Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how long her Department has been aware of issues associated with health technology appraisal of combination medicines for blood cancers; and whether her Department is giving additional resources to (a) NICE and (b) NHS England to tackle those issues.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Competition and Markets Authority (CMA) published a statement in November 2023 that clarifies the circumstances under which it will not prioritise enforcement action against drug firms when they implement a specific negotiation framework, to make more combination therapies available on the National Health Service. The statement is available at the following link:

https://www.gov.uk/government/publications/combination-therapies-prioritisation-statement

In the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to launching a consultation on updating the NHS England Commercial Framework for New Medicines, by July of this year. This consultation will reflect the CMA’s statement, and will be used to consider options for transacting a solution for some combination therapies, under specific circumstances.

The National Institute for Health and Care Excellence (NICE) also gave specific consideration to the evaluation of combination therapies in the comprehensive review of its methods and processes for health technology evaluation, that concluded in January 2022. The NICE’s published health technology evaluation manual describes the considerations that will be given to the evaluation of combination therapies where relevant.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to NHS England's vaccination strategy, published on 13 December 2023, what guidance her Department plans to provide to Integrated Care Boards (ICBs) to ensure that vaccinators are trained to consider people with blood cancer who have received stem cell transplants when determining who has access to re-vaccination programmes, once ICBs become responsible for training vaccinators.

Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

Eligibility for vaccination programmes is determined by the Joint Committee on Vaccination and Immunisation (JCVI) rather than the National Health Service or individual vaccinators. NHS England or JCVI may issue guidance on administering vaccines to certain groups and individuals including those who are immunocompromised. Training standards in vaccine administration will continue to be set by the UK Health Security Agency, and employers will be responsible for training their staff in accordance with these standards. In line with the vaccination strategy, NHS England will consider which national training and workforce management tools would support integrated care boards and employers to drive innovation in vaccination delivery including ways of supporting different eligible groups.

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Question

To ask the Scottish Government what data it holds on how many patients have been diagnosed with a blood cancer through Rapid Cancer Diagnostic Services.

Answered by Gray, Neil - Cabinet Secretary for NHS Recovery, Health and Social Care

The recently published University of Strathclyde evaluation report https://strathprints.strath.ac.uk/88280/7/Maguire-etal-2024-Final-report-of-the-evaluation-of-rapid-cancer-diagnostic-services.pdf showed that 13.5% of cancers diagnosed through the Rapid Cancer Diagnostic Services (RCDS) were blood cancers.

The Scottish Government does not hold data on exact numbers but work is underway with Public Health Scotland to create a national RCDS data-set.

Immunosuppressed people are at high risk of serious illness or death.

In a similar [petition to the UK Parliament](https://petition.parliament.uk/petitions/611884?fbclid=IwAR0aGICF6l171OmyV5HnypZVr_9UdS3kY12lEoUfUPLIp1OGg9uKQEuopEU&s=09), the petitioner notes:

* Lockdown and shielding has not ended for many people with blood cancer, organ transplants, and other forms of immune compromise
* Treatments like Evusheld may offer protection for immunosuppressed people, similar to the way COVID-19 vaccines protect much of the wider population.

The clinical trials for Evusheld, showed positive results and was found to reduce the risk of developing symptomatic COVID-19 by 77%. As a result Evusheld has been [authorised by the Medicines and Healthcare products Regulatory Agency (MHRA)](https://www.gov.uk/government/news/evusheld-approved-to-prevent-covid-19-in-people-whose-immune-response-is-poor).

This treatment has also been recommended for authorisation by the [European Medicines Agency](https://www.ema.europa.eu/en/news/ema-recommends-authorisation-covid-19-medicine-evusheld), with further information on the clinical trial and decision to approve Evusheld in the UK available in [the BMJ](https://www.bmj.com/content/376/bmj.o722).

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