The Government is committed to putting patients first, by making sure that they are seen on time and that they have the best possible experience of care, including those with digestive system disorders. We have committed to getting back to the National Health Service constitutional standard that at least 92% of people should wait no longer than 18 weeks from referral to treatment, and we have already made progress, exceeding our pledge to deliver an extra two million operations, scans, and appointments, with over three million more delivered between July 2024 and January 2025.

In January, we published the Elective Reform Plan. This commits to pathway reform starting in five areas, with gastroenterology being one. The commitment is to develop an integrated pathway across primary, community, and secondary care for common gastroenterology conditions. We will also drive the rapid adoption of remote monitoring in appropriate gastroenterology pathways, which reduces consultant-led outpatient appointments by over 50%.

The plan also commits to work with patients, carers, and their representatives to publish the standards patients should expect to experience while they wait for care, including for those waiting for gastroenterology services.

The use of transanal submucosal resection techniques for bowel treatment on the National Health Service would be a decision for clinical commissioning groups (CCGs). NHS England expects CCGs to take account of the National Institute for Health and Care Excellence guidelines and local population needs when making commissioning decisions.

The Medicines and Healthcare products Regulatory Agency (MHRA) continuously monitors the safety of all medicines on the market in the United Kingdom and seeks independent expert advice from the Commission on Human Medicines on important new safety issues. The MHRA is aware of a recently published United States study which reported that use of particular types of gastrointestinal (GI) drug known as proton pump inhibitors (PPIs) were associated with an increased risk of death when compared with use of other types of GI medication known as H2 receptor blockers.

As with all medicines, all new evidence on the safety of PPIs is kept under close review and this latest study will be carefully considered and any new advice for healthcare professionals or patients will be communicated.

There have not been any discussions by MHRA with clinical bodies on this issue.

PPIs are effective medicines in treating and preventing stomach ulcers and other GI disorders, and any patients on a PPI should continue their treatment as recommended by their healthcare professional.

Up to date information on the number of people waiting for lung and pancreas transplant can be found on the NHS Blood and Transplant website at:

https://www.organdonation.nhs.uk/supporting-my-decision/statistics-about-organ-donation/

Five individuals are on the waiting list for intestinal transplants which include the small bowel.

NHS Blood and Transplant does not maintain a national transplant list for corneas and tissues. These lists are maintained at local hospital level with surgical teams requesting corneas and tissues for a specific date. If the requested tissues are available they will then be issued to the hospital by NHS Blood and Transplant. Waiting list figures can fluctuate daily as patients are removed or added to the transplant list as their condition improves or deteriorates.

Responsibility for continence services sits with NHS England and clinical commissioning groups (CCGs). NHS England has advised that no assessment has been made on the effectiveness on the guidance issued to doctors and nurses on diagnosing blocked bowels in the elderly.

NHS England is responsible for the commissioning of specialised colorectal services and has produced a number of service specifications on various types of incontinence, clearly defining what is expected to be in place for providers to offer evidence-based, safe and effective services. Service specifications published by NHS England on colorectal services include Colorectal Complex Inflammatory Bowel Disease (Adult) and Colorectal services: faecal incontinence (adults).

CCGs are responsible for commissioning a high quality continence service for their local populations and performance managing their providers in the delivery of high quality services.

We expect providers of colorectal services and continence care to take into account any relevant National Institute for Health and Care Excellence guidance on diagnosing blocked bowels.

We are fully committed to improving early diagnosis and treatment of people with oesophageal cancer both nationally and locally. Alongside supporting Public Health England to increase symptom awareness amongst the general population, NHS England are also working to increase cancer symptom awareness amongst healthcare professionals, and to provide support to general practitioners in early diagnosis of cancer and pre-cancerous conditions.

NHS England’s oesophageal and gastric cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective oesophageal cancer services, in line with the National Institute for Health and Care Excellence’s clinical guideline, published in 2001, Improving Outcomes for Upper Gastro-Intestinal Cancers.

Public Health England will run a national Be Clear on Cancer campaign from 26 January to the end of February 2015 aimed at men and women aged 50 years and over, to raise awareness of oesophageal and stomach cancers. This campaign will also aim to identify patients with Barrett’s oesophagus, a possible or potential precursor to oesophageal cancer. Campaign plans are still to be finalised but are likely to include television, radio, press, digital and out of home advertising.

The decision to run this campaign was based on the evidence of significant impact from the regional campaign which ran in the Northern England Strategic Clinical Network region from February to March 2014.

The information is not available in the format requested. The total number of flexible-sigmoidoscopy tests undertaken by National Health Service trusts, foundation trusts and independent sector organisations from 2011-12 to 2013-14 is provided in the following table. This national dataset includes all routes of referral for diagnostic tests including general practitioners (GPs), hospital based and other routes of referral. It does not separately identify where the tests were commissioned.

Table: number of flexible-sigmoidoscopy tests, 2011-12 to 2013-14

Source: NHS England monthly diagnostics waiting times and activity

Notes:

1. The data includes all referral routes (i.e. whether the patient was referred by a GP or by a hospital-based clinician or other route) and also all settings (i.e. outpatient clinic, inpatient ward, x-ray department, primary care one-stop centres etc.)

The National Institute for Health and Care Excellence (NICE) has not published guidance specifically on bowel management.

NICE has published a number of related clinical guidelines including on the management of faecal incontinence in adults (CG49), irritable bowel syndrome (CG61), Crohn's disease (CG152) and colorectal cancer (CG131).

NICE regularly reviews its clinical guidelines to ensure they take account of the available evidence base.

NICE Pathways are online resources that represent all of NICE's current guidance on a particular topic. NICE Pathways are updated when the associated NICE guidance or quality standards are updated.

The National Institute for Health and Care Excellence (NICE) has not published guidance specifically on bowel management.

NICE has published a number of related clinical guidelines including on the management of faecal incontinence in adults (CG49), irritable bowel syndrome (CG61), Crohn's disease (CG152) and colorectal cancer (CG131).

NICE regularly reviews its clinical guidelines to ensure they take account of the available evidence base.

NICE Pathways are online resources that represent all of NICE's current guidance on a particular topic. NICE Pathways are updated when the associated NICE guidance or quality standards are updated.

The Shropshire and Staffordshire area team does not hold a budget for specialised commissioning.

NHS England is responsible for commissioning specialised services. The prime objective of NHS England is to drive improvement in the quality of the NHS services, and the Government will hold them to account for this through the NHS Mandate.

NHS England is implementing a single operating model for the commissioning of 143 specialised services. This replaces the previous arrangements whereby 10 regional organisations were responsible for commissioning specialised services and where there was wide variation in the range, quality and access to specialised services that were commissioned.

Single nationally agreed service specifications are being developed for each of the 143 services to ensure that patients have equitable access to high quality services, regardless of where they live in England.