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516687

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anticoagulants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assessment his Department has made of the practical barriers to prescribing novel oral anti-coagulants at a local level; and what steps his Department is taking to enable patients to receive the most effective medicines to prevent strokes recommended by NICE.
tabling member constituency	Chesham and Amersham
tabling member printed	Mrs Cheryl Gillan
uin	36034
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Guidance published by the National Institute for Health and Care Excellence (NICE) in June 2014 makes it clear that the choice of anticoagulant should be determined through discussion with the patient.</p><p> </p><p>Alongside this, the NICE Implementation Collaborative, which brings together the National Health Service, industry, healthcare professionals and NICE, published a <a href="http://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> which addresses some of the barriers to prescribing novel oral anti-coagulants (NOACs).</p><p> </p><p>NHS England and Public Health England, working with the Primary Care Cardiovascular Disease Leadership Forum and third sector organisations including the British Heart Foundation and the Stroke Association, have also developed resources to support evidence-based commissioning and clinical practice in relation to anticoagulants. These include the CVD Primary Care Intelligence Packs and <em>Atrial Fibrillation – How Can We Do Better</em>, which emphasise the role of NOACs in stroke prevention in atrial fibrillation and recommend that local clinicians agree a consensus approach that reflects current guidance.</p><p> </p><p>The latest information in the Innovation Scorecard on the uptake of NOACs (dabigatran etexilate, rivaroxaban and apixaban) shows that regional variation is reducing. This variation could be driven by a number of causes including variation in the number of patients eligible and use of different treatment options in different areas, as well as variation in clinical practice.</p><p> </p><p>The Accelerated Access Review has the potential to benefit the health system, aiming to improve care and outcomes by giving patients quicker access to new treatments and improve the longer-term affordability of the product pipeline. This will allow the NHS to meet demand for these products in future years.</p><p> </p><p>The Review will make recommendations to Government on speeding up access to transformative new medicines and technologies for NHS patients by summer 2016.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman grouped question UIN 36033 36035 question first answered 04/05/2016 11:43:11 answering member 4020 label Biography information for George Freeman
tabling member	18 label Biography information for Dame Cheryl Gillan

516688

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Atrial Fibrillation
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assessment he has made of the reasons for the level of variation in (a) the amount of novel oral anti-coagulants and (b) other aspects of implementing NICE guidance on preventing strokes in patients with atrial fibrillation.
tabling member constituency	Chesham and Amersham
tabling member printed	Mrs Cheryl Gillan
uin	36035
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Guidance published by the National Institute for Health and Care Excellence (NICE) in June 2014 makes it clear that the choice of anticoagulant should be determined through discussion with the patient.</p><p> </p><p>Alongside this, the NICE Implementation Collaborative, which brings together the National Health Service, industry, healthcare professionals and NICE, published a <a href="http://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> which addresses some of the barriers to prescribing novel oral anti-coagulants (NOACs).</p><p> </p><p>NHS England and Public Health England, working with the Primary Care Cardiovascular Disease Leadership Forum and third sector organisations including the British Heart Foundation and the Stroke Association, have also developed resources to support evidence-based commissioning and clinical practice in relation to anticoagulants. These include the CVD Primary Care Intelligence Packs and <em>Atrial Fibrillation – How Can We Do Better</em>, which emphasise the role of NOACs in stroke prevention in atrial fibrillation and recommend that local clinicians agree a consensus approach that reflects current guidance.</p><p> </p><p>The latest information in the Innovation Scorecard on the uptake of NOACs (dabigatran etexilate, rivaroxaban and apixaban) shows that regional variation is reducing. This variation could be driven by a number of causes including variation in the number of patients eligible and use of different treatment options in different areas, as well as variation in clinical practice.</p><p> </p><p>The Accelerated Access Review has the potential to benefit the health system, aiming to improve care and outcomes by giving patients quicker access to new treatments and improve the longer-term affordability of the product pipeline. This will allow the NHS to meet demand for these products in future years.</p><p> </p><p>The Review will make recommendations to Government on speeding up access to transformative new medicines and technologies for NHS patients by summer 2016.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman grouped question UIN 36033 36034 question first answered 04/05/2016 11:43:11 answering member 4020 label Biography information for George Freeman
tabling member	18 label Biography information for Dame Cheryl Gillan

516689

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Sepsis: Children
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what plans he has to extend the awareness campaign to adults on sepsis in children.
tabling member constituency	Chesham and Amersham
tabling member printed	Mrs Cheryl Gillan
uin	36036
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>The NHS England cross-system action plan is clear that prevention and raising professional awareness are effective means of improving outcomes for all patients at risk from sepsis. Health Education England has also agreed to develop their education training resources to emphasise the importance of good communication with patients concerning the risks, signs and symptoms of sepsis, where appropriate.</p><p> </p><p>In addition to this action focused on professionals, we have asked Public Health England to develop an awareness campaign for parents that focuses upon the symptoms of serious infections in children, such as meningitis and septicaemia, including sepsis.</p> answering member constituency Ipswich answering member printed Ben Gummer question first answered 04/05/2016 16:15:58 answering member 3988 label Biography information for Ben Gummer
tabling member	18 label Biography information for Dame Cheryl Gillan

516690

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Warfarin: Clinics
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assessment he has made of the potential merits of reclassifying warfarin clinics as anti-coagulation clinics in order to increase availability for anti-coagulation medicines other than warfarin which have been approved and recommended by NICE.
tabling member constituency	Chesham and Amersham
tabling member printed	Mrs Cheryl Gillan
uin	36037
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>No assessment has been made of the merits of reclassification of warfarin clinics as anti-coagulation clinics as provision of these is a matter for clinical commissioning groups.</p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 04/05/2016 14:26:21 answering member 4020 label Biography information for George Freeman
tabling member	18 label Biography information for Dame Cheryl Gillan

516691

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Fertility: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what proportion of clinical commissioning groups in England are working together on implementation of NICE guidelines on fertility treatment.
tabling member constituency	Birmingham, Selly Oak
tabling member printed	Steve McCabe
uin	36038
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Information about clinical commissioning groups’ approach to commissioning fertility services is not collected centrally.</p><p> </p><p>The Department has not made any estimate of the proportion of children conceived in the United Kingdom using in-vitro fertilisation relative to those countries mentioned.</p><p> </p><p>The Department has no plans to instruct NHS England to commission fertility treatment centrally. Fertility services do not meet the criteria set out in the Health and Social Care Act 2012 to be nationally commissioned by NHS England.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 36039 36040 36055 question first answered 04/05/2016 11:46:09 answering member 3918 label Biography information for Jane Ellison
tabling member	298 label Biography information for Steve McCabe

516692

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Fertility: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether he plans to instruct NHS England to commission fertility treatment centrally.
tabling member constituency	Birmingham, Selly Oak
tabling member printed	Steve McCabe
uin	36039
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Information about clinical commissioning groups’ approach to commissioning fertility services is not collected centrally.</p><p> </p><p>The Department has not made any estimate of the proportion of children conceived in the United Kingdom using in-vitro fertilisation relative to those countries mentioned.</p><p> </p><p>The Department has no plans to instruct NHS England to commission fertility treatment centrally. Fertility services do not meet the criteria set out in the Health and Social Care Act 2012 to be nationally commissioned by NHS England.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 36038 36040 36055 question first answered 04/05/2016 11:46:09 answering member 3918 label Biography information for Jane Ellison
tabling member	298 label Biography information for Steve McCabe

516693

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Fertility: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what proportion of clinical commissioning groups are fully implementing NICE guidelines on fertility treatment.
tabling member constituency	Birmingham, Selly Oak
tabling member printed	Steve McCabe
uin	36040
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Information about clinical commissioning groups’ approach to commissioning fertility services is not collected centrally.</p><p> </p><p>The Department has not made any estimate of the proportion of children conceived in the United Kingdom using in-vitro fertilisation relative to those countries mentioned.</p><p> </p><p>The Department has no plans to instruct NHS England to commission fertility treatment centrally. Fertility services do not meet the criteria set out in the Health and Social Care Act 2012 to be nationally commissioned by NHS England.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 36038 36039 36055 question first answered 04/05/2016 11:46:09 answering member 3918 label Biography information for Jane Ellison
tabling member	298 label Biography information for Steve McCabe

516694

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anticoagulants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if he will take steps to ensure that there are not incentives to use particular brands of anticoagulants across the NHS; and if he will make a statement.
tabling member constituency	Chesham and Amersham
tabling member printed	Mrs Cheryl Gillan
uin	36033
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>Guidance published by the National Institute for Health and Care Excellence (NICE) in June 2014 makes it clear that the choice of anticoagulant should be determined through discussion with the patient.</p><p> </p><p>Alongside this, the NICE Implementation Collaborative, which brings together the National Health Service, industry, healthcare professionals and NICE, published a <a href="http://www.nice.org.uk/resource/CG180/pdf/c/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs?id=gvyb3hjdqrcjtn6ytpwx3ydb64" target="_blank">consensus statement</a> which addresses some of the barriers to prescribing novel oral anti-coagulants (NOACs).</p><p> </p><p>NHS England and Public Health England, working with the Primary Care Cardiovascular Disease Leadership Forum and third sector organisations including the British Heart Foundation and the Stroke Association, have also developed resources to support evidence-based commissioning and clinical practice in relation to anticoagulants. These include the CVD Primary Care Intelligence Packs and <em>Atrial Fibrillation – How Can We Do Better</em>, which emphasise the role of NOACs in stroke prevention in atrial fibrillation and recommend that local clinicians agree a consensus approach that reflects current guidance.</p><p> </p><p>The latest information in the Innovation Scorecard on the uptake of NOACs (dabigatran etexilate, rivaroxaban and apixaban) shows that regional variation is reducing. This variation could be driven by a number of causes including variation in the number of patients eligible and use of different treatment options in different areas, as well as variation in clinical practice.</p><p> </p><p>The Accelerated Access Review has the potential to benefit the health system, aiming to improve care and outcomes by giving patients quicker access to new treatments and improve the longer-term affordability of the product pipeline. This will allow the NHS to meet demand for these products in future years.</p><p> </p><p>The Review will make recommendations to Government on speeding up access to transformative new medicines and technologies for NHS patients by summer 2016.</p><p> </p><p> </p><p> </p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman grouped question UIN 36034 36035 question first answered 04/05/2016 11:43:11 answering member 4020 label Biography information for George Freeman
tabling member	18 label Biography information for Dame Cheryl Gillan

516695

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Junior Doctors: Contracts
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many junior doctors' contracts have been imposed since July 2015, and in which NHS trusts such contracts have been imposed.
tabling member constituency	Walsall South
tabling member printed	Valerie Vaz
uin	36058
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>The new 2016 contract will start to be introduced in England from 3 August 2016 for general practitioner trainees and trainees in hospital posts approved for postgraduate medical/dental education. Positions are currently being filled according to the terms of the new contract.</p> answering member constituency Ipswich answering member printed Ben Gummer question first answered 04/05/2016 16:17:23 answering member 3988 label Biography information for Ben Gummer
tabling member	4076 label Biography information for Valerie Vaz

516696

registered interest
date	28/04/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Radiotherapy
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if he will make it his policy for patients to be able to choose a location convenient to them for receiving radiotherapy treatment; and if he will make a statement.
tabling member constituency	Stevenage
tabling member printed	Stephen McPartland
uin	36031
answer	answer is ministerial correction date of answer 04/05/2016 answer text <p>It is a National Cancer Peer Review measure that all cancer patients are managed by a cancer-type specific multi-disciplinary team (MDT). This MDT agrees, oversees and co-ordinates the full range of care the patient receives, and considers the importance of ensuring that any cancer treatment is viewed as part of each patient’s whole cancer pathway, including clinical and supportive care. In certain circumstances, a patient may choose to have some aspects of their care delivered by a different team at a different hospital, particularly if they wish to stay with family or friends in a different part of the country to where they live whilst they receive their radiotherapy treatment. In these circumstances, the patient’s care is referred from the local MDT to the chosen MDT during this period.</p> answering member constituency Battersea answering member printed Jane Ellison question first answered 04/05/2016 11:46:49 answering member 3918 label Biography information for Jane Ellison
tabling member	4093 label Biography information for Stephen McPartland