Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve the collection and reporting of ethnicity data for breast cancer patients to support understanding of variations in outcomes and patient experience of NHS care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including for breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.
Correspondence Apr. 17 2024
Committee: Women and Equalities CommitteeFound: Correspondence from the Minister for State for Health and Secondary Care, relating to breast screening
Asked by: Luke Evans (Conservative - Bosworth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to support women with a genetic history of breast cancer to access screening services in (a) England and (b) Leicestershire.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In Leicestershire and nationwide, women with a very high risk (VHR) of breast cancer due to family history may be offered screening earlier and more often, as part of the NHS Breast Screening Programme.
Women formally identified as eligible for VHR breast screening are referred to the National Health Service breast screening service associated with their general practice. They are eligible to be screened from the age of 25 years old upwards, and should be invited every year. The diagnostic screen includes mammography or magnetic resonance imaging, depending on age and risk criteria, and is therefore not the same as the routine breast screening service. To support screening of VHR women, a new central database is planned to ensure all referrals reach NHS breast screening services.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 1 February (HL1933), what progress they have made on reducing variation in breast screening services since 2019.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Breast Screening Programmes were affected by the COVID-19 pandemic, and some breast screening offices took the decision to pause services temporarily to support the pandemic response. All breast cancer screening services have now recovered from the pandemic, and have no backlog of people waiting to be screened.
Increasing uptake and reducing health inequalities remains paramount as part of the ambitions set out in the NHS Long Term Plan to directly support early detection and diagnosis of breast cancer. Regional commissioners are working closely with cancer alliances and cancer charities to develop uptake plans which address their specific populations needs.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of breast cancer monitoring devices on global health outcomes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has not yet assessed the potential impact of breast cancer monitoring devices. This technology is at an early stage and further evidence is needed before we can assess whether it could be trialled in medical settings.
Improving the early diagnosis of cancer, including breast cancers, is a priority for the National Health Service. NHS England has an ambition to diagnose 75% of cancers at stage one or two by 2028, which will help tens of thousands of people live for longer. NHS England is working to meet the Faster Diagnosis Standard (FDS) which sets a target of 28 days from urgent referral by a general practitioner or screening programme, to patients being told that they have cancer, or that cancer is ruled out.
In January 2022 the Department provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, so more women can be checked for signs of cancer, speeding up diagnosis and treatment.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of low rates of breastfeeding on incidences of breast cancer.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Improving early diagnosis of cancer, including breast cancer, is a priority for the National Health Service. The public health benefits of breastfeeding for child and maternal health are significant and well established. Evidence suggests a range of potential benefits, for example, research published in the British Medical Journal found breastfeeding gave protection against breast cancer.
We want to ensure that every parent and carer understands the benefits of breastfeeding and has access to the high-quality infant feeding services they need, in their local area, to achieve their breastfeeding goals. Through the Family Hubs and Start for Life Programme, we are investing £50 million to increase the range of specialist support, which is enabling parents to access face-to-face and virtual support whenever they need it.
Asked by: Tanmanjeet Singh Dhesi (Labour - Slough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the potential impact of (a) the breast cancer monitoring device and (b) other innovative medical devices on (i) early cancer detection rates and (ii) patient outcomes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has not yet assessed the potential impact of breast cancer monitoring devices. This technology is at an early stage and further evidence is needed before we can assess whether it could be trialled in medical settings.
Improving the early diagnosis of cancer, including breast cancers, is a priority for the National Health Service. NHS England has an ambition to diagnose 75% of cancers at stage one or two by 2028, which will help tens of thousands of people live for longer. NHS England is working to meet the Faster Diagnosis Standard (FDS) which sets a target of 28 days from urgent referral by a general practitioner or screening programme, to patients being told that they have cancer, or that cancer is ruled out.
In January 2022 the Department provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, so more women can be checked for signs of cancer, speeding up diagnosis and treatment.
Asked by: Dawn Butler (Labour - Brent Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help ensure the Major Conditions Strategy improves breast cancer outcomes for ethnic minority women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women, including black women, is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including metastatic breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in operational planning guidance for the health system. The Core20PLUS5 approach for adults has been rolled out as an NHS England framework to focus action on reducing inequalities on issues within the National Health Services’ direct influence, which are major contributors to inequalities in life expectancy through major conditions like cancer, cardiovascular disease, respiratory disease, and others, or Long-Term Plan priorities where stark inequalities are evident, such as maternity or severe mental illness.
The key actions for systems as highlighted in NHS England’s planning guidance for 2024/25 is to continue to deliver against the five strategic priorities for tackling health inequalities. Additionally, by the end of June 2024, NHS England aims to publish joined-up action plans to address health inequalities, and implement the Core20PLUS5 approach.
Improving earlier diagnosis of cancers, including breast cancer, is also a priority for the Government. The NHS has an ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, which will help tens of thousands of people live for longer. Additionally, the new cancer standards developed and supported by cancer doctors and implemented in October 2023, will ensure patients are diagnosed faster, and that treatment starts earlier. In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support the delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.
Whilst the Major Conditions Strategy does not seek to describe everything that is being done, or could be done, to meet the challenges of individual conditions in silo, it instead focuses on the changes likely to make the most difference across the six groups of major conditions, including cancer.
Asked by: Dawn Butler (Labour - Brent Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve breast cancer outcomes amongst Black women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women, including black women, is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including metastatic breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in operational planning guidance for the health system. The Core20PLUS5 approach for adults has been rolled out as an NHS England framework to focus action on reducing inequalities on issues within the National Health Services’ direct influence, which are major contributors to inequalities in life expectancy through major conditions like cancer, cardiovascular disease, respiratory disease, and others, or Long-Term Plan priorities where stark inequalities are evident, such as maternity or severe mental illness.
The key actions for systems as highlighted in NHS England’s planning guidance for 2024/25 is to continue to deliver against the five strategic priorities for tackling health inequalities. Additionally, by the end of June 2024, NHS England aims to publish joined-up action plans to address health inequalities, and implement the Core20PLUS5 approach.
Improving earlier diagnosis of cancers, including breast cancer, is also a priority for the Government. The NHS has an ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, which will help tens of thousands of people live for longer. Additionally, the new cancer standards developed and supported by cancer doctors and implemented in October 2023, will ensure patients are diagnosed faster, and that treatment starts earlier. In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support the delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.
Whilst the Major Conditions Strategy does not seek to describe everything that is being done, or could be done, to meet the challenges of individual conditions in silo, it instead focuses on the changes likely to make the most difference across the six groups of major conditions, including cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made in reducing inequalities in outcomes for breast cancer patients from black and minority ethnic backgrounds over the past (1) 10 years, (2) five years, and (3) two years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority women is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including for breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.
NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.