Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made, in each of the past five years, of the economic costs of the effects of post-operative cancer treatments.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is working jointly with NHS England and Cancer Alliances to ensure every person receives personalised care and support from cancer diagnosis onwards, including post-treatment. As outlined in the NHS Long Term Plan for cancer, where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. After treatment, the person will move to a follow-up pathway that suits their needs, and ensures they can get rapid access to clinical support, where they are worried that their cancer may have recurred.
Post-operative cancer treatments encompass a wide variety of care, depending on the type and stage of cancer, the treatment the patient has had, and the patient’s needs. Follow-up care often includes regular check-ups, blood tests, scans, and procedures. It may also involve further treatments to deal with late and long-term side effects, including chemotherapy or radiotherapy to reduce the risk of cancer coming back. These highly individualised treatments have varying economic costs.
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, whether her Department plans to shorten the diagnostic pathway for ovarian cancer by allowing the CA125 blood test and ultrasound to be undertaken at the same time.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is supporting NHS England in developing Best Practice Timed pathways, to support the ongoing improvement effort to shorten diagnosis pathways, reduce variation, improve patient experience of care, and meet the Faster Diagnosis Standard. This standard ensures patients are told they have cancer, or that cancer is ruled out, within 28 days of urgent cancer referral from general practice or screening service.
In March 2023, NHS England published guidance for local health and care systems to implement a timed gynaecological cancer diagnostic pathway, including for ovarian cancer. The gynaecological pathway ensures that at day zero, when presenting with symptoms, an ultrasound and a minimum data set is obtained, which includes a full blood count. For patients with suspected ovarian cancer, the minimum dataset should also include tumour marker CA125, with confirmation of suspicious features of ovarian cancer on ultrasound.
The guidance further ensures that patients with persistent abdominal symptoms, raised CA125, and a normal pelvic scan should be referred through the non-specific symptoms rapid diagnostic centre pathway. Women over 50 years old with elevated CA125 and palpable mass or ascites, or both, or with a previous ultrasound with risk of malignancy, should be referred straight to a computed tomography scan.
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, what her expected timescale is for the availability of the Galleri blood test in cancer testing and diagnosis across the NHS.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The NHS-Galleri trial is looking into the use of a new blood test to see if it can help the National Health Service to detect cancer early, when used alongside existing cancer screening. The trial recruited the target of 140,000 participants, and interim results are expected in spring or summer 2024.
If the trial is successful, the NHS has committed to rolling out up to one million Galleri tests in 2024 and 2025, as part of an interim implementation pilot. The clinical trial is currently planned to conclude in 2025, with results expected in 2026.
Should the final results be positive, the UK National Screening Committee (UK NSC) may consider the use of the test in a national screening programme. A UK NSC-recommended national screening programme would need to consider the effectiveness of the test, balancing the risk of false positives and unnecessary invasive treatments, against potential early detection.
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, 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.
Asked by: Rachael Maskell (Labour (Co-op) - York 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 improve pancreatic cancer outcomes in York Central constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Working with NHS England, we are delivering a range of interventions that are expected to increase early diagnosis and improve outcomes for those with pancreatic cancer across England, including the York Central constituency. This includes providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer and diagnose cancers sooner; creating new pathways to support faster referral routes for people with non-specific symptoms that could be linked to a range of cancer types; and increasing direct access for general practitioners to diagnostic tests.
To increase early diagnosis, NHS England is implementing non-symptom specific pathways (NSS) for patients who present with non-specific symptoms, or combinations of non-specific symptoms, to receive the right tests at the right time. There are currently 113 NSS pathways live with the aim to have full national coverage by March 2024.
NHS England is also funding a new audit into pancreatic cancer, the aim of which is to provide regular and timely evidence to cancer service providers of where patterns of care in England may vary, to increase the consistency of access to treatments and to stimulate improvements in cancer treatment and outcomes for patients. The Royal College of Surgeons began work on this audit in October 2022 and a scoping exercise in consultation with key stakeholders has taken place to shape the direction of the audit. The first report is expected in October 2024.
In addition, the Getting It Right First Time team in NHS England is undertaking a deep dive into pancreatic cancer, which will highlight actions National Health Service providers need to take to improve services, as well as gathering examples of good practice to share.
To encourage people to see their general practitioner if they notice symptoms that could be cancer, NHS England runs the Help Us, Help You campaigns, which address the barriers that deter patients from accessing the National Health Service. In addition, the NHS has allocated £10 million to trial innovations that may support earlier and more efficient diagnosis, including a trial for the PinPoint blood test and a new genetic test that may be used as a liquid biopsy for those with suspected pancreatic 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 ensure adequacy of funding for cancer research over the next ten years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Research is crucial in tackling cancer, which is why the Department invests over £1 billion per year in health research through the National Institute for Health Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23 and the NIHR spends more on cancer than any other disease group.
In terms of future funding, the NIHR funds research both in response to proposals received from scientists and by identifying areas, like brain cancer, where we want to see more research. It is not usual practice to ring-fence funds for particular topics or conditions. All research applications are subject to peer review and judged in open competition.
Future investment in research and innovation is a priority for the Government. We know developments in areas including genomics and artificial intelligence have the potential to transform the experience of cancer, informed by research. The United Kingdom, with its extensive experience of delivering innovative cancer trials, is well placed to integrate research and treatment for the benefit of cancer patients. Innovative trials such as the Galleri blood test and cancer vaccines are already ongoing, and we are investing in crucial research into new treatments, diagnostics, and medical technologies through the NIHR and research funding partners to transform the future of cancer.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
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 improve pancreatic cancer diagnosis in South Holland and The Deepings constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is working with NHS England to increase diagnosis of cancer, including pancreatic cancer, across England. This includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis, as set out in the Elective Recovery Plan published in February 2022. In addition, the Government awarded £2.3 billion at the 2021 Spending Review to transform diagnostic services over the next three years, most of which will help increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, prioritising CDCs for cancer services.
The National Health Service introduced the Faster Diagnosis Standard (FDS), which aims to ensure patients have cancer diagnosed or ruled out within 28 days of urgent suspected cancer referral from a general practice (GP) or screening services. To achieve the FDS target NHS England are implementing non symptom specific pathways (NSS) for patients who present with non-specific symptoms, or combinations of non-specific symptoms, to receive the right tests at the right time. There are currently 113 NSS pathways live, with the aim to have full national coverage by 2025.
To encourage people to see their GP if they notice symptoms that could be cancer, NHS England runs the Help Us, Help You campaigns, which address the barriers that deter patients from accessing the NHS. In addition, the NHS has allocated £10 million to trial innovations that may support earlier and more efficient diagnosis, including a trial for the PinPoint blood test and a new genetic test that may be used as a liquid biopsy for those with suspected pancreatic cancer.
Asked by: Peter Gibson (Conservative - Darlington)
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 the detection of liver disease in Darlington constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Northern Cancer Alliance (NCA) is supporting services to enable the early detection of liver disease across North East and North Cumbria Integrated Care Board (ICB). More than 80% of patients with liver cirrhosis, a type of liver disease, have been invited to monthly ultrasound surveillance. For 2024/25, the NCA has invested over £200k into trusts across the ICB to help improve their monitoring systems for cirrhosis patients. This investment has also included £30,000 for County Durham and Darlington NHS Foundation Trust who will be using their funds to improve systems in relation to call and recall of patients to their six-monthly checks.
The ICB is also enrolled in a Community Liver Health Check pilot in Newcastle, being delivered by the systems Hepatitis C Operational Delivery Networks. This will provide FibroScans in one stop community clinics where patients have relevant blood testing, liver ultrasound and other investigations as required. The pilot has expanded into North Tyneside and when resources allow, they intend to develop clinics elsewhere including Gateshead and Sunderland.
Asked by: Ian Byrne (Labour - Liverpool, West Derby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has plans to invest in diagnostic infrastructure for people with dementia.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
We committed in 2019 to double funding for dementia research to £160 million per year by 2024/25. This will span all areas of research from causes and prevention to treatment and care, delivering evidence to help prevent, diagnose and treat dementia, enabling the best possible care and quality of life for people with dementia.
NHS England is also working with partner agencies to support and inform further research into other diagnostic modalities, including blood-based biomarker and digital tests, which will help improve identification and management of Alzheimer’s disease.
The National Health Service is a world leader in rolling out innovative treatments, including personalised cancer and life-saving gene therapies, and has established a dedicated programme team to prepare the NHS for the potential arrival of new Alzheimer’s treatments that are approved by the Medicines and Healthcare products Regulatory Agency and determined to be clinically and cost-effective by the National Institute for Health and Care Excellence.
The team at NHS England are assessing the additional scanning, treating and monitoring capacity which would be required across the country. This includes securing additional diagnostic capacity including magnetic resonance imaging, lumbar puncture, and positron emission tomography and computed tomography.
Asked by: Andrew Gwynne (Labour - Denton and Reddish)
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.