Question to the Department for Work and Pensions:

To ask His Majesty's Government, further to the Written Answer by Baroness Sherlock on 19 January (HL13274), whether they have now responded to the recommendations from the Keep Britain Working Review regarding the fit note; what further reforms to the fit note system they plan beyond the WorkWell Primary Care Innovation Fund pilots; and when they expect to publish those plans.

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

On 20th May 2026, the Government announced that it would test reform of the fit note, beginning with pilots across four integrated care boards in England. These pilots are funded by £3m in the first year and will take place within a small number of GP surgeries across the following areas: Birmingham and Solihull, Cornwall and Isles of Scilly, Coventry and Warwickshire, and Lancashire and South Cumbria.

The pilots will explore replacing the traditional GP-led fit note process with newly designed plans that provide better support to people who fall ill at work. They aim to move from a process of administrative sickness certification to a new service focussed on getting people the support they need to stay in work and sustainably return.

Whilst specific elements of pilot design are to be shaped locally, broadly, the pilots will test:

• New stay in work and return to work plans that provide patients with timely, proportionate, and actionable advice and support to manage their health condition
• New work and health teams who develop the plans and facilitate joined-up conversations between patients and their employers around support or adjustments needed in the workplace

The pilots have been designed through close engagement with GP leaders and the health system. We are also working with employer and patient groups to shape design as pilots progress. Within all four pilots, teams will be able to sign people off work who need time to recover from their illness. The pilots are focussed on the in-work population (either those who are at risk of falling out of work due to illness or those who are already signed off sick). Participation will be voluntary, and the pilots will not determine eligibility for any benefit entitlement or replace the Work Capability Assessment. Any future rollout or legislative reform will be informed by learnings from the pilots.

The fit note pilots are a key element of the Government's response to the recommendations made in the Keep Britain Working Review, published in November 2025. The Review was clear that the fit note is 'not working as intended', and called for the Government to test alternatives and replacements to the fit note. Any long-term system reform is expected to combine employer and state funded provision, balancing the engagement benefits of employer-led support with the necessity for non-workplace provision (for example, for those who leave work due to illness). We are working closely with the Keep Britain Working Vanguards as they test the 'best case' for an employer-led intervention, with the NHS-based pilots running in parallel, and learnings from each model being used to inform future reform.

Question to the Attorney General:

To ask His Majesty's Government, further to the Written Answer by Lord Hermer on 27 April (HL16377), how the artificial intelligence tool developed by Cabinet Office and No.10 defines "disproportionate" reporting and consultation duties; and on what data or criteria the tool was trained to make that determination.

Answered by Lord Hermer

The AI tool identifies solely the reporting and consultation duties, it does not specify whether they are ‘disproportionate’ or not. The policy development around this is ongoing; decisions on proportionality remain the purview of ministers.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what proportion of Midlife MOTs were delivered (1) online, and (2) in person, in each of the last five years.

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

The Department for Work and Pensions has published management information on the number of claimants referred to and who attended the Jobcentre Plus Midlife MoT group sessions since the launch of the policy in January 2023 to June 2025. See “Jobcentre Plus Midlife MOT Group Sessions, January 2023 to June 2025”. Table 1 below provides a yearly breakdown of these figures. Providing data beyond June 2025 would exceed the cost limits in answering Parliamentary Questions.

Table 1 – Number of referrals and attendees to JCP Midlife MoT group sessions

Table 2 below shows an age breakdown of the volumes of individuals referred to and who attended a JCP Midlife MOT group session during January 2023 to June 2025. Providing data beyond June 2025 and by individual year would exceed the cost limits in answering Parliamentary Questions.

Table 2 Age group breakdown of referrals and starts to JCP Midlife MoT group sessions, January 2023 to June 25

The DWP Midlife MOT website and the JCP Midlife MOT group sessions cover similar topics but are not directly comparable in terms of content. Figures for the two policies are as follows. From January 2024 to June 2025 there have been 85,142 individuals referred to and 64,105 individuals who have attended a Jobcentre Plus Midlife MoT group session.

Figures for the number of visitors to the DWP Midlife MoT website have been published as part of the evaluation of the DWP Midlife MoT website, see “Evaluation evidence from policies aimed at claimants aged 50 plus”. This report provides figures from Nov 2023 to March 2026. During this period the website was accessed by users 59,968 times by a total of 38,554 individuals. The evaluation did not collect any data on whether visits to the DWP Midlife MOT website influenced users’ behaviour. Providing further data on the JCP Midlife MoT group sessions and the DWP Midlife MoT website would exceed the costs limits for answering Parliamentary Questions.

DWP has published an evaluation of the Private Sector Midlife MOT scheme. See “Private Sector Midlife MOT Pilots qualitative research interim findings”. Low employer and participant uptake resulted in the pilots concluding early.

Question to the Department for Work and Pensions:

To ask His Majesty's Government how many individuals have received Midlife MOTs, broken down by age, in each of the last five years.

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

The Department for Work and Pensions has published management information on the number of claimants referred to and who attended the Jobcentre Plus Midlife MoT group sessions since the launch of the policy in January 2023 to June 2025. See “Jobcentre Plus Midlife MOT Group Sessions, January 2023 to June 2025”. Table 1 below provides a yearly breakdown of these figures. Providing data beyond June 2025 would exceed the cost limits in answering Parliamentary Questions.

Table 1 – Number of referrals and attendees to JCP Midlife MoT group sessions

Table 2 below shows an age breakdown of the volumes of individuals referred to and who attended a JCP Midlife MOT group session during January 2023 to June 2025. Providing data beyond June 2025 and by individual year would exceed the cost limits in answering Parliamentary Questions.

Table 2 Age group breakdown of referrals and starts to JCP Midlife MoT group sessions, January 2023 to June 25

The DWP Midlife MOT website and the JCP Midlife MOT group sessions cover similar topics but are not directly comparable in terms of content. Figures for the two policies are as follows. From January 2024 to June 2025 there have been 85,142 individuals referred to and 64,105 individuals who have attended a Jobcentre Plus Midlife MoT group session.

Figures for the number of visitors to the DWP Midlife MoT website have been published as part of the evaluation of the DWP Midlife MoT website, see “Evaluation evidence from policies aimed at claimants aged 50 plus”. This report provides figures from Nov 2023 to March 2026. During this period the website was accessed by users 59,968 times by a total of 38,554 individuals. The evaluation did not collect any data on whether visits to the DWP Midlife MOT website influenced users’ behaviour. Providing further data on the JCP Midlife MoT group sessions and the DWP Midlife MoT website would exceed the costs limits for answering Parliamentary Questions.

DWP has published an evaluation of the Private Sector Midlife MOT scheme. See “Private Sector Midlife MOT Pilots qualitative research interim findings”. Low employer and participant uptake resulted in the pilots concluding early.

Question to the Department for Work and Pensions:

To ask His Majesty's Government how many Midlife MOTs were delivered annually in the each of the last five years.

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

The Department for Work and Pensions has published management information on the number of claimants referred to and who attended the Jobcentre Plus Midlife MoT group sessions since the launch of the policy in January 2023 to June 2025. See “Jobcentre Plus Midlife MOT Group Sessions, January 2023 to June 2025”. Table 1 below provides a yearly breakdown of these figures. Providing data beyond June 2025 would exceed the cost limits in answering Parliamentary Questions.

Table 1 – Number of referrals and attendees to JCP Midlife MoT group sessions

Table 2 below shows an age breakdown of the volumes of individuals referred to and who attended a JCP Midlife MOT group session during January 2023 to June 2025. Providing data beyond June 2025 and by individual year would exceed the cost limits in answering Parliamentary Questions.

Table 2 Age group breakdown of referrals and starts to JCP Midlife MoT group sessions, January 2023 to June 25

The DWP Midlife MOT website and the JCP Midlife MOT group sessions cover similar topics but are not directly comparable in terms of content. Figures for the two policies are as follows. From January 2024 to June 2025 there have been 85,142 individuals referred to and 64,105 individuals who have attended a Jobcentre Plus Midlife MoT group session.

Figures for the number of visitors to the DWP Midlife MoT website have been published as part of the evaluation of the DWP Midlife MoT website, see “Evaluation evidence from policies aimed at claimants aged 50 plus”. This report provides figures from Nov 2023 to March 2026. During this period the website was accessed by users 59,968 times by a total of 38,554 individuals. The evaluation did not collect any data on whether visits to the DWP Midlife MOT website influenced users’ behaviour. Providing further data on the JCP Midlife MoT group sessions and the DWP Midlife MoT website would exceed the costs limits for answering Parliamentary Questions.

DWP has published an evaluation of the Private Sector Midlife MOT scheme. See “Private Sector Midlife MOT Pilots qualitative research interim findings”. Low employer and participant uptake resulted in the pilots concluding early.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what plans they have to support older adults to gain the numerical and financial literacy skills to manage their finances ahead of and during retirement.

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

The government recognises the importance of ensuring that people have the skills, knowledge and support necessary to manage their finances effectively and offers a range of initiatives to help individuals prepare ahead of and during retirement.

Adults in England can access funded Essential Skills provision, including numeracy courses, to help them develop practical maths skills for everyday life, including budgeting and managing household finances.

For those receiving benefits, work coaches can refer customers with numeracy skills gaps to appropriate training. In addition, Midlife MOTs delivered in Jobcentres help people aged over 50 on Universal Credit review their finances, skills and health, and signpost them to suitable support. A digital Midlife MOT is also available to everyone.

The government also supports financial capability through the Money and Pensions Service. Its MoneyHelper service provides free and impartial money and pensions guidance, budgeting tools and calculators, while Pension Wise offers free guidance appointments to people aged 50 and over to help them understand their pension options and make informed decisions about retirement.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what assessment they have made of the private sector Midlife MOT pilot scheme delivered in the North East of England, Cornwall and Devon, and East Anglia.

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

The Department for Work and Pensions has published management information on the number of claimants referred to and who attended the Jobcentre Plus Midlife MoT group sessions since the launch of the policy in January 2023 to June 2025. See “Jobcentre Plus Midlife MOT Group Sessions, January 2023 to June 2025”. Table 1 below provides a yearly breakdown of these figures. Providing data beyond June 2025 would exceed the cost limits in answering Parliamentary Questions.

Table 1 – Number of referrals and attendees to JCP Midlife MoT group sessions

Table 2 below shows an age breakdown of the volumes of individuals referred to and who attended a JCP Midlife MOT group session during January 2023 to June 2025. Providing data beyond June 2025 and by individual year would exceed the cost limits in answering Parliamentary Questions.

Table 2 Age group breakdown of referrals and starts to JCP Midlife MoT group sessions, January 2023 to June 25

The DWP Midlife MOT website and the JCP Midlife MOT group sessions cover similar topics but are not directly comparable in terms of content. Figures for the two policies are as follows. From January 2024 to June 2025 there have been 85,142 individuals referred to and 64,105 individuals who have attended a Jobcentre Plus Midlife MoT group session.

Figures for the number of visitors to the DWP Midlife MoT website have been published as part of the evaluation of the DWP Midlife MoT website, see “Evaluation evidence from policies aimed at claimants aged 50 plus”. This report provides figures from Nov 2023 to March 2026. During this period the website was accessed by users 59,968 times by a total of 38,554 individuals. The evaluation did not collect any data on whether visits to the DWP Midlife MOT website influenced users’ behaviour. Providing further data on the JCP Midlife MoT group sessions and the DWP Midlife MoT website would exceed the costs limits for answering Parliamentary Questions.

DWP has published an evaluation of the Private Sector Midlife MOT scheme. See “Private Sector Midlife MOT Pilots qualitative research interim findings”. Low employer and participant uptake resulted in the pilots concluding early.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what assessment they have made of the reach and impact of the Digital Midlife MOT website.

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

The Department for Work and Pensions has published management information on the number of claimants referred to and who attended the Jobcentre Plus Midlife MoT group sessions since the launch of the policy in January 2023 to June 2025. See “Jobcentre Plus Midlife MOT Group Sessions, January 2023 to June 2025”. Table 1 below provides a yearly breakdown of these figures. Providing data beyond June 2025 would exceed the cost limits in answering Parliamentary Questions.

Table 1 – Number of referrals and attendees to JCP Midlife MoT group sessions

Table 2 below shows an age breakdown of the volumes of individuals referred to and who attended a JCP Midlife MOT group session during January 2023 to June 2025. Providing data beyond June 2025 and by individual year would exceed the cost limits in answering Parliamentary Questions.

Table 2 Age group breakdown of referrals and starts to JCP Midlife MoT group sessions, January 2023 to June 25

The DWP Midlife MOT website and the JCP Midlife MOT group sessions cover similar topics but are not directly comparable in terms of content. Figures for the two policies are as follows. From January 2024 to June 2025 there have been 85,142 individuals referred to and 64,105 individuals who have attended a Jobcentre Plus Midlife MoT group session.

Figures for the number of visitors to the DWP Midlife MoT website have been published as part of the evaluation of the DWP Midlife MoT website, see “Evaluation evidence from policies aimed at claimants aged 50 plus”. This report provides figures from Nov 2023 to March 2026. During this period the website was accessed by users 59,968 times by a total of 38,554 individuals. The evaluation did not collect any data on whether visits to the DWP Midlife MOT website influenced users’ behaviour. Providing further data on the JCP Midlife MoT group sessions and the DWP Midlife MoT website would exceed the costs limits for answering Parliamentary Questions.

DWP has published an evaluation of the Private Sector Midlife MOT scheme. See “Private Sector Midlife MOT Pilots qualitative research interim findings”. Low employer and participant uptake resulted in the pilots concluding early.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what mechanisms currently allow local authority-commissioned services, including treatment services funded through the Public Health Grant, to access nationally negotiated NHS commercial prices for pharmaceuticals; how frequently those mechanisms are used; and what is the total value of pharmaceuticals purchased by local authorities at nationally negotiated NHS prices in the most recent financial year for which data is available.

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

Local authorities are responsible for commissioning drug and alcohol treatment services according to local need, including the provision of pharmaceuticals such as methadone and long-acting injectable buprenorphine.

From 2026/27, funding for drug and alcohol treatment and recovery is provided through the Department’s ringfenced Public Health Grant. The Department encourages local authorities to prioritise appropriate investment in evidence-based interventions and treatments.

National Health Service commercial arrangements for pharmaceuticals are primarily established to support the procurement of medicines for NHS-funded services. The Department has no current plans to establish separate national commercial agreements specifically for pharmaceuticals used in Public Health Grant-funded substance misuse services. We continue to work with NHS England and local authority partners to consider opportunities to improve access to effective treatments and secure value for money.

The Department supports interventions to expand the provision of long-acting injectable buprenorphine. We are currently undertaking further analysis to understand cost-effectiveness, developing clinical guidance, and considering options to expand access further.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have, if any, to establish national commercial agreements for pharmaceuticals used in Public Health Grant-funded substance misuse services; and whether any barriers prevent the extension of NHS Medicines Procurement and Supply Chain framework access to drug and alcohol treatment services.

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

Local authorities are responsible for commissioning drug and alcohol treatment services according to local need, including the provision of pharmaceuticals such as methadone and long-acting injectable buprenorphine.

From 2026/27, funding for drug and alcohol treatment and recovery is provided through the Department’s ringfenced Public Health Grant. The Department encourages local authorities to prioritise appropriate investment in evidence-based interventions and treatments.

National Health Service commercial arrangements for pharmaceuticals are primarily established to support the procurement of medicines for NHS-funded services. The Department has no current plans to establish separate national commercial agreements specifically for pharmaceuticals used in Public Health Grant-funded substance misuse services. We continue to work with NHS England and local authority partners to consider opportunities to improve access to effective treatments and secure value for money.

The Department supports interventions to expand the provision of long-acting injectable buprenorphine. We are currently undertaking further analysis to understand cost-effectiveness, developing clinical guidance, and considering options to expand access further.

Found: Lord Stevenson of Balmacara Baroness Shawcross-Wolfson

Found: Lord Massey of Hampstead Baroness Shawcross-Wolfson

Found: Apologies and notices Apologies were received from Lord Barber of Chittlehampton, Baroness Shawcross- Wolfson

Found: Mohammed of Tinsley Lord Mott Baroness Nichols of Selby Baroness Pidgeon Baroness Redfern Baroness Shawcross-Wolfson

Found: Other members present: Baroness Shawcross-Wolfson

Found: Lord Stevenson of Balmacara Other members present: Baroness Shawcross-Wolfson

Found: Frognal; Lord Hampton; Baroness Hamwee; Lord Hannett of Everton; Lord Massey of Hampstead; Baroness Shawcross-Wolfson

Found: of Marylebone Lord Mohammed of Tinsley Lord Mott Baroness Pidgeon Baroness Redfern Baroness Shawcross-Wolfson

Found: of Tinsley; Lord Mott; Baroness Nichols of Selby; Baroness Pidgeon; Baroness Redfern; Baroness Shawcross-Wolfson

Found: Baroness Shawcross-Wolfson Former school governor and trustee of a mathematics charity.

Found: Garden of Frognal; Baroness Hamwee; Lord Hannett of Everton; Lord Massey of Hampstead; Baroness Shawcross-Wolfson

Found: Garden of Frognal; Baroness Hamwee; Lord Hannett of Everton; Lord Massey of Hampstead; Baroness Shawcross-Wolfson

Found: Apologies were received from Lord Faulkner of Worcester, Baroness Nichols of Selby, and Baroness Shawcross-Wolfson

Found: Marylebone; Lord Mohammed of Tinsley; Lord Mott; Baroness Pidgeon; Baroness Redfern; Baroness Shawcross-Wolfson

Found: Hollins Lord Mohammed of Tinsley Lord Mott Baroness Nichols of Selby Baroness Pidgeon Baroness Shawcross-Wolfson

Found: Bexley Health and Wellbeing Board Baroness Pidgeon No relevant interests to declare Baroness Shawcross-Wolfson

Found: Tinsley Lord Mott Baroness Nichols of Selby Baroness O’Neill of Bexley Baroness Pidgeon Baroness Shawcross-Wolfson