Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of waiting lists for gynaecology appointments within NHS England; and what steps they will take to reduce them.

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

It is unacceptable that patients are waiting too long to get the care they need. The Department and NHS England are continuously monitoring data on performance and demand for elective care, including for gynaecology services.

At the end of September 2024, the gynaecology waiting list in England stood at 587,909, with 54.6% of Referral to Treatment (RTT) patient pathways waiting within 18 weeks. The median average RTT waiting time for gynaecology incomplete pathways was 15.9 weeks in September 2024.

Tackling waiting lists is a key part of our Health Mission. We will deliver an extra 40,000 operations, scans, and appointments per week, including for gynaecology services, in our first year of Government, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks.

There are a range of efforts underway to address the challenges identified and to reduce the time patients are waiting for gynaecological care, including support to trusts where performance is of concern, ongoing efforts to transform outpatient pathways, and the use of surgical hubs which provide high volume low complexity surgery.

In addition, women’s health hubs bring together healthcare professionals and existing services to provide integrated women’s health services in the community. Women’s health hubs aim to improve access to care, patient experiences, and health outcomes for women, whilst reducing healthcare inequalities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is their timescale for progressing the 10-Year Cancer Plan; and whether it will include a specific focus on blood cancer.

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

The Health Mission sets the objective of building a National Health Service fit for the future. As part of that work, and in response to Lord Darzi’s report, we have launched an extensive programme of engagement to develop a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts, from hospitals to the community, from analogue to digital, and from sickness to prevention.

In addition, following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including those with blood cancer.

We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be, and will provide updates on this, including on publication dates, at the earliest opportunity.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they will take to improve (1) cardiovascular disease pathways, (2) waiting lists, and (3) earlier diagnosis, as part of the NHS Long Term Plan and the Major Conditions Strategy.

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

We are committed to tackling deaths from cardiovascular disease (CVD), of which there are far too many, and setting a goal for fewer lives being lost to the biggest killers, including CVD. The development of the Major Conditions Strategy was paused following the general election. NHS England’s 2019 Long Term Plan sets out a number of actions that aim to help prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029, and progress towards this is ongoing. To deliver the National Health Service Long Term Plan priorities, a CVD programme has been established which is clinically led by national clinical directors and national specialty advisors, and supported by senior clinicians from a breadth of cardiac and stroke specialties, and primary care, as part of expert advisory groups.

Tackling waiting lists and ensuring that patients receive the care they need when they need it is a key part of our Health Mission. Funding announced in the Autumn Budget will support the delivery of an additional 2 million operations, scans, and appointments during our first year in Government, which is the equivalent to 40,000 per week, as a first step in our commitment to ensuring patients can expect to be treated within 18 weeks.

The NHS Health Check programme, England’s CVD prevention programme, finds people aged 40 to 74 years old who are at risk of CVD and supports them to reduce their risk, preventing approximately 500 heart attacks or strokes each year. To improve access and engagement with the life-saving programme, we are developing a digital NHS Health Check which will be ready for testing in early 2025, and will enable people to undertake a check at home. We are also trialling the delivery of heart health checks to over 130,000 people in workplaces across the country, all of which would improve earlier diagnosis of CVD.

At the 2024 Autumn Budget, my Rt Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community. We will also address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce elective and cancer waits. Finally, the NHS is prioritising roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres, with capacity prioritised for cancer diagnostics.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the care and treatment for heart valve disease patients.

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

Heart valve disease (HVD) care in the United Kingdom has made strides in addressing treatment gaps, yet challenges such as late diagnosis, health disparities, and regional variations in care persist. NHS England is driving initiatives to improve pathways, reduce inequalities, and enhance access to timely and equitable care, while also addressing broader elective care pressures.

Significant progress is being made in the care and treatment of HVD patients in the UK. NHS England has established an expert advisory group to drive targeted pathway improvement projects, aiming to reduce referral-to-treatment times for severe valvular disease in 2024/25. Referral rates for cardiac rehabilitation have improved notably, rising from 7% in 2019 to 15% in 2024. Over 80% of heart failure patients consistently receive care from specialist teams, reflecting steady progress in specialist access.

Efforts to address health inequalities are also advancing, including a review of disparities in the presentation and treatment of conditions like aortic stenosis, and updates to primary care eLearning to improve early diagnosis. These strides demonstrate our commitment to improving outcomes in HVD care.

Question to the Department for Business and Trade:

To ask His Majesty's Government whether the new right to flexible working in the Employment Rights Bill will include a requirement for additional consideration of requests from those who are pregnant.

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

The Government understands that the availability of flexible working can be important for those who are pregnant and in work. It can be equally as important for a number of other groups, including new parents, those with other caring responsibilities and those managing a disability or long term health condition. That is why, through the Employment Rights Bill, the Government is making flexible working the default for all employees, except where not reasonably feasible.

Question to the Cabinet Office:

To ask His Majesty's Government what recent stakeholder engagement they have undertaken regarding the benefits of the Windsor Framework; and what steps they will take to engage further.

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

This Government is committed to the faithful implementation of the Windsor Framework and stakeholder engagement is an important aspect of this. When agreeing the Windsor Framework both the UK and EU made commitments to implement enhanced engagement mechanisms, allowing stakeholders the routes to share their views on the implementation of the Framework.

Since the Political Declaration was published on 27 February 2023 the government has continuously engaged with relevant stakeholders to discuss the Windsor Framework and to ensure businesses are able to realise its benefits. We established the Joint Consultative Working Group (JCWG) sub-groups and the UK-EU joint engagement programme which meet regularly, with the most recent engagements taking place in October. This was referenced in the last UK-EU Joint Statement, following the Specialised Committee on the Implementation of the Windsor Framework on 22 October.

Outside of these joint UK-EU engagements the UK government regularly engages with people and businesses in Northern Ireland. The Minister for the Cabinet Office has met with the First Minister and deputy First Minister of Northern Ireland to discuss the Windsor Framework. He also recently attended a roundtable at Queen’s University Belfast with businesses and civic society representatives to discuss Windsor Framework implementation. Likewise, the Secretary of State for Northern Ireland regularly engages with NI stakeholders and hosted a roundtable in Belfast for the Northern Ireland Business Brexit Working Group to discuss the Windsor Framework on October 31.

UK government departments continuously engage with stakeholders to discuss the technical aspects of the Windsor Framework arrangements and this government is committed to continuing this engagement further.

Question to the Cabinet Office:

To ask His Majesty's Government what main issues emerged from their stakeholder engagement on the implementation of the Windsor Framework.

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

This Government is committed to the faithful implementation of the Windsor Framework and stakeholder engagement is an important aspect of this. When agreeing the Windsor Framework both the UK and EU made commitments to implement enhanced engagement mechanisms, allowing stakeholders the routes to share their views on the implementation of the Framework.

Since the Political Declaration was published on 27 February 2023 the government has continuously engaged with relevant stakeholders to discuss the Windsor Framework and to ensure businesses are able to realise its benefits. We established the Joint Consultative Working Group (JCWG) sub-groups and the UK-EU joint engagement programme which meet regularly, with the most recent engagements taking place in October. This was referenced in the last UK-EU Joint Statement, following the Specialised Committee on the Implementation of the Windsor Framework on 22 October.

Outside of these joint UK-EU engagements the UK government regularly engages with people and businesses in Northern Ireland. The Minister for the Cabinet Office has met with the First Minister and deputy First Minister of Northern Ireland to discuss the Windsor Framework. He also recently attended a roundtable at Queen’s University Belfast with businesses and civic society representatives to discuss Windsor Framework implementation. Likewise, the Secretary of State for Northern Ireland regularly engages with NI stakeholders and hosted a roundtable in Belfast for the Northern Ireland Business Brexit Working Group to discuss the Windsor Framework on October 31.

UK government departments continuously engage with stakeholders to discuss the technical aspects of the Windsor Framework arrangements and this government is committed to continuing this engagement further.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to (1) support the capacity of Systemic Anti-Cancer Therapy services, and (2) adopt new treatments for blood cancer patients.

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

The Department continues to support the National Health Service in England to increase cancer treatment capacity. NHS England had previously established a task-and-finish group to gather, collate, and compile available information to establish Systemic Anti-Cancer Therapy delivery capacity, and to generate recommendations for the short, medium, and longer term to alleviate any identified pressures on service delivery.

The adoption of new treatments into NHS England is generally the result of National Institute for Health and Care Excellence (NICE) guidance and commissioner decisions. Implementation of any NICE approvals will be supported by a service readiness assessment and the development of additional capacity where necessary.

However, NHS England’s Cancer Drugs Fund supports rapid access for NHS patients to the most promising new cancer medicines through managed access agreements, while further real-world evidence is collected where there is too much uncertainty for the NICE to be able to recommend routine funding.

Additionally, the Department is committed to implementing the recommendations of Lord O'Shaughnessy’s review into commercial clinical trials, making sure that the United Kingdom leads the world in clinical trials, and that innovative, lifesaving treatments are accessible to NHS patients, including those with blood cancer.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of any regional variation in access to infusion services; and whether they have any plans to publish the latest data on this variation.

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

The Department and NHS England do not collect information on infusion services as such. However, the rise in the number of infused medicines approved for use in the National Health Service in England continues, as new and innovative medicines come to market.

The increase in demand for existing infused medicines such as chemotherapy and immunotherapies continues, as diagnosis and survival rates for patients improve. I understand from NHS England that over 70% of the secondary care medicines budget is spent on infused medicines.

In recognition of this, NHS England has created the Infusions and Special Medicines programme to oversee capital development, to improve capacity, and to develop the skilled workforce needed to compound these medicines.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they plan to take to ensure blood cancer patients are given greater choice in decisions about their treatment and care within the 10-year NHS plan.

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

As part of the Government’s five long-term missions, we have launched a 10-Year Health Plan to reform the National Health Service and make it fit for the future. To help shape this Plan, the government is currently inviting the public, including blood cancer patients, to share their views, experiences and ideas at the Change NHS online portal.

Following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including those with blood cancer. We are in discussions about what form that plan should take, its relationship to the 10-Year Health Plan and the Government’s wider Health Mission and will provide updates on this in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the levels of blood cancer in England; and what plans they have to involve the blood cancer community, including patients, clinicians and industry representatives, in the development of a potential cancer strategy for England.

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

The National Cancer Registration Service and the National Cancer Analysis Service collect information on levels of blood cancer in England. They show that in 2022 there were 35,466 diagnoses for blood cancer, broken down to 15,196 for females and 20,270 for males.

To help shape a 10-Year Health Plan to make the National Health Service fit for the future, the Government is inviting people to share their views, experiences, and ideas at the Change NHS online portal. We are also currently in discussions about what form a potential cancer strategy for England should take, including its relationship to the 10-Year Health Plan and the Government’s wider Health Mission,and will provide updates in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what action they are taking to support consistent implementation of the recently published asthma guidelines from the British Thoracic Society, the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network; and how they will monitor progress on that implementation.

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

NHS England welcomes the publication of the asthma guidance and the clear national framework it provides. It has just been published, and we are closely studying its recommendations.

There is a wide range of work taking place across NHS England to support the implementation of the recommendations of the National Institute for Health and Care Excellence. In relation to access to diagnosis, NHS England has published commissioning standards, which are available on the NHS.UK website, in an online only format, and worked with a range of partners to create a package for systems containing the information and support required to help increase the number of people receiving early and accurate diagnosis for respiratory disease, including those with chronic obstructive pulmonary disease.​

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the role of financial incentives in improving access to respiratory care and treatment.

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

There is a wide range of work taking place across NHS England to support the implementation of the recommendations of National Institute for Health and Care Excellence. In relation to access to diagnosis, NHS England has published commissioning standards, which are available on the NHS.UK website in an online only format, and worked with a range of partners to create a package for systems containing the information and support required to help increase the number of people receiving early and accurate diagnosis for respiratory disease, including those with chronic obstructive pulmonary disease (COPD).​

NHS England has incentivised diagnosis within the Quality Outcomes Framework, which includes respiratory indicators in relation to the diagnosis of asthma and COPD. Community Diagnostic Centres are being established to deliver additional, digitally connected, diagnostic capacity in England, providing patients with a coordinated set of diagnostic tests in the community, in as few visits as possible, enabling an accurate and fast diagnosis on a range of clinical pathways, including for people with chronic respiratory disease.

To support patients with a timely follow-up after hospital discharge, a discharge bundle for COPD is included within the Guidance on best practice tariffs for 2023 to 2025, a copy of which is attached. This includes a review of medication, the provision of a self-management plan, including an emergency drug pack where appropriate, smoking cessation support, assessment for pulmonary rehabilitation, and ensuring appropriate follow up arrangements are in place prior to discharge.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the availability of, and access to, pulmonary rehabilitation services within NHS England.

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

A national programme of work is underway to support systems with improving access to pulmonary rehabilitation (PR) for the eligible population, to increase capacity of provision to reduce waiting lists, and to improve the quality and consistency of rehabilitation programmes through accreditation. In December 2023, commissioning standards for PR services were published by NHS England, setting out key areas for the appropriate provision of PR services. The standards are aimed at integrated care board commissioners. Guidance on developing and growing the PR workforce was published in March 2024.

Data is not currently available at a national level that provides an accurate assessment of the level of eligible need for PR, and the degree to which this is being met. NHS England is working in partnership with experts in the field to explore ways to assess eligible need. This is part of the work to provide systems with the data and the information they need to best meet the needs of their populations, which continues to be a key priority.

National Respiratory Audit Programme data shows that the number of people completing PR in 2023/24 exceeded pre-pandemic levels, those between 2019 and 2020, an important milestone in post-pandemic service recovery.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they will take to rebalance geographic disparities in access to care and treatment for individuals suffering from (1) chronic obstructive pulmonary disease, and (2) asthma.

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

Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities at both a national and system level. The approach provides a vehicle for targeted interventions to detect and treat those diseases, including chronic obstructive pulmonary disease (COPD), which are major contributors to inequalities in life expectancy and healthy life expectancy.

The focus for action on respiratory health is to increase vaccination uptake in people with COPD to avoid exacerbations leading to emergency treatment in hospital and inpatient care.

Core20PLUS5 for children and young people includes asthma as one of its priority areas. The primary focus is to address over reliance on reliever medications and decrease the number of asthma attacks.

The Core20PLUS5 approach has been mobilised across the National Health Service using a variety of methods to deliver change examples of this work for COPD.

Question to the Department for Business and Trade:

To ask His Majesty's Government what steps they are taking to address the late submission of regulatory impact assessments for legislative proposals.

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

Since the General Election, the Cabinet Office, with the support of the Department for Business & Trade, has written to departments to remind them of their responsibility to consider in their legislative plans the general requirement to make regulatory impact assessments available when bringing forward relevant legislation to Parliament. The Department for Business & Trade provides training and advice to officials across government to support their departments’ compliance with this and the wider requirements of the Guide to Making Legislation and Better Regulation Framework Guidance. The government supports the Regulatory Policy Committee in holding departments to account for their compliance with the framework; this includes publishing statements of lateness when regulatory provisions reach Parliament without a regulatory impact assessment or opinion from the committee where they require one.

Question to the Cabinet Office:

To ask His Majesty's Government what plans they have to provide training on evaluation techniques and methodologies to Civil Servants; and to what extent this training will take into account practices from outside Government.

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

In 2021, the National Audit Office published a report on evaluating government spending. The report highlighted several challenges regarding the Civil Service’s capacity to evaluate government policies, including a skills gap in evaluation.

It is the responsibility of individual government departments and professions to ensure that they have the capacity and capability to evaluate their policies and programmes, and to address any capability gaps they may have.

To support departments, the Cabinet Office is taking steps to improve the skills of analysts and policy officials across the Civil Service. For example, the Evaluation Task Force has created the Evaluation Academy to address a cross-government skills gap and build evaluation capacity in the analytical profession. The Evaluation Academy comprises 10 modules including process, impact and value-for-money evaluation that are aligned to the Magenta Book, the government’s guidance on evaluation. The Academy has been run for two consecutive years and has already led to more than 2,000 civil servants receiving training on evaluation topics and methods. The Evaluation Task Force has also provided advice on evaluation methods for 382 government programmes worth a total value of £202 billion.

Additionally, the Government Skills Campus project is building and rolling out a new Civil Service wide digital platform which will log the skills of all civil servants, including evaluation skills. This will create a Civil Service-wide skills dataset allowing for even more data-driven workforce planning and targeted action on capability gaps. Roll out begins in 2025.

Question to the Cabinet Office:

To ask His Majesty's Government what assessment they have made of the Civil Service capacity needed to provide robust evaluation of Government policies; and how they will address any identified gaps.

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

In 2021, the National Audit Office published a report on evaluating government spending. The report highlighted several challenges regarding the Civil Service’s capacity to evaluate government policies, including a skills gap in evaluation.

It is the responsibility of individual government departments and professions to ensure that they have the capacity and capability to evaluate their policies and programmes, and to address any capability gaps they may have.

To support departments, the Cabinet Office is taking steps to improve the skills of analysts and policy officials across the Civil Service. For example, the Evaluation Task Force has created the Evaluation Academy to address a cross-government skills gap and build evaluation capacity in the analytical profession. The Evaluation Academy comprises 10 modules including process, impact and value-for-money evaluation that are aligned to the Magenta Book, the government’s guidance on evaluation. The Academy has been run for two consecutive years and has already led to more than 2,000 civil servants receiving training on evaluation topics and methods. The Evaluation Task Force has also provided advice on evaluation methods for 382 government programmes worth a total value of £202 billion.

Additionally, the Government Skills Campus project is building and rolling out a new Civil Service wide digital platform which will log the skills of all civil servants, including evaluation skills. This will create a Civil Service-wide skills dataset allowing for even more data-driven workforce planning and targeted action on capability gaps. Roll out begins in 2025.

Question to the HM Treasury:

To ask His Majesty's Government what plans they have to update the Government Social Research Publication Protocol, which was last revised in 2022.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The Government Social Research (GSR) publication protocol is reviewed on a regular basis and changes are made as required.

The protocol was developed by the GSR in collaboration with the Government Analysis Function and the Office for Statistics Regulation. The guidance is consistent with the Code of Practice for Statistics which is statutory. The protocol is reviewed each time it is recirculated, which happens on change of administration or roughly annually, with small or more significant changes made as needed.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to improve access to diagnosis, timely follow-up after hospital discharge, and treatment recommended by the National Institute for Health and Care Excellence for people living with chronic obstructive pulmonary disease.

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

There is a wide range of work taking place across NHS England to support the implementation of the recommendations of National Institute for Health and Care Excellence. In relation to access to diagnosis, NHS England has published commissioning standards, which are available on the NHS.UK website in an online only format, and worked with a range of partners to create a package for systems containing the information and support required to help increase the number of people receiving early and accurate diagnosis for respiratory disease, including those with chronic obstructive pulmonary disease (COPD).​

NHS England has incentivised diagnosis within the Quality Outcomes Framework, which includes respiratory indicators in relation to the diagnosis of asthma and COPD. Community Diagnostic Centres are being established to deliver additional, digitally connected, diagnostic capacity in England, providing patients with a coordinated set of diagnostic tests in the community, in as few visits as possible, enabling an accurate and fast diagnosis on a range of clinical pathways, including for people with chronic respiratory disease.

To support patients with a timely follow-up after hospital discharge, a discharge bundle for COPD is included within the Guidance on best practice tariffs for 2023 to 2025, a copy of which is attached. This includes a review of medication, the provision of a self-management plan, including an emergency drug pack where appropriate, smoking cessation support, assessment for pulmonary rehabilitation, and ensuring appropriate follow up arrangements are in place prior to discharge.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to address respiratory diseases such as asthma and chronic obstructive pulmonary disease in their upcoming 10-year health plan.

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

The 10-Year Health Plan will consider the changes needed to meet the three health mission goals, those being: a fairer system where everyone lives well for longer; a National Health Service that is there when people need it; and fewer lives lost to the biggest killers.

We will carefully be considering policies with input from the public, patients, health staff, and our stakeholders as we develop the plan.

Found: After Clause 4 BARONESS RITCHIE OF DOWNPATRICK 74_ After Clause 4, insert the following new Clause—

Found: After Clause 4 BARONESS RITCHIE OF DOWNPATRICK 74_ After Clause 4, insert the following new

Found: After Clause 4 BARONESS RITCHIE OF DOWNPATRICK 74_ After Clause 4, insert the following new