The NHS Health Check Programme has been subject to a phased roll out since 2009 and the number of offered appointments and take up reflect this. Estimated returns indicate that about 1 million to 1.4 million checks were offered in 2009-10 and 2010-11, respectively. In 2011-12 this increased to 2.2 million offers and 1.1 million checks received. During 2012-13, 2.57 million offers and 1.26 million checks were received: an uptake of 49%. This level of uptake for a new programme is a good achievement.

Local authorities are now mandated to continue the roll out of the programme with an expectation of increasing uptake to 75% which will focus programme activity. The number of NHS Health Checks offered and received is an indicator in the Public Health Outcomes Framework.

Public Health England is actively supporting the roll out and uptake of NHS Health Checks and in July will publish a multi-agency review of implementation and action plan.

The NHS Health Check Programme has been subject to a phased roll out since 2009 and the number of offered appointments and take up reflect this. Estimated returns indicate that about 1 million to 1.4 million checks were offered in 2009-10 and 2010-11, respectively. In 2011-12 this increased to 2.2 million offers and 1.1 million checks received. During 2012-13, 2.57 million offers and 1.26 million checks were received: an uptake of 49%. This level of uptake for a new programme is a good achievement.

Local authorities are now mandated to continue the roll out of the programme with an expectation of increasing uptake to 75% which will focus programme activity. The number of NHS Health Checks offered and received is an indicator in the Public Health Outcomes Framework.

Public Health England is actively supporting the roll out and uptake of NHS Health Checks and in July will publish a multi-agency review of implementation and action plan.

There have been ongoing discussions between the Home Office, Public Health England and Department of Health officials as part of the Government's current roll-out of pre-migration tuberculosis screening for non-European Economic Area nationals applying for visas to enter the United Kingdom for more than six months. I have met the Minister for Immigration, my hon. Friend the Member for Forest of Dean (Mr Harper), to discuss the wider impact of immigration on the national health service of which pre-migration screening was discussed.

During 2012-13, 2.57 million offers were made and 1.26 million NHS Health Check appointments were received: an uptake of 49%. Since the national programme is in its second year of implementation following a phased roll out, uptake levels are promising.

Increasing uptake and onward referral for the NHS Health Check programme is a priority for local government, Public Health England and NHS England. Public Health England are leading an implementation review and action plan of the programme and working with multiple partners, including NHS England and local authorities to implement action that will increase uptake.

This is cervical screening awareness week. What plans does the Minister have further to encourage women aged 60 to 64 to attend cervical screening, given the declining levels of screening uptake and the increasing levels of incidence in this age group?

The information is not available in the format requested. Information on the number of women screened for England, the West Midlands strategic health authority (SHA) and Birmingham is provided in the following table.

The Department has not issued any guidance to clinical commissioning groups on diabetes screening for general practitioners. However, diabetes is included in the “Cardiovascular Disease Outcomes Strategy”, which reiterates our commitment to the NHS Health Check programme.

Local authorities have been delivering the NHS Health Check programme since April 2013, and NHS England has an objective in the mandate to work with Public Health England to support local government in this work.

The NHS Health Check is aimed at everyone aged between 40 and 74 years of age and assesses an individual's risk of heart disease, stroke, diabetes and kidney disease and supports them to reduce their risk through individually

tailored advice. Preventing diabetes is a key element of the programme and a systematic way of tackling diabetes prevention is one of its key drivers.

The programme has a strong evidence base and could prevent 4,000 people a year from developing type 2 diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier, allowing for the better management of a patient's condition and quality of life in the long-term.

The NHS Health Check programme is a clear priority for both NHS England and NHS Improving Quality, whose role it is to drive the implementation of the NHS Operating Framework through effective improvement programmes.

The national Quality and Outcomes Framework (QOF) is a voluntary incentive scheme that provides additional reward to general practitioner (GP) practices for how well they care for patients based on performance against a number of agreed indicators.

Since 2004, GPs have been paid incentives for providing the nine basic checks on people with diabetes. Performance and patient care has improved considerably as a result of this.

The latest list of indicators is available here:

http://www.nhsemployers.org/Aboutus/Publications/Documents/gof-2013-14.pdf

NHS Cancer Screening Programmes gave approval for human papilloma virus (HPV) testing to begin across Sussex and East Surrey (which covers Mid and West Sussex) in early July 2012, and testing commenced on 25 July 2012. In year one of implementation, HPV testing for triage was done on the first occurrence of low grade abnormalities in eligible women routinely invited for screening (women aged 25 to 64), along with HPV test-of-cure for newly treated women with normal or low grade abnormalities six months after treatment. In year two, from July 2013, HPV testing as triage will be extended to all women with low grade abnormalities, and HPV test-of-cure extended to all women treated for abnormalities who have normal or low grade abnormalities six months after treatment.

The pilot of HPV testing as primary screening began in May 2013 at two of the six pilot sites. None of the six pilot sites covers the Mid and West Sussex areas. The pilot will be formally evaluated and, based on the results of the evaluation, HPV testing as primary screening will be rolled out across England. Timetables for this roll-out will be determined once we have the results of the evaluation.

NHS Cancer Screening Programmes gave approval for human papilloma virus (HPV) testing to begin across Sussex and East Surrey (which covers Mid and West Sussex) in early July 2012, and testing commenced on 25 July 2012. In year one of implementation, HPV testing for triage was done on the first occurrence of low grade abnormalities in eligible women routinely invited for screening (women aged 25 to 64), along with HPV test-of-cure for newly treated women with normal or low grade abnormalities six months after treatment. In year two, from July 2013, HPV testing as triage will be extended to all women with low grade abnormalities, and HPV test-of-cure extended to all women treated for abnormalities who have normal or low grade abnormalities six months after treatment.

The pilot of HPV testing as primary screening began in May 2013 at two of the six pilot sites. None of the six pilot sites covers the Mid and West Sussex areas. The pilot will be formally evaluated and, based on the results of the evaluation, HPV testing as primary screening will be rolled out across England. Timetables for this roll-out will be determined once we have the results of the evaluation.

At present, there are no validated blood screening tests for variant Creutzfeldt-Jakob disease. The Department, together with the United Kingdom blood services, continues to monitor scientific research and development in this area.

At present, there are no validated blood screening tests for variant Creutzfeldt-Jakob disease. The Department, together with the United Kingdom blood services, continues to monitor scientific research and development in this area.

The commissioning of all chemotherapy drugs is defined as a prescribed service for direct commissioning by NHS England. Medical Genetics is additionally a prescribed service for direct commissioning by NHS England. National clinical reference groups have been established for both chemotherapy drugs and for Medical Genetics to improve the commissioning of these services.

The suitability of a diagnostic for specialised commissioning would be a matter for NHS England.

The National institute for Health and Care Excellence (NICE) is consulting on draft diagnostic guidance on tests to assess the suitability of chemotherapy in certain breast cancer patients. It is anticipated that the final guidance ‘Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in early breast cancer management: MammaPrint, Oncotype DX, IHC4 and Mammostrat’ will be published in September 2013. The guidance can be found on the NICE website at:

www.nice.org.uk

by typing ‘gene expression profiling’ into the search bar.

From April 2013 the NHS Commissioning Board will be responsible for commissioning specialised haemoglobinopathy services on a national basis. This includes the requirement for specialist centres to provide transcranial Doppler scanning services for children with sickle cell disease to help identify those at high risk of stroke.

At its meeting on 24 November 2011, the Advisory Committee on Cervical Screening recommended that there was enough evidence for a proposal of a pilot of human papillomavirus (HPV) testing as primary screening to go to the UK National Screening Committee. At its meeting on 25 April 2012, the UK National Screening Committee gave support for a pilot to assess the value of using HPV testing as the primary screen for cervical disease.

As set out in the second annual report of “Improving Outcomes: A Strategy for Cancer” in December 2012, six cervical screening sites will begin piloting HPV testing as primary screening shortly. The pilot sites are Liverpool; Manchester; Northwick Park, London; Bristol; Sheffield and Norwich.

At its meeting on 24 November 2011, the Advisory Committee on Cervical Screening recommended that there was enough evidence for a proposal of a pilot of human papillomavirus (HPV) testing as primary screening to go to the UK National Screening Committee. At its meeting on 25 April 2012, the UK National Screening Committee gave support for a pilot to assess the value of using HPV testing as the primary screen for cervical disease.

As set out in the second annual report of “Improving Outcomes: A Strategy for Cancer” in December 2012, six cervical screening sites will begin piloting HPV testing as primary screening shortly. The pilot sites are Liverpool; Manchester; Northwick Park, London; Bristol; Sheffield and Norwich.

“Improving Outcomes: A Strategy for Cancer” (January 2011) makes clear the important role that cervical screening plays in preventing cervical cancer. The strategy also notes that some groups and communities are not accessing cancer screening services. To encourage all eligible women aged 25 to 64 to make the important

decision to attend routine cervical screening, we are working with NHS Cancer Screening Programmes, the Advisory Committee on Cervical Screening and stakeholders to refine the information we provide to women when they are invited for screening so all are fully supported to make an informed choice to attend.

To tackle low uptake among women aged 25-29, the National Institute for Health Research Health Technology Assessment programme has commissioned a study costing over £1 million to determine which interventions are effective at increasing screening uptake amongst women receiving their first invitation from the NHS Cervical Screening Programme. The “Strategies to increase cervical screening uptake at first invitation (STRATEGIC)” study is trialling interventions such as a pre-invitation leaflet; internet appointment booking; timed appointments; the provision of personal support through nurse navigators; and human papillomavirus self-sampling. The study began in November 2011 and is due to run until October 2015.

On 26 January 2012, NHS Cancer Screening Programmes and Jo's Cervical Cancer Trust jointly held an event at the King's Fund looking at challenges to screening uptake among black and minority ethnic (BME) communities. The meeting updated attendees on current data about challenges to improve screening uptake among BME groups and offered an opportunity to share best practice. Documents and links from the event have been circulated to all attendees to help promote information on cervical screening in their respective communities. This was the second such meeting. The National Cancer Action Team, in partnership with BME charities and faith communities, is piloting a targeted approach to raise awareness about cancer and increase screening uptake among BME communities. As part of the Cancer Does Not Discriminate campaign, the pilot, which is due to end in March 2013, is using commercial radio, targeted and tailored information, and direct awareness raising events.

NHS Cancer Screening Programmes has funded an award winning campaign targeting lesbian and bisexual women in the north west of England to raise awareness about the need to attend for regular cervical screening tests. The Lesbian and Gay Foundation's Are You Ready for Your Screen Test? campaign was the winner of the Jo's Cervical Cancer Trust 2011 Cervical Screening Award. This is now being rolled out across the country.

From April 2011, in agreement with the General Practitioners (GPs) Committee of the British Medical Association, we amended the existing Directed Enhanced Service arrangements to provide practices with additional flexibilities for them to offer patients appointments at more convenient times to see a general practitioner or nurse within their practice. The Quality and Outcomes Framework for GP practices also includes incentives for practices to achieve high uptake levels in cervical screening. Cervical screening coverage is also an indicator in the Public Health Outcomes Framework.

“Improving Outcomes: A Strategy for Cancer” (January 2011) makes clear the important role that cervical screening plays in preventing cervical cancer. The strategy also notes that some groups and communities are not accessing cancer screening services. To encourage all eligible women aged 25 to 64 to make the important

decision to attend routine cervical screening, we are working with NHS Cancer Screening Programmes, the Advisory Committee on Cervical Screening and stakeholders to refine the information we provide to women when they are invited for screening so all are fully supported to make an informed choice to attend.

To tackle low uptake among women aged 25-29, the National Institute for Health Research Health Technology Assessment programme has commissioned a study costing over £1 million to determine which interventions are effective at increasing screening uptake amongst women receiving their first invitation from the NHS Cervical Screening Programme. The “Strategies to increase cervical screening uptake at first invitation (STRATEGIC)” study is trialling interventions such as a pre-invitation leaflet; internet appointment booking; timed appointments; the provision of personal support through nurse navigators; and human papillomavirus self-sampling. The study began in November 2011 and is due to run until October 2015.

On 26 January 2012, NHS Cancer Screening Programmes and Jo's Cervical Cancer Trust jointly held an event at the King's Fund looking at challenges to screening uptake among black and minority ethnic (BME) communities. The meeting updated attendees on current data about challenges to improve screening uptake among BME groups and offered an opportunity to share best practice. Documents and links from the event have been circulated to all attendees to help promote information on cervical screening in their respective communities. This was the second such meeting. The National Cancer Action Team, in partnership with BME charities and faith communities, is piloting a targeted approach to raise awareness about cancer and increase screening uptake among BME communities. As part of the Cancer Does Not Discriminate campaign, the pilot, which is due to end in March 2013, is using commercial radio, targeted and tailored information, and direct awareness raising events.

NHS Cancer Screening Programmes has funded an award winning campaign targeting lesbian and bisexual women in the north west of England to raise awareness about the need to attend for regular cervical screening tests. The Lesbian and Gay Foundation's Are You Ready for Your Screen Test? campaign was the winner of the Jo's Cervical Cancer Trust 2011 Cervical Screening Award. This is now being rolled out across the country.

From April 2011, in agreement with the General Practitioners (GPs) Committee of the British Medical Association, we amended the existing Directed Enhanced Service arrangements to provide practices with additional flexibilities for them to offer patients appointments at more convenient times to see a general practitioner or nurse within their practice. The Quality and Outcomes Framework for GP practices also includes incentives for practices to achieve high uptake levels in cervical screening. Cervical screening coverage is also an indicator in the Public Health Outcomes Framework.