The Sickle Cell and Thalassaemia Screening Programme is an antenatal population screening programme which is offered to all pregnant women regardless of their risk, and to fathers to be, where antenatal screening shows that the mother is a genetic carrier. The offer to be screened is a joint offer.

Screening coverage for sickle cell and thalassaemia is reported by region only and can be accessed below:

http://www.phoutcomes.info/search/SICKLE%20CELL

Screening data for sickle cell and thalassaemia by NHS trusts and clinical commissioning groups over the last three years can be viewed:

https://www.gov.uk/government/collections/nhs-screening-programmes-national-data-reporting

Newborn babies are screened for sickle cell as part of the newborn blood spot screening programme. Data in screening for sickle cell and thalassaemia in the Newborn Blood Spot Programme over the last three years is available at:

https://www.gov.uk/government/collections/nhs-screening-programmes-national-data-reporting

A search of the Department’s ministerial correspondence database has identified two items of correspondence from the Down’s Syndrome Association received since 1 January 2016 on non-invasive prenatal testing and information provided by health professionals about Down’s syndrome to prospective parents. This figure represents correspondence received by the Department’s ministerial correspondence unit only.

The information requested is not currently available. The first figures of the numbers of individuals who have been systemically tested and treated for latent tuberculosis (TB) will be published in the Annual TB report in the autumn of this year.

There is a range of work going on to understand the reasons for the decline in cervical screening uptake amongst women aged 25 to 29 and to try to address them. They include:

a) Data and information – access to data, cleansing, benchmarking for providers, timely and useful information for commissioners;

b) Behavioural insight – communication with commissioners, providers, patients and public;

c) Commissioning levers – commissioning contracts in public health (S7a) and primary care;

d) Partnership work – relationships with commissioners and providers; and

e) Sharing best practice – what works well, evaluation and how to embed quality improvement

Public Health England (PHE) is working with colleagues in NHS England and Health and Social Care Information Centre to implement the Accessible Information Standard which is intended to improve access to services for vulnerable and disadvantaged groups. Through the re-development of cervical Information Technology systems opportunities will arise to review how to help improve uptake.

PHE supports providers to help meet the Accessible Information Standard through the provision of high quality information for people with learning disabilities or sensory loss. A national group of experts and service users has been set up to oversee this work and will be updating the existing easy read leaflets and developing new materials over the next 18 months.

PHE is aware that there are a range of factors which may act as barriers in hindering women from attending cervical screening. It is hoped that through the STRATEGIC (Strategies to Increase Cervical screening uptake at first invitation) interventions will be identified to help minimise barriers and assist women to attend screening whilst increasing uptake across all quintiles. The STRATEGIC trial was completed in 2015 and researchers are expected to publish findings later this year.

There is a range of work going on to understand the reasons for the decline in cervical screening uptake amongst women aged 25 to 29 and to try to address them. They include:

a) Data and information – access to data, cleansing, benchmarking for providers, timely and useful information for commissioners;

b) Behavioural insight – communication with commissioners, providers, patients and public;

c) Commissioning levers – commissioning contracts in public health (S7a) and primary care;

d) Partnership work – relationships with commissioners and providers; and

e) Sharing best practice – what works well, evaluation and how to embed quality improvement

Public Health England (PHE) is working with colleagues in NHS England and Health and Social Care Information Centre to implement the Accessible Information Standard which is intended to improve access to services for vulnerable and disadvantaged groups. Through the re-development of cervical Information Technology systems opportunities will arise to review how to help improve uptake.

PHE supports providers to help meet the Accessible Information Standard through the provision of high quality information for people with learning disabilities or sensory loss. A national group of experts and service users has been set up to oversee this work and will be updating the existing easy read leaflets and developing new materials over the next 18 months.

PHE is aware that there are a range of factors which may act as barriers in hindering women from attending cervical screening. It is hoped that through the STRATEGIC (Strategies to Increase Cervical screening uptake at first invitation) interventions will be identified to help minimise barriers and assist women to attend screening whilst increasing uptake across all quintiles. The STRATEGIC trial was completed in 2015 and researchers are expected to publish findings later this year.

There is a range of work going on to understand the reasons for the decline in cervical screening uptake amongst women aged 25 to 29 and to try to address them. They include:

a) Data and information – access to data, cleansing, benchmarking for providers, timely and useful information for commissioners;

b) Behavioural insight – communication with commissioners, providers, patients and public;

c) Commissioning levers – commissioning contracts in public health (S7a) and primary care;

d) Partnership work – relationships with commissioners and providers; and

e) Sharing best practice – what works well, evaluation and how to embed quality improvement

Public Health England (PHE) is working with colleagues in NHS England and Health and Social Care Information Centre to implement the Accessible Information Standard which is intended to improve access to services for vulnerable and disadvantaged groups. Through the re-development of cervical Information Technology systems opportunities will arise to review how to help improve uptake.

PHE supports providers to help meet the Accessible Information Standard through the provision of high quality information for people with learning disabilities or sensory loss. A national group of experts and service users has been set up to oversee this work and will be updating the existing easy read leaflets and developing new materials over the next 18 months.

PHE is aware that there are a range of factors which may act as barriers in hindering women from attending cervical screening. It is hoped that through the STRATEGIC (Strategies to Increase Cervical screening uptake at first invitation) interventions will be identified to help minimise barriers and assist women to attend screening whilst increasing uptake across all quintiles. The STRATEGIC trial was completed in 2015 and researchers are expected to publish findings later this year.

Cervical screening data is provided at local authority (LA) level.

The screening coverage trend for Ashfield and other LAs in the last five years for women age appropriate can be accessed using the following link:

http://www.phoutcomes.info/search/cervical%20screening#page/4/gid/1/pat/6/par/E12000004/ati/101/are/E07000170/iid/22002/age/167/sex/2

Manipulation of the tool is necessary for obtaining information for other LAs.

In 2012 the United Kingdom National Screening Committee made a recommendation that the age of first invitation for cervical screening should be 25. This was based on a review which looked at the latest available evidence on risks and benefits for cervical screening in women aged 20-24.

There is a range of work going on to understand the reasons for the decline and to try to address them. This includes:

- Data and information – access to data, cleansing, benchmarking for providers, timely and useful for commissioners;

- behavioural insight – communication with commissioners, providers, patients, public;

- commissioning levers – commissioning contracts in public health (S7a), primary care;

- partnership work – relationships with commissioners and providers; and

- sharing best practice – what works well, evaluation, how to embed quality improvement

Public Health England Screening is also awaiting the outcome from the Strategies to Increase Cervical screening uptake at first invitation (STRATEGIC) trial which looks at various interventions to help assist women to attend screening and increase uptake across all quintiles. The trial was completed in 2015 and researchers are expected to publish findings later this year.

The attached table shows cervical screening coverage data (the proportion of the eligible population who are screened) for a range of age groups from 50 years and older. Results are presented at screening intervals of five years.

It should be noted that although the data provided reports on an older definition of coverage from the KC53 return, data reported to the new coverage definition (age appropriate coverage) is only available from 2011.

The National Health Service will support women who have had female genital mutilation (FGM) and will provide them with appropriate care to ensure that cervical screening can be done as comfortably as possible, as for all women invited for cervical screening. FGM survivors may feel anxious about the procedure, and NHS staff are encouraged to have sensitive conversations with women about their worries.

It is important that all women invited for screening attend appointments. Taking a cervical sample may not always be possible for women with FGM, and in such cases women can be referred to specialist gynaecological services who are trained in treating complications that can be caused by FGM.

NHS England closely monitors the coverage rates for cervical screening in all age groups. NHS England is committed to improving coverage and reducing variation between all age groups.

Local NHS England commissioners analyse coverage rates within their area and work with general practices to improve coverage by sharing best practice. In addition a primary care cancer screening best practice guide has been developed jointly with the transforming cancer services team, clinical commissioning groups and local authority public health representatives.

NHS England is working in partnership with Cancer Research UK and Macmillan Cancer Support on the ACE (Accelerate, Coordinate, Evaluate) Programme aiming to generate knowledge about effective approaches to achieve earlier diagnosis. A number of ACE test sites are evaluating approaches to increase screening rates in a range of groups.

A range of research studies are also underway, such as Imperial College conducting a randomised controlled trial to assess the effectiveness of texting non-responders on improving coverage. In addition, the Department’s Behavioural Insight team has undertaken a trial to investigate the use of behavioural insights to optimise the content of the invitation letter for cervical screening. Results are due shortly.

The Independent Cancer Taskforce recognised the importance of screening for cervical cancer and the potential of the new human papillomavirus (HPV) test in their report, Achieving World-Class Cancer Outcomes, published in July 2015. NHS England has appointed Cally Palmer as National Cancer Director to lead the implementation of the strategy, and an implementation plan outlining the key first steps for the national cancer programme was published on 12 May. In addition, the routine HPV vaccination programme, offering immunisation to girls aged 12-14 years, is expected to reduce the already low rates of cervical cancer in these young women and allow them to be protected for years to come.

Ministers welcome cervical cancer prevention week and we are fully supportive of the work Jo’s Cervical Cancer Trust does to raise awareness of cervical cancer and the importance of cervical screening for eligible women.

According to the Organisation for Economic Co-operation and Development (OECD) report, Health at a Glance 2015: How does the United Kingdom compare?, the UK has cervical screening rates well above the OECD average. Further information is available at:

https://www.oecd.org/unitedkingdom/Health-at-a-Glance-2015-Key-Findings-UK.pdf

http://www.oecd-ilibrary.org/docserver/download/8115071ec053.pdf?expires=1465810879&id=id&accname=guest&checksum=102E30B1A256588EDD14918B5BE3AA4C

NHS England closely monitors the coverage rates for cervical screening in all age groups. NHS England is committed to improving coverage and reducing variation between all age groups.

Local NHS England commissioners analyse coverage rates within their area and work with general practices to improve coverage by sharing best practice. In addition a primary care cancer screening best practice guide has been developed jointly with the transforming cancer services team, clinical commissioning groups and local authority public health representatives.

NHS England is working in partnership with Cancer Research UK and Macmillan Cancer Support on the ACE (Accelerate, Coordinate, Evaluate) Programme aiming to generate knowledge about effective approaches to achieve earlier diagnosis. A number of ACE test sites are evaluating approaches to increase screening rates in a range of groups.

A range of research studies are also underway, such as Imperial College conducting a randomised controlled trial to assess the effectiveness of texting non-responders on improving coverage. In addition, the Department’s Behavioural Insight team has undertaken a trial to investigate the use of behavioural insights to optimise the content of the invitation letter for cervical screening. Results are due shortly.

The Independent Cancer Taskforce recognised the importance of screening for cervical cancer and the potential of the new human papillomavirus (HPV) test in their report, Achieving World-Class Cancer Outcomes, published in July 2015. NHS England has appointed Cally Palmer as National Cancer Director to lead the implementation of the strategy, and an implementation plan outlining the key first steps for the national cancer programme was published on 12 May. In addition, the routine HPV vaccination programme, offering immunisation to girls aged 12-14 years, is expected to reduce the already low rates of cervical cancer in these young women and allow them to be protected for years to come.

Ministers welcome cervical cancer prevention week and we are fully supportive of the work Jo’s Cervical Cancer Trust does to raise awareness of cervical cancer and the importance of cervical screening for eligible women.

According to the Organisation for Economic Co-operation and Development (OECD) report, Health at a Glance 2015: How does the United Kingdom compare?, the UK has cervical screening rates well above the OECD average. Further information is available at:

https://www.oecd.org/unitedkingdom/Health-at-a-Glance-2015-Key-Findings-UK.pdf

http://www.oecd-ilibrary.org/docserver/download/8115071ec053.pdf?expires=1465810879&id=id&accname=guest&checksum=102E30B1A256588EDD14918B5BE3AA4C

NHS England closely monitors the coverage rates for cervical screening in all age groups. NHS England is committed to improving coverage and reducing variation between all age groups.

Local NHS England commissioners analyse coverage rates within their area and work with general practices to improve coverage by sharing best practice. In addition a primary care cancer screening best practice guide has been developed jointly with the transforming cancer services team, clinical commissioning groups and local authority public health representatives.

NHS England is working in partnership with Cancer Research UK and Macmillan Cancer Support on the ACE (Accelerate, Coordinate, Evaluate) Programme aiming to generate knowledge about effective approaches to achieve earlier diagnosis. A number of ACE test sites are evaluating approaches to increase screening rates in a range of groups.

A range of research studies are also underway, such as Imperial College conducting a randomised controlled trial to assess the effectiveness of texting non-responders on improving coverage. In addition, the Department’s Behavioural Insight team has undertaken a trial to investigate the use of behavioural insights to optimise the content of the invitation letter for cervical screening. Results are due shortly.

The Independent Cancer Taskforce recognised the importance of screening for cervical cancer and the potential of the new human papillomavirus (HPV) test in their report, Achieving World-Class Cancer Outcomes, published in July 2015. NHS England has appointed Cally Palmer as National Cancer Director to lead the implementation of the strategy, and an implementation plan outlining the key first steps for the national cancer programme was published on 12 May. In addition, the routine HPV vaccination programme, offering immunisation to girls aged 12-14 years, is expected to reduce the already low rates of cervical cancer in these young women and allow them to be protected for years to come.

Ministers welcome cervical cancer prevention week and we are fully supportive of the work Jo’s Cervical Cancer Trust does to raise awareness of cervical cancer and the importance of cervical screening for eligible women.

According to the Organisation for Economic Co-operation and Development (OECD) report, Health at a Glance 2015: How does the United Kingdom compare?, the UK has cervical screening rates well above the OECD average. Further information is available at:

https://www.oecd.org/unitedkingdom/Health-at-a-Glance-2015-Key-Findings-UK.pdf

http://www.oecd-ilibrary.org/docserver/download/8115071ec053.pdf?expires=1465810879&id=id&accname=guest&checksum=102E30B1A256588EDD14918B5BE3AA4C

NHS England is working with key partners to ensure better co-ordination and integration of all services with the aim of delivering person-centred and coordinated care which is tailored to the needs and preferences of the individual, their carer and family.

Specifically on heart failure, NHS England is working with Health Education England to look at ways of improving the provision of and increase access to echocardiography, which is used for the diagnosis of heart failure.

NHS England has also established a best practice tariff for acute heart failure. This aims to encourage better practice in the caring for heart failure patients. In addition, the National Institute for Health and Care Excellence (NICE) has published quality standards for acute heart failure and chronic heart failure, which can be found at:

https://www.nice.org.uk/Guidance/QS9

https://www.nice.org.uk/guidance/qs103

NHS England expects commissioners and providers to take account of quality standards in the services that are delivered to patients.

The use of natriuretic peptides in diagnosing heart failure is widely understood and pathology laboratories are used to measuring them. The NICE’s guidance on acute heart failure and chronic heart failure both cover the use of natriuretic peptides. This guidance can be found at:

https://www.nice.org.uk/guidance/cg108

https://www.nice.org.uk/guidance/cg187

The NICE has also developed a commissioning toolkit for the use of natriuretic peptides assessment in primary care for suspected heart failure:

https://www.nice.org.uk/sharedlearning/a-commissioning-toolkit-for-use-of-natriuretic-peptide-assessment-for-suspected-heart-failure-in-primary-care

The information is not available in the format requested.

Ministers have accepted the UK National Screening Committee’s (UK NSC) recommendation on replacing the guaiac Faecal Occult Blood test with the Faecal Immunochemical Test (FIT) in the NHS Bowel Cancer Screening Programme. Following the change to FIT we expect that around 200,000 more people per year will take up the opportunity to be screened as part of the NHS Bowel Cancer Screening Programme in England. This has the potential to save hundreds more lives by detecting bowel cancer earlier. Public Health England is responsible for the leadership of the NHS Screening Programmes and will oversee the change to the programme in partnership with NHS England.

Ministers are currently considering the UK NSC’s recommendation that human papillomavirus testing should replace the currently used cytology test as primary screening for cervical disease.

Ministers have accepted the UK National Screening Committee’s (UK NSC) recommendation on replacing the guaiac Faecal Occult Blood test with the Faecal Immunochemical Test (FIT) in the NHS Bowel Cancer Screening Programme. Following the change to FIT we expect that around 200,000 more people per year will take up the opportunity to be screened as part of the NHS Bowel Cancer Screening Programme in England. This has the potential to save hundreds more lives by detecting bowel cancer earlier. Public Health England is responsible for the leadership of the NHS Screening Programmes and will oversee the change to the programme in partnership with NHS England.

Ministers are currently considering the UK NSC’s recommendation that human papillomavirus testing should replace the currently used cytology test as primary screening for cervical disease.

Lyme disease is a complex infection where challenges in understanding of disease progression, and consequently diagnosis and treatment, remain.

The National Health Service and Public Health England (PHE) use well established validated diagnostic tests for Lyme disease that are highly reproducible between laboratories. International External Quality Assurance schemes are in place to ensure consistency between different test centres. Commercial manufacturers and international academic groups have research programmes into improved tests and PHE continuously reviews new Lyme serology tests and will validate and implement new tests if appropriate.

All treatment for Lyme disease within the NHS should be evidence based, and targeted at the disease mechanisms underlying those symptoms. Most cases are diagnosed in primary care and PHE has published a referral pathway for general practitioners to follow to ensure problem cases are seen by an appropriate NHS specialist.

To further strengthen the evidence base we have commissioned the National Institute for Health and Care Excellence to develop a new clinical guideline on Lyme disease, for both primary and secondary care, for publication in 2018. The Department is also commissioning three Systematic Reviews by independent academic groups to cover

― diagnosis and diagnostic tests;

― treatment; and

― epidemiology/transmission routes.

NHS England is holding a Clinical Summit on 15 June 2016, bringing together cardiologists and cardiac surgeons to examine the issues relating to heart valve disease. This will discuss variation and the outputs will be used to inform the future commissioning approach within specialised commissioning.

In addition, the office of the Chief Scientific Officer for NHS England is working with the National Clinical Director for Heart Disease and Health Education England to look at ways to improve provision and increase access to echocardiography for the identification of heart valve disease.

NHS England has also undertaken a significant programme of work on congenital heart services, working very closely with the relevant stakeholders, including patients and their representatives, clinicians and hospital managers. This work produced a new set of service standards with the aim of achieving the best outcomes for all patients, consistently across the whole country and with excellent patient experience. Following consultation these standards were agreed by the board of NHS England in July 2015 and came into effect on 1 April 2016.