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386467

	registered interest
	date	30/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pancreatic Cancer: Nurses
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they are taking to ensure that all pancreatic cancer patients have access to a clinical nurse specialist.
	tabling member printed	Lord Aberdare
	uin	HL962
	answer	answer is ministerial correction date of answer 09/07/2015 answer text <p>NHS England has a published service specification for pancreatic cancer which clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards.</p><p> </p><p> </p><p> </p><p>Patients being treated at cancer units should have access to an upper gastrointestinal cancer nurse. All district general hospitals should have such a person in post. If the patient is transferred to a cancer centre they should then have access to a pancreatic nurse specialist. This person should see every patient and become their key worker.</p><p> </p><p> </p><p> </p><p>Patients with suspected pancreatic cancer are usually first investigated by an ultrasound scan. If this shows biliary dilatation, or anything else suspicious, the patient should then be sent for a pancreas protocol computerised tomography scan which is the best investigation for identifying pancreatic cancer.</p><p> </p><p> </p><p> </p><p>Increasing the capacity of diagnostic and imaging services is clearly recognised as a priority for the National Health Service and it is has been raised as a key issue by the independent Cancer Taskforce, as well as by the Cancer Waiting Times Taskforce. We expect a new cancer strategy to be published this summer which will set out the strategy for the system for the next five years and will include consideration of the whole cancer pathway, including the capacity of diagnostic services.</p><p> </p><p> </p><p> </p><p>In addition, NHS England is testing various approaches to new models of care which could potentially deliver improved access to diagnostic services for cancer patients, including those with pancreatic cancer.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL963 question first answered 09/07/2015 12:43:47 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	3898 label Biography information for Lord Aberdare

386468

	registered interest
	date	30/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pancreatic Cancer: Tomography
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what plans they have to increase the capacity of imaging services available to pancreatic cancer patients across the National Health Service, including computerised tomography scans.
	tabling member printed	Lord Aberdare
	uin	HL963
	answer	answer is ministerial correction date of answer 09/07/2015 answer text <p>NHS England has a published service specification for pancreatic cancer which clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards.</p><p> </p><p> </p><p> </p><p>Patients being treated at cancer units should have access to an upper gastrointestinal cancer nurse. All district general hospitals should have such a person in post. If the patient is transferred to a cancer centre they should then have access to a pancreatic nurse specialist. This person should see every patient and become their key worker.</p><p> </p><p> </p><p> </p><p>Patients with suspected pancreatic cancer are usually first investigated by an ultrasound scan. If this shows biliary dilatation, or anything else suspicious, the patient should then be sent for a pancreas protocol computerised tomography scan which is the best investigation for identifying pancreatic cancer.</p><p> </p><p> </p><p> </p><p>Increasing the capacity of diagnostic and imaging services is clearly recognised as a priority for the National Health Service and it is has been raised as a key issue by the independent Cancer Taskforce, as well as by the Cancer Waiting Times Taskforce. We expect a new cancer strategy to be published this summer which will set out the strategy for the system for the next five years and will include consideration of the whole cancer pathway, including the capacity of diagnostic services.</p><p> </p><p> </p><p> </p><p>In addition, NHS England is testing various approaches to new models of care which could potentially deliver improved access to diagnostic services for cancer patients, including those with pancreatic cancer.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL962 question first answered 09/07/2015 12:43:47 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	3898 label Biography information for Lord Aberdare

386469

	registered interest
	date	30/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pancreatic Cancer: Diagnosis
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what assessment they have made of (1) the number, and (2) the proportion, of pancreatic cancer patients whose diagnosis is made following an emergency admission; and how those figures compare with patients of other cancer types.
	tabling member printed	Lord Aberdare
	uin	HL964
	answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The Routes to Diagnosis study defines a methodology by which the route the patient follows to the point of diagnosis can be categorised, in order to examine demographic, organisational, service and personal reasons for delayed diagnosis.</p><p> </p><p> </p><p> </p><p>Administrative Hospital Episode Statistics data are combined with cancer waiting times data, data from the cancer screening programmes and cancer registration data from the National Cancer Data Repository.</p><p> </p><p> </p><p> </p><p>Using these datasets every case of cancer registered in England which was diagnosed in 2006-2010 is categorised into one of eight ‘Routes to Diagnosis’.</p><p> </p><p> </p><p> </p><p>The methodology is described in detail in the British Journal of Cancer article <em>Routes to Diagnosis for cancer - Determining the patient journey using multiple routine datasets</em>, which can be found at the following link and is also attached.</p><p> </p><p> </p><p> </p><p>http://www.nature.com/bjc/journal/v107/n8/full/bjc2012408a.html</p><p> </p><p> </p><p> </p><p>Emergency presentations are defined as “an emergency route via A&amp;E, emergency GP referral, emergency transfer, emergency admission or attendance.” More detail can be found in the attached technical document.</p><p> </p><p> </p><p> </p><p>Data on all malignant neoplasms (excluding non-melanoma skin cancer) and pancreatic cancer was taken from the “Routes to diagnosis 2006-2010 workbook (a)” – this can also be found in the attached article.</p><p> </p><p> </p><p> </p><p>The Emergency Presentation Route is the principle route to diagnosis for patients with pancreatic cancer. This reflects the lack of easily recognisable symptoms of early disease, with advanced disease often presenting with the acute onset of jaundice.</p><p> </p><p> </p><p> </p><p>The percentage of emergency presentations ranges from 3% for melanoma to 63% for acute lymphoblastic leukaemia.</p><p> </p><p> </p><p> </p><p>Table 1: Percentage of diagnoses by emergency presentation route, England, persons, 2006-2010</p><p> </p><table><tbody><tr><td> </td><td><p>Number of cases</p></td><td><p>Number of cases by emergency presentation route</p></td><td><p>Percentage by emergency presentation route</p></td></tr><tr><td><p> </p></td><td><p>a</p></td><td><p>b</p></td><td><p>(b/a)x100</p></td></tr><tr><td><p>All malignant neoplasms</p><p>(excl. non-melanoma skin cancer)</p></td><td><p>1,272,584</p></td><td><p>291,391</p></td><td><p>23%</p></td></tr><tr><td><p>Pancreas</p></td><td><p>34,012</p></td><td><p>16,460</p></td><td><p>48%</p></td></tr></tbody></table><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p> answering member printed Lord Prior of Brampton question first answered 14/07/2015 13:47:58 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Routes to diagnosis for cancer.pdf title Routes to Diagnosis for cancer
	tabling member	3898 label Biography information for Lord Aberdare

583465

	registered interest
	date	14/09/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	First Aid: Education
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, in the light of the finding of the recent British Red Cross research report <i>Are prehospital deaths from trauma and accidental injury preventable? </i>that up to 59 per cent of pre-hospital deaths from injury could have been prevented with basic first aid, what they are doing to ensure that first aid education features within public health strategies.
	tabling member printed	Lord Aberdare
	uin	HL1928
	answer	answer is ministerial correction date of answer 28/09/2016 answer text <p>The Government recognises that the timely application of first aid can help minimise the impact of injuries, as well as health conditions such as heart attacks and strokes, and contribute to avoiding preventable deaths.</p><p> </p><p>The NHS Choices website contains information for the public on first aid responses to various injuries and health incidents including burns, bleeding, choking, drowning, fractures, heart attacks, strokes and poisoning; the possible symptoms to note; how to respond to them; and how to administer cardiopulmonary resuscitation. A copy of the relevant NHS Choices web page is attached.</p><p> </p><p>In addition, the Government is making available another £1 million to make public access defibrillators and coronary pulmonary resuscitation training more widely available in communities across England. This builds on last year’s funding of £1 million, which provided almost 700 more publicly accessible defibrillators in communities across England and increased the numbers of people trained in cardiopulmonary resuscitation.</p><p> </p><p>The national <em>Act Fast </em>campaign also aims to raise awareness of the symptoms of stroke, teach people what to look out for in themselves and others, and encourage those who notice the symptoms to call 999. Since <em>Act Fast</em> launched in 2009, it is estimated that an additional 47,000 people reached hospital within the vital three-hour window and over 5,000 fewer people became disabled as a result of a stroke.</p><p> </p><p>Local authorities in England have the lead responsibility for identifying and meeting needs for local interventions to improve the health of their populations, including steps to reduce preventable deaths.</p> answering member printed Baroness Chisholm of Owlpen question first answered 28/09/2016 14:03:31 answering member 4330 label Biography information for Baroness Chisholm of Owlpen attachment 1 file name First aid information from NHS Choices website.docx title First aid information NHS choices website
	tabling member	3898 label Biography information for Lord Aberdare