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.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what discussions they are holding with NHS England and the UK National Screening Committee on coordinating evidence review, funding decisions and procurement so that, if approved, digital breast tomosynthesis can be implemented at pace and scale across the NHS breast screening programme.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the benefits that emerging innovative technologies such as digital breast tomosynthesis (DBT) may bring to the NHS Breast Screening Programme. At present, DBT is an optional tool in the assessment of screen detected soft tissue breast abnormalities following mammography. Digital mammography, which offers high quality images, currently remains the primary screening tool for the programme as recommended by the UK National Screening Committee (UK NSC).
In 2025, the UK NSC, who advise the Government on all screening matters, set up a working group of breast cancer screening experts to help it consider new and emerging evidence and developments that could further improve the United Kingdom breast screening programmes. This includes exploring modalities such as DBT in addition to other tests and technologies, to detect breast cancer in women with dense breast tissue.
If, following this work, the UK NSC makes a recommendation regarding DBT, my Rt Hon. Friend, the Secretary of State for Health and Social Care, would be asked to make a decision on whether to accept the recommendation, alongside wider policy and operational advice.
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 cost effectiveness of digital breast tomosynthesis in the NHS breast screening programme, including the impact of improved cancer detection and reduced recall rates on treatment costs and patient outcomes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the benefits that emerging innovative technologies such as digital breast tomosynthesis (DBT) may bring to the NHS Breast Screening Programme. At present, DBT is an optional tool in the assessment of screen detected soft tissue breast abnormalities following mammography. Digital mammography, which offers high quality images, currently remains the primary screening tool for the programme as recommended by the UK National Screening Committee (UK NSC).
In 2025, the UK NSC, who advise the Government on all screening matters, set up a working group of breast cancer screening experts to help it consider new and emerging evidence and developments that could further improve the United Kingdom breast screening programmes. This includes exploring modalities such as DBT in addition to other tests and technologies, to detect breast cancer in women with dense breast tissue.
If, following this work, the UK NSC makes a recommendation regarding DBT, my Rt Hon. Friend, the Secretary of State for Health and Social Care, would be asked to make a decision on whether to accept the recommendation, alongside wider policy and operational advice.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will set clear timelines in the NHS breast screening programme for implementing innovative technologies, including digital breast tomosynthesis.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the benefits that emerging innovative technologies such as digital breast tomosynthesis (DBT) may bring to the NHS Breast Screening Programme. At present, DBT is an optional tool in the assessment of screen detected soft tissue breast abnormalities following mammography. Digital mammography, which offers high quality images, currently remains the primary screening tool for the programme as recommended by the UK National Screening Committee (UK NSC).
In 2025, the UK NSC, who advise the Government on all screening matters, set up a working group of breast cancer screening experts to help it consider new and emerging evidence and developments that could further improve the United Kingdom breast screening programmes. This includes exploring modalities such as DBT in addition to other tests and technologies, to detect breast cancer in women with dense breast tissue.
If, following this work, the UK NSC makes a recommendation regarding DBT, my Rt Hon. Friend, the Secretary of State for Health and Social Care, would be asked to make a decision on whether to accept the recommendation, alongside wider policy and operational advice.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Baroness Merron on 24 November 2025 (HL Deb col 1107), when they intend to launch the consultation on emergency police powers of detention.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
On 24 November, the Department announced its commitment to consult on the powers available to different professionals in different situations and settings, in particular, but not limited to, the operation of the emergency powers in sections 135 and 136. The consultation will seek views on powers and joint working approaches to ensure that health and social care professionals and police have the appropriate powers to act in order to prevent people harming themselves and others when in a mental health crisis.
The Department also set out plans to work closely with a range of stakeholders to shape the scope of that consultation. Officials at the Department of Health and Social Care have started engagement with Home Office officials and stakeholders from the police, health, and social care to consider the options to consult on that support better outcomes for patients and services, and we will set out further detail on the timing of the consultation in due course.
Asked by: Earl Howe (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 19 March (HL15393), how many doctors have been subject to (1) suspension, and (2) erasure, for dishonestly claiming to be neurodivergent or have learning disabilities in 2025–26 up to and including the latest period for which figures are available.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold this data centrally.
The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants (PAs), and physician assistants in anaesthesia (PAAs), still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. It sets and enforces the standards all doctors, Pas, and PAAs must adhere to. The GMC is independent of the Government, is directly accountable to Parliament, and is responsible for operational matters concerning the discharge of its statutory duties.
The GMC owns data on its fitness to practise processes and publishes annual fitness to practise statistics reports on its website.
Asked by: Earl Howe (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 19 March (HL15393), how many doctors have been subject to (1) suspension, and (2) erasure, for dishonestly claiming to be neurodivergent or have learning disabilities in 2024–25.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold this data centrally.
The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants (PAs), and physician assistants in anaesthesia (PAAs), still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. It sets and enforces the standards all doctors, Pas, and PAAs must adhere to. The GMC is independent of the Government, is directly accountable to Parliament, and is responsible for operational matters concerning the discharge of its statutory duties.
The GMC owns data on its fitness to practise processes and publishes annual fitness to practise statistics reports on its website.
Asked by: Earl Howe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps are being taken to ensure NHS pathways and commissioning decisions for heart valve disease align with the most up-to-date clinical guidelines.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In 2025, NHS England’s Getting It Right First Time programme published new and revised cardiology pathways to support evidence-based, including National Institute for Health and Care Excellence guidance, efficient, and consistent care across primary and secondary settings, including for aortic stenosis for patients with severe symptomatic heart valve disease.
NHS England has established an Expert Advisory Group on Heart Valve Disease with the aim of ensuring excellence in care whilst exploring ways to improve heart valve disease management nationwide.