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872272

	registered interest
	date	26/03/2018
	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	Acute Lymphoblastic Leukaemia: Medical Treatments
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the availability of treatments for patients diagnosed with Refractory B-cell Acute Lymphoblastic Leukaemia.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	134186
	answer	answer is ministerial correction date of answer 03/04/2018 answer text <p>The following treatments are routinely available, having undergone Technical Appraisals by the National Institute for Health and Care Excellence (NICE). They were previously accessible through the Cancer Drugs Fund.</p><p> </p><p>- Blinatumomab for relapsed refractory (r/r) Philadelphia negative acute lymphoblastic leukaemia (ALL); and</p><p>- Ponatinib for Philadelphia positive ALL in patients in whom imatinib is not clinically appropriate (which might cover some r/r).</p><p> </p><p>The following treatments are currently under consideration by NICE:</p><p> </p><p>- CAR-T (Tisagenlecleucel-T and also Axicabtagene ciloleucel) for previously treated B-cell ALL in people aged 3 to 21 at initial diagnosis;</p><p>- Inotuzumab ozogamicin for treating r/r ALL; and</p><p>- Blinatumomab in other extended indications in ALL.</p><p> </p><p>Finally, the following treatments are currently accessible through the Cancer Drugs Fund.</p><p> </p><p>- Clofarabine for treating ALL in children after two therapies; and</p><p>- Nelarabine for treating ALL after two therapies.</p><p> </p><p>Information on the number and proportion of patients with refractory B-cell Acute Lymphoblastic Leukaemia who have been unable to access treatments for that condition is not held centrally.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 134187 question first answered 03/04/2018 13:25:08 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

872273

	registered interest
	date	26/03/2018
	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	Acute Lymphoblastic Leukaemia: Medical Treatments
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many and what proportion of patients with Refractory B-cell Acute Lymphoblastic Leukaemia have been unable to access treatments for that condition.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	134187
	answer	answer is ministerial correction date of answer 03/04/2018 answer text <p>The following treatments are routinely available, having undergone Technical Appraisals by the National Institute for Health and Care Excellence (NICE). They were previously accessible through the Cancer Drugs Fund.</p><p> </p><p>- Blinatumomab for relapsed refractory (r/r) Philadelphia negative acute lymphoblastic leukaemia (ALL); and</p><p>- Ponatinib for Philadelphia positive ALL in patients in whom imatinib is not clinically appropriate (which might cover some r/r).</p><p> </p><p>The following treatments are currently under consideration by NICE:</p><p> </p><p>- CAR-T (Tisagenlecleucel-T and also Axicabtagene ciloleucel) for previously treated B-cell ALL in people aged 3 to 21 at initial diagnosis;</p><p>- Inotuzumab ozogamicin for treating r/r ALL; and</p><p>- Blinatumomab in other extended indications in ALL.</p><p> </p><p>Finally, the following treatments are currently accessible through the Cancer Drugs Fund.</p><p> </p><p>- Clofarabine for treating ALL in children after two therapies; and</p><p>- Nelarabine for treating ALL after two therapies.</p><p> </p><p>Information on the number and proportion of patients with refractory B-cell Acute Lymphoblastic Leukaemia who have been unable to access treatments for that condition is not held centrally.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 134186 question first answered 03/04/2018 13:25:08 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

1039028

	registered interest
	date	10/01/2019
	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	Asparaginase
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, whether Erwinase will be available for the treatment for children with acute lymphoblastic leukaemia between January 2019 and March 2019; and if he will make a statement.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	207238
	answer	answer is ministerial correction date of answer 18/01/2019 answer text <p>Erwinase is produced by Porton Biopharma Ltd (PBL) and is licensed and distributed by Jazz Pharmaceuticals under a global licencing agreement.</p><p> </p><p>Due to increased demand for Erwinase and because PBL are manufacturing at capacity, until increases in capacity are brought into beneficial use there will be occasional stock-outs.</p><p> </p><p>The product is currently in stock in the United Kingdom. The Department has been informed, it is likely there will be a short stock-out in early February 2019 and then a further batch is planned to be released to Jazz Pharmaceuticals, who are responsible for the packaging/distribution and allocation of worldwide product supply, anticipated to reach the UK market by mid-February 2019 which should last until the end of March 2019.</p><p> </p><p>The Department and Public Health England (PHE) are in close contact with, and have been kept informed by the PBL management of short periods of interrupted supply. PBL have and will be implementing a series of initiatives to increase capacity and better supply the market in both the short and long term. PBL are fully aware of the consequences that the unavailability of Erwinase has on patients and are absolutely committed to working with all involved to resolve any issues and be able to supply this critical medicine.</p><p> </p><p>The Department and PHE will continue to monitor the situation closely.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 18/01/2019 12:18:00 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

1050101

	registered interest
	date	28/01/2019
	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	Asparaginase
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 18 January 2019 to Question 207238 on Asparaginase, what steps Porton Biopharma will take to increase capacity of erwinase and better supply the (a) UK and (b) world market for the remainder of 2019.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	213322
	answer	answer is ministerial correction date of answer 05/02/2019 answer text <p>Porton Biopharma Ltd (PBL) are implementing a series of initiatives to increase capacity and supply in both the short and long term. These include the following:</p><p>- Extending operational activities to 24 hours a day, seven days a week to maximise fermentation of the product;</p><p>- Implementing an ongoing capital programme including construction of a new pharmaceutical fermentation facility. The facility was completed in April 2018 and is currently undergoing testing; it has an increased capacity fermentation suite which will enable PBL to manufacture at larger scale and is due to start producing product Q3 2019 for regulatory approval to market;</p><p>- A new filling and freeze-drying building was completed in February 2016. The installation of a new filling line which covers the entire process, including vial washing, filling, stoppering and freeze drying. The new line has been designed with systems which monitor all critical parameters throughout the process to accelerate batch release and will accommodate increased capacity. The beneficial use of this and the fermentation facility will coincide to maximise increased product output; and</p><p>- Sourcing replacement suppliers, including for new stoppers and new vials for the product, ensuring that maximum batch sizes can be achieved with minimal product rejects. This programme is complete.</p><p> </p><p>PBL has made significant investments into increasing product capacity and will continue to release future batches as soon as they become available to Jazz Pharmaceuticals (who are responsible for the packaging/distribution and allocation of worldwide product supply).</p> answering member constituency Winchester answering member printed Steve Brine question first answered 05/02/2019 15:09:48 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

860743

	registered interest
	date	12/03/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care what proportion of patients referred to a multidisciplinary diagnostic centre have been (a) suspected of having blood cancer and (b) diagnosed with blood cancer; and if he will make a statement.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	132100
	answer	answer is ministerial correction date of answer 19/03/2018 answer text <p>An evaluation is currently being prepared on the work of the multi-disciplinary diagnostic centres, which will include further information on blood cancer patient referral and diagnosis numbers. A final report will be published in December 2018.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 19/03/2018 15:32:36 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

836021

	registered interest
	date	02/02/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effectiveness of the National Institute for Health and Clinical Excellence guidance, Haematological cancers: Improving outcomes (NG 47); and if he will make a statement.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	126376
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>Currently there has been no assessment of NG47.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 08/02/2018 14:38:00 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

896505

	registered interest
	date	02/05/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what plans his Department has to ensure people with blood cancer are diagnosed as soon as possible.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	140696
	answer	answer is ministerial correction date of answer 14/05/2018 answer text <p>Early diagnosis of blood cancers is difficult as symptoms, such as tiredness or back pain, are often misdiagnosed. For suspected blood cancers, the National Institute for Health and Care Excellence published a revised guideline in 2015 which clearly sets out that general practitioners should consider a very urgent full blood count within 48 hours to assess for leukaemia if adults present with suspicious symptoms.</p><p> </p><p>In December 2016 NHS England announced transformation funding of £200 million for Cancer Alliances to encourage new and innovative ways to diagnose cancer earlier, improve the care for those living with cancer and ensure that each cancer patient gets the right care for them.</p><p> </p><p>Additionally, the Accelerate, Coordinate and Evaluate Programme is a unique early diagnosis initiative, a programme of 60 projects exploring innovative concepts of diagnosing cancer earlier across England. The programme is testing a new multi-disciplinary diagnostic centre approach to diagnosing patients with vague or unclear but concerning symptoms, often characteristic of hard to diagnose cancers like blood cancers.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 14/05/2018 11:23:24 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

837754

	registered interest
	date	06/02/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, with reference to the most recent results of the National Cancer Patient Experience Survey, what steps (a) his Department and (b) NHS England are taking to improve the training for healthcare professionals to ensure that people with blood cancer understand their diagnosis.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	126785
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>Health Education England, alongside NHS England, has recently published the Cancer Workforce plan, which sets out the steps to transform the cancer workforce in line with the independent cancer taskforce recommendations. This will aim to improve patient outcomes and deliver a better patient experience across all tumour types, including haematological cancers. The report sets out the plan for improving the training of healthcare professionals, as well as recruitment and retention plans. The report can be found at:</p><p><a href="https://www.hee.nhs.uk/news-blogs-events/hee-news/health-education-england-unveils-plan-transform-future-nhs-cancer-workforce" target="_blank">https://www.hee.nhs.uk/news-blogs-events/hee-news/health-education-england-unveils-plan-transform-future-nhs-cancer-workforce</a></p> answering member constituency Winchester answering member printed Steve Brine question first answered 08/02/2018 15:29:34 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

836016

	registered interest
	date	02/02/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many emergency presentations there were of blood cancer; what proportion of those presentations were of all diagnoses of blood cancer; and what proportion those were of the total of all emergency presentations of cancer in each of the last five years for which figures are available.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	126371
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>In 2015, the latest year for which data are available, the percentage of patients diagnosed after an emergency presentation in England for all blood cancers was 28% (7,626 of 26,869).</p><p> </p><p>There has been a fall in the percentage diagnosed through this emergency presentation route over the last 10 years for some of these cancers: chronic lymphocytic leukaemia (26% in 2006 down to 13% in 2015), multiple myeloma (37% down to 31%), and other haematological malignancies (37% down to 25%). The proportion over time in the other groups remained relatively stable.</p><p> </p><p>As a proportion of all emergency diagnoses, the proportion of blood cancers diagnosed as an emergency was 12% in 2011 and 13% in each of 2012-2015.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 126372 question first answered 08/02/2018 14:30:04 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

836017

	registered interest
	date	02/02/2018
	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	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of trends in the instances of blood cancer being diagnosed after an emergency admission; and if he will make a statement.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	126372
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>In 2015, the latest year for which data are available, the percentage of patients diagnosed after an emergency presentation in England for all blood cancers was 28% (7,626 of 26,869).</p><p> </p><p>There has been a fall in the percentage diagnosed through this emergency presentation route over the last 10 years for some of these cancers: chronic lymphocytic leukaemia (26% in 2006 down to 13% in 2015), multiple myeloma (37% down to 31%), and other haematological malignancies (37% down to 25%). The proportion over time in the other groups remained relatively stable.</p><p> </p><p>As a proportion of all emergency diagnoses, the proportion of blood cancers diagnosed as an emergency was 12% in 2011 and 13% in each of 2012-2015.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 126371 question first answered 08/02/2018 14:30:04 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith