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922988

registered interest
date	12/06/2018
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	Medical Treatments
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what process NHS England used to interpret guidance on individual treatments issued by the National Institute of Health and Clinical Excellence; and how they ensure such guidance is implemented consistently across England.
tabling member printed	Lord Mendelsohn
uin	HL8561
answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8562 HL8563 HL8564 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4286 label Biography information for Lord Mendelsohn

922989

registered interest
date	12/06/2018
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: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how NHS England formulates approval criteria for drugs already approved by the National Institute for Health and Clinical Excellence; and how it involves (1) patients, and (2) clinicians in this process.
tabling member printed	Lord Mendelsohn
uin	HL8562
answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8563 HL8564 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4286 label Biography information for Lord Mendelsohn

922990

registered interest
date	12/06/2018
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	Blood Cancer
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many Individual Funding Requests have been submitted to the NHS for the treatment of blood cancer; and of those, how many requests were (1) successful, and (2) unsuccessful.
tabling member printed	Lord Mendelsohn
uin	HL8563
answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8562 HL8564 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4286 label Biography information for Lord Mendelsohn

922991

registered interest
date	12/06/2018
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	Leukaemia: Ibrutinib
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government (1) what evidence NHS England considered, (2) which clinicians it consulted, and (3) which patient groups it consulted when deciding that ibrutinib should not be prescribed to people with chronic lymphocytic leukaemia who have been in remission for more than three years.
tabling member printed	Lord Mendelsohn
uin	HL8564
answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8562 HL8563 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4286 label Biography information for Lord Mendelsohn

922992

registered interest
date	12/06/2018
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: Clinical Reference Groups
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 transparency of the decision-making process of NHS England in relation to cancer clinical reference groups and the frequency with which such groups meet.
tabling member printed	Lord Mendelsohn
uin	HL8565
answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England’s current model of Clinical Reference Groups (CRG) was established following an extensive public engagement process which was completed during April 2016.</p><p>Since April 2016, the Cancer National Programme of Care has been supported by five CRGs (Chemotherapy, Radiotherapy, Specialised Cancer Surgery, Specialised Cancer Diagnostics and Children’s and Young People’s Cancer Services). The role of each CRG is to provide the primary source of clinical advice and leadership to NHS England on those services that are nationally commissioned. Each CRG comprises clinicians, patient and public voice representatives, professional association representation, public health experts and a commissioner and will usually meet between two and four times per year.</p><p>Transparency of decision making is important to NHS England. As a result, both stakeholder testing and public consultation are conducted regularly, in accordance with NHS England’s published Service Development Policy and Methods, in relation to the development of new clinical commissioning policy and service specifications.</p> answering member printed Lord O'Shaughnessy question first answered 26/06/2018 12:17:33 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4286 label Biography information for Lord Mendelsohn

921801

registered interest
date	11/06/2018
answering body	Department for Digital, Culture, Media and Sport
answering dept id	10
answering dept short name	Digital, Culture, Media and Sport
answering dept sort name	Digital, Culture, Media and Sport
hansard heading	Broadband
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government when they will publish their plans for delivering full-fibre to the premises broadband connections to the majority of homes and businesses by 2025; and what proportion of homes and businesses they plan to reach by (1) 2020, and (2) 2022.
tabling member printed	Lord Mendelsohn
uin	HL8502
answer	answer is ministerial correction date of answer 21/06/2018 answer text <p>The Future Telecoms Infrastructure Review, launched in the Government’s Industrial Strategy, will set out the regulatory and policy changes that are needed to support investment in full fibre networks and deliver on the Government’s ambition, as announced by the Chancellor in his CBI speech for fibre rollout: 15 million premises covered by 2025 with a national network by 2033. The Report is due to be published in due course.</p> answering member printed Lord Ashton of Hyde grouped question UIN HL8503 HL8504 question first answered 21/06/2018 10:26:41 answering member 4247 label Biography information for Lord Ashton of Hyde
tabling member	4286 label Biography information for Lord Mendelsohn

921802

registered interest
date	11/06/2018
answering body	Department for Digital, Culture, Media and Sport
answering dept id	10
answering dept short name	Digital, Culture, Media and Sport
answering dept sort name	Digital, Culture, Media and Sport
hansard heading	Broadband
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what additional investment will be available to deliver their plans for full-fibre to the premises broadband connections to the majority of homes and businesses by 2025.
tabling member printed	Lord Mendelsohn
uin	HL8503
answer	answer is ministerial correction date of answer 21/06/2018 answer text <p>The Future Telecoms Infrastructure Review, launched in the Government’s Industrial Strategy, will set out the regulatory and policy changes that are needed to support investment in full fibre networks and deliver on the Government’s ambition, as announced by the Chancellor in his CBI speech for fibre rollout: 15 million premises covered by 2025 with a national network by 2033. The Report is due to be published in due course.</p> answering member printed Lord Ashton of Hyde grouped question UIN HL8502 HL8504 question first answered 21/06/2018 10:26:41 answering member 4247 label Biography information for Lord Ashton of Hyde
tabling member	4286 label Biography information for Lord Mendelsohn

921804

registered interest
date	11/06/2018
answering body	Department for Digital, Culture, Media and Sport
answering dept id	10
answering dept short name	Digital, Culture, Media and Sport
answering dept sort name	Digital, Culture, Media and Sport
hansard heading	Future Telecoms Infrastructure Review
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government when they will publish a response to their Future Telecoms Infrastructure Review consultation which closed in January.
tabling member printed	Lord Mendelsohn
uin	HL8504
answer	answer is ministerial correction date of answer 21/06/2018 answer text <p>The Future Telecoms Infrastructure Review, launched in the Government’s Industrial Strategy, will set out the regulatory and policy changes that are needed to support investment in full fibre networks and deliver on the Government’s ambition, as announced by the Chancellor in his CBI speech for fibre rollout: 15 million premises covered by 2025 with a national network by 2033. The Report is due to be published in due course.</p> answering member printed Lord Ashton of Hyde grouped question UIN HL8502 HL8503 question first answered 21/06/2018 10:26:41 answering member 4247 label Biography information for Lord Ashton of Hyde
tabling member	4286 label Biography information for Lord Mendelsohn

921805

registered interest
date	11/06/2018
answering body	Treasury
answering dept id	14
answering dept short name	Treasury
answering dept sort name	Treasury
hansard heading	Cryptocurrencies
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they have raised with the Bank of England, the Financial Conduct Authority, or any other regulatory authority, the question of whether crypto currencies should be classified as an investment rather than as a currency and regulated as such.
tabling member printed	Lord Mendelsohn
uin	HL8505
answer	answer is ministerial correction date of answer 25/06/2018 answer text <p>The government has established a Cryptoassets Taskforce, consisting of HM Treasury, the Bank of England, and the Financial Conduct Authority to explore these questions further. It is looking at the impact of cryptoassets, the potential benefits and challenges of the application of distributed ledger technology in financial services, and assessing what, if any, regulation is required in response. The Taskforce will report back by the end of summer.</p> answering member printed Lord Bates question first answered 25/06/2018 15:55:31 answering member 1091 label Biography information for Lord Bates
tabling member	4286 label Biography information for Lord Mendelsohn

921806

registered interest
date	11/06/2018
answering body	Treasury
answering dept id	14
answering dept short name	Treasury
answering dept sort name	Treasury
hansard heading	Pensions: Advisory Services
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how much they estimate the lack of competition in the pension advice market has cost pensioners; and whether the Financial Conduct Authority or the Competition and Markets Authority have raised concerns about the lack of competition in the market for pension advice.
tabling member printed	Lord Mendelsohn
uin	HL8506
answer	answer is ministerial correction date of answer 25/06/2018 answer text <p>The Government has acted to support the development of a market that provides consumers with affordable and accessible pensions advice. That is why the Treasury and the Financial Conduct Authority (FCA) launched the Financial Advice Market Review (FAMR) in August 2015.</p><p> </p><p>HM Treasury and the FCA have, as part of FAMR, identified a range of indicators, to understand the demand and supply of financial advice in the market and establish a baseline. These include issues such as the cost of advice, number of firms in the market, consumer engagement, and reasons for not taking advice<sup><sup>[1]</sup></sup>. HM Treasury and the FCA will be carrying out a follow-up exercise in 2019 to see the extent to which issues in the market have been addressed.</p><p> </p><p>FAMR also proposed remedies to improve supply of affordable advice in the market. These included setting up an Advice Unit by the FCA to provide firms developing large-scale automated advice models with regulatory support to help bring these to the market more quickly. Automated advice has the potential to provide affordable advice to the mass market, with some existing models charging a fixed fee of below £500.</p><p> </p><p>The FCA has also been considering various issues regarding consumers who do not take advice in relation to their pension. They published the interim report of their Retirement Outcome Review<sup><sup>[2]</sup></sup> last year and will publish its final findings shortly. The government will be following the FCA’s findings closely.</p><p> </p><p> </p><p>[1] https://www.fca.org.uk/publications/research/financial-advice-market-review-famr-baseline-report</p><p>[2] https://www.fca.org.uk/publications/market-studies/retirement-outcomes-review</p> answering member printed Lord Bates question first answered 25/06/2018 16:03:23 answering member 1091 label Biography information for Lord Bates
tabling member	4286 label Biography information for Lord Mendelsohn