Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she has taken with NHS England to help raise awareness by (a) patients and (b) GPs of the increased risk of breast cancer in people with neurofibromatosis type 1.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department works with NHS England to raise awareness of cancers, including for people with increased risk of cancer. In January 2024, NHS England relaunched the Help Us Help You cancer awareness campaign, designed to increase earlier diagnosis by encouraging people to come forward with suspected signs of cancers.
For individuals with neurofibromatosis type 1 (NF1), who are at increased risk of breast cancer, the National Health Service in England recommends breast screening from the age of 40 years old. It is important that awareness of this is widespread among patients and general practices (GPs). Treatment for NF1 involves regular monitoring, and if a patient develops complex problems, their GP can usually refer them to one of two specialist NHS centres, so that a treatment plan can be drawn up. These centres are at Guy’s and St Thomas’ in London, and at Manchester University Hospital.
We expect clinicians to keep themselves appraised of developments within conditions, and to refer to the National Institute for Clinical Excellence guidance as part of their clinical decision-making process.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have for developing a best practice timed pathway for leukaemia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to reduce the rates of emergency diagnosis of leukaemia.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve acute myeloid leukaemia survival rates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has implemented non symptom specific pathways (NSS) for patients who present with non-specific symptoms or combinations thereof that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. As of December 2023, there are 113 NSS pathways already live, an increase from 12 live Rapid Diagnostic Centre pathways in March 2020, with over 5,500 patients seen per month and a total of over 100,000 referrals since May 2020.
Raising awareness, delivering more research, and improving early diagnosis of cancers, which includes blood related cancers such as leukaemia, are crucial for improving survival rates and are key priorities for the Government.
NHS England is taking steps to raise awareness of all cancers, including leukaemia, to improve early diagnosis. In January 2024, NHS England relaunched their ‘Help Us Help You’ cancer awareness campaign, designed to increase earlier diagnosis of cancer by encouraging people to come forward with suspected signs of cancers. The campaign aims to reduce barriers to seeking earlier help, as well as to increase body awareness and knowledge of key red flag symptoms. This relaunch follows NHS England’s launch of their original ‘Help Us Help You’ campaigns in April 2020, a major public information campaign to persuade the public to seek urgent care and treatment when they needed it.
Delivering more research is key to understanding the causes of cancers and increasing survival rates of all cancers, including leukaemia, further. That is why investment in research and innovation is a priority for the Government. Our world-leading scientists and clinicians are driving the discovery, development, and testing of new treatments. The Department invested almost £122 million into cancer research in 2022/23 via the National Institute for Health and Care Research. In addition, alongside Cancer Research UK, health departments across the United Kingdom are jointly funding a network of Experimental Cancer Medicine Centres (ECMCs), collectively investing more than £35 million between 2017 and 2022. The network of 17 adult and 12 paediatric ECMCs enhances the existing bench-to-bedside pathway by supporting the most promising innovations from the academic and industry sectors into the cancer medicines of tomorrow.
More broadly, the National Health Service is working towards its Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. To support early diagnosis, the Government has invested £2.3 billion into community diagnostic centres across England which are speeding up diagnosis for cancer, with checks and scans being delivered at 160 sites across England. Cancer is also one of six major conditions included in our upcoming Major Conditions Strategy.
With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what proportion of leukaemia patients have received a diagnosis within the 28-day 'faster diagnosis' standard.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
For the Faster Diagnostic Standard (FDS), data regarding leukaemia and its sub-types is collected using the following two categories: suspected acute leukaemia; and suspected haematological malignancies, excluding acute leukaemia. The latter category includes non-acute leukaemia when there is a suspicion. These statistics are published monthly and are available on the NHS Cancer Waiting Times website, in an online only format. Performance against the FDS for suspected acute leukaemia in March 2024 was at 74.1%. Performance against the FDS for suspected haematological malignancies, excluding acute leukaemia, in March 2024 was at 56.8%.
For the 31- and 62-day referral to treatment combined standards, data is collected at an International Classification of Diseases 10 (ICD-10) level, and NHS England publishes data as an aggregation of these reports, to manage the risk of disclosure. Data regarding leukaemia and its sub-types is reported under cancer type ‘Haematological – Other (a)’. These are ICD-10 codes that are haematological, excluding lymphoma, and this aggregation includes ICD-10 codes C91.0 to C96.9, which includes all leukaemia codes. Further information on the ICD-10 classification is available on the NHS England website, in an online only format.
According to NHS England, the 31-day referral to treatment performance for acute leukaemia, testicular, and children’s cancer is no longer published as a separate category, due to the low numbers of patients seen with these cancers. These patients continue to be included within the numerator and denominator of the 31-day and 62-day all cancer National Statistics, published by NHS England.
Asked by: Tom Hunt (Conservative - Ipswich)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what her steps her Department is taking to improve early diagnosis rates for prostate cancer prior to the TRANSFORM trial findings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Improving early diagnosis of cancer, including prostate cancer, remains a priority for the Government and we are working towards the NHS Long Term Plan ambition of diagnosing 75% of stageable cancers at stage 1 and 2 by 2028. We know more people are surviving cancer in the United Kingdom than ever and that is partly down to early diagnosis.
Prior to the TRANSFORM trial, we are helping more people get diagnosed earlier by raising awareness, implementing the faster diagnosis standard and funding investment in research and diagnostics. NHS England takes steps to raise awareness of prostate cancer where there are opportunities to do so; for example NHS England partners with cancer alliances, charities and local representatives to reach people through projects in the heart of their communities. Cancer alliances have also been undertaking action to alert ‘at risk’ groups about prostate cancer, this is determined at a local level and so will vary depending on local needs and priorities.
To support faster diagnosis, NHS England is streamlining cancer pathways and in October 2022 introduced the best practice timed pathway for prostate cancer. This guidance recommends those with suspected prostate cancer undertake a multi-parametric magnetic resonance imaging (MRI) before biopsy, which ensures only those men most at risk of having cancer undergo an invasive biopsy.
In 2018, the Government announced £75 million of funding for clinical trials for prostate cancer, focusing on early diagnosis, survival rates and treatment options. Since April 2018, the National Institute for Health and Care Research (NIHR) has awarded over £60 million to more than 28 research studies relevant to prostate cancer. These include randomised controlled trials of different treatments, a randomised controlled trial of different methods of biopsy and a survivors’ rehabilitation evaluation.
Alongside cutting-edge research, we are helping more people get diagnosed earlier for cancer and other conditions by rolling out additional tests, checks and scans at 160 locations across England through our Community Diagnostics Centres programme.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made in reducing inequalities in outcomes for breast cancer patients from black and minority ethnic backgrounds over the past (1) 10 years, (2) five years, and (3) two years.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority 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 for 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 the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve the collection and reporting of ethnicity data for breast cancer patients to support understanding of variations in outcomes and patient experience of NHS care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing inequalities and improving breast cancer outcomes for ethnic minority 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 for 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 the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.
The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.
NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.
NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.
Asked by: Lord Kempsell (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to ensure equity and quality in care and support across the entire cancer pathway, including (1) fairness and equity in diagnostics, (2) on time treatment, and (3) patients being offered conversations about the additional care and support they may need.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is taking steps to ensure equity and quality in care and support for patients is available across the entire cancer pathway. Reducing inequalities and variation in cancer diagnosis and treatment are a priority for the Government, as is increasing early cancer diagnosis, as this is a key contributor to reducing cancer health inequalities. 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. As part of this, we are increasing diagnostic capacity by rolling out community diagnostic centres across England, with capacity prioritised for cancer checks. Additionally, and 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.
The Department's ministers and officials frequently meet with key stakeholders within the cancer community, including discussions on support for patients and their families. The National Health Service 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.
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.
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 provides 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.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made towards ensuring that people with cancer who require radiotherapy treatment can start treatment within their target of 31 days.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are seeing continued high levels of urgent cancer referrals, with over 12,000 urgent referrals seen for suspected cancer per working day in March 2024, compared to approximately 9,000 in March 2019. In March 2023, 89.7% of patients received a first or subsequent radiotherapy treatment within 31 days of a decision to treat, which is 0.6% higher than last year. From March 2023/24, 127,336 people received a first or subsequent radiotherapy treatment, which is 1,359 more than the previous year.
The Government continues to work with NHS England on implementing the Delivery plan for tackling the COVID-19 backlog of 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.
We are building our cancer workforce. In January 2024 there were over 35,200 full-time equivalent (FTE) staff in the cancer workforce, an increase of over 13,300, or 60.7% since January 2010. This includes over 8,100 FTE consultants in January 2024, an increase of over 3,300, or 69.6% since January 2010.
Since 2016, the Department has invested £162 million into cutting-edge radiotherapy equipment to replace or upgrade more than 100 radiotherapy treatment machines, so we can deliver the best possible outcomes for patients. From April 2022, the responsibility for investing in new radiotherapy machines sits with local systems.