Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that NHS targets and metrics incentivise improvements in patient care and experience.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to putting patients first. This means making sure patients are seen on time and ensuring that people have the best possible experience of care.
Earlier this year, acting on the findings of The Darzi Review, and in order to move power from the health centre to local leaders, NHS England published the 2025/26 priorities and operational planning guidance, setting out the first steps for reform and the immediate actions for systems to take to deliver on the Government’s objectives. This rationalised the number of targets given to National Health Service systems, with the previous version for the 2024/25 financial year having had 32 targets, while this year’s has 18 and focuses on what matters most to patients, including, for instance, improving patient experience of access to general practice as measured by the Office for National Statistics’ Health Insights Survey and shifting focus from inputs to outcomes for patients.
Additionally, in the Elective Reform Plan, published on 6 January 2025, the Government committed to working with patients, carers, and their representatives to publish the standards that patients should expect to experience while they wait for care. Once published, these standards will set an expectation to all trusts for the service they are expected to deliver. We will continue to work with patients and carers to build on this work and establish a gold standard for experience.
We will support NHS trusts to prioritise the experience of care by ensuring they make customer care training available to non-clinical staff with patient facing roles, as well as ensuring the take up of training already available on the e-Referral Services to support more effective referral, booking, and waiting list management processes. NHS trusts will also be required to name an existing director who will be responsible for improving experience of care.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Cabinet Office:
To ask His Majesty's Government what assessment they have made of the tariffs imposed on the United Kingdom and European Union by the United States of America with regard to the Windsor Framework.
Answered by Baroness Anderson of Stoke-on-Trent - Baroness in Waiting (HM Household) (Whip)
We continue to closely monitor the impact on Northern Ireland of any tariffs. This government will always act in the best interests of all UK businesses which of course includes those in Northern Ireland.
Northern Ireland is a part of the United Kingdom customs territory and internal market. Northern Ireland exporters will face 10% US tariffs like exporters elsewhere in the UK.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government, following their Pathways to Work: Reforming Benefits and Support to Get Britain Working Green Paper, what steps they will take to upscale resources to accommodate the proposed increase in face-to-face Personal Independence Payment assessments.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
The Green Paper sets out measures to make improvements to the PIP assessment, including looking again at our safeguarding processes, moving back to having more face-to-face assessments while continuing to meet the needs of people who may require different assessment methods, recording more assessments to increase trust in the process, and exploring ways to use evidence from eligibility for other services to reduce the need for some people with very severe health conditions to undergo a full PIP functional assessment. The Department will consider its commitment to ensure resources are in place to carry out more face to face PIP assessments alongside other plans for reform laid out within Pathways to Work.
We also plan to review the PIP benefit assessment, working closely with stakeholders and those with lived experience, with an ambition of shaping a system of active support that helps people manage and adapt to their condition in ways that expand their functioning and improve their independence.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made, if any, of the impact of announced 50 per cent cuts to the running costs of integrated care boards on the provision of support to blood cancer patients, particularly in relation to patient experience and shared decision-making initiatives.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As part of the necessary changes to support the National Health Service to recover, NHS England has indicated that integrated care boards (ICBs) should reduce in size. The Government is supportive of NHS England’s decision and will work with NHS England to make the tough choices that are needed to get the NHS back on its feet. We expect ICBs to deliver on all of their commissioning responsibilities, including the provision of support for blood cancer patients. The Department has not carried out an assessment in regard to this area.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the NHS 10 Year Health Plan will include a long-term strategic approach to managing long-term conditions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We have committed to developing a 10-Year Health Plan to deliver a National Health Service fit for the future. While it’s too soon to say exactly what will be in the plan, it will set the vision for what good joined-up care looks like for people with long-term complex health needs.
The 10-Year Health Plan will deliver the three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions closer to home. Earlier diagnosis of conditions will help prevent deterioration and improve survival rates. All of these are relevant to managing and improving long-term conditions in all parts of the county.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take towards a decision on the expansion of the shingles national immunisation programme for adult cohorts aged 80 and over, as recommended by the Joint Committee on Vaccination and Immunisation in November 2024, and what is their timeline for that decision.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In November 2024, the Joint Committee on Vaccination and Immunisation provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over, as well as severely immunosuppressed adults aged 18 years old and over.
The Department is considering this advice as it sets the policy on who should be offered shingles vaccinations, and will update in due course. A timeline for decision-making has not been formally agreed.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what support they are providing to integrated care boards to develop effective multidisciplinary care pathways for primary biliary cholangitis, ensuring consistent and equitable care across different regions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The initial management of primary biliary cholangitis is through secondary care liver services, known as hepatology, and is commissioned by integrated care boards (ICBs). ICBs are responsible for arranging National Health Service services which meet the needs of their respective populations. A proportion of patients do not respond well to first line medical treatments and should be referred to specialised hepatology centres for advanced, second line therapies. These are commissioned by NHS England from specialised centres. Through the England rare diseases action plans, we are working to address sources of inequity and build a fairer system. Work is ongoing to include rare diseases in NHS England’s Core20PLUS5 framework, to support ICBs in addressing inequalities. In the 2025 action plan, we have introduced an action to incentivise providers to run clinics for multi-system disorders, which recognises the importance of a multidisciplinary approach and reduces the burden of co-ordination of care on families.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to engage stakeholders in local health services in adopting shared decision-making practices to improve patient choice and care outcomes for blood cancer.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As part of the National Cancer Plan, we are committed to working closely with partners and patient groups to shape the long-term vision for cancer, including for blood cancer. The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care. It will seek to improve every aspect of cancer care, including the design of services and the experience and outcomes for people with cancer. The Department does not currently have plans to engage in shared decision-making for blood cancer services specifically.
The Department is planning to engage blood cancer partners, charities, and those within the cancer community, seeking the views of individuals, professionals, and organisations to understand how we can do more to achieve this ambition. You may wish to share your views on the new online platform, which can be done via an online only format.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to ensure that care for people living with long-term conditions is provided in their local area.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Most services for long-term conditions are commissioned locally by integrated care boards (ICBs). ICBs have a statutory responsibility to commission services which meet the needs of their local population. It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop services and care pathways that are convenient and meet patients’ needs.
We have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future. While it’s too soon to say exactly what will be in the plan, it will set the vision for what good joined-up care looks like for people with long-term complex health needs.
The 10-Year Health Plan will deliver three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions closer to home.
As of December 2024, community diagnostic centres (CDCs) are now delivering additional tests and checks at 168 sites across the country. Since July 2021, CDCs have delivered over 12.2 million additional tests.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that patients at higher risk of severe illness from respiratory syncytial virus infection, such as those with pre-existing conditions or children who were born prematurely, are protected ahead of winter.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In line with independent expert advice from the Joint Committee on Vaccination and Immunisation (JCVI), respiratory syncytial virus (RSV) vaccination programmes were introduced in England in September 2024 to protect infants, via maternal vaccination, and older adults at the greatest risk of harm from RSV infection. The JCVI did not provide advice on other groups, as the analysis that informed their advice looked at burden by age.
When advising on the introduction of the RSV programmes, the JCVI said that an extension to the initial programmes would be considered when there was more certainty about protection for patients at higher risk of severe illness from RSV, including people aged 80 years old and older, and the real-world impact of the programme for 75 to 80 year olds. Advice for individuals less than 75 years old in clinical risk groups, including the immunocompromised and those with chronic obstructive pulmonary disease, would be guided by emerging evidence on disease incidence.
At their October 2024 main committee meeting, the JCVI agreed that it would need to formally review the evidence for a potential extension to the programme for people aged 80 years old and older and those in clinical risk groups. During the main committee meeting of 5 February 2025, the JCVI noted that it planned further discussions on potential advice towards extending the programme to those over 80 years old. JCVI meeting minutes are publicly available on the GOV.UK website, in an online only format. The Department will consider any further JCVI advice on who should be offered an RSV vaccine in due course.
The National Health Service also offers high-risk eligible infants a monoclonal antibody called palivizumab over the RSV season. Palivizumab is typically reserved for premature infants with specific major underlying medical conditions. In February 2023, the JCVI advised that existing infant risk groups eligible for RSV monoclonal antibody immunisation should preferentially be protected with nirsevimab over palivizumab. In October 2024, the committee supported work being taken forward for such a programme for all very/extremely premature infants, ideally from 2025/26. However, to date it has not been possible for the NHS to obtain a supply of nirsevimab for the programme. We are continuing to explore all options to ensure there is effective protection against severe RSV illness for this high-risk group.