Department of Health and Social Care

The Government is committed to putting patients first, including in Lincolnshire. This means making sure that patients, including those waiting to see a phlebotomist, are seen on time, and ensuring that people have the best possible experience during their care.

The Government recognises that care, including phlebotomy, needs to be easily accessible, and in locations convenient to patients, in order to support the shift towards greater care being provided in the community.

That is why in January 2025, we published the Elective Reform Plan. The plan sets out the productivity and reform efforts needed to return to the 18-week constitutional standard by the end of this Parliament. The Elective Reform Plan commits to transforming and expanding diagnostic services and speeding up waiting times for tests, a crucial part of reducing overall waiting times and returning to the 18-week constitutional standard.

Community diagnostic centres, including those in Lincolnshire, are supporting one of the Government’s key strategic shifts, moving care from the hospital to the community. They offer local populations a wide range of diagnostic tests, including those related to phlebotomy, closer to home, as well as greater choice on where and how they are undertaken, reducing the need for hospital visits and speeding up diagnosis, whilst also reducing pressure on hospitals.

We have wasted no time in getting to work cutting National Health Service waiting lists and ensuring people have the best possible experience during their care, including in the Bournemouth West constituency. We promised change, and we’ve delivered early, with a reduction in the list of over 190,000 pathways, and two million extra appointments provided.

The Elective Reform Plan, published in January 2025, sets out a whole system approach to hitting the 18-week referral to treatment target by March 2029, a standard which has not been met consistently since September 2015.

The newly published Planning Guidance for 2025/26 sets a target that 65% of patients wait for 18 weeks or less by March 2026, with every trust expected to deliver a minimum 5% improvement on current performance over that period.

Acupuncturists are not statutorily regulated in the United Kingdom. The Professional Standards Authority for Health and Social Care (PSA) operates a voluntary registers programme, which provides a proportionate means of assurance for unregulated professions and which sits between employer controls and statutory regulation by setting standards for organisations holding voluntary registers for unregulated health and social care occupations.

The British Acupuncture Council (BAcC) holds a register of acupuncturists, which is accredited by the PSA. To gain accreditation from the PSA, organisations must meet its nine Standards for Accredited Registers. These standards require organisations: to have a focus on public protection; to have processes for handling complaints against practitioners; to set appropriate levels of education and training for entry to the register; to require registrants to undertake continuing professional development; and to understand and monitor the risks associated with the practices of registrants.

The BAcC is an independent, representative body and as such, does not fall under Government oversight. Therefore, any decisions about the practice requirements for the professions it represents are a matter for the organisation and its members.

The Government would encourage anyone accessing acupuncture services to establish whether their practitioner is registered with a voluntary register accredited by the PSA, such as that held by the BAcC.

Acupuncturists are not statutorily regulated in the United Kingdom. The Professional Standards Authority for Health and Social Care (PSA) operates a voluntary registers programme, which provides a proportionate means of assurance for unregulated professions and which sits between employer controls and statutory regulation by setting standards for organisations holding voluntary registers for unregulated health and social care occupations.

The British Acupuncture Council (BAcC) holds a register of acupuncturists, which is accredited by the PSA. To gain accreditation from the PSA, organisations must meet its nine Standards for Accredited Registers. These standards require organisations: to have a focus on public protection; to have processes for handling complaints against practitioners; to set appropriate levels of education and training for entry to the register; to require registrants to undertake continuing professional development; and to understand and monitor the risks associated with the practices of registrants.

The BAcC is an independent, representative body and as such, does not fall under Government oversight. Therefore, any decisions about the practice requirements for the professions it represents are a matter for the organisation and its members.

The Government would encourage anyone accessing acupuncture services to establish whether their practitioner is registered with a voluntary register accredited by the PSA, such as that held by the BAcC.

Working with NHS England, we continue to keep the selection process for all applicants to medical speciality training under review.

NHS England launched an extensive engagement and listening exercise to help shape the future of postgraduate medical training in February 2025. This engagement exercise will run through to June, with findings evaluated and reported in the summer.

This data is not held centrally. The Government is committed to prioritising women’s health and improving the care for gynaecological conditions, including endometriosis.

The National Institute for Health and Care Excellence (NICE) published an update to the guideline on endometriosis diagnosis and management in November 2024. This makes firmer recommendations for healthcare professionals on referrals and investigations for women with suspected endometriosis, which will help women receive a diagnosis and treatment more quickly.

For many women with symptoms of endometriosis, the initial pharmacological treatment takes place in primary care and can be in parallel with a referral for further investigations. As a result, looking at diagnosis times alone is unlikely to be the only measure of whether women are receiving care for endometriosis in a timely matter. NHS England is looking into metrics that best reflect the timely access to care and outcomes for women, including for endometriosis. This work will explore whether time to diagnosis is the optimum measure.

An ongoing Office for National Statistics investigation is looking into the impact of endometriosis on women's labour market outcomes. One component of this study is linking primary and secondary care data to better understand diagnosis times for endometriosis.

We are committed to improving women’s health. This will be taken forward as an important part of the 10 Year Plan. The plan will draw on a range of evidence and analyses when establishing our priorities for rebuilding and reforming our health system over the next ten years.

The Department does not have any diversity, equality, or inclusion targets for recruitment. The Department does, however, aim to ensure that its staff are drawn from all walks of life and are representative of the public it serves.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds.

It will remain the policy of the Department and NHS England before, during, and after this transition that information relating to people’s identifiable health and care is shared appropriately, lawfully, and in line with their reasonable expectations.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, as we undertake the integration of NHS England and the Department, to ensure that the expected savings will be reinvested in frontline services to deliver better care for patients.

As part of the necessary changes to support the National Health Service to recover, NHS England has also indicated that integrated care boards (ICBs) should reduce in size. We will work with the NHS to make the necessary choices that are needed to get the NHS back on its feet.

In a letter from Sir Jim Mackey to all ICBs and NHS trusts and foundation trusts on 1 April 2025, NHS England published further detail on the future of the ICBs. This letter is available at the following link:

https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/

NHS Frimley does not currently have contracted support for myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). Patients who require support are offered services within neighbouring systems.

At a national level, the responses to the Department’s Improving the experiences of people with ME/CFS: interim delivery plan consultation, along with continued close engagement with stakeholders, will inform the development of the final ME/CFS delivery plan, which we aim to publish by the end of June 2025. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease, including those in the Surrey Heath constituency.

We also intend to provide additional support to ME/CFS researchers to develop high quality funding applications and access existing National Institute for Health and Care Research and Medical Research Council research funding. All research funding applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. Our forthcoming ME/CFS delivery plan will outline the additional support we will offer to the research community to increase the volume and quality of applications and, therefore, increase the allocation of funding to this area.

We do not anticipate setting up a new centre of excellence for care and research specifically for post-viral or infection-associated conditions. The Department funds research on post-viral conditions through the National Institute for Health and Care Research (NIHR). The NIHR and the Medical Research Council (MRC) remain committed to funding high-quality research to understand the causes, consequences, and treatment of post-viral and infection-associated conditions such as myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), and long COVID, and are actively exploring next steps for stimulating further research in this area. The MRC and NIHR currently fund research through a variety of routes, including infrastructure, research programmes, capacity building, for example with research fellowships, and in the case of the NIHR, research delivery to support recruitment to studies. Funding is available for post-viral and infection-associated research.

The Department commissions the National Institute for Health and Care Excellence (NICE) to undertake Late-Stage Assessments (LSAs) to help commissioners, clinicians, and patients identify the most effective products that offer the best value for the National Health Service.

The NICE’s LSA of intermittent urethral catheters for chronic incomplete bladder emptying focuses on urethral catheters used in primary care and community settings. This will ensure that as more healthcare is delivered in community settings, commissioners, clinicians, and patients will be better informed when identifying the most effective and best value for money intermittent catheters in a crowded market.

The Department is working closely with industry through the Drug Tariff Committee to finalise the detail of the update to the product categorisation and listing process of Part IX of the Drug Tariff. The Department remains committed to ensuring that the reforms represent a positive change for patients, the National Health Service, and the medical technology sector. For example, to support innovation and inward investment, a new two-year temporary listing mechanism will be introduced so that innovative products can be made available for patients more quickly.

The Department commissioned the National Institute for Health and Care Excellence (NICE) to undertake Late-Stage Assessments (LSAs) to help commissioners, clinicians, and patients identify the most effective products that offer the best value for the National Health Service. LSAs benefit health technology manufacturers by giving all manufacturers a transparent, robust, and evidence-based process for demonstrating the added value of their products.

Part IX of the Drug Tariff covers medical technology products prescribed in the community. In 2025, the Department is updating the product categorisation and listing process, following extensive engagement with patient groups, the National Health Service, and industry. The updated categorisation will support the NHS to prescribe the right products for patients. The new listing process will, for the first time, include the patient’s voice and clinical subject matter experts in the decision-making process, and a new temporary listing process will support early access for patients of innovative products able to support the three big shifts.

The Government recognises that racial health inequalities are linked to broader socioeconomic factors. Tackling these inequalities is central to building a fairer health system where outcomes are not dictated by race or background.

Community-led approaches, including peer support and culturally sensitive social prescribing, are integral to preventing poor health outcomes and improving self-management. These will be key features of the upcoming 10-Year Health Plan.

The NHS Framework for Action on Inclusion Health is advancing improvements in culturally competent and trauma-informed care, ensuring services are responsive to the needs of ethnic minority groups and other marginalised populations.

As raised in last year’s health inequalities public board report, the National Health Service has also established the NHS Race and Health Observatory to better understand and address the stark health inequalities experienced by black and minority ethnic communities. Further information on last year’s health inequalities public board report and the NHS Race and Health Observatory is available, respectively, at the following two links:

https://www.england.nhs.uk/long-read/annual-report-on-nhs-englands-work-on-healthcare-inequalities-and-the-nhs-race-and-health-observatory-2/

https://www.nhsrho.org/about-us/

Integrated care boards (ICBs) are responsible for commissioning services for people with long COVID. ICBs are allocated funding by NHS England to meet local need and priorities, and to improve outcomes.

Due to the very low numbers of patients with long COVID now being referred for treatment, NHS Frimley has taken the decision to no longer operate dedicated long COVID services. As of 18 March 2025, patients presenting with symptoms that may be linked to long COVID will be referred, depending on their symptoms, to other available services, including chronic fatigue services, occupational therapy, physiotherapy, and mental health services such as talking therapies.

Every effort will be made to ensure that patients who are currently accessing the long COVID services complete their therapy and are transferred to other services specific to their need, if appropriate.

NHS Frimley recognises that this decision may cause concern for people who have been receiving care from its long COVID services. However, patients will continue to receive support and advice, and NHS Frimley is working with the providers of long COVID services to ensure that current patients complete their care treatment.

Anyone who has a long-term symptom following COVID-19 and needs assistance should speak to their general practitioner.

Tackling health inequalities is a priority for the Government. Men aged 50 years old or over can ask their general practitioner for a Prostate-Specific Antigen (PSA) test, even if they do not have symptoms. This applies to anyone aged 50 years old or over in any part of England.

Screening for prostate cancer is currently not recommended in the United Kingdom. This is because of the inaccuracy of the current best test. Whilst it is recognised that the PSA test can be a valuable diagnostic tool in certain contexts, such as for men who present with symptoms, its limitations mean it is not currently recommended for population-level screening.

We are finding the best way to test for prostate cancer, which is why we are investing £16 million towards the Prostate Cancer UK led TRANSFORM screening trial, which is seeking to find better ways of catching prostate cancer in men.

The UK National Screening Committee, an independent scientific committee which advises ministers on screening, is also currently reviewing the evidence for both population wide screening and targeted prostate cancer screening. If the UK National Screening Committee makes a positive recommendation regarding screening for prostate cancer, an impact assessment will be produced using the HM Treasury Green Book methodology, which considers wider social and economic impacts.

Tackling health inequalities is a priority for the Government. Men aged 50 years old or over can ask their general practitioner for a Prostate-Specific Antigen (PSA) test, even if they do not have symptoms. This applies to anyone aged 50 years old or over in any part of England.

Screening for prostate cancer is currently not recommended in the United Kingdom. This is because of the inaccuracy of the current best test. Whilst it is recognised that the PSA test can be a valuable diagnostic tool in certain contexts, such as for men who present with symptoms, its limitations mean it is not currently recommended for population-level screening.

We are finding the best way to test for prostate cancer, which is why we are investing £16 million towards the Prostate Cancer UK led TRANSFORM screening trial, which is seeking to find better ways of catching prostate cancer in men.

The UK National Screening Committee, an independent scientific committee which advises ministers on screening, is also currently reviewing the evidence for both population wide screening and targeted prostate cancer screening. If the UK National Screening Committee makes a positive recommendation regarding screening for prostate cancer, an impact assessment will be produced using the HM Treasury Green Book methodology, which considers wider social and economic impacts.

NHS England and other National Health Service organisations, nationally and locally, publish information on the signs and symptoms of many different types of cancer, including those that are most common in teenagers and young adults. Further information on cancer signs and symptoms is available on the NHS.UK website.

The Department is committed to improving outcomes for teenagers and young adults with cancer. That’s why we have relaunched the Children and Young People Cancer Taskforce. The taskforce will explore opportunities for improvement in England, including detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience. The taskforce will ensure that the unique needs of children and young people, including teenagers with cancer, are carefully considered as part of the National Cancer Plan for England, due to be published later this year.

As part of this work, the Department is committed to directly engaging with patients and their families to discuss their experiences. We are working with taskforce members to assemble a Patient Experience Panel, made up of young people with lived experience of cancer and their families, which will feed directly into the work of the taskforce.

NHS England and other National Health Service organisations, nationally and locally, publish information on the signs and symptoms of many different types of cancer, including those that are most common in teenagers and young adults. Further information on cancer signs and symptoms is available on the NHS.UK website.

The Department is committed to improving outcomes for teenagers and young adults with cancer. That’s why we have relaunched the Children and Young People Cancer Taskforce. The taskforce will explore opportunities for improvement in England, including detection and diagnosis, genomic testing and treatment, research and innovation, and patient experience. The taskforce will ensure that the unique needs of children and young people, including teenagers with cancer, are carefully considered as part of the National Cancer Plan for England, due to be published later this year.

As part of this work, the Department is committed to directly engaging with patients and their families to discuss their experiences. We are working with taskforce members to assemble a Patient Experience Panel, made up of young people with lived experience of cancer and their families, which will feed directly into the work of the taskforce.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.

At this stage, while we are scoping the programme, it is too early to say what the precise changes in organisational design will be.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.

At this stage, while we are scoping the programme, it is too early to say what the precise changes in organisational design will be.

Responsibility for commissioning ambulance services is a matter for the local integrated care board. The London Ambulance Service received £704.2 million in the financial year 2024/25.

The information requested is not held. Decisions on the use of private ambulance companies to increase capacity are taken at a local level by the relevant ambulance trust.

At a national level, the Government and NHS England are committed to improving ambulance services. The National Health Service’s 2025/26 priorities and operational planning guidance set national priorities, which include improving accident and emergency waiting times and ambulance response times compared to 2024/25.

The information requested is not held. Decisions on the use of private ambulance companies to increase capacity are taken at a local level by the relevant ambulance trust.

At a national level, the Government and NHS England are committed to improving ambulance services. The National Health Service’s 2025/26 priorities and operational planning guidance set national priorities, which include improving accident and emergency waiting times and ambulance response times compared to 2024/25.

This data is not held in the format requested. As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from referral to treatment by March 2029, a standard which has not been met consistently since September 2015.

We have delivered an additional two million appointments, seven months ahead of schedule. This includes operations, consultations, diagnostic tests, and treatments. These additional appointments have taken place across a number of specialities, including neurology.

Whilst no specific assessment has been made of how workforce shortages are impacting the delivery of care, there are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the Neurology Transformation Programme.

We have launched a 10-Year Health Plan to reform the National Health Service. The plan will set out a bold agenda to deliver on the three big shifts needed, to move healthcare from hospital to the community, from analogue to digital, and from treatment to prevention.

A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

We have delivered an additional two million appointments, seven months ahead of schedule. This includes operations, consultations, diagnostic tests, and treatments. These additional appointments have taken place across a number of specialities, including neurology.

Whilst no specific assessment has been made of how workforce shortages are impacting the delivery of care, there are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the Neurology Transformation Programme.

We have launched a 10-Year Health Plan to reform the National Health Service. The plan will set out a bold agenda to deliver on the three big shifts needed, to move healthcare from hospital to the community, from analogue to digital, and from treatment to prevention.

A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

No specific assessment has been made of the adequacy of the availability of hernia operations. Integrated care boards are responsible for commissioning services, considering the needs of their local population and national guidance, such as that from the National Institute for Health and Care Excellence.

There are several types of hernia and therefore decisions about the eligibility to treat will be based on guidelines and clinical judgement appropriate to the individual circumstances.

No assessment has been made of the potential merits of adopting intelligent booking systems to maximise the utilisation of the National Health Service’s property estate. NHS trusts decide locally how best to manage their estate.

Data for the occupancy and utilisation rates of clinical rooms in the NHS estate for the latest period, from 2023 to 2024, published in December 2024, is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2023-24

No estimate has been made of the cost to the NHS of unused and underused clinical buildings and rooms.

No assessment has been made of the potential merits of adopting intelligent booking systems to maximise the utilisation of the National Health Service’s property estate. NHS trusts decide locally how best to manage their estate.

Data for the occupancy and utilisation rates of clinical rooms in the NHS estate for the latest period, from 2023 to 2024, published in December 2024, is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2023-24

No estimate has been made of the cost to the NHS of unused and underused clinical buildings and rooms.

No assessment has been made of the potential merits of adopting intelligent booking systems to maximise the utilisation of the National Health Service’s property estate. NHS trusts decide locally how best to manage their estate.

Data for the occupancy and utilisation rates of clinical rooms in the NHS estate for the latest period, from 2023 to 2024, published in December 2024, is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2023-24

No estimate has been made of the cost to the NHS of unused and underused clinical buildings and rooms.

The Department recognises the importance of understanding the experiences of women living with endometriosis. In 2023, the Department commissioned the Women's Reproductive Health Survey to gather views on women’s experiences in all aspects of their reproductive health, including menstrual problems and endometriosis. A report on the initial findings has been published, and is available at the following link:

https://www.lshtm.ac.uk/research/centres-projects-groups/reproductive-health-survey-england#research

The Department will update plans to conduct the survey again in due course. The Department also commissions research through the National Institute for Health and Care Research (NIHR). The NIHR has recently funded a qualitative study into patient and healthcare professionals' experiences of the management, diagnosis, and treatment of endometriosis. Further information is available at the following link:

https://fundingawards.nihr.ac.uk/award/NIHR156216.

An ongoing Office for National Statistics study is investigating the impact of endometriosis on women's labour market outcomes. One component of this study is linking primary and secondary care data to better understand diagnosis times for endometriosis.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds.

The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job. We will empower staff to focus on delivering better care for patients, driving productivity up, and getting waiting times down.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds.

The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job. We will empower staff to focus on delivering better care for patients, driving productivity up, and getting waiting times down.

The Department has made no assessment of the potential merits of offering guidance or funding support for charities who are assisting refugees with medical qualifications into the National Health Service.

Many regulators, royal colleges, and other organisations provide support or prioritise services for refugees, including some flexibility in the information that candidates need to provide for employment checks.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new, licenced medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by the NICE for eligible patients in line with its recommendations.

The NICE has published guidance recommending abiraterone for the treatment of metastatic hormone-relapsed prostate cancer before chemotherapy is indicated and for castration-resistant metastatic prostate cancer previously treated with a docetaxel-containing regimen. NHS England funds abiraterone for these indications of prostate cancer in line with the NICE’s recommendations, making it routinely available for clinicians to prescribe to eligible patients.

NHS England considered abiraterone as an off-label treatment for hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process, NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication and it was ranked in the highest priority level. However, NHS England could not identify the necessary recurrent funding to support commissioning of abiraterone, or any other treatments within the prioritisation round. Ministers are considering further advice on this issue.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that its independent committees use in their evaluations, independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022 as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024, and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis, Duchenne muscular dystrophy, childhood epilepsy, hepatitis D, and sickle cell disease. The NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that its independent committees use in their evaluations, independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022 as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024, and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis, Duchenne muscular dystrophy, childhood epilepsy, hepatitis D, and sickle cell disease. The NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that its independent committees use in their evaluations, independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022 as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024, and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis, Duchenne muscular dystrophy, childhood epilepsy, hepatitis D, and sickle cell disease. The NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that its independent committees use in their evaluations, independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022 as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024, and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis, Duchenne muscular dystrophy, childhood epilepsy, hepatitis D, and sickle cell disease. The NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

We have committed to tackling waiting lists and getting back to the National Health Service constitutional standard, that 92% of patients should wait no longer than 18 weeks from referral to treatment, by March 2029. We will use every lever to do this, and independent sector providers have a key role to play.

A new partnership agreement between the NHS and the independent sector was published in January 2025, the first of its kind for 25 years. The aim of this agreement is to ensure that private providers and the NHS work closely together to tackle waiting lists and improve elective services, providing NHS patients with the ability to choose to be treated privately where there is capacity, at no cost to them. The independent sector committed to reviewing their clinical exclusion criteria to ensure that they allow the choice of an independent provider to as broad a cohort of patients as possible. The agreement also set a shared goal to improve access to treatment in the independent sector for the most challenged specialties.

Local systems are best placed to commission activity, considering the patients and providers in their area, and ensuring assets are utilised effectively, and that patients requiring urgent procedures are treated quickly. All patients should be offered a choice of provider at the point of referral, including independent providers where clinically appropriate, and should be provided with information on waiting times to inform their decision.