Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what her policy is on establishing a national policy for neurogenic bowel cancer; and what steps her Department is taking to ensure adequate care is available for people who need it.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has no plans at present to establish a national policy on neurogenic bowel disorder. To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
No estimate has been made of the cost to the National Health Service of a lack of specialist bowel care for patients with neurogenic bowel disorders. Nor has an estimate been made of the costs incurred by the diagnosis and treatment of pressure sores, resulting from inadequate care and other secondary complications.
Asked by: Navendu Mishra (Labour - Stockport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment her Department has made of the adequacy of (a) diagnosis and (b) treatment services for bowel cancer at Stepping Hill hospital.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
No specific assessment has been made of the adequacy of diagnosis and treatment services for bowel cancer at Stepping Hill Hospital. However, data held at the provider level can give us insight into lower gastrointestinal (GI) cancer for Stockport NHS Foundation Trust. Of those patients referred to Stockport NHS Foundation Trust for suspected lower GI cancer in February 2024, 86.1% received a diagnosis or ruling out of cancer within 28 days. This is above the 75.0% standard, and shows an increase of 4.2% since January. Furthermore, of those patients referred to Stockport NHS Foundation Trust for lower GI cancer in February 2024, 95.2% received a first or subsequent treatment within 31 days of a decision to treat. This is above national performance of 91.1%, against the standard of 96.0%. For lower GI cancer in the same period, 67.4% of patients received treatment within 62 days of an urgent suspected cancer or screening referral, or consultant upgrade, to a first definitive treatment for cancer. This is above national performance of 63.9% against the standard of 85.0%.
Mar. 17 2010
Source Page: Table showing A count of Finished Admission Episodes and Emergency Admission Episodes where the was a primary diagnosis of (i) Lung Cancer, (ii) Bowel cancer, (iii) Upper Gastrointestinal Cancer and (iv) Haematological cancer for England and by PCT of responsibility for 2004/05 to 2008/09. 48 p.Found: Finished Admission Episodes and Emergency Admission Episodes where the was a primary diagnosis of (i) Lung Cancer
Asked by: Taiwo Owatemi (Labour - Coventry North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she plans to take to help increase the (a) stock of colonoscopy equipment, (b) number of colonoscopy facilities and (c) number of trained staff; and what other steps she plans to take to increase the use of colonoscopies in detecting bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is not currently planning to take steps to increase the stock of colonoscopy equipment. £2.3 billion was awarded at the Spending Review 2021 to transform diagnostic services over the next three years. Within this funding, NHS England is delivering an expected net increase uplift of 67 endoscopy rooms in acute trusts or in non-community diagnostic centre (CDC) developments. In CDCs, current plans are for 46 sites to be delivering endoscopies from March 2025, of which, 39 will deliver colonoscopies. This will help to support integrated care boards not currently meeting the optimal capacity of 3.5 rooms per 100,000 people over 50 years old, to do so.
NHS England will continue to deliver initiatives to train around 100 clinical endoscopists per annum to be capable of delivering colonoscopies and other gastrointestinal procedures. In addition to this NHS England is also training doctors, such as gastroenterologists, in the same procedures and continuing to develop, implement and improve immersive and rapid colonoscopy training through endoscopy academies.
As of October 2023, there are over 3,200 full-time equivalent doctors working in the specialty of gastroenterology within National Health Service trusts and other core organisations in England. This is over 100, or 4.3%, more than in 2022, over 500, or 20.1%, more than in 2019, and almost 1,400, or 75.2%, more than in 2010.
To improve bowel cancer diagnosis, the NHS has implemented timed cancer pathways for gastro-intestinal (GI) disease. This includes the implementation of Faecal Immunochemical Testing for those with symptoms in the lower GI, to prevent these patients from having unnecessary colonoscopies, freeing up capacity for these procedures and ensuring the most urgent symptomatic patients are seen more quickly.
Mar. 17 2010
Source Page: Table showing Finished Consultant Episode Bed days where an elective or emergency admission took place for the following primary diagnosis: (i) Lung Cancer, (ii) Bowel cancer, (iii) Upper Gastrointestinal Cancer and (iv) Haematological cancer for England and by PCT of responsibility, for the years 1997/98 to 2008/09. 48 p.Found: days where an elective or emergency admission took place for the following primary diagnosis: (i) Lung Cancer
Asked by: Gill Furniss (Labour - Sheffield, Brightside and Hillsborough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 16 November to Question 881 on Bowel Cancer: Screening, when the last review of the national bowel cancer screening programme was completed; and what her planned timetable is for completing the next review.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The UK National Screening Committee (UK NSC) last looked at the evidence to optimise the population screening of bowel cancer in 2018. The Committee recommended screening every two years with the FIT test at 50 to 74 years old, rather than starting at 60 years old.
Since then, work has been underway to lower the bowel cancer screening age from 60 years old in a phased manner, so that by 2025, people aged 50 years old will receive a FIT test.
With these changes still being implemented, a date for the next review of bowel cancer screening has not yet been set. In the meantime, if any member of the public or stakeholder feels there should be further changes to the programme, these can be submitted via the UK NSC’s next annual call, which opens in summer 2024.
Asked by: Gill Furniss (Labour - Sheffield, Brightside and Hillsborough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 16 November to Question 881 on Bowel Cancer: Screening, what her planned timetable is for publishing a decision on lowering the screening age for bowel cancer from 60 to 50 years old.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England started the lowering of age for bowel cancer screening in April 2021. The following table shows the rollout plan for the bowel screening:
Cohort age at first invitation | Year invitations start |
Age 56 | 2021/22 |
Age 58 | 2022/23 |
Age 54 | 2023/24 |
Age 50 and 52 | 2024/25 |
Note: The timeline may differ slightly from region to region
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has taken recent steps to (a) increase the availability of and (b) support the rollout of new immunotherapy treatments for bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based recommendations for the National Health Service in England on whether medicines represent a clinically and cost-effective use of NHS resources. NICE appraises all newly licensed medicines within their licensed indications and the NHS in England is legally required to fund medicines recommended by NICE. Cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of draft NICE guidance.
NICE has already recommended several immunotherapies for bowel cancer, which are now available for the treatment of eligible NHS patients in line with NICE’s recommendations. These include including panitumumab, pembrolizumab, and nivolumab with ipilimumab. NICE is also due to start its appraisal of nivolumab for previously treated metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency in March 2024.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken since the 2019 publication of 'Asymptomatic Inflammatory Bowel Disease and Colorectal Cancer Screening Programs' by Farrukh and Mayberry in Gastrointestinal Disorders in respect of its findings of differences and discrimination in the delivery of (1) colorectal screening in healthy people, and (2) care and surveillance of patients with inflammatory bowel disease.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
If someone is detected during bowel screening to have blood in their faeces, then found to have inflammatory bowel disease (IBD) through follow up tests they are referred to the symptomatic service for onward management and surveillance. They are then offered screening every two years along with ongoing monitoring and surveillance, the timeframes of which are detailed below.
The National Institute for Health and Care Excellence (NICE)’s guideline on colorectal cancer prevention was published in March 2011 and updated in September 2022. It recommends using colonoscopy to check for signs of bowel cancer in people aged 18 years old and over with ulcerative colitis or Crohn’s disease. The guidance recommends that follow-up and ongoing colonoscopic surveillance should be arranged at regular intervals for people with IBD and tubular adenoma as follows:
- Low risk: offer colonoscopy at five years;
- Intermediate risk: offer colonoscopy at three years; or
- High risk: offer colonoscopy at one year.
A copy of the guidance is attached.
We expect integrated care boards (ICBs) to have due regard to relevant NICE guidelines when commissioning services. It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, in line with these NICE guidelines.
Mentions:
1: Mountain, Edward (Con - Highlands and Islands) To ask the Scottish Government what its position is on whether bowel cancer screening is being carried - Speech Link
2: Mountain, Edward (Con - Highlands and Islands) I accept that Scotland leads the way on the sensitivity of screening for bowel cancer, but that is not - Speech Link
3: Mountain, Edward (Con - Highlands and Islands) cancer as early as possible, thereby making it treatable and preventing the potential horrors of bowel - Speech Link
4: Minto, Jenni (SNP - Argyll and Bute) I recognise the work that Edward Mountain has done to raise awareness of the importance of bowel cancer - Speech Link