Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many women were turned away from mammogram screening tests because they were unable to hold the required position for sufficient time in each of the last five years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England does not hold this information at a national level. NHS England is committed to improving the accessibility of the screening programmes it commissions and contractually, providers of National Health Service screening services are required to make reasonable adjustments to ensure that their services are accessible for people with disabilities.
Services make reasonable adjustments within the constraints of mammography equipment, to ensure that people with disabilities are offered the opportunity to have screening; However, there may be situations where this is not possible.
Local providers will have a better understanding of any accessibility issues for individual patients and will deal with these on a case by case basis. Providers will offer an alternative approach as necessary. For example, for women who are unable to have a mammogram, may be offered a referral to a symptomatic breast clinic for a physical check.
Asked by: Ruth Cadbury (Labour - Brentford and Isleworth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what representations she has made to NICE on the availability of Enhertu.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department meets regularly with the National Institute for Health and Care Excellence (NICE) to discuss a range of issues, including access to medicines. The NICE has recommended Enhertu, also known as trastuzumab deruxtecan and made by Daiichi Sankyo, for use through the Cancer Drugs Fund, for the treatment of HER2-positive metastatic or unresectable breast cancer. It is available to eligible National Health Service patients in England, in line with the NICE’s recommendations.
The NICE is currently evaluating Enhertu for the treatment of HER2-low metastatic or unresectable breast cancer. Following negotiations between NHS England and the company, which concluded without a commercial agreement to make it available at a cost-effective price for the NHS, the NICE published final draft guidance on 5 March 2024, that does not recommend it as an option for this indication. The NICE remains open to further discussions with NHS England and the company, and currently expects to publish final guidance on 15 May 2024.
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 link between women’s increasing consumption of alcohol and incidences of breast cancer.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Public Health England’s evidence review, ‘The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies’, which was published in 2016 and updated in 2018, found there is strong evidence for an association between alcohol consumption and female breast cancer, and that for breast cancer, any level of drinking increases your risk so there is no ‘safe’ level of drinking. A copy of the review is attached.
The Government believes in informing and empowering citizens and has a responsibility to provide the most up to date, clear information to enable people to make informed choices about their drinking. The 2016 United Kingdom Chief Medical Officers’ low risk drinking guidelines provide the public with the most up to date scientific information and highlight the risk of a range of health problems, including breast cancer, from alcohol consumption.
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 she has made of performance against the 62-day referral to treatment cancer standard in England.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In February 2024, 63.9% of patients, against the standard of 85%, received treatment within 62 days of an urgent suspected cancer or breast symptomatic referral or consultant upgrade, to a first definitive treatment for cancer. This is 1.6% higher than performance in January 2024, and 1.4% higher than the same time last year.
The pandemic and recent industrial action placed significant pressure on elective services, including cancer care. We are seeing record levels of referrals, with over 12,000 urgent referrals seen for suspected cancer per working day in February 2024.
As outlined in the 2024/25 NHS England Planning Guidance, NHS England is providing over £266 million in cancer service development funding to Cancer Alliances to support delivery of the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity. The Government remains committed to continuing its recovery from the pandemic, and specifically, to reduce local and national waiting times for cancer treatment.
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: 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 recent assessment she has made of trends in the level of uptake for breast cancer screenings amongst ethnic minority women.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The national breast screening programme does not currently have the capability to routinely cross reference patient’s ethnicity data with uptake data. NHS England has started work to improve its data collection capabilities as part of the development of the new screening IT system, through the Digital Transformation of Screening programme. This will support the collection of population-level data on protected characteristics such as ethnicity, to support services in improving uptake.
More widely, NHS England has developed a national plan to improve uptake, including interventions to address inequalities and screening barriers. This includes ensuring appointments are as convenient as possible, and efforts are focused on areas and groups with low uptake.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
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 access to breast screening for people with physical disabilities that prevent them from holding the required position for sufficient time to complete the screening.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is committed to improving the accessibility of the screening programmes it commissions under the Public Health Services (S7a) agreement, particularly for under-served groups in society. Contractually, providers of National Health Service screening services are required to make reasonable adjustments to ensure that their services are accessible for people with disabilities. For example, the NHS breast screening service offers longer appointments at accessible sites to support women with physical disabilities.
Services make reasonable adjustments within the constraints of mammography equipment, to ensure that people with disabilities are offered the opportunity to have screening. However, there may be situations where this is not possible. Providers will deal with these on a case by case basis, and offer an alternative approach as necessary. For example, for women who are unable to have a mammogram, they may be offered a referral to a symptomatic breast clinic for a physical check.
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 ensure that patients at high risk of developing breast cancer are recalled for MRI screening.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Women at very high risk (VHR) of breast cancer are eligible to be screened from the age of 25 years old upwards, and should be invited every year. The screening includes mammography or magnetic resonance imaging (MRI), depending on age and risk criteria.
In March, NHS England wrote to a small number of VHR women who had not been referred for annual MRI surveillance, and the National Health Service has been working hard to ensure these women are checked as a matter of urgency, as described in their individual letters. To support screening of VHR women, a new central database is planned to ensure all referrals reach NHS breast screening services.
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.