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: Alison McGovern (Labour - Wirral South)
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 the treatment of Cholangiocarcinoma cancers; and whether a proportion of the additional funding allocated to her Department in the Spring Budget 2024 will be used to treat Cholangiocarcinoma cancers.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Cancer is being diagnosed at an earlier stage, more often, with survival rates improving across almost all types of cancer, and the National Health Service has been seeing and treating record numbers of cancer patients over the last two years. Improving early diagnosis of cancer, including cholangiocarcinoma cancers, is a priority for the NHS. 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.
Although funding for treatment isn’t allocated for specific cancers, the Government has provided significant additional funding to the NHS and adult social care in England. Measures introduced at the Spring Budget will protect levels of funding for the NHS in England in real terms in 2024/25, by providing an extra £2.5 billion for 2024/25, meaning a total budget of £164.9 billion.
While this additional spending is needed, the Government recognises that more money cannot always be the answer to improving outcomes for patients. Alongside the £2.5 billion of extra funding for day-to-day activities, the Government will invest £3.4 billion to reform the way the NHS works. This funding will significantly reduce the 13 million hours of time doctors spend on poor IT, freeing up significant capacity, and revolutionising treatment for a range of illnesses such as cancer and strokes. This will double the investment in technological and digital transformation in the NHS in England, and turn the NHS into one of the most digitally enabled, productive healthcare systems in the world.
On 14 August 2023, the Government published the Major Conditions Strategy’s Case for Change and Our Strategic Framework, which sets out our approach to making the choices over the next five years that will deliver the most value when facing the health challenges of today and of the decades ahead, including for cancer. It will look at the treatment and prevention of cancer, covering the patient pathway. The strategy will look at a wide range of interventions and enablers, to improve outcomes and experience for cancer patients.
Asked by: Tulip Siddiq (Labour - Hampstead and Kilburn)
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 the potential implications for her policies of Pancreatic Cancer UK's Optimal Care Pathway recommendations.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England is delivering a range of interventions that are expected to increase early diagnosis, and improve outcomes for those with pancreatic cancer. 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 general practice direct access to diagnostic tests. NHS England has also formed an expert group to consider a pathway for hepato-pancreato-biliary cancers, including pancreatic cancer.
Asked by: Alison McGovern (Labour - Wirral South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions her Department has had with cancer treatment support groups on the use of direct funds to support patients and their families.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer treatment, which encompasses recovery spaces. Additionally, and as outlined in the 2024/25 NHS England Planning Guidance, NHS England are providing over £266 million in cancer service development funding to Cancer Alliances, to support delivery of the operational priorities for cancer.
The Department and NHS England meet regularly to discuss a wide range of issues regarding cancer. The Department's ministers and officials also frequently meet with key stakeholders within the cancer community, including discussions on support for patients and their families. As stated 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. NHS England provides personalised cancer care and support plans, to support both patients and their families at all stages of their cancer journey. This is being delivered in line with the NHS Comprehensive Model for Personalised Care, empowering people to manage their care and the impact of their cancer, and maximise the potential of digital and community-based support. NHS England estimates that approximately 80% of cancer multidisciplinary teams are now offering Personalised Care and Support Planning, ensuring physical, practical, emotional, and social needs are identified and addressed at all stages of the cancer pathway. Additionally, Personalised Stratified Follow Up pathways, which adapt care to the needs of individual patients after cancer treatment, are being rolled out by cancer multi-disciplinary teams, and are required for at least eight cancer types by 2023/24.
General practice surgeries also conduct cancer care reviews at regular intervals after cancer diagnosis, to offer support with any needs patients may have. This includes providing access to other specialist-led services who work alongside patients’ medical teams, to support patients and their families, such as counsellors, rehabilitation specialists, or social prescribers, who can connect you to community groups or services for more support. This is part of NHS England’s drive to universal personalised care that will see at least 2.5 million people benefiting from personalised care by 2023/24.
NHS England and the integrated care boards are responsible for commissioning and ensuring the healthcare needs of local communities in England are met, including for cancer patients. NHS England provide access to a personal health budget, which is an amount of NHS money that is allocated to support the health and wellbeing needs of a patient if eligible. More information is available at the following link:
https://www.nhs.uk/nhs-services/help-with-health-costs/what-is-a-personal-health-budget/
Asked by: Alison McGovern (Labour - Wirral South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what funding has her Department allocated to provide recovery spaces for families of cancer treatment patients.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer treatment, which encompasses recovery spaces. Additionally, and as outlined in the 2024/25 NHS England Planning Guidance, NHS England are providing over £266 million in cancer service development funding to Cancer Alliances, to support delivery of the operational priorities for cancer.
The Department and NHS England meet regularly to discuss a wide range of issues regarding cancer. The Department's ministers and officials also frequently meet with key stakeholders within the cancer community, including discussions on support for patients and their families. As stated 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. NHS England provides personalised cancer care and support plans, to support both patients and their families at all stages of their cancer journey. This is being delivered in line with the NHS Comprehensive Model for Personalised Care, empowering people to manage their care and the impact of their cancer, and maximise the potential of digital and community-based support. NHS England estimates that approximately 80% of cancer multidisciplinary teams are now offering Personalised Care and Support Planning, ensuring physical, practical, emotional, and social needs are identified and addressed at all stages of the cancer pathway. Additionally, Personalised Stratified Follow Up pathways, which adapt care to the needs of individual patients after cancer treatment, are being rolled out by cancer multi-disciplinary teams, and are required for at least eight cancer types by 2023/24.
General practice surgeries also conduct cancer care reviews at regular intervals after cancer diagnosis, to offer support with any needs patients may have. This includes providing access to other specialist-led services who work alongside patients’ medical teams, to support patients and their families, such as counsellors, rehabilitation specialists, or social prescribers, who can connect you to community groups or services for more support. This is part of NHS England’s drive to universal personalised care that will see at least 2.5 million people benefiting from personalised care by 2023/24.
NHS England and the integrated care boards are responsible for commissioning and ensuring the healthcare needs of local communities in England are met, including for cancer patients. NHS England provide access to a personal health budget, which is an amount of NHS money that is allocated to support the health and wellbeing needs of a patient if eligible. More information is available at the following link:
https://www.nhs.uk/nhs-services/help-with-health-costs/what-is-a-personal-health-budget/
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: Helen Hayes (Labour - Dulwich and West Norwood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much funding has been provided for research into (a) lobular breast cancer and (b) other forms of breast cancer in each of the last five years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is proud to invest £1.3 billion per year into health research, with more spent on cancer than any other disease group, through the National Institute for Health and Care Research (NIHR). Department officials meet regularly to discuss a wide-range of our investments, including into lobular and other breast cancers, to drive the maximum collective research impact on policy, practice, and individual lives. The NIHR invests in translational and implementation research to drive innovations into policy and practice.
We are proud to have invested £29 million into the Institute of Cancer Research (ICR) and the Royal Marsden NIHR Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, including lobular breast cancer. This is complemented by wider investments into breast cancer research including, for example, a £1.3 million project to determine whether an abbreviated form of breast magnetic resonance imaging can detect breast cancers missed by screening through mammography, again including lobular breast cancer. Our support to the NIHR’s Clinical Research Network has enabled the delivery of 10 further lobular breast-cancer related studies.
While the NIHR cannot respond to direct solicitations for funding, instead commissioning on the basis of research excellence, we would welcome more applications from researchers on lobular breast cancer, including from the ICR. The NIHR funds research on cancer prevention, detection, diagnosis, and treatment and care, which saves lives.
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.
Asked by: Ellie Reeves (Labour - Lewisham West and Penge)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an estimate of the average time taken to diagnose pancreatic cancer in Lewisham West and Penge constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Data on the average time taken to diagnose pancreatic cancer is not published by NHS England who are responsible for publishing cancer waiting times data. 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. Latest published data from February 2024 shows FDS performance was 78.1% nationally. Of those patients referred to Lewisham and Greenwich NHS Trust in February 2024, 81.2% received a diagnosis or ruling out of cancer within four weeks which was above the 75% standard. For the same period 76.2% of patients referred to providers part of NHS South East London Integrated Care Board received a diagnosis or ruling out of cancer within 28 days.
Data on FDS does not individualise pancreatic cancer specifically, however it does include suspected upper gastrointestinal (GI) cancer, which encompasses pancreatic cancer, at provider level. Of those patients referred to Lewisham and Greenwich NHS Trust for suspected GI cancer in February 2024, 82.3% received a diagnosis or ruling out of cancer within four weeks.
The Department is taking steps to reduce cancer treatment waiting times across England, including the time between an urgent general practitioner referral and the commencement of treatment. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.