Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 6 March (HL15294), whether they plan for ministers to be responsible for approving the NHS Payment Scheme after NHS England is abolished; and if so, whether ministers will be consulted about approval of that scheme in the transition period before new legislation is passed by Parliament to transfer that responsibility to ministers.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Primary legislation is required to enable the transfer of NHS England’s functions, powers and responsibilities formally to the Department or out to the wider system. Primary legislation is subject to the will of Parliament, and the Government welcomes parliamentary scrutiny of these provisions. The bill will be introduced in Parliament when parliamentary time allows.
Currently, NHS England is responsible for publishing the NHS Payment Scheme, with the relevant legislation set out in schedule 10 of the 2022 Health and Care Act. Under NHS England’s Scheme of Delegation, responsibility for approving the NHS Payment Scheme rests with the Chief Executive Officer of NHS England, delegated to the Chief Financial Officer of NHS England.
During development of the NHS Payment Scheme, NHS England engages with a wide range of stakeholders, including the Department. The 2026/27 NHS Payment Scheme was published on 26 March 2026 and incorporates a number of changes following consultation.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 18 December 2025 (HL12723), whether they have made a decision on whether to ask the National Audit Office to make an assessment of the 10 Year Workforce Plan; and when they expect to publish that plan.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
A decision on whether the National Audit Office will be asked to make an assessment of the 10 Year Workforce Plan has not been made. The plan’s modelling will, however, be subject to external scrutiny. The plan will be published in spring 2026.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 11 March (HL15135), in what circumstances a direction under the statutory instrument coming into force on 24 March would not be made.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is important that there is stability in the medicines regulatory and access landscape, and there should be a high bar for making changes to the cost-effectiveness threshold. It is the Government’s intention, therefore, that the power to set the cost-effectiveness threshold would be used rarely.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend that the 2026/27 NHS Payment Scheme consultation outcome in respect of guide prices for ADHD and autism assessments will be agreed to by Ministers before implementation.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The full responsibility for developing and setting the National Tariff, which is a set of rules, prices, and guidance that determine how providers of National Health Service funded healthcare are paid for the services they provide, was given to NHS England through the Health and Social Care Act 2012. The Health and Care Act 2022 confirmed this responsibility and renamed the ‘National Tariff’ to the ‘NHS Payment Scheme’. The legislation relating to the NHS Payment Scheme is set out in schedule 10 of the 2022 Act.
Under NHS England’s ‘Scheme of Delegation’, responsibility for approving the NHS Payment Scheme rests with the Chief Executive Officer of NHS England, delated to the Chief Financial Officer of NHS England. Ministerial agreement of the consultation is not currently a requirement of the regulations set out in the act.
NHS England will continue to work with policy teams at the Department and wider stakeholders to further develop currencies and consider appropriate payment options for attention deficit hyperactivity disorder and autism, in line with the overall direction set by ministers.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of NHS England's proposals in the consultation on the 2026/27 NHS Payment Scheme to set a £950 guide price for both adult and children and young people's autism assessments, given that children and young people's assessments includes additional components not required for adult assessments.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England was advised by a number of clinicians, policy professionals, commissioners, and providers of attention deficit hyperactivity disorder (ADHD) and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation. All National Health Service providers, commissioners, and independent sector providers of NHS-funded autism and ADHD services were invited to an NHS Payment Scheme engagement session in September.
The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all stakeholders to review the consultation guidance and provide comments and feedback. This consultation was open to the public, but NHS England specifically reached out to all NHS providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and ADHD services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation.
NHS England are currently reviewing this feedback to inform the final 2026/27 Payment Scheme.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in regard to the consultation on the 2026/27 NHS Payment Scheme, why NHS England have proposed the same guide price for adult and child autism assessments and different guide prices for child and adult attention deficit hyperactivity disorder assessments.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England was advised by a number of clinicians, policy professionals, commissioners, and providers of attention deficit hyperactivity disorder (ADHD) and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation. All National Health Service providers, commissioners, and independent sector providers of NHS-funded autism and ADHD services were invited to an NHS Payment Scheme engagement session in September.
The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all stakeholders to review the consultation guidance and provide comments and feedback. This consultation was open to the public, but NHS England specifically reached out to all NHS providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and ADHD services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation.
NHS England are currently reviewing this feedback to inform the final 2026/27 Payment Scheme.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to monitor the delivery of efficiency savings by NHS England, integrated care boards and NHS providers in order to fund the NHS Agenda for Change staff pay award 2026–27; and what steps they plan to take to ensure that those savings do not impact frontline services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has accepted the NHS Pay Review Body (NHSPRB) recommendation for a 2026/27 headline pay award, for all National Health Service staff on Agenda for Change (AfC), of a 3.3% pay rise effective from April 2026. We hugely appreciate the work of so many talented staff across the NHS. Accepting the recommendation gives NHS staff on AfC a deserved real terms pay rise.
The additional pressure above 2.5% affordability will be managed by the Department and the arms length bodies, including NHS England’s central budgets, but will not be paid for by cutting frontline services or an additional efficiency ask of integrated care boards and providers.
At the 2024 Autumn Statement and in our NHSPRB evidence, the Government reaffirmed its commitment to a 2% annual productivity growth target for the NHS and productivity is currently ahead of this target at 2.8% for the first seven months in this financial year. In 2025/26, systems have planned £11.1 billion of efficiencies and savings, or 7.1% of the total allocation. The planned efficiency and savings for the 2026/27 financial year will be finalised as part of the normal planning process that is currently underway.
Both efficiency and productivity performance is monitored on a monthly basis as part of our routine financial management to ensure the NHS lives within its budget.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the cash value of the productivity and efficiency savings to be made by NHS England, integrated care boards and NHS providers in order to fund the NHS Agenda for Change staff pay award 2026–27.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has accepted the NHS Pay Review Body (NHSPRB) recommendation for a 2026/27 headline pay award, for all National Health Service staff on Agenda for Change (AfC), of a 3.3% pay rise effective from April 2026. We hugely appreciate the work of so many talented staff across the NHS. Accepting the recommendation gives NHS staff on AfC a deserved real terms pay rise.
The additional pressure above 2.5% affordability will be managed by the Department and the arms length bodies, including NHS England’s central budgets, but will not be paid for by cutting frontline services or an additional efficiency ask of integrated care boards and providers.
At the 2024 Autumn Statement and in our NHSPRB evidence, the Government reaffirmed its commitment to a 2% annual productivity growth target for the NHS and productivity is currently ahead of this target at 2.8% for the first seven months in this financial year. In 2025/26, systems have planned £11.1 billion of efficiencies and savings, or 7.1% of the total allocation. The planned efficiency and savings for the 2026/27 financial year will be finalised as part of the normal planning process that is currently underway.
Both efficiency and productivity performance is monitored on a monthly basis as part of our routine financial management to ensure the NHS lives within its budget.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they still plan to increase the National Institute for Health and Care Excellence cost per quality-adjusted life years thresholds in April; and what steps they will take to implement that increase.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) currently assesses value for money for the National Health Service by applying a standard cost-effectiveness range of £20,000 to £30,000 per quality adjusted life year (QALY) gained over and above current treatments. As part of the landmark pharmaceuticals trade deal with the United States of America, it has been agreed that the cost-effectiveness threshold will be increased to £25,000 to £35,000 per QALY.
My Rt Hon. Friend, the Secretary of State for Health and Social Care, does not currently have the legal power to direct NICE to amend the cost-effectiveness threshold used in its technology appraisal or highly specialised technology programmes. The Government has therefore proceeded to amend the NICE regulations, to give ministers a limited power of direction to set the core cost-effectiveness threshold that NICE uses in the development of guidance, and remove the requirement for NICE to consult on methods changes where these result from a ministerial direction. The regulation change has been made by a statutory instrument which was laid before Parliament on 3 March 2026 and, subject to the will of Parliament, will come into force on 24 March 2026. In line with the United Kingdom-United States’ deal, NICE will implement the cost-effectiveness threshold increase in April 2026, following a direction from my Rt Hon. Friend, the Secretary of State for Health and Social Care.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the number of National Institute for Health and Care Excellence appraisals which are paused pending increases in the cost per quality-adjusted life year threshold in April.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently two appraisals paused, at the request of the company, until the National Institute for Health and Care Excellence (NICE) has the power to apply the new cost-effectiveness threshold:
NICE anticipates that its cost-effectiveness threshold will increase in April 2026 and will provide a further update to stakeholders at that time.