Question to the Department for Work and Pensions:

To ask His Majesty's Government what pilots are currently underway to test reforms to the fit note system, including the locations and duration of those pilots, and the groups of patients and employers involved; what further reforms to the fit note system they are planning, beyond the current pilots; and when they expect to publish further details.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

On 11th July 2025, we announced a WorkWell Primary Care Innovation Fund, which offered a portion of £1.5 million of single year funding to each of the fifteen WorkWell pilot sites to test innovative approaches to the fit note within primary care.

The funding is supporting local areas to boost capacity in primary care to provide better work and health support via the fit note process, with the longer term aims of reducing pressure on GPs and improving patients’ work and health outcomes.

Each of the 15 WorkWell Integrated Care Boards has received up to £100,000, with interventions running from October 2025 to March 2026. The locations of the sites are:

Birmingham and Solihull,

Black Country,

Bristol North Somerset and South Gloucestershire (BNSSG),

Cambridgeshire,

Cornwall and Isles of Scilly,

Coventry,

Frimley,

Greater Manchester,

Herefordshire,

Lancashire and South Cumbria,

Leicester, Leicestershire and Rutland (LLR),

North Central London,

North West London,

South Yorkshire, and

Surrey Heartlands.

One of the key aims of the funding is to build the evidence base for how the fit note process within primary care can be improved, and findings will inform future policy development. Most sites are using the funding to test new or additional roles within Primary Care Networks, including social prescribers, work and health coaches, or physiotherapists, to either issue the fit note instead of the GP or provide wraparound work and health support to the fit note recipient.

However, we know that we need to go further. The Keep Britain Working Review was clear that the fit note is ‘not working as intended’ and recommended that we test alternative approaches to the fit note, working with GPs and health services to explore improvements and replacements. We are currently considering how to respond to the Review’s recommendations on the fit note, and we will bring forward more information in due course.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what progress they have made on setting up the Workplace Health Intelligence Unit proposed in the Mayfield Review, and what its planned remit, governance arrangements, and timetable for operation are.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.

As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.

The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.

Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what progress they have made on establishing the Vanguard taskforce proposed in the Mayfield Review, and when the taskforce is expected to start work.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.

As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.

The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.

Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what are their plans for reforming the Access to Work scheme, including the objectives and timetable of any such reform, and how they will involve disabled people and representative organisations.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

This Government values the input of disabled people and people with health conditions, their representative organisations and people that support them. The Pathways to Work Green Paper launched a consultation which has now concluded. We are considering responses to the consultation.

We also have recently concluded the Access to Work Collaboration Committees, in which we engaged with a range of stakeholders, including disabled people’s organisation representatives and lived experience users, to provide discussion, experience, and challenge to the design of the future Access to Work Scheme.

Whilst the committees have now ended, we will seek opportunity to engage with stakeholders as we move forward with policy development, recognising the value of their input and expertise.

The findings from the consultation and Collaboration Committees will inform the chosen future direction of Access to Work. Once this is established we will set out our plans working closely with stakeholders to ensure an appropriate transition.

Question to the Cabinet Office:

To ask His Majesty's Government, further to the Written Answer by Baroness Anderson of Stoke-on-Trent on 2 January (HL13204), whether they expect the overall Civil Service headcount to decrease, stay the same, or increase between this year and 2030.

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

Departments are developing plans on the size and shape of their workforces as per the financial settlements that were agreed with HMT in the Spending Review and the priorities set by Ministers, including those set out in the Autumn Budget. These plans will take a whole workforce approach based on the cost of civil servants, Contingent Labour, Consultancy and Managed Services.

At an overall Civil Service level, we have set out plans to reduce back office costs by 16% over the next five years, delivering savings of over £2.2 billion a year by 2030 and targeting spending on front line services. The Civil Service is committed to publishing a Civil Service Strategic Workforce Plan this year, which will confirm more details about the plans for our workforce.

Question to the Cabinet Office:

To ask His Majesty's Government, further to the Written Answer by Baroness Anderson of Stoke-on-Trent on 2 January (HL13132), whether the arm's length bodies (ALB) review described as "recently completed" in paragraph 2.84 of the November 2025 Budget is a separate review to the one described as ongoing in this answer; and whether the decision to close NHS England, announced on 13 March 2025, was a result of either of these ALB reviews.

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

The reference in paragraph 2.84 of the November 2025 Budget refers to the arm's length body review that was launched on 6 April 2025. That review is ongoing. The decision to close NHS England, announced on 13 March 2025, predates the launch of the arm's length bodies (ALB) review.

Question to the Department for Business and Trade:

To ask His Majesty's Government what specific targets they have to reduce government regulation.

Answered by Baroness Lloyd of Effra - Baroness in Waiting (HM Household) (Whip)

The Government has published a comprehensive Regulation Action Plan that sets out our plans to reform the regulatory system to unlock growth, boost innovation and reduce burdens on businesses across key sectors.

One of the key commitments in the Action Plan is the target to cut the administrative burden of regulation on business by 25%, or £5.6bn, by the end of the Parliament. This pledge will save businesses time and money and help create a regulatory environment that is targeted, proportionate, transparent and agile enough to support economic growth.