Asked by: Siobhain McDonagh (Labour - Mitcham and Morden)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to improve access to clinical nurse specialists for patients recovering from a stem cell transplant.
Answered by Steve Brine
NHS England’s service specification sets out the requirements for equitable and consistent commissioning of specialised care. This specification describes the elements of care in the pathway, including those which reach beyond those paid for by specialised commissioning. The service specification stipulates that a clinical nurse specialist shall be available to provide support to transplants patients.
The service specifications for haematopoietic stem cell transplantation can be accessed at:
https://www.england.nhs.uk/wp-content/uploads/2013/06/b04-haema-adult.pdf
Asked by: Lord Kinnock (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government why adult sufferers from sickle cell anaemia who could benefit from stem cell treatment are not able to receive such treatment under the NHS when child sufferers can; and whether they are considering changing this policy.
Answered by Lord O'Shaughnessy
Decisions related to the provision of stem cell transplantation are an operational matter for NHS England. Stem cell transplants for sickle cell disease in adults are not routinely commissioned by NHS England. Whilst stem cell transplants can be effective for some carefully selected patients, stem cell transplantation can also lead to a number of complications, some of which can be severe and life threatening.
NHS England commissioning policy for stem cell transplants is kept under review in the light of the latest clinical evidence. The National Institute for Health Research is currently inviting research proposals for a multicentre randomised control trial to address the clinical and cost effectiveness of stem cell transplantation in adults with severe sickle cell disease. Evidence from this trial will inform NHS England commissioning policy related to stem cell transplants in adults with sickle cell disease.
Asked by: Derek Thomas (Conservative - St Ives)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether he plans to review the decision no longer to fund second stem cell transplants for blood cancer patients.
Answered by David Mowat
The commissioning of stem cell transplantation is managed as part of the overall system to deliver specialised services. To ensure that investment decisions are affordable and offer value for money, NHS England has established a defined prioritisation process. This involves assessment of all proposals based on clinical benefit and cost. On 2 August 2016, NHS England announced a re-run of the prioritisation process carried out earlier this year.
The Department is not planning to review the decision related to the commissioning of second stem cell transplants.
Asked by: Gareth Johnson (Conservative - Dartford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people have had stem cell transplantation procedures interrupted in England in each of the last five years.
Answered by Baroness Blackwood of North Oxford
Stem treatments may be discontinued due to a range of clinical reasons or patient choice. NHS England does not hold information on the number of patients that start but do not complete this form of treatment.
Asked by: Gareth Johnson (Conservative - Dartford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the cost per patient is of carrying out stem cell transplantation.
Answered by Baroness Blackwood of North Oxford
Costs associated with stem cell transplants can vary widely depending on the specific clinical circumstances.
Asked by: Gareth Johnson (Conservative - Dartford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what his Department's policy is on the interruption of stem cell transplantation.
Answered by Baroness Blackwood of North Oxford
The decision to perform a stem cell transplant will be made by specialist clinicians in discussion with the patient based on the potential benefits and risks of this form of treatment. Treatments may be discontinued for clinical reasons or in accordance with the wishes of the patient.
Asked by: Adam Afriyie (Conservative - Windsor)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to increase awareness of the importance of (a) blood and platelet donation, (b) stem cell donation, (c) bone marrow donation and (d) organ registration among school-aged children.
Answered by Baroness Blackwood of North Oxford
NHS Blood and Transplant runs donor recruitment campaigns for blood, platelet, stem cell and organ donation throughout the year. Examples include the recently launched Missing Type campaign to promote blood donation; implementation of their Taking Organ Transplantation to 2020: A UK Strategy and management of the NHS Cord Blood Bank and British Bone Marrow Registry, working with Anthony Nolan.
Specific action addressing awareness of registration among school-aged children includes the introduction of new education resources designed to equip secondary school teachers with the knowledge to educate and engage students about organ donation and working with Anthony Nolan to run the Be a Lifesaver education programme which trains volunteers to educate 16-18 year olds about stem cell, blood and organ donation.
Asked by: Adam Afriyie (Conservative - Windsor)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to increase registration for (a) blood and platelet, (b) stem cell, (c) bone marrow and (d) organ donation.
Answered by Baroness Blackwood of North Oxford
NHS Blood and Transplant runs donor recruitment campaigns for blood, platelet, stem cell and organ donation throughout the year. Examples include the recently launched Missing Type campaign to promote blood donation; implementation of their Taking Organ Transplantation to 2020: A UK Strategy and management of the NHS Cord Blood Bank and British Bone Marrow Registry, working with Anthony Nolan.
Specific action addressing awareness of registration among school-aged children includes the introduction of new education resources designed to equip secondary school teachers with the knowledge to educate and engage students about organ donation and working with Anthony Nolan to run the Be a Lifesaver education programme which trains volunteers to educate 16-18 year olds about stem cell, blood and organ donation.
Asked by: Shabana Mahmood (Labour - Birmingham, Ladywood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the adequacy of research into sickle cell disease in meeting the needs of people with that disease.
Answered by Baroness Blackwood of North Oxford
The Department has made no specific assessment of this.
The National Institute for Health Research (NIHR) is investing £15.1 million in four Blood and Transplant Research Units (BTRUs) that support the future needs of donors, patients and NHS Blood and Transplant (NHSBT). Each BTRU is a partnership between a university and NHSBT. One BTRU is based at the University of Bristol and is carrying out research to aid the development of new blood products for treatment of patients with rare blood types and those needing regular transfusions including patients with sickle cell disease (SCD).
The NIHR has also recently funded a £0.3 million study on improvement of pain and quality of life in patients with SCD with nocturnal oxygen therapy or auto-adjusting continuous positive airways pressure. A current £0.5 million NIHR study is examining young adult patients’ experiences of transitions from paediatric to adult services for SCD, and the NIHR is currently seeking to commission research on whether haematopoietic stem cell transplantation in adults with severe SCD is cost effective and improves quality of life.
The Department’s NIHR welcomes funding applications for research into any aspect of human health, including SCD. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.
Asked by: Steve McCabe (Labour - Birmingham, Selly Oak)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the sample size from which NHS England concluded that second stem cell transplants for patients with blood cancer will be one of the lowest cost benefit priorities for treatment.
Answered by David Mowat
NHS England has advised the Department that specialised services policy proposals are built on the findings of independent reviews of published evidence. In the case of the proposal for second stem cell transplants for relapsed disease, the evidence review identified relevant peer-reviewed international studies – including data from the British Society for Blood and Bone Marrow Transplantation - from 2005 relating to around 5,000 patients. As with all policy propositions, the draft policy and evidence review which supported it was subject to public consultation.