Question to the HM Treasury:

To ask His Majesty's Government whether the Trader Support Service procurement process includes assessment of bidders' previous contract performance.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The Trader Support Services contract is being procured in compliance with the Public Contracts Regulations 2015. As part of its procurement process, HMRC rigorously assesses any bidders and proposed contracts to ensure their suitability to deliver this service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 June (HL8217), whether they have considered the recommendation from the European Food Safety Authority to the European Commission in March 2023 to revise the maximum levels of nitrites allowed in food down to a "safe" level of 0.07mg per kg of body weight per day.

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

The Food Standards Agency (FSA) considers that the existing levels of nitrites, approved food additives, provide sufficient protection for consumers. The FSA is aware of the changes made by the European Union, but has no plans to alter the maximum levels currently in legislation, because they remain important preservatives in a range of foods. As with all food additives, they have undergone safety assessments before authorisation and have been subject to various reviews both at a national and international level.

The FSA continues to keep new evidence under review as part of our rolling surveillance for previously authorised food additives. A review of the safety of nitrates and nitrites as food additives has been recently commissioned and will report back any significant changes in the supporting evidence base.

Current Government advice on red and processed meat consumption is based on the Scientific Advisory Committee on Nutrition’s (SACN) report Iron and Health published in 2010. More recent studies demonstrating nitrites as a plausible mechanism for the correlation of red and processed meat intake and an increased risk of cancer have not yet been considered by the SACN. However, the committee is due to consider the topic of iron, which will likely include an assessment of the risks and benefits in relation to red and processed meat consumption.

In relation to processed foods more broadly, the SACN’s April 2025 rapid evidence update on processed foods and health found that the categories of processed food consistently associated with adverse health outcomes, including cancer, included meat and animal products. The SACN therefore reiterated its existing advice on processed foods, including avoiding high intakes of red and processed meat.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 June (HL8217), whether they have considered the findings of more recent studies demonstrating nitrites as a plausible mechanism for the correlation of red and processed meat intake and an increased risk of cancer.

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

The Food Standards Agency (FSA) considers that the existing levels of nitrites, approved food additives, provide sufficient protection for consumers. The FSA is aware of the changes made by the European Union, but has no plans to alter the maximum levels currently in legislation, because they remain important preservatives in a range of foods. As with all food additives, they have undergone safety assessments before authorisation and have been subject to various reviews both at a national and international level.

The FSA continues to keep new evidence under review as part of our rolling surveillance for previously authorised food additives. A review of the safety of nitrates and nitrites as food additives has been recently commissioned and will report back any significant changes in the supporting evidence base.

Current Government advice on red and processed meat consumption is based on the Scientific Advisory Committee on Nutrition’s (SACN) report Iron and Health published in 2010. More recent studies demonstrating nitrites as a plausible mechanism for the correlation of red and processed meat intake and an increased risk of cancer have not yet been considered by the SACN. However, the committee is due to consider the topic of iron, which will likely include an assessment of the risks and benefits in relation to red and processed meat consumption.

In relation to processed foods more broadly, the SACN’s April 2025 rapid evidence update on processed foods and health found that the categories of processed food consistently associated with adverse health outcomes, including cancer, included meat and animal products. The SACN therefore reiterated its existing advice on processed foods, including avoiding high intakes of red and processed meat.

Question to the Cabinet Office:

To ask His Majesty's Government what ongoing contractor monitoring and accountability processes are in place to ensure value for money and service quality.

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

The impact of the Horizon scandal on postmasters and their families has been horrendous. The Government is determined to hold those responsible to account and will continue to seek to make rapid progress on compensation and redress. Fujitsu’s role in Horizon is one of the issues currently being reviewed by Sir Wyn Williams’s statutory inquiry. The Government are carefully considering volume 1 of the report. Once the inquiry has established the full facts, we will review its final report and consider any further action, where appropriate.

In January 2024, Fujitsu committed to withdraw from bidding for contracts with new government customers until the Post Office Horizon inquiry concludes. It will bid for work with existing government customers only where it already has a contract with them or where there is an agreed need for Fujitsu’s skills and capabilities.

Individual contracting authorities are responsible for the award and management of contracts. With regard to scrutiny during procurement processes, the Procurement Act 2023 enables and, where appropriate, requires the exclusion of suppliers where they pose particular risks to public procurement. The Cabinet Office has issued substantial guidance for departments, available on gov.uk. The exclusions regime provides a framework within which contracting authorities must consider a supplier’s recent past behaviour and circumstances (or their presence on the debarment list) to determine whether it should be allowed to compete for or be awarded a public contract.

The National Procurement Policy Statement asks contracting authorities to ensure they have the appropriate procurement and contract management skills and capability necessary to deliver public contracts and encourages the use of collaborative procurement frameworks, where appropriate, to deliver value for money.

To provide transparency, the government regularly publishes Key Performance Indicators (KPIs) for its most important contracts, and the performance of the vendor against those KPIs.

Question to the Cabinet Office:

To ask His Majesty's Government what steps they are taking to ensure that Fujitsu is subject to enhanced scrutiny during procurement processes.

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

The impact of the Horizon scandal on postmasters and their families has been horrendous. The Government is determined to hold those responsible to account and will continue to seek to make rapid progress on compensation and redress. Fujitsu’s role in Horizon is one of the issues currently being reviewed by Sir Wyn Williams’s statutory inquiry. The Government are carefully considering volume 1 of the report. Once the inquiry has established the full facts, we will review its final report and consider any further action, where appropriate.

In January 2024, Fujitsu committed to withdraw from bidding for contracts with new government customers until the Post Office Horizon inquiry concludes. It will bid for work with existing government customers only where it already has a contract with them or where there is an agreed need for Fujitsu’s skills and capabilities.

Individual contracting authorities are responsible for the award and management of contracts. With regard to scrutiny during procurement processes, the Procurement Act 2023 enables and, where appropriate, requires the exclusion of suppliers where they pose particular risks to public procurement. The Cabinet Office has issued substantial guidance for departments, available on gov.uk. The exclusions regime provides a framework within which contracting authorities must consider a supplier’s recent past behaviour and circumstances (or their presence on the debarment list) to determine whether it should be allowed to compete for or be awarded a public contract.

The National Procurement Policy Statement asks contracting authorities to ensure they have the appropriate procurement and contract management skills and capability necessary to deliver public contracts and encourages the use of collaborative procurement frameworks, where appropriate, to deliver value for money.

To provide transparency, the government regularly publishes Key Performance Indicators (KPIs) for its most important contracts, and the performance of the vendor against those KPIs.

Question to the Cabinet Office:

To ask His Majesty's Government how many suppliers have been placed on the debarment list under the Procurement Act 2023; and what criteria are used to determine placement on this list.

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

The Government is committed to tackling misconduct in public procurement. All contracting authorities and suppliers are expected to act, and be seen to act, with integrity. The debarment regime came into effect on 24 February 2025.

A supplier may only be added to the debarment list if an investigation conducted by the Debarment Review Service (DRS), on behalf of the Minister, establishes that a mandatory or discretionary exclusion ground (as outlined in Schedules 6 and 7 of the Procurement Act 2023) applies and that the circumstances leading to the exclusion ground are continuing or likely to occur again.

The Minister's decision and the outcomes of all debarment investigations, will be publicly available on gov.uk. Currently, there are no suppliers on the debarment list

Question to the Department for Digital, Culture, Media & Sport:

To ask His Majesty's Government what assessment they have made of self-rating partnerships between British Board of Film Classification (BBFC) and streaming services, and whether they plan to take steps to encourage wider adoption of BBFC age ratings on streaming services.

Answered by Baroness Twycross - Baroness in Waiting (HM Household) (Whip)

The Government has not made an assessment of self-rating partnerships between the British Board of Film Classification (BBFC) and video-on-demand (VoD) services. Ofcom, as the independent regulator, now has a new duty introduced through the Media Act 2024 to assess audience protection measures used by VoD services, such as age ratings, to ensure they are adequate to protect audiences from harm. The Government will in due course be designating mainstream VoD services, bringing them under enhanced regulation by Ofcom. Ofcom will then consult on a new standards Code for these services, similar to the Broadcasting Code. This could include the use of age ratings, if Ofcom considers it appropriate.

Question to the Department of Health and Social Care:

To ask His Majesty's Government on what date they will respond to the Hughes Report into the medical and health challenges presented by sodium valproate for individuals, published on 7 February 2024; and what plans they have to implement a national financial redress scheme.

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

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have made an assessment of the impact of the reintegration of NHS England on the delivery of the National Congenital Anomaly and Rare Disease Registration Service.

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

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. Digital data and technology are an underpinning theme of the framework. We acknowledge the important role of the National Congenital Anomaly and Rare Disease Registration Service, part of the National Disease Registration Service, play in underpinning the delivery of England’s rare diseases action plans. Ministers and senior Departmental officials are working with the new executive team at the top of NHS England, led by Sir Jim Mackey, to lead the formation of a new joint centre. The important role of the National Disease Registration Service will be considered as part of future plans. Whilst this transformation takes place, we will ensure that we continue to evaluate impacts and work collaboratively to ensure continuity of care and that there are no risks to patient safety.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they have made an assessment of the impact of the abolition of NHS England on people with rare conditions.

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

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases.

Ministers and senior Departmental officials are working with the new executive team at the top of NHS England, led by Sir Jim Mackey, to lead the formation of a new joint centre. Whilst this transformation takes place, we will ensure that we continue to evaluate impacts and work collaboratively to ensure continuity of care and that there are no risks to patient safety.

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

To ask His Majesty's Government when they plan to publish a report on the implementation of the policies set out in the Joint Fisheries Statement, published on 22 November 2022.

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

The fisheries policy authorities are required to publish a report every three years setting out the extent to which the policies in the Joint Fisheries Statement (JFS) have been implemented, and the contribution these policies have made towards achieving the Fisheries Act 2020 objectives. The first report must cover the policies implemented in the three-year period following the publication of the JFS on 22 November 2022. We therefore expect to publish the first report in 2026.

Question to the Department for Science, Innovation & Technology:

To ask His Majesty's Government what estimate they have of the number of new jobs that will be created by building data centres in the United Kingdom over the next 10 years.

Answered by Baroness Jones of Whitchurch

Data centres can be significant sources of employment, both during construction and to operate and maintain the data centres once completed. These include highly specialised jobs across IT, engineering, cybersecurity, and support services. Data centres also indirectly support employment in other industries, particularly in tech and AI.

My Department has not made a specific estimate of the number of jobs that will be created due to the substantial potential investment in the UK by data centre developers but is actively monitoring the sector. TechUK have estimated that by 2035 there could be 40,200 additional jobs directly employed in data centre operational roles and 18,200 additional jobs directly employed in data centre construction roles over the period 2025–35.

Question to the Cabinet Office:

To ask His Majesty's Government what is the total value of the 12 contracts issued to Fujitsu in the last 12 months; and how many of these were new contracts rather than transitional arrangements.

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

The timeline for completing assessments of suppliers who have engaged in poor performance or professional misconduct is dependent on the circumstances of each individual case.

The impact of the Horizon scandal on postmasters and their families has been horrendous. The Government is determined to hold those responsible to account and will continue to seek to make rapid progress on compensation and redress. Fujitsu’s role in Horizon is one of the issues currently being reviewed by Sir Wyn Williams’s statutory inquiry. The Government are carefully considering volume 1 of the report. Once the inquiry has established the full facts, we will review its final report and consider any further action, where appropriate.

In January 2024, Fujitsu committed to withdraw from bidding for contracts with new government customers until the Post Office Horizon inquiry concludes. It will bid for work with existing government customers only where it already has a contract with them or where there is an agreed need for Fujitsu’s skills and capabilities.

Individual contracting authorities are responsible for the award and management of contracts. With regard to scrutiny during procurement processes, the Procurement Act 2023 enables and, where appropriate, requires the exclusion of suppliers where they pose particular risks to public procurement. The Cabinet Office has issued substantial guidance for departments, available on gov.uk. The exclusions regime provides a framework within which contracting authorities must consider a supplier’s recent past behaviour and circumstances (or their presence on the debarment list) to determine whether it should be allowed to compete for or be awarded a public contract.

The National Procurement Policy Statement asks contracting authorities to ensure they have the appropriate procurement and contract management skills and capability necessary to deliver public contracts and encourages the use of collaborative procurement frameworks, where appropriate, to deliver value for money.

To provide transparency, the government regularly publishes Key Performance Indicators (KPIs) for its most important contracts, and the performance of the vendor against those KPIs.

Question to the Cabinet Office:

To ask His Majesty's Government whether they have assessed Fujitsu for exclusion under the Procurement Act 2023.

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

The timeline for completing assessments of suppliers who have engaged in poor performance or professional misconduct is dependent on the circumstances of each individual case.

The impact of the Horizon scandal on postmasters and their families has been horrendous. The Government is determined to hold those responsible to account and will continue to seek to make rapid progress on compensation and redress. Fujitsu’s role in Horizon is one of the issues currently being reviewed by Sir Wyn Williams’s statutory inquiry. The Government are carefully considering volume 1 of the report. Once the inquiry has established the full facts, we will review its final report and consider any further action, where appropriate.

In January 2024, Fujitsu committed to withdraw from bidding for contracts with new government customers until the Post Office Horizon inquiry concludes. It will bid for work with existing government customers only where it already has a contract with them or where there is an agreed need for Fujitsu’s skills and capabilities.

Individual contracting authorities are responsible for the award and management of contracts. With regard to scrutiny during procurement processes, the Procurement Act 2023 enables and, where appropriate, requires the exclusion of suppliers where they pose particular risks to public procurement. The Cabinet Office has issued substantial guidance for departments, available on gov.uk. The exclusions regime provides a framework within which contracting authorities must consider a supplier’s recent past behaviour and circumstances (or their presence on the debarment list) to determine whether it should be allowed to compete for or be awarded a public contract.

The National Procurement Policy Statement asks contracting authorities to ensure they have the appropriate procurement and contract management skills and capability necessary to deliver public contracts and encourages the use of collaborative procurement frameworks, where appropriate, to deliver value for money.

To provide transparency, the government regularly publishes Key Performance Indicators (KPIs) for its most important contracts, and the performance of the vendor against those KPIs.

Question to the Cabinet Office:

To ask His Majesty's Government, further to the answer by Baroness Anderson of Stoke-on-Trent on 9 July (HL Deb col 1326), what is the timeline for completing assessments under the Procurement Act 2023 of suppliers who have engaged in poor performance or professional misconduct.

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

The timeline for completing assessments of suppliers who have engaged in poor performance or professional misconduct is dependent on the circumstances of each individual case.

The impact of the Horizon scandal on postmasters and their families has been horrendous. The Government is determined to hold those responsible to account and will continue to seek to make rapid progress on compensation and redress. Fujitsu’s role in Horizon is one of the issues currently being reviewed by Sir Wyn Williams’s statutory inquiry. The Government are carefully considering volume 1 of the report. Once the inquiry has established the full facts, we will review its final report and consider any further action, where appropriate.

In January 2024, Fujitsu committed to withdraw from bidding for contracts with new government customers until the Post Office Horizon inquiry concludes. It will bid for work with existing government customers only where it already has a contract with them or where there is an agreed need for Fujitsu’s skills and capabilities.

Individual contracting authorities are responsible for the award and management of contracts. With regard to scrutiny during procurement processes, the Procurement Act 2023 enables and, where appropriate, requires the exclusion of suppliers where they pose particular risks to public procurement. The Cabinet Office has issued substantial guidance for departments, available on gov.uk. The exclusions regime provides a framework within which contracting authorities must consider a supplier’s recent past behaviour and circumstances (or their presence on the debarment list) to determine whether it should be allowed to compete for or be awarded a public contract.

The National Procurement Policy Statement asks contracting authorities to ensure they have the appropriate procurement and contract management skills and capability necessary to deliver public contracts and encourages the use of collaborative procurement frameworks, where appropriate, to deliver value for money.

To provide transparency, the government regularly publishes Key Performance Indicators (KPIs) for its most important contracts, and the performance of the vendor against those KPIs.

Question to the Department for Energy Security & Net Zero:

To ask His Majesty's Government what plans they have to work with Ofgem to publish updated planning and grid connection guidance for digital infrastructure to prevent bottlenecks in the grid connections queue and to ensure that other sectors are not deprioritised in favour of data centres.

Answered by Lord Wilson of Sedgefield - Lord in Waiting (HM Household) (Whip)

As announced in the Industrial Strategy, my department is developing measures to accelerate the connection of high-value strategic demand projects in a wide range of sectors, while continuing to support all users to connect to the grid more quickly through broader grid upgrades.

The Department is also working with Ofgem on its End-to-End Review of the obligations and incentives pertaining to network companies in the delivery of grid connections. This will improve customer communications and ensure high levels of service for all customers. This complements ongoing, fundamental reforms to the connections process that will significantly reduce congestion and bottlenecks.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the benefits of introducing a comprehensive breast cancer risk assessment for all women, including younger pre-screening age women.

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

In England, breast screening is offered to women under the age of 50 years old according to nationally recommended guidelines, based on their assessed risk of developing breast cancer. These can be found on the National Institute for Health and Care Excellence’s website in an online-only format.

Women younger than 50 years old are not routinely screened for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 years old tend to have denser breasts. The denseness of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.

Due to this and other factors, there is a risk of over-treatment and distress for women who do not have breast cancer but would be subjected to invasive and painful medical treatments and diagnostic tests. Therefore, the Government does not currently plan to introduce comprehensive breast cancer risk assessments for women under 50 years old, although the UK National Screening Committee keeps age brackets under review.

Some women have an increased chance of developing breast cancer because of their genes. Five to 10 out of 100, or 5% to 10% of, all breast cancers happen because of an inherited tendency, also called a genetic predisposition.

National Health Service breast cancer risk assessments in England are undertaken to identify the risk of having an inherited tendency of developing breast cancer. It is up to integrated care boards to commission breast cancer risk assessment services locally in line with national clinical guidance.

The NHS website has a webpage that raises awareness of checking breasts for potential symptoms of breast cancer in all age groups. The NHS Breast Screening Programme produced a five-point plan for being breast aware. The plan sets out that individuals should know what's normal for them, look at and feel their breasts, know what changes to look for, report any changes to a general practitioner without delay and attend routine screening when invited.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to extend breast cancer risk assessment to women under 50 years of age.

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

In England, breast screening is offered to women under the age of 50 years old according to nationally recommended guidelines, based on their assessed risk of developing breast cancer. These can be found on the National Institute for Health and Care Excellence’s website in an online-only format.

Women younger than 50 years old are not routinely screened for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 years old tend to have denser breasts. The denseness of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.

Due to this and other factors, there is a risk of over-treatment and distress for women who do not have breast cancer but would be subjected to invasive and painful medical treatments and diagnostic tests. Therefore, the Government does not currently plan to introduce comprehensive breast cancer risk assessments for women under 50 years old, although the UK National Screening Committee keeps age brackets under review.

Some women have an increased chance of developing breast cancer because of their genes. Five to 10 out of 100, or 5% to 10% of, all breast cancers happen because of an inherited tendency, also called a genetic predisposition.

National Health Service breast cancer risk assessments in England are undertaken to identify the risk of having an inherited tendency of developing breast cancer. It is up to integrated care boards to commission breast cancer risk assessment services locally in line with national clinical guidance.

The NHS website has a webpage that raises awareness of checking breasts for potential symptoms of breast cancer in all age groups. The NHS Breast Screening Programme produced a five-point plan for being breast aware. The plan sets out that individuals should know what's normal for them, look at and feel their breasts, know what changes to look for, report any changes to a general practitioner without delay and attend routine screening when invited.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the regional variations in access to specialist care for chronic spontaneous urticaria, and what steps they are taking to address those variations.

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

NHS England’s Getting It Right First Time (GIRFT) programme addresses regional variations in healthcare by identifying areas of unwarranted variation and working with local teams to implement improvements and reduce differences. Through GIRFT’s Further Faster programme, hospital trust clinicians and operational teams are being brought together with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.

A Further Faster handbook for dermatology, which covers conditions like chronic spontaneous urticaria, has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

In addition, NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have, if any, to include personalised breast cancer risk assessments in the NHS Health Check programme for women under 50 years of age.

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

Some women have an increased risk of developing breast cancer because of their genetics. NHS breast cancer risk assessments are undertaken to identify women under the age of 50 years old at higher risk and offer them breast screening according to national guidelines.

The NHS Health Check, a core component of England’s cardiovascular disease prevention programme, assesses risk factors for cardiovascular disease in people aged 40 to 74 years old and refers them to behavioural support services and clinical management where appropriate.

For these reasons, the Department does not have plans to include personalised breast cancer risk assessments for women under 50 years old in the NHS Health Check Programme.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to increase capacity in specialist dermatology services.

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

NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what consideration is being given to specialised dermatology, immunology and allergy services as part of NHS England’s review of commissioning, including services for patients living with chronic spontaneous urticaria.

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

NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what assessment they have made of the advisory opinion of the International Court of Justice on 19 July 2024 regarding the legal consequences arising from the policies and practices of Israel in the Occupied Palestinian Territory; and when they expect to publish their analysis of that advisory opinion and its policy implications.

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

The UK respects the independence of the International Court of Justice, and we are considering its Advisory Opinion of 19 July 2024 with the seriousness and rigour it deserves. We have been clear that many aspects of the Opinion are already government policy: Israeli settlements are illegal under international law, and Israel should end its presence in the Occupied Palestinian Territories as swiftly as possible.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what consideration has been given to the use of AI algorithms to help triage patients in primary care settings, particularly in relation to patients presenting with dermatological symptoms that can be mistaken as allergy, such as patients living with chronic spontaneous urticaria.

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

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to improve awareness of chronic spontaneous urticaria among clinicians, particularly in primary care settings, to help reduce delays to diagnosis.

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

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in regard to page 12 of the European Federation of Pharmaceutical Industries and Associations Patients Waiting to Access Innovative Therapies Indicator 2023 Survey, published in June 2024, which shows that 28 per cent of new medicines approved by the European Medicines Agency had full public availability for patients in England in 2019–2022, what assessment they have made of the impact of the uniform pricing policy on the full availability of new multi-indication medicines.

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

In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines. This framework includes the approach for assessing the eligibility for medicines that may treat multiple indications to qualify for indication-specific pricing, and the terms for doing so. Following consultation, NHS England adopted the following criteria for the use of indication-specific pricing:

- the medicine for the indication under consideration meets an unmet clinical need;

- the company can demonstrate with a high degree of confidence that uniform pricing would reduce the total revenue for a medicine across all indications;

- sufficient data is available within existing National Health Service systems to make such arrangements operationally feasible; and

- the cost-effective price is highly differentiated for all indications under consideration.

NHS England’s approach to indication-specific pricing has supported patient access to medicines for many new indications which would otherwise have been unavailable if the only alternative was a uniform price for all indications. The National Institute for Health and Care Excellence is able to recommend the vast majority of medicines for use in the NHS, including medicines licensed for multiple indications. The latest European Federation of Pharmaceutical Industries and Association’s Patients Waiting to Access Innovative Therapies Indicator report 2024, published in May 2025, reports that the 37% of medicines licensed between 2020 and 2023 were fully available to NHS patients in England, compared with an European Union average of 29%.

As agreed under the terms of the Voluntary Scheme for Branded Medicines Pricing, Access and Growth, and subsequently set out in the NHS England consultation response, indication-specific pricing agreements will continue to be reserved for medicines that are normally expected to have value propositions at or below the lower end of the National Institute for Health and Care Excellence’s cost-effectiveness range.

The Life Sciences Sector Plan committed to faster patient access to medicines and reduced industry costs, while ensuring good value for the NHS. A new, proportionate approach to National Institute for Health and Care Excellence appraisals and indication-specific pricing will streamline access for multi-indication medicines with strong outcomes and low affordability risk. This will create a more agile, predictable commercial environment that supports investment into the United Kingdom.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in regard to the NHS commercial framework for new medicines, published on 29 January, whether they will consult on the principle to provide additional value for medicines at or below the lower end of the standard National Institute for Health and Care Excellence cost-effectiveness threshold range in the second phase of the review of that framework.

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

In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines. This framework includes the approach for assessing the eligibility for medicines that may treat multiple indications to qualify for indication-specific pricing, and the terms for doing so. Following consultation, NHS England adopted the following criteria for the use of indication-specific pricing:

- the medicine for the indication under consideration meets an unmet clinical need;

- the company can demonstrate with a high degree of confidence that uniform pricing would reduce the total revenue for a medicine across all indications;

- sufficient data is available within existing National Health Service systems to make such arrangements operationally feasible; and

- the cost-effective price is highly differentiated for all indications under consideration.

NHS England’s approach to indication-specific pricing has supported patient access to medicines for many new indications which would otherwise have been unavailable if the only alternative was a uniform price for all indications. The National Institute for Health and Care Excellence is able to recommend the vast majority of medicines for use in the NHS, including medicines licensed for multiple indications. The latest European Federation of Pharmaceutical Industries and Association’s Patients Waiting to Access Innovative Therapies Indicator report 2024, published in May 2025, reports that the 37% of medicines licensed between 2020 and 2023 were fully available to NHS patients in England, compared with an European Union average of 29%.

As agreed under the terms of the Voluntary Scheme for Branded Medicines Pricing, Access and Growth, and subsequently set out in the NHS England consultation response, indication-specific pricing agreements will continue to be reserved for medicines that are normally expected to have value propositions at or below the lower end of the National Institute for Health and Care Excellence’s cost-effectiveness range.

The Life Sciences Sector Plan committed to faster patient access to medicines and reduced industry costs, while ensuring good value for the NHS. A new, proportionate approach to National Institute for Health and Care Excellence appraisals and indication-specific pricing will streamline access for multi-indication medicines with strong outcomes and low affordability risk. This will create a more agile, predictable commercial environment that supports investment into the United Kingdom.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the pricing and reimbursement of multi-indication medicines does not deter future investment in UK-based research and development or the launches of new medicines.

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

In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines. This framework includes the approach for assessing the eligibility for medicines that may treat multiple indications to qualify for indication-specific pricing, and the terms for doing so. Following consultation, NHS England adopted the following criteria for the use of indication-specific pricing:

- the medicine for the indication under consideration meets an unmet clinical need;

- the company can demonstrate with a high degree of confidence that uniform pricing would reduce the total revenue for a medicine across all indications;

- sufficient data is available within existing National Health Service systems to make such arrangements operationally feasible; and

- the cost-effective price is highly differentiated for all indications under consideration.

NHS England’s approach to indication-specific pricing has supported patient access to medicines for many new indications which would otherwise have been unavailable if the only alternative was a uniform price for all indications. The National Institute for Health and Care Excellence is able to recommend the vast majority of medicines for use in the NHS, including medicines licensed for multiple indications. The latest European Federation of Pharmaceutical Industries and Association’s Patients Waiting to Access Innovative Therapies Indicator report 2024, published in May 2025, reports that the 37% of medicines licensed between 2020 and 2023 were fully available to NHS patients in England, compared with an European Union average of 29%.

As agreed under the terms of the Voluntary Scheme for Branded Medicines Pricing, Access and Growth, and subsequently set out in the NHS England consultation response, indication-specific pricing agreements will continue to be reserved for medicines that are normally expected to have value propositions at or below the lower end of the National Institute for Health and Care Excellence’s cost-effectiveness range.

The Life Sciences Sector Plan committed to faster patient access to medicines and reduced industry costs, while ensuring good value for the NHS. A new, proportionate approach to National Institute for Health and Care Excellence appraisals and indication-specific pricing will streamline access for multi-indication medicines with strong outcomes and low affordability risk. This will create a more agile, predictable commercial environment that supports investment into the United Kingdom.