Payment for cataract surgery within the National Health Service depends on complexity and tariffs for each procedure varies from £973.42 to £1070.36. Data is not collected on the cost of cataract operations carried out by the independent sector, on behalf of the NHS.

Data on the cost of cataract operations undertaken outside of National Health Service hospital trusts is not collected.

No such assessment has been made.

Immediate sequential bilateral cataract surgery (ISBCS) is supported by the Royal College of Ophthalmologists, who advise that ISBCS can help reduce patient visits to hospital whilst providing an optimum visual outcome, in appropriately selected and assessed patients.

Clinical commissioning groups are required to consider the National Institute for Health and Care Excellence’s guidelines, which state that bilateral cataract surgery should be considered for routine cases for those who are suitable, in making commissioning decisions.

No such assessment has been made.

Immediate sequential bilateral cataract surgery (ISBCS) is supported by the Royal College of Ophthalmologists, who advise that ISBCS can help reduce patient visits to hospital whilst providing an optimum visual outcome, in appropriately selected and assessed patients.

Clinical commissioning groups are required to consider the National Institute for Health and Care Excellence’s guidelines, which state that bilateral cataract surgery should be considered for routine cases for those who are suitable, in making commissioning decisions.

Following the National Outpatient Transformation Programme for ophthalmology, NHS England and NHS Improvement conducted a survey into local pricing of bilateral cataracts in late 2020. NHS England and NHS Improvement will utilise the results of this survey to publish local pricing guidance to be used alongside the 2021-22 National Tariff Payment System.

The data requested on cancelled surgery is not collected centrally.

The Department is currently making an assessment of National Health Service waiting times in England, including the capacity to return to pre-pandemic levels.

No formal assessment has been made. Data on protected characteristics and socio-economic background is not collected centrally.

Decisions about surgical funding are made by clinical experts and therefore it would not be appropriate for Government to intervene.

Surgical treatment for individuals can be considered for pectus deformity if a clinician believes that a treatment or service, not routinely offered by the National Health Service, is the best treatment for their patient. In this case the clinician can, on behalf of their patient, make an individual funding request which takes into account individual clinical circumstances - for example, exceptional circumstances either in terms of clinical presentation or the ability of a patient to benefit.

NHS England has not issued any clinical guidance to doctors to assess the severity of pectus deformity or on the non-surgical options for pectus deformity treatment.

Decisions about surgical funding are made by clinical experts and therefore it would not be appropriate for Government to intervene.

Surgical treatment for individuals can be considered for pectus deformity if a clinician believes that a treatment or service, not routinely offered by the National Health Service, is the best treatment for their patient. In this case the clinician can, on behalf of their patient, make an individual funding request which takes into account individual clinical circumstances - for example, exceptional circumstances either in terms of clinical presentation or the ability of a patient to benefit.

NHS England has not issued any clinical guidance to doctors to assess the severity of pectus deformity or on the non-surgical options for pectus deformity treatment.

The full impact of the COVID-19 pandemic on services will not be known for some time. Cancer services remain a priority for the National Health Service and thanks to the efforts of staff, have been maintained throughout the pandemic.

In order to ensure that cancer treatment can continue during the pandemic, the NHS has established COVID-19 secure cancer hubs, consolidating cancer surgery and centralising triage to prioritise based on clinical need, and drawing on the independent sector (IS) to increase capacity. Regions are drafting plans on how to maximise IS use over the next six weeks to cope with COVID-19 surges. Urgent cancer surgery patients are the first priority for accessing IS services. In local escalation plans, any decision to reschedule cancer treatment will be a last resort.

Health is a devolved matter in the United Kingdom and each of the devolved administrations has established its own systems and processes for determining which at and how healthcare services will be available. In England, specialised services and treatments are the responsibility of NHS England and NHS Improvement and decisions are made in accordance with their published processes.

NHS England and NHS Improvement’s position on surgery for pectus deformity is set out in their clinical commissioning policy from February 2019. Their conclusion is that there is not enough evidence to routinely commission the intervention, although this policy will be reviewed when warranted by the receipt of new information.

NHS England and NHS Improvement published a clinical commissioning policy in February 2019 about surgical treatment for patients with physical complications arising from pectus deformity. Following a review of clinical practice and options for treatment, they determined that there is insufficient evidence to routinely commission a surgical intervention. However, this policy states that if new evidence is presented, the position can be reviewed.

It is right that decisions about either further research required or surgical funding are made by clinical experts. The position for commissioning surgery for individuals is for clinicians to make an individual funding request where they feel it is clinically appropriate - for example because of exceptional circumstances in terms of either clinical presentation or the ability of a patient to benefit.

NHS England and NHS Improvement published a clinical commissioning policy in February 2019 about surgical treatment for patients with physical complications arising from pectus deformity. Following a review of clinical practice and options for treatment, they determined that there is insufficient evidence to routinely commission a surgical intervention. However, this policy states that if new evidence is presented, the position can be reviewed.

It is right that decisions about either further research required or surgical funding are made by clinical experts. The position for commissioning surgery for individuals is for clinicians to make an individual funding request where they feel it is clinically appropriate - for example because of exceptional circumstances in terms of either clinical presentation or the ability of a patient to benefit.

Any decision to fund surgery and make commissioning decisions by assessing needs, planning and prioritising is a matter for NHS England and NHS Improvement. It would therefore not be appropriate for the Government to influence their ‘Commissioning through Evaluation’ programme, which enables new clinical patient data to be collected for treatments that show significant promise.

NHS England and NHS Improvement advise that if new evidence on the surgical treatment for pectus deformity is presented, their current policy can be reviewed.

This information is not held in the format requested.

National Health Service providers have worked hard to recover as much elective activity as possible whilst preparing for winter, making full use of available capacity. The Prime Minister has announced £3 billion of extra funding to support the NHS this winter and this includes ensuring the retention of the Nightingale hospital surge capacity and continued access to independent hospitals capacity to help meet patient demand. Essential care should only be postponed if a clinician and patient agree it is in the patient’s best interest.

Supporting the NHS workforce is crucially important and testing of staff remains a top priority. All NHS staff are eligible for priority testing for COVID-19, access is provided through pillar 1 testing and there is capacity within trusts to ensure staff can get tested.

To support the wider wellbeing of NHS staff the NHS People Plan published in July sets out our vision and immediate actions to make the NHS the best place to work, where our NHS people are valued and supported.

The NHS England and NHS Improvement online publication Clinical Commissioning Policy relating to surgery for pectus deformity (all ages) sets out the policy position for commissioning surgery for pectus deformity.

NHS England has concluded that there is not sufficient evidence to support the routine commissioning of surgical treatment for pectus deformity.

NHS England is always willing to look at new evidence and, where appropriate, consider revising policy positions. NHS England and NHS Improvement have been working with clinicians and the National Institute for Health Research to identify ways to close the gaps in the current evidence base, for example through formal research.

The NHS England and NHS Improvement online publication Clinical Commissioning Policy relating to surgery for pectus deformity (all ages) sets out the policy position for commissioning surgery for pectus deformity.

NHS England has concluded that there is not sufficient evidence to support the routine commissioning of surgical treatment for pectus deformity.

NHS England is always willing to look at new evidence and, where appropriate, consider revising policy positions. NHS England and NHS Improvement have been working with clinicians and the National Institute for Health Research to identify ways to close the gaps in the current evidence base, for example through formal research.

Throughout the pandemic urgent services, such as cancer treatment, urgent operations and stroke care have remained open. Even at the peak of demand, hospitals were still able to look after two non-COVID-19 inpatients for everyone COVID-19 inpatient.

The following table shows the total number of completed admitted pathways during the COVID-19 pandemic period.

Stroke Sentinel National Audit Programme data shows that during the COVID-19 pandemic, improvements were seen in access to stroke units and in the time taken for brain scanning and acute assessments by a stroke specialist. There was a decrease in stroke admissions of 13% during March-May 2020. Seven-day crude mortality data for March-June 2020 shows that there is an overall adjusted risk of mortality of 12% which is consistent with the case mix adjusted 30-day mortality data average of 12% between 2016-2019.

The number of people starting treatment for cancer in August was 78% of the same month last year, having recovered from a low of 63% in May. The majority of people who have not been diagnosed are assessed as being those who did not come forward for checks.

Chemotherapy treatments are largely delivered on a day case or outpatient basis and only a small proportion would normally be delivered in an inpatient setting. Between March and August 2020, there were around 5,300 chemotherapy admissions for inpatient treatment. This is lower than in the same period in 2019, when around 9,000 admissions were recorded. The National Institute for Health and Care Excellence guidance NG161, published in April 2020 to support clinicians in the management of patients requiring systemic treatment through the pandemic, provided advice on alternative chemotherapy treatment approaches to reduce the risk of infection to patients and avoid unnecessary admissions and visits to hospital where possible.