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48240

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what progress his Department has made on diagnosis rates of brain tumours in the last 10 years; and if he will make a statement.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196261
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p><em>Improving Outcomes: A Strategy for Cancer</em>, published on 12 January 2011, stated that general practitioners (GPs) need easy access to the right diagnostic tests to diagnose or exclude cancer earlier. The strategy committed over £450 million over four years, to achieve early diagnosis of cancer, including improving access to key diagnostic tests, such as Magnetic Resonance Imaging (MRI) scans to support the diagnosis of brain cancer. The funding was also designed to cover subsequent testing and treatment in secondary care.</p><p> </p><p>In 2012, the Department published <em>Direct Access to Diagnostic Tests for Cancer</em>,<em>Best Practice Referral Pathways for General Practitioners. </em>The document includes criteria for accessing key diagnostic tests including MRI brain scan and aims to raise awareness of the symptoms that require urgent referral to specialists and sets out where a direct referral for an MRI brain scan may benefit patients through achieving a faster diagnosis. GPs are able to access these tests directly in cases where the two week urgent referral pathway is not appropriate but a patient's symptoms require further investigation. The intention is that more people presenting with relevant symptoms will be tested and at an earlier stage.</p><p> </p><p>NHS England monitors the use of these diagnostic tests through the Diagnostic Imaging Dataset. Latest provisional data published by NHS England on 27 March 2014 for the period November 2012 to November 2013, showed that over a quarter of all tests that may have been used to diagnose or discount cancer were requested by GPs under direct access arrangements. In that period, 509,215 MRI tests were requested including 35,055 through direct GP access arrangements. The published data is available at:</p><p> </p><p><a href="http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/" target="_blank">www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/</a>.</p><p> </p><p>Information on diagnosis rates of brain tumours is not centrally collected. Information on number of patients with suspected brain or central nervous system tumours who were seen by a specialist within two weeks from a GP referral is provided in the attached tables, for the last 10 years.</p><p> </p><p>Before 2009, the operational standard for two week waits was 98%. Starting from the 1 of January 2009, the basis for reporting waiting times data was changed. The new standards were set to be more in line with the already implemented referral to treatment routes. The scope of cover for the new standards was widened (as set out in the Cancer Reform Strategy 2008), and the collection was made simpler by not using clock pauses. From 2009 onwards the operational standard for two week waits was set to 93% (assumed to be the maximum sustainable performance level) including tolerances for:</p><p>- The number of patients who make themselves unavailable or decline an appointment within two weeks.</p><p>- Patients who cancel a booked outpatient appointment (giving advance notice), and rebook appointments outside of 14-days.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 196258 question first answered 06/05/2014 12:00:00 answering member 3918 label Biography information for Jane Ellison attachment 1 file name No of patients with suspected brain or central nervous system tumours.docx title Tables for PQs 196258 and 196261
	tabling member	3950 label Biography information for Dame Tracey Crouch

48241

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he has taken to increase public understanding of the services offered by independent pharmacies.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	type	WrittenParliamentaryQuestion
	uin	196241
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high quality care and support, improving people's health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long term conditions and helping make sure patients and the National Health Service get the best use from medicines.</p><p> </p><p>NHS England's public consultation, <em>Improving care through community pharmacy –</em> <em>a call to action</em>, which closed on 18 March, has provided an important opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:</p><p> </p><p>www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/</p><p> </p><p>In the meantime, NHS England's <em>The earlier, the better</em> campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and reduce pressures on other parts of the NHS.</p><p> </p><p>On 14 April, the Department and NHS England published <em>Transforming Primary Care - Safe, proactive, personalised care for those who need it most</em>. This sets out plans for more proactive, personalised and joined up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196239 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name 196239_and_196241_-_Library_document[1].pdf title Transforming Primary Care document
	tabling member	4006 label Biography information for Dr Matthew Offord

48242

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what criteria his Department use to define illness as mental as opposed to physical.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	type	WrittenParliamentaryQuestion
	uin	196245
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196254 196255 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48243

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, if he will consider creating the role of bereavement midwives to work exclusively with parents who have experienced the death of their baby shortly before, during or after birth; and if he will make a statement.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196273
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>It is for the National Health Service locally to ensure appropriate facilities and services are in place to support bereaved parents following the death of a baby. In line with the Nursing and Midwifery Council's Standards of proficiency for pre-registration midwifery education, all midwives should be proficient in providing care for women who have suffered pregnancy loss, stillbirth or neonatal death.</p><p> </p><p>To assist NHS commissioners and providers, the Royal College of Obstetricians and Gynaecologists' <em>Standards for Gynaecology</em> and <em>Standards for Maternity</em> sets out clear standards for the level of care provided to help women and their partners experiencing pregnancy loss, including the availability of skilled staff to support parents following a stillbirth or miscarriage. A number of trusts now employ specialist bereavement midwives to provide this support.</p><p> </p><p>Local NHS maternity care providers are responsible for ensuring parents receive appropriate information on bereavement support and services following the death of a baby. To complement information provided locally, information on support for parents after a stillbirth is available on the NHS Choices website at:</p><p> </p><p>http://www.nhs.uk/Conditions/Stillbirth/Pages/Getting-help.aspx</p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter grouped question UIN 196274 question first answered 06/05/2014 12:00:00 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	3950 label Biography information for Dame Tracey Crouch

48244

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he is taking to ensure that information on bereavement support and services is made available to parents who have suffered the loss of a baby.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196274
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>It is for the National Health Service locally to ensure appropriate facilities and services are in place to support bereaved parents following the death of a baby. In line with the Nursing and Midwifery Council's Standards of proficiency for pre-registration midwifery education, all midwives should be proficient in providing care for women who have suffered pregnancy loss, stillbirth or neonatal death.</p><p> </p><p>To assist NHS commissioners and providers, the Royal College of Obstetricians and Gynaecologists' <em>Standards for Gynaecology</em> and <em>Standards for Maternity</em> sets out clear standards for the level of care provided to help women and their partners experiencing pregnancy loss, including the availability of skilled staff to support parents following a stillbirth or miscarriage. A number of trusts now employ specialist bereavement midwives to provide this support.</p><p> </p><p>Local NHS maternity care providers are responsible for ensuring parents receive appropriate information on bereavement support and services following the death of a baby. To complement information provided locally, information on support for parents after a stillbirth is available on the NHS Choices website at:</p><p> </p><p>http://www.nhs.uk/Conditions/Stillbirth/Pages/Getting-help.aspx</p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter grouped question UIN 196273 question first answered 06/05/2014 12:00:00 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	3950 label Biography information for Dame Tracey Crouch

48245

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what recent assessment he has made of the sufficiency of access to imagery scanning for diagnosing brain tumours; and if he will issue revised guidance on when to refer a patient for a scan with the aim of raising diagnosis rates and decreasing mortality rates.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196258
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p><em>Improving Outcomes: A Strategy for Cancer</em>, published on 12 January 2011, stated that general practitioners (GPs) need easy access to the right diagnostic tests to diagnose or exclude cancer earlier. The strategy committed over £450 million over four years, to achieve early diagnosis of cancer, including improving access to key diagnostic tests, such as Magnetic Resonance Imaging (MRI) scans to support the diagnosis of brain cancer. The funding was also designed to cover subsequent testing and treatment in secondary care.</p><p> </p><p>In 2012, the Department published <em>Direct Access to Diagnostic Tests for Cancer</em>,<em>Best Practice Referral Pathways for General Practitioners. </em>The document includes criteria for accessing key diagnostic tests including MRI brain scan and aims to raise awareness of the symptoms that require urgent referral to specialists and sets out where a direct referral for an MRI brain scan may benefit patients through achieving a faster diagnosis. GPs are able to access these tests directly in cases where the two week urgent referral pathway is not appropriate but a patient's symptoms require further investigation. The intention is that more people presenting with relevant symptoms will be tested and at an earlier stage.</p><p> </p><p>NHS England monitors the use of these diagnostic tests through the Diagnostic Imaging Dataset. Latest provisional data published by NHS England on 27 March 2014 for the period November 2012 to November 2013, showed that over a quarter of all tests that may have been used to diagnose or discount cancer were requested by GPs under direct access arrangements. In that period, 509,215 MRI tests were requested including 35,055 through direct GP access arrangements. The published data is available at:</p><p> </p><p><a href="http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/" target="_blank">www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/</a>.</p><p> </p><p>Information on diagnosis rates of brain tumours is not centrally collected. Information on number of patients with suspected brain or central nervous system tumours who were seen by a specialist within two weeks from a GP referral is provided in the attached tables, for the last 10 years.</p><p> </p><p>Before 2009, the operational standard for two week waits was 98%. Starting from the 1 of January 2009, the basis for reporting waiting times data was changed. The new standards were set to be more in line with the already implemented referral to treatment routes. The scope of cover for the new standards was widened (as set out in the Cancer Reform Strategy 2008), and the collection was made simpler by not using clock pauses. From 2009 onwards the operational standard for two week waits was set to 93% (assumed to be the maximum sustainable performance level) including tolerances for:</p><p>- The number of patients who make themselves unavailable or decline an appointment within two weeks.</p><p>- Patients who cancel a booked outpatient appointment (giving advance notice), and rebook appointments outside of 14-days.</p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 196261 question first answered 06/05/2014 12:00:00 answering member 3918 label Biography information for Jane Ellison attachment 1 file name No of patients with suspected brain or central nervous system tumours.docx title Tables for PQs 196258 and 196261
	tabling member	3950 label Biography information for Dame Tracey Crouch

48246

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he is taking to encourage international collaboration in research and the sharing of best practice on quality of life for patients diagnosed with brain tumours.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196259
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>NHS England has made a recent assessment of the sufficiency of access to information about support and services for people diagnosed with a brain tumour through its Peer Review Programme (PRP). This programme includes measures that require all brain and central nervous system multidisciplinary teams (MDTs) to demonstrate the availability and adequacy of patient information. The outcome of the 2013-14 assessment of compliance with these measures indicated that out of 91 MDTs and 36 treatment centres, 84% were compliant with the patient information measure at the most robust level.</p><p> </p><p>There is a programme of work aimed at improving the care and experience of people living with a diagnosis of cancer, developed in collaboration with Macmillan Cancer Support which draws from a wide range of evidence based good practice.</p><p> </p><p>The National Cancer Intelligence Network runs a brain and central nervous system- related cancers Clinical Reference Group, which works closely with a brain cancer charities. In addition to this, the PRP measures participation in drug trials and research internationally.</p><p> </p><p>The Department works closely with its cancer research funding partners through the National Cancer Research Institute (NCRI). The NCRI is a strategic partnership of 22 government, charity and industry cancer research funders, together with patients. The NCRI is a member of the International Cancer Research Partnership (ICRP), which includes cancer research funders from USA, Canada, Europe, Japan and Australia. The ICRP is a unique alliance of cancer organisations working together to enhance global collaboration and strategic coordination of research. Researchers can search the ICRP database to avoid duplication and identify collaborators in specific areas of cancer research including brain tumour research.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 196257 question first answered 06/05/2014 12:00:00 answering member 3918 label Biography information for Jane Ellison
	tabling member	3950 label Biography information for Dame Tracey Crouch

48247

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Midwives
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what recent assessment he has made of the benefits of all expectant mothers being assigned one specific midwife for the duration of their pregnancy in ensuring (a) continued care, (b) correct information being received and (c) prevention of stillbirth.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196272
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p /> <p /> <p>The benefits of pregnant women being cared for by a named midwife are widely recognised. The latest available evidence for antenatal clinical practice was considered as part of the development of the National Institute for Health and Care Excellence's (NICE) Quality Standard for antenatal care in 2012. Based on this evidence, NICE recommends that pregnant women are cared for by a named midwife who is responsible for providing all or most of her antenatal and postnatal care and the women's coordinating care should they not be available.</p><p> </p><p>The Care Quality Commission's 2013 survey of women's experiences of maternity care found that women who saw the same midwife each time tended to report more positive experiences of antenatal and postnatal care.</p><p> </p><p>Health Education England is currently leading a project to explore the ambitions for personalised maternity care and consider different scenarios for how maternity services could be configured in the future, including the capability and capacity of the workforce.</p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 06/05/2014 12:00:00 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	3950 label Biography information for Dame Tracey Crouch

48248

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what recent assessment he has made of the sufficiency of access to information about support and services for people diagnosed with a brain tumour; and if he will make a statement.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196257
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>NHS England has made a recent assessment of the sufficiency of access to information about support and services for people diagnosed with a brain tumour through its Peer Review Programme (PRP). This programme includes measures that require all brain and central nervous system multidisciplinary teams (MDTs) to demonstrate the availability and adequacy of patient information. The outcome of the 2013-14 assessment of compliance with these measures indicated that out of 91 MDTs and 36 treatment centres, 84% were compliant with the patient information measure at the most robust level.</p><p> </p><p>There is a programme of work aimed at improving the care and experience of people living with a diagnosis of cancer, developed in collaboration with Macmillan Cancer Support which draws from a wide range of evidence based good practice.</p><p> </p><p>The National Cancer Intelligence Network runs a brain and central nervous system- related cancers Clinical Reference Group, which works closely with a brain cancer charities. In addition to this, the PRP measures participation in drug trials and research internationally.</p><p> </p><p>The Department works closely with its cancer research funding partners through the National Cancer Research Institute (NCRI). The NCRI is a strategic partnership of 22 government, charity and industry cancer research funders, together with patients. The NCRI is a member of the International Cancer Research Partnership (ICRP), which includes cancer research funders from USA, Canada, Europe, Japan and Australia. The ICRP is a unique alliance of cancer organisations working together to enhance global collaboration and strategic coordination of research. Researchers can search the ICRP database to avoid duplication and identify collaborators in specific areas of cancer research including brain tumour research.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison grouped question UIN 196259 question first answered 06/05/2014 12:00:00 answering member 3918 label Biography information for Jane Ellison
	tabling member	3950 label Biography information for Dame Tracey Crouch

48249

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, if he will bring forward from 42 weeks the period for inducing labour in at risk expectant mothers.
	tabling member constituency	Chatham and Aylesford
	tabling member printed	Tracey Crouch
	type	WrittenParliamentaryQuestion
	uin	196280
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p /> <p /> <p>The induction of labour is a clinical decision for healthcare professionals. These decisions are based on the latest available evidence and take account of the risk and other clinical factors for each individual pregnancy.</p><p> </p><p>To assist healthcare professionals, the National Institute for Health and Care Excellence has published clinical guidelines on the induction of labour, which are available on the NICE website at:</p><p> </p><p>www.nice.org.uk/nicemedia/live/12012/41256/41256.pdf.</p><p> </p><p>The NICE guidelines advise that women with uncomplicated pregnancies should usually be offered induction of labour between 41+0 and 42+0 weeks.</p><p> </p><p>Women can be deemed high risk for a multitude of reasons. Each reason will carry its own set of criteria for delivery. It is not possible to say that induction for all at risk pregnancies should be brought forward as these should be reviewed according to individual needs.</p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 06/05/2014 12:00:00 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	3950 label Biography information for Dame Tracey Crouch