Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to move care for chronic obstructive pulmonary disease from hospitals into community settings.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England is leading on the development of an approach for chronic obstructive pulmonary disease management to support proactive identification and management of rising risk patients in winter to reduce demand on primary and secondary care. The approach fully aligns with a Neighbourhood Health Service model and includes: identification of rising risk patients through a nationally developed search tool for use in General Practice IT and clinical review; optimisation of care through an in depth OPTIMISE review by a respiratory specialist in an integrated team to prevent deterioration; support and management through remote monitoring and a greater focus on self-management and education; and strengthened support via access to support in the community, for example, through out of hours and seven-day service.

OPTIMISE includes eight processes of care:

• optimise treatment;
• pulmonary rehabilitation;
• tobacco dependence;
• inhaler technique;
• maximising vaccination coverage;
• increasing physical activity;
• support for psychological wellbeing; and
• education and self-management.

To assist with the testing of this approach and to support services this winter, NHS England has developed a range of accompanying resources, including a patient search tool to identify potential patients who would benefit from review and a template to support the OPTIMISE review.

Question to the Department for Energy Security & Net Zero:

To ask His Majesty's Government what plans they have to discuss linking the respective emissions trading schemes of the UK and EU at the UK-EU Leaders Summit on 19 May 2025.

Answered by Lord Hunt of Kings Heath - Minister of State (Department for Energy Security and Net Zero)

Under the terms of the Trade and Cooperation Agreement (TCA), the UK Government and EU agreed to give serious consideration to linking our respective carbon pricing schemes and to cooperate on carbon pricing. As part of our reset with the EU the Government continues to explore all options to improve trade and investment.

Question to the Department for Energy Security & Net Zero:

To ask His Majesty's Government what assessment they have made of the impact on clean energy investment in Northern Ireland of the EU Carbon Border Adjustment Mechanism.

Answered by Lord Hunt of Kings Heath - Minister of State (Department for Energy Security and Net Zero)

The EU’s Carbon Border Adjustment Mechanism (CBAM) is in an implementation period and applies to exports of electricity to the EU but not electricity for the UK market. The EU Commission has said that it intends to finalise the regulation via legislation ahead of the CBAM entering its definitive period.

The UK will continue to engage closely with the EU as it finalises the CBAM and will continue to raise the need for clarity on the practical implementation of the CBAM for trade in electricity, given the challenges involved.

Question to the Department for Science, Innovation & Technology:

To ask His Majesty's Government when they expect the Independent Pornography Review conducted by Baroness Bertin to be completed and published.

Answered by Baroness Jones of Whitchurch - Baroness in Waiting (HM Household) (Whip)

The Independent Pornography Review assessed the effectiveness of current pornography legislation, regulation and enforcement. The Review has now concluded, and the report was published on Thursday 27 of February 2025. It is available at: https://www.gov.uk/government/publications/creating-a-safer-world-the-challenge-of-regulating-online-pornography.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many single technology appraisals of medicines conducted by the National Institute for Health and Care Excellence for (1) non-orphan medicines and (2) orphan medicines resulted in (a) a positive recommendation, (b) an optimised recommendation, (c) a recommendation for managed access, (d) a negative recommendation and (e) termination in each financial year since 2022–23.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The number and percentage of orphan and non-orphan medicines appraised by the National Institute of Health and Care Excellence through its Technology Appraisal and Highly Specialised Technology work programmes is presented in the attached table. Orphan drugs are drugs that are intended for the treatment or prevention of rare and severe diseases, that provide significant benefit to those affected by the condition.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when the National Institute for Health and Care Excellence will publish its report on the impact of its 2022 manual changes as set out in the England Rare Diseases Action Plan 2024.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

In the 2022 England Rare Diseases Action Plan, action 13 committed to capitalising on the changes made to the National Institute for Health and Care Excellence’s (NICE) methods and processes to ensure that NICE continues to support the rapid adoption of effective new treatments for National Health Service patients with rare diseases. An update was provided in the 2024 action plan, pointing to ongoing work to review the impact of the severity modifier and the highly specialised technology criteria.

NICE has now concluded its review of the implementation of the severity modifier and its report was presented to the NICE board in September 2024. NICE’s approval rate overall has increased compared with its previous methods and the severity modifier has contributed to an increase in positive decisions for both cancer and non-cancer medicines. The severity modifier has been applied to diseases including non-end-of-life cancers as well as non-cancer conditions that have dramatic and far-reaching impacts on patients, such as cystic fibrosis and chronic hepatitis D. A copy of the report is attached.

The 2025 England Rare Diseases Action Plan was published on 28 February 2025 providing further updates on progress on this action.

Question to the Department of Health and Social Care:

To ask His Majesty's Government further to the Written Answers by Baroness Merron on 27 January (HL4224 and HL4225), what steps they are taking to ensure hospitals meet the Commissioning for Quality and Innovation target of revascularisation in patients with chronic limb-threatening ischaemia within five days of admission.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

In 2022, NHS England commissioned the two-year Commissioning for Quality and Innovation (CQUIN) scheme, which incentivised the adoption of the Vascular Peripheral Arterial Disease Quality Improvement Framework, to support timely interventions for revascularisation. This measures the proportion of patients who have a diagnosis of chronic limb threatening ischaemia (CLTI) and who undergo revascularisation within five days of a non-elective admission to vascular providers.

NHS England commissions the National Vascular Registry (NVR) to provide information on the quality and outcomes of care for adults who have major vascular procedures. The NVR provides annual and quarterly reports for emergency and elective vascular procedures, including for those people with peripheral arterial disease who undergo either a lower limb angioplasty/stent, lower limb bypass surgery, or major lower limb amputation. From quarter one of 2022 to quarter four of 2024, NVR data demonstrated that vascular providers achieving the CQUIN standards had increased from 47% to 55%. During this period, the number of providers submitting data to the NVR had increased by approximately 14%, and every National Health Service region showed an improvement in CLTI revascularisation quality.

Furthermore, NHS England has commissioned the NVR to facilitate an ‘outliers’ process in which vascular providers are monitored on several key performance metrics, including CLTI revascularisation. NHS England continues to monitor all specialised vascular disease services via the NVR, working in collaboration with NHS England regional teams and integrated care boards.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to make administrative processes in the NHS a priority for staff and patients, and to set goals for improving and measuring people’s experience of administration.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government is committed to improving National Health Service administrative processes, which are a crucial factor for patient experience. This includes reforming the digital landscape to improve efficiency and convenience for patients. We are changing the NHS App as part of our shift from an analogue to digital service, to make it quicker and easier for patients to access information about appointments. By the end of March 2025, 85% of acute trusts will enable patients, who wish to use it, to view appointment information via the NHS App.

Two-way communication, for example via patient engagement portals, is also important and enables patients and their healthcare team to send messages and documents. An improved NHS App will help with this, and NHS England will provide support to all acute trusts adopting these technologies.

In addition to improving communication with patients, we are taking action to reduce the burden of administration for clinicians in between seeing patients. This includes the Red Tape Challenge, launched in October 2024 by the Government and NHS England, which is looking to address bureaucracy between primary and secondary care to ensure health professionals can make the most effective use of clinical time.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government how the Circular Economy Taskforce will engage with ministers and the healthcare sector to coordinate work to develop a circular health economy.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

This Government is committed to transitioning to a circular economy. The Secretary of State for Environment, Food and Rural Affairs has convened the Circular Economy Taskforce to help us develop a Circular Economy Strategy for England, which will be supported by with a series of roadmaps detailing the interventions that the government and others will make on a sector-by-sector basis.

This is a cross-government agenda and together we are considering the evidence for interventions right across the economy. We are exploring the circularity impacts of a wide range of levers, including in the health sector, as we develop our strategy.

Furthermore, the Department of Health and Social Care’s (DHSC) Design for Life programme is dedicated to the delivery of a circular economy for medical devices, through greater reuse, remanufacture, and recycling. DHSC published the Design for Life Roadmap in October 2024, which sets out the plan to achieve this vision and transition away from all avoidable single-use medical technology products by 2045.

Question to the Cabinet Office:

To ask His Majesty's Government what steps they intend to take to ensure that the principles of the Windsor Framework are not compromised as a result of the EU Carbon Border Adjustment Mechanism.

Answered by Baroness Anderson of Stoke-on-Trent - Baroness in Waiting (HM Household) (Whip)

We intend to apply UK CBAM across the UK including in NI. The EU's CBAM could only apply in Northern Ireland with the agreement of the UK and in line with the democratic safeguards of the Windsor Framework. The UK will continue to work with international partners, including the EU, to ensure our approach is implemented in a way that works for businesses.

Question to the Northern Ireland Office:

To ask His Majesty's Government what assessment they have made of the EU Carbon Border Adjustment Mechanism's impact on the cost of electricity for households and businesses in Northern Ireland.

Answered by Baroness Anderson of Stoke-on-Trent - Baroness in Waiting (HM Household) (Whip)

The Government plans to apply the UK CBAM across the whole UK, including Northern Ireland, from 2027. The UK will continue to work with international partners, including the EU, to ensure our approach is implemented in a way that works for businesses.

The EU's CBAM could only apply in Northern Ireland with the agreement of the UK and in line with the democratic safeguards of the Windsor Framework.

Question to the HM Treasury:

To ask His Majesty's Government whether they (1) are preparing, and (2) will provide, guidance to businesses in Northern Ireland on the impact of the EU Carbon Border Adjustment Mechanism.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

Following its transitional period, the EU Carbon Border Adjustment Mechanism (CBAM) will enter its definitive regime from January 2026. UK officials have been discussing CBAM requirements with the EU and engaging affected businesses to support them in responding to new requirements.

For goods moving from Northern Ireland into the EU, guidance is a matter for the European Commission and EU Member States. The Commission website [1] is the most up to date source of information for businesses seeking guidance on requirements.

Businesses experiencing EU market access issues in relation to CBAM may wish to seek additional support via the Government’s UK Export Support Service [2].

[1] https://taxation-customs.ec.europa.eu/carbon-border-adjustment-mechanism_en

[2] https://www.great.gov.uk/support/get-in-touch/

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government when the communique for the Inter-Ministerial Group for Environment, Food and Rural Affairs held on 27 January will be published on Gov.uk.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

The communique was published on 26 February 2025 and can be accessed here.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government, further to the Written Answer by Lord Collins of Highbury on 17 February (HL4711), what steps they are taking develop a policy on tackling the dehumanisation of Palestinians.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

We recognise that dehumanising language and hate speech can lay the ground for and seek to justify identity-based violence in conflict. The proliferation of harmful online narratives and its impact on conflict is an emerging challenge. Partnering with specialist organisations, the Foreign, Commonwealth and Development Office (FCDO) is working to identify global best practices for mitigating harmful digital behaviours in conflict - including misinformation, disinformation and hate speech - and considering how action on such digital harms can be integrated into our wider approach to conflict and atrocity prevention.

Found: Elliott of Mickle Fell; Baroness Goudie; Lord Hope of Craighead; Baroness Pitkeathley; Baroness Ritchie of Downpatrick

Found: Elliott of Mickle Fell; Baroness Goudie; Lord Hope of Craighead; Baroness Pitkeathley; Baroness Ritchie of Downpatrick

Found: that affected smaller numbers of patients.118 PQs NHS: Drugs, UIN HL5175 Asked by: Baroness Ritchie of Downpatrick

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