Lord Freyberg – 2015 Parliamentary Question to the Department of Health
The below Parliamentary question was asked by Lord Freyberg on 2015-11-30.
To ask Her Majesty’s Government what percentage of stage 2b cancer or higher patients in (1) tertiary, and (2) secondary, care centres were tested by NHS England in 2014 for genetic mutations that can confer resistance to targeted cancer therapies, in particular (a) AR amplification mutations, (b) ESR1 activation mutations, (c) PIK3CA mutations, (d) KRAS activation mutations, (e) EGFR amplification and activation mutations, (f) KRAS activation mutations, and (g) EGFR amplification and activation mutations.
Lord Prior of Brampton
NHS England has not, to date, undertaken a direct comparison of the English and French health systems in respect of genetic testing practice for cancer.
NHS England does not hold data on the percentage of stage 2b, or higher, cancer patients in secondary and tertiary centres who were genetically tested. Detailed information on the clinical circumstances, or reasons, for referral for genetic testing for individual patients is not currently collated on a national basis.
NHS England does not consider business cases from individual National Health Service trusts in relation to the adoption of new genetic tests. Instead, NHS England considers national clinical commissioning policy proposals on the eligibility of a particular test, or treatments to be made available in the presence of particular genetic markers. These are considered and where agreed, funded consistently across England for services falling within NHS England’s direct commissioning responsibilities.
Examples include the separate policies (published in July 2015) confirming eligibility for Ivacaftor for the treatment of cystic fibrosis in the presence of certain gene mutations, and confirming eligibility for testing for BRCA1 and BRCA2 gene mutations, respectively. Copies of the policies are attached.
In addition, the UK Genetic Testing Network currently presents new genetic testing proposals to NHS England for funding consideration based on the conclusions of their assurance programme. These are considered, alongside other new policy proposals, as part of the annual funding prioritisation process, where there is a net annual investment to be made to support their adoption.
Information on the average turnaround time for cancer genetic tests is not currently collated, or analysed, nationally. However, NHS England will be undertaking a procurement exercise in the coming months to support the strengthened provision of genetic testing across England. This includes more consistent reporting of activity and other performance indicators, including the timeliness of reporting on receipt on referrals. The supporting national service specification, setting out the standards required of commissioned providers, has been the subject of a recent public consultation.
