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Cancer: Health Services

Volume 479: debated on Monday 1 September 2008

To ask the Secretary of State for Health whether his Department has provided guidance to commissioners on how to commission cancer genetic services, as referred to in paragraph 2.53 of his Department’s Cancer Reform Strategy. (220934)

As set out in paragraph 9.9 of the Cancer Reform Strategy, the Department is working with Macmillan Cancer Support to develop a chapter on commissioning cancer genetics services to be included in the “Guidance on Commissioning Cancer Services”. The guidance is based on the evaluations of the jointly funded pilots of delivering cancer genetics services in the national health service in England. The guidance is due in the autumn, with the chapter on genetics services available shortly thereafter, as some evaluation data is still awaited. Data will also be included in the accompanying web-based commissioning toolkit.

To ask the Secretary of State for Health when he plans to begin auditing all patients newly diagnosed with cancer, as referred to in paragraph 3.61 of his Department's Cancer Reform Strategy. (220950)

The Royal College of General Practitioners has begun work on developing an audit methodology, which will be tested in late 2008/early 2009.

To ask the Secretary of State for Health (1) what percentage of all (a) drug treatment and (b) surgical treatments were delivered to cancer patients within 31 days in the latest period for which figures are available; when the 31-day treatment standard for cancer treatments begins, as referred to in paragraph 4.8 of his Department's Cancer Reform Strategy; and what the milestones are for meeting the 31-day treatment standard for radiotherapy services by December 2010; (220951)

(2) whether his Department has provided guidance on how patients with suspected cancer detected through national screening programmes enter the 62-day pathway, as referred to in paragraph 4.8 of his Department's Cancer Reform Strategy;

(3) what progress is being made towards ensuring that all localities have implemented arrangements ensuring that patients highly suspected of having cancers are managed on the 62-day pathway, as referred to in paragraph 4.8 of his Department's Cancer Reform Strategy;

(4) pursuant to the answer of 8 July 2008, Official Report, column 1504W, on cancer: health services, if he will issue guidance to primary care trusts instructing them that all treatments for which funding is initially denied but then granted on appeal must be given to patients within the 31-day cancer waiting-time standard.

The currently available performance figures, reflecting the current waiting times standards, are published quarterly. Performance data for the extended standards that come into force at the end of this year will be available for publication next spring.

Figures for the latest quarter available (January 2008 to March 2008) show that 99.5 per cent. of patients are first treated within one month of diagnosis. Thus the current standard has been met. This data is not currently broken down by treatment type, but the 99.5 per cent. achievement does cover all treatment types, including drug and surgical interventions. This data is available on the Department's website at:

www.performance.doh.gov.uk/cancerwaits/

An extension to the current cancer treatment standards, building on their success, was announced in December's Cancer Reform Strategy, with a timetable for delivery:

the extension of the 31 day standard to include all surgical and drug treatments comes into force from December 2008, and for radiotherapy and all other treatments from December 2010—this covers subsequent treatments (not just the first treatment, which is the current standard);

the extension of the 62 day standard, putting patients referred from screening programmes onto the 62 day care pathway, comes into force from December 2008;

the extension of the standard enabling consultant upgrades (of patients highly suspected of having cancers) onto the 62-day pathway comes into force from December 2008; and

the extension of the two weeks standard (to include all patients referred with breast symptoms) comes into force from December 2009.

The Department is developing guidance, in liaison with the NHS, on all of these new standards, which will be published shortly.

To ask the Secretary of State for Health which cancer networks (a) have met and (b) are on target to meet the milestones contained in the National Institute for Health and Clinical Excellence’s Improving Outcomes Guidance on supportive and palliative care for adults. (220963)

All Cancer Networks have submitted plans which will meet the requirements for partial implementation by December 2008. The expectation is that they will be fully compliant by the end 2009 and progress will be monitored by the National Cancer Action Team and peer review.

To ask the Secretary of State for Health what progress has been made towards developing a course on effective face-to-face communication skills for children and young people with cancer, as referred to in paragraph 5.14 of his Department's Cancer Reform Strategy; and when he expects the course to be launched. (220964)

A working group has now been established to develop:

a group of course facilitators specialising in working with children and young people; and

specific materials and trigger tapes to support the training of those working with children and young people.

It is expected the first courses will run in spring 2009.

To ask the Secretary of State for Health in which primary care trust areas clinical nurse specialist provision has been found to be insufficient, as referred to in paragraph 5.47 of his Department’s Cancer Reform Strategy; what steps he is taking to encourage commissioners to address shortfalls in clinical nurse specialist provision; and if he will make a statement. (220966)

Data on the number of clinical nurse specialists (CNS) are not collected centrally. It is for Cancer Networks to work in partnership with strategic health authorities, NHS trusts and postgraduate deaneries to put in place a sustainable process to assess, plan and review their workforce needs and the education and training of all staff linked to local and national priorities for cancer. Commissioners should benchmark their local CNS provision against similar primary care trusts and take action where the CNS workforce is found to be insufficient.

To ask the Secretary of State for Health what recent assessment he has made of the extent to which the NHS is providing advice on returning to work for patients of working age with cancer. (220967)

The Department has not made an assessment of the provision by the national health service of advice on returning to work for patients of working age with cancer.

The Cancer Reform Strategy, published in December 2007, set out a number of initiatives to improve patient support services for those living with and beyond cancer which includes ensuring that patients receive high quality personalised information throughout their cancer journey. As part of this, the strategy makes clear that commissioners should make sure that information for people who work and have cancer is made available to patients on diagnosis and that advice on returning to work should be available for all patients of working age.

To ask the Secretary of State for Health if he will publish the report outlining the outcome of the event held in March 2008 on Making the Cancer Survivorship Initiative a Reality, as referred to in paragraph 5.61 of his Department's Cancer Reform Strategy, which priority workstreams have been identified as part of the National Cancer Survivorship Initiative; and what future work he expects the National Cancer Survivorship Initiative to undertake. (220968)

Work on the National Cancer Survivorship Initiative (NCSI) is being co-led by the National Cancer Director, Professor Mike Richards, and the chief executive of Macmillan Cancer Support, Mr. Ciaran Devane, and the steering group held its first meeting in July.

A summary of the ThinkTank event held in March 2008 has been published on Macmillan Cancer Support's website at:

www.macmillan.org.uk/Documents/Support_Material/Get_involved/Campaigns/Survivorship/survivorship_report.pdf

We hope to launch the NCSI's work streams at the initiative's conference on 11 September 2008. The future work of the NCSI will be based around those work streams.

To ask the Secretary of State for Health with reference to paragraph 5.73 of his Department's Cancer Reform Strategy, whether an NHS Cancer Patient Experience Survey Programme has been established; and when he expects the first annual patient experience survey will (a) take place and (b) be published. (220969)

To support and advise on the development of the national health service cancer patient experience survey programme (NHS CPESP), an advisory group has been established, chaired by Professor Mike Richards, the National Cancer Director. The advisory group met for the first time on 29 May 2008. It is intended to hold the first annual patient experience survey in 2009-10. Experience from previous such surveys suggests that results will be made available 6 to 12 months after the survey takes place.

To ask the Secretary of State for Health with reference to paragraph 6.9 of his Department's Cancer Reform Strategy, what specific goals have been agreed by his Department for reducing cancer mortality in each cancer network; and if he will make a statement. (220970)

An advisory group has been set up to support and advise on the work of the newly established National Cancer Equality Initiative (NCEI). Work on agreeing challenging goals for reducing cancer mortality in every cancer network will be taken forward alongside the rest of the NCEI work programme.

To ask the Secretary of State for Health what recent estimate he has made of the proportion of primary care trusts which have undertaken a local equality impact assessment, as referred to on page 86 of his Department’s Cancer Reform Strategy. (220971)

It is the responsibility of primary care trusts, working together with their strategic health authorities, stakeholders and local cancer services, including cancer networks, to undertake local equality impact assessments and take appropriate steps to address local issues.

To ask the Secretary of State for Health which primary care trusts (a) have and (b) have not reviewed current bed utilisation by (i) tumour group and (ii) the split between elective and emergency use, as referred to in paragraph 7.37 of his Department’s Cancer Reform Strategy. (220973)

The electronic commissioning toolkit, which is currently being developed and is expected to be launched during autumn 2008, will enable primary care trusts to review current bed utilisation for cancer patients as set out in the Cancer Reform Strategy.

To ask the Secretary of State for Health what progress has been made in developing an inpatient management programme for cancer patients, as referred to in paragraph 7.39 of his Department’s Cancer Reform Strategy; and when he expects the programme to be implemented nationwide. (220974)

We expect the steering group for the in-patient management programme to be established in the autumn. The steering group will agree the programme’s work streams and begin work to take these forward.

The Cancer Action Team has held five events with cancer networks and primary care trusts to explore developing local programmes on in-patient management. These events have highlighted the following four potential work streams for the in-patient management programme to take forward:

Management of elective surgery

Management of elective oncology/haematology

Management of emergency in-patient treatment for patients with a cancer diagnosis; and

Management of emergency in-patient treatment for patients who are subsequently diagnosed with cancer.

To ask the Secretary of State for Health what proportion of NHS trusts submit data to cancer registries in an electronic format; and what steps he is taking to ensure that all NHS Trusts do so by 2009, as referred to in paragraph 8.16 of his Department’s Cancer Reform Strategy, published on 3 December 2007. (220975)

All trusts are providing some data to cancer registries in an electronic format. However, few trusts are currently submitting their entire registry dataset in an electronic format.

The Cancer Reform Strategy’s estimated date of 2009 for trusts to provide data in an electronic format has been affected by wider delays in the national programme for information technology. As a result of these delays, the National Contract for Acute Services now requires all trusts to provide data in an electronic format by March 2011. The Clinical Outcomes Programme Manager at the National Cancer Intelligence Network is currently leading on this work with the cancer registries, cancer networks and NHS trusts.

To ask the Secretary of State for Health when he expects the first annual report of the National Cancer Intelligence Network to be published. (220977)

The first annual report of the National Cancer Intelligence Network is scheduled for publication in spring 2009.

To ask the Secretary of State for Health when he expects to publish the guide for cancer commissioners referred to in paragraph 9.9 of his Department’s Cancer Reform Strategy; and if he will make a statement. (220978)

The guidance on commissioning cancer services is currently in development and publication is expected during autumn 2008. The guidance will set out the appropriate level for the commissioning of different cancer services and identify key questions a commissioner should ask when assessing the quality of a service.

To ask the Secretary of State for Health with reference to paragraph 9.9 of his Department's Cancer Reform Strategy, what progress is being made in developing (a) an electronic commissioning toolkit for cancer services and (b) service specifications for each cancer pathway; and when he expects to make each available for use in the NHS. (220979)

A demonstration version of the electronic commissioning toolkit was launched to the NHS in June 2008. Following further development a final version of the toolkit is expected to be launched to the national health service during autumn 2008.

Service specifications for each cancer pathway are still in development. A model generic services specification for colorectal cancer has been shared with cancer networks and a model colorectal pathway placed on the Map of Medicine. Cancer networks are each leading on the development of a service specification/model pathway for different tumours. This work is being facilitated by the National Cancer Action Team who are ensuring appropriate guidance around the sign off of the model pathways with Map of Medicine.

To ask the Secretary of State for Health whether he plans to ask the Care Quality Commission to undertake an improvement review of cancer services in 2009, as referred to in paragraph 9.25 of his Department's Cancer Reform Strategy. (220980)

We are working with the Healthcare Commission on assessing whether cancer services are delivering the Improving Outcomes Guidance. We will in due course work with the Care Quality Commission and this might involve asking it to undertake an improvement review.

To ask the Secretary of State for Health before which financial year he expects to include implementation of the Improving Outcomes Guidance in the national model contract, as referred to in paragraph 9.25 of his Department's Cancer Reform Strategy. (220981)

The details have still to be agreed but the plan is to make appropriate changes to the standard contract from April 2009.

To ask the Secretary of State for Health what recent estimate for benchmarking purposes he has made of the level of spending on English cancer services compared with the spending of other countries. (220982)

As part of our work on the Cancer Reform Strategy we looked at the latest information published by other countries about their expenditure on cancer services.

This published information showed that England spends 5.6 per cent. of its public healthcare budget on cancer, compared to 7.7 per cent. in France, 9.2 per cent. in the United States and 9.6 per cent. in Germany.

As stated in the Cancer Reform Strategy, we will continue to monitor how spending on spending on English cancer services compares with other countries.

The Department regularly publishes information on cancer spend in the national health service in England through programme budgeting figures. Programme budgeting figures provide a breakdown by programmes of how NHS resources have been spent.

To ask the Secretary of State for Health what progress has been made in developing a kitemark for good cancer facilities, as referred to in paragraph 11.18 of his Department's Cancer Reform Strategy; and when he expects it to be made available for use in the NHS. (220983)

Following discussions with key stakeholders, it is anticipated that the kitemark for good cancer facilities will be made available by spring 2010.

To ask the Secretary of State for Health when he expects publication of the National Cancer Research Institute’s five-year plan to take place, as referred to in paragraph 11.25 of his Department’s Cancer Reform Strategy. (220984)

The National Cancer Research Institute’s Strategic Plan 2008-13 was published on 28 April 2008 and is available on the Institute’s website at:

www.ncri.org.uk

To ask the Secretary of State for Health whether he has established a pilot training programme for laparoscopic surgery, as referred in paragraph 4.20 of his Department's Cancer Reform Strategy; and when he anticipates a training programme to be implemented nationwide. (220985)

The pilot training programme for laparoscopic colorectal cancer was set up, following a tender exercise, by the national Cancer Action Team in January 2008. 10 training centres have been appointed, together with a national coordination centre, as follows:

Hull and East Yorkshire NHS Trust (Training Centre and National Coordination Centre);

Newcastle-upon-Tyne NHS Trust;

Bradford Teaching Hospitals NHS Trust;

Nottingham University Hospitals NHS Trust;

North West London Hospitals NHS Trust;

King's College Hospital And Guy's and St Thomas NHS Foundation Trusts;

Oxford Radcliffe NHS Trust;

The Pelican centre and Basingstoke and North Hampshire Foundation Trust;

Portsmouth Hospitals NHS Trust; and

The South West Laparoscopic Consortium (Bristol, Yeovil and Plymouth).

Imperial College London has been appointed to develop the underpinning educational and assessment materials. The pilot is due to run for a period of 18 months with an evaluation being carried out towards the end of the project.

To ask the Secretary of State for Health what information has been submitted to his Department by the NHS Cancer Action Team in each month since 3 December 2007. (220986)

A list of the information received from the National Cancer Action Team (NCAT) is not held centrally.

The NCAT supports delivery of the Cancer Reform Strategy and it is in regular communication with the Department. Information that it provides to the Department includes:

updates/progress reports on the areas of work it leads on;

draft and final copies of guidance, reports and other documents it produces for the NHS

feedback from cancer networks that might be of interest to the Department;

general advice on implementation strategies and ad hoc queries; and

information to contribute to parliamentary and ministerial business.