Tag: Tessa Munt

The below Parliamentary question was asked by Tessa Munt on 2014-06-04.

To ask the Secretary of State for Health, with reference to the Answer of 24 March 2014, Official Report, column 132W, on radiotherapy and with reference to section 3 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, which primary care trusts in the south west of England commissioned treatment with the gamma knife at University College Hospital London for patients before 1 April 2013.

Jane Ellison

NHS England has advised that no primary care trusts in the south west of England commissioned gamma knife treatment for patients at University College Hospital London before 1 April 2013.

The below Parliamentary question was asked by Tessa Munt on 2014-06-04.

To ask the Secretary of State for Health, with reference to the Answer of 24 March 2014, Official Report, column 132W, on radiotherapy, and with reference to section 3 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, for what reasons NHS England is not funding patients to be treated with the gamma knife at University College Hospital London.

Jane Ellison

Section 3 of Monitor’s substantive guidance on The National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 provides guidance to commissioners on publishing new contract opportunities for National Health Service health care services.

On page 42 of the guidance, it states that "a commissioner may decide to carry out a detailed review of the provision of particular services (for example, A&E services) in its local area in order to understand how those services can be improved in the interests of patients. The review may involve extensive public consultation and engagement with existing and potential providers and other stakeholders. Reviewing available services and providers in this way is good commissioning practice and something that commissioners should consider doing as a matter of course."

In its role as commissioner, NHS England is currently undertaking such a review of stereotactic radiosurgery services. This will inform procurement decisions for these services.

University College London Hospitals is not contracted by NHS England, nor was it contracted by former primary care trusts, to provide Gamma Knife services. It is for this reason that NHS patients cannot normally be treated at this facility. Instead, NHS patients requiring Gamma Knife treatment should be treated by the Gamma Knife services commissioned by the NHS, that have been shown to meet NHS England service specifications. These can be accessed by patients in London without a waiting time, fully maintaining the continuity of their care and normally with the same consultant and clinical team.

Until the capacity requirements are made clear as part of the review being undertaken, NHS England has said that it would be inappropriate to encourage new market entrants to provide this service as it cannot be clear what the potential consequential impacts on service quality, sustainability (financial and clinical) and potential unintended changes to patient pathways will be. Until the review is complete NHS England has said no substantive changes will be made to the current provision.

The below Parliamentary question was asked by Tessa Munt on 2014-06-13.

To ask the Secretary of State for Health, pursuant to the Answer of 9 June 2014, Official Report, column 61W, on radiotherapy, what reports he has received of the reasons NHS England has paid for gamma knife treatment at University College Hospital London for a patient referred there from Plymouth Derriford Hospital by James Palmer, NHS England’s Clinical Director of Specialised Commissioning.

Jane Ellison

For reasons of patient confidentiality, it is not possible to comment explicitly on either case referred to. However, any primary care trust authorisations made for the gamma knife prior to 1 April 2013 were honoured by NHS England and the invoice associated with the agreed work was paid. University College London Hospitals (UCLH) were required to forward any referrals made after 1 April 2013 to NHS England, along the prescribed pathway, in accordance with the contract between the two. No invoices for work carried out by Queen’s Square Radiotherapy Centre at its own risk on behalf of UCLH have been paid by NHS England for referrals after 1 April 2013.

The below Parliamentary question was asked by Tessa Munt on 2014-06-13.

To ask the Secretary of State for Health, whether guidance issued by Monitor is mandatory for NHS England to follow.

Jane Ellison

It is the National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 that place requirements on NHS England, including requirements as to good practice in relation to procurement.

Enforcement of the procurement requirements by Monitor may only follow its investigation of a complaint that there has been a failure by a commissioner to comply with the requirements. Guidance issued by Monitor on the regulations, including guidance issued in April, provides advice for commissioners on compliance with the regulations.

The below Parliamentary question was asked by Tessa Munt on 2014-05-01.

To ask the Secretary of State for Health, with reference to section 2 of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, if he will request that NHS England reinstates the commissioning of stereotactic radiotherapy to the level before 1 April 2013 while it conducts its review into the future use of this treatment.

Jane Ellison

All existing contracts for stereotactic radiotherapy services were transferred to NHS England on 1 April 2013 and it continues to commission against these contracts, as previously.

NHS England commenced the review of stereotactic radiosurgery in August 2013 and expects a final report to be considered at its specialised commissioning oversight group, post a public consultation period, in October 2014.

NHS England will consult with the public, patients and professionals and take account of those views when taking a final decision. A summary of the responses received will be included when publishing the final report post the consultation period.

The below Parliamentary question was asked by Tessa Munt on 2014-06-13.

To ask the Secretary of State for Health, with reference to the Answer of 24 March 2014, Official Report, column 132W, on radiotherapy, what reports he has received on the reasons NHS England has paid for Gamma Knife treatment at University College Hospital London (UCHL) for a patient with an acoustic neuroma referred to UCHL from Bournemouth and Poole Hospital.

Jane Ellison

For reasons of patient confidentiality, it is not possible to comment explicitly on either case referred to. However, any primary care trust authorisations made for the gamma knife prior to 1 April 2013 were honoured by NHS England and the invoice associated with the agreed work was paid. University College London Hospitals (UCLH) were required to forward any referrals made after 1 April 2013 to NHS England, along the prescribed pathway, in accordance with the contract between the two. No invoices for work carried out by Queen’s Square Radiotherapy Centre at its own risk on behalf of UCLH have been paid by NHS England for referrals after 1 April 2013.

The below Parliamentary question was asked by Tessa Munt on 2014-05-01.

To ask the Secretary of State for Health, if he will publish (a) a list of all stakeholders who have so far been consulted by NHS England as part of its review into stereotactic radiosurgery and (b) the responses from those stakeholders.

Jane Ellison

All existing contracts for stereotactic radiotherapy services were transferred to NHS England on 1 April 2013 and it continues to commission against these contracts, as previously.

NHS England commenced the review of stereotactic radiosurgery in August 2013 and expects a final report to be considered at its specialised commissioning oversight group, post a public consultation period, in October 2014.

NHS England will consult with the public, patients and professionals and take account of those views when taking a final decision. A summary of the responses received will be included when publishing the final report post the consultation period.

The below Parliamentary question was asked by Tessa Munt on 2014-05-01.

To ask the Secretary of State for Health, when NHS England began its review into the future of stereotactic radiosurgery; and when its plans to complete the review.

Jane Ellison

All existing contracts for stereotactic radiotherapy services were transferred to NHS England on 1 April 2013 and it continues to commission against these contracts, as previously.

NHS England commenced the review of stereotactic radiosurgery in August 2013 and expects a final report to be considered at its specialised commissioning oversight group, post a public consultation period, in October 2014.

NHS England will consult with the public, patients and professionals and take account of those views when taking a final decision. A summary of the responses received will be included when publishing the final report post the consultation period.

The below Parliamentary question was asked by Tessa Munt on 2014-04-30.

To ask the Secretary of State for Health, when NHS England will publish a tariff for stereotactic ablative radiotherapy.

Dr Daniel Poulter

I refer my hon. Friend to the reply I have her on 25 November, 2013, Official Report, column 160W.

Monitor and NHS England published Methodology Discussion Paper on the 23 April 2014, which is available at:

www.monitor.gov.uk/node/6272

where the sector can provide feedback on the 2015/16 national tariff payment system. A copy has been placed in the Library.

The sector will have further opportunities to comment and provide evidence during the summer of 2014 prior to the final tariff publication. Services which have been subject to local price setting will also be reviewed for the local pricing arrangements as part of the review for 2015-16 and 2016-17.

The below Parliamentary question was asked by Tessa Munt on 2014-04-30.

To ask the Secretary of State for Health, what progress NHS England is making on improving access to stereotactic ablative radiotherapy for patients suffering with cancer of the prostate, liver, pancreas, spinal tumours and cancer of the head and neck.

Jane Ellison

The business case for the gamma-knife centre at Oxford was originally agreed with the primary care trust (PCT) prior to April 2013, with an assumption that the PCT would stop sending patients to other centres elsewhere, and start sending them to the new centre once it was completed.

As of April 2013, commissioning of these services transferred to the specialist commissioning team in NHS England.

NHS England is currently undertaking a review of stereotactic radiosurgery (SRS) (e.g. Gamma Knife) and stereotactic ablative radiotherapy (SABR, e.g. Cyber-knife) for intracranial conditions to establish what the national demand is in line with its national clinical commissioning policies on SRS and SABR, and what the national capacity requirements are for this specialised treatment.

Until the capacity requirements are clear, NHS England has said that it would be inappropriate to encourage new market entrants to provide this service as it cannot be clear what the potential consequential impacts on service quality, sustainability (financial and clinical) and potential unintended changes to patient pathways will be. Until the review is complete NHS England has said no substantive changes will be made to the current provision.

As part of the transition of this service to NHS England, it developed, consulted upon and published a series of national clinical commissioning policies for intracranial SRS and SRT treatment.

A report setting out the emerging findings of this review has been shared with clinical reference groups to seek their views and help NHS England develop a final draft. Once the views of stakeholders have been gathered, this will then go to Specialised Commissioning Oversight Group (SCOG) to agree a preferred option. Once the SCOG has a preferred option, NHS England will consult with patients and professionals and take account of those views when taking a final decision. If it is concluded there are to be significant changes in the provision of services, there will be a full public consultation before any changes are made.

NHS England is expecting that the draft report will be ready for consideration at SCOG in June and then it would commence a public consultation on the draft report and preferred option during July to September. The report and recommendations will then be finalised after taking account of the views expressed during the consultation stage and a final decision taken by SCOG in September 2014.

NHS England inherited the range of gamma knife providers currently in place, of which University College London Hospitals (UCLH) was not one. NHS England is currently undertaking a review of stereotactic radiosurgery provision and will consult widely with stakeholders and providers prior to making changes to service provision. There are two long established providers of gamma knife surgery commissioned by NHS England located in central London to whom patients from all six London specialist neurosurgical centres have been referred for gamma knife treatment for a number of years, including patients from UCLH.

Finally, there was no contract in place with UCLH to provide gamma knife surgery for any PCT prior to 1 April 2013. Any activity that may have been undertaken there would have been done on an ad-hoc, non-contracted basis and NHS England does not hold this information.