Asked by: Catherine West (Labour - Hornsey and Wood Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions he has had with (a) NHS and (b) NICE officials on the availability of the drug Anti GD2 for the treatment of neuroblastoma.
Answered by Steve Brine
Current treatments for high-risk neuroblastoma include chemotherapy, radiotherapy, stem cell transplantation, surgery and isotretinoin. Dinutuximab beta gained marketing authorisation in May 2017 and is used in combination with interleukin-2 (aldesleukin) as an additional treatment option for patients who have high-risk neuroblastoma and have shown some improvement with previous treatments or with relapsed or refractory neuroblastoma.
The National Institute for Health and Care Excellence (NICE) published final draft technology appraisal guidance on 12 July that recommends dinutuximab beta as a clinically and cost-effective use of National Health Service resources for patients meeting specified clinical criteria. Stakeholders now have an opportunity to appeal NICE’s draft recommendations. NICE expects to publish final guidance in August 2018.
Ministers and Departmental officials regularly discuss a range of issues with colleagues in NHS England and NICE, including the availability of individual treatments.
Asked by: Eleanor Smith (Labour - Wolverhampton South West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the average cost to the NHS is of providing a kidney transplant.
Answered by Jackie Doyle-Price
NHS Improvement publishes reference cost data relating to kidney transplants, which can be found at the following link:
https://improvement.nhs.uk/resources/reference-costs/
Reference costs are the average unit cost to the National Health Service of providing defined services to NHS patients in England in a given financial year. The information relating to kidney transplants is collected in two ways, the actual transplant episodes and the preparatory and follow-up screening and examinations in the case of live donor transplants. Reference costs for 2016-17 are given in the following tables.
Reference costs for kidney transplant episodes 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Kidney Transplant, 19 years and over, from Cadaver Non-Heart-Beating Donor | 645 | £12,167 | £7,847,829 |
Kidney Transplant, 18 years and under, from Cadaver Non-Heart-Beating Donor | 11 | £5,780 | £63,576 |
Kidney Transplant, 19 years and over, from Cadaver Heart-Beating Donor | 1,171 | £12,888 | £15,092,002 |
Kidney Transplant, 18 years and under, from Cadaver Heart-Beating Donor | 40 | £15,157 | £606,268 |
Kidney Transplant, 19 years and over, from Live Donor | 708 | £13,854 | £9,808,873 |
Kidney Transplant, 18 years and under, from Live Donor | 60 | £15,149 | £908,964 |
| 2,635 | £13,028 | £34,327,513 |
Source: NHS Improvement
Notes:
Reference cost data for pre and post-transplant episodes for activities associated with kidney transplants 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Live Kidney Donor Screening | 1,083 | £215 | £232,565 |
Kidney Pre-Transplantation Workup of Live Donor | 2,422 | £270 | £654,200 |
Kidney Pre-Transplantation Workup of Recipient, 19 years and over | 9,150 | £271 | £2,483,885 |
Kidney Pre-Transplantation Workup of Recipient, 18 years and under | 27 | £991 | £26,750 |
Examination for Post-Transplantation of Kidney of Recipient, 19 years and over | 75,261 | £239 | £18,010,518 |
Examination for Post-Transplantation of Kidney of Recipient, 18 years and under | 396 | £250 | £99,024 |
Examination for Post-Transplantation of Kidney of Live Donor | 2,809 | £173 | £487,293 |
| 91,148 | £241 | £21,994,236 |
Source: NHS Improvement
Notes:
There are additional costs associated with a kidney transplant for immunosuppressant therapy, at an average cost of £6,000 per patient per year, and ongoing outpatient follow up but this information will depend on the individual patient and is not collected centrally.
Information on hospital bed days used by patients waiting for organ or stem cell transplants is not centrally collected.
Asked by: Eleanor Smith (Labour - Wolverhampton South West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many hospital bed days were used by patients waiting for (a) organ and (b) stem cell transplants in each of the last three years.
Answered by Jackie Doyle-Price
NHS Improvement publishes reference cost data relating to kidney transplants, which can be found at the following link:
https://improvement.nhs.uk/resources/reference-costs/
Reference costs are the average unit cost to the National Health Service of providing defined services to NHS patients in England in a given financial year. The information relating to kidney transplants is collected in two ways, the actual transplant episodes and the preparatory and follow-up screening and examinations in the case of live donor transplants. Reference costs for 2016-17 are given in the following tables.
Reference costs for kidney transplant episodes 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Kidney Transplant, 19 years and over, from Cadaver Non-Heart-Beating Donor | 645 | £12,167 | £7,847,829 |
Kidney Transplant, 18 years and under, from Cadaver Non-Heart-Beating Donor | 11 | £5,780 | £63,576 |
Kidney Transplant, 19 years and over, from Cadaver Heart-Beating Donor | 1,171 | £12,888 | £15,092,002 |
Kidney Transplant, 18 years and under, from Cadaver Heart-Beating Donor | 40 | £15,157 | £606,268 |
Kidney Transplant, 19 years and over, from Live Donor | 708 | £13,854 | £9,808,873 |
Kidney Transplant, 18 years and under, from Live Donor | 60 | £15,149 | £908,964 |
| 2,635 | £13,028 | £34,327,513 |
Source: NHS Improvement
Notes:
Reference cost data for pre and post-transplant episodes for activities associated with kidney transplants 2016-17
| Total | ||
HRG1 Description | Activity | Unit Cost | Total Cost |
Live Kidney Donor Screening | 1,083 | £215 | £232,565 |
Kidney Pre-Transplantation Workup of Live Donor | 2,422 | £270 | £654,200 |
Kidney Pre-Transplantation Workup of Recipient, 19 years and over | 9,150 | £271 | £2,483,885 |
Kidney Pre-Transplantation Workup of Recipient, 18 years and under | 27 | £991 | £26,750 |
Examination for Post-Transplantation of Kidney of Recipient, 19 years and over | 75,261 | £239 | £18,010,518 |
Examination for Post-Transplantation of Kidney of Recipient, 18 years and under | 396 | £250 | £99,024 |
Examination for Post-Transplantation of Kidney of Live Donor | 2,809 | £173 | £487,293 |
| 91,148 | £241 | £21,994,236 |
Source: NHS Improvement
Notes:
There are additional costs associated with a kidney transplant for immunosuppressant therapy, at an average cost of £6,000 per patient per year, and ongoing outpatient follow up but this information will depend on the individual patient and is not collected centrally.
Information on hospital bed days used by patients waiting for organ or stem cell transplants is not centrally collected.
Asked by: Priti Patel (Conservative - Witham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to encourage BAME people to register as stell cell donors.
Answered by Jackie Doyle-Price
The Department funds Anthony Nolan and NHS Blood and Transplant to improve equity of access to unrelated donor stem cell transplantation for Black, Asian and Minority Ethnic (BAME) patients through targeted recruitment to the Anthony Nolan and the NHS Stem Cell Registry.
More than £20 million has been provided to NHS Blood and Transplant and Anthony Nolan for stem cell donation since 2015, and this funding includes very specific stipulations about the numbers of newly registered bone marrow donors, and the proportion umbilical cords stored in the United Kingdom Cord Blood Bank that must be from BAME backgrounds (35-40%).
In 2016 NHS Blood and Transplant began a partnership with Team Margot and launched the Golden Ticket campaign. This project created 35,000 Golden Tickets which were circulated to existing BAME and mixed-race blood donors to encourage them to sign on to the stem cell donor register.
Asked by: Mohammad Yasin (Labour - Bedford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to encourage BAME people to sign up to the stem cell donor register.
Answered by Jackie Doyle-Price
The Department funds Anthony Nolan and NHS Blood Transplant to improve equity of access to unrelated donor stem cell transplantation for Black, Asian, and minority ethnic (BAME) patients through targeted recruitment to the Anthony Nolan and the NHS Stem Cell Registry.
More than £20 million has been provided to NHS Blood and Transplant and Anthony Nolan for stem cell donation since 2015, and this funding includes very specific stipulations about the numbers of newly registered bone marrow donors, and the proportion of umbilical cords stored in the UK Cord Blood Bank that must be from BAME backgrounds (35-40%). This includes specific funding to support recruitment of donors from BAME backgrounds.
In 2016 NHS Blood Transplant began a partnership with Team Margot and launched the Golden Ticket campaign. This project created 35,000 Golden Tickets which were circulated to existing BAME and mixed-race blood donors to encourage them to sign on to the stem cell donor register.
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, if he will take steps to address the findings of the Anthony Nolan Trust on the comparatively low survival rates for people with blood cancer from BAME backgrounds.
Answered by Steve Brine
The Government funds Anthony Nolan and NHS Blood and Transplant to improve equity of access to unrelated donor stem cell transplantation for Black, Asian and minority ethnic (BAME) patients through targeted recruitment to the United Kingdom Stem Cell Registry.
The National Cancer Programme is committed to transforming cancer care and outcomes for all people living with cancer, including those with rarer and hard to diagnose cancers. Ambitions have been set for all cancers and we are clear that we will not meet those ambitions without improving what we do for haematological cancers.
Although cancer patients in England rated their overall care 9 out of 10 in the 2016 Cancer Patient Experience Survey, the survey also tells us that BAME patients report poorer experiences of cancer care. NHS England is therefore working with clinical commissioning groups to ensure they use the very best evidence when planning, commissioning and monitoring services for these communities.
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 his Department has assessed the potential merits of producing a strategy to support research into the barriers and motivations affecting BAME organ, blood and stem cell donation; and if he will make a statement.
Answered by Jackie Doyle-Price
NHS Blood and Transplant (NHSBT) is responsible for the collection, manufacturing and issuing of blood products to the National Health Service in England; for organ and tissue donation in the United Kingdom; and for the British Bone Marrow Registry, to which it recruits registered blood donors to be potential stem cell donors.
NHSBT has ongoing strategies to recruit more blood, organ and stem cell donors from black, Asian and minority ethnic (BAME) backgrounds in order to address the health inequalities faced by patients from those communities. These strategies are informed by research; for example, in 2013 NHSBT commissioned a report by Optimisa Research to understand attitudes and behaviours towards organ donation. Research conducted in 2015 by ESRO Ltd revealed some of the barriers and motivations of people from BAME communities towards blood donation. Copies of these reports are attached.
NHSBT strategies include targeted marketing activity, events, education resources, PR and media work and engagement with faith organisations. The impact of these strategies is evaluated on an ongoing basis to inform future work.
There will be a new national campaign to increase the number of BAME organ donors later this year. The Department sponsors Anthony Nolan and NHSBT to improve equity of access to unrelated donor stem cell transplantation for BAME patients.
Asked by: Mark Tami (Labour - Alyn and Deeside)
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 21 December 2017 to Question 119731 on Pneumoccocol Diseases: Vaccination, whether NHS England is responsible for funding the vaccination of adults who have undergone stem cell transplantation under paragraph 4.2 of the NHS public health functions agreement 2017-18: Service specification no.8 Pneumococcal immunisation programme.
Answered by Steve Brine
NHS England is responsible for the delivery of vaccinations to those undergoing stem cell transplants (under the pneumococcal polysaccharide vaccination immunosuppressed indications) as part of the Public Health functions agreement section 7a. The funding is via the directly enhanced services, whereby the first dose delivered has an automatic payment. Where a patient requires additional pneumococcal vaccination (if severely immunosuppressed) the specialist clinicians are expected to use their discretion and deliver this or advise the general practitioner to deliver. The practice is required to make arrangements with their local commissioners with regards to payment.
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, when the ATIR treatment for people with leukaemia will be available on the NHS.
Answered by Steve Brine
The National Institute for Health and Care Excellence (NICE) has been asked to develop technology appraisal guidance on the use of ATIR101 to support haematopoietic stem cell transplantation using partially mismatched (haploidentical) family members as donors, for the treatment of some blood cancers. NICE’s appraisal is being scheduled in line with a clinical trial that is expected to complete in 2020.
Asked by: Richard Burden (Labour - Birmingham, Northfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what recent assessment he has made of the effectiveness of the provision of care and support available to patients following a stem cell transplant.
Answered by Jackie Doyle-Price
NHS England is responsible for commissioning and funding the transplant related care which takes place 30 days before transplant and continues until 100 days post-transplant. As outlined in the Manual, after 100 days post-transplant, commissioning responsibility for the routine follow-up of patients switches from NHS England to clinical commissioning groups (CCGs).
The Manual for Prescribed Specialised Services describes which elements of specialised services are commissioned by NHS England and which are commissioned by CCGs is available at:
https://www.england.nhs.uk/wp-content/uploads/2017/10/prescribed-specialised-services-manual-2.pdf
In the event that transplant patients experience serious complications post-transplant, elements of their care would likely continue to be planned, organised and funded by NHS England specialised commissioning. For example, if a patient requires Extracorporeal Photophersis which is a treatment for acute and chronic graft versus host disease following transplantation, NHS England commissions this care post-transplant.
NHS England’s work in supporting the roll out of the Recovery Package for cancer patients, including those who received blood and marrow transplants, helps ensure patients have more personal care and support from the point they are diagnosed and once treatment ends. For patients this means working with their care team to develop a comprehensive plan outlining not only their physical needs, but also additional support, such as help at home or financial advice. By 2020 NHS England wants all cancer patients to have access to the Recovery Package.