Baroness Merron Portrait

Baroness Merron

Labour - Lincoln

Became Member: 28th January 2021

Opposition Whip (Lords)

(since May 2021)

Shadow Spokesperson (Health and Social Care)

(since May 2021)

1 APPG membership (as of 24 Jan 2024)
Performing Arts Education and Training
Shadow Spokesperson (Culture, Media and Sport)
21st Feb 2023 - 26th Oct 2023
Shadow Spokesperson (Digital, Culture, Media and Sport)
18th May 2021 - 20th Feb 2023
Parliamentary Under-Secretary (Department of Health)
9th Jun 2009 - 6th May 2010
Minister of State (Department of Health) (Public Health)
9th Jun 2009 - 6th May 2010
Parliamentary Under-Secretary (Foreign and Commonwealth Office)
5th Oct 2008 - 9th Jun 2009
Parliamentary Under-Secretary (Department for International Development)
24th Jan 2008 - 5th Oct 2008
Parliamentary Under-Secretary (Cabinet Office)
28th Jun 2007 - 25th Jan 2008
Parliamentary Under-Secretary (Regional Affairs) (East Midlands)
28th Jun 2007 - 25th Jan 2008
Minister of State (Regional Affairs) (East Midlands)
28th Jun 2007 - 25th Jan 2008
Parliamentary Under-Secretary (Department for Transport)
5th May 2006 - 28th Jun 2007
Lord Commissioner (HM Treasury) (Whip)
28th Oct 2004 - 5th May 2006
Assistant Whip (HM Treasury)
1st Jan 2002 - 28th Oct 2004
Trade & Industry
9th Jul 1997 - 9th Nov 1998


Department Event
Monday 26th February 2024
Department of Health and Social Care
Orders and regulations - Main Chamber
Anaesthesia Associates and Physician Associates Order 2024 and the associated regret motions and motion to decline.
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Note: This event involves a Department with which this person is linked, and does not guarantee their actual attendance.
Scheduled Event
Tuesday 5th March 2024
Oral questions - Main Chamber
Current levels of safety, and involvement of patients and carers, when mental health patients are discharged from inpatient settings and emergency departments
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Division Votes
Tuesday 6th February 2024
Electoral Commission Strategy and Policy Statement
voted Aye - in line with the party majority
One of 94 Labour Aye votes vs 0 Labour No votes
Tally: Ayes - 175 Noes - 159
Speeches
Monday 19th February 2024
NHS Dentistry
My Lords, the Minister has previously suggested that the 15 mobile dental vans would be able to address emergency situations …
Written Answers
Friday 16th February 2024
Medicine: Apprentices
To ask His Majesty's Government what discussions they have had with the General Medical Council regarding the regulation of medical …
Early Day Motions
None available
Bills
None available
MP Financial Interests
None available

Division Voting information

During the current Parliament, Baroness Merron has voted in 339 divisions, and never against the majority of their Party.
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Debates during the 2019 Parliament

Speeches made during Parliamentary debates are recorded in Hansard. For ease of browsing we have grouped debates into individual, departmental and legislative categories.

Sparring Partners
Lord Markham (Conservative)
Parliamentary Under-Secretary (Department of Health and Social Care)
(136 debate interactions)
Lord Kamall (Conservative)
(99 debate interactions)
Lord Parkinson of Whitley Bay (Conservative)
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
(78 debate interactions)
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Department Debates
Department of Health and Social Care
(255 debate contributions)
Leader of the House
(11 debate contributions)
View All Department Debates
Legislation Debates
Health and Care Act 2022
(16,255 words contributed)
Online Safety Act 2023
(14,034 words contributed)
Telecommunications (Security) Act 2021
(10,367 words contributed)
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View all Baroness Merron's debates

Lords initiatives

These initiatives were driven by Baroness Merron, and are more likely to reflect personal policy preferences.


Baroness Merron has not introduced any legislation before Parliament

Baroness Merron has not co-sponsored any Bills in the current parliamentary sitting


281 Written Questions in the current parliament

(View all written questions)
Written Questions can be tabled by MPs and Lords to request specific information information on the work, policy and activities of a Government Department
7 Other Department Questions
16th Mar 2023
To ask His Majesty's Government what discussions they have had with (1) sporting bodies, and (2) other stakeholders, regarding guidance for schools and clubs about (a) the prevention of concussion, and (b) promotion of good health, whilst playing contact sports.

The safety, wellbeing, and welfare of everyone taking part in sport is paramount. National governing bodies are responsible for ensuring the safe provision of their sports.

The Department for Culture, Media and Sport is currently working with sporting bodies and others to develop a single set of concussion guidelines to be shared across the UK, which will be published in the near future.

The guidelines are designed for everyone involved in grassroots sport from school age upwards – participants, coaches, volunteers, and parents – as well as those working in educational settings and in healthcare.

The Government remains committed to working with interested parties to promote safer sport.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
16th Mar 2023
To ask His Majesty's Government what plans they have, if any, to commission a review of rugby similar to that of the Fan-Led Review of Football Governance.

His Majesty’s Government recognises the recent challenges faced by Rugby Union and is clear that robust governance is essential to sustainable and successful sport, but has no plans to commission a review similar to the Fan-Led Review of Football Governance.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
26th Apr 2022
To ask Her Majesty's Government what trends they have identified, if any, in period poverty and shame; and what steps they are taking to address any such trends.

Period poverty is an issue the government takes very seriously and has taken a number of steps to address the problem.

Since January 2020, a Department for Education scheme provides free period products in schools and 16-19 education institutions in England. Additionally, from 1 January 2021, the ‘tampon tax’ has been abolished - with a zero rate of VAT applying to all period products. Prior to the abolition of the tax, a Tampon Tax fund was in place to allocate the funds generated from the VAT on period products, to projects which improve the lives of disadvantaged women and girls. A final round of £11.25 million in grant funding was awarded in November 2021 to distribute the VAT collected on period products in the final nine months of the 2020/21 financial year, before the tax ended.

As well as these steps, in 2019, NHS England announced that it would offer period products to every hospital patient who needs them and the Home Office changed the law to ensure that all people in custody are provided with health and hygiene products for free, to include period products.

In March 2020, in light of COVID-19, the work of the Period Poverty Taskforce was paused to free up resources to focus on the pandemic. Further announcements on the plans and the work of the Taskforce will be made in due course.

26th Apr 2022
To ask Her Majesty's Government what steps they are taking to monitor the issues of period poverty and shame.

Period poverty is an issue the government takes very seriously and has taken a number of steps to address the problem.

Since January 2020, a Department for Education scheme provides free period products in schools and 16-19 education institutions in England. Additionally, from 1 January 2021, the ‘tampon tax’ has been abolished - with a zero rate of VAT applying to all period products. Prior to the abolition of the tax, a Tampon Tax fund was in place to allocate the funds generated from the VAT on period products, to projects which improve the lives of disadvantaged women and girls. A final round of £11.25 million in grant funding was awarded in November 2021 to distribute the VAT collected on period products in the final nine months of the 2020/21 financial year, before the tax ended.

As well as these steps, in 2019, NHS England announced that it would offer period products to every hospital patient who needs them and the Home Office changed the law to ensure that all people in custody are provided with health and hygiene products for free, to include period products.

In March 2020, in light of COVID-19, the work of the Period Poverty Taskforce was paused to free up resources to focus on the pandemic. Further announcements on the plans and the work of the Taskforce will be made in due course.

26th Apr 2022
To ask Her Majesty's Government whether they remain committed to their target of ending period poverty and shame in the UK by 2025.

Period poverty is an issue the government takes very seriously and has taken a number of steps to address the problem.

Since January 2020, a Department for Education scheme provides free period products in schools and 16-19 education institutions in England. Additionally, from 1 January 2021, the ‘tampon tax’ has been abolished - with a zero rate of VAT applying to all period products. Prior to the abolition of the tax, a Tampon Tax fund was in place to allocate the funds generated from the VAT on period products, to projects which improve the lives of disadvantaged women and girls. A final round of £11.25 million in grant funding was awarded in November 2021 to distribute the VAT collected on period products in the final nine months of the 2020/21 financial year, before the tax ended.

As well as these steps, in 2019, NHS England announced that it would offer period products to every hospital patient who needs them and the Home Office changed the law to ensure that all people in custody are provided with health and hygiene products for free, to include period products.

In March 2020, in light of COVID-19, the work of the Period Poverty Taskforce was paused to free up resources to focus on the pandemic. Further announcements on the plans and the work of the Taskforce will be made in due course.

26th Apr 2022
To ask Her Majesty's Government whether the Period Poverty Taskforce will restart its meetings; and if so, when.

Period poverty is an issue the government takes very seriously and has taken a number of steps to address the problem.

Since January 2020, a Department for Education scheme provides free period products in schools and 16-19 education institutions in England. Additionally, from 1 January 2021, the ‘tampon tax’ has been abolished - with a zero rate of VAT applying to all period products. Prior to the abolition of the tax, a Tampon Tax fund was in place to allocate the funds generated from the VAT on period products, to projects which improve the lives of disadvantaged women and girls. A final round of £11.25 million in grant funding was awarded in November 2021 to distribute the VAT collected on period products in the final nine months of the 2020/21 financial year, before the tax ended.

As well as these steps, in 2019, NHS England announced that it would offer period products to every hospital patient who needs them and the Home Office changed the law to ensure that all people in custody are provided with health and hygiene products for free, to include period products.

In March 2020, in light of COVID-19, the work of the Period Poverty Taskforce was paused to free up resources to focus on the pandemic. Further announcements on the plans and the work of the Taskforce will be made in due course.

24th Oct 2022
To ask His Majesty's Government when they will respond to the report by the Public Services Committee Fit for the future? Rethinking the public services workforce (HL Paper 48), published on 19 July.

The Government issued a response to the report on Monday 7 November.

Baroness Neville-Rolfe
Minister of State (Cabinet Office)
18th Jul 2022
To ask Her Majesty's Government (1) how, and (2) when, they will report on the broader impacts of the hot weather on public services.

All departments are responsible for monitoring and reporting on impacts from the extreme heat in their own sectors.

For example, Network Rail are communicating regularly with the public on rail disruption.

However, impacts related to the extreme heat were limited by the early and accurate weather forecasting by the Met Office, the effective preparedness and response at the local and national levels, and the positive response of the British public to warnings and advice issued by all sectors to take pressure off vital public services.

Lord True
Leader of the House of Lords and Lord Privy Seal
5th Jul 2021
To ask Her Majesty's Government when the updated Cyber Strategy will be published.

The Integrated Review published in March set a goal of cementing the UK’s position as a leading responsible and democratic cyber power, and committed to launching a new comprehensive cyber strategy in 2021 to implement this vision. The strategy will set out how we will build up the UK’s cyber resilience; deter our adversaries; and influence tomorrow’s technologies so they are safe, secure and open. Work is well underway to develop the new strategy, and the government plans to continue engaging with partners before publishing it later this year and aligning with funding decisions in the next Spending Review.

Lord True
Leader of the House of Lords and Lord Privy Seal
19th Jan 2022
To ask Her Majesty's Government what plans they have to help small booksellers compete with online retailers beyond the reliefs implemented during the COVID-19 pandemic.

The government is committed to ensuring digital markets, such as the e-commerce market, remain competitive and deliver positive outcomes for small businesses, consumers, and society. Our digital competition consultation set out a vision for the UK’s new pro-competition regime for digital markets and the powers of the new Digital Markets Unit, which is already operating in non-statutory form inside the CMA. The regime will enable the UK’s competition authorities to tackle the unique challenges of fast-moving digital markets and will aim to boost competition and innovation by tackling the sources and effects of market power in digital markets. The consultation closed on 1 October 2021 and we are now carefully considering the responses.

At budget, my Rt hon Friend Mr Chancellor of the Exchequer announced further business rates relief of 50% in 2022/23 for eligible retail, hospitality, and leisure businesses worth almost £1.7 billion and we are freezing the multiplier for 2022/23 saving businesses £4.6 billion over the next five years.

Lord Callanan
Parliamentary Under Secretary of State (Department for Energy Security and Net Zero)
5th Jul 2021
To ask Her Majesty's Government when the final communications sectoral definition under the National Security and Investment Act 2021 will be published.

The Government will publish the draft notifiable acquisition regulations as part of the ​implementation of the National Security and Investment Act 2021 in due course. This will include descriptions of the proposed ​acquisitions in the communications sector which must be notified to my Rt. Hon. Friend the Secretary of State.

Lord Callanan
Parliamentary Under Secretary of State (Department for Energy Security and Net Zero)
28th Jun 2022
To ask Her Majesty's Government what steps they are taking to reach those who are (1) less engaged in current affairs, (2) vulnerable, or (3) have accessibility considerations, to help them tackle misinformation and disinformation; and how they will ensure that such groups have the necessary media literacy skills to identify misinformation or disinformation.

Her Majesty’s Government published its Online Media Literacy Strategy in July 2021, setting out plans to support the education and empowerment of people to make safe and informed choices online. The strategy has a particular focus on vulnerable users.

Through our Year 1 Online Media Literacy Strategy we established the pilot ‘Train the Trainer’ grant scheme. We administered £250,000 in funding to five media literacy organisations working with schools to adapt their resources for teachers of children with special educational needs. Three of the grantees specialise in news literacy programmes which help build resilience to misinformation and disinformation through information literacy.

Our Year 2 Action Plan announced plans to establish the Media Literacy Programme Fund which will further support media literacy organisations which are undertaking work to support vulnerable users. We have also established the expert Media Literacy Taskforce which has been charged with exploring how to extend the reach of media literacy initiatives to those who are disengaged or lack access to support.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
27th Jun 2022
To ask Her Majesty's Government what assessment they have made of the Online Safety Bill's ability to ensure companies in scope are (1) supporting, and (2) improving, the media literacy skills of their users.

The Online Safety Bill includes measures to encourage regulated service providers to promote media literacy to their users. Following a recommendation from the Joint Committee which conducted the pre-legislative scrutiny of the Online Safety Bill, media literacy is now included in the risk assessment duties. This requires in-scope companies to consider how the promotion of users’ media literacy can be used to mitigate harms on their platforms.

Media literacy is also expressly referred to in Ofcom’s new transparency reporting and information gathering powers, giving Ofcom enhanced visibility of industry spending and activity related to media literacy. Social media platforms currently play a significant role in boosting media literacy, in particular with regards to the funding of programmes. This greater visibility of spending and activity in this area will therefore strengthen Ofcom’s ability to undertake its statutory duty to promote media literacy.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
27th Jun 2022
To ask Her Majesty's Government what research they have undertaken on the effectiveness of different types of media literacy initiatives in tackling (1) misinformation, and (2) disinformation.

On 16 April 2022, DCMS published the Year 2 Online Media Literacy Action Plan, setting out our media literacy work programme for the financial year 2022/23. The Action Plan announced that DCMS is establishing a media literacy research programme to bridge evidence gaps about the effectiveness of media literacy interventions, which includes initiatives tackling misinformation and disinformation. We will report on the progress of the Action Plan in due course.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
23rd May 2022
To ask Her Majesty's Government what information gathering powers they intend to give to Ofcom to assess streaming services’ audience protection arrangements; and whether they will ask Ofcom to assess whether platforms are basing age ratings on UK standards to prevent children seeing inappropriate programmes.

Ofcom will be given the necessary information-gathering and enforcement powers to fulfil a new ongoing duty to assess Ofcom-regulated video-on-demand providers’ audience protection measures and ensure that the systems put in place are effective and fit for purpose. As the independent regulator, it will be for Ofcom to determine how that assessment is carried out.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
23rd May 2022
To ask Her Majesty's Government whether the Online Safety Bill will contain provisions to enable Ofcom (1) to proactively investigate pornography websites' compliance with the law, and (2) to take swift enforcement action where necessary.

Ofcom will have a range of robust powers at its disposal to help it assess compliance with the Bill. Ofcom will have the power to require information from regulated companies and relevant third parties, to interview employees, to require a company to undertake, and pay for, a skilled person’s report, to enter and inspect companies’ premises, and to carry out audits on services to assess compliance. Ofcom will need to take a proportionate approach in exercising these powers, and will be able to use information from a wide range of sources to help prioritise its investigation and enforcement activity.

Ofcom will also have robust enforcement powers to take action against companies which fail to comply. Those powers will include being able to require companies to take action to come into compliance or remedy any breach, impose fines and, in exceptional circumstances, to apply to the Court for business disruption measures to block or restrict access to non-compliant services. The Bill also provides for interim business disruption measures, which will provide a fast track, where appropriate, to blocking measures.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
23rd May 2022
To ask Her Majesty's Government whether the Online Safety Bill will ensure that commercial pornography websites do not carry any illegal content, such as (1) extreme pornography, or (2) prohibited images of children.

The Online Safety Bill principally applies to services that allow users to post content online or to interact with each other, and to search engines. Where commercial pornography websites facilitate user-generated content, they will have to deliver the illegal content duties under the Bill and, where the service is likely to be accessed by children, to protect them from harmful content. These will ensure that all platforms in scope of the Bill tackle illegal user-generated content on their services, including extreme pornography and prohibited images of children.

Where the illegal content is not user-generated but rather is created and published by the relevant company on its own site, then that website service is likely to be committing an offence so will potentially be liable for prosecution. Part 5 of the Bill creates a new duty on providers of published pornography, which includes some dedicated commercial pornography websites, to protect children from accessing pornographic content.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
5th Apr 2022
To ask Her Majesty's Government what plans they have, if any, to introduce restrictions on gambling advertising following the completion of their review of gambling regulation.

Her Majesty’s Government is reviewing the Gambling Act to make sure it is fit for the digital age. We have been clear, however, that work to raise standards and tackle gambling-related harm should continue alongside the review, and does not need to wait for it to be concluded. We are determined to protect those at risk of gambling related-harm and welcome the new measures announced by the Advertising Standards Authority further to reduce the appeal of gambling adverts to children and to ensure that the content of gambling adverts is appropriate for the age-restricted nature of the products.

As part of the broad scope of the review, we called for evidence on the potential benefits or harms of allowing licensed gambling operators to advertise, engage in sponsorship arrangements, and make promotional offers. We are currently considering the evidence carefully and will publish a White Paper outlining our conclusions and any proposals for reform in the coming weeks.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
5th Apr 2022
To ask Her Majesty's Government what assessment they have made, if any, of the decision by the Advertising Standards Authority to ban gambling adverts featuring footballers and other sports personalities.

Her Majesty’s Government is reviewing the Gambling Act to make sure it is fit for the digital age. We have been clear, however, that work to raise standards and tackle gambling-related harm should continue alongside the review, and does not need to wait for it to be concluded. We are determined to protect those at risk of gambling related-harm and welcome the new measures announced by the Advertising Standards Authority further to reduce the appeal of gambling adverts to children and to ensure that the content of gambling adverts is appropriate for the age-restricted nature of the products.

As part of the broad scope of the review, we called for evidence on the potential benefits or harms of allowing licensed gambling operators to advertise, engage in sponsorship arrangements, and make promotional offers. We are currently considering the evidence carefully and will publish a White Paper outlining our conclusions and any proposals for reform in the coming weeks.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
1st Apr 2022
To ask Her Majesty's Government what assessment they have made of the value of voluntary industry initiatives around responsible gambling.

HM Government welcomes the progress by industry to introduce new safer gambling measures over recent years, but both the Government and the Gambling Commission will continue to mandate further action where it is required. As part of its broad scope, the Gambling Act Review is looking at whether the right controls are in place to protect people who gamble in the digital age. We are considering the evidence carefully and will publish a White Paper outlining conclusions in the coming weeks.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
1st Apr 2022
To ask Her Majesty's Government when they intend to publish the findings of their review of the Gambling Act 2005.

HM Government welcomes the progress by industry to introduce new safer gambling measures over recent years, but both the Government and the Gambling Commission will continue to mandate further action where it is required. As part of its broad scope, the Gambling Act Review is looking at whether the right controls are in place to protect people who gamble in the digital age. We are considering the evidence carefully and will publish a White Paper outlining conclusions in the coming weeks.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
1st Apr 2022
To ask Her Majesty's Government how many ministers have accepted hospitality from gambling firms since the launch of the gambling review in December 2020; and what is the cumulative value of such hospitality.

Records of ministerial hospitality are published quarterly and are available on GOV.UK. This link also declares all meetings. There has been a wide-ranging series of meetings with a number of gambling stakeholders to support the ongoing Gambling Act Review. There have also been meetings with the gambling industry on other issues, for instance its relationship with racing and the impacts of the Covid pandemic.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
1st Apr 2022
To ask Her Majesty's Government what is their estimate of the cumulative cost to the Exchequer of gambling-related harm since May 2010.

Public Health England’s (PHE) evidence review of gambling-related harms reported that 0.5% of the adult population reached the threshold to be considered ‘problem gamblers’ (defined as those gambling with negative consequences and a possible loss of control), and that this proportion has remained relatively consistent since 2012. PHE’s review also included estimates on the costs associated with gambling-related harm. On costs to the Exchequer, the report estimated the annual direct costs associated with people who are problem gamblers to be approximately £647 million, but was unable to make a direct assessment of the costs caused by gambling-related harm.

Additional data on problem gambling prevalence comes from the Gambling Commission’s quarterly participation and prevalence survey, the latest results of which were published in February. The survey found that in the year to December 2021, the overall problem gambling rate was statistically stable at 0.3%, compared to the year to December 2020. In the year to December 2019, the rate was 0.6%.

Our Review of the Gambling Act aims to ensure that the protections in place to prevent harm are appropriate and effective for the digital age. It is looking at issues regarding research as part of its broad scope.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
1st Apr 2022
To ask Her Majesty's Government what assessment they have made of the (1) prevalence, and (2) cost to the Exchequer, of gambling-related harm in each of the last three years.

Public Health England’s (PHE) evidence review of gambling-related harms reported that 0.5% of the adult population reached the threshold to be considered ‘problem gamblers’ (defined as those gambling with negative consequences and a possible loss of control), and that this proportion has remained relatively consistent since 2012. PHE’s review also included estimates on the costs associated with gambling-related harm. On costs to the Exchequer, the report estimated the annual direct costs associated with people who are problem gamblers to be approximately £647 million, but was unable to make a direct assessment of the costs caused by gambling-related harm.

Additional data on problem gambling prevalence comes from the Gambling Commission’s quarterly participation and prevalence survey, the latest results of which were published in February. The survey found that in the year to December 2021, the overall problem gambling rate was statistically stable at 0.3%, compared to the year to December 2020. In the year to December 2019, the rate was 0.6%.

Our Review of the Gambling Act aims to ensure that the protections in place to prevent harm are appropriate and effective for the digital age. It is looking at issues regarding research as part of its broad scope.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
16th Mar 2022
To ask Her Majesty's Government what criteria they have for foreign bodies (1) owning, and (2) investing in, football teams in England; and what measures they have in place to safeguard the interests of fans.

The ownership of football clubs is, and has historically been, a matter for the football authorities, not for HM Government.

The tests for ownership of clubs were raised in the report of the Fan-Led Review which recommended stronger tests independently administered by a new independent regulator.

HM Government is considering the recommendations of the Review, including those made on enhancing the existing owners’ and directors’ tests, and working swiftly to determine the most effective way to deliver an independent regulator.

We will issue a formal response to the Fan-Led Review in the coming weeks.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
16th Mar 2022
To ask Her Majesty's Government what assessment they have made of the operation of Government-backed COVID-19 insurance schemes for the creative industries.

The UK Live Events Reinsurance Scheme and Film and TV Production Restart Scheme were introduced as part of HM Government's commitment to provide support during the Covid-19 pandemic and address market failure in the insurance sector.

Both schemes have contributed positively to the creative industries.The UK Film and TV Production Restart Scheme has supported a production boom during the pandemic, so far protecting over 95,000 jobs and nearly £3 billion of production spend, ensuring the continued production of content for our screens. Since the Live Events Reinsurance Scheme’s launch in September 2021, around £110 million of cover has been written for a wide variety of events, including business events, concerts and theatre performances. So far, 2.7 million people have attended or are due to attend events covered by the Scheme. In addition to directly supporting events, the scheme also protects the supply chains and local economies that depend on their taking place.

The Film and TV Production Restart Scheme’s operation was assessed by an independent body in a Process Evaluation published in January 2022. The research found that close working with industry on establishing the scheme ensured that those most in need of support were able to benefit. An impact evaluation will be published by the end of the year. Similarly, the Live Events Reinsurance Scheme will be undergoing a review in the Spring to assess its effectiveness, including the extent to which it has benefitted the live events sector while also delivering value for money for UK taxpayers. A full evaluation of the Scheme will follow in early 2023.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
19th Jan 2022
To ask Her Majesty's Government what plans they have to meet the Booksellers Association to discuss ways to support small creative businesses.

The Booksellers Association regularly engages at Ministerial level with the Department for Business, Energy and Industrial Strategy (BEIS).

On 15 July, BEIS published the Build Back Better High Streets Strategy, in which the Government committed to continue working with the retail sector, in particular the Retail Sector Council, on its long-term strategic needs to ensure that businesses are profitable, resilient, innovative, and able to support local economies in socially and environmentally responsible ways.

More broadly, DCMS regularly engages with the creative industries, including the publishing sector, through the Creative Industries Council. I have also met individual booksellers, most recently The Bound in Whitley Bay on 29 January, to hear how the Government can best support small creative businesses.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
11th Jan 2022
To ask Her Majesty's Government what plans they have to instruct Ofcom to develop (1) mandatory age assurance technology, and (2) a governance code for age assurance, ahead of the Online Safety Bill being introduced to Parliament.

We are considering fully and carefully the recommendations from the Joint Committee and are grateful to its members for their work scrutinising this important Bill. The Bill will not mandate that companies use specific technologies for protecting children online, as it is vital that the Bill is future-proofed. However, Ofcom will set out in its codes of practice the steps companies need to take to comply with their child safety duties. We expect this to include, where appropriate, age assurance technologies. Ofcom will also be able to include in its regulatory codes specific standards relating to age assurance. Companies would need to follow these steps, including putting in place these technologies and following these standards, or demonstrate that the approach they are taking delivers the same level of protection for children. If they do not, they risk facing enforcement action from Ofcom.

In the meantime, DCMS is already working closely with Ofcom to ensure that the implementation period that will be necessary following passage of the legislation is as short as possible. We expect companies to take steps now to improve safety, and not wait for the legislation to come into force before acting.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
11th Jan 2022
To ask Her Majesty's Government, further to the report of the Joint Committee on the Draft Online Safety Bill (Session 2021–22, HL Paper 129), what plans they have to adopt recommendations relating to (1) the statutory regulation of, and (2) minimum standards for, age assurance technologies.

We are considering fully and carefully the recommendations from the Joint Committee and are grateful to its members for their work scrutinising this important Bill. The Bill will not mandate that companies use specific technologies for protecting children online, as it is vital that the Bill is future-proofed. However, Ofcom will set out in its codes of practice the steps companies need to take to comply with their child safety duties. We expect this to include, where appropriate, age assurance technologies. Ofcom will also be able to include in its regulatory codes specific standards relating to age assurance. Companies would need to follow these steps, including putting in place these technologies and following these standards, or demonstrate that the approach they are taking delivers the same level of protection for children. If they do not, they risk facing enforcement action from Ofcom.

In the meantime, DCMS is already working closely with Ofcom to ensure that the implementation period that will be necessary following passage of the legislation is as short as possible. We expect companies to take steps now to improve safety, and not wait for the legislation to come into force before acting.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
11th Jan 2022
To ask Her Majesty's Government what steps they are taking to protect children from the harms of online pornography prior to the introduction of the Online Safety Bill.

The Online Safety Bill aims to make the UK the safest place in the world to be a child online, but the Government is not waiting for it to become law in order to protect children from online pornography. Ofcom already has responsibility for the regulation of video-sharing platforms and video-on-demand services, which includes requirements to protect children from harmful content such as pornography.

Furthermore, in July 2021, the government published the Online Media Literacy Strategy. The strategy supports the empowerment of users, including young people, with the skills and knowledge they need to make safe and informed decisions online. In June 2021, we also published Safety by Design guidance and a “One Stop Shop” on child online safety. These provide guidance on steps that platforms can take to design safer services and protect children.

In addition, the new Relationships, Sex and Health Education curriculum is clear that, by the end of secondary school, pupils should be taught about the impact that viewing harmful content, such as pornography, can have on the way people see themselves in relation to others and negatively affect how they behave towards sexual partners.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
11th Jan 2022
To ask Her Majesty's Government whether they consider the Information Commissioner’s Office’s (ICO) Age Appropriate Design Code to apply to providers of online pornography; and, if not, what plans they have to (1) direct the ICO, or (2) legislate in this area.

The Age Appropriate Design Code sets out the privacy standards companies must adopt when offering online services that are likely to be accessed by children. If a service is one that children should not be using, such as a pornography service, the Code does not apply. It is the government’s view that the focus of such a service should be on how to prevent children’s access to it rather than undertaking a data protection impact assessment with the aim of making the service child-friendly.

The Online Safety Bill will deliver comprehensive protections for children from accessing pornography by placing new duties on in-scope companies to protect children from harmful content online. The Bill will cover many of the most visited pornography sites, social media, video sharing platforms, forums and search engines, thereby capturing sites through which a large proportion of children access pornography. We recognise the concerns that have been raised about protecting children from online pornography on services which do not currently fall within the scope of the Bill. We are exploring ways to provide wider protections for children from accessing online pornography through the Bill.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
9th Sep 2021
To ask Her Majesty's Government how many days of visa free and work permit touring is allowed per visit for a musician based in the UK and with UK citizenship, for each of the 19 EU Member States described as allowing visa and work permit free touring.

This government recognises the importance of the UK’s creative and cultural industries, not only to the economy and international reputation of the United Kingdom, but also to the wellbeing and enrichment of our people. We want musicians and performers to be able to tour abroad easily, as we understand it is a vital part at every stage of a musician’s and performer’s career.

Member States of the European Union are principally responsible for deciding the rules governing what work UK visitors can undertake in the EU. That is why we have spoken to every Member State about the importance of touring. Following these talks 19 out of 27 Member States have confirmed that UK musicians do not require visas or work permits for some short term touring. In the majority of cases this is for at least 30 days. Other Member States, including France and Germany, allow visas or work permits for some short term touring for up to three months. Travellers should always check what requirements they need to fulfill with the EU Member State to which they are travelling.

We want our world-leading creative and cultural artists to travel widely, learning their craft, growing their audiences and showing the best of British creativity to the world. That is why we are looking carefully at proposals for a new Creative Export Office that could provide further practical help to support individuals and businesses in touring.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
9th Sep 2021
To ask Her Majesty's Government what assessment they have made of (1) the ability of (a) under-25s, (b) musicians from less privileged socio-economic backgrounds, and (c) working-class musicians, to tour in the EU under the terms of the UK–EU Trade and Cooperation Agreement, and (2) the frequency of such musicians doing so.

This government recognises the importance of the UK’s creative and cultural industries, not only to the economy and international reputation of the United Kingdom, but also to the wellbeing and enrichment of our people. We want musicians and performers to be able to tour abroad easily, as we understand it is a vital part at every stage of a musician’s and performer’s career.

Member States of the European Union are principally responsible for deciding the rules governing what work UK visitors can undertake in the EU. That is why we have spoken to every Member State about the importance of touring. Following these talks 19 out of 27 Member States have confirmed that UK musicians do not require visas or work permits for some short term touring. In the majority of cases this is for at least 30 days. Other Member States, including France and Germany, allow visas or work permits for some short term touring for up to three months. Travellers should always check what requirements they need to fulfill with the EU Member State to which they are travelling.

We want our world-leading creative and cultural artists to travel widely, learning their craft, growing their audiences and showing the best of British creativity to the world. That is why we are looking carefully at proposals for a new Creative Export Office that could provide further practical help to support individuals and businesses in touring.

Lord Parkinson of Whitley Bay
Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
22nd Jul 2021
To ask Her Majesty's Government whether the chair of their Telecoms Supply Chain Diversification Advisory Council has any current financial interests or holdings with Fujitsu.

The chair of the Telecoms Supply Chain Diversification Advisory Council has declared any relevant financial interests in line with the usual appointment process. There are no current financial interests to declare.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
8th Jul 2021
To ask Her Majesty's Government how many members there are of the Telecoms Supply Chain Diversification Advisory Council; and what their names are.

The membership is not fully decided yet, but many of the members of the Diversification Taskforce have agreed to continue providing expertise as part of the Telecoms Supply Chain Diversification Advisory Council. The Government will publish the full membership ahead of the first meeting in the autumn.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
8th Jul 2021
To ask Her Majesty's Government what is the salary of the chair of the Telecoms Supply Chain Diversification Advisory Council.

The work of the Advisory Council is non-remunerative. The Chair and all members have volunteered their time and effort.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
8th Jul 2021
To ask Her Majesty's Government whether the Secretary of State for the Department of Digital, Culture, Media and Sport discussed the appointment of the new chair of the Telecoms Supply Chain Diversification Advisory Council with the Prime Minister before the announcement on 2 July.

Simon Blagden was formally appointed by Matt Warman MP, Minister for Digital Infrastructure. This was agreed through the usual public appointments procedure.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
8th Jul 2021
To ask Her Majesty's Government who made the final decision on the appointment of Simon Blagden as chair of the Telecoms Supply Chain Diversification Advisory Council.

Simon Blagden was formally appointed by Matt Warman MP, Minister for Digital Infrastructure. This was agreed through the usual public appointments procedure.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
8th Jul 2021
To ask Her Majesty's Government what were the appointment (1) criteria, and (2) process, for the chair of the Telecoms Supply Chain Diversification Advisory Council.

Simon Blagden, Chair of the Telecoms Supply Chain Advisory Council, was selected on the basis of having the skills and experience required for the role, with over 30 years experience in the telecoms and digital industries.

He was appointed following the standard Government process for direct appointments, suitable for short term roles where an independent advisory function is filled. Appropriate due diligence and conflict of interest checks have been carried out.

The Terms and Conditions which the Chair and members of the Advisory Council are expected to adhere to will be published on GOV.UK following the first meeting of the Advisory Council. The Council is advisory and there will be a wide ranging membership incorporating views from industry and academia.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Jul 2021
To ask Her Majesty's Government, following the publication of the Telecoms Diversification Taskforce Report on 20 April, whether the taskforce now been disbanded; and if not, what role and responsibilities the Taskforce now has.

The Telecoms Diversification Taskforce has completed its work and submitted its independent recommendations to the Government in April. The Taskforce will now transition to become the permanent Telecoms Supply Chain Diversification Advisory Council with Simon Blagden CBE as the new chair; as announced in the Government’s response to the recommendations published on 2 July. Many of the Taskforce members will continue to provide advice as part of the Advisory Council.

The Advisory Council will play a key role in overseeing and offering scrutiny to the delivery of the 5G Supply Chain Diversification Strategy. We will also draw on the expertise of the Advisory Council for wider telecoms supply chain diversification issues beyond the RAN (Radio Access Network).

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Jul 2021
To ask Her Majesty's Government what is the total cost of removing Huawei from the telecommunications network by 2027.

As the Secretary of State set out in his statement to the House of Commons on 14 July 2020, we estimate that implementation of the advice to remove Huawei 5G equipment from the UK’s telecom network will cost up to two billion pounds.

The estimated cost breakdown is set out in the impact assessment published for the Telecommunications (Security) Bill.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Jul 2021
To ask Her Majesty's Government how much additional funding will be provided to Ofcom to support the costs of monitoring and compliance with the new powers for that body in the Telecommunications Security Bill.

Ofcom's budget for telecoms security this financial year has been increased by £4.6 million, to reflect its enhanced security role under the Telecommunications (Security) Bill. This is in addition to its current security budget of £2 million.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Jul 2021
To ask Her Majesty's Government what estimate they have made of how many companies in the UK telecommunications sector are estimated to be majority owned by Russian or Chinese entities.

The telecommunications sector includes tens of thousands of companies, including telecommunications providers, equipment providers and service providers in the supply chain. The Government does not monitor the nationality of the owners of each of these on a routine basis.

The UK economy thrives, in part, as a result of foreign direct investment (FDI) and the Government therefore strives to be the premier destination for investment in the world. However, an open approach to international investment must include appropriate safeguards to protect our national security and the safety of our citizens. The new National Security & Investment Act introduces a new regime for reviewing and intervening in business transactions, such as takeovers, that might raise national security concerns.

The Government has also recently introduced the Telecommunications (Security) Bill to establish an enhanced legislative framework for telecoms security, which includes new national security powers for the Secretary of State to manage the risks posed by high risk vendors.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
29th Jun 2021
To ask Her Majesty's Government what assessment they have made of the impact on tourism for (1) Liverpool, and (2) the wider North West region, of the UNESCO World Heritage Site status of that city’s waterfront.

We know from the excellent report prepared by the UK National Commission for UNESCO that UNESCO designations such as World Heritage status are worth over £150 million a year to communities across the UK and in its Overseas Territories, as well as contributing to sustainable development and other policy goals. We do not have a precise figure which can be attributed to the world heritage site of Liverpool Maritime Mercantile City, but we know that many international tourists are keen to visit the UK’s 32 world heritage sites, with concomitant economic benefits across the tourism and hospitality sector.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Dec 2022
To ask His Majesty's Government whether, and if so how, they track the mental health outcomes of care-experienced children and young people.

The department is working closely with other government departments to increase our ability to track many aspects of care-experienced children’s outcomes, including their physical and mental health.

Statutory guidance is clear that local authorities are responsible for making sure a health assessment takes place annually for every child in the social care system. This health assessment includes a strengths and difficulties questionnaire that measures any emotional or behavioural difficulties experienced by the child. This provides an outcomes measure within our data collection for care-experienced children that tracks emotional and behavioural needs at a national level.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Dec 2022
To ask His Majesty's Government what steps they are taking to overcome the barriers for care-experienced children and young people in accessing mental health support.

The department recognises the importance of securing appropriate support for children who have experienced trauma, which may include children in care, kinship care or who have been adopted

Local authorities have a statutory duty to promote the welfare of all looked after children. They are responsible for carrying out an annual health assessment for every child in the care system to produce a health plan that addresses the child’s physical, emotional, and mental health needs. This health assessment is reviewed at least annually and is part of a dynamic and continuous cycle of care planning.

Foster carers should be involved in drawing up the health plan as part of the overall care plan for their foster children. Foster carers should be supported by named health professionals for looked-after children on how to access services, including Child and Adolescent Mental Health Service consultations, that the child needs.

For adopted children and children under Special Guardianship orders who were previously in care, the Adoption Support Fund is designed to complement the healthcare system and provide support for those who are suffering trauma and attachment issues. An assessment of need will always be undertaken beforehand, to ensure that the most appropriate support is provided.

The healthcare system is of course available to all children, and parents and carers will be able to receive appropriate advice on how to access this, including support for trauma-related issues as appropriate.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Dec 2022
To ask His Majesty's Government what assessment they have made of barriers for care-experienced children and young people in accessing mental health support.

The department recognises the importance of securing appropriate support for children who have experienced trauma, which may include children in care, kinship care or who have been adopted

Local authorities have a statutory duty to promote the welfare of all looked after children. They are responsible for carrying out an annual health assessment for every child in the care system to produce a health plan that addresses the child’s physical, emotional, and mental health needs. This health assessment is reviewed at least annually and is part of a dynamic and continuous cycle of care planning.

Foster carers should be involved in drawing up the health plan as part of the overall care plan for their foster children. Foster carers should be supported by named health professionals for looked-after children on how to access services, including Child and Adolescent Mental Health Service consultations, that the child needs.

For adopted children and children under Special Guardianship orders who were previously in care, the Adoption Support Fund is designed to complement the healthcare system and provide support for those who are suffering trauma and attachment issues. An assessment of need will always be undertaken beforehand, to ensure that the most appropriate support is provided.

The healthcare system is of course available to all children, and parents and carers will be able to receive appropriate advice on how to access this, including support for trauma-related issues as appropriate.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
5th Dec 2022
To ask His Majesty's Government what steps they are taking to ensure that children and young people in care can receive mental health assessments and support from specialist practitioners who can tailor support for their particular experiences.

The department recognises the importance of securing appropriate support for children who have experienced trauma, which may include children in care, kinship care or who have been adopted

Local authorities have a statutory duty to promote the welfare of all looked after children. They are responsible for carrying out an annual health assessment for every child in the care system to produce a health plan that addresses the child’s physical, emotional, and mental health needs. This health assessment is reviewed at least annually and is part of a dynamic and continuous cycle of care planning.

Foster carers should be involved in drawing up the health plan as part of the overall care plan for their foster children. Foster carers should be supported by named health professionals for looked-after children on how to access services, including Child and Adolescent Mental Health Service consultations, that the child needs.

For adopted children and children under Special Guardianship orders who were previously in care, the Adoption Support Fund is designed to complement the healthcare system and provide support for those who are suffering trauma and attachment issues. An assessment of need will always be undertaken beforehand, to ensure that the most appropriate support is provided.

The healthcare system is of course available to all children, and parents and carers will be able to receive appropriate advice on how to access this, including support for trauma-related issues as appropriate.

Baroness Barran
Parliamentary Under-Secretary (Department for Education)
18th Jan 2024
To ask His Majesty's Government what discussions they have had on how a ban on all wet wipes containing plastic might affect products used in the National Service for infection prevention and control practices.

The consultation on the proposed ban of the manufacture, supply and sale of wet wipes containing plastic closed on 25th November 2023. Defra officials are currently analysing consultation responses.

The consultation included questions on the potential impacts the proposed ban – including for those who require wet wipes containing plastic for medical purposes. Defra officials are engaging with a range of stakeholders, including the NHS, on whether a medical exemption will be required.

Details of the policy will be announced in the Government Response to the consultation, to be published in due course.

Lord Douglas-Miller
Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)
18th Jan 2024
To ask His Majesty's Government what assessment they have made of the impact on public health of a ban on all wet wipes made with plastic where such products are currently used for infection prevention and control practices in the National Health Service and workplaces.

The consultation on the proposed ban of the manufacture, supply and sale of wet wipes containing plastic closed on 25th November 2023. Defra officials are currently analysing consultation responses.

The consultation included questions on the potential impacts the proposed ban – including for those who require wet wipes containing plastic for medical purposes. Defra officials are engaging with a range of stakeholders, including the NHS, on whether a medical exemption will be required.

Details of the policy will be announced in the Government Response to the consultation, to be published in due course.

Lord Douglas-Miller
Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)
18th Jan 2024
To ask His Majesty's Government what assessment they have made about the extent of the use of wet wipe products containing plastics in infection prevention and control practices undertaken in workplaces and the National Health Service.

The consultation on the proposed ban of the manufacture, supply and sale of wet wipes containing plastic closed on 25th November 2023. Defra officials are currently analysing consultation responses.

The consultation included questions on the potential impacts the proposed ban – including for those who require wet wipes containing plastic for medical purposes. Defra officials are engaging with a range of stakeholders, including the NHS, on whether a medical exemption will be required.

Details of the policy will be announced in the Government Response to the consultation, to be published in due course.

Lord Douglas-Miller
Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)
20th Jul 2022
To ask Her Majesty's Government what steps they are taking to develop the fine particulate matter (PM2.5) monitoring network in order to monitor the progress made towards achieving the air pollution targets set under the Environment Act 2021.

As part of our work to assess progress towards the new PM2.5 targets, we have already invested £1m to expand the PM2.5 monitoring network in 2021/22, and have added 17 monitoring sites (as of July 2022) to the existing 63 (December 2021). By the end of 2025 we will have invested a further £10m to at least double the size of the original PM2.5 network.

20th Jul 2022
To ask Her Majesty's Government what steps they are taking to ensure that fine particulate matter (PM2.5) pollution which is generated from vehicle tyres and breaks is controlled in towns and cities.

The development of regulations to limit emissions from tyre and brake wear depends on the development of an internationally recognised test procedure for measuring them. This issue is being examined by the UN ECE Particle Measurement Programme (PMP), which includes DfT officials, other international governments, and the automotive industry. DfT is one of the founders of PMP and has played a leading role since its inception.

To support the work of the PMP group further, DfT commissioned a 3-year research project in February 2021 aimed at understanding better the measurement techniques, material properties and control parameters of tyre and brake wear emissions from road vehicles. This project will inform policy and legislation aiming at reducing these emissions on a domestic and international level.

Furthermore, Government is continuing to invest through Innovate UK grants in emerging technologies which reduce non-exhaust emissions.

Baroness Vere of Norbiton
Parliamentary Secretary (HM Treasury)
20th Jul 2022
To ask Her Majesty's Government what plans they have to deliver traffic reduction schemes that (1) incentivise people to switch to cleaner modes of transport, and (2) support those who might struggle to get around without a car, to access (a) newer, and (b) less polluting, vehicles.

Local authorities are responsible for delivering traffic reduction schemes as they are best placed to make the decisions that will deliver the practical changes required. However, as set out in the Transport Decarbonisation Plan, the Government is committed to supporting places reduce emissions from transport while making journeys better.

We have invested in a range of schemes to help local transport authorities to manage demand on their roads. This includes £4.8 billion of funding via the Levelling-Up Fund, which so far through Round One has allocated funding for 19 places to deliver transport-based projects with decarbonisation benefits. We have also supported innovative trials through the Future Transport Zones programme, such as the Transport for West Midlands Mobility Credits pilot which is helping Coventry residents switch their old, more polluting, cars for local bus and rail services as well as car clubs or bike share schemes.

In April, we published the Local Authority Decarbonisation Toolkit, which provides practical support to authorities to help encourage sustainable travel whilst also providing accessible transport services and access to newer and less polluting transport options, like car clubs. We will continue to support local authorities to drive improvements through their Local Transport Plans.

Baroness Vere of Norbiton
Parliamentary Secretary (HM Treasury)
12th Feb 2024
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 9 February (HL2206), whether a specific body will be set up to lead their joint exploration, with NHS England, of supporting the provision of fracture liaison services.

As per the Major Conditions Strategy: Case for change and our strategic framework, the Government, together with NHS England, will explore supporting the provision of fracture liaison services. The Government has no current plans to set up a specific body to lead this joint exploration, as this is part of the ongoing policy engagement between the Department and NHS England.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2024
To ask His Majesty's Government what discussions they have had with (1) medical royal colleges, and (2) medical professional bodies, about the establishment of medical apprenticeships.

NHS England is providing £150,000 of funding per medical degree apprentice over the term of the programme, as an Employer Support Fund, for cohorts that commence in 2024 and 2025.

Medical schools will receive the Strategic Priorities Grant, funded by the Office of Students, for cohorts commencing in 2024 and 2025. Employers can utilise their apprenticeship levy up to a maximum of £27,000 over the term of the programme as a contribution to medical school tuition fees.

The Department has regular discussions with the medical royal colleges and medical professional bodies about a range of issues, including the introduction of the medical degree apprenticeship.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2024
To ask His Majesty's Government how much funding has been provided for medical apprenticeships by (1) Health Education England, and (2) other sources.

NHS England is providing £150,000 of funding per medical degree apprentice over the term of the programme, as an Employer Support Fund, for cohorts that commence in 2024 and 2025.

Medical schools will receive the Strategic Priorities Grant, funded by the Office of Students, for cohorts commencing in 2024 and 2025. Employers can utilise their apprenticeship levy up to a maximum of £27,000 over the term of the programme as a contribution to medical school tuition fees.

The Department has regular discussions with the medical royal colleges and medical professional bodies about a range of issues, including the introduction of the medical degree apprenticeship.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2024
To ask His Majesty's Government what plans they have, if any, to further regulate medical apprenticeship programmes.

The Department has regular discussions with the General Medical Council (GMC) on a range of issues, including all aspects of the introduction of the medical degree apprenticeship. People who undertake and successfully complete the medical degree apprenticeship will receive the same medical degree as those who study through a full-time university medical degree route and will need to achieve the same outcome standards set by the GMC.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Feb 2024
To ask His Majesty's Government what discussions they have had with the General Medical Council regarding the regulation of medical apprenticeships.

The Department has regular discussions with the General Medical Council (GMC) on a range of issues, including all aspects of the introduction of the medical degree apprenticeship. People who undertake and successfully complete the medical degree apprenticeship will receive the same medical degree as those who study through a full-time university medical degree route and will need to achieve the same outcome standards set by the GMC.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Feb 2024
To ask His Majesty's Government whether they are considering using the new screening technology, developed by OsteoSight, for estimating bone mineral density from routine X-rays that has been approved by the Food and Drug Administration in the United States to give earlier diagnosis of osteoporosis.

OsteoSight is not a registered product with the Medicines and Healthcare Products Regulatory Agency, therefore the Government is not currently considering the use of this technology. However, we will continue to explore areas where artificial intelligence can be deployed in health and care to support clinicians, transform patient experience and improve outcomes.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Feb 2024
To ask His Majesty's Government what assessment they have made of the correlation between the deprivation and availability of fracture liaison services.

The Government has not made an assessment on the correlation between the deprivation and availability of fracture liaison services (FLS). The Fracture Liaison Service Database Annual Report 2023 examines differences in FLS performance based on age, gender and care home residence for 2021, a copy of which is attached. The Falls and Fragility Fracture Audit Programme is also planning to report on social deprivation and ethnicity in the future.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Feb 2024
To ask His Majesty's Government whether they have plans to set up an expert steering group on fracture liaison services.

The Government recognises the value of quality-assured secondary fracture prevention services, including fracture liaison services (FLS). Over 3 million people are estimated to have osteoporosis in the United Kingdom, and over 500,000 patients present with fragility fractures to hospitals each year.

On the 24 January 2023, we announced our plan to publish the Major Conditions Strategy: Case for change and our strategic framework. This strategy will explore how we can tackle the key drivers of ill-health in England, reduce pressure on the National Health Service and reduce ill-health related labour market inactivity. The strategy will focus on six major groups of conditions including musculoskeletal conditions, such as osteoporosis. Aligning work across several groups of conditions will allow us to focus on where there are similarities in approach and ensure care is better centred around the patient.

As per the strategy, the Government will, together with NHS England, explore supporting the provision of fracture liaison services. This includes ongoing engagement with NHS England on musculoskeletal conditions such as osteoporosis as well as preventative interventions such as FLS. In addition, we engage with a range of groups and organisations across musculoskeletal conditions and those with lived experience.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Feb 2024
To ask His Majesty's Government what assessment they have made of why their target for sugar reduction in food and drink has not been met.

Assessments have been made of why the overall 20% reduction ambition for the voluntary sugar reduction programme has not been delivered. The progress monitoring for retailers and manufacturers for the sugar reduction programme, which is what is being referred to, uses sales weighted averages. These are calculated by weighting mean sugar levels by total volume sales. This gives more weight to products with higher volume sales.

Between 2015 and 2020, good levels of reduction were seen in sales weighted average sugar levels in some categories included in the programme for retailers and manufacturers, including reductions of approximately 15% in breakfast cereals, 13.5% in yogurt and fromage frais, and 7.2% in ice creams, lollies and sorbets.

However, increases were seen in the volume sales of higher sugar products included in the programme, for retailers and manufacturers between 2015 and 2020, including a 32% increase in sweet spreads and sauces and a 27.8% increase in chocolate confectionery. When calculating the overall, sales weighted average sugar reduction figure of 3.5%, these increase in sales negate the reductions made in breakfast cereals and other categories included in the programme.

It is also more difficult for some products included in the programme to reduce sugar levels. Some of these categories have instead taken action to reduce calorie levels, with sales weighted average calorie levels for retailers and manufacturers reducing by 7.1% in ice creams, lollies and sorbets, 4.3% in cakes and 3.2% in chocolate confectionery. These are not included in the overall assessment of sugar reduction achieved to date of 3.5%.

Due to limitations with the data, it is not possible to produce sales weighted average figures for the eating out of home sector, so changes made to products sold in these businesses are not covered in the data above.

The Major Conditions Strategy: case for change and strategic framework, included a commitment to continue to work with stakeholders and industry to reduce levels of sugar, calories and salt, including in baby food and drink.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Feb 2024
To ask His Majesty's Government whether they intend to commission further research into the accuracy of BMI thresholds for (1) adults, and (2) children.

The National Institute for Health and Care Excellence (NICE) recommends that Body Mass Index (BMI) for adults and BMI centile, adjusted for age and sex, for children and young people should be used as a practical measure for estimating and defining adiposity, the measure of fatty tissue. In September 2022, NICE reviewed evidence on the most accurate methods and thresholds for assessing the risk associated with overweight and obesity in adults, children and young people, which included BMI.

The Government accepts NICE’s evidence review and recommendations on BMI, including that: BMI is used as a practical measure of overweight and obesity in both adults and children and young people but needs to be interpreted with caution because it is not a direct measure of central adiposity, the accumulation of excess fat in the abdominal area which directly relates to health risks such as type 2 diabetes, hypertension and cardiovascular disease; in adults with a BMI below 35 kilograms per metre squared, waist-to-height ratio should be measured and used as well as BMI, as a practical estimate of central adiposity; in children or young people with a BMI on or above the 91st centile, waist to height ratio should be measured to estimate the degree of central adiposity to help identify or predict future health risks; and a child’s BMI centile should always be plotted on the Royal College of Paediatrics and Child Health UK-World Health Organization growth charts and BMI charts.

NICE also recommended further research, for adults as well as children and young people, on the most accurate and suitable measurements and boundary values to assess the health risks associated with overweight, obesity and central adiposity in people of different ethnicities, particularly those from black, Asian and minority ethnic family backgrounds.

The Department have noted NICE’s recommendations for research. The Department delivers research through the National Institute for Health and Care Research, which funds and supports research across all areas of health and social care, including obesity. Research proposals in all areas compete for the funding available, with awards made on the basis of scientific quality, value for money, and importance of the topic to patients and the health and care system.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Feb 2024
To ask His Majesty's Government what recent assessment they have made of the accuracy of BMI thresholds for (1) adults, and (2) children.

The National Institute for Health and Care Excellence (NICE) recommends that Body Mass Index (BMI) for adults and BMI centile, adjusted for age and sex, for children and young people should be used as a practical measure for estimating and defining adiposity, the measure of fatty tissue. In September 2022, NICE reviewed evidence on the most accurate methods and thresholds for assessing the risk associated with overweight and obesity in adults, children and young people, which included BMI.

The Government accepts NICE’s evidence review and recommendations on BMI, including that: BMI is used as a practical measure of overweight and obesity in both adults and children and young people but needs to be interpreted with caution because it is not a direct measure of central adiposity, the accumulation of excess fat in the abdominal area which directly relates to health risks such as type 2 diabetes, hypertension and cardiovascular disease; in adults with a BMI below 35 kilograms per metre squared, waist-to-height ratio should be measured and used as well as BMI, as a practical estimate of central adiposity; in children or young people with a BMI on or above the 91st centile, waist to height ratio should be measured to estimate the degree of central adiposity to help identify or predict future health risks; and a child’s BMI centile should always be plotted on the Royal College of Paediatrics and Child Health UK-World Health Organization growth charts and BMI charts.

NICE also recommended further research, for adults as well as children and young people, on the most accurate and suitable measurements and boundary values to assess the health risks associated with overweight, obesity and central adiposity in people of different ethnicities, particularly those from black, Asian and minority ethnic family backgrounds.

The Department have noted NICE’s recommendations for research. The Department delivers research through the National Institute for Health and Care Research, which funds and supports research across all areas of health and social care, including obesity. Research proposals in all areas compete for the funding available, with awards made on the basis of scientific quality, value for money, and importance of the topic to patients and the health and care system.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Jan 2024
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1798), why there are no timescales for reaching the achievable target of 80 per cent for breast cancer screening.

NHS England has developed an internal national plan in collaboration with key stakeholders to improve uptake within the breast screening programme from 2023 and beyond. This plan will encompass a series of evaluative projects which are expected to report by April 2024

There is currently no intention of publishing the internal plan, but it is available on the NHS Futures Platform. This is a collaboration platform that empowers everyone working in health and social care to safely connect, share and learn across boundaries.

NHS England and the Department are working in collaboration to establish a set of improvement objectives. Rather than a timescale for reaching the target of 80%, each region has a local improvement plan and are working to reach the agreed efficiency standard following restoration of services post COVID-19 pandemic. It was agreed that a quantified focus on reducing variation was preferable to setting timescales.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Jan 2024
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1800), why the improvement plan for the NHS breast screening programme is not set to be published.

NHS England has developed an internal national plan in collaboration with key stakeholders to improve uptake within the breast screening programme from 2023 and beyond. This plan will encompass a series of evaluative projects which are expected to report by April 2024

There is currently no intention of publishing the internal plan, but it is available on the NHS Futures Platform. This is a collaboration platform that empowers everyone working in health and social care to safely connect, share and learn across boundaries.

NHS England and the Department are working in collaboration to establish a set of improvement objectives. Rather than a timescale for reaching the target of 80%, each region has a local improvement plan and are working to reach the agreed efficiency standard following restoration of services post COVID-19 pandemic. It was agreed that a quantified focus on reducing variation was preferable to setting timescales.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
25th Jan 2024
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 24 January (HL1798), in what circumstances the economic benefits of improved healthcare are assessed.

Economic assessment is undertaken in support of Governmental decision-making, particularly where significant new or existing public resources are required. HM Treasury’s Green Book provides detail of this and sets out guidance on appraising the impacts of government policy. These include employment and productivity effects, environmental impacts and changes in risks to life or health.

The Green Book guidance covers spending control processes, including the development of business cases, as well as regulatory control processes, including regulatory impact assessments.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Jan 2024
To ask His Majesty's Government, further to the Written Answer by the Minister of State at the Department for Health and Social Care on 15 September 2023 (198696), what actions are included in the Uptake Improvement Plan for the breast screening programme; and what are the recommended timeframes for those actions.

Whilst no assessment has been made of the economic benefits of increasing breast screening uptake or the timescales for reaching the achievable target of 80%, the Government continues to be committed to supporting and improving uptake the NHS breast screening programme.

A national plan has been developed by NHS England in collaboration with key stakeholders such as cancer alliances, to improve uptake in the breast screening programme from 2023 and beyond; this is in line with the Long Term Plan commitment that by 2028, 75% of cancers will be diagnosed at stages one and two.

The improvement plan is not set to be published, but covers the priorities and interventions needed to increase uptake. This includes expanding access to screening, reducing inequalities, continuing to develop IT systems to improve data analytics, and ensuring communications are inclusive and accessible to all.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Jan 2024
To ask His Majesty's Government, further to the Written Answer by the Minister of State for the Department of Health and Social Care on 15 September 2023 (198696), whether they will make the Uptake Improvement Plan for the breast screening programme public.

Whilst no assessment has been made of the economic benefits of increasing breast screening uptake or the timescales for reaching the achievable target of 80%, the Government continues to be committed to supporting and improving uptake the NHS breast screening programme.

A national plan has been developed by NHS England in collaboration with key stakeholders such as cancer alliances, to improve uptake in the breast screening programme from 2023 and beyond; this is in line with the Long Term Plan commitment that by 2028, 75% of cancers will be diagnosed at stages one and two.

The improvement plan is not set to be published, but covers the priorities and interventions needed to increase uptake. This includes expanding access to screening, reducing inequalities, continuing to develop IT systems to improve data analytics, and ensuring communications are inclusive and accessible to all.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Jan 2024
To ask His Majesty's Government, based on the current speed of recovery, what estimate they have made of when breast screening uptake in England could reach the achievable target of 80 per cent.

Whilst no assessment has been made of the economic benefits of increasing breast screening uptake or the timescales for reaching the achievable target of 80%, the Government continues to be committed to supporting and improving uptake the NHS breast screening programme.

A national plan has been developed by NHS England in collaboration with key stakeholders such as cancer alliances, to improve uptake in the breast screening programme from 2023 and beyond; this is in line with the Long Term Plan commitment that by 2028, 75% of cancers will be diagnosed at stages one and two.

The improvement plan is not set to be published, but covers the priorities and interventions needed to increase uptake. This includes expanding access to screening, reducing inequalities, continuing to develop IT systems to improve data analytics, and ensuring communications are inclusive and accessible to all.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Jan 2024
To ask His Majesty's Government, further to the Demos and Breast Cancer Now report The Cost of Breast Cancer: Modelling the economic impact to the UK, published on 22 January, what assessment they have made of the economic benefits of increasing breast screening uptake.

Whilst no assessment has been made of the economic benefits of increasing breast screening uptake or the timescales for reaching the achievable target of 80%, the Government continues to be committed to supporting and improving uptake the NHS breast screening programme.

A national plan has been developed by NHS England in collaboration with key stakeholders such as cancer alliances, to improve uptake in the breast screening programme from 2023 and beyond; this is in line with the Long Term Plan commitment that by 2028, 75% of cancers will be diagnosed at stages one and two.

The improvement plan is not set to be published, but covers the priorities and interventions needed to increase uptake. This includes expanding access to screening, reducing inequalities, continuing to develop IT systems to improve data analytics, and ensuring communications are inclusive and accessible to all.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Jan 2024
To ask His Majesty's Government, further to the Public Accounts Committee report Adult health screening, published on 10 May 2019 (HC 1746), what progress they have made towards the first recommendation contained in that report to publish a plan, with timeframes for action, to explain how they intend to address the health inequalities that exist in breast screening.

Public Health England published an inequalities strategy in an online-only format in October 2020 aimed at supporting local screening services, commissioners, and others to address inequalities. Accepted recommendations from the 2019 Public Accounts Committee (PAC) report on Adult Health Screening have now been implemented, so NHS England no longer reports against the PAC report.

NHS England has developed a national plan to improve uptake within the breast screening programme, including interventions to address inequalities and screening barriers. This includes working to ensure that breast screening appointments are as convenient to people as possible and focusing its efforts on low uptake areas and groups. NHS England is also working to ensure they have data, including on protected characteristics, to support services to deliver more targeted initiatives.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Jan 2024
To ask His Majesty's Government what checks are in place to ensure that information from NHS records used in courts has been obtained without coercion.

The Department does not routinely monitor how National Health Service records are used in courts but there are extensive safeguards in place to ensure people are not being coerced to access their medical records online, which NHS England has developed by engaging with professional bodies, patients, charities, and safeguarding experts.

This engagement has also helped shape NHS England’s patient and general practitioner (GP) communications packs and advice, the messages issued on the NHS App and the NHS website and system changes. Communication packs have also been issued to over 50 charities which support people who may be at risk.

People can only access their prospective records via the NHS App. Before viewing their record in the NHS App, users are given advice about what to do if they are being pressured to share their information. Patients are able to prevent access via an online process, by disabling their NHS login or can request that their GP redact details of specific consultations or treatment.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Dec 2023
To ask His Majesty's Government what consideration has been given to making it simpler to switch off access to patient health records through the NHS app, particularly for vulnerable groups.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Dec 2023
To ask His Majesty's Government whether any concerns about risk to personal safety and security have been identified by the expert safeguarding group reviewing the implementation of NHS App.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Dec 2023
To ask His Majesty's Government what advice is being provided to domestic abuse survivors and other at-risk groups about medical apps they have downloaded on their devices.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
19th Dec 2023
To ask His Majesty's Government what assessment they have made of the risk of being pressured into showing confidential medical records on the NHS App to third parties faced by (1) patients requesting covert contraception forbidden in their home or relationship, (2) patients who are suffering domestic abuse, and (3) other vulnerable groups including the elderly.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Dec 2023
To ask His Majesty's Government what measures they have put in place to deal with the predicted unequal impact of climate change and associated health conditions on those who are vulnerable, including children, older people, and those with medical conditions or living in deprived areas.

The UK Health Security Agency (UKHSA) is conducting a review of the available evidence to better understand the unequal health impacts of climate change and the solutions taken to address climate change in populations included in the CORE20PLUS framework which informs action to reduce healthcare inequalities in the United Kingdom. The findings of this evidence review will inform future work by UKHSA.

In April 2023, UKHSA published the Adverse Weather and Health Plan (AWHP) to protect individuals and communities from the health effects of adverse weather and developed new guidance to address the needs of specific population groups and settings. A copy of the plan is attached.

Further development of the guidance will be informed by an AWHP equity review which will outline available evidence pertaining to populations included in the CORE20PLUS framework. This review will be followed by a series of research and public health recommendations.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Dec 2023
To ask His Majesty's Government what measures they have put in place to ensure the right research, data and information are in place to tackle the increasing health risks from climate change.

The UK Health Security Agency (UKHSA) works extensively with academic groups through joint research projects, and with European and international colleagues on sharing intelligence and experience on emerging disease risks. UKHSA has prioritised intervention evaluation for climate risks to health within its research partnerships and business planning. UKHSA’s Centre for Climate and Health Security is developing and expanding capacity to assess the effectiveness of measures to mitigate climate change threats to health, supported by UKHSA’s Evaluation and Epidemiological Science Unit.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Dec 2023
To ask His Majesty's Government what assessment they have made of the UK’s preparedness and resilience for increased risk from vector-borne diseases, and how that will be tested.

The UK Health Security Agency (UKHSA) conducts horizon scanning to detect, assess and communicate potential infectious threats to UK public health. Working across Government, UKHSA has developed guidance, and contingency plans are in preparation to support the prevention, management, and control of infectious diseases.

The cross-Government One Health - Human Animal Infections Risk Assessment group assesses these threats, including vector-borne diseases posed to the four nations. Surveillance systems and diagnostic pathways are in place to detect, monitor, report and rapidly diagnose infectious diseases. UKHSA specialist laboratories work with partners to ensure readiness of testing capacity for vector-borne diseases, and to develop testing approaches to detect emerging pathogens. UKHSA will continue to work with partners on preparatory activities for vector-borne disease emergence and review and amend these plans as the risk changes.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Dec 2023
To ask His Majesty's Government how agreements at the recent COP 28 and previously are expected to affect the conditions in which vector-borne diseases proliferate.

The COP28 UAE Declaration on Climate and Health includes a commitment by governments to tackle the health threats of climate change. Commitments made at COP28 under the ‘UAE Consensus’ also include an agreement to reduce global emissions and accelerate climate change adaptation.

The extent to which the COP28 agreements will result in a real reduction in vector-borne disease risk in the United Kingdom is dependent upon the voluntary implementation of emissions reductions and adaptation measures taken by global nations as indicated within the UAE Consensus. If these emissions reductions and targeted adaptations are realised, this will reduce the likelihood of a worst-case scenario in the UK, specifically the likelihood of invasive mosquitoes that thrive in high temperatures establishing in the UK and the likelihood of mosquito-borne viruses being transmitted as warmer temperatures favour transmission.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Dec 2023
To ask His Majesty's Government what (1) estimates, or (2) management information, they have available regarding the number of patients waiting for a spirometry test within each integrated care board.

The Department does not currently hold validated data on the number of patients waiting for a spirometry test in England or within each integrated care board. NHS England plans to expand the national diagnostics data collection in 2024. This will provide regular data on spirometry services for the first time.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
11th Dec 2023
To ask His Majesty's Government what (1) data, (2) estimates, or (3) management information, they have available regarding the number of patients waiting for a spirometry test in England.

The Department does not currently hold validated data on the number of patients waiting for a spirometry test in England or within each integrated care board. NHS England plans to expand the national diagnostics data collection in 2024. This will provide regular data on spirometry services for the first time.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2023
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 6 December (HL563), when the helipad at the Royal Sussex County Hospital was first opened and operational; what the costs were associated with building the helipad; what further works are required for the facility to become fully operational; and when they will be completed.

The helipad has not been opened yet and is not currently operational. The costs associated with building the helipad are currently £14.2 million. There are several activities required to allow the helipad to become operational. These include recruitment and training of the response/fire team, completion of standard operating procedures, and Civil Aviation Authority final inspection and test flights.

In addition, a review of outstanding backlog maintenance issues for the block on which the helipad is located, to ensure any items that may prevent operation of the helipad are resolved, where possible. This includes a review of the external windows. The current planning assumption is that the helipad will be operational during 2024/25.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2023
To ask His Majesty's Government when the Commission on Human Medicines is expected to make recommendations about whether anaesthesia associates will be given prescribing rights.

On 13 December 2023, the Department laid draft legislation in both Houses and in the Scottish Parliament that will empower the General Medical Council (GMC) to regulate anaesthesia associates and physician associates.

Subject to parliamentary scrutiny, this legislation will instruct the GMC to commence regulation. The GMC will have 12 months to consult on their own rules, policies and guidance and begin regulating these roles.

Extending prescribing responsibilities to a profession involves a separate legislative process to the introduction of statutory professional regulation as amendments are needed to the Human Medicines Regulations.

The process to extend prescribing responsibilities to a role is jointly led by NHS England and the Department. This work is exploratory at this stage, in advance of regulation.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2023
To ask His Majesty's Government when they plan to introduce legislation to regulate anaesthesia associates.

On 13 December 2023, the Department laid draft legislation in both Houses and in the Scottish Parliament that will empower the General Medical Council (GMC) to regulate anaesthesia associates and physician associates. Subject to parliamentary scrutiny, this legislation will instruct the GMC to commence regulation. The GMC will have 12 months to consult on their own rules, policies and guidance and begin regulating these roles.

Regulation will provide a standardised framework of governance and assurance for clinical practice and professional conduct, to enable these roles to make a greater contribution to patient care.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2023
To ask His Majesty's Government how many anaesthesia associates were practising in England in (1) 2005, (2) 2010, (3) 2015, (4) 2020, and (5) 2023.

The Department does not hold the historical data requested.

There are two proxy measures which could be used to understand the number of anaesthesia associates (AAs) currently practicing in England. Firstly, data on the National Health Service workforce is drawn from the Electronic Staff Record (ESR) and published by NHS England. ESR is the payroll system for the NHS. The latest data for June 2023 shows that there are 72 full-time equivalent staff recorded as AAs working in NHS trusts and other core organisations in England. Coding of AAs on ESR was only introduced in 2021 and it is therefore likely that some people are not coded correctly.

Secondly, the Royal College of Anaesthetists holds and publishes a voluntary register of AAs across the United Kingdom who have completed the anaesthetist associate training. As of November 2023, this held 167 registered members, 134 of whom have listed an NHS trust as their employer. The register is voluntary and so may not include all those who have completed training. In addition, registration with the voluntary register does not guarantee that an individual is currently practicing.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2023
To ask His Majesty's Government what discussions they have had with NHS England about their desktop review of national home care medicines, and whether they will publish the terms of reference and timetable for this review.

We have had no specific discussions. NHS England’s desktop exercise to review homecare medicines services is not guided by terms of reference. The next steps are to bring together data from the desktop exercise with the House of Lords inquiry report recommendations to shape a programme of work on homecare medicines. The Committee will be updated on progress in January and March 2024.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2023
To ask His Majesty's Government what plans they have for raising public awareness of the use of medical associate professions in the NHS.

The Department is committed to ensuring that the public are aware of the role of physician associates (PAs) and anaesthesia associates (AAs) in the National Health Service. The introduction of regulation by the General Medical Council will also provide a standardised framework of governance and assurance for the clinical practice and professional conduct of PAs and AAs and make it easier for employers, patients, and the public to understand the relationship between this role and that of doctors. In implementing the NHS Long Term Workforce Plan, NHS England is working with the relevant professional colleges and regulators, to ensure the roles are expanded safely and effectively.

NHS England has produced patient-facing materials that have been shared widely with general practices to support patient awareness and understanding of the PA role. NHS England has also utilised media assets in a large-scale social media campaign targeted at the public to raise awareness and understanding of the AA role. These materials along with other commissioned infographic material also forms part of a longer-term communications and engagement strategy with the objective of raising public awareness of the use of medical associate professions.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2023
To ask His Majesty's Government how much funding they provided to train Physician Associates and Anaesthesia Associates in 2022, and whether this funding came from the NHS workforce training budget or a from separate funding stream.

In 2022/23, funding to train physician associates and anaesthesia associates was delivered through a national funding model by Health Education England’s multi professional education and training investment plan. Health Education England is now part of NHS England.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2023
To ask His Majesty's Government when they will publish a progress report on the NHS Long Term Workforce Plan, what the interim targets for the plan are, and how the impact of the plan will be measured.

We have established a Long Term Workforce Plan Governance Board which will ensure the delivery of the Plan.

The modelling that NHS England has used in the Plan is founded on data, evidence and analysis and provides a set of broad ranges to measure the potential impact of actions over its 15-year timeframe. We have committed to refreshing the modelling that underpins the plan every two years, or in line with fiscal events.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Nov 2023
To ask His Majesty's Government whether the National Homecare Medicines Committee will consult publicly on future key performance indicators as part of their review of national homecare medicines.

Homecare performance data is collected already. 27 key performance indicators (KPIs) were developed by the National Homecare Medicines Committee (NHMC) and published by the Royal Pharmaceutical Society. The performance data is not published by the National Health Service.

Aligned to the NHMC consultation process, draft updated KPIs have been consulted on by members of the NHMC and the organisations they represent. Membership includes NHS trusts, the Association of the British Pharmaceutical Industry, pharmaceutical manufacturers, homecare providers and regulators. The NHMC project group is currently preparing the final draft of the updated KPIs for approval, with these being aimed for publication in the first quarter of 2024/25.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
23rd Nov 2023
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 9 December 2022 (HL3930), what progress they are making towards starting operations of the helipad at Royal Sussex County Hospital.

Royal Sussex County Hospital is still assessing the work required to reopen the helipad.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
23rd Nov 2023
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 9 December 2022 (HL3930), what assessment they have made of the impact of the helipad at Royal Sussex County Hospital on (1) safety relating to the cladding on the tower, and (2) noise.

University Hospitals Sussex NHS Foundation Trust has undertaken remedial works to fix the issues with the cladding on the helipad at Royal Sussex County Hospital. However, additional surveys have identified concerns with the glazed curtain wall. The trust is discussing these with its building contractor to determine the likely extent of additional remedial works. Noise issues are considered as part of the design of helipads as referenced in the relevant guidance from the Civil Aviation Authority, Standards for helicopter landing areas at hospitals. A copy of the guidance is attached.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2023
To ask His Majesty's Government, in each year since 2014, how much funding they provided to community pharmacies in retained margin in real terms as part of the Community Pharmacy Contractual Framework; and what was the cost of medicines bought by community pharmacies.

The retained medicine margin as allowed under the Community Pharmacy Contractual Framework funding for years 2014/15 to 2021/22 was £800 million per year; for 2022/23 and 2023/24 it is £850 million. The Department does not hold the cost information requested as our data refers to the whole of primary care and we do not have figures for community pharmacy only

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2023
To ask His Majesty's Government how many patients have been given structured medication reviews (SMRs) by pharmacists in general practice and primary care networks in each year since the launch of the Additional Roles Reimbursement Scheme in 2019; and what is the total number of patients that NHS England deems eligible to receive SMRs.

NHS England records the number of patients who have received a structured medication review (SMR) on NHS.UK in an online-only format. The total number of SMRs delivered in 2022/23 was 2,694,812; however, this data does not include who delivered the SMR.

NHS England does not hold data either on how many patients have been given structured medication reviews by pharmacists in general practice in each year since 2019, or on the number of patients eligible for an SMR.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2023
To ask His Majesty's Government what plans they have to incorporate independent prescribing into community pharmacy services, once the Pathfinder sites have reported and evaluated their outcomes.

No assessment has been made so far of other conditions Pharmacy First could cover. NHS England is working with integrated care boards to recruit over 200 community pharmacy Pathfinder sites to establish how independent prescribers can be used to incorporate independent prescribing into clinical services available to the public through community pharmacy in the longer-term. A detailed formative and summative evaluation, undertaken by independent evaluators, of the Pathfinder programme is planned to inform any potential future commissioning decisions.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2023
To ask His Majesty's Government what assessment they have made of what other conditions the Pharmacy First service could cover, beyond the seven conditions announced as part of the Delivery Plan for Recovering Access to Primary Care.

No assessment has been made so far of other conditions Pharmacy First could cover. NHS England is working with integrated care boards to recruit over 200 community pharmacy Pathfinder sites to establish how independent prescribers can be used to incorporate independent prescribing into clinical services available to the public through community pharmacy in the longer-term. A detailed formative and summative evaluation, undertaken by independent evaluators, of the Pathfinder programme is planned to inform any potential future commissioning decisions.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask His Majesty's Government what data is being collected on the detection rates of prostate cancer in the pilot programme for early detection of prostate cancer using mobile health clinics funded by NHS England for men at highest risk of prostate cancer, in particular (1) Black men, and (2) men with a family history of prostate cancer; and how this data is being shared with the National Screening Committee.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask His Majesty's Government how the clinically significant cancer detection rates in the pilot programme for early detection of prostate cancer using mobile health clinics funded by NHS England compare to the detection rates in existing prostate cancer screening programmes.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask Her Majesty's Government what progress has been made with the pilot programme for early detection of prostate cancer using mobile health clinics funded by NHS England and developed by the Royal Marsden NHS Foundation Trust, the Institute of Cancer Research and RM Partners West London Cancer Alliance.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask His Majesty's Government what recent analysis they have undertaken of the approval thresholds used by the National Institute for Health and Care Excellence (NICE) to approve new medications.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask His Majesty's Government what assessment they have made of the finding in the report by the London School of Economics and Political Science Promoting population health through pharmaceutical policy: The role of the UK Voluntary Scheme, published in June, that the NHS are exceeding spending predictions on hospital-prescribed medications; and what steps they are taking in response.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2023
To ask His Majesty's Government what analysis they have undertaken in each of the past five years of the NHS's spending on hospital-prescribed medications.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Oct 2023
To ask His Majesty's Government when steps they are taking to reduce the number of autistic people confined to inpatient care in mental health hospitals.

In July 2022, we published the Building the Right Support (BtRS) Action Plan, which sets out cross-government actions to strengthen community support and reduce reliance on mental health inpatient care for autistic people and people with a learning disability.

The BtRS Delivery Board is overseeing implementation of the Action Plan. The Board includes representatives from across government and public services who are working together to drive faster progress, identifying new actions and mitigations as appropriate.

This year, we are investing an additional £121 million to improve community support as part of the NHS Long Term Plan, including funding for Children and Young People’s keyworkers.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Oct 2023
To ask His Majesty's Government whether they have any plans to set targets aimed at reducing the number of autistic people without a learning disability confined to inpatient care in mental health hospitals.

The NHS Long Term plan commits to achieving a 50% net reduction in the number of autistic people and people with a learning disability who are inpatients in mental health hospitals by end of March 2024. This objective is inclusive of autistic inpatients who are not diagnosed with a learning disability.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2023
To ask His Majesty's Government what steps they are taking to reduce backlogs for elective procedures in child health services.

Cutting National Health Service waiting lists, including for elective child health services, is one of the Government’s top priorities. To support elective recovery, the Government plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity. Steps taken include increasing capacity, seeking alternative capacity in other trusts or the independent sector and engaging with patients to understand their choices.

We met our target to virtually eliminate long waits of two years or more for elective procedures in July 2022. We also virtually eliminated waits of over 18 months by the end of June 2023, a reduction of over 94% from the peak of 125,000 in September 2021. Our next ambition is to eliminate waits of 65 and 52 weeks.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2023
To ask His Majesty's Government what steps they are taking to reduce NHS treatment waiting times for children and young people.

Cutting National Health Service waiting lists, including for elective child health services, is one of the Government’s top priorities. To support elective recovery, the Government plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity. Steps taken include increasing capacity, seeking alternative capacity in other trusts or the independent sector and engaging with patients to understand their choices.

We met our target to virtually eliminate long waits of two years or more for elective procedures in July 2022. We also virtually eliminated waits of over 18 months by the end of June 2023, a reduction of over 94% from the peak of 125,000 in September 2021. Our next ambition is to eliminate waits of 65 and 52 weeks.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Sep 2023
To ask His Majesty's Government what steps they are taking to reduce backlogs in community child health services.

We are committed to reducing community health care waiting lists for children and young people. That is why the NHS Long Term Workforce Plan sets commitments to grow the community workforce, with increases in training places for district nurses, health visitors, school nurses and allied health professionals, and a renewed focus on retaining existing staff.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Sep 2023
To ask His Majesty's Government whether they have assessed demographic data in respect of the move by some sexual health services to offer in-person appointments only to those reporting symptoms of a sexually transmitted infection.

No assessment has been made of demographic data on provision of sexual health services.

Local authorities are responsible for commissioning comprehensive open access to most sexual health services through the public health grant funded at £3.5 billion in 2023/24.  It is for individual local authorities to decide their spending priorities based on an assessment of local need and to commission and evaluate the service lines that best suit their population, including online and in-person provision.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
17th Jul 2023
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 17 July (HL8936), when updated guidance will be available from NHS England; how the "transformation" of adult eating disorder (AED) services will be defined and its effectiveness assessed; and by what date integrated care systems will be expected to have transformed AED services.

To support services to plan and implement improvements, NHS England has developed a community mental health roadmap intended to set out the different elements which make up the delivery of the NHS Long Term Plan commitments on community mental health transformation, including eating disorders. A transformed adult eating disorder service is defined as:

- Specialist teams that are able to provide support to a spectrum of severity and different types of eating disorders;

- Able to embed lived experience in service development and delivery;

- Supporting early intervention using models such as First Episode Rapid Early Intervention for Eating Disorders (FREED) and not employing body mass index or weight thresholds;

- Working with primary care to provide clear arrangements for medical monitoring;

- Working jointly with children and young people’s services, particularly to support smooth transitions; and

- Able to accept self-referrals and referrals from primary care and voluntary, community and social enterprise organisations.

NHS England routinely monitors performance returns from integrated care systems to track progress against these deliverables.

Since April 2021, all integrated care systems have received fair-share funding to transform their adult community mental health services, including eating disorders, with the expectation that all will have transformed adult eating disorder services in place by March 2024.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Jul 2023
To ask His Majesty's Government what long-term strategy they are using to ensure that people living in cities and high polluting areas are not at increased risk of life-threatening illnesses, including lung cancer.

In 2021 the Government passed the Environment Act, which established a legally binding duty on the Government to bring forward air quality targets, in secondary legislation, focused on reducing the impact of air pollution on the public’s health. Following consultation, two new targets were set earlier in 2023: to reduce population exposure to PM2.5 by 35% in 2040 compared to 2018 levels; and to require a maximum annual mean concentration of 10 micrograms of PM2.5 per cubic metre (µg/m3) by 2040.

The Environmental Improvement Plan, published on 31 January 2023, set out the steps the Government intends to take to improve the environment and established additional interim targets to drive action in the shorter term. The plan reflects the fact that the greatest amount of air pollution within the United Kingdom is generated in urban areas.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2023
To ask His Majesty's Government what recent assessment they have made of the availability of digital infrastructure to enable effective digital working in healthcare organisations.

We are committed to advancing the use of digital and technology in the National Health Service, as outlined in ‘A Plan for Digital Health and Social Care’, published in June 2022 in an online-only format. As part of this, digital maturity assessments are underway in the What Good Looks Like programme to give health and care organisations a baseline to understand their progress on meeting digitisation standards. This will enable more targeted support for those organisations that need it. Digital maturity assessments will be updated yearly to track progress on their journey to achieving what good looks like.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2023
To ask His Majesty's Government what consideration they have given to the findings of a study led by the University of Manchester, published in Nursing Standard on 9 May, on nurses’ adoption and use of digital technology during the COVID-19 pandemic; and what plans they have to improve access for nursing staff to efficient, effective and reliable digital infrastructure.

No formal consideration has been given to these findings. However, in June 2022, we set out our plans to digitally transform the National Health Service in ‘A plan for digital health and social care’, which is available in an online-only format. By March 2025, constituent organisations of an integrated care system should have ensured all health and social care settings have the right infrastructure and connectivity to work digitally.

There are programmes in place to support NHS staff build their digital literacy, including the Florence Nightingale Foundation Digital Scholarship. The Scholarship is an introduction to the knowledge needed by digital nurses and midwives, with Health Education England having funded over 40 scholarship places.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2023
To ask His Majesty's Government what recent assessment they have made of digital literacy of the healthcare workforce.

Both the Topol Review in 2019 and the Laura Wade-Gery Review in 2021 highlighted the need to build digital literacy across the National Health Service workforce. This is being addressed via the establishment of the Digital Academy, which is now positioned as the home for digital learning and development. We have programmes and packages in place to support this, including the Digital Health Leadership Programme, the Topol Digital Fellowship, and the Digital Skills Assessment Tool.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2023
To ask His Majesty's Government what assessment they have made of the finding of the University of Manchester, published in Nursing Standard on 9 May, that there is a significant variation in reported usability of the same types of digital technology across different healthcare organisations.

Whilst we have made no specific assessment of the Nursing Standard article, we have found that the primary reason for variation in digital maturity is disparity in national and local investment over the past two decades. We are aiming to address this through the £2 billion investment in frontline digitisation.

Where feasible, we are encouraging systems to explore integrated care system-wide solutions to support integrated care. As part of our Frontline Digitisation support offer, we are also working to build an England-wide community to share lessons learnt, improvements and develop peer-to-peer networks to share best practice.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Jul 2023
To ask His Majesty's Government what recent assessment they have made of the usability of electronic health record systems across healthcare organisations; and what plans they have to improve usability.

The primary reason for variation in digital maturity is disparity in national and local investment over the past two decades. NHS England aims to address this through the £2 billion investment in Frontline Digitisation. This includes supporting systems to improve Electronic Patient Record coverage and digital capability across secondary care. Where feasible, we are encouraging the use of integrated care system-wide solutions to support integrated care.

To improve the usability of systems and maximise clinical efficiency, patient care, and financial returns on investment, NHS England plans to provide targeted support to trusts, develop scenario-based guidance materials, and run nationally available events to support mutual learning and inter-trust information sharing.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government what steps they are taking to ensure that all patients needing radiotherapy treatment have access to a treatment centre within the recommended 45-minute travel time.

There is no limit on the distance that would be required for someone to receive cancer treatment. Specialised services are not available in every local hospital because they need to be delivered by specialist teams of health professionals who have the necessary skills, experience and access to equipment and medicines.

Patient-specific requirements are based on what each individual could manage and cope with and would be discussed between the patient and clinician.

Patients travelling for cancer treatment via NHS Patient Transport Services (PTS) are exempt from any eligibility checks (both on medical and mobility grounds) and are automatically deemed PTS "eligible" for both the inbound and outbound journeys as frequently as these are required, which has been the case for some years now.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government how many cancer patients received radiotherapy treatment within the 62-day referral to treatment target; and what steps they are taking to reduce waiting times for patients who have been diagnosed with cancer and are waiting for treatment.

Between May 2022 and April 2023, 9,333 patients received radiotherapy treatment on the Urgent Suspected Cancer pathway, of which 2,402 were treated within 62 days.

The Government worked with NHS England to publish the delivery plan for tackling the COVID-19 backlogs in elective care in February 2022. The Government also plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.

This will further be supported by the additional £3.3 billion of funding in each of the next two years announced at the Autumn Statement to support the National Health Service, enabling rapid action to improve emergency, elective and primary care performance towards pre-pandemic levels.

NHS England’s recent letter ‘Elective care 2023/24 Priorities’ set out the progress to date in reducing the number of patients with urgent suspected cancer waiting longer than 62 days and meeting the faster diagnosis standard for the first time in February. It also confirmed the ongoing priorities to make further progress to improve performance and long waits, prioritise diagnostic capacity and focus on cancer pathway redesign.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government what discussions they have had with NHS England regarding the creation of regional Joint Committees between NHS England and the various Integrated Care Boards in England; and when the regional Joint Committees between NHS England and the various Integrated Care Boards in England will be established.

NHS England published a roadmap in May 2022 setting the direction of travel for greater integration of specialised services with Integrated Care Board (ICB) commissioned services to better join up patient pathways. The roadmap is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

An analysis of the entire specialised services portfolio was undertaken to determine which services are both suitable and ready for greater ICB leadership. Following an assessment of ICB system readiness at the end of 2022 using a pre-delegation assessment framework, nine statutory joint committees between NHS England and multi-ICB collaborations were established on 1 April 2023 taking on joint responsibility for commissioning decisions on 59 specialised services.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government whether they will publish the data for waiting times for adults needing treatment for eating disorders; and if so, when.

We are working with NHS England on the introduction new waiting time standards for mental health as part of its clinically-led review of NHS access standards. One of these is that adults and older adults presenting to community-based mental health services, including eating disorder services, should start to receive help within four weeks from referral. A date for its introduction has not yet been set.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government what assessment they have made of the commissioning of integrated services for eating disorders for (1) children and young people, and (2) adults.

NHS England is refreshing guidance on children and young people's eating disorders, including to increase the focus on early identification and intervention. Updated guidance will highlight the importance of improved integration between dedicated community eating disorder services, wider children and young people's mental health services, schools, colleges and primary care to improve awareness, provide expert advice and improve support for children and young people presenting with problems with eating, whilst ensuring swift access to specialist support as soon as an eating disorder is suspected.

Improving adult eating disorder (AED) services is a key priority for NHS England and a fundamental part of our LTP commitment to expand and improve mental health services.

The NHS Long Term Plan sets out an ambition to give 370,000 adults and older adults with severe mental illness, including eating disorders, greater choice and control over their care and support them to live well in their communities by 2023/24. This includes creating integrated pathways of care across primary care, mental health services, VCS organisations, and social care, for people with severe mental illness. This programme will deliver just under £1 billion of additional funding per year for transforming community mental health by 2023/24.

Since April 2021 all integrated care systems (ICSs) have received fair-share funding to transform their community mental health services, including eating disorders, with the expectation that all ICS will have transformed AED services in place by 2023/24.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
29th Jun 2023
To ask His Majesty's Government what assessment they have made of the effectiveness of specialist day care provision and home-based treatment for eating disorders, as compared to inpatient treatment for (1) children and young people, and (2) adults.

NHS England is refreshing guidance on children and young people's eating disorders, with an increased focus on early identification and intervention. Updated guidance will highlight the importance of improved integration between community eating disorder services, wider children and young people's mental health services, schools, colleges and primary care. This will improve awareness, provide expert advice and improve support for children and young people presenting with problems with eating.

In 2019, NHS England published an addendum to the national Children and Young People’s Eating Disorder Guidance to include guidance on integration between community eating disorder services and inpatient and day care services, noting that “children and young people should be treated as close to home as possible, at the earliest opportunity, to substantially reduce the need for admission and length of stay”.

In 2022/23, 47% more children and young people have started National Institute for Health and Care Excellence concordant evidence-based treatment in the community, compared to 2019/20.

For adults, National Health Service guidance on intensive day patient treatment and home-based treatment outlines that intensive day patient treatment provides step-down care from inpatient treatment or an alternative to admission.

It may be provided by either an inpatient unit or a community eating disorder (CED) service, at least four to five times a week, and should include support around main meals as well as encouraging people to learn skills and engage in activities that contribute towards their recovery. Integrated working across day patient and CED services can help support people to live in the community and prevent relapse or readmission.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
28th Jun 2023
To ask His Majesty's Government what assessment they have made of the reasons that, according to the British Heart Foundation, excess deaths due to cardiovascular disease outnumber excess deaths involving all other individual diseases since the onset of the pandemic in England.

Whilst a detailed assessment of reasons for excess cardiovascular deaths outnumbering other diseases is not available, evidence on excess mortality attributable to non-COVID-19 related causes implies that it is likely due to a combination of factors. This may include disruption to routine care during the first two years of the pandemic, lifestyle factors and disruption to emergency care and urgent elective procedures.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Jun 2023
To ask His Majesty's Government what response they have to the recent analysis by the British Heart Foundation that since the start of the COVID-19 pandemic in England, nearly 100,000 more people than expected have died from cardiovascular disease.

Between March 2020 and May 2023 cardiovascular disease was a significant contributor to excess deaths. That is why we are going further to empower and support people to manage their heart health risks through the development of a digital NHS Health Check and have appointed Professor Deanfield to lead work to develop an ambitious approach to personalised prevention.

Cardiovascular disease will form a part of the Government’s Major Conditions Strategy which will focus on conditions that contribute most to morbidity and mortality across the population in England. The Strategy will set out a strong and coherent policy agenda that underpins a shift to integrated, whole-person care, building on measures that we have already taken forward through the NHS Long Term Plan. Interventions set out in the Strategy will aim to alleviate pressure on the health system, as well as support the government’s objective to increase healthy life expectancy and reduce ill-health related labour market inactivity.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
21st Jun 2023
To ask His Majesty's Government when an update (1) was last published, and (2) will next be published, on the partnerships on analytical projects between the National Cancer Registration and Analysis Service and organisations such as Cancer Research UK, Macmillan, and various universities.

Information on National Cancer Registration and Analysis Service’s (NCRAS) analytical partnerships is publicly available in an online-only format on the National Disease Registration Service (NDRS) website. This page is in development after the transition of NDRS from Public Health England to NHS Digital and subsequently into NHS England in January this year. The web page is being continually updated with more information. Previous information of NCRAS analytical partnerships was published by Public Health England in March 2019.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Jun 2023
To ask His Majesty's Government, further to the Written Statement by Lord Markham on 8 June (HLWS826), what estimate they have made of the number of people who have previously been diagnosed with HIV but who are not currently receiving treatment for it; and what steps they are taking to find and support those people.

The UK Health Security Agency (UKHSA) HIV Action Plan monitoring and evaluation framework showed in 2021, 147 people were diagnosed and not yet linked to specialist human immunodeficiency virus (HIV) care, 4,444 people had not attended care for at least 15 months and 1,195 had been seen for HIV care but were not on treatment, corresponding to a lower estimate of 5,786 people diagnosed and not receiving treatment in 2021. UKHSA also estimate that there could be an additional 18,226 people seen for care since January 2015, with at least a 15 months gap in HIV care and not seen again by end of 2021, corresponding to an upper estimate of 24,012 people diagnosed but not on antiretroviral treatment.

As part of the HIV Action Plan, we committed to ensure everyone with an HIV positive status receives adequate treatment and to optimise access, retention and re-engagement in HIV care. Therefore, we established a sub group of the HIV Action Plan implementation Steering Group, which includes UKHSA, the British HIV Association and other organisations who will provide advice on increasing the number of people retained and re-engaged in care and receiving effective medical care.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Jun 2023
To ask His Majesty's Government how many cancer patients received radiotherapy treatment within the 62-day referral to treatment target in the most recent year for which data are available.

Between May 2022 and April 2023, 2,402 patients received radiotherapy treatment on the Urgent Suspected Cancer pathway within 62 days.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Jun 2023
To ask His Majesty's Government what steps they are taking to reduce waiting times for patients who have been diagnosed with cancer and are waiting for radiotherapy treatment.

Eleven Radiotherapy Networks were established across England in 2019/20 to drive improvements through greater workforce resilience and increased access to specialist skills and knowledge, ensuring all patients can access the very best treatment regardless of where they live.

Since 2016, around £162 million of central investment has been made to replace or upgrade around 100 radiotherapy machines so that every radiotherapy service has access to modern equipment capable of delivering innovative treatment techniques. This investment was in addition to the investment that National Health Service trusts make to maintain their infrastructure. NHS England is currently undertaking a stocktake of LINAC age, which will be completed in summer 2023 and is working with partners to undertake a demand and capacity review which will complete in 2023/24.

NHS England are working with professional bodies to explore opportunities for developing apprenticeship schemes for radiotherapy physicists, dosimetrists, and radiographers.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Jun 2023
To ask His Majesty's Government what steps they are taking to exploit artificial intelligence in radiotherapy treatment services.

The Department has provided £123 million to 86 artificial intelligence (AI) technologies through the Health and Care Award. The Award is accelerating the testing and evaluation of the most promising AI technologies likely to meet the aims set out in the NHS Long Term Plan.

Two of these AI technologies, Mirada Medical and project OSAIRIS, specialise in assisting clinicians with segmenting radiotherapy scans. This process, which is currently done by hand by clinicians, outlines healthy organs so they can be avoided during radiotherapy treatment. These technologies have been testing the feasibility of AI tools that could automatically identify healthy organs and segment scans. This could speed up the segmentation process and help patients start radiotherapy treatment sooner and reduce workloads for clinicians.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
14th Jun 2023
To ask His Majesty's Government what is the total number of radiotherapy machines for NHS patient use in England, and how many of those have exceeded their recommended 10-year lifespan; what assessment they have made of the effectiveness of radiotherapy machines that have exceeded their recommended 10-year lifespan; and what guidance they have issued to local procurement systems for replacing radiotherapy machines that have exceeded their recommended 10-year lifespan.

The total number of radiotherapy machines for National Health Service patient use in England is not held. NHS England is currently undertaking a stocktake of Linear Accelerator (LINAC) age, which will be completed in summer 2023 and is working with partners to undertake a demand and capacity review which will complete in 2023/24. The output of this work will support local systems to plan for equipment replacement. All radiotherapy equipment is subject to regular servicing, calibration, and quality assurance checks which is the responsibility of individual NHS trusts that deliver radiotherapy.

The Capital Planning Guidance, published April 2022, states that integrated care systems will need to develop replacement plans as part of their multi-year capital plans, in partnership with specialised commissioners, Cancer Alliances and Radiotherapy Operational Delivery Networks, based on an assessment of equipment age, capacity and demand, opportunities to improve access and service risk.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th May 2023
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 11 May (HL7533), when the next highly specialised services annual report will be published; whether it will include the results of NHS England's assessment of the levels of uptake of rare disease treatments; and whether they plan to place a copy of the assessment in the Library of the House.

NHS England’s specialised commissioning team has assessed the levels of uptake of rare disease treatments and presented the results to the last meeting of the NHS England Rare Diseases Advisory Group in April 2023. NHS England currently have no plans to publish this assessment or a further version of the highly specialised services annual report.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2023
To ask His Majesty's Government how many of the ambulances ordered so far to meet the increase in numbers as set out in the Delivery plan for recovering urgent and emergency care services, published in January, are replacement vehicles.

All ambulance trusts have now placed their ambulance orders for delivery in the current year, 2023/24, under existing contracts and tenders have been received for mental health ambulances which are being evaluated by NHS England.

In total, NHS England expect delivery in 2023/24 of 628 Dual Crew Ambulances, 154 lightweight ambulances, 40 Mental health ambulances and 11 electric ambulances.

The timing of the decommissioning of existing vehicles is a matter for individual ambulance trusts. NHS England is working with ambulance trusts to quantify fleet replacement plans as they are firmed up over the coming months.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
11th May 2023
To ask His Majesty's Government, further to the Delivery plan for recovering urgent and emergency care services, published in January, what progress they have made in delivering 800 new ambulances and increasing the fleet by 10 per cent.

All ambulance trusts have now placed their ambulance orders for delivery in the current year, 2023/24, under existing contracts and tenders have been received for mental health ambulances which are being evaluated by NHS England.

In total, NHS England expect delivery in 2023/24 of 628 Dual Crew Ambulances, 154 lightweight ambulances, 40 Mental health ambulances and 11 electric ambulances.

The timing of the decommissioning of existing vehicles is a matter for individual ambulance trusts. NHS England is working with ambulance trusts to quantify fleet replacement plans as they are firmed up over the coming months.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd May 2023
To ask His Majesty's Government what steps they are taking to identify whether more than one NHS Trust in England is having the same issues with the same homecare medicines services provider; where common issues are identified, what are the next steps taken; and where accountability lies for resolving such issues with a provider when they occur across a number of Trusts.

Section 4.4 of the Royal Pharmaceutical Society’s guidance on managing complaints and incidents, a copy of which is attached, states that for complaints requiring written response, acknowledgement should be provided within three business days; and final written response within 30 business days unless agreed otherwise with the complainant.

When the Key Performance Indicators (KPIs) from individual contracts or reports from NHS Trusts indicate that service levels are not to the standard expected across multiple NHS Trusts, the National Homecare Medicines Committee (NHMC) enacts a Supplier Engagement Escalation Process. Meetings are held with the individual provider at which they are expected to provide a report of current status and investigations to date and a recovery plan. Each Chief Pharmacist within each NHS organisation is the responsible officer for the homecare medicines services that the hospital provides and will receive this information.

A provider’s position on an NHS regional or national framework agreement may be suspended or terminated in the event of poor performance or other breach, subject to provisions of the agreement. The NHMC does not hold any enforcement powers, instead leveraging strong relationships with homecare providers and NHS organisations to facilitate safe and effective service provision and service recovery where appropriate. If necessary, the regulators Care Quality Commission (CQC) and the General Pharmaceutical Council (GPhC) are also informed.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd May 2023
To ask His Majesty's Government what is the expected timeframe for homecare medicines providers to resolve complaints made by people receiving homecare medicines in England from the date the complaint is raised.

Section 4.4 of the Royal Pharmaceutical Society’s guidance on managing complaints and incidents, a copy of which is attached, states that for complaints requiring written response, acknowledgement should be provided within three business days; and final written response within 30 business days unless agreed otherwise with the complainant.

When the Key Performance Indicators (KPIs) from individual contracts or reports from NHS Trusts indicate that service levels are not to the standard expected across multiple NHS Trusts, the National Homecare Medicines Committee (NHMC) enacts a Supplier Engagement Escalation Process. Meetings are held with the individual provider at which they are expected to provide a report of current status and investigations to date and a recovery plan. Each Chief Pharmacist within each NHS organisation is the responsible officer for the homecare medicines services that the hospital provides and will receive this information.

A provider’s position on an NHS regional or national framework agreement may be suspended or terminated in the event of poor performance or other breach, subject to provisions of the agreement. The NHMC does not hold any enforcement powers, instead leveraging strong relationships with homecare providers and NHS organisations to facilitate safe and effective service provision and service recovery where appropriate. If necessary, the regulators Care Quality Commission (CQC) and the General Pharmaceutical Council (GPhC) are also informed.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd May 2023
To ask His Majesty's Government what assurances they have received in the past 12 months from the Care Quality Commission and General Pharmaceutical Council about the standard of care provided by homecare medicines services in England.

Homecare providers are contracted for their services through National Health Service trusts. The Care Quality Commission (CQC) holds trusts to account for the governance and oversight of third-party arrangements. There are eleven clinical homecare providers registered with CQC. Those that are registered with CQC are held to account through assessment and inspection under the Health and Social Care Act 2008.

Under the new Single Assessment Framework, due to be rolled out later this year, CQC will no longer use a service's rating as the main driver when deciding when the next assessment is required. Evidence collected or information received at any time may trigger an assessment.

The General Pharmaceutical Council (GPhC) has not found any recent systemic issues affecting any pharmacies providing homecare medicines services in England.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd May 2023
To ask His Majesty's Government what discussions have taken place between NHS England and the Parliamentary and Health Service Ombudsman regarding complaints made about homecare medicines services in England in the past 18 months.

Neither the Department, NHS England’s Commercial Medicines Unit, which manages the four national framework agreements for providers to deliver homecare medicines services, nor the National Homecare Medicines Committee have had discussions with the Parliamentary and Health Service Ombudsman about the homecare medicines service in the last 18 months.

Following the Royal Pharmaceutical Society’s guidance on managing complaints and incidents, complaints by patients can be raised through either the prescribing NHS Trust or the specific Homecare Medicines provider.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
3rd May 2023
To ask His Majesty's Government what discussions they have had with the Parliamentary and Health Service Ombudsman regarding complaints made about homecare medicines services in England in the past 18 months.

Neither the Department, NHS England’s Commercial Medicines Unit, which manages the four national framework agreements for providers to deliver homecare medicines services, nor the National Homecare Medicines Committee have had discussions with the Parliamentary and Health Service Ombudsman about the homecare medicines service in the last 18 months.

Following the Royal Pharmaceutical Society’s guidance on managing complaints and incidents, complaints by patients can be raised through either the prescribing NHS Trust or the specific Homecare Medicines provider.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Apr 2023
To ask His Majesty's Government, with reference to the England Rare Diseases Action Plan 2023, whether they will publish an update on progress relating to the action to measure the time to diagnosis for both genetic and non-genetic rare conditions; how engagement will be carried out with the patient community once researchers are selected; and when this work will be finalised.

The National Institute for Health and Care Research works with the public to ensure there are opportunities to participate in research and that their perspectives and experiences help to shape research. Commissioning research, under action 17 of the England Rare Diseases Action Plan 2023 to measure the time to diagnosis, is currently in progress through an open competitive process. Announcements on the process for engagement with the patient community will be made once this process has been completed, and contracts agreed with successful bidders for the research.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Apr 2023
To ask His Majesty's Government, with reference to the England Rare Diseases Action Plan 2022, whether NHS England still plans to assess and publish a report on levels of uptake of rare disease treatments, in addition to the highly specialised services annual report.

NHS England’s specialised commissioning team has assessed the levels of uptake of rare disease treatments and presented the results to the last meeting of the NHS England Rare Diseases Advisory Group in April 2023. NHS England currently have no plans to publish the report.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Apr 2023
To ask His Majesty's Government whether rare cancers will be included in the scope of the Major Conditions Strategy.

The Major Conditions Strategy will look at the treatment and prevention of cancer in people of all ages, covering the patient pathway. The Strategy will look at a wide range of interventions and enablers to improve outcomes and experience for cancer patients.

This Strategy will draw on previous work on cancer, including over 5,000 submissions provided to the Department as part of our Call for Evidence last year.  We will continue to work closely with stakeholders, citizens, and the National Health Service in coming weeks to identify actions for the Strategy that will have the most impact.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Apr 2023
To ask His Majesty's Government what assessment NHS England and NICE have made of the likely number of products that will be eligible for entry into the Innovative Medicines Fund in (1) 2023–24, and (2) 2024–25.

Medicines are recommended for the Innovative Medicines Fund through the National Institute for Health and Care Excellence (NICE) appraisal process in line with the published principles. Medicines are eligible for the Innovative Medicines Fund only if they have been unable to be recommended for routine commissioning in the National Health Service and further evidence collected during a period of managed access will sufficiently support the case for such a recommendation in the future. Therefore, no assessment has been made on the number of products that may enter the Fund in future.

NICE and NHS England continue to track the pipeline of new medicines for possible candidates and proactively work with industry to ensure the identified medicines can be made available to patients, through routine funding or the Innovative Medicines Fund.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Apr 2023
To ask His Majesty's Government how they plan to hold integrated care boards to account on meeting NICE guidelines on the uptake of treatments for people with rare diseases.

The Care Quality Commission does assess the processes by which providers implement and comply with National Institute for Health and Care Excellence (NICE) guidance, and as part of the future regulatory assessments will consider how Integrated Care Systems and Integrated Care Boards consider and implement NICE guidance and other national guidance on best practice in care and treatment.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Mar 2023
To ask His Majesty's Government whether they will meet with the British Society for Rheumatology to discuss concerns about the safety and reliability of homecare medicines services in England.

The National Homecare Medicines Committee (NHMC), managed by and including representation from NHS England, and the National Clinical Homecare Association (NCHA) have met with the British Society for Rheumatology (BSR) to discuss their concerns about the safety and reliability of homecare medicines services, including delays in treatment. The NCHA have proposed to BSR that they will repurpose their bi-annual NCHA All Members Meeting to commence the wider discussion on the main areas of concern identified. The NCHA have reported that they intend to seek a broad base of stakeholder engagement at this event which will include NCHA full and associate members, the Association of British Pharmaceutical Industry, NHMC members and BSR.

This represents a high degree of commitment from the NCHA and NHMC to work actively with the BSR and other stakeholders to resolve the concerns and issues which have been raised. The BSR has written to the Department requesting a meeting and the Department will be responding to the BSR shortly.

NHMC’s standardisation programme includes an NHS Digital strategy project. Within the NHMC there is a digital sub-group working closely with NHS Digital on the output-based specification for e-prescribing for homecare medicines services to use an Electronic Prescribing System. This work is at an advanced stage in preparation for consultation with NHMC during 2023.

NHS England’s Commercial Medicines Unit, which manages four national framework agreements for the provision of homecare medicines services for Home Parenteral Nutrition, Lysosomal Storage Disorders, Pulmonary Hypertension and Clotting Factors, holds regular engagement meetings with providers on the framework and when appropriate will discuss recruitment and retention of staff. NHMC also holds discussions regarding recruitment, retention and vacancies during engagement meetings with providers when appropriate to do so.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Mar 2023
To ask His Majesty's Government what assessment they have made about the impact of delays, workforce shortages, and lack of e-prescribing systems, on the health and well-being of patients receiving homecare medicines services.

The National Homecare Medicines Committee (NHMC), managed by and including representation from NHS England, and the National Clinical Homecare Association (NCHA) have met with the British Society for Rheumatology (BSR) to discuss their concerns about the safety and reliability of homecare medicines services, including delays in treatment. The NCHA have proposed to BSR that they will repurpose their bi-annual NCHA All Members Meeting to commence the wider discussion on the main areas of concern identified. The NCHA have reported that they intend to seek a broad base of stakeholder engagement at this event which will include NCHA full and associate members, the Association of British Pharmaceutical Industry, NHMC members and BSR.

This represents a high degree of commitment from the NCHA and NHMC to work actively with the BSR and other stakeholders to resolve the concerns and issues which have been raised. The BSR has written to the Department requesting a meeting and the Department will be responding to the BSR shortly.

NHMC’s standardisation programme includes an NHS Digital strategy project. Within the NHMC there is a digital sub-group working closely with NHS Digital on the output-based specification for e-prescribing for homecare medicines services to use an Electronic Prescribing System. This work is at an advanced stage in preparation for consultation with NHMC during 2023.

NHS England’s Commercial Medicines Unit, which manages four national framework agreements for the provision of homecare medicines services for Home Parenteral Nutrition, Lysosomal Storage Disorders, Pulmonary Hypertension and Clotting Factors, holds regular engagement meetings with providers on the framework and when appropriate will discuss recruitment and retention of staff. NHMC also holds discussions regarding recruitment, retention and vacancies during engagement meetings with providers when appropriate to do so.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Mar 2023
To ask His Majesty's Government what plans they have to ask NHS England to undertake a review into the safety and reliability of homecare medicines services in England.

The National Homecare Medicines Committee (NHMC), managed by and including representation from NHS England, and the National Clinical Homecare Association (NCHA) have met with the British Society for Rheumatology (BSR) to discuss their concerns about the safety and reliability of homecare medicines services, including delays in treatment. The NCHA have proposed to BSR that they will repurpose their bi-annual NCHA All Members Meeting to commence the wider discussion on the main areas of concern identified. The NCHA have reported that they intend to seek a broad base of stakeholder engagement at this event which will include NCHA full and associate members, the Association of British Pharmaceutical Industry, NHMC members and BSR.

This represents a high degree of commitment from the NCHA and NHMC to work actively with the BSR and other stakeholders to resolve the concerns and issues which have been raised. The BSR has written to the Department requesting a meeting and the Department will be responding to the BSR shortly.

NHMC’s standardisation programme includes an NHS Digital strategy project. Within the NHMC there is a digital sub-group working closely with NHS Digital on the output-based specification for e-prescribing for homecare medicines services to use an Electronic Prescribing System. This work is at an advanced stage in preparation for consultation with NHMC during 2023.

NHS England’s Commercial Medicines Unit, which manages four national framework agreements for the provision of homecare medicines services for Home Parenteral Nutrition, Lysosomal Storage Disorders, Pulmonary Hypertension and Clotting Factors, holds regular engagement meetings with providers on the framework and when appropriate will discuss recruitment and retention of staff. NHMC also holds discussions regarding recruitment, retention and vacancies during engagement meetings with providers when appropriate to do so.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Mar 2023
To ask His Majesty's Government what assessment they have made of the legal and reputational risks of NHS England’s decision to instruct hospitals to use Palantir’s Faster Data Flows database.

The Faster Data Flows pilot makes use of data infrastructure (Data Management Platform Services) already procured by NHS England. The pilot aims to collect data already submitted via legacy collection systems with an aim to reduce data latency and will not collect any data from providers which they are not already asked to provide.

The General Data Protection Regulation requires a Data Protection Impact Assessment (DPIA) to be completed by a data controller to demonstrate how they will comply with data protection law and in doing so identify and minimise data protection risks. NHS England and NHS Digital, as they existed separately at the relevant time, have produced DPIAs for the Faster Data Flows pilot.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Mar 2023
To ask His Majesty's Government, further to NHS England’s instruction to hospitals to use Palantir’s Faster Data Flows database, what safeguards they will put in place to protect patient privacy.

All uses of data by the National Health Service must be ethical, for the public good, and comply with data protection law. This means there must always be a valid lawful basis for the collection and processing of personal information as defined under data protection legislation. Palantir only operates under the instruction of NHS England when processing data on the Foundry platform and does not have access to data, identifiable or otherwise, held within the Foundry platform instances licensed to NHS England nor are they permitted to use or share it for their own purposes.

NHS England will only share de-identified data with internal NHS England data analysts, integrated care boards and the NHS Providers that provided the data. De-identification practices mean that personal identifiers are removed from datasets to protect patient confidentiality. This includes techniques such as aggregation, anonymisation, and pseudonymisation. The level of de-identification applied to data may vary based on user roles and requirements for accessing the data. This is in line with guidance from the Information Commissioner’s Office as well as the General Data Protection Regulation.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Mar 2023
To ask His Majesty's Government, further to NHS England’s instruction to hospitals to use Palantir’s Faster Data Flows database, what categories of patient data Palantir will have access to.

Palantir does not have access to data, identifiable or otherwise, held within the Foundry platform instances licensed to NHS England. Foundry, which is the platform used for Faster Data Flows, is a ‘Software as a Service’ platform licenced to NHS England as a product and integrated into NHS England systems. The National Health Service always remains the data controller and only NHS organisations have access to the data and otherwise determine access rights.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Mar 2023
To ask His Majesty's Government what was the process for selecting a company to provide the NHS England data platform; and which other companies they considered bids from before awarding the service to Palantir.

A procurement process for the ‘Provision of Data Management Platform Services’ was carried out by NHS England ahead of the contract award in December 2020, with a route to market evaluation identifying the G-Cloud 11 framework as the optimal route.

In line with the G-Cloud process, selection criteria helped to identify 19 suppliers with potential solutions. A process of clarification and evaluation informed by subject matter experts (SMEs) against agreed functional, non-functional, and financial criteria was carried out. The identity of bidders is not made public as this information is commercially sensitive.

The nine suppliers who met the minimum technical threshold were invited to give demonstrations in October 2020, following which they were evaluated against a set of criteria agreed by the SMEs. Palantir was subsequently selected as the preferred supplier based on receiving the highest score in the evaluation.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Mar 2023
To ask His Majesty's Government, further to NHS England’s instruction to hospitals to use Palantir’s Faster Data Flows database, whether hospitals will be required to seek patients’ consent for the sharing of their data.

My Rt hon. Friend, the Secretary of State for Health and Social Care has directed NHS England to undertake data collections. The directions create a legal obligation for the NHS England collection and processing and as a result consent is not required.

The Faster Data Flows pilot aims to collect data already submitted via legacy collection systems with an aim to reduce data latency. The pilot will not collect any data from providers which they are not already asked to provide, as it is the collection method which is changing, not the information being collected.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Mar 2023
To ask His Majesty's Government what support they are providing for research into the potential long-term health impacts, including an increased risk of dementia, of contact sport.

The Department of Health and Social Care commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is supporting research on the long-term effects of sport on brain health through the NIHR MedTech Co-operative. This includes a study on the detection of prodromal dementia symptoms in former professional footballers. The NIHR is also contributing to a £9.5 million research call to establish a United Kingdom Traumatic Brain Injury (TBI) platform. The platform will support new research on the health impacts of TBI and concussion occurring through different contexts including sport. Additionally, the NIHR is supporting research into a potential link between concussion and dementia through the PROTECT study.

The NIHR welcomes funding applications for research into any aspect of human health, including the potential health impacts of contact sport. The Department for Culture, Media and Sport has established a new Concussion in Sport Research Forum led by the Medical Research Council and UK Research and Innovation. The aim of this group is to bring together key academic experts with experience of traumatic brain injury, concussion and related areas to identify priority research questions for the sporting sector.

The Government remains committed to working with sports stakeholders to build on the positive work that is already taking place to mitigate the causes and effects of concussion in sport.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Mar 2023
To ask His Majesty's Government what assessment they have made of the impact of HIV prevalence on the difficulties in booking a sexual health clinic appointment online or by telephone; and what steps they are taking to improve ease of access.

No formal assessment has been made of linkages between the availability of sexual health service appointments and human immunodeficiency virus (HIV) prevalence in local areas.

As part of the HIV Action Plan, the Government and NHS England committed £20 million over three years in 2022 to 2025, to expand HIV opt-out testing in emergency departments in areas with extremely high HIV prevalence. In the first 100 days of opt out HIV testing, NHS England found nearly 200 people with undiagnosed or untreated HIV.

Local authorities in England are responsible for commissioning open access sexual and reproductive health services, including HIV testing, through the Public Health Grant, funded at £3.5 billion in 2023/24.  It is for individual local authorities to decide their spending priorities based on an assessment of local need and to commission the service lines that best suit their population, including access to HIV testing.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Mar 2023
To ask His Majesty's Government when they will publish their pre-exposure prophylaxis (PrEP) Action Plan.

As part of the implementation of the HIV Action Plan, we are developing a plan to improve equitable access to human immunodeficiency (HIV) virus pre-exposure prophylaxis (PrEP) for key population groups and in settings outside of specialist sexual health services. Recommendations of the PrEP Access and Equity Task and Finish Group, including key stakeholder and delivery partners, are being considered by the HIV Action Plan Implementation Steering Group, and the plan will be made available in 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
16th Mar 2023
To ask His Majesty's Government what consideration they have given to introducing a national online pre-exposure prophylaxis (PrEP) service to make it easier for HIV negative people at risk of getting HIV to obtain repeat prescriptions.

As part of the implementation of the HIV Action Plan, we are developing a plan to improve equitable access to human immunodeficiency (HIV) virus pre-exposure prophylaxis (PrEP) for key population groups and in settings outside of specialist sexual health services. Recommendations of the PrEP Access and Equity Task and Finish Group, including key stakeholder and delivery partners, are being considered by the HIV Action Plan Implementation Steering Group, and the plan will be made available in 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2023
To ask His Majesty's Government which minister is linked with each Integrated Care Board.

Ministers regularly meet leaders from integrated care systems, including chairs and chief executives of integrated care boards and chairs of integrated care partnerships to discuss a range of issues on the delivery and improvement of health and care. As part of the ongoing engagement, we will seek to combine the benefits of a sustained relationship with the opportunity for Ministers to engage with different systems.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2023
To ask His Majesty's Government how the effectiveness of linking ministers with Integrated Care Boards will be measured.

Ministers regularly meet leaders from integrated care systems, including chairs and chief executives of integrated care boards and chairs of integrated care partnerships to discuss a range of issues on the delivery and improvement of health and care. As part of the ongoing engagement, we will seek to combine the benefits of a sustained relationship with the opportunity for Ministers to engage with different systems.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Mar 2023
To ask His Majesty's Government what is the role of ministers who are linked with Integrated Care Boards.

Ministers regularly meet leaders from integrated care systems, including chairs and chief executives of integrated care boards and chairs of integrated care partnerships to discuss a range of issues on the delivery and improvement of health and care. As part of the ongoing engagement, we will seek to combine the benefits of a sustained relationship with the opportunity for Ministers to engage with different systems.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Mar 2023
To ask His Majesty's Government what assessment they have made of the cost to the economy of the 55 per cent of patients waiting for orthopaedic treatment who are economically inactive due to their condition.

No formal estimate has been made. The COVID-19 pandemic has put enormous pressures on the National Health Service with elective waiting lists growing to over 7.2 million patients, but the Department remains committed to ensuring people get the right care at the right time. That is why we are delivering record staffing numbers and putting in record levels of funding, to help the NHS recover and transform services.

Having virtually met our target to eliminate long waits of two years or more for elective procedures in July, our next ambition is to eliminate waits of eighteen months or more by April 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Mar 2023
To ask His Majesty's Government what assessment they have made of the merits of using training provided by the independent sector for trainee NHS trauma and orthopaedic surgeons.

In delivering its responsibilities for education and training, Health Education England makes a thorough assessment of training possibilities in the independent sector for medical specialities, including for trauma and orthopaedic surgery.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government when they will respond to the NHS Pension Scheme: proposed amendments to scheme regulations consultation, which ran from 5 December 2022 to 30 January 2023.

The Department published its response to the consultation on amendments to the NHS Pension Scheme on 7 March 2023 in an online-only format. Overall, the proposed changes were well received and most of the respondents agreed that they should be implemented. The Department therefore intends to proceed with the proposals it set out.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government what assessment they have made of the impact of the proposed changes to the NHS Pension Scheme on the retention of (1) trauma, and (2) orthopaedic, surgeons.

The Department recently consulted on a range of pensions measures, including new retirement flexibilities to enable National Health Service staff to work more flexibly up to and beyond retirement age, and changes to scheme rules to address inflation. The Department confirmed on 7 March 2023 that it intends to implement the measures as planned.

The changes will remove barriers for experienced staff, including trauma and orthopaedic surgeons, retiring and returning to work and will allow them to draw down some or all of their pension but continue working and building more pension benefits. Staff affected by Annual Allowance (AA) charges will be able to reduce pensionable pay on partial retirement to avoid AA charges without necessarily reducing overall work commitments.

By fixing the unintended impacts of inflation, the changes will also help to retain senior clinicians affected by pension tax who might otherwise reduce their workloads or take early retirement.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government what assessment they have made of the impact of the NHS Workforce Plan on reducing the waiting lists for elective orthopaedic procedures.

The Government has commissioned NHS England to deliver a National Health Service Long Term Workforce Plan (LTWP). This will include independently verified projections for the number of doctors, nurses and other professionals that will be needed in five, 10 and 15 years’ time.

The LTWP looks across the whole of the NHS workforce to provide an assessment of future need over the next 15 years and will not provide assessments on the impact of reducing waiting lists for speciality specific procedures.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government what assessment they have made of the adequacy of numbers of orthopaedic trauma surgeons, given (1) the increasing ageing population, and (2) the need to train the next generation of surgeons.

The Government has committed to publishing a long-term workforce plan shortly which will include independently verified forecasts for the number of healthcare professionals required in future years, taking account of improvements in retention and productivity. The workforce plan is for the whole of the National Health Service workforce.

As of November 2022, there were 3,590 full time equivalent (FTE) doctors in training in the Trauma & Orthopaedic Surgery specialty in the NHS in England. This is an increase of 650 (22.1%%) since November 2010. As of November 2022, there were 2,699 FTE consultants in the Trauma & Orthopaedic Surgery speciality in the NHS in England. This is an increase of 712 (35.9%) since November 2010.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government when the NHS Workforce Plan will be published.

We are committed to growing the National Health Service workforce, which is why we commissioned NHS England to publish a long-term workforce plan to help recruit and retain more staff. This plan is in development, and we have committed to publishing it shortly.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Mar 2023
To ask His Majesty's Government what plans they have to improve the retention of (1) trauma, and (2) orthopaedic, surgeons.

The National Health Service People Plan and People Promise have set out a comprehensive range of actions to improve staff retention. They provide a strong focus on creating a more modern, compassionate and inclusive NHS culture by strengthening health and wellbeing, equality and diversity, culture and leadership and flexible working.

The NHS, via its 2023/24 priorities and operational planning guidance, has asked systems to refresh their 2022/23 whole system workforce plans to improve staff retention through a systematic focus on all elements of the NHS People Promise. Staff wellbeing should be strategically aligned with elective recovery plans, including workforce demand and capacity planning.

In addition, the NHS Retention Programme continuously seeks to understand why staff leave the NHS, resulting in targeted interventions to support staff to stay whilst keeping them well. A staff retention guide has been updated and includes information on supporting staff in their late and early career with specific focus on induction, reward and recognition and menopause support.

These initiatives apply across staff groups including trauma and orthopaedic surgeons.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Mar 2023
To ask His Majesty's Government which Integrated Care Systems have submitted draft operating plans forecasting that they will have no deficit at the end of the 2023–24 financial year.

The 2022/23 year-end debt position of each individual organisation in the National Health Service will be confirmed in their individual balance sheets included in their accounts due to be published later this year. The Department does not hold in-year reporting data on debt.

The 2023/24 forecast surplus/deficit position against budget for individual integrated care systems (ICSs) will be agreed as part of the operational planning process between NHS England and ICSs which is currently ongoing. Draft plans are being resubmitted to NHS England and will be shared with the Department when they are finalised. We therefore do not currently have the information to show whether any ICS is planning to end 2023/24 with a deficit against their agreed budget.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
6th Mar 2023
To ask His Majesty's Government which Integrated Care Systems are forecast to be in debt at the end of the 2022–23 financial year.

The 2022/23 year-end debt position of each individual organisation in the National Health Service will be confirmed in their individual balance sheets included in their accounts due to be published later this year. The Department does not hold in-year reporting data on debt.

The 2023/24 forecast surplus/deficit position against budget for individual integrated care systems (ICSs) will be agreed as part of the operational planning process between NHS England and ICSs which is currently ongoing. Draft plans are being resubmitted to NHS England and will be shared with the Department when they are finalised. We therefore do not currently have the information to show whether any ICS is planning to end 2023/24 with a deficit against their agreed budget.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Feb 2023
To ask His Majesty's Government whether, as reported, the upcoming NHS workforce plan will include a doubling of medical school places.

We do not comment on press leaks.

The Government is already doing a substantial amount of work to help ensure the National Health Service has the workforce it needs for the future. The Government has already funded 1,500 more medical school places each year for domestic students in England, a 25% increase over three years.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Feb 2023
To ask His Majesty's Government what steps they are taking to facilitate more and earlier diagnosis of Growth Hormone Deficiency.

The 2021 UK Rare Diseases Framework sets out four priorities to improve the lives of people living with rare diseases, such as Growth Hormone Deficiency. To implement the Framework, we published England’s first Rare Diseases Action Plan in February 2022. The Plan includes actions to improve the timely diagnosis of rare conditions and raise awareness of rare conditions among healthcare professionals. Progress against these actions will be reported in England’s second Rare Diseases Action Plan, due to be published in early 2023.

The National Institute for Health and Care Excellence are currently updating its guideline on the assessment and early management of head injury. The final guideline is expected to be published in March 2023.

The curricula for postgraduate specialty training such as endocrinology are set by the relevant Royal College and has to meet the standards set by the General Medical Council and be formally approved by them.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Feb 2023
To ask His Majesty's Government what steps they are taking (1) to train GPs to make appropriate referrals for Growth Hormone Deficiency (GHD), and (2) to encourage endocrinologists to offer appropriate GHD treatments, including glucose stimulation and insulin stress tests, given estimates that only 10,000 out of around 300,000 patients are getting reliable treatments.

The 2021 UK Rare Diseases Framework sets out four priorities to improve the lives of people living with rare diseases, such as Growth Hormone Deficiency. To implement the Framework, we published England’s first Rare Diseases Action Plan in February 2022. The Plan includes actions to improve the timely diagnosis of rare conditions and raise awareness of rare conditions among healthcare professionals. Progress against these actions will be reported in England’s second Rare Diseases Action Plan, due to be published in early 2023.

The National Institute for Health and Care Excellence are currently updating its guideline on the assessment and early management of head injury. The final guideline is expected to be published in March 2023.

The curricula for postgraduate specialty training such as endocrinology are set by the relevant Royal College and has to meet the standards set by the General Medical Council and be formally approved by them.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Feb 2023
To ask His Majesty's Government, further to the forthcoming National Institute for Clinical Excellence guidance on head injury, what steps they intend to take to tackle the difficulties many patients are facing in getting the correct diagnosis for adult Growth Hormone Deficiency following a head injury.

The 2021 UK Rare Diseases Framework sets out four priorities to improve the lives of people living with rare diseases, such as Growth Hormone Deficiency. To implement the Framework, we published England’s first Rare Diseases Action Plan in February 2022. The Plan includes actions to improve the timely diagnosis of rare conditions and raise awareness of rare conditions among healthcare professionals. Progress against these actions will be reported in England’s second Rare Diseases Action Plan, due to be published in early 2023.

The National Institute for Health and Care Excellence are currently updating its guideline on the assessment and early management of head injury. The final guideline is expected to be published in March 2023.

The curricula for postgraduate specialty training such as endocrinology are set by the relevant Royal College and has to meet the standards set by the General Medical Council and be formally approved by them.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Feb 2023
To ask His Majesty's Government what assessment they have made of the cost of diagnosing and treating Growth Hormone Deficiency patients versus the cost of not doing so, given the costs arising from untreated patients including increased incidence of unemployment benefits and mental health treatments.

No specific assessment has been made.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Jan 2023
To ask His Majesty's Government what assessment they have made of the impact of waiting times for mental health support on the incidence of self-harm.

Whilst we have made no specific assessment, we expanded the scope of the National Suicide Prevention Strategy in 2017 to include addressing self-harm as a highlighted issue, and we continue to fund the Multi-Centre Study of Self-harm which is the most in-depth analysis and monitoring of self-harming trends in England. The NHS Long Term Plan also commits an additional £2.3 billion a year for the expansion and transformation of mental health services in England by 2023/24 so that an additional two million people can get the NHS-funded mental health support that they need.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Jan 2023
To ask His Majesty's Government what is the average waiting time for mental health support from (1) Step 1 initial assessment, (2) Step 2 low intensity, and (3) Step 3 high intensity; and in each case, what is the level of variation from the average by Trust.

The information requested is not collected centrally, as a national access and waiting times standard for both adults’ and children and young people’s mental health services has not yet been defined or set.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
20th Jan 2023
To ask His Majesty's Government, further to the recent approval of lecanemab in the United States, what plans they have to invest in equipment for diagnosing dementia to prepare the NHS for the arrival of new and innovative dementia treatments.

NHS England is currently exploring what pathways, processes and equipment might best support future disease modifying treatments, including for Alzheimer’s disease.

National Institute for Health and Care Excellence (NICE) guidelines provide evidence-based recommendations for health and care, including on assessment, management and support for people living with dementia and their carers. NICE guideline NG97 states that clinicians should consider a fluorodeoxyglucose positron emission tomography scan and cerebrospinal fluid tests when the diagnosis of Alzheimer’s disease is uncertain. A copy of the guidelines is attached. Integrated commissioning boards are expected to commission appropriate resources, including such testing, in line with the local population health needs.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Dec 2022
To ask His Majesty's Government what assessment they have made of the standards set by the Royal Pharmaceutical Society’s Professional Standards for Homecare Services in England, published in September 2013, which are embedded into all framework agreement service specifications for providers of homecare medicines services; and in particular, what assessment they have made whether those standards are sufficient regarding (1) delayed deliveries, (2) delayed treatment initiation, and (3) missed doses.

No recent assessment has been made. However, in 2014 the Royal Pharmaceutical Society published the Handbook for Homecare Services in England to aid implementation of the 2013 standards. This identified examples of good practice which may be used by homecare teams to develop robust arrangements for compliance with those standards. A copy of Handbook for Homecare Services in England is attached.

The National Homecare Medicines Committee holds regular meetings with all homecare providers focused on Key Performance Indicators (KPIs) for standards based on those contained in Appendix 10 National KPI definitions of the Handbook for Homecare Services in England. These definitions include the monitoring of delayed deliveries, treatment initiation and missed doses. A copy of Appendix 10 National KPI definitions is attached.

In addition, NHS England’s Commercial Medicines Unit hold regular review meetings with contracted homecare providers every three months. Homecare providers are assessed on a monthly basis against the same KPIs. Where these KPIs not met, suppliers are held to account through stakeholder meetings, reporting metrics and face to face meetings to ensure that levels of service are aligned with the relevant professional standards.

The National Homecare Medicines Committee also enacts an escalation process where the relevant homecare provider is required to communicate a summary of the issues, mitigations and expected timescales for recovery to the National Health Service organisations involved. If necessary, the Care Quality Commission and the General Pharmaceutical Council are also informed.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Dec 2022
To ask His Majesty's Government whether they will publish the minutes of meetings between NHS England and the National Homecare Medicines Committee at which actions to address safety and performance of homecare medicines services were discussed and agreed.

The National Clinical Homecare Association is arranging a meeting with the British Society for Rheumatology and the National Homecare Medicines Committee (NHMC), which includes representation from NHS England, to discuss the safety and performance of the Homecare Medicine Delivery Service.

The NHMC’s Supplier Engagement sub-group, which is facilitated, managed by and includes representation from NHS England, holds face-to-face meetings with individual providers to discuss ongoing performance.

Where Key Performance Indicators or reports from National Health Service hospitals indicate that service levels do not meet the required standard expected, the NHMC undertakes an escalation process. Where this escalation process is in place, the affected homecare provider will provide a summary of the issues, mitigations and expected timescales for recovery to the relevant NHS organisation. If necessary, the Care Quality Commission and the General Pharmaceutical Council are also informed.

Whilst NHS England holds records of the NHMC’s face-to-face meetings and those held through the escalation process, we are unable to provide this information as it is commercially sensitive.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
13th Dec 2022
To ask His Majesty's Government what plans they have to meet the British Society for Rheumatology to discuss its concerns about the safety and performance of homecare medicines services.

The National Clinical Homecare Association is arranging a meeting with the British Society for Rheumatology and the National Homecare Medicines Committee (NHMC), which includes representation from NHS England, to discuss the safety and performance of the Homecare Medicine Delivery Service.

The NHMC’s Supplier Engagement sub-group, which is facilitated, managed by and includes representation from NHS England, holds face-to-face meetings with individual providers to discuss ongoing performance.

Where Key Performance Indicators or reports from National Health Service hospitals indicate that service levels do not meet the required standard expected, the NHMC undertakes an escalation process. Where this escalation process is in place, the affected homecare provider will provide a summary of the issues, mitigations and expected timescales for recovery to the relevant NHS organisation. If necessary, the Care Quality Commission and the General Pharmaceutical Council are also informed.

Whilst NHS England holds records of the NHMC’s face-to-face meetings and those held through the escalation process, we are unable to provide this information as it is commercially sensitive.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Dec 2022
To ask His Majesty's Government, further to their England Rare Diseases Action Plan 2022, published on 28 February, whether the percentage of education frameworks that include sufficient rare disease content has increased since the publication of the Action Plan; and whether they plan to take any further steps to increase this percentage.

Health Education England (HEE) has adapted its approach to the development of healthcare competencies to deliver high quality care for patients and families with a rare disease. HEE has collaborated with the Academy of Royal Colleges to evaluate medical curricula and ensure an increase in the content for genomic and rare diseases. However, the information requested on the percentage increase is not held in the format requested.

We are developing role and profession specific frameworks through the introduction of the clinical pathway initiative; competency frameworks for the leaders of genomic medicine; and nursing and midwifery specific competency frameworks. HEE will evaluate uptake, acceptability and efficacy using a case study method, quantitative scoring and qualitative thematic analysis.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Dec 2022
To ask His Majesty's Government, further to their England Rare Diseases Action Plan 2022, published on 28 February, what progress they have made to support rapid access to drugs for patients with rare diseases; and when they plan to publish the report on whether or not there is access at the point of anticipated delivery.

The Innovative Licensing and Access Pathway is enabling the rapid review and approval of promising new medicines. The Innovative Medicines Fund will also allow patients with rare diseases to benefit from early access to innovative treatments, where the National Institute for Health and Care Excellence (NICE) considers there is insufficient evidence to make a positive recommendation and where the collection of further evidence is required. NHS England will produce an annual report by the end of 2022/23 on access to drugs for patients with rare diseases. This report will also include an analysis of overall uptake and geographical equity for those drugs recommended in NICE’s highly specialised technology programme. NHS England is working with pharmaceutical companies and providers to assess the commissioning model to ensure access can be provided at the point of delivery.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Dec 2022
To ask His Majesty's Government, further to their England Rare Diseases Action Plan 2022, published on 28 February, when they will publish the toolkit currently being developed for virtual consultations; and what will be included in this toolkit.

The toolkit will be published as soon as possible. It aims to provide acute hospital teams with principles for improving digital and phone clinics for patients with rare, complex and multi-system disorders, where these are in addition to or instead of face-to-face outpatient appointments. The toolkit may also support the initial assessment of new patients or service users.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
12th Dec 2022
To ask His Majesty's Government what steps they are taking to track and reduce health inequalities in highly specialised NHS services.

All annual clinical meetings for highly specialised services review health inequalities. NHS England provides advice on how the arrangement of highly specialised services should consider health inequalities, with a focus on access, experience and outcomes. NHS England is developing a framework and resources on how health inequalities can be identified and addressed in the commissioning of highly specialised services, which will be piloted in several services.

NHS England is also collating information on how procurements of healthcare services have addressed healthcare inequalities to provide lessons learned and best practice. An equalities health impact assessment is used when procuring highly specialised services and guidance is available to commissioners on how this assessment should be completed.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government, further to the Roadmap for integrating specialised services within Integrated Care Systems, published on 31 May, whether NHS England will maintain their current arrangements for commissioning high cost drugs.

NHS England plans to maintain the arrangements for commissioning high cost drugs established in 2020/21 to 2023/24. During 2020/21 NHS England established a central reimbursement process for high cost drugs based on reported data, to ensure that providers and local commissioners are not exposed to financial risk on drugs which have recently approved by the National Institute for Health and Care Excellence, monitor allocation and expenditure and improve financial control.

NHS England is exploring more flexibility for systems on the use of high cost drugs to support savings initiatives and reinvestments according to local priorities, while avoiding unnecessary financial risks.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government when NHS England will confirm how many multi-Integrated Care Board footprints will be established in 2023 to take on joint commissioning responsibility for specialised services.

The number of integrated care boards (ICBs) which will take on responsibility for specialised commissioning and the number of multi-ICB footprints has not yet been confirmed. The responsibility for commissioning services assessed to be suitable will be delegated to ICBs or to joint committees of NHS England and ICBs in 2023/24, following an assessment of system readiness.

NHS England is currently working with ICBs to assess system readiness, including identifying multi-ICB footprints. Following a moderation process, recommendations will be made to NHS England’s board for final decisions early in 2023, prior to the deployment of the new arrangements from April 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government how many Integrated Care Boards they forecast will take on full delegated specialised commissioning responsibility from April 2023.

The number of integrated care boards (ICBs) which will take on responsibility for specialised commissioning and the number of multi-ICB footprints has not yet been confirmed. The responsibility for commissioning services assessed to be suitable will be delegated to ICBs or to joint committees of NHS England and ICBs in 2023/24, following an assessment of system readiness.

NHS England is currently working with ICBs to assess system readiness, including identifying multi-ICB footprints. Following a moderation process, recommendations will be made to NHS England’s board for final decisions early in 2023, prior to the deployment of the new arrangements from April 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government when NHS England will finalise the recruitment of new clinical leaders in specialised services, including national clinical directors and national specialty advisors.

This recruitment is complete with the exception of a small number of roles. Further recruitment for these roles is expected to be completed by the end of January 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government what specialised services service specifications NHS England will update in 2023.

NHS England will review and update service specifications for specialised services during the next three to five years. NHS England is currently determining which specifications will be updated in 2023, taking into account progress made in 2022/23 and the emerging priorities for 2023/24.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Dec 2022
To ask His Majesty's Government when NHS England will publish a timeline for the update of service specifications in specialised services.

NHS England will review and update service specifications for specialised services during the next three to five years. NHS England is currently determining which specifications will be updated in 2023, taking into account progress made in 2022/23 and the emerging priorities for 2023/24.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Dec 2022
To ask His Majesty's Government what steps they are taking to ensure care-experienced children and young people have access to specialist, trauma-informed mental health support if they need it.

Funding for mental health services will increase by at least £2.3 billion a year by 2023/24 to allow an additional 345,000 children and young people, including those in care, to access National Health Service-funded specialist mental health support.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
5th Dec 2022
To ask His Majesty's Government what, if any, mandatory training is provided to frontline professionals who work with care-experienced children and young people to help them identify, understand and respond to mental health needs.

There is no specific training nationally for frontline health and care staff. Local authorities are responsible for the development of the children’s social care workforce and the Department for Education has developed post qualifying standards for child and family social work, which set out the skills and knowledge required for social workers to protect vulnerable children, including mental health needs.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Nov 2022
To ask His Majesty's Government which institutions in England offer midwifery apprenticeships.

The following table shows the sites of nine approved midwifery degree apprenticeship programmes in England.

Location

Description

University of Bedfordshire

This is a shortened programme

University of Birmingham

This is a shortened programme which is approved but not currently running

Buckingham New University

This is a three year programme which is approved but not currently running

University of Cumbria

This is a three year programme which is integrated with the fee paying programme and runs in September each year

University of Greenwich

This is a three year programme which is integrated with the fee paying programme and runs in September and January each year

Huddersfield University

This is a three year programme which is approved but not currently running

University of West of England

This is a three year programme which is approved but not currently running

University of West London

This is a three year programme which is integrated with the fee paying programme and runs in September and April each year

Wolverhampton University

This is a three year programme which is integrated with the fee paying programme and runs in September each year

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Nov 2022
To ask His Majesty's Government what assessment they have made of the extent to which midwifery apprenticeships are an effective route into the profession in England.

Health Education England has commissioned the Royal College of Midwives to undertake an evaluation of midwifery degree apprenticeship programmes. This will undertake a cost/benefit analysis of the programme and evaluate the experience of delivery. The outcomes are expected in April 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Nov 2022
To ask His Majesty's Government how many midwifery apprentices there are in England.

At the end of July 2022 there were a total of 87 Midwife apprenticeship starts in England.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
22nd Nov 2022
To ask His Majesty's Government what plans they have, if any, to make a statement on the midwifery profession in England.

In 2022, we have invested an additional £127 million in the National Health Service maternity workforce and improving neonatal care. This is further to the £95 million invested in 2021 to fund an additional 1,200 midwives and 100 consultant obstetricians. The NHS People Plan also aims to improve working conditions for staff through flexible working and supporting an inclusive and compassionate workplace culture.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November (HL2833), what plans they have to update the service specification for specialised endocrinology services.

A review of the service specification for specialised endocrinology services will be proposed in the work programme for the Internal Medicine Programme of Care for 2023/24 and will take approximately six months to complete. It is expected to conclude by autumn 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November (HL2833), what plans they have to include a measurement of access to clinical psychologists as part of the Specialised Services Quality Dashboard for rheumatology services.

A review of the Specialised Services Quality Dashboard for specialised rheumatology services will be undertaken as part of the review of the service specification. The Specialised Rheumatology Clinical Reference Group will provide advice to NHS England on the most appropriate metrics to allow assessment of the quality of rheumatology services.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November (HL2833), what plans they have to update the service specification for specialised rheumatology services.

A review of the service specification for specialised rheumatology services is included on the work programme for the internal medicine programme of care, one of six national programmes of care overseeing the commissioning of specialised and highly specialised services. Preliminary work has been undertaken and the revision is expected to be completed by spring 2023.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November, how they measure patient access to multi-disciplinary teams; and what steps they are taking to ensure that people with rare bone conditions can access a multi-disciplinary team.

The level of patient access to multi-disciplinary teams is not currently measured. Services for rare bone conditions are required to have multi-disciplinary teams as outlined in the specialised rheumatology service specification. This defines the standards of care expected from organisations funded by NHS England to provide specialised care.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November (HL2834), what process they use to assess compliance with the specialised rheumatology service specification, including the requirement for clinical psychologists to be provided as a core component of a multi-disciplinary team.

NHS England does not specifically assess compliance with the national service specification. However, regional commissioning teams work with providers to regularly review provision.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
15th Nov 2022
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 November (HL2833), what plans they have to update the service specification for inherited metabolic disorders.

NHS England has no current plans to review the adult and paediatric metabolic disorders service specifications. The Metabolic disorders Clinical Reference Group is responsible for the adult and paediatric metabolic disorders service specifications and the Lysosomal Storage Disorders Service (Children). It is anticipated that the service specification for Lysosomal Storage Disorders Service (Children) will be reviewed by the Clinical Reference Group in 2023/24.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2022
To ask His Majesty's Government, further to the Professional Standards Authority report Safer care for all: Solutions from professional regulation and beyond, published on 6 September, what steps they will take in response to the recommendation that there should be "a coherent practitioner regulatory strategy to support delivery of national workforce strategies across the UK".

We will consider the report’s recommendations through the Government’s programme of regulatory reform which will deliver improvements to the system of professional regulation, to the health and care workforce and patient and public safety. The programme will also consider the powers available to the Professional Standards Authority and how this can be used to improve healthcare regulation.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2022
To ask His Majesty's Government, further to the Professional Standards Authority report Safer care for all: Solutions from professional regulation and beyond, published on 6 September, what steps they will take in response to the recommendation that there should be "an independent Health and Social Care Safety Commissioner (or equivalent) for each UK country to identify current, emerging, and potential risks across the whole health and social care system, and bring about the necessary action across organisations".

We will consider the report’s recommendations through the Government’s programme of regulatory reform which will deliver improvements to the system of professional regulation, to the health and care workforce and patient and public safety. The programme will also consider the powers available to the Professional Standards Authority and how this can be used to improve healthcare regulation.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
8th Nov 2022
To ask His Majesty's Government whether they will seek the advice of the Joint Committee on Vaccination and Immunisation (JCVI) on coronavirus immunisation treatment using prophylactic antibodies.

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert advisory committee which provides advice to Government on immunisation. The JCVI’s remit is focused on vaccination, rather than antibody treatments and prophylaxis, therefore there are no plans to commission such advice.

The multi-agency RAPID C-19 was established in 2020 to ensure treatments for COVID-19 are made safely available for National Health Service patients as soon as possible. RAPID C-19 has the relevant expertise in the range of therapeutic options available for COVID-19 treatment and prevention. It also draws on relevant expertise, including an NHS expert working group and the Prophylaxis Oversight Group.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2022
To ask His Majesty's Government what assessment they have made of the effectiveness of (1) accountability, and (2) governance, mechanisms around the (a) safety, and (b) performance, of homecare medicines services.

In England there are 12 providers of homecare medicines services to National Health Service patients under contracts or framework agreements which may be held at national, regional or local level. Homecare providers are assessed on a monthly basis against Key Performance Indicators (KPIs), which include the monitoring of patients’ adverse events, complaints and incidents and hold regular meetings with the National Homecare Medicines Committee (NHMC) and NHS England. Providers which do not meet KPIs are held to account and action will be taken to ensure that levels of service return the relevant standards, which measure quality and patient safety.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2022
To ask His Majesty's Government what assessment they made of the impact of underperformance of homecare medicines services on (1) patient safety, and (2) early treatment initiation; and what steps they are taking to mitigate any such impact.

In England there are 12 providers of homecare medicines services to National Health Service patients under contracts or framework agreements which may be held at national, regional or local level. Homecare providers are assessed on a monthly basis against Key Performance Indicators (KPIs), which include the monitoring of patients’ adverse events, complaints and incidents and hold regular meetings with the National Homecare Medicines Committee (NHMC) and NHS England. Providers which do not meet KPIs are held to account and action will be taken to ensure that levels of service return the relevant standards, which measure quality and patient safety.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
7th Nov 2022
To ask His Majesty's Government what assessment they have made of concerns about the (1) safety, and (2) performance, of homecare medicines services in NHS (a) contracts, and (b) framework agreements; and what steps are being taken to mitigate any concerns.

In England there are 12 providers of homecare medicines services to National Health Service patients under contracts or framework agreements which may be held at national, regional or local level. Homecare providers are assessed on a monthly basis against Key Performance Indicators (KPIs), which include the monitoring of patients’ adverse events, complaints and incidents and hold regular meetings with the National Homecare Medicines Committee (NHMC) and NHS England. Providers which do not meet KPIs are held to account and action will be taken to ensure that levels of service return the relevant standards, which measure quality and patient safety.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2022
To ask His Majesty's Government what is the current status of NHS Blood and Transplant’s blood donation operations, following the amber alert declared on 12 October.

Since 12 October, blood stocks have improved and NHS Blood and Transplant advised hospitals in England to return to the pre-amber phase from 8 November.

As of 7 November, total blood stocks were at target levels of 6.8 days of supply. NHS Blood and Transplant aims to increase stocks during the winter to provide greater resilience and continues to advise hospitals to manage demand and ensure stocks are issued in accordance with clinical guidance. NHS Blood and Transplant is recruiting additional donor carers and nursing staff and increasing the number of donor appointments.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
2nd Nov 2022
To ask His Majesty's Government what is the current status of NHS Blood and Transplant’s blood stocks; and how they plan to ensure that their target of six days' worth of supply is reliably maintained.

NHS Blood and Transplant returned to a pre-amber alert on 8 November 2022. Blood stocks have stabilised to target levels and as of 18 November, red cells were at a total of 7.4 days of supply. NHS Blood and Transplant has created additional capacity to accept donations and donors with the blood groups in greatest need have been fast-tracked to appointments.

It is increasing frontline staffing levels to ensure appointments for blood donors are available to maintain the target of six days’ worth of blood supply over the winter period. NHS Blood and Transplant is working with NHS England to ensure that clinical guidance for blood stock management is followed, while also increasing workforce resilience.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government what plans they have to attract more people, including those in the mid or late stages of their career, into the nursing profession.

Nursing degree students can access non-repayable grants of at least £5,000 per year, with further financial support available for childcare, accommodation, and travel costs. The Universities and Colleges Admissions Service’s data shows that the number of people aged 21 years old and over applying to nursing courses increased by 29% between 2019 and 2020 and a further 14% between 2020 and 2021.

In 2020, the blended learning nursing degree was launched to ensure those who may be unable to study in the traditional way can access routes into the nursing profession. We have also expanded nursing apprenticeships, including a pathway from healthcare assistant to registered nurse. In October, the National Health Service launched a national recruitment campaign to promote careers in nursing.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government whether they plan to increase the number of clinical placements available to nurses; and if so, (1) by how many, and (2) when.

Individual higher education institutions are responsible for working with placement providers and Health Education England (HEE) to ensure an adequate number of clinical placements are available for students. Since 2019/20, HEE has invested approximately £55 million to support additional placement capacity and simulated learning capacity. This is in addition to an annual £180 million allocated via the Education and Training Tariff to placement providers. There are currently 120,000 nursing, midwifery and allied health profession students in training in England. In 2021, there were more than 30,000 acceptances for nursing and midwifery undergraduate programmes, a 28% increase compared to 2019.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government what plans they have, if any, to develop new routes into the nursing profession.

The Government has established a full apprenticeship pathway from healthcare support worker to registered nurse and onto advanced clinical practitioner and we are expanding new roles, such as associates and assistants. The nursing associate role was developed in 2017 as a route into professional roles, such as becoming a registered nurse. In 2020/21 there were 4,304 entrants on apprenticeship programmes compared to 1,417 in 2017/18.

In 2021, we also established a blended learning nursing programme which offers predominantly online, remote-access study. Health Education England anticipates that approximately 8,500 nurses will commence training in blended learning programmes in the next five years. We have recently launched the blended learning programme for midwifery.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government what plans they have to address the disparity between the average ages at which men and women leave the nursing profession.

The Institute for Fiscal Studies report was commissioned by the Department and NHS England was involved in its development. As the report found, retention is a complex matter influenced by multiple factors, including trust leadership and organisational culture, staff experience in the workplace and economic opportunities in the local area. We welcome the report's findings, including the relationship between age, gender and experience of staff and decisions to remain in the workforce.

The findings will inform NHS England’s work to strengthen retention in the National Health Service, which seeks to understand why staff leave and provide targeted interventions to support staff to stay. Each trust is required to have retention action plans in place which will target support where needed locally. In July 2022, NHS England asked each NHS organisation to prioritise the delivery of actions on nursing and midwifery retention, which includes enhanced support for those joining the NHS, menopause support and improved advice and guidance for those later in their career with flexible working and pensions.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government what assessment they have made of the report by the Institute for Fiscal Studies Factors associated with staff retention in the NHS acute sector, published on 23 August, which found a disparity in the ages at which men and women leave the nursing profession.

The Institute for Fiscal Studies report was commissioned by the Department and NHS England was involved in its development. As the report found, retention is a complex matter influenced by multiple factors, including trust leadership and organisational culture, staff experience in the workplace and economic opportunities in the local area. We welcome the report's findings, including the relationship between age, gender and experience of staff and decisions to remain in the workforce.

The findings will inform NHS England’s work to strengthen retention in the National Health Service, which seeks to understand why staff leave and provide targeted interventions to support staff to stay. Each trust is required to have retention action plans in place which will target support where needed locally. In July 2022, NHS England asked each NHS organisation to prioritise the delivery of actions on nursing and midwifery retention, which includes enhanced support for those joining the NHS, menopause support and improved advice and guidance for those later in their career with flexible working and pensions.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
1st Nov 2022
To ask His Majesty's Government whether they intend to expand existing routes into nursing; and if so, in what ways.

The Government offers a range of routes into nursing, from undergraduate and postgraduate degree routes to apprenticeship routes. As of 2021, we also offer a blended learning programme offering predominantly online, remote-access study. The Universities and Colleges Admissions Service’s data shows over 30,000 students accepted places to study nursing and midwifery undergraduate courses in England in the 2021 recruitment cycle. This is a 28% increase compared to the 2019 cycle.

We are also continuing to expand the registered nursing degree apprenticeship (RNDA), nursing associate (NA) apprenticeship and blended learning routes. At the end of the 2020/21 academic year, there were approximately 2,200 people commencing a RNDA compared to 304 at the start of the programme in 2017/18. There were 4,304 NA apprenticeship starters compared to 1,417 in 2017/18. Health Education England anticipate that approximately 8,500 nurses will start training using blended learning programmes over the next five years.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
27th Oct 2022
To ask His Majesty's Government, further to the Department of Health and Social Care’s Annual report and accounts: 2020–2021, published on 31 January, which stated that £2.6 billion of procured PPE was “not suitable for use within the health and social care sector but which the Department considers might be suitable for other uses (although these potential other uses are as yet uncertain)”, whether any other uses have been identified; and if so, what these uses are.

The Department manages stock which is unsuitable for use in certain health and care settings through re-sale, re-purposing and donations domestically and internationally. In addition, the Department is also resolving disputed contracts to enable personal protective equipment to be used, replaced or refunded.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2022
To ask His Majesty's Government what plans they have to address any regional disparities in the provision of psychological and social care support for people with rare bone conditions.

No recent assessment has been made. However, care for patients with rare bone conditions are addressed through the specialised rheumatology service specification, which requires clinical psychologists to be provided as a core component of a multi-disciplinary team.

Local commissioners are responsible for the provision of services to meet the needs of the local population. Local authorities are responsible for assessing an individual’s eligibility for care and support, as set out in the Care Act 2014. Where a person is assessed as having eligible care and support needs, the local authority should undertake a financial assessment. Where individuals are not eligible for financial support, local authorities will support them, should they require assistance, to make arrangements for care services.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2022
To ask His Majesty's Government what recent assessment they have made of the provision of psychological and social care support for people with rare bone conditions.

No recent assessment has been made. However, care for patients with rare bone conditions are addressed through the specialised rheumatology service specification, which requires clinical psychologists to be provided as a core component of a multi-disciplinary team.

Local commissioners are responsible for the provision of services to meet the needs of the local population. Local authorities are responsible for assessing an individual’s eligibility for care and support, as set out in the Care Act 2014. Where a person is assessed as having eligible care and support needs, the local authority should undertake a financial assessment. Where individuals are not eligible for financial support, local authorities will support them, should they require assistance, to make arrangements for care services.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
24th Oct 2022
To ask His Majesty's Government what assessment they have made of the waiting times faced by people with rare bone conditions in accessing multidisciplinary specialist care.

No specific assessment has been made.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Oct 2022
To ask His Majesty's Government whether the white paper on health disparities will be published before the end of the year.

‘Our plan for patients’, published in an online only format on 22 September, sets out the immediate priorities to support individuals to live healthier lives, including improving access to health and care services. In addition, the Department continues to review how health disparities can be addressed and further information will be available in due course.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Oct 2022
To ask His Majesty's Government whether the Health Promotion Taskforce is planning to meet before the end of the year.

An updated Cabinet committee structure has been agreed to deliver on the Government’s priorities. A committee can discuss a wide range of policy areas relevant to its terms of reference. The Health Promotion Taskforce is not included in this updated structure. However, as announced in ‘Our plan for patients’, we will address preventable ill-health through collaboration across Government and the National Health Service.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
10th Oct 2022
To ask His Majesty's Government whether it remains their policy to narrow the gap in healthy life expectancy between areas where it is highest and lowest by 2030; and if so, by what amount.

The Government is committed to supporting individuals to live healthier lives and improving access to health and care services. This includes improving healthy life expectancy by five years by 2035 and narrowing the gap by 2030.

A significant proportion of ill-health is preventable. By focusing on major conditions which contribute to early death and reduce years of good health and behaviours such as smoking, poor diet and alcohol which disproportionately impact some communities, we will make progress on reducing health disparities. We remain committed to the ambition for England to be smoke-free by 2030 and we are working with the food industry to ensure it is easier for people to make healthier choices and to increase progress on the reformulation of foods. We will set out more information on plans to address health disparities in due course.

Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
18th Jul 2022
To ask Her Majesty's Government what steps they will take in response to 71 per cent of monkeypox cases being concentrated in London.

The UK Health Security Agency (UKHSA) is working with the National Health Service and sexual health, voluntary and community sector organisations in London to share accurate information on the outbreak with those at increased risk and prevent onward transmission of the virus. The UKHSA is raising awareness and advising the public on symptoms and how to access the appropriate treatment options.

Vaccines are being offered to gay, bisexual and other men who have sex with men considered to be at higher risk of exposure to monkeypox. Vaccines are also offered to those most likely to be exposed to monkeypox, including healthcare workers and close contacts of those infected. The UKHSA has provided approximately 8,000 doses of the Imvanex vaccine to sites in London and continues to conduct outreach work.

18th Jul 2022
To ask Her Majesty's Government how the (1) UK Health Security Agency, and (2) NHS, are monitoring heat-related illnesses; and how other government departments are assessing the broader impacts of the hot weather on public services.

The UK Health Security Agency (UKHSA) coordinates national syndromic surveillance of public health indicators for heat-related illnesses in individuals presenting to the National Health Service. This includes calls to NHS 111 and the ambulance service; online assessments; accident and emergency attendances; and general practitioner consultations.

The UKHSA supports the cross-Government response by providing information on impacts observed across the health system due to high temperatures. This provides advice to Government agencies at regular Ministerial meetings to co-ordinate the response and improve preparedness for future events. In addition, UKHSA publishes an online annual heat mortality report following each summer, which shows the impacts over a continuous period.

18th Jul 2022
To ask Her Majesty's Government what steps they are taking to respond to the monkeypox outbreak.

The UK Health Security Agency (UKHSA) is working with the National Health Service and the public health agencies in the four nations to prevent onward transmission of monkeypox virus. The UKHSA is raising awareness of the outbreak with the public, including advice on symptoms and how to access the appropriate treatment options.

The UKHSA recommends that gay, bisexual and other men who have sex with men at higher risk of exposure to monkeypox should be offered a dose of a smallpox vaccine, such as Imvanex. Vaccines are also offered to those most likely to be exposed to monkeypox including healthcare workers and close contacts of those infected.

5th Jul 2022
To ask Her Majesty's Government what discussions they have had with NHS trusts that have set up food banks; and whether those trusts have set them up to provide food and support for (1) staff, or (2) others.

Information on food banks established by National Health Service trusts is not held centrally. No specific assessment has been made and there have been no such discussions. Any arrangements would be implemented by individual trusts and would vary across organisations.

5th Jul 2022
To ask Her Majesty's Government what assessment they have made of the reasons why NHS trusts have set up food banks.

Information on food banks established by National Health Service trusts is not held centrally. No specific assessment has been made and there have been no such discussions. Any arrangements would be implemented by individual trusts and would vary across organisations.

5th Jul 2022
To ask Her Majesty's Government how many NHS trusts have set up food banks in England.

Information on food banks established by National Health Service trusts is not held centrally. No specific assessment has been made and there have been no such discussions. Any arrangements would be implemented by individual trusts and would vary across organisations.

20th Jun 2022
To ask Her Majesty's Government, further to the Alcohol Health Alliance UK’s report Contents unknown: How alcohol labelling still fails consumers, published in June, what plans they have to improve the public’s awareness of the Chief Medical Officers’ low-risk drinking guidelines.

The Government has announced its intention to consult on whether to introduce mandatory calorie labelling on pre-packed alcohol and alcohol sold in on-trade businesses, such as pubs and restaurants. The consultation will also seek views on whether the provision of the United Kingdom Chief Medical Officers’ low risk drinking guidelines should be mandatory or continue on a voluntary basis. Respondents to the consultation can also suggest additional labelling requirements for consideration. The Department continues to promote the low risk drinking guidelines through public health messaging, including the ‘Better Health’ campaign and the Drink Free Days app.

20th Jun 2022
To ask Her Majesty's Government, further to the Alcohol Health Alliance UK’s report Contents unknown: How alcohol labelling still fails consumers, published in June, what plans they have for improving consumer knowledge on the potential health impacts of alcohol consumption.

The Government has announced its intention to consult on whether to introduce mandatory calorie labelling on pre-packed alcohol and alcohol sold in on-trade businesses, such as pubs and restaurants. The consultation will also seek views on whether the provision of the United Kingdom Chief Medical Officers’ low risk drinking guidelines should be mandatory or continue on a voluntary basis. Respondents to the consultation can also suggest additional labelling requirements for consideration. The Department continues to promote the low risk drinking guidelines through public health messaging, including the ‘Better Health’ campaign and the Drink Free Days app.

9th Jun 2022
To ask Her Majesty's Government what plans they have to introduce waiting times targets for respiratory conditions for (1) diagnosis, and (2) treatment.

There are existing operational standards and targets for elective care services, including for respiratory services. For patients referred for non-urgent, consultant-led treatment, the waiting time target is 18 weeks from the day the appointment is booked or when the hospital or service receives the referral letter. The waiting time target for diagnostic tests is six weeks.

The operational standard states that less than 1% of patients should wait six weeks or more from referral for a diagnostic test and less than 92% of patients should wait 18 weeks or more from referral for consultant-led treatment.

9th Jun 2022
To ask Her Majesty's Government what plans they have to improve upon (1) 30, and (2) 90, day re-admission rates for those leaving hospital with Chronic Obstructive Pulmonary Disease.

NHS England and NHS Improvement are implementing a care bundle for patients with chronic obstructive pulmonary disease (COPD) on discharge from hospital which aims to reduce the overall number of patients readmitted, including the rates at 30 and 90 days. This care bundle includes five actions to ensure improved clinical outcomes for patients admitted with an acute exacerbation of COPD. Patients should receive a review of medication and inhaler use; a written self-management plan and emergency drug pack; an assessment and referral for smoking cessation; referral for pulmonary rehabilitation if appropriate; and a follow up call within 72 hours of discharge. The discharge bundle is included in the Best Practice Tariff for COPD.

4th Apr 2022
To ask Her Majesty's Government whether they will place in the Library of the House a copy of the Statement of Requirements for the contracts agreed on 29 March with (1) Veolia ES (UK) Ltd. and (2) Suez Recycling, Ltd., under procurement references CF-0748100D0O000000rwimUAA1 and CF-0749100D0O000000rwimUAA1, including the maximum volumes of personal protective equipment available for recycling or disposal under each contract over the period March 2022 to March 2024.

A copy of the Department’s Statement of Requirements for the contracts agreed on 29 March with Veolia ES (UK) Ltd and Suez Recycling Ltd is attached. Information which is commercially sensitive and information held by a public authority relating to environmental regulations has been redacted.

The Department currently estimates that 300,000 pallets of personal protective equipment will be recycled or disposed of between March 2022 and 2024. However, this information is subject to the completion of a feasibility analysis by waste partners.

15th Mar 2022
To ask Her Majesty's Government what steps they are taking to reduce health inequalities for people with osteoporosis.

The NHS Best MSK Health initiative includes a programme aimed at addressing health inequalities in planned care for those with musculoskeletal conditions, with a particular focus on the gender disparity in access to treatment and outcomes faced by women with osteoporosis.

As part of the forthcoming Women’s Health Strategy, we have committed to explore areas of healthcare in which disparities between men and women are greatest, including long-term conditions such as osteoporosis. We aim to publish the Women’s Health Strategy in spring 2022.

15th Mar 2022
To ask Her Majesty's Government what funding they plan to make available for Fracture Liaison Services through (1) the Elective Recovery Fund, and (2) the Best MSK health programme.

Fracture Liaison Services (FLS) are commissioned locally by clinical commissioning groups which are best placed to plan the provision of services subject to local prioritisation and funding. Service providers are also eligible to apply for funding for FLS to support elective recovery via the Elective Recovery Fund.

The Best MSK health programme is working with a range of stakeholders to improve musculoskeletal services. The Best MSK health programme does not have its own budget to fund FLS.

15th Mar 2022
To ask Her Majesty's Government what assessment they have made of the adequacy of waiting times for access to a DXA bone density scan.

No formal assessment has been made. However, NHS England’s data as of January 2022 shows that 36.3% of patients waiting for DEXA scans have been waiting more than six weeks.

2nd Mar 2022
To ask Her Majesty's Government what steps they are taking to enable more people to benefit from the (1) mental, (2) physical, and (3) social, health benefits of (a) green spaces, and (b) gardening.

In 2020, Public Health England published Improving access to greenspace: A new review for 2020, which examined the health effects access to green space, including gardening. The report found evidence that exposure to greenspaces can promote and protect good health, aid in recovery from illness and help with managing poor physical and mental health, including social impacts such as loneliness and community interaction. A copy of the review is attached.

The Office for Health Improvement and Disparities is supporting the preparation of a national cross-Government framework of green infrastructure standards, to ensure new developments include accessible green spaces and areas with little or no green space can be improved for the benefit of local communities. Good quality green infrastructure plays an important role in addressing issues of social inequality and environmental decline in urban and rural locations, whilst also leading to better places to live.

The Department for the Environment, Food and Rural Affairs is leading a cross-Government project on tackling mental ill-health through green social prescribing with the Department of Health and Social Care, NHS England and NHS Improvement, Natural England, Sport England and the Department for Levelling Up, Housing and Communities. The project is taking place between April 2021 to April 2023 at seven sites in England. It will test ideas for embedding green social prescribing such as gardening and walking into communities, in order to improve mental health outcomes including social health; reduce health inequalities; reduce demand on the health and social care system; and develop best practice in making green social activities more resilient and accessible.

2nd Mar 2022
To ask Her Majesty's Government what assessment they have made of the benefits of (1) green spaces, and (2) gardening, to (a) mental, (b) physical, and (c) social, health.

In 2020, Public Health England published Improving access to greenspace: A new review for 2020, which examined the health effects access to green space, including gardening. The report found evidence that exposure to greenspaces can promote and protect good health, aid in recovery from illness and help with managing poor physical and mental health, including social impacts such as loneliness and community interaction. A copy of the review is attached.

The Office for Health Improvement and Disparities is supporting the preparation of a national cross-Government framework of green infrastructure standards, to ensure new developments include accessible green spaces and areas with little or no green space can be improved for the benefit of local communities. Good quality green infrastructure plays an important role in addressing issues of social inequality and environmental decline in urban and rural locations, whilst also leading to better places to live.

The Department for the Environment, Food and Rural Affairs is leading a cross-Government project on tackling mental ill-health through green social prescribing with the Department of Health and Social Care, NHS England and NHS Improvement, Natural England, Sport England and the Department for Levelling Up, Housing and Communities. The project is taking place between April 2021 to April 2023 at seven sites in England. It will test ideas for embedding green social prescribing such as gardening and walking into communities, in order to improve mental health outcomes including social health; reduce health inequalities; reduce demand on the health and social care system; and develop best practice in making green social activities more resilient and accessible.

3rd Feb 2022
To ask Her Majesty's Government what are the reasons for the delay in commencing the consultation of alcohol labelling since its announcement in 2020.

We have committed to consult on our intention to introduce calorie labelling on pre-packaged alcohol and alcohol sold in on-trade businesses such as pubs and restaurants in due course. The consultation will set out further details about the proposed policy and seek views on whether the provision of the United Kingdom Chief Medical Officers’ low risk drinking guidelines should become mandatory or continue on a voluntary basis. The consultation has been delayed due to the pandemic and the focus to date on delivering legislation on promotions, advertising and out of home calorie labelling

3rd Feb 2022
To ask Her Majesty's Government when they will publish the details of their consultation on the calorie labelling of alcohol.

We have committed to consult on our intention to introduce calorie labelling on pre-packaged alcohol and alcohol sold in on-trade businesses such as pubs and restaurants in due course. The consultation will set out further details about the proposed policy and seek views on whether the provision of the United Kingdom Chief Medical Officers’ low risk drinking guidelines should become mandatory or continue on a voluntary basis. The consultation has been delayed due to the pandemic and the focus to date on delivering legislation on promotions, advertising and out of home calorie labelling

3rd Feb 2022
To ask Her Majesty's Government what plans they have to ensure that alcohol labels include the Chief Medical Officers’ guidelines on low-risk consumption of alcohol.

We have committed to consult on our intention to introduce calorie labelling on pre-packaged alcohol and alcohol sold in on-trade businesses such as pubs and restaurants in due course. The consultation will set out further details about the proposed policy and seek views on whether the provision of the United Kingdom Chief Medical Officers’ low risk drinking guidelines should become mandatory or continue on a voluntary basis. The consultation has been delayed due to the pandemic and the focus to date on delivering legislation on promotions, advertising and out of home calorie labelling

3rd Feb 2022
To ask Her Majesty's Government what steps they are taking to reduce the appeal of alcohol to children.

The UK Code of Non-broadcast Advertising and Direct & Promotional Marketing and The UK Code of Broadcast Advertising provide that marketing communications and advertisements for alcoholic drinks should not be targeted at people under 18 years of age and should not imply, condone or encourage immoderate, irresponsible or anti-social drinking. The Codes provide that more than 25% of the audience in adjacent programmes or for the relevant publication should not be under 18 years old. Alcohol advertising must not be likely to appeal ‘strongly’ to young people under 18 years old, reflect or associate with youth culture or show adolescent or juvenile behaviour. No children and no one who is or appears to be under the age of 25 years old may play a significant role in the advertising of alcoholic drinks. Copies of the Codes are attached. Education on alcohol use is a statutory component of Relationships Education, Relationships and Sex Education and Health Education in England.

19th Jan 2022
To ask Her Majesty's Government what assessment they have made of existing levels of accountability of NHS decision-making; and what plans they have to increase the centrality of patients in decision-making structures in future.

The Health and Care Bill includes duties on integrated care boards (ICBs) to involve patients, carers and the public in their decision making, which applies at all levels of the organisation. Currently, NHS England assesses each clinical commissioning group on its delivery against the patient and public involvement duties through the NHS Oversight Framework. We anticipate that this will continue for ICBs. The assessment includes providing evidence of how the involvement of people and communities has informed the organisation’s decision-making about commissioning and changes to services.

Subject to Parliamentary approval, NHS England will produce statutory guidance to support integrated care systems to effectively involve people and communities. This will clarify the responsibilities of all ICB members to provide leadership and accountability for how people and communities are involved.

19th Jan 2022
To ask Her Majesty's Government what plans they have to create formal roles for patient representation at all levels of NHS decision-making structures, including Integrated Care Boards.

The Health and Care Bill includes duties on integrated care boards (ICBs) to involve patients, carers and the public in their decision making, which applies at all levels of the organisation. Currently, NHS England assesses each clinical commissioning group on its delivery against the patient and public involvement duties through the NHS Oversight Framework. We anticipate that this will continue for ICBs. The assessment includes providing evidence of how the involvement of people and communities has informed the organisation’s decision-making about commissioning and changes to services.

Subject to Parliamentary approval, NHS England will produce statutory guidance to support integrated care systems to effectively involve people and communities. This will clarify the responsibilities of all ICB members to provide leadership and accountability for how people and communities are involved.

19th Jan 2022
To ask Her Majesty's Government what plans they have to introduce greater transparency over how Integrated Care Systems will be (1) scrutinised, and (2) held to account, in relation to patient care.

NHS England will continue to transparently scrutinise and hold to account National Health Service organisations which form part of an integrated care system (ICS). Subject to the passage of the Health and Care Bill, NHS England will publish an updated Oversight Framework in 2022/23 that reflects the new statutory basis for integrated care boards (ICBs) and ICSs. The Bill will also place a new duty on the Care Quality Commission (CQC) to review each ICBs’ provision of NHS care, public health, adult social care, the functions of the ICB, local authorities and CQC-registered providers for that provision and the system as a whole. ICBs will also be subject to transparency requirements, including the Public Bodies (Admission to Meetings) Act 1960, to allow patients and the public to hold their ICB to account.

13th Jan 2022
To ask Her Majesty's Government when the public health grant allocations for 2022/23 will be announced.

Local authority Public Health Grant allocations for 2022/23 will be confirmed shortly.

17th Nov 2021
To ask Her Majesty's Government when they plan to publish their updated Tobacco Control Plan.

We are undertaking further policy development to support the Tobacco Control Plan, which will be published in due course.

17th Nov 2021
To ask Her Majesty's Government what assessment they have made as to whether revenues from a ‘polluter pays’ charge could be used towards the delivery of their Smokefree 2030 programme.

The Department is currently assessing a range of policy and regulatory proposals for consideration in the development of the new Tobacco Control Plan. However, no specific assessment has been made of a polluter pays charge on tobacco manufacturers or whether revenues from this charge could be used towards achieving the Smokefree 2030 programme.

17th Nov 2021
To ask Her Majesty's Government what assessment they have made of recommendations to introduce a ‘polluter pays’ charge on tobacco manufacturers; and whether the forthcoming Tobacco Control Plan will include such a charge.

The Department is currently assessing a range of policy and regulatory proposals for consideration in the development of the new Tobacco Control Plan. However, no specific assessment has been made of a polluter pays charge on tobacco manufacturers or whether revenues from this charge could be used towards achieving the Smokefree 2030 programme.

9th Nov 2021
To ask Her Majesty's Government what support they intend to provide (1) to the NHS, and (2) to other areas of society, to tackle the effects of alcohol consumption.

Alcohol is a cross-cutting issue affecting several Government departments. As part of the NHS Long Term Plan, NHS England and NHS Improvement have invested £27 million in a four year programme between 2019/20 and 2023/24 to both establish and improve alcohol care teams to provide specialist alcohol interventions in hospitals where needed. Implementation is estimated to prevent 50,000 admissions over five years.

Furthermore, we have made the largest increase in substance misuse treatment funding for 15 years, with £80 million of new investment in 2021/22. £9.8 million of this has been made available for medically managed inpatient detoxification units, crucial for treating those most dependent on alcohol and drugs. This funding is in addition to the money local authorities already spend on substance misuse from the public health grant.

The focus of the newly established Office for Health Improvement and Disparities is on improving the nation’s health and levelling up health disparities. This includes tackling alcohol-related health harms.

This year, we are delivering £52 million for substance misuse treatment services for people sleeping rough, building on £23 million in 2020/21. This will fund evidence-based drug and alcohol treatment and wraparound support to improve access to treatment, including for those with co-occurring mental health needs.

9th Nov 2021
To ask Her Majesty's Government what recent estimate they have made of the cost of alcohol on (1) the NHS, and on (2) society in general.

Alcohol-related harm was estimated to cost the National Health Service £3.5 billion per year in 2009/10.

The cost of alcohol to society in England was estimated to be £21 billion per year in 2012. This includes the costs associated with alcohol-related health disorders and disease, crime and anti-social behaviour, and loss of productivity in the workplace.

3rd Nov 2021
To ask Her Majesty's Government how the additional funding announced in the Comprehensive Spending Review to build a bigger and better NHS workforce will be distributed.

The Department is working closely with Health Education England and NHS England and NHS Improvement to develop detailed workforce spending plans in the coming months.

The Government has committed to training some of the biggest undergraduate intakes of medical and nursing students ever. In addition, we will be training more midwives and allied health professionals, who are key to delivering the full range of services to the National Health Service.

We have already seen significant increases to the NHS workforce, with 20% more NHS staff in Hospital and Community Health Services since June 2011, and over 21,000 more full time equivalent nurses in the NHS since June 2019. We recognise there is more to be done however, and a key part of ensuring there are sufficient specialists is training more people who can join the NHS. This is why we remain committed to delivering the government commitment of 50,000 additional nurses.

3rd Nov 2021
To ask Her Majesty's Government which specialties will receive the additional funding announced in the Comprehensive Spending Review to build a bigger and better NHS workforce.

The Department is working closely with Health Education England and NHS England and NHS Improvement to develop detailed workforce spending plans in the coming months.

The Government has committed to training some of the biggest undergraduate intakes of medical and nursing students ever. In addition, we will be training more midwives and allied health professionals, who are key to delivering the full range of services to the National Health Service.

We have already seen significant increases to the NHS workforce, with 20% more NHS staff in Hospital and Community Health Services since June 2011, and over 21,000 more full time equivalent nurses in the NHS since June 2019. We recognise there is more to be done however, and a key part of ensuring there are sufficient specialists is training more people who can join the NHS. This is why we remain committed to delivering the government commitment of 50,000 additional nurses.

3rd Nov 2021
To ask Her Majesty's Government how much additional funding announced in the Comprehensive Spending Review they are committing to build a bigger and better NHS workforce.

The Department is working closely with Health Education England and NHS England and NHS Improvement to develop detailed workforce spending plans in the coming months.

The Government has committed to training some of the biggest undergraduate intakes of medical and nursing students ever. In addition, we will be training more midwives and allied health professionals, who are key to delivering the full range of services to the National Health Service.

We have already seen significant increases to the NHS workforce, with 20% more NHS staff in Hospital and Community Health Services since June 2011, and over 21,000 more full time equivalent nurses in the NHS since June 2019. We recognise there is more to be done however, and a key part of ensuring there are sufficient specialists is training more people who can join the NHS. This is why we remain committed to delivering the government commitment of 50,000 additional nurses.

3rd Nov 2021
To ask Her Majesty's Government what plans they have to respond to the Sir Mike Richards 2020 review of services, which found that (1) 20 NHS trusts require a complete rebuild of their endoscopy facilities, and (2) 200 new endoscopy rooms are needed to meet rising patient needs.

The National Health Service is transforming diagnostics services in line with the recommendations from Sir Mike Richards’ Review: Diagnostics Recovery and Renewal, including rolling out at least 100 Community Diagnostic Centres (CDCs) by 2024/25. The Government has made £2.3 billion available to support this transformation over the next three years.

The Department and NHS England and NHS Improvement are working with Regions and local systems to determine how the funding will be divided across diagnostics services. The amount for improving endoscopy services specifically and how these services will be improved is still being finalised.

The funding is on top of the £325 million announced for this year, which is supporting the roll out of over 40 CDCs across England, many of which will provide additional endoscopy capacity.

3rd Nov 2021
To ask Her Majesty's Government how much of the £2.3 billion announced by the Chancellor of the Exchequer to transform diagnostic services will be used to implement the recommendations from Sir Mike Richards 2020 review of services to rebuild and expand endoscopy services.

The National Health Service is transforming diagnostics services in line with the recommendations from Sir Mike Richards’ Review: Diagnostics Recovery and Renewal, including rolling out at least 100 Community Diagnostic Centres (CDCs) by 2024/25. The Government has made £2.3 billion available to support this transformation over the next three years.

The Department and NHS England and NHS Improvement are working with Regions and local systems to determine how the funding will be divided across diagnostics services. The amount for improving endoscopy services specifically and how these services will be improved is still being finalised.

The funding is on top of the £325 million announced for this year, which is supporting the roll out of over 40 CDCs across England, many of which will provide additional endoscopy capacity.

14th Oct 2021
To ask Her Majesty's Government what steps they are taking to promote self-care for minor ailments in order to reduce pressure on GPs and A&E departments.

No assessment has been made of a separate strategy for the integration of self-care for minor ailments, as supported self-management and self-care for short term and ongoing physical and mental health conditions is an integral part of the NHS Long Term Plan.

Community pharmacies in England delivering NHS services provide support for self-care as part of their essential services. The Community Pharmacist Consultation Advanced Service enables NHS111 and general practitioners to refer patients with a minor illness to a pharmacist for a consultation to reduce pressure on primary care and accident and emergency departments.

14th Oct 2021
To ask Her Majesty's Government what assessment they have made, if any, of the benefits of a national strategy which fully integrates self-care for minor ailments into the NHS.

No assessment has been made of a separate strategy for the integration of self-care for minor ailments, as supported self-management and self-care for short term and ongoing physical and mental health conditions is an integral part of the NHS Long Term Plan.

Community pharmacies in England delivering NHS services provide support for self-care as part of their essential services. The Community Pharmacist Consultation Advanced Service enables NHS111 and general practitioners to refer patients with a minor illness to a pharmacist for a consultation to reduce pressure on primary care and accident and emergency departments.

14th Oct 2021
To ask Her Majesty's Government what assessment they have made, if any, of the benefits of (1) a centralised web-based system to support the sharing of local health and social care records, and (2) ensuring that community pharmacists are able to populate such records.

The NHS Long Term Plan and the Community Pharmacy Contractual Framework envisage an increased role for community pharmacy and there is agreement across stakeholders that read and write access to patient records, where they are involved in the patient’s direct care, is necessary to support this.

NHSX is developing interoperable National Health Service IT systems, focussing on shared data standards and infrastructure across settings to allow clinicians including community pharmacists to safely and securely access patient records, make informed clinical decisions and populate records. NHSX will engage with stakeholders including pharmacy contractors, IT suppliers and the public to test any proposed digital solutions and consider issues such as patient consent and data security.

20th Jul 2021
To ask Her Majesty's Government how many Osteoporosis Nurse Specialists are currently in post in each of the NHS England regions.

The Department does not hold the data requested.

20th Jul 2021
To ask Her Majesty's Government when all the musculoskeletal regional leads for NHS England will be (1) appointed, and (2) in post.

As part of the national Best MSK health programme every region in the country has been advised to recruit a musculoskeletal lead. The recruitment process is currently on-going. While there is no fixed timeline for completion, progress against this recruitment will be reviewed in September and subsequently on a quarterly basis.

20th Jul 2021
To ask Her Majesty's Government what steps they are taking to ensure adequate succession planning within the NHS for (1) osteoporosis, and (2) bone health specialists.

Individual National Health Service trusts are responsible for ensuring staffing arrangements are in place which deliver safe and effective care, including succession planning.

Osteoporosis and other bone health conditions are treated by a range of healthcare professionals, such as general practitioners (GPs), endocrinologists, rheumatologists and orthopaedic surgeons. Since 2010, the number of endocrinologists has increased by over 58%, rheumatologists by over 29% and trauma and orthopaedic surgeons by over 24%. We also have over 900 more full-time equivalent GPs March 2021, compared to March 2020. We continue to monitor the NHS’s workforce requirements and ensure that the NHS has the staff that it needs, including for the treatment of osteoporosis and bone health.

19th Jul 2021
To ask Her Majesty's Government what assessment they have made of the number of additional radiographers and radiologists required to deliver the increased number of diagnostic imaging scanners referred to in the National Health Service Long Term Plan.

Following the NHS Long Term Plan, NHS England commissioned Sir Professor Mike Richards to review diagnostic services, which was completed in October 2020. The review recommended that there should be an expansion in the imaging workforce with an additional 2,000 radiologists and 4,000 radiographers over the next five years. NHS England and NHS Improvement are planning how to implement the report’s recommendations.

In 2020/2021, Health Education England’s Cancer Workforce Plan committed to training 300 reporting radiographers and the NHS People Plan committed to training a further 150. Further workforce requirements will be considered as part of the upcoming Spending Review.

19th Jul 2021
To ask Her Majesty's Government what plans they have to ensure that National Health Service Improvement Musculoskeletal Pathway is included and prioritised within individual Integrated Care Systems.

We expect musculoskeletal, fragility fractures and fall services to be fully incorporated into integrated care systems (ICSs) and for the musculoskeletal pathway to play a key role in shaping planning and decision-making.

NHS England and NHS Improvement have convened the National Pathways Improvement Programme to reduce variation in access and outcomes and improve performance. Within this programme the Best MSK health collaborative is supporting those in musculoskeletal leadership roles, including within ICSs, and a specific work stream is focused on osteoporosis, falls and fragility fractures in collaboration with professional and patient-facing stakeholders, as well as those with lived experience.

19th Jul 2021
To ask Her Majesty's Government what steps they are taking to ensure musculoskeletal, fragility fractures and falls are being incorporated into Integrated Care Systems.

We expect musculoskeletal, fragility fractures and fall services to be fully incorporated into integrated care systems (ICSs) and for the musculoskeletal pathway to play a key role in shaping planning and decision-making.

NHS England and NHS Improvement have convened the National Pathways Improvement Programme to reduce variation in access and outcomes and improve performance. Within this programme the Best MSK health collaborative is supporting those in musculoskeletal leadership roles, including within ICSs, and a specific work stream is focused on osteoporosis, falls and fragility fractures in collaboration with professional and patient-facing stakeholders, as well as those with lived experience.

19th Jul 2021
To ask Her Majesty's Government what assessment they have made of the impact that the Getting it Right First Time programme will have in delivering improved levels of onward referral for patients with newly diagnosed vertebral fractures.

The Getting It Right First Time (GIRFT) programme reviewed all spinal surgery providers in England in 2019 and highlighted several areas for improvement. We are assessing the impact of these findings and the GIRFT team is due to report on progress later this year when new ‘time to surgery’ data for these conditions has been collected. NHS England and NHS Improvement also plan to increase the number of rehabilitation beds available nationally, which is expected to have a significant impact in improving levels of referrals.

21st Jun 2021
To ask Her Majesty's Government what steps they are taking to promote NHS England's and NHS Improvement's Good Communication with Patients Waiting for Care, published on 25 May, to local integrated care systems and NHS trusts.

NHS England and NHS Improvement have been working to promote the guidance via corporate channels, including a range of system-facing bulletins and networks. The guidance and communication principles have also been built into other relevant publications including the Clinical Prioritisation of Diagnostic Waiting Lists Framework.

19th Jan 2022
To ask Her Majesty's Government what plans they have to introduce an online sales tax; and, as part of any such plans, whether they intend to hold consultative forums with small businesses, including booksellers.

At Autumn Budget 2021, the Government announced that it will continue to explore the arguments for and against an Online Sales Tax (OST). No decisions on whether to proceed with an OST have yet been made. If implemented, the revenue from an OST would be used to provide business rates relief for in-store retail. The consultation will launch shortly.

The Government would welcome views and evidence from a range of stakeholders, including small businesses and booksellers. Details of how interested stakeholders can engage with the process will be published alongside the consultation.

Viscount Younger of Leckie
Parliamentary Under-Secretary (Department for Work and Pensions)
9th Nov 2021
To ask Her Majesty's Government what assessment they have made of the impact of the proposed reform of alcohol duty announced in the Autumn Budget Statement on (1) alcohol-related hospitalisations, (2) alcohol-related deaths, and (3) other health outcomes.

The reform of alcohol duty has been designed to support the Government’s public health objectives. From 2023, all drinks will be taxed according to their alcohol content. Some high strength products such as white cider will go up in duty, whilst draught beer and cider in pubs will pay less duty. The Government expects that these changes will have a positive impact, with the potential to reduce alcohol-related hospitalisations and deaths, as well as providing other positive health outcomes.
9th Nov 2021
To ask Her Majesty's Government what assessment they have made of the impact of the proposed reform of alcohol duty announced in the Autumn Budget Statement on alcohol consumption.

The reform of alcohol duty has been designed to support the Government’s public health objectives. From 2023, all drinks will be taxed according to their alcohol content. Some high strength products such as white cider will go up in duty, whilst draught beer and cider in pubs will pay less duty. The Government expects that these changes will have a positive impact, with the potential to reduce alcohol-related hospitalisations and deaths, as well as providing other positive health outcomes.
9th Sep 2021
To ask Her Majesty's Government what projections HMRC has made of the number of ATA Carnet applications it will need to process in (1) 2021/22, and (2) 2022/23.

When moving goods temporarily into or out of the UK, an ATA Carnet provides an option which can help simplify customs formalities by allowing a single document to be used for clearing goods through customs in the countries that are part of ATA Carnet system. The use of a carnet is optional and is a commercial decision depending on an individual or business’s specific circumstances. In the UK, ATA Carnets are administered by the London Chamber of Commerce and Industry (LCCI).

International travel has been severely affected by the COVID-19 pandemic and the number of goods movements using ATA Carnets has dropped. At the moment it is difficult to project numbers with any certainty. Numbers are likely to increase owing to the UK’s withdrawal from the EU and the gradual lifting of travel restrictions throughout the world. HMRC, in conjunction with the LCCI and Border Force, monitor ATA Carnet usage on a regular basis.

An alternative option to an ATA Carnet is the use of the Temporary Admission procedure in conjunction with Returned Goods Relief. Temporary Admission is a customs special procedure that may be used to temporarily import goods into the UK without payment of duties subject to relevant conditions being met.

Businesses and individuals returning goods to the UK, having temporarily imported them to another customs territory, can claim relief from import VAT and any customs duty under Returned Goods Relief providing specific conditions are met. Returned Goods Relief applies to goods exported from the UK and re-imported in an unaltered state.

The EU operates similar procedures therefore, for goods moving temporarily to the EU, the EU’s Temporary Admission procedure may be applicable, and the EU’s Returned Goods Relief may apply where goods are returned to the EU having been temporarily imported into the UK. The management of EU import and export procedures is the responsibility of the customs authorities of the EU Member States.

22nd Nov 2022
To ask His Majesty's Government, in the light of the shortage of health care assistants for working age disabled people, whether they have any plans (1) to review the criteria for the sponsorship of overseas workers, and (2) to make reasonable adjustments to the criteria to allow disabled people to employ personal carers directly.

The sponsorship system is designed to strike the balance between enabling UK employers to recruit overseas workers, while ensuring employers only sponsor workers who are eligible for visas, that those they do sponsor will comply with the conditions of their visa and that the safety and wellbeing of those workers is safeguarded. This approach ensures the integrity of the immigration system and provides important safeguards for those who migrate to the UK and for individuals requiring care.

The Government has no plans change this position.

6th Mar 2023
To ask His Majesty's Government which of the local authorities they have designated as priority category 1 have received funding from the Levelling Up Fund in either round 1 or round 2; and which ones have not.

We have published a full list of priority categorisation for round 1 (attached) and round 2 (attached) of the Levelling Up Fund on gov.uk.

Along with this, we have also provided the list of successful applicants to the first (attached) and second rounds of the Fund.

Baroness Scott of Bybrook
Parliamentary Under Secretary of State (Department for Levelling Up, Housing and Communities)
2nd Mar 2022
To ask Her Majesty's Government what assessment they have made of the role of (1) gardens, and (2) green spaces, in achieving their Levelling Up ambitions.

The Levelling Up White Paper is clear that green infrastructure is a key component to levelling up, as so many levelling up goals are connected to green places that local people can be proud of. People’s lives are shaped by the social and physical fabric of their communities. The local mix of social and physical capital, which includes good quality green spaces, gives areas their unique character and vibrancy, and makes residents proud to live there.

A beautiful built environment, access to leisure and cultural amenities and safe neighbourhoods can also attract businesses to high streets, leading to increased footfall and private sector investment in communities. To make this a reality, communities must have strong civic institutions, assets and relationships that anchor local pride in place.

My department has set out in the National Planning Policy Framework that planning policies and decisions should take into account the desirability of maintaining an area’s prevailing character and setting, which can include preserving residential gardens.

My department is delivering the £9 million Levelling Up Parks Fund which provides direct grants to deliver over 100 green spaces in the communities with the lowest access to green space.

The Government also announced in the Levelling Up White Paper that we will invest a further £30 million to refurbish at least 30 parks in England, with an emphasis on providing facilities for young families.

Further details on these funds will be announced in due course.

29th Jun 2021
To ask Her Majesty's Government, further to the reported threat to Liverpool's UNESCO World Heritage Site status, what plans they have to (1) review, and (2) amend, relevant national planning guidance.

The Government is committed to the protection of our historic environment, including our World Heritage Sites. As set out in the recent Planning White Paper, Planning for the Future , we consider that the existing heritage planning framework has worked well and we want to build on it as we develop the new planning system. In bringing forward our reforms we will work with those who have experience and expert knowledge of the planning system to ensure that our heritage is fully considered and continues to be protected going forward.

17th Jan 2024
To ask His Majesty's Government what is the incidence over the last 24 months of spouses or partners who use their spouse's or partner's NHS records in custody and other disputes.

The information requested could only be obtained at disproportionate cost.

The data readily available to the Government does not enable the Government to determine whether, and if so to what extent, spouses or partners have used their spouses’ or partners’ NHS records in custody or other disputes. The use of NHS data in such circumstances without consent would in normal circumstances constitute a breach of patient confidentiality.

Lord Bellamy
Parliamentary Under-Secretary (Ministry of Justice)