Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the effect of NHS England’s decision not to allow GPs to refer patients for Stem Cell treatment for MS on (a) patient health and (b) West Lancashire constituent Ms Townsend's (i) halted treatment and (b) recovery.
Answered by Caroline Dinenage
NHS England first published its commissioning policy in 2013, revised in 2015, which permits access to autologous haematopoietic stem cell transplant (HSCT) as a clinical option for some patients with multiple sclerosis (MS). The commissioning policy is available at the following link:
As with any HSCT there are risks to the procedure and when considering this treatment for patients with MS the balance of risk and benefit must be carefully assessed for each patient. Neurologists and transplant doctors in the United Kingdom are guided by the recommendations of the European Society for Blood and Marrow Transplantation, published in 2012, and the guidance of the British Society of Blood and Marrow Transplantation when considering the suitability of transplant. These criteria restrict the use of autologous HSCT to a small group of MS patients with high levels of inflammatory activity despite one or more approved disease modifying therapies and very rare patients with 'malignant' forms of MS. Patients should be assessed by both MS and transplant specialists.
Neurologist and transplant doctors should be guided by these recommendations and decisions related to a patient’s care are a matter for clinicians.
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, when haematopoietic stem cell transplantation treatment will be made available on the NHS for people with multiple sclerosis.
Answered by Caroline Dinenage
NHS England has a published commissioning policy which permits access to autologous haematopoietic stem cell transplant as a clinical option for some patients with multiple sclerosis (MS) who have been clinically assessed as eligible by transplant and MS specialists taking into account risks and benefits. The commissioning policy is available at the following link:
Asked by: Baroness Walmsley (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have made any medium to long-term horizon scanning assessment concerning medical research advances in transplantation of material of human origin in the UK and worldwide.
Answered by Lord O'Shaughnessy
NHS Blood and Transplant (NHSBT) is directed by the Secretary of State for Health and Social Care to conduct or commission research into organ donation and transplantation and into the uses, or development, of stem cells and tissues.
NHSBT’s Research, Innovation and Novel Technologies Advisory Group monitors research programmes that require access to donated human material where consent has been given for research. Members of the group include leading researchers who cover all aspects of transplantation. The group also has representation from the British Transplantation Society.
The National Institute for Health Research (NIHR), funded by the Department, also has an important role. The NIHR Biomedical Research Centre has a research theme on Transplantation and Regenerative Medicine which aims to improve outcomes in solid organ transplantation and the use of clinical advances to support the development of cell based therapies. The NIHR Innovation Observatory is a national medical horizon scanning facility which identifies technologies up to 10 years from being publicly available.
Asked by: Colleen Fletcher (Labour - Coventry North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to encourage (a) men aged 16-30 and (b) people from black, Asian or minority ethnic backgrounds to sign up to the stem cell donor register.
Answered by Jackie Doyle-Price
Young people play a pivotal role in the stem cell landscape. Research has identified that younger donors offer the potential for better patient outcomes and a greater chance of survival. In 2017, 82% of people who were selected to donate their stem cells were male, and 58% were men aged 30 and under. In acknowledgement of this fact, the Department provides funding to Anthony Nolan and NHS Blood and Transplant to support recruitment of young male donors. In 2017 69% of new potential donors recruited to the United Kingdom registry were under the age of 30, and 40% of new potential donors were male.
The Department also funds Anthony Nolan and NHS Blood and Transplant to improve equity of access to unrelated donor stem cell transplantation for Black, Asian and Minority Ethnic (BAME) patients through targeted recruitment to the Anthony Nolan and the NHS Stem Cell Registry.
The Department has provided more than £26 million to NHS Blood and Transplant and Anthony Nolan for stem cell donation since 2011 and have set very specific targets about the proportion of donors that must be from BAME backgrounds; for example, in this financial year, Anthony Nolan will continue to target more than 35% of the umbilical cords stored in the UK Cord Blood Bank to be donated by mothers from BAME backgrounds.
Asked by: Alex Sobel (Labour (Co-op) - Leeds Central and Headingley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to encourage (a) men aged 16-30 and (b) people from black, Asian and ethnic minority backgrounds to register as stem cell donors.
Answered by Matt Hancock
Young people play a pivotal role in the stem cell landscape. Research has identified that younger donors offer the potential for better patient outcomes and a greater chance of survival. In 2017, 82% of people who donated their stem cells were male, and 58% were men aged 30 and under. In acknowledgement of this fact, the Department provides funding to Anthony Nolan and NHS Blood and Transplant (NHSBT) to support recruitment of young male donors.
In 2017 69% of new potential donors recruited to the United Kingdom registry were under the age of 30, and 40% of new potential donors were male.
The Department also funds Anthony Nolan and NHSBT to improve equity of access to unrelated donor stem cell transplantation for Black, Asian, Minority and Ethnic (BAME) patients through targeted recruitment to the Anthony Nolan and the NHS Stem Cell Registry.
The Department has provided more than £26 million to NHSBT and Anthony Nolan for stem cell donation since 2011 and have set very specific targets about the proportion of donors that must be from BAME backgrounds; for example, in this financial year, Anthony Nolan will continue to target more than 35% of the umbilical cords stored in the UK Cord Blood Bank to be donated by mothers from BAME backgrounds.
Asked by: Catherine West (Labour - Hornsey and Friern Barnet)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that children with Neuroblastoma have access to the most effective (a) treatments and (b) drugs.
Answered by Steve Brine
Current treatments for high-risk neuroblastoma include chemotherapy, radiotherapy, stem cell transplantation, surgery and isotretinoin. Dinutuximab beta gained marketing authorisation in May 2017 and is used in combination with interleukin-2 (aldesleukin) as an additional treatment option for patients who have high-risk neuroblastoma and have shown some improvement with previous treatments or with relapsed or refractory neuroblastoma.
The National Institute for Health and Care Excellence (NICE) published final draft technology appraisal guidance on 12 July that recommends dinutuximab beta as a clinically and cost-effective use of National Health Service resources for patients meeting specified clinical criteria. Stakeholders now have an opportunity to appeal NICE’s draft recommendations. NICE expects to publish final guidance in August 2018.
Ministers and Departmental officials regularly discuss a range of issues with colleagues in NHS England and NICE, including the availability of individual treatments.
Asked by: Catherine West (Labour - Hornsey and Friern Barnet)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with (a) NHS and (b) NICE officials on the availability of the drug Anti GD2 for the treatment of neuroblastoma.
Answered by Steve Brine
Current treatments for high-risk neuroblastoma include chemotherapy, radiotherapy, stem cell transplantation, surgery and isotretinoin. Dinutuximab beta gained marketing authorisation in May 2017 and is used in combination with interleukin-2 (aldesleukin) as an additional treatment option for patients who have high-risk neuroblastoma and have shown some improvement with previous treatments or with relapsed or refractory neuroblastoma.
The National Institute for Health and Care Excellence (NICE) published final draft technology appraisal guidance on 12 July that recommends dinutuximab beta as a clinically and cost-effective use of National Health Service resources for patients meeting specified clinical criteria. Stakeholders now have an opportunity to appeal NICE’s draft recommendations. NICE expects to publish final guidance in August 2018.
Ministers and Departmental officials regularly discuss a range of issues with colleagues in NHS England and NICE, including the availability of individual treatments.
Asked by: Eleanor Smith (Labour - Wolverhampton South West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the average cost to the NHS is of providing a kidney transplant.
Answered by Jackie Doyle-Price
NHS Improvement publishes reference cost data relating to kidney transplants, which can be found at the following link:
https://improvement.nhs.uk/resources/reference-costs/
Reference costs are the average unit cost to the National Health Service of providing defined services to NHS patients in England in a given financial year. The information relating to kidney transplants is collected in two ways, the actual transplant episodes and the preparatory and follow-up screening and examinations in the case of live donor transplants. Reference costs for 2016-17 are given in the following tables.
Reference costs for kidney transplant episodes 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Kidney Transplant, 19 years and over, from Cadaver Non-Heart-Beating Donor | 645 | £12,167 | £7,847,829 |
Kidney Transplant, 18 years and under, from Cadaver Non-Heart-Beating Donor | 11 | £5,780 | £63,576 |
Kidney Transplant, 19 years and over, from Cadaver Heart-Beating Donor | 1,171 | £12,888 | £15,092,002 |
Kidney Transplant, 18 years and under, from Cadaver Heart-Beating Donor | 40 | £15,157 | £606,268 |
Kidney Transplant, 19 years and over, from Live Donor | 708 | £13,854 | £9,808,873 |
Kidney Transplant, 18 years and under, from Live Donor | 60 | £15,149 | £908,964 |
| 2,635 | £13,028 | £34,327,513 |
Source: NHS Improvement
Notes:
Reference cost data for pre and post-transplant episodes for activities associated with kidney transplants 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Live Kidney Donor Screening | 1,083 | £215 | £232,565 |
Kidney Pre-Transplantation Workup of Live Donor | 2,422 | £270 | £654,200 |
Kidney Pre-Transplantation Workup of Recipient, 19 years and over | 9,150 | £271 | £2,483,885 |
Kidney Pre-Transplantation Workup of Recipient, 18 years and under | 27 | £991 | £26,750 |
Examination for Post-Transplantation of Kidney of Recipient, 19 years and over | 75,261 | £239 | £18,010,518 |
Examination for Post-Transplantation of Kidney of Recipient, 18 years and under | 396 | £250 | £99,024 |
Examination for Post-Transplantation of Kidney of Live Donor | 2,809 | £173 | £487,293 |
| 91,148 | £241 | £21,994,236 |
Source: NHS Improvement
Notes:
There are additional costs associated with a kidney transplant for immunosuppressant therapy, at an average cost of £6,000 per patient per year, and ongoing outpatient follow up but this information will depend on the individual patient and is not collected centrally.
Information on hospital bed days used by patients waiting for organ or stem cell transplants is not centrally collected.
Asked by: Eleanor Smith (Labour - Wolverhampton South West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many hospital bed days were used by patients waiting for (a) organ and (b) stem cell transplants in each of the last three years.
Answered by Jackie Doyle-Price
NHS Improvement publishes reference cost data relating to kidney transplants, which can be found at the following link:
https://improvement.nhs.uk/resources/reference-costs/
Reference costs are the average unit cost to the National Health Service of providing defined services to NHS patients in England in a given financial year. The information relating to kidney transplants is collected in two ways, the actual transplant episodes and the preparatory and follow-up screening and examinations in the case of live donor transplants. Reference costs for 2016-17 are given in the following tables.
Reference costs for kidney transplant episodes 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Kidney Transplant, 19 years and over, from Cadaver Non-Heart-Beating Donor | 645 | £12,167 | £7,847,829 |
Kidney Transplant, 18 years and under, from Cadaver Non-Heart-Beating Donor | 11 | £5,780 | £63,576 |
Kidney Transplant, 19 years and over, from Cadaver Heart-Beating Donor | 1,171 | £12,888 | £15,092,002 |
Kidney Transplant, 18 years and under, from Cadaver Heart-Beating Donor | 40 | £15,157 | £606,268 |
Kidney Transplant, 19 years and over, from Live Donor | 708 | £13,854 | £9,808,873 |
Kidney Transplant, 18 years and under, from Live Donor | 60 | £15,149 | £908,964 |
| 2,635 | £13,028 | £34,327,513 |
Source: NHS Improvement
Notes:
Reference cost data for pre and post-transplant episodes for activities associated with kidney transplants 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Live Kidney Donor Screening | 1,083 | £215 | £232,565 |
Kidney Pre-Transplantation Workup of Live Donor | 2,422 | £270 | £654,200 |
Kidney Pre-Transplantation Workup of Recipient, 19 years and over | 9,150 | £271 | £2,483,885 |
Kidney Pre-Transplantation Workup of Recipient, 18 years and under | 27 | £991 | £26,750 |
Examination for Post-Transplantation of Kidney of Recipient, 19 years and over | 75,261 | £239 | £18,010,518 |
Examination for Post-Transplantation of Kidney of Recipient, 18 years and under | 396 | £250 | £99,024 |
Examination for Post-Transplantation of Kidney of Live Donor | 2,809 | £173 | £487,293 |
| 91,148 | £241 | £21,994,236 |
Source: NHS Improvement
Notes:
There are additional costs associated with a kidney transplant for immunosuppressant therapy, at an average cost of £6,000 per patient per year, and ongoing outpatient follow up but this information will depend on the individual patient and is not collected centrally.
Information on hospital bed days used by patients waiting for organ or stem cell transplants is not centrally collected.
Asked by: Priti Patel (Conservative - Witham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to encourage BAME people to register as stell cell donors.
Answered by Jackie Doyle-Price
The Department funds Anthony Nolan and NHS Blood and Transplant to improve equity of access to unrelated donor stem cell transplantation for Black, Asian and Minority Ethnic (BAME) patients through targeted recruitment to the Anthony Nolan and the NHS Stem Cell Registry.
More than £20 million has been provided to NHS Blood and Transplant and Anthony Nolan for stem cell donation since 2015, and this funding includes very specific stipulations about the numbers of newly registered bone marrow donors, and the proportion umbilical cords stored in the United Kingdom Cord Blood Bank that must be from BAME backgrounds (35-40%).
In 2016 NHS Blood and Transplant began a partnership with Team Margot and launched the Golden Ticket campaign. This project created 35,000 Golden Tickets which were circulated to existing BAME and mixed-race blood donors to encourage them to sign on to the stem cell donor register.