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, pursuant to the Answer of 18 April 2024 to Question 21865 on Bowel Cancer: Greater Manchester, what is the average waiting time to receive (a) an appointment for a coloscopy and (b) the results from a colonoscopy in (i) England, (ii) Greater Manchester and (iii) Stepping Hill Hospital.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Statistics on diagnostics waiting times via modality for England, and at commissioner and provider levels, is publicly available and can be accessed via the following link:
Asked by: Damien Moore (Conservative - Southport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent progress she has made on increasing access to cancer screening in the North West.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England North West has carried out significant work to improve access to cancer screening in the area, including: insight work into cervical screening, which has highlighted some issues, resulting in the piloting of potential solutions; a breast mobile site review being carried out, with findings and recommendations to be shared with trusts to act upon; five bowel and seven breast providers have been trained to use data to develop a Health Equity Audit, which will be submitted at the end of June 2024, with funding being offered to providers to design, develop, implement, and evaluate an intervention to reduce inequalities and barriers experienced by a population group they have identified in their Health Equity Audit; and funding being provided for Improving Uptake in Screening Officers, working to support non responders to take up the offer of breast screening.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of progress in the development of a clinical analytical service for specialised commissioning.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Commissioners of Specialised Services have access to the analysis of clinical data via their regional business intelligence teams, or the nationally commissioned Commissioning Support Unit (CSU) service provision.
Routine reporting can be accessed via the National Commissioning Data Repository, and more focused analytics can be performed across commissioning and clinical datasets collected by NHS England. NHS England has developed 181 Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services and maintain clinical registries ranging from bowel cancer to pulmonary hypertension. The full list is available at the following link:
https://digital.nhs.uk/data-and-information/clinical-audits-and-registries
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what practical assistance is available for those with a physical or mental condition which prevents them from doing medical tests at home, such as bowel cancer screening, unaided.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are aware of the issues faced by some people with physical or mental health conditions that can make attending a screening appointment, or carrying out a home test, more difficult. Currently, national screening IT systems do not have the facilities to flag conditions for individuals which could make it more difficult to carry out the bowel cancer screening, fecal immunochemical test (FIT) at home. It is therefore recommended that individuals contact their general practice (GP) in these situations, so that GPs can work with the screening provider to arrange further support. For example, carrying out a FIT test at the GP or at home, with the support of a family member or community nurse.
NHS England has started work to improve its national screening IT systems through the Digital Transformation of Screening programme. This will enable screening providers to flag heath issues that may make carrying out a FIT test at home more difficult, and to offer any appropriate support.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government which groups have a lower-than-average rate of participation in home-kit bowel cancer screening; and what plans they have to increase participation.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The national IT system for the NHS Bowel Cancer Screening Programme does not routinely collect data that could identify groups that have a lower-than-average uptake rate of the fecal immunochemical bowel cancer screening test.
Research has found that groups which are less likely to take part in bowel screening include men, people from ethnic minority backgrounds, and people in more deprived areas. Physical or mental health conditions can also make carrying out a home test more difficult.
NHS England has started work to improve its national screening IT systems through the Digital Transformation of Screening programme. This will enable screening providers to record protected characteristics, to more accurately identify groups with the lowest uptake, and target initiatives to improve uptake.
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%.
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 steps her Department is taking to (a) trial and (b) roll-out early cancer screening.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In England, early cancer screening is already in place for cervical, breast, and bowel cancer. The UK National Screening Committee (UK NSC) does not currently recommend screening for prostate cancer due to the inaccuracy of the current best test, called Prostate Specific Antigen. We are providing £16 million of funding to Prostate Cancer UK's £42 million trial, which is aimed at helping us find a way of catching prostate cancer in men as early as possible. The UK NSC is also commissioning evidence for six possible approaches to targeted prostate screening for those at higher risk. The UK NSC will publish its recommendations when complete.
NHS England is responsible for the running of the Targeted Lung Health Check Programme, and its conversion to a nationally rolled out NHS Targeted Lung Cancer Screening Programme by 2030.
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 estimate she has made of the (a) cost to the NHS of lack of specialist bowel care for patients with neurogenic bowel disorders and (b) additional costs incurred by (i) diagnosis and treatment of pressure sores resulting from inadequate care and (ii) other secondary complications.
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: 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: Henry Smith (Conservative - Crawley)
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 help improve genomics testing for bowel cancer patients.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
A National Health Service testing programme is helping to diagnose thousands of people with a genetic condition, Lynch Syndrome, that increases the chance of developing certain cancers including bowel cancer. The national programme ensures all people diagnosed with bowel cancer are offered genomic testing, with a diagnosis for Lynch Syndrome not only helping to guide more personalised cancer treatment but enabling their families and relatives to be offered testing too. Relatives who receive a diagnosis of Lynch Syndrome can be referred to genetic services to discuss regular testing options to help catch any cancers as early as possible, as well as to consider preventive options such as taking aspirin or undergoing risk-reducing surgery.
Genomic testing in the NHS in England is provided through the NHS Genomic Medicine Service (GMS) and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory (NGTD) which outlines the full range of genomic testing offered by the NHS in England including tests for 3,200 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The NGTD sets out the eligibility criteria for patients to access testing as well as the genomic targets to be tested and the method that should be used, including testing for bowel cancer patients.
The NHS GMS cancer genomic testing strategy has facilitated a move to a consolidated laboratory network through the seven NHS GLHs delivering more extensive panel testing using cutting edge high throughput Next Generation Sequencing (NGS) technology. For patients, including those with bowel cancer, this technology enables testing for a larger number of genetic variations to give a more precise diagnosis, identify biomarkers to target treatment and opportunities to access innovative medicines, and can support enrolment into molecularly stratified clinical trials.
Testing is available for all eligible patients across the whole of England. Individuals should discuss with their healthcare professional (for example, their general practitioner or other healthcare professional if they are already being seen in a relevant service) whether genomic testing is appropriate for them. Their healthcare professional will then make a decision whether to refer the individual either directly or via an NHS clinical genomics service or other relevant clinical speciality for genomic testing following clinical review of their and their family’s medical history if known, and the relevant genomic testing eligibility criteria.
The 17 NHS Clinical Genomic Services (NHS CGSs), commissioned by NHS England, deliver a comprehensive clinical genomic and counselling service that directs the diagnosis, risk assessment and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a rare genetic or genomic condition. As part of the NHS CGS, the patient and their family will access diagnosis, and management relevant to their particular condition, but also receive support and guidance so that they are able to understand their condition, its implications, and their options in relation to reproduction, screening, prevention and clinical management.