Lord Hunt of Kings Heath

Decisions about prescribing liothyronine are made by the responsible clinician. NHS England guidance, which aligns with National Institute for Health and Care Excellence guidance on the assessment and management of thyroid disease, is clear that liothyronine should not be routinely prescribed in primary care. Where clinically appropriate, liothyronine should only be initiated by a National Health Service consultant endocrinologist, and only where no clinically appropriate alternative treatment is available.

Integrated care boards are responsible for local commissioning arrangements and for supporting the application of national guidance, but it is for clinicians, working with their patients, to decide on the most appropriate treatment in line with that guidance.

As the Care Quality Commission (CQC) is operationally independent, the Government has not made its own assessment of individual CQC assessments.

The CQC has advised that its 8 January 2026 assessment of Orchard Nursing Home, Huyton included consideration of how residents and family members were supported to raise concerns and share their experiences, with inspectors finding a positive culture in which people felt able to speak up and confident that issues would be listened to and addressed. The CQC took into full account concerns raised about the care people received and noted improvements the service had made under new management.

The assessment also found evidence that care plans had improved, with personalised care plans developed before admission, routinely monitored, and reviewed regularly to reflect people’s needs and preferences.

In addition, inspectors considered how complaints were identified, investigated and responded to. A complaints policy was in place, information on how to raise concerns was accessible, and complaints were taken seriously, investigated appropriately, and used to support learning and ongoing improvement.

As the Care Quality Commission (CQC) is operationally independent, the Government has not made its own assessment of individual CQC assessments.

The CQC has advised that its 8 January 2026 assessment of Orchard Nursing Home, Huyton included consideration of how residents and family members were supported to raise concerns and share their experiences, with inspectors finding a positive culture in which people felt able to speak up and confident that issues would be listened to and addressed. The CQC took into full account concerns raised about the care people received and noted improvements the service had made under new management.

The assessment also found evidence that care plans had improved, with personalised care plans developed before admission, routinely monitored, and reviewed regularly to reflect people’s needs and preferences.

In addition, inspectors considered how complaints were identified, investigated and responded to. A complaints policy was in place, information on how to raise concerns was accessible, and complaints were taken seriously, investigated appropriately, and used to support learning and ongoing improvement.

The Department has no current plans to meet representatives of Thyroid UK and The Thyroid Trust to discuss the prescribing of liothyronine in primary care.

The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.

No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.

The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.

The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.

No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.

The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.

The inclusion of liothyronine in the guidance will be reviewed only if there is a significant change in the evidence, including National Institute for Health and Care Excellence (NICE) guidance on the assessment and management of thyroid disease, which currently aligns with the policy guidance recommendations.

No assessment of integrated care boards’ adherence to guidance has been made. Regions cascaded the ‘items that should not be prescribed in primary care’ policy guidance to systems who are responsible for ensuring prescribing is in line with the available guidance.

The Department and NHS England do not collect or hold this data, as integrated care boards make exceptional funding requests for liothyronine, and therefore the information would be held by individual integrated care boards.

Community health services are a fundamental part of the health and care system and an essential building block in developing a neighbourhood health service.

We know people are waiting too long for community services. That is why, for the first time, we have set a clear target for systems to work to reduce long waits in NHS England’s Medium-Term Planning Framework.

The Medium Term Planning Framework outlines how integrated care boards (ICBs) should strengthen community services in line with the left shift ambitions set out in the 10-Year Health Plan. Specifically, it asks that in 2026/27 all ICBs:

- increase community health service capacity to meet growth in demand, expected to be approximately 3% nationally per year;

- actively manage long waits for community health services, reducing the proportion of waits over 18 weeks and developing a plan to eliminate all 52-week waits.

As part of the medium term planning process, ICBs should ensure community health services are adequately funded to meet these targets, and must submit plans which set out how they will implement this ambition. NHS England is currently in the process of assuring these plans and will continue to monitor their implementation.

To support the shift to neighbourhood health, we published in 2025 an overview of the core community health services, called Standardising Community Health Services, that ICBs should consider when planning for their local populations to support improved commissioning and delivery of community health services, a vital part of neighbourhood health. Further guidance was published in February 2026, providing more detailed descriptions of the core components of community health services for ICBs. Codifying community health services will help to better assess demand and capacity. It will also help commissioners make investment choices as they design neighbourhood health provision that shifts care to community-based settings.

Community health services are a fundamental part of the health and care system and an essential building block in developing a neighborhood health service.

We know people are waiting too long for community services. That is why, for the first time, we have set a clear target for systems to work to reduce long waits in NHS England’s Medium-Term Planning Framework.

The Medium Term Planning Framework outlines how integrated care boards (ICBs) should strengthen community services in line with the left shift ambitions set out in the 10-Year Health Plan. Specifically, it asks that in 2026/27 all ICBs:

- increase community health service capacity to meet growth in demand, expected to be approximately 3% nationally per year; and

- actively manage long waits for community health services, reducing the proportion of waits over 18 weeks and developing a plan to eliminate all 52-week waits.

As part of the medium term planning process, and to hold the system to account, ICBs have to submit plans which set out how they will implement this ambition. NHS England is currently in the process of assuring these plans and will continue to monitor their implementation.

To support the shift to neighbourhood health, we published in 2025 an overview of the core community health services, called Standardising Community Health Services, that ICBs should consider when planning for their local populations to support improved commissioning and delivery of community health services, a vital part of neighbourhood health. Further guidance was published in February 2026, providing more detailed descriptions of the core components of community health services for ICBs. Codifying community health services will help to better assess demand and capacity. It will also help commissioners make investment choices as they design neighbourhood health provision that shifts care to community-based settings.

NHS England publishes regular updates on the financial performance of all National Health Service organisations in both their quarterly Oversight Framework segmentation league tables and their monthly board papers.

At month nine (M9), the end of December 2025, there are year to date overspends across NHS systems totalling £445 million, reflecting the impact of held back deficit support funding. Six systems account for more than half of this overspend, while 17 systems were delivering in line with their financial plans at that point in the year.

Further details can be found in the M9 Financial Position 2025/26 update to the February NHS England board on the NHS England website.

Following actions taken by this government, England currently has the highest number of fully qualified general practitioners (GPs) since 2015.

We want to go further than this, and that’s why thousands more GPs are being trained to expand capacity further. The number of GP training places has been expanded by 250, taking the total number of available places to 4250 for 2025/26, and we plan to expand this again for 2026/27. Current and future expansions to post-graduate training, including foundation training and GP specialty training, have been planned on the basis of relative need, balanced with ability of locations to support trainees.

There has long been criticism that the way GP funding is allocated across England (the Carr-Hill formula), is considered outdated. This is why we are reviewing the Carr-Hill formula, to ensure funding for core services is distributed equitably between practices across the country. The first phase of the review is expected to conclude in March 2026.

Following feedback from the 2026/27 GP contract consultation, this Government is introducing a practice-level GP reimbursement scheme using £292 million of repurposed funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions with existing GPs to improve access to general practice. The funding is equivalent to 1600 FTE GPs nationally and aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment.

We are also increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner.

The Additional Roles Reimbursement Scheme (ARRS) provides funding for a number of additional roles to help increase capacity in general practice, enabling primary care networks (PCNs) to create bespoke teams.

Following feedback from the 2026/27 GP contract consultation, we are increasing flexibility of the ARRS, enabling PCNs to recruit a broader range of ARRS roles, including primary care chaplains, where agreed with the commissioner.

2025/26 marks a financial reset year for the National Health Service and the majority of NHS systems remain on track to deliver the plans they agreed at the beginning of the year. At the end of December, NHS systems are overspending by £445 million and six systems account for more than half of the total overspend. 17 systems have delivered in line with their plans. At the same point last year systems had overspent by £1,031 million with only four systems delivering their plans to that point.

Where an organisation is assessed to be significantly off track and amongst the most challenged in the country, NHS England will provide a range of national and regional support, including potential enforcement actions, to help organisations develop individual recovery plans and get back on track. More details on NHS England’s oversight and support for challenged organisations are available at the following link:

https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/#performance-assessment

Kent and Medway Integrated Care Board (ICB) has recently updated the forecast for the system and declared a potential overspend of approximately £190 million against the plan it agreed with NHS England at the beginning of the financial year. An external review has been commissioned to understand the drivers behind this recently reported overspend and, working with NHS England’s regional team, the ICB will use the outcomes of that review to develop a sustainable recovery plan.

The Government and the Care Quality Commission (CQC) both recognise the independent statutory role of Healthwatch England (HWE) in championing the views of those who use health and care services. Although the Health and Social Care Act 2012 established HWE as a statutory committee of the CQC, HWE sets its own priorities, has its own brand identity, and speaks with an independent voice. This arrangement is set out in the CQC’s formal framework agreement with the Department.

Following the Government’s commitment in the 10-Year Health Plan to incorporate the functions of HWE into a new Patient Experience Directorate within the Department, the CQC has been working closely with HWE on all aspects of a closure programme. This work includes engaging with relevant trade unions and regular meetings to plan for the abolishment of HWE in its current format.

The Government and the Care Quality Commission (CQC) both recognise the independent statutory role of Healthwatch England (HWE) in championing the views of those who use health and care services. Although the Health and Social Care Act 2012 established HWE as a statutory committee of the CQC, HWE sets its own priorities, has its own brand identity, and speaks with an independent voice. This arrangement is set out in the CQC’s formal framework agreement with the Department.

Following the Government’s commitment in the 10-Year Health Plan to incorporate the functions of HWE into a new Patient Experience Directorate within the Department, the CQC has been working closely with HWE on all aspects of a closure programme. This work includes engaging with relevant trade unions and regular meetings to plan for the abolishment of HWE in its current format.

The Department and NHS England expect midwives, sonographers, and obstetricians to follow national guidance described by the Royal College of Obstetricians and Gynaecologists for the diagnosis and management of placenta accreta spectrum (PAS). There are no plans to introduce mandatory training for all sonographers and obstetricians in how to diagnose PAS.

In the instance of women delivering with PAS, surgeons and anaesthetists in all obstetric hospitals are trained to deal with complex operative findings as well as the management of post-partum haemorrhage. This will be strengthened further through the implementation of the recently published Maternal Care Bundle, which includes an element focussed on optimal management of obstetric haemorrhage.

The Department and NHS England expect midwives, sonographers, and obstetricians to follow national guidance described by the Royal College of Obstetricians and Gynaecologists for the diagnosis and management of placenta accreta spectrum (PAS). There are no plans to introduce mandatory training for all sonographers and obstetricians in how to diagnose PAS.

In the instance of women delivering with PAS, surgeons and anaesthetists in all obstetric hospitals are trained to deal with complex operative findings as well as the management of post-partum haemorrhage. This will be strengthened further through the implementation of the recently published Maternal Care Bundle, which includes an element focussed on optimal management of obstetric haemorrhage.

We have not made an assessment of the causes of variations in the reported prevalence of placenta accreta spectrum (PAS). NHS England does not currently collect national data on PAS prevalence or outcomes.

Through the national audit into maternal mortality, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK will report on PAS-associated deaths later this year. The National Institute for Health and Care Research and the Government funded PRiSMM programme will be reporting on PAS by region within the national maternal morbidity surveillance system.

No specific assessment has been made. Paramedics are highly trained and competent professionals who routinely and autonomously carry out procedures where required.

While patients wait for hospital intervention, paramedics work alongside acute trusts to provide robust protection measures, alongside Rapid Release protocols implemented in most ambulance services and acute trusts, allowing ambulances to clear and be available for the next call. Where protocols have not been implemented, there is a plan in place for rapid implementation.

Whether paramedics are able to undertake or supervise treatment procedures whilst patients wait for admission to hospital depends on a number of factors, including local policies and clinical governance frameworks.

The Care Quality Commission (CQC) has not instructed or advised Healthwatch England to refrain from public comment about its abolition or the transfer of its functions.

The CQC is operationally independent and continues to work with Healthwatch England in line with its statutory duties.

The Department continues to engage with both the CQC and Healthwatch England, as its strategic functions move to a new patient experience directorate within the Department following Dr Penny Dash’s Review of patient safety across the health and care landscape.

Ambulance paramedics are regulated by the Health and Care Professions Council (HCPC), but the HCPC does not set a national list of procedures such as catheterisation or infusion. Paramedics are highly trained and competent professionals who may routinely and autonomously carry out procedures such as cannulation in the field.

However, while waiting for hospital admission, whether paramedics are able to undertake or supervise these procedures depends on a number of factors, such as local policies and clinical governance frameworks.

The Government expects all system partners to work together to provide robust protection measures, including handover protocols, to ensure patients are cared for in the right place, at the right time.

It was not expected that all trusts would adopt the platform by April 2026, and the NHS Federated Data (NHS FDP) programme is on track to support adoption of the NHS FDP to 85% of all National Health Service trusts by March 2026.

NHS England published its regular benefits and uptake data on 12 February 2026, which shows that at the end of January 2026 there were 110 NHS trusts live or in delivery of the Federated Data Platform. 167 trusts have signed up to the NHS FDP, or 81% of the 205 providers of secondary and tertiary care in the NHS.

It was not expected that all trusts would adopt the platform by April 2026, and the NHS Federated Data (NHS FDP) programme is on track to support adoption of the NHS FDP to 85% of all National Health Service trusts by March 2026.

NHS England published its regular benefits and uptake data on 12 February 2026, which shows that at the end of January 2026 there were 110 NHS trusts live or in delivery of the Federated Data Platform. 167 trusts have signed up to the NHS FDP, or 81% of the 205 providers of secondary and tertiary care in the NHS.

Healthwatch has played an important role in supporting patient involvement in the National Health Service, and in our 10-Year Health Plan we recognise the valuable work they have done to gather patient feedback and influence the debate around local service delivery.

Healthwatch was one of six organisations covered by Dr Penny Dash’s review of patient safety across the health and care landscape. The review found that there are too many organisations doing this type of work, which can create confusion for patients and risks limiting impact given their distance from service providers and commissioners.

In response, we have committed in our 10-Year Health Plan to bring Healthwatch England’s strategic functions ‘in house’ within a reformed Department, giving patients a stronger national voice through the creation of a new National Director of Patient Experience. At the same time, the statutory functions of Local Healthwatch will be brought together with the involvement and engagement responsibilities of integrated care boards, ensuring that patient insight is more directly connected to local decision-making and service improvement.

There are currently no plans to introduce mandatory national reporting of placenta accreta spectrum cases and outcomes. Neither Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) nor the National Maternity and Perinatal Audit record placenta accreta routinely in regular surveillance. However, MBRRACE-UK captures this data as part of their confidential enquiries relating to haemorrhage.

In 2020, NHS England commissioned placenta accreta networks in the United Kingdom which support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. Placenta accreta centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

There are currently no plans to introduce mandatory national reporting of placenta accreta spectrum cases and outcomes. Neither Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) nor the National Maternity and Perinatal Audit record placenta accreta routinely in regular surveillance. However, MBRRACE-UK captures this data as part of their confidential enquiries relating to haemorrhage.

In 2020, NHS England commissioned placenta accreta networks in the United Kingdom which support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. Placenta accreta centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

In 2020, NHS England commissioned placenta accreta networks in the United Kingdom which support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. These centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

At present, placenta accreta spectrum is not included as an indicator in NHS England maternity safety improvement programmes and dashboards. There are no plans to add this as an indicator in the future.

There are no plans to introduce mandatory national reporting of placenta accreta spectrum cases and outcomes. Neither Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) nor the National Maternity and Perinatal Audit record placenta accreta spectrum routinely in regular surveillance. However, MBRRACE-UK captures this data as part of the haemorrhage confidential enquiries. There are currently no plans to discuss the publication of this data.

In 2020, NHS England commissioned placenta accreta networks in the United Kingdom which support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. These centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

At present, placenta accreta spectrum is not included as an indicator in NHS England maternity safety improvement programmes and dashboards. There are no plans to add this as an indicator in the future.

There are no plans to introduce mandatory national reporting of placenta accreta spectrum cases and outcomes. Neither Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) nor the National Maternity and Perinatal Audit record placenta accreta spectrum routinely in regular surveillance. However, MBRRACE-UK captures this data as part of the haemorrhage confidential enquiries. There are currently no plans to discuss the publication of this data.

In 2020, NHS England commissioned placenta accreta networks in the United Kingdom which support local and regional screening, shared protocols, and co-ordinated referral pathways to specialist pregnancy accreta centres. These centres consist of highly experienced multidisciplinary teams with the expertise to manage this condition and improve the safety outcomes for women and babies.

At present, placenta accreta spectrum is not included as an indicator in NHS England maternity safety improvement programmes and dashboards. There are no plans to add this as an indicator in the future.

There are no plans to introduce mandatory national reporting of placenta accreta spectrum cases and outcomes. Neither Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) nor the National Maternity and Perinatal Audit record placenta accreta spectrum routinely in regular surveillance. However, MBRRACE-UK captures this data as part of the haemorrhage confidential enquiries. There are currently no plans to discuss the publication of this data.

NHS England regional teams, in conjunction with their local integrated care boards as the responsible commissioners, are leading on commissioning specialised placenta accreta spectrum centres within their geographies. The treating clinician, in consultation with the patient, will advise on referral routes for patients under their care.

Areas with NHS-commissioned placenta accreta spectrum specialist centres:

London:

• North East London: Barts Health NHS Trust; and Barking, Havering and Redbridge University Hospitals NHS Trust (two site, one service model).
• North West London: Chelsea and Westminster Hospital NHS Foundation Trust; and Imperial College Healthcare NHS Trust (two site, one service model).
• South West London: St George's University Hospitals NHS Foundation Trust.
• South East London: King’s College Hospital NHS Foundation Trust; and Guy’s and St Thomas’ NHS Foundation Trust (two site, one service model).
• North Central London: University College London Hospitals NHS Foundation Trust.

East of England:

• Norfolk and Norwich University Hospitals NHS Foundation Trust; and
• Cambridge University Hospitals NHS Foundation Trust.

North East Yorkshire and Humber:

• Sheffield Teaching Hospitals NHS Foundation Trust;
• Leeds Teaching Hospitals NHS Trust; and
• the Newcastle upon Tyne Hospitals NHS Foundation Trust

South West:

• University Hospitals Bristol and Weston NHS Foundation Trust; and
• University Hospitals Plymouth NHS Trust.

East Midlands:

• University Hospitals Leicester NHS Trust; and
• Nottingham University Hospitals NHS Trust.

West Midlands:

• Birmingham Women’s and Children’s Hospital NHS Foundation Trust;
• University Hospitals Birmingham NHS Foundation Trust;
• University Hospital of North Midlands NHS Trust; and
• the Royal Wolverhampton NHS Trust.

Our Medium-Term Planning Framework, published in October 2025, made it clear to integrated care boards (ICBs) that timely and effective community health services will be critical to shifting care out of hospital and into the community to deliver our ambitions for neighbourhood health.

ICB core programme allocations for 2026/27 to 2028/29, published in November 2025, gave an average recurrent allocation growth across all ICBs in England of 2.72% in 2026/27 and 2.92% in 2027/28.

And, for the first time, we have set a target for systems to reduce long waits for community health services in the Medium-Term Planning Framework. By 2028/29 at least 80% of community health services activity should take place within 18 weeks, bringing community health services in line with targets for elective care. Systems have also been asked to increase the capacity of community health services and to work to standardise the provision of core community services.

To help bring about integration, the Department and NHS England will create effective mechanisms which enable service level funding to flow from acute care to community health services and create financial incentives to invest in services that improve patient outcomes and deliver better value by creating funding flows and payment mechanisms that connect the savings from improved quality of care with the investment in new services in the community.

NHS England is responsible for determining allocations of financial resources to integrated care boards (ICBs), informed by a target formula to determine the ‘fair share’ of total funding available for each ICB. NHS England published allocations for ICBs covering 2026/27 to 2028/29 in November 2025, with further information available at the following link:

https://www.england.nhs.uk/publication/allocation-of-resources-2026-27-to-2027-28/

We remain committed to working together across Government and with national autism charities to improve services and outcomes for autistic people.

On 23 January, we published our response to the House of Lords Autism Act 2009 Inquiry Committee’s report Time to deliver: The Autism Act 2009 and the new autism strategy. We are carefully considering the report’s recommendations as well as our approach to the national autism strategy and will set out a position, including our plans to engage with stakeholders, in due course.