It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.<\/p>
To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,<\/em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient\u2019s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.<\/p> It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.<\/p> To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,<\/em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient\u2019s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.<\/p> The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
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, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/387206/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL1032"}
, {"_value" : "HL1033"}
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, "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:42.3Z", "_datatype" : "dateTime"}
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, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-02", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government whether they plan to replace the current test for human vitamin B12 status with the Active B12 (holotranscobalamin) test; and if not, why not.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1042"}
, {"_about" : "http://data.parliament.uk/resources/386923", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/386923/answer", "answerText" : {"_value" : " The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
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, "attachment" : {"_about" : "http://data.parliament.uk/resources/386923/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL1033"}
, {"_value" : "HL1034"}
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, "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government what steps they are taking to find an alternative and reliable test to assess the vitamin B12 status of the population; and what level of false high results the current test provides.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1032"}
, {"_about" : "http://data.parliament.uk/resources/386924", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/386924/answer", "answerText" : {"_value" : " The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
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, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/386924/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL1032"}
, {"_value" : "HL1034"}
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, "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:41.81Z", "_datatype" : "dateTime"}
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, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government whether they plan to review how pernicious anaemia and other symptoms of vitamin B12 deficiency in the United Kingdom population are diagnosed and treated, particularly taking into account the neurological and mental health impact of any failure to diagnose quickly and accurately; and, if not, why not.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1033"}
, {"_about" : "http://data.parliament.uk/resources/386925", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/386925/answer", "answerText" : {"_value" : " The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/386925/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL1032"}
, {"_value" : "HL1033"}
, {"_value" : "HL1035"}
, {"_value" : "HL1036"}
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], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:41.947Z", "_datatype" : "dateTime"}
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, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government what steps they are taking to ensure that a reliable test to assess the vitamin B12 status of the United Kingdom population is made available as a means to prevent serious and irreversible neurological damage before any mandatory fortification of flour with folic acid is introduced.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1034"}
, {"_about" : "http://data.parliament.uk/resources/386926", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/386926/answer", "answerText" : {"_value" : " The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/386926/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL1032"}
, {"_value" : "HL1033"}
, {"_value" : "HL1034"}
, {"_value" : "HL1036"}
, {"_value" : "HL1042"}
], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:42.073Z", "_datatype" : "dateTime"}
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, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government what assessment they have made of the frequency at which patients with pernicious anaemia require vitamin B12 replacement therapy by injection; whether they have any evidence that patients are purchasing additional supplies from unregulated sources; and whether they will review current guidance.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1035"}
, {"_about" : "http://data.parliament.uk/resources/386927", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/386927/answer", "answerText" : {"_value" : " The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders<\/em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.<\/p> <\/p> The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.<\/p> <\/p> <\/p> <\/p> The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.<\/p> <\/p> <\/p> <\/p> When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.<\/p> <\/p> <\/p> <\/p> Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.<\/p> <\/p> <\/p> <\/p> Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.<\/p> <\/p> <\/p> <\/p> The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/386927/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BSCH Guidance"}
, "dateOfAnswer" : {"_value" : "2015-07-14", "_datatype" : "dateTime"}
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, {"_value" : "HL1033"}
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, {"_value" : "HL1035"}
, {"_value" : "HL1042"}
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, "questionFirstAnswered" : [{"_value" : "2015-07-14T15:00:42.183Z", "_datatype" : "dateTime"}
]}
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, "answeringDeptShortName" : {"_value" : "Health"}
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, "date" : {"_value" : "2015-07-01", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Vitamin B12"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government whether they have assessed the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies; and, if so, what they consider them to be.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
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}
The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document has already been placed in the Library and<\/del> is attached.<\/p>
More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/390599/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BCSH Guidelines pernicious anaemia"}
, "dateOfAnswer" : {"_value" : "2015-07-24", "_datatype" : "dateTime"}
, "isMinisterialCorrection" : {"_value" : "true", "_datatype" : "boolean"}
, "previousAnswerVersion" : {"_about" : "http://data.parliament.uk/resources/390599/answer/previousversion/17459", "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/390599/answer/previousversion/17459/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BCSH Guidelines pernicious anaemia"}
}
, "questionFirstAnswered" : [{"_value" : "2015-07-24T13:21:19.45Z", "_datatype" : "dateTime"}
], "questionFirstMinisteriallyCorrected" : [{"_value" : "2015-10-14T11:21:08.233Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-16", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Anaemia"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government what action they are taking to address the problems associated with the late diagnosis of pernicious anaemia, in the light of the results of the survey published in the British Nursing Journal<\/i> in April 2014.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1539"}
, {"_about" : "http://data.parliament.uk/resources/390600", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/390600/answer", "answerText" : {"_value" : "
The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document has already been placed in the Library and<\/del> is attached.<\/p>
More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/390600/answer/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BCSH Guidelines pernicious anaemia"}
, "dateOfAnswer" : {"_value" : "2015-07-24", "_datatype" : "dateTime"}
, "isMinisterialCorrection" : {"_value" : "true", "_datatype" : "boolean"}
, "previousAnswerVersion" : {"_about" : "http://data.parliament.uk/resources/390600/answer/previousversion/17460", "answeringMember" : {"_about" : "http://data.parliament.uk/members/127", "label" : {"_value" : "Biography information for Lord Prior of Brampton"}
}
, "answeringMemberPrinted" : {"_value" : "Lord Prior of Brampton"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/390600/answer/previousversion/17460/attachment/1", "fileName" : {"_value" : "colbalamin and folate disorders.pdf"}
, "title" : "BCSH Guidelines pernicious anaemia"}
}
, "questionFirstAnswered" : [{"_value" : "2015-07-24T13:21:19.357Z", "_datatype" : "dateTime"}
], "questionFirstMinisteriallyCorrected" : [{"_value" : "2015-10-14T11:21:19.847Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2015-07-16", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Anaemia"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government how they propose to alert medical practitioners to the severe and irreversible nerve damage that can occur when pernicious anaemia is misdiagnosed.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/1861", "label" : {"_value" : "Biography information for The Countess of Mar"}
}
, "tablingMemberPrinted" : [{"_value" : "The Countess of Mar"}
], "uin" : "HL1540"}
, {"_about" : "http://data.parliament.uk/resources/387206", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/387206/answer", "answerText" : {"_value" : "