Tag: Lord Freyberg

The below Parliamentary question was asked by Lord Freyberg on 2016-01-13.

To ask Her Majesty’s Government what molecular testing takes place in the UK in mesothelioma and other rare cancers; and how that compares to more common cancers such as breast, lung or colorectal cancer.

Lord Prior of Brampton

The UK Genetic Testing Network evaluates new genetic tests and aims to promote equity of access to genetic testing in the National Health Service. Genetic testing is not performed routinely in cases of mesothelioma and there is currently no approved genetic test for patients with mesothelioma.

In September 2015, the Department confirmed a commitment from NHS England to implement the independent Cancer Taskforce’s recommendations on molecular diagnostics. This will mean that around 25,000 additional people a year will have their cancers genetically tested to identify the most effective treatments.

The below Parliamentary question was asked by Lord Freyberg on 2016-02-22.

To ask Her Majesty’s Government, further to the Written Answers by Lord Prior of Brampton on 4 February (HL5344) and on 11 February (HL5970), how many of the 8,000 expected clinical reports are in the cancer part of that project, as compared to the rare disease; and in the cancer part of that project, how many are planned for delivery by the end of (1) March, (2) June, and (3) September.

Lord Prior of Brampton

The 100,000 Genomes project cancer pipeline is still being evaluated and the precise proportion of the reports that will relate to cancer is not currently known.

The below Parliamentary question was asked by Lord Freyberg on 2016-06-13.

To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 11 February (HL5970), how many of the 8,000 planned reports in 2016 will come from (1) the rare disease programme, and (2) the cancer programme.

Lord Prior of Brampton

At this stage, Genomics England cannot provide an exact breakdown of the 8,000 planned reports. This will depend on the participants that NHS Genomic Medicine Centres recruit.

The below Parliamentary question was asked by Lord Freyberg on 2016-09-05.

To ask Her Majesty’s Government what measures they intend to put in place to ensure that patients with radioiodine refractory differentiated thyroid cancer can receive all effective clinical treatments currently available through EU authorisation.

Lord Prior of Brampton

Changes to the process for evaluating cancer drugs were introduced at the end of July 2016 as part of the new arrangements for the Cancer Drugs Fund (CDF). Under the new arrangements, all new cancer drugs are expected to be referred to the National Institute for Health and Care Excellence (NICE) for evaluation through its technology appraisal programme. In some cases, NICE will recommend that the cancer drug is funded through the CDF, which enables further evaluation of its place in therapy. Drugs that have a European Union (EU) or United Kingdom marketing authorisation for radioiodine refractory differentiated thyroid cancer will therefore be reviewed under this process and if found to be clinically and cost effective will become established treatment within the National Health Service.

The UK remains a member of the EU until Article 50 negotiations have concluded. EU law continues to apply and ongoing compliance with EU law is considered important in facilitating orderly transition, for negotiating purposes, and to offer certainty in the meantime. As long as the UK is subject to EU law, the present arrangements remain in place.

The below Parliamentary question was asked by Lord Freyberg on 2015-10-28.

To ask Her Majesty’s Government whether they intend to take steps to increase the number of vocational pathways in design disciplines, and if so, by how many.

Lord Nash

There are a variety of different options available to young people to enable them to gain the skills required to enter design related occupations. 14-16 year olds can study design related GCSEs and government approved technical awards. 16-19 year olds can study design related A Levels and government approved technical certificates or tech levels, which are supported by employers. Options beyond this include higher education or employment, and there are apprenticeships currently available in the field of design.

We want to go further to reform technical and professional education to develop a world-leading system to deliver the skills that the economy needs. The Productivity Plan, published in July 2015, announced the government’s intention to reform technical and professional education to provide individuals with clear, high-quality routes to employment.

The below Parliamentary question was asked by Lord Freyberg on 2016-01-13.

To ask Her Majesty’s Government what assessment the National Institute for Health Research Horizon Scanning Research and Intelligence Centre and Genomic England have made of the potential of precision oncology for less common cancers.

Lord Prior of Brampton

Genomics England undertook a comprehensive assessment of the technological and scientific challenges faced by molecular pathology in the context of the 100,000 Genomes Project. As part of the Project there has been extensive experimental work to identify best practice for molecular pathology (and more specifically genomics). In particular, the sequencing of whole tumour genomes at scale poses a significant scientific and clinical challenge. The Project is pushing these boundaries, driving new scientific knowledge and transformational change. Like all transformative projects there are barriers but the Project is providing the impetus to address those challenges.

Genomics England is working in partnership with NHS England, Health Education England and the newly inaugurated NHS Genomic Medicine Centres to facilitate the translation of scientific developments into practice, and to support the development of the molecular pathology workforce.

The Project will involve in-depth analysis of tumour genomics, creating new scientific discoveries which will in turn inform precision oncology. The Project includes both common and rare tumours to spread the transformative impact of the project across a range of cancer types.

In 2014, theNational Institute for Health Research Horizon Scanning Research and Intelligence Centreadvised the NHS England Molecular Testing Group (cancer) on the potential for horizon scanning in the use of genomic tests for cancer.

The below Parliamentary question was asked by Lord Freyberg on 2016-02-22.

To ask Her Majesty’s Government what were the results, by health region, for the data in the most recent National Prostate Cancer Audit (NPCA), as shown in figure 8 of the NPCA Second Year Annual Report, regarding the proportion of (1) men with locally advanced disease undergoing radical prostate cancer treatment, (2) those operations with a hospital length of stay of over three days, and (3) those operations requiring emergency readmission within 90 days.

Lord Prior of Brampton

The proportion of men diagnosed with locally advanced prostate cancer between 2010 and 2013 (the Audit period) who had radical treatment, and the proportion who had a hospital length of stay over three days and who required an emergency readmission within 90 days following an operation, are presented by health region in the attached headed Table 1.

It should be noted that the results presented are based on an analysis of data from the English Cancer Registry linked to the Hospital Episode Statistics. These data were collected before the start of the National Prostate Cancer Audit (NPCA) in April 2013.

The number of radical prostatectomies undertaken in men diagnosed between 2010 and 2013, and the proportion of men who had a hospital length of stay over three days and who had an emergency readmission within 90 days following an operation, are presented in the attached headed Table 2. The results of 56 men included in the data set used to generate Figure 8 in the NPCA Annual Report 2015 could not be included in Table 2. Of these men, 37 were treated in National Health Service trusts that treated fewer than five patients during the Audit period; and for 19 patients it was not possible to identify the NHS trust where they had undergone treatment without incurring disproportionate cost.

The first results for the patient-reported outcomes of men who were diagnosed with prostate cancer between 1 April 2014 and 30 September 2014, and who underwent radical treatment (prostatectomy, external beam radiation, brachytherapy, cryotherapy, and high-intensity focused ultrasound), will be included in the NPCA’s Annual Report 2016, which is due to be published in the last quarter of 2016. These results will include incontinence rates.

Men who had radical prostate cancer treatment were invited to complete a questionnaire about their experiences of care as well as about treatment outcomes, 18 months after the date of diagnosis. It was decided that questionnaires should be sent out at this time after diagnosis because it can take more than one year for men who have radiotherapy, in combination with androgen deprivation therapy, to complete their treatment. Subsequently, it will take at least three months for men to fully recover from the transient side effects of the radiotherapy. In order to include all men and to measure the final treatment outcome – rather than outcomes still affected by the transient side effects – an 18-month period was chosen.

The below Parliamentary question was asked by Lord Freyberg on 2016-06-13.

To ask Her Majesty’s Government what success Genomic England has had in engaging the NHS with (1) the number of informed consents captured by each of the 13 Genomic Medical Centres (GMCs), (2) the number of samples supplied by each of the 13 GMCs to Genomic England, (3) the number of usable samples received from each of the 13 GMCs by Genomic England, (4) the number of Binary Alignment Map files generated to date for each of the 13 GMCs, (5) the number of variant files (VCF) generated to date for each of the 13 GMCs, and (6) the number of clinical reports returned to patients for each of the 13 GMCs, in (a) the rare disease and (b) the cancer programme.

Lord Prior of Brampton

Genomics England (GeL) and NHS England have confirmed that:

The total number of informed consents as reported by NHS Genomic Medicine Centres (GMCs) is 9,939. The breakdown by NHS GMC can be found in the table below.

The total number of samples sent to the United Kingdom biobank from NHS GMCs is 6,777. The breakdown by GMC can be found in the table below.

Over 99% of samples have passed quality control first time in the biorepository, and the others are being followed up with NHS GMCs directly to obtain replacement samples.

In terms of the number of Binary Alignment Map files generated to date, GeL does not break its figures down in this way. It has confirmed that the number of completed Whole Genome Sequences (WGS) is 10,079 consisting of 8,408 rare disease and 1,671 cancer.

In terms of the number of variant files generated to date, GeL does not break its figures down in this way. It has confirmed that the number of completed WGS is 10,079 consisting of 8,408 rare disease and 1,671 cancer. GeL is in the process of developing rare disease and cancer reports and is discussing these with clinical sites. GeL has returned 39 reports to pilot sites and expects the number of reports to increase steadily over the coming year.

NHS GMC	GMC self- reported recruitment	Samples received at UK Biobank
North East and North Cumbria	426	357
West London	307	262
Greater Manchester	666	232
South London	1,436	1,316
East of England	923	795
Oxford	927	678
South West	337	221
North Thames	2,483	1,290
Wessex	638	510
West Mids	1,327	786
North West Coast	434	321
Yorks and Humber	35	0
Total	9,939	6,777

The below Parliamentary question was asked by Lord Freyberg on 2015-11-26.

To ask Her Majesty’s Government what percentage of NHS tertiary care centres provide in-house tumour genetic testing in (1) breast cancer, (2) colorectal cancer, (3) lung cancer, and (4) melanoma.

Lord Prior of Brampton

All NHS England commissioned secondary and tertiary hospitals will be able to collect blood and/or tissue samples for the purpose of genetic testing, depending on the sampling technique required. The testing itself is however usually undertaken by commissioned genetic laboratories, which will typically serve a catchment area much greater than the hospital in which they are based. There will usually be recommended criteria in place to guide National Health Service referrals for genetic testing.

In a small number of cases, usually for very rare conditions, a test may need to be sent away to a non commissioned laboratory, including some abroad and some falling within the private sector, to access expertise. Funding will, however, continue to be provided from NHS budgets.

The United Kingdom is also leading the world by using cutting edge technology in the form of whole genome sequencing to transform healthcare and health research. The Prime Minister launched the 100,000 Genomes Project to bring the benefits of genome sequencing to NHS patients. The Project will sequence 100,000 whole human genomes of NHS patients with cancer or a rare disease by the end of 2017. Eleven Genomic Medicine Centres have been established across the country and are recruiting patients to this landmark project. Otherwise, NHS England does not hold data on private or self-funded care or testing commissioned from either NHS or third party laboratories.

Information on the percentage of eligible patients who received access to genetic testing is not held by NHS England. Due to data protection requirements, detailed data on the reasons for referral for specific tests are not currently aggregated at national level.

The below Parliamentary question was asked by Lord Freyberg on 2016-01-13.

To ask Her Majesty’s Government what assessment the National Institute for Health Research Horizon Scanning Research and Intelligence Centre and Genomic England have made of the barriers to adopting national molecular pathology.

Lord Prior of Brampton

Genomics England undertook a comprehensive assessment of the technological and scientific challenges faced by molecular pathology in the context of the 100,000 Genomes Project. As part of the Project there has been extensive experimental work to identify best practice for molecular pathology (and more specifically genomics). In particular, the sequencing of whole tumour genomes at scale poses a significant scientific and clinical challenge. The Project is pushing these boundaries, driving new scientific knowledge and transformational change. Like all transformative projects there are barriers but the Project is providing the impetus to address those challenges.

Genomics England is working in partnership with NHS England, Health Education England and the newly inaugurated NHS Genomic Medicine Centres to facilitate the translation of scientific developments into practice, and to support the development of the molecular pathology workforce.

The Project will involve in-depth analysis of tumour genomics, creating new scientific discoveries which will in turn inform precision oncology. The Project includes both common and rare tumours to spread the transformative impact of the project across a range of cancer types.

In 2014, theNational Institute for Health Research Horizon Scanning Research and Intelligence Centreadvised the NHS England Molecular Testing Group (cancer) on the potential for horizon scanning in the use of genomic tests for cancer.