Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether there is a realistic pathway for current British medical students to access specialist training either abroad or at home following the implementation of the Medical Training (Prioritisation) Act 2026.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026 implements the Government’s commitment in the 10-Year Health Plan to prioritise United Kingdom medical graduates for foundation training places, and to prioritise UK medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, under the Act, immigration status will no longer automatically determine priority for specialty training. Instead, the act provides a power to specify in regulations any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department is working with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations. We will set out next steps in due course.
The Act is not designed to, and does not, exclude any eligible applicants from applying for medical foundation or specialty training. Non-prioritised graduates can still apply, and they will be offered places if vacancies remain after prioritised applicants have received offers. For individuals who do not secure a foundation year one post this year, there are alternative routes to pursuing a medical career in the UK. These include obtaining full General Medical Council (GMC) registration through the established GMC pathways, such as completing an approved internship in the country where they trained and then entering the UK healthcare system through applying to a locally employed doctor role or another non-training post.
The Government has no plans to introduce transitional arrangements for the implementation of the Act.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether previous structured undergraduate clinical training in NHS hospitals will count towards the requirement in the Medical Training (Prioritisation) Act 2026 that prioritised applicants for postgraduate medical training should have had significant experience of working in the NHS; and if so, to what extent.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026 implements the Government’s commitment in the 10-Year Health Plan to prioritise United Kingdom medical graduates for foundation training places, and to prioritise UK medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, under the Act, immigration status will no longer automatically determine priority for specialty training. Instead, the act provides a power to specify in regulations any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department is working with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations. We will set out next steps in due course.
The Act is not designed to, and does not, exclude any eligible applicants from applying for medical foundation or specialty training. Non-prioritised graduates can still apply, and they will be offered places if vacancies remain after prioritised applicants have received offers. For individuals who do not secure a foundation year one post this year, there are alternative routes to pursuing a medical career in the UK. These include obtaining full General Medical Council (GMC) registration through the established GMC pathways, such as completing an approved internship in the country where they trained and then entering the UK healthcare system through applying to a locally employed doctor role or another non-training post.
The Government has no plans to introduce transitional arrangements for the implementation of the Act.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether students who were already enrolled in medical degree courses recognised by the General Medical Council before the Medical Training (Prioritisation) Act 2026 was passed will receive transitional or grandfathering protection
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026 implements the Government’s commitment in the 10-Year Health Plan to prioritise United Kingdom medical graduates for foundation training places, and to prioritise UK medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, under the Act, immigration status will no longer automatically determine priority for specialty training. Instead, the act provides a power to specify in regulations any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department is working with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations. We will set out next steps in due course.
The Act is not designed to, and does not, exclude any eligible applicants from applying for medical foundation or specialty training. Non-prioritised graduates can still apply, and they will be offered places if vacancies remain after prioritised applicants have received offers. For individuals who do not secure a foundation year one post this year, there are alternative routes to pursuing a medical career in the UK. These include obtaining full General Medical Council (GMC) registration through the established GMC pathways, such as completing an approved internship in the country where they trained and then entering the UK healthcare system through applying to a locally employed doctor role or another non-training post.
The Government has no plans to introduce transitional arrangements for the implementation of the Act.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to consult British medical students currently studying on overseas campuses of British universities before finalising the regulations due to be made in 2027 under the Medical Training (Prioritisation) Act 2026.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026 implements the Government’s commitment in the 10-Year Health Plan to prioritise United Kingdom medical graduates for foundation training places, and to prioritise UK medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, under the Act, immigration status will no longer automatically determine priority for specialty training. Instead, the act provides a power to specify in regulations any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department is working with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations. We will set out next steps in due course.
The Act is not designed to, and does not, exclude any eligible applicants from applying for medical foundation or specialty training. Non-prioritised graduates can still apply, and they will be offered places if vacancies remain after prioritised applicants have received offers. For individuals who do not secure a foundation year one post this year, there are alternative routes to pursuing a medical career in the UK. These include obtaining full General Medical Council (GMC) registration through the established GMC pathways, such as completing an approved internship in the country where they trained and then entering the UK healthcare system through applying to a locally employed doctor role or another non-training post.
The Government has no plans to introduce transitional arrangements for the implementation of the Act.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government on the basis of what evidence a period of five years was been chosen as the period necessary to demonstrate "significant NHS experience" for the purposes of the Medical Training (Prioritisation) Act 2026.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medical Training (Prioritisation) Act 2026 implements the Government’s commitment in the 10-Year Health Plan to prioritise United Kingdom medical graduates for foundation training places, and to prioritise UK medical graduates and other doctors with significant National Health Service experience for specialty training places.
For specialty training places starting in 2026, immigration statuses are being used as a proxy to capture applicants who are most likely to have significant experience working in the health service in the UK.
From 2027, under the Act, immigration status will no longer automatically determine priority for specialty training. Instead, the act provides a power to specify in regulations any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. The Department is working with NHS England, the devolved administrations, and other partners on how best to define and evidence significant NHS experience as part of the development of those regulations. We will set out next steps in due course.
The Act is not designed to, and does not, exclude any eligible applicants from applying for medical foundation or specialty training. Non-prioritised graduates can still apply, and they will be offered places if vacancies remain after prioritised applicants have received offers. For individuals who do not secure a foundation year one post this year, there are alternative routes to pursuing a medical career in the UK. These include obtaining full General Medical Council (GMC) registration through the established GMC pathways, such as completing an approved internship in the country where they trained and then entering the UK healthcare system through applying to a locally employed doctor role or another non-training post.
The Government has no plans to introduce transitional arrangements for the implementation of the Act.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what arrangements are in place to ensure independent assessment of the performance of Integrated Care Boards (ICBs) following the abolition of NHS England; and who will be responsible for publishing comparative performance data between ICBs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Health Bill, subject to parliamentary passage, proposes to transfer the requirement to conduct annual assessments of integrated care boards from NHS England to my Rt Hon. Friend, the Secretary of State for Health and Social Care, and to focus assessments on the statutory functions of these organisations.
The Health Bill also proposes that my Rt Hon. Friend, the Secretary of State for Health and Social Care, must publish a report each financial year containing a summary of the results of each performance assessment conducted with respect to that year.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what data they collect on variation in diagnostic waiting times between Integrated Care Boards; and whether those data will be published routinely.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Waiting times for 15 key diagnostic tests (DM01) are collected and published monthly, reported two months in arrears. Diagnostic performance is reported as the proportion of diagnostic waits of over six weeks. Statistics on DM01 performance variation by integrated care board are published on the NHS.UK website in an online-only format.
Asked by: Earl Howe (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 benefits that single point of access models of referral could bring to improving access to specialist care, reducing pressure on NHS services and supporting earlier intervention in relation to heart disease.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Emerging evidence from local services suggests Single Point of Access (SPoA) supports patients to receive rapid specialist assessments and a clear next step for their treatment by embedding a timely specialist clinical review at the start of the pathway, including for cardiology and cardiothoracic referrals. The model helps patients access the right clinic, diagnostic service, or care setting the first time, and averts the need for them to join lengthy hospital waiting lists unnecessarily, ensuring capacity is available for patients that need specialist care. We are also supporting the development and evaluation of streamlined referral pathways, including SPoA and rapid access valve assessment models, as part of wider cardiovascular pathway improvement work.
As set out in the Medium Term Planning Framework all providers are, from April 2026, expected to prioritise Advice and Guidance (A&G) requests for at least 10 specialties, selected locally for the greatest overall benefit, ahead of ensuring all appropriate requests and referrals flow through a SPoA model from October 2026. Providers are expected to begin implementation of SPoA by prioritising the 10 specialties selected for A&G. The specialties selected by providers could include cardiology or cardiothoracic surgery, which would cover care for heart valve disease.
Technical guidance has been issued to providers outlining expectations to support SPoA implementation. There are currently no specific plans to mandate SPoA in national service specifications. However, we are developing a new Cardiovascular Disease Modern Service Framework, due to be published shortly, which will support the adoption of evidence‑based pathway improvements.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to include single point of access referral models for heart valve disease within future national service specifications, clinical guidance or strategic plans for cardiovascular disease services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Emerging evidence from local services suggests Single Point of Access (SPoA) supports patients to receive rapid specialist assessments and a clear next step for their treatment by embedding a timely specialist clinical review at the start of the pathway, including for cardiology and cardiothoracic referrals. The model helps patients access the right clinic, diagnostic service, or care setting the first time, and averts the need for them to join lengthy hospital waiting lists unnecessarily, ensuring capacity is available for patients that need specialist care. We are also supporting the development and evaluation of streamlined referral pathways, including SPoA and rapid access valve assessment models, as part of wider cardiovascular pathway improvement work.
As set out in the Medium Term Planning Framework all providers are, from April 2026, expected to prioritise Advice and Guidance (A&G) requests for at least 10 specialties, selected locally for the greatest overall benefit, ahead of ensuring all appropriate requests and referrals flow through a SPoA model from October 2026. Providers are expected to begin implementation of SPoA by prioritising the 10 specialties selected for A&G. The specialties selected by providers could include cardiology or cardiothoracic surgery, which would cover care for heart valve disease.
Technical guidance has been issued to providers outlining expectations to support SPoA implementation. There are currently no specific plans to mandate SPoA in national service specifications. However, we are developing a new Cardiovascular Disease Modern Service Framework, due to be published shortly, which will support the adoption of evidence‑based pathway improvements.
Asked by: Earl Howe (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 potential contribution of single point of access referral models to reducing avoidable mortality and improving outcomes for patients with heart valve disease.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Emerging evidence from local services suggests Single Point of Access (SPoA) supports patients to receive rapid specialist assessments and a clear next step for their treatment by embedding a timely specialist clinical review at the start of the pathway, including for cardiology and cardiothoracic referrals. The model helps patients access the right clinic, diagnostic service, or care setting the first time, and averts the need for them to join lengthy hospital waiting lists unnecessarily, ensuring capacity is available for patients that need specialist care. We are also supporting the development and evaluation of streamlined referral pathways, including SPoA and rapid access valve assessment models, as part of wider cardiovascular pathway improvement work.
As set out in the Medium Term Planning Framework all providers are, from April 2026, expected to prioritise Advice and Guidance (A&G) requests for at least 10 specialties, selected locally for the greatest overall benefit, ahead of ensuring all appropriate requests and referrals flow through a SPoA model from October 2026. Providers are expected to begin implementation of SPoA by prioritising the 10 specialties selected for A&G. The specialties selected by providers could include cardiology or cardiothoracic surgery, which would cover care for heart valve disease.
Technical guidance has been issued to providers outlining expectations to support SPoA implementation. There are currently no specific plans to mandate SPoA in national service specifications. However, we are developing a new Cardiovascular Disease Modern Service Framework, due to be published shortly, which will support the adoption of evidence‑based pathway improvements.