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657941

registered interest
date	13/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Medical Treatments: Access
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to prevent NHS England from imposing restrictions on patients' access to NICE-approved treatments for melanoma and other conditions; and if he will make a statement.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57299
answer	answer is ministerial correction date of answer 20/12/2016 answer text <p>The Department has placed no restrictions on patients accessing treatments for advanced (stage 4) melanoma.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) has published guidance on the following treatments for melanoma. National Health Service commissioners are legally required to fund drugs and treatments recommended by NICE for eligible patients within three months of final guidance.</p><p> </p><table><tbody><tr><td><p>Appraisal number</p></td><td><p>Year of publication</p></td><td><p>Technology/condition</p></td><td><p>Recommendation</p></td></tr><tr><td><p>TA268</p></td><td><p>2012</p></td><td><p>Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA269</p></td><td><p>2012</p></td><td><p>Vemurafenib for locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA319</p></td><td><p>2014</p></td><td><p>Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA321</p></td><td><p>2014</p></td><td><p>Dabrafenib for unresectable or metastatic BRAF V600 mutation‑positive melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA357<sup>1</sup></p></td><td><p>2015</p></td><td><p>Pembrolizumab for advanced melanoma after disease progression with ipilimumab</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA366<sup>1</sup></p></td><td><p>2015</p></td><td><p>Pembrolizumab for advanced melanoma not previously treated with ipilimumab</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA384</p></td><td><p>2016</p></td><td><p>Nivolumab for advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation.</p></td></tr><tr><td><p>TA396</p></td><td><p>2016</p></td><td><p>Trametinib in combination with dabrafenib for unresectable or metastatic melanoma</p></td><td><p>Recommended in line with marketing authorisation.</p></td></tr><tr><td><p>TA400</p></td><td><p>2016</p></td><td><p>Nivolumab in combination with ipilimumab for advanced melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA410</p></td><td><p>2016</p></td><td><p>Talimogene laherparepvec for unresectable metastatic melanoma</p></td><td><p>Optimised recommendation for talimogene laherparepvec as an option for treating unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs, only if: - treatment with systemically administered immunotherapies is not suitable; and - the company provides talimogene laherparepvec with the discount agreed in the patient access scheme.</p></td></tr><tr><td><p>TA414</p></td><td><p>2016</p></td><td><p>Cobimetinib in combination with vemurafenib for unresectable or metastatic BRAF V600 mutation-positive melanoma</p></td><td><p>At the time of appraisal, the technology was not considered to be an appropriate use of NHS resources based on the data available.</p></td></tr></tbody></table><p><sup>1</sup> pembrolizumab within its licensed indication was appraised across two separate appraisals.</p><p> </p><p>NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.</p><p> </p><p>Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.</p><p> </p><p>The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:</p><p> </p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf</a></p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood grouped question UIN 57212 question first answered 20/12/2016 10:28:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

657942

registered interest
date	13/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Derbyshire Healthcare NHS Foundation Trust: Disciplinary Proceedings
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many people have been suspended from the Derbyshire Mental Health Trust in the last two years; and for how long those suspensions were active.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57293
answer	answer is ministerial correction date of answer 19/12/2016 answer text <p>The information requested is not available centrally. It may be obtained from Derbyshire Healthcare NHS Foundation Trust. We have written to Richard Gregory, Chair of the Trust, informing him of the hon. Member’s enquiry. He will reply shortly and a copy of the letter will be placed in the Library.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 19/12/2016 15:17:15 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

657098

registered interest
date	12/12/2016
answering body	Department for Environment, Food and Rural Affairs
answering dept id	13
answering dept short name	Environment, Food and Rural Affairs
answering dept sort name	Environment, Food and Rural Affairs
hansard heading	Ivory
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Environment, Food and Rural Affairs, pursuant to the oral contribution by the Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs of 8 December 2016, Official Report, columns 188-9WH, whether her Department's proposals to widen the UK ban on ivory sales will include sales of ivory products dating from before 1947.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57276
answer	answer is ministerial correction date of answer 15/12/2016 answer text <p>We have been actively exploring options to implement the Government’s manifesto commitment to press for a total ban on ivory sales and early next year we will consult on our proposal to ban sales of ivory that is less than 70 years old as of March 2017. As part of this, we plan to seek evidence on options and impacts of taking further action.</p><p> </p> answering member constituency Suffolk Coastal answering member printed Dr Thérèse Coffey question first answered 15/12/2016 15:20:53 answering member 4098 label Biography information for Dr Thérèse Coffey
tabling member	4025 label Biography information for Mrs Pauline Latham

657124

registered interest
date	12/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Skin Cancer: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what restrictions have been placed on patients accessing treatments for advanced (stage 4) melanoma by (a) NHS England, (b) his Department and (c) NICE.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57212
answer	answer is ministerial correction date of answer 20/12/2016 answer text <p>The Department has placed no restrictions on patients accessing treatments for advanced (stage 4) melanoma.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) has published guidance on the following treatments for melanoma. National Health Service commissioners are legally required to fund drugs and treatments recommended by NICE for eligible patients within three months of final guidance.</p><p> </p><table><tbody><tr><td><p>Appraisal number</p></td><td><p>Year of publication</p></td><td><p>Technology/condition</p></td><td><p>Recommendation</p></td></tr><tr><td><p>TA268</p></td><td><p>2012</p></td><td><p>Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA269</p></td><td><p>2012</p></td><td><p>Vemurafenib for locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA319</p></td><td><p>2014</p></td><td><p>Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA321</p></td><td><p>2014</p></td><td><p>Dabrafenib for unresectable or metastatic BRAF V600 mutation‑positive melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA357<sup>1</sup></p></td><td><p>2015</p></td><td><p>Pembrolizumab for advanced melanoma after disease progression with ipilimumab</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA366<sup>1</sup></p></td><td><p>2015</p></td><td><p>Pembrolizumab for advanced melanoma not previously treated with ipilimumab</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA384</p></td><td><p>2016</p></td><td><p>Nivolumab for advanced (unresectable or metastatic) melanoma</p></td><td><p>Recommended in line with marketing authorisation.</p></td></tr><tr><td><p>TA396</p></td><td><p>2016</p></td><td><p>Trametinib in combination with dabrafenib for unresectable or metastatic melanoma</p></td><td><p>Recommended in line with marketing authorisation.</p></td></tr><tr><td><p>TA400</p></td><td><p>2016</p></td><td><p>Nivolumab in combination with ipilimumab for advanced melanoma</p></td><td><p>Recommended in line with marketing authorisation and following agreement of patient access scheme.</p></td></tr><tr><td><p>TA410</p></td><td><p>2016</p></td><td><p>Talimogene laherparepvec for unresectable metastatic melanoma</p></td><td><p>Optimised recommendation for talimogene laherparepvec as an option for treating unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs, only if: - treatment with systemically administered immunotherapies is not suitable; and - the company provides talimogene laherparepvec with the discount agreed in the patient access scheme.</p></td></tr><tr><td><p>TA414</p></td><td><p>2016</p></td><td><p>Cobimetinib in combination with vemurafenib for unresectable or metastatic BRAF V600 mutation-positive melanoma</p></td><td><p>At the time of appraisal, the technology was not considered to be an appropriate use of NHS resources based on the data available.</p></td></tr></tbody></table><p><sup>1</sup> pembrolizumab within its licensed indication was appraised across two separate appraisals.</p><p> </p><p>NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.</p><p> </p><p>Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.</p><p> </p><p>The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:</p><p> </p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf</a></p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood grouped question UIN 57299 question first answered 20/12/2016 10:28:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

657133

registered interest
date	12/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Skin Cancer: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps are being taken to ensure melanoma patients have access to the most clinically effective treatment options if they have (a) brain metastases and (b) previously taken part in a clinical trial.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57206
answer	answer is ministerial correction date of answer 20/12/2016 answer text <p>The National Institute for Health and Care Excellence (NICE) has recommended a number of drugs for use in the treatment of melanoma. National Health Service patients have a right in the NHS Constitution to drugs and treatments that have been recommended by NICE, where clinically appropriate.</p><p> </p><p>NHS England has advised that it has carefully translated the evidence base on which NICE has based its recommendations of clinical and cost effectiveness for drugs and treatments for melanoma into practical clarifications which directly relate to how the recommended drug indication is incorporated into known treatment pathways in use in England.</p><p> </p><p>Each set of clarifications is in keeping with the NICE recommendations within the marketing authorisation of the relevant drug.</p><p> </p><p>The treatment criteria for both Cancer Drugs Fund and baseline-funded drug indications are set out in the National Cancer Drugs Fund List which is available at:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2016/12/national-cdf-list-v1-15.pdf</a></p><p> </p><p>Discussions are taking place with NHS regional and National Cancer Research Institute experts on melanoma on formulating chemotherapy algorithms for the treatment of advanced or metastatic melanoma. These discussions relate in part to the drug treatment of brain metastases and the need to preserve recruitment to clinical trials and whether the qualifications that NHS England has applied in terms of treatment criteria for melanoma drugs within their respective marketing authorisations should be changed.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 20/12/2016 10:30:04 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

657164

registered interest
date	12/12/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Patients' Rights: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what his policy is on ensuring that patients have the right set out in the NHS Constitution to access any NICE-approved treatments that are clinically appropriate for them.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	57204
answer	answer is ministerial correction date of answer 16/12/2016 answer text <p>National Health Service patients’ right in the NHS Constitution to drugs and treatments recommended in National Institute for Health and Care Excellence (NICE) technology appraisal and highly specialised technology guidance, where clinically appropriate, is underpinned by the legal requirement for NHS commissioners to fund such treatments, normally within three months of NICE issuing its final guidance.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 16/12/2016 12:11:23 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

643933

registered interest
date	24/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
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 implications for his policies of the findings in the Clinical Commissioning Group (CCG) Improvement and Assessment Framework data, published in September 2016, which showed that over two-thirds of CCGs have been rated as either needs improvement or greatest need for improvement in diabetes services; and if he will make a statement.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	54681
answer	answer is ministerial correction date of answer 01/12/2016 answer text <p>The Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) contains two recognised evidence-based measures of whether patients with diabetes are being supported to successfully manage their condition. These are the achievement of the National Institute for Health and Care Excellence (NICE) treatment targets, which cover blood sugar, blood pressure and cholesterol control, and participation in structured education programmes.</p><p> </p><p>These measures were selected to reflect matters highlighted by the Public Accounts Committee (PAC) in January 2016 in its report on the management of adult diabetes services. The purpose of the CCG IAF is to highlight the key areas where clinical commissioning groups (CCGs) need to make improvements. The number of CCGs in need of improvement against these two indicators is consistent with the findings of the PAC.</p><p> </p><p>The NHS Operational Planning and Contracting Guidance 2017-2019 included an announcement that NHS England intends to launch a major programme of investment in the treatment and care of people with diabetes. As part of this, CCGs will be able to bid for additional funding of around £40 million per year for priorities which include improvements in relation to the achievement of the treatment targets and attendance at structured education programmes.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 01/12/2016 14:59:58 answering member 4080 label Biography information for David Mowat
tabling member	4025 label Biography information for Mrs Pauline Latham

641291

registered interest
date	21/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to hold NHS England to account on the delivery of the diabetes metrics outlined in the Clinical Commissioning Group Improvement and Assessment Framework 2016-17.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	54082
answer	answer is ministerial correction date of answer 28/11/2016 answer text <p>The mandate to NHS England requires it to develop the Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) and its supporting indicators in 2016-17, and in subsequent years to improve CCG performance against the indicators by 2020. This includes a specific reference to diabetes. NHS England is being held to account for achieving the deliverables in the 2016-17 mandate through regular assurance and accountability meetings with senior Departmental officials and my Rt. hon. Friend the Secretary of State. NHS England has completed the development of the framework and established baseline data for each group of indicators. In subsequent years, NHS England will be held to account for supporting CCGs to deliver improvements in the CCG IAF indicators.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 28/11/2016 15:22:27 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

641310

registered interest
date	21/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to support clinical commissioning groups that need improvement or have the greatest need for improvement for diabetes care under the Clinical Commissioning Group Improvement and Assessment Framework.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	53992
answer	answer is ministerial correction date of answer 28/11/2016 answer text <p>NHS England will work with health communities/clinical commissioning groups (CCGs) in need of improvement against CCG Improvement and Assessment Framework indicators to mutually identify the nature of the change needed and the type of support required to achieve this. A key focus of improvement will be to support CCGs and providers to locally map their services against nationally recognised best practice diabetes pathways and to identify where local pathways need to change in order to improve outcomes. NHS England is developing plans for additional support to be available from 2017/18 onwards:</p><p> </p><p>- The NHS Operational Planning and Contracting Guidance 2017-2019 included an announcement that NHS England intends to launch a major programme of investment in the treatment and care of people with diabetes, for which CCGs will be able to bid for additional funding of approximately £40 million per year, focused on the key areas of diabetes care where improvements in outcomes will be most beneficial.</p><p> </p><p>- A Diabetes CCG Improvement and Assessment Framework Independent Panel has been developed, chaired by the Chief Executive of Diabetes UK and includes panel members with a wide range of other diabetes clinical expertise. This will consider CCG positions in relation to the diabetes Improvement and Assessment Framework indicators and advise on actions to support improvement.</p><p> </p><p>- Sustainability and Transformation Plans (STPs). As part of supporting the development of STPs, a “How to” guide for diabetes has been issued which sets out advice the actions which CCGs can take to support improvements.</p><p> </p><p>- NHS England regional teams: NHS England has funded diabetes programme leads within each of the National Health Service regions to work with CCGs to support improvement.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 28/11/2016 15:27:55 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham

641311

registered interest
date	21/11/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Diabetes
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what timetable he has set for publishing the next diabetes-specific ratings as part of the Clinical Commissioning Group Improvement and Assessment Framework; and if he will publish that data on a quarterly basis.
tabling member constituency	Mid Derbyshire
tabling member printed	Pauline Latham
uin	53993
answer	answer is ministerial correction date of answer 28/11/2016 answer text <p>As part of its statutory duty to perform an annual assessment of clinical commissioning groups (CCGs), NHS England will publish its 2016/17 annual assessment of the six clinical priority areas within the CCG Improvement and Assessment Framework in July 2017, which include diabetes. All indicators that are available are updated as frequently as possible; the diabetes indicators are based on annual data.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 28/11/2016 15:23:21 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4025 label Biography information for Mrs Pauline Latham