The National Institute for Health and Clinical Excellence (NICE) has not issued technology appraisal guidance on any drug listed in section 4.3 of the British National Formulary, “Antidepressant drugs”.

However guidance on the use of specific antidepressant drugs is included in a number of NICE's clinical guidelines, such as those on depression in children and young people (CG28) and depression in adults (CG90).

During 2011-12, we piloted the collection of metastatic and recurrent breast cancer data to identify what information could be collated from routine national health service data and cancer registries. In March 2012, the report ‘Recurrent and Metastatic Breast Cancer Data Collection Project Pilot’ was published. This set out the lessons learned and recommendations for routine collection of data, which is currently under way.

The pilot also collected data about access to supportive care from a clinical nurse specialist (CNS), palliative care professional or other key worker. A little over a half of patients in the pilot were recorded as being offered such support. We know that this is much lower than the proportion of breast cancer patients who generally report having a CNS. As set out in the National Institute for Health and Clinical Excellence (NICE) Breast Cancer Quality Standard, published in January 2012, women with breast cancer

should be offered supportive care. NICE is developing Quality Standards for a number of cancers, which will act as markers of high quality, cost-effective patient care in NHS.

The Department is not collecting data on the number of national health service organisations that have implemented National Institute for Health and Clinical Excellence (NICE) quality standards. NICE quality standards are not a compliance tool. The Care Quality Commission will inspect against essential standards, but NICE quality standards will continue to define excellence. It will be for commissioners to decide whether, when and how to use them in meeting their obligations to improve outcomes for patients.

The Health and Social Care Act (2012) makes it clear that the NHS Commissioning Board, in discharging its duty to improve the quality of health services:

“must have regard to the quality standards prepared by NICE”.

The NHS Commissioning Board (NHS CB) will, therefore, draw upon NICE NHS quality standards to inform the development of the Commissioning Outcomes Framework (COF) and any commissioning guidance in clinical areas that the NHS CB produces. The Commissioning Outcomes Framework will drive up quality improvement by allowing clinical commissioning groups to benchmark their progress and by providing clear comparative information on quality and outcomes to patients and the public. The COF will allow the NHS CB to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.

The Department is not collecting data on the number of national health service organisations that have implemented National Institute for Health and Clinical Excellence (NICE) quality standards. NICE quality standards are not a compliance tool. The Care Quality Commission will inspect against essential standards, but NICE quality standards will continue to define excellence. It will be for commissioners to decide whether, when and how to use them in meeting their obligations to improve outcomes for patients.

The Health and Social Care Act (2012) makes it clear that the NHS Commissioning Board, in discharging its duty to improve the quality of health services:

“must have regard to the quality standards prepared by NICE”.

The NHS Commissioning Board (NHS CB) will, therefore, draw upon NICE NHS quality standards to inform the development of the Commissioning Outcomes Framework (COF) and any commissioning guidance in clinical areas that the NHS CB produces. The Commissioning Outcomes Framework will drive up quality improvement by allowing clinical commissioning groups to benchmark their progress and by providing clear comparative information on quality and outcomes to patients and the public. The COF will allow the NHS CB to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.

The Department is not collecting data on the number of national health service organisations that have implemented National Institute for Health and Clinical Excellence (NICE) quality standards. NICE quality standards are not a compliance tool. The Care Quality Commission will inspect against essential standards, but NICE quality standards will continue to define excellence. It will be for commissioners to decide whether, when and how to use them in meeting their obligations to improve outcomes for patients.

The Health and Social Care Act (2012) makes it clear that the NHS Commissioning Board, in discharging its duty to improve the quality of health services:

“must have regard to the quality standards prepared by NICE”.

The NHS Commissioning Board (NHS CB) will, therefore, draw upon NICE NHS quality standards to inform the development of the Commissioning Outcomes Framework (COF) and any commissioning guidance in clinical areas that the NHS CB produces. The Commissioning Outcomes Framework will drive up quality improvement by allowing clinical commissioning groups to benchmark their progress and by providing clear comparative information on quality and outcomes to patients and the public. The COF will allow the NHS CB to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.

The Department is not collecting data on the number of national health service organisations that have implemented National Institute for Health and Clinical Excellence (NICE) quality standards. NICE quality standards are not a compliance tool. The Care Quality Commission will inspect against essential standards, but NICE quality standards will continue to define excellence. It will be for commissioners to decide whether, when and how to use them in meeting their obligations to improve outcomes for patients.

The Health and Social Care Act (2012) makes it clear that the NHS Commissioning Board, in discharging its duty to improve the quality of health services:

“must have regard to the quality standards prepared by NICE”.

The NHS Commissioning Board (NHS CB) will, therefore, draw upon NICE NHS quality standards to inform the development of the Commissioning Outcomes Framework (COF) and any commissioning guidance in clinical areas that the NHS CB produces. The Commissioning Outcomes Framework will drive up quality improvement by allowing clinical commissioning groups to benchmark their progress and by providing clear comparative information on quality and outcomes to patients and the public. The COF will allow the NHS CB to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.

The Department is not collecting data on the number of national health service organisations that have implemented National Institute for Health and Clinical Excellence (NICE) quality standards. NICE quality standards are not a compliance tool. The Care Quality Commission will inspect against essential standards, but NICE quality standards will continue to define excellence. It will be for commissioners to decide whether, when and how to use them in meeting their obligations to improve outcomes for patients.

The Health and Social Care Act (2012) makes it clear that the NHS Commissioning Board, in discharging its duty to improve the quality of health services:

“must have regard to the quality standards prepared by NICE”.

The NHS Commissioning Board (NHS CB) will, therefore, draw upon NICE NHS quality standards to inform the development of the Commissioning Outcomes Framework (COF) and any commissioning guidance in clinical areas that the NHS CB produces. The Commissioning Outcomes Framework will drive up quality improvement by allowing clinical commissioning groups to benchmark their progress and by providing clear comparative information on quality and outcomes to patients and the public. The COF will allow the NHS CB to identify the contribution of clinical commissioning groups to achieving the priorities for health improvement in the NHS Outcomes Framework, while also being accountable to patients and local communities.

The National Institute for Health and Clinical Excellence (NICE) undertakes assessments of the evidence base for treatments. Both drug therapy and mindfulness-based cognitive behavioural therapy are approved by NICE for the treatment of recurrent depression.

The “Health Grant” made available to the Thalidomide Trust has no bearing on the work we are doing on palliative care funding.

Following on from the report of the independent Palliative Care Funding review, we are working through eight Palliative Care Funding pilot sites to gather the data and information we need to develop a new per-patient funding system for palliative care for adults and children. The new funding system will cover care regardless of which organisation provides it; encourage more community-based care, so people can remain in their own homes; and be fair and transparent to all organisations involved in end of life care. The aim is to have a new system in place by 2015.

I met with the Thalidomide Trust and members of their National Advisory Council on 12 June 2012. I committed to making and sharing a decision on the way forward with the Trust in the autumn following a thorough evaluation of the ‘Securing Our Future’ report.

Hospital admission rates for anorexia are falling. However, this is one part of a complex picture and there is no room for complacency about this distressing condition. The Department is funding the 'Children and Young People's Improving Access to Psychological Therapies' project, which is transforming child and adolescent mental health services providing training for staff in the National Institute for Health and Clinical Excellence approved best evidence-based therapies and embedding intensive, session by session outcome monitoring to make sure children and young people have improved access to the best possible psychological therapies in a way they find acceptable and relevant.

In year one 2011-12, the therapies offered were cognitive behavioural therapy and parenting programmes for three to 10-year-olds. In 2012-13 as part of the additional investment of £22 million over the next three years announced in February 2012, the

geographical reach of the project will be extended and two further therapies added: systemic family therapy and interpersonal psychotherapy. Together these will help support children, young people and their families and address some of the major mental health problems of adolescence including eating disorders. We are also developing a suite of interactive e-learning programmes to extend the skills and knowledge of all staff working with children and young people, including health professionals, teachers, social workers and others to help them understand and recognise emotional and mental health problems and offer early and effective interventions.

We also welcome the work of the Government Equalities Office's Body Image campaign, which seeks to raise awareness about body image and ensure that young people have healthier and happier futures regardless of their physical appearance.

The Health and Social Care Act (2012) sets out a range of reforms that will improve outcomes and ensure improved access to services. It will also create more local accountability for services for neurological conditions, including those for people with an acquired brain injury. The Department has made no specific assessment.

Specialised rehabilitation services for brain injury and complex disability for all ages form part of the Specialised Services National Definitions set.

Under the Health and Social Care Act (2012), the NHS Commissioning Board (NHSCB) will have responsibility for the direct commissioning of a number of services including those specialised services that are currently commissioned on a national or regional basis.

Work is currently in hand to determine the list of services. No final decisions have yet been made on which services the NHSCB will directly commission from April 2013. Ministers expect to be in a position to set out an initial list in the summer. This will then be subject to consultation with the NHSCB, prior to setting out in regulations.

Health care providers collect administrative and clinical information locally to support the care of patients, including those with acquired brain injury. These data are submitted at regular intervals to the Secondary Uses Services (SUS), which supports health care planning, commissioning, public health and national policy development. The data currently managed within SUS are derived from

commissioning datasets, which providers of national health service care must submit and make available to commissioners. They are also added to the Health Episode Statistics data warehouse.

The Department has received a variety of representations from Members of Parliament and other interested parties on the United Kingdom Acquired Brain Injury Forum's publication, “Life after Brain Injury—A Way Forward”.

This information cannot be provided in the format requested. During 2011-12, we piloted the collection of metastatic and recurrent breast cancer data to identify what information could be collated from routine national health service data and cancer registries. In March 2012, the report ‘Recurrent and Metastatic Breast Cancer Data Collection Project Pilot’ was published. This set out the lessons learned and recommendations for routine collection of data, which is currently under way. A copy of the report has already been placed in the Library.

As we progress with the collection of metastatic and recurrent breast cancer data, we will consider how to make this information routinely available in the future.

The design of the National Breast Cancer Audit will be considered at a specification meeting hosted by the Healthcare Quality Improvement Partnership (HQIP) and chaired by the Department later this year. Interested stakeholders, including patient group representatives, will be invited to the meeting to contribute to the design of the audit. Minutes from this meeting will be published on the HQIP website. Following this meeting, HQIP will invite tender returns for the delivery of this national audit.

Information concerning the number of women with secondary breast cancer who are given access to a clinical nurse specialist (CNS) and the number and proportion of breast cancer patients who are offered a written follow-up care plan, a named individual to contact and other personalised information and support is not collected.

However, ‘The National Report of the 2010 Cancer Patient Experience Survey’, published in December 2010, included a series of questions about CNSs, written information and provision of support. The views of over 67,000 cancer patients were included in the survey results, of which 14,264 had breast cancer. Patients with secondary breast cancer are included in this figure, but are not identified.

Set out in the following table are the responses of patients with breast cancer to questions concerning CNSs, written information and support, presented alongside the results for all cancers.

Datasets for the 2010 National Cancer Patient Experience Survey and the forthcoming 2010-11 survey are based on International Classification of Diseases, 10th Revision (ICD-10) codes. C50 covers all malignant neoplasms of the breast, so patients with secondary or recurrent breast cancer cannot be identified separately.

The National Cancer Survivorship Initiative pilot Patient Reported Outcomes Measures survey of cancer survivors in 2011 asked breast cancer patients how' their cancer responded to treatment. One of the possible responses to this question was ‘My breast cancer has come back after it was originally treated’, so these women will be separately identifiable. Results of the pilot are expected to be published in the autumn.

We know that cancer patients greatly value the care and support of CNSs. To support the national health service to develop the CNS work force, ‘Improving Outcomes: A Strategy for Cancer’ sets out our

intention to build the evidence base for the benefits and costs savings that CNSs can offer. This follows an independent report we published in December 2010 that showed that, in many scenarios, the costs of additional support roles are likely to be outweighed by the savings that can be achieved.

Information concerning the number of women with secondary breast cancer who are given access to a clinical nurse specialist (CNS) and the number and proportion of breast cancer patients who are offered a written follow-up care plan, a named individual to contact and other personalised information and support is not collected.

However, ‘The National Report of the 2010 Cancer Patient Experience Survey’, published in December 2010, included a series of questions about CNSs, written information and provision of support. The views of over 67,000 cancer patients were included in the survey results, of which 14,264 had breast cancer. Patients with secondary breast cancer are included in this figure, but are not identified.

Set out in the following table are the responses of patients with breast cancer to questions concerning CNSs, written information and support, presented alongside the results for all cancers.

Datasets for the 2010 National Cancer Patient Experience Survey and the forthcoming 2010-11 survey are based on International Classification of Diseases, 10th Revision (ICD-10) codes. C50 covers all malignant neoplasms of the breast, so patients with secondary or recurrent breast cancer cannot be identified separately.

The National Cancer Survivorship Initiative pilot Patient Reported Outcomes Measures survey of cancer survivors in 2011 asked breast cancer patients how' their cancer responded to treatment. One of the possible responses to this question was ‘My breast cancer has come back after it was originally treated’, so these women will be separately identifiable. Results of the pilot are expected to be published in the autumn.

We know that cancer patients greatly value the care and support of CNSs. To support the national health service to develop the CNS work force, ‘Improving Outcomes: A Strategy for Cancer’ sets out our

intention to build the evidence base for the benefits and costs savings that CNSs can offer. This follows an independent report we published in December 2010 that showed that, in many scenarios, the costs of additional support roles are likely to be outweighed by the savings that can be achieved.

Information concerning the number of women with secondary breast cancer who are given access to a clinical nurse specialist (CNS) and the number and proportion of breast cancer patients who are offered a written follow-up care plan, a named individual to contact and other personalised information and support is not collected.

However, ‘The National Report of the 2010 Cancer Patient Experience Survey’, published in December 2010, included a series of questions about CNSs, written information and provision of support. The views of over 67,000 cancer patients were included in the survey results, of which 14,264 had breast cancer. Patients with secondary breast cancer are included in this figure, but are not identified.

Set out in the following table are the responses of patients with breast cancer to questions concerning CNSs, written information and support, presented alongside the results for all cancers.

Datasets for the 2010 National Cancer Patient Experience Survey and the forthcoming 2010-11 survey are based on International Classification of Diseases, 10th Revision (ICD-10) codes. C50 covers all malignant neoplasms of the breast, so patients with secondary or recurrent breast cancer cannot be identified separately.

The National Cancer Survivorship Initiative pilot Patient Reported Outcomes Measures survey of cancer survivors in 2011 asked breast cancer patients how' their cancer responded to treatment. One of the possible responses to this question was ‘My breast cancer has come back after it was originally treated’, so these women will be separately identifiable. Results of the pilot are expected to be published in the autumn.

We know that cancer patients greatly value the care and support of CNSs. To support the national health service to develop the CNS work force, ‘Improving Outcomes: A Strategy for Cancer’ sets out our

intention to build the evidence base for the benefits and costs savings that CNSs can offer. This follows an independent report we published in December 2010 that showed that, in many scenarios, the costs of additional support roles are likely to be outweighed by the savings that can be achieved.