Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the evaluation framework of the Joint Committee on Vaccination and Immunisation reflects the full economic and societal value of vaccination.

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

As an independent Departmental Expert Committee, the Joint Committee on Vaccination and Immunisation (JCVI) advises the Department on matters related to vaccination and immunisation. The JCVI bases its advice and recommendations on evidence of the burden of disease, of vaccine safety and efficacy, and of the impact and cost-effectiveness of immunisation strategies.

The cost-effectiveness analysis which is presented to the JCVI for its consideration does not include broader socio-economic factors such as productivity costs from illness, improved educational attainment from reduced school absences, or out-of-pocket expenses and opportunity costs from attending a vaccination. However, these impacts may be highlighted by the JCVI or by officials who provide advice to ministers.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of chimeric antigen receptor T-cell therapies for treatment for cancers; and whether new medicines using these therapies this will be approved.

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

NHS England funds the use of licensed medicines that have been recommended by the National Institute for Health and Care Excellence (NICE), or the off-label use of licensed medicines that have been approved via the NHS England clinical policy process.

NICE has evaluated and recommended several CAR-T therapies for both high-grade and low-grade lymphomas, some of which are recommended for a period of managed access:

• Brexucabtagene autoleucel, which includes relapsed or refractory mantle cell lymphoma (managed access) and/or relapsed or refractory B-cell acute lymphoblastic leukaemia in people 26 years old and over (managed access);
• Tisagenlecleucel, which includes relapsed or refractory B-cell acute lymphoblastic leukaemia in people 25 years old and under;
• Axicabtagene ciloleucel, which includes diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after two or more systemic therapies and/or relapsed or refractory diffuse large B-cell lymphoma after first-line chemoimmunotherapy;
• Lisocabtagene maraleucel, which includes relapsed or refractory large B-cell lymphoma after first-line chemoimmunotherapy when a stem cell transplant is suitable;
• Obecabtagene autoleucel, which includes relapsed or refractory B-cell acute lymphoblastic leukaemia; and
• relapsed or refractory B-cell acute lymphoblastic leukaemia.

To support implementation of NICE recommendations, NHS England sets clinical treatment criteria to ensure that treatments are made available to those intended by the NICE guidance. Clinical input helps set the clinical and patient treatment criteria based on the NICE committee deliberations, how the treatment will be used within the treatment pathway, and the evidence base considered by NICE and the Medicines and Healthcare products Regulatory Agency.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of access to new innovative therapies for cancers.

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

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service in England on whether new licensed medicines should be routinely funded by the NHS based on an assessment of clinical and cost effectiveness. NICE aims wherever possible to issue guidance on new medicines close to the time of licensing to ensure that patients are able to benefit from rapid access to clinically and cost effective new medicines. The NHS in England is legally required to fund medicines recommended in a NICE technology appraisal, normally within three months of the publication of final guidance.

NICE is able to recommend the most promising new cancer drugs for use through the Cancer Drugs Fund (CDF) where there is too much uncertainty for NICE to be able to recommend routine funding. NHS England funds NICE-recommended cancer medicines from the CDF from the point of positive draft NICE guidance, bringing forward patient access by approximately five months than would otherwise be the case.

In England in 2024/25, 93% of NICE recommendations for cancer treatments were positive. Positive includes recommended, optimised, recommended in the CDF, and optimised in the CDF. Where guidance is optimised, the treatment has been recommended for a subset of patients rather than the full cohort for which it is licensed.

Question to the HM Treasury:

To ask His Majesty's Government what plans they have to promote long-term fiscal devolution; and what assessment they have made of the potential of greater fiscal devolution to address regional inequalities and growth rates.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The United Kingdom Government regularly considers how fiscal devolution arrangements are working in practice, taking into account the views of a range of stakeholders.

Question to the HM Treasury:

To ask His Majesty's Government what plans they have to consider the learnings on fiscal devolution of each nation and region in Council of the Nations and Regions.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The United Kingdom Government regularly considers how fiscal devolution arrangements are working in practice, taking into account the views of a range of stakeholders.

Question to the HM Treasury:

To ask His Majesty's Government what plans they have to consider the learnings on fiscal devolution of each nation and region in the British–Irish Council.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The United Kingdom Government regularly considers how fiscal devolution arrangements are working in practice, taking into account the views of a range of stakeholders.

Question to the HM Treasury:

To ask His Majesty's Government further to the Written Answer by Baroness Ritchie of Downpatrick on 22 September (HL10373), when they will publish an updated plan for the delivery of a single trade window.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The Government is committed to minimising administrative burdens and frictions experienced by businesses trading internationally and is engaging with key stakeholders to better understand their needs for the future operation of the UK border.

The Government does not have a definitive timeframe for the implementation of the Single Trade Window, though traders are able to submit import and export documentations electronically via the Customs Declaration Service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the report by the Food Standards Agency, Safety of Nitrates and Nitrites as Food Additives, published on 1 October; what discussions they have had with the FSA about publishing the correspondence, criteria and communications relating to the preparation of that review; and whether they plan to commission a comprehensive multidisciplinary study of the safety of nitrites in processed meats.

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

The Food Standards Agency’s (FSA) review of nitrates and nitrites as food additives is an important piece of work that summarises recent evidence from human studies to inform policy decisions.

To maintain transparency, the full report, including its scope, search criteria, and details of the external contract, has been published on Government websites. This allows stakeholders and the public to see exactly how the review was conducted and how conclusions were reached.

The published report clearly sets out the methodology and criteria used, providing clarity and confidence in the process. The FSA does not routinely publish internal correspondence or preparatory communications, due to the potential inclusion of commercially sensitive or personal information. However, the report itself provides full transparency on the evidence base and decision-making approach. There have been no discussions on changing this approach.

There are no plans to commission a broader multidisciplinary study. Existing permitted nitrite levels are based on robust international risk assessments and remain appropriate to protect public health. Commissioning a new study would require significant resource and is not justified without new evidence indicating a change in risk.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to prioritise (1) dermatology, (2) allergy, and (3) immunology, as clinical specialties within future modern service frameworks.

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

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time 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.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the use of virtual clinics for chronic spontaneous urticaria to reduce waiting times and improve patient outcomes.

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

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time 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.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to address regional disparities in chronic spontaneous urticaria service provision and capacity across England.

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

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time 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.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to include chronic spontaneous urticaria within a future modern service framework.

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

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time 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.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the NHS 10-year workforce plan will consider and prioritise the recruitment, development and retention of GPs and clinicians with extended roles in allergy and dermatology.

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

The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. We are working through how the plan will articulate the changes for different professional groups.

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

To ask His Majesty's Government when they plan to publish the post-implementation review of the Reduction and Prevention of Agricultural Diffuse Pollution (England) Regulations 2018.

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

We will publish the statutory report into this important regulation (known as the Farming rules for Water) in due course.