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1006649

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	HIV Infection
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what consideration they are giving to the needs of people living with HIV as part of their development of a long-term plan for the NHS.
	tabling member printed	Lord Black of Brentwood
	uin	HL11429
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>Following the announcement in June 2018, the Prime Minister has asked the National Health Service to develop a long term plan for the service. The plan will set out how the NHS will develop over the coming years, underpinned by a five-year funding offer which will see the NHS budget grow by over £20.5 billion a year in real terms by 2023-24. It provides an excellent opportunity to look at how HIV and other services can be further improved over the next decade. The plan is currently in development and will be published later in the year.</p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:31:11 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4171 label Biography information for Lord Black of Brentwood

1006668

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Screening
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government which cancers have been recommended by NICE for molecular testing; and of those cancers, for which biomarkers in relation to (1) prognostic tests, and (2) theranostic or treatment predictive tests.
	tabling member printed	Lord Freyberg
	uin	HL11448
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>The National Institute for Health and Care Excellence (NICE) recommends molecular testing for the following cancers:</p><p>- Acute myeloid leukaemia;</p><p>- Bladder;</p><p>- Brain;</p><p>- Breast;</p><p>- Chronic lymphocytic leukaemia;</p><p>- Chronic myeloid leukaemia;</p><p>- Colorectal;</p><p>- Non-small-cell lung cancer;</p><p>- Melanoma;</p><p>- Oesophago-gastric;</p><p>- Ovarian, fallopian tube and peritoneal;</p><p>- Pancreatic;</p><p>- Prostate;</p><p>- Upper aerodigestive tract; and</p><p>- Unknown primary origin.</p><p>NICE refers to the following companion diagnostic biomarkers in its guidance:</p><p>- c-Kit (CD117);</p><p>- HER2;</p><p>- KRAS;</p><p>- EGFR-TK;</p><p>- Philadelphia chromosome;</p><p>- BRAF V600;</p><p>- ALK;</p><p>- BRCA;</p><p>- p53;</p><p>- PD-L1;</p><p>- RAS;</p><p>- BCR-ABL1;</p><p>- FLT3;</p><p>- ROS1;</p><p>- BRCA1 (germline); and</p><p>- Somatostatin receptor-positive.</p><p> </p><p>Tests that are primarily used for diagnosis, monitoring or screening often provide prognostic information. Consequently, there are a large number of biomarkers, many of which are used in standard testing practice and so are not specifically referred to in NICE guidance. Multiple and combinations of biomarkers are often used to provide prognostic information and companies developing tests often create their own combinations.</p><p>As many tests look for multiple biomarkers for a single purpose and many tests in standard practice provide prognostic information, NICE is unable to provide categorical information on prognostic tests.</p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:29:48 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

1006669

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Screening
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government which NHS England trusts currently carry out cancer tests in compliance with NICE guidelines; and in relation to which cancers.
	tabling member printed	Lord Freyberg
	uin	HL11449
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>NHS England does not hold this information.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL11450 HL11451 question first answered 27/11/2018 15:48:20 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

1006670

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Screening
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government which NHS England trusts, if any, have secured funding to test for cancers clinically beyond the NICE guidelines, including through use of theranostic tests and somatic gene panels that can report back to patients within a clinically actionable time frame; and in relation to which cancers.
	tabling member printed	Lord Freyberg
	uin	HL11450
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>NHS England does not hold this information.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL11449 HL11451 question first answered 27/11/2018 15:48:20 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

1006671

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Screening
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of the main reasons for non-compliance with NICE guidelines for testing for cancer by NHS England trusts.
	tabling member printed	Lord Freyberg
	uin	HL11451
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>NHS England does not hold this information.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL11449 HL11450 question first answered 27/11/2018 15:48:20 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

1006672

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Screening
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what progress they have made towards the Cancer Task Force’s recommendation for a national molecular pathology service; and when they anticipate to implement this fully in relation to adult cancer diagnosis and care.
	tabling member printed	Lord Freyberg
	uin	HL11452
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>In 2015, the Independent Cancer Taskforce Report highlighted limited access to molecular diagnostics across the National Health Service and limited use of technology to systematically identify patients with cancer and suggested that this has resulted in the NHS falling behind other countries in the delivery of high-quality, cost-effective cancer care.</p><p>To address this, building on the world leading 100,000 Genomes Project and the existing infrastructure, NHS England announced in October 2018 that over the next 18 months work to mobilise the NHS Genomic Medicine Service (GMS) would get underway. The GMS will bring together existing clinical genetics services and the new genomic laboratory infrastructure to provide seamless service delivery for patients with rare and inherited disease and cancer.</p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:48:42 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

1006695

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Eating Disorders
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, following the recommendations of the Parliamentary and Health Service Ombudsman, what steps they are taking to ensure that information about the (1) number, and (2) duration of training posts in eating disorders for Foundation grade doctors is collected and scrutinised at the national level by Health Education England; and whether this will include how such junior doctors are taught and assessed against a relevant part of their nutrition curriculum.
	tabling member printed	Baroness Parminter
	uin	HL11475
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>In response to the Parliamentary and Health Service Ombudsman report, NHS England has convened a working group with NHS Improvement, Health Education England (HEE), the Department and other partners to co-ordinate actions being taken in response to the recommendations, taking them into account in planning for improvements to adult eating disorder services.</p><p>Foundation training covers core generic skills which will include nutrition and all its facets, one of which is eating disorders. Currently, around 47% of foundation programmes in England offer four-month posts in psychiatry, and management of eating disorders and associated conditions is included in the curriculum and learning objectives for such posts.</p><p>The Foundation Programme ensures that newly qualified doctors demonstrate their ability to learn in the workplace, develop their clinical and professional skills in the workplace in readiness for core, specialty or general practice training.</p><p>Increasing psychiatry posts and training opportunities in foundation is part of HEE’s current review of the Foundation Programme. There are quality management systems in place to monitor HEE’s performance against those objectives.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:51:18 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4178 label Biography information for Baroness Parminter

1006701

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Standards
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of the progress of NHS programmes for reducing variation in (1) the Getting It Right First Time programme, and (2) NHS RightCare; and what additional funding, if any, will be allocated to expand such improvement initiatives as part of NHS England’s long-term plan.
	tabling member printed	Lord Warner
	uin	HL11481
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>The Getting It Right First Time (GIRFT) programme aims to improve the quality of surgical and medical care within the National Health Service by working with frontline clinicians to identify and reduce unwarranted variations in service delivery and clinical practice. Since it was set up in 2016, the programme has been expanded to clinically review 35 surgical and medical specialties.</p><p>In terms of tracking progress, the programme measures quality improvement in key outcomes or practices. Since 2016/17, the programme has delivered quality and efficiency improvements, shortening waiting times for surgery, reducing costly cancellations and delays to elective procedures, aiding trusts to meet performance targets, and reducing spend on costly consultancy services.</p><p>Since its establishment as a national programme in 2016, NHS RightCare has actively worked with every health system in England to transform services over a wide range of pathways and reduce unwarranted variation. NHS RightCare underpins its activity with robust evaluation to understand the change and impact of local projects through robust planning and modelling. Nationally, this ensures the programme can report on change in reducing variation in terms of finance, activity and health outcomes via the Clinical Commissioning Group Improvement Assessment Framework.</p><p> </p><p>The Prime Minister has asked the NHS to develop a long-term plan for the service, setting out how the NHS will develop over the coming years supported by the significant additional funding. This provides an excellent opportunity to look at how reducing variation can be accelerated over the next decade. The plan is currently in development and will be published later in the year.</p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:55:10 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1732 label Biography information for Lord Warner

1006702

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Chronic Inflammation
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what work they have undertaken to embed pathways across NHS England that support earlier treatment and use of medicine in chronic inflammatory conditions to improve patient outcomes.
	tabling member printed	Lord Warner
	uin	HL11482
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>The Department is not directly responsible for developing or reviewing clinical guidance for identification and management of diseases and disorders. The National Institute for Health and Care Excellence (NICE) was established by the Government to develop evidence based best practice for the National Health Service. NICE has published a range of guidance on different chronic inflammatory conditions, and corresponding pathways, to support commissioners and clinicians are able to deliver evidence based local services, to diagnose and treat patients. Commissioners should take NICE guidance into account when planning services for local populations.</p><p>Other organisations, such as the clinical Royal Colleges, and charitable organisations also convene expert groups to develop guidance for health professionals.</p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 15:29:16 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1732 label Biography information for Lord Warner

1006703

	registered interest
	date	13/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Standards
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have to help to accelerate the spread and uptake of best practice across NHS England to reduce variation in patient outcomes.
	tabling member printed	Lord Warner
	uin	HL11483
	answer	answer is ministerial correction date of answer 27/11/2018 answer text <p>As part of our commitment to delivering the response to the Accelerated Access Review, we have established the Accelerated Access Collaborative (AAC) which brings together representatives from Government, the National Health Service and industry to drive the uptake and adoption of those innovations within the NHS that will be most transformative for patients.</p><p>Specifically, the AAC will oversee the Accelerated Access Pathway, which will launch later this year, to provide tailored support to increase the uptake of the most transformative innovations. This will help to promote best practice across the NHS and ensure all patients have access to the most effective new treatments.</p><p>Alongside this, the Academic Health Science Networks continue to work with their local populations to ensure they benefit from significantly improved health outcomes through promotion of health equality and best practice, alongside transformation in leadership, quality and safety of care.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 27/11/2018 17:06:54 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1732 label Biography information for Lord Warner