department of Health, 2011) did include a specific commitment to develop a commissioning and funding structure which would enable the efficient delivery of high quality molecular diagnostic testing through centres of excellence. The first phase of this work included the establishment of the Human Genomics Strategy Group (HGSG). NHS England drew upon the work of the HGSG, specifically the report Building on our Inheritance; Genomic technology in healthcare (2012), in the production of the proposed genetics laboratory service specification.

Since 2011, the field of genetic medicine and genomics has progressed rapidly with many molecular tests now available locally. Further work is underway to better understand the specific responsibilities of NHS England as a direct commissioner of specialised services, clarify the legacy arrangements of how such tests are currently commissioned and ensure alignment with the National Tariff payment rules. This may highlight the need to develop specific commissioning policies, or undertake other commissioning interventions, that will support the continued diffusion of such technology across the National Health Service.

Molecular diagnostics for cancer is the responsibility of a range of commissioners, and historically many of these tests have been funded in a number of different ways including by industry (i.e., have been free to the NHS). The legacy work may highlight a need for NHS England to undertake commissioning interventions, which could include the development of specific commissioning policies or pricing work.

Funding for these molecular tests is complex. At this stage, the earliest opportunity for changes to be made to the National Tariff, should such action be thought to be necessary, is now 2016-17 with consultation on any proposals being launched in summer 2015.

In the meantime, NHS England is currently consulting on a new service specification for the genetic/genomic laboratory services which is its direct commissioning responsibility. A procurement process will take place following the consultation. The consultation, including the proposed service specification, can be accessed at:

https://www.engage.england.nhs.uk/consultation/genomic-laboratories

The Department is not aware of any such targets for introducing and funding diagnostics testing. NHS England do not agree that there has been reduced access to molecular testing for cancer, but accept that there has always been variation.

The Department holds NHS England to account for achieving its objectives in a number of ways. The Mandate to NHS England, published by the Department, sets out its core objectives. NHS England must publish an annual business plan, and report on progress against its objectives at the end of each year. At the end of each year, the Secretary of State also publishes an assessment of NHS England’s performance. The Secretary of State holds regular accountability meetings with NHS England based on an assessment of performance against the Mandate and its wider functions.

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