Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government why the NHS North East and North Cumbria Integrated Care Board did not increase the units of dental activity (UDA) value of contracts awarded through its March 2024 procurement by the same percentage their regional UDA values increased by, following two separate increases to the minimum UDA value for existing contract holders; and what assessment they have made of the potential impact of this decision on the financial viability of those newly tendered contracts, particularly given their requirement to treat new patients with higher treatment needs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population. Therefore, responses to these questions should be requested directly from the North East and North Cumbria ICB.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the NHS North East and North Cumbria Integrated Care Board awarded dental contracts subsequent to its March 2024 procurement outside of a formal procurement process without transparently offering all NHS contract holders the opportunity to apply; if so, what assessment they have made of these awards; and if commissioning flexibility has been applied in such cases, why similar flexibility has not been extended to contracts awarded through the March 2024 procurement.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population. Therefore, responses to these questions should be requested directly from the North East and North Cumbria ICB.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, of the 11 new NHS dental contracts procured by NHS North East and North Cumbria Integrated Care Board in March 2024 to address shortages in NHS dentistry in the region, how many were successfully awarded; and how many are now operational.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population. Therefore, responses to these questions should be requested directly from the North East and North Cumbria ICB.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will require NHS England to use its powers under section 14Z61 of the National Health Service Act 2006 to ensure that integrated care boards allow the prescription of liothyronine where clinically appropriate.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
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.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of Action 6(iii) in the report, A Bolder, Braver Approach for Organ Donation in the UK, published by the Organ Donation Joint Working Group on 21 January, to change the Human Tissue Authority Code of Practice and NHS Blood and Transplant processes so that families are approached for information to support donation proceeding using affirmative language.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has not held discussions with the Human Tissue Authority (HTA) regarding the final report of the Evaluation of the Organ Donation (Deemed Consent) Act 2019.
The Organ Donation Joint Working Group, jointly chaired by the Department and NHS Blood and Transplant (NHSBT), made recommendations which ministers have noted, and which action owners are working together to implement. As part of this work, the Department, NHSBT, and HTA have met to discuss the report’s findings and actions. The HTA is currently at an early stage of reviewing its current statutory codes of practice and will revise them where necessary to ensure they remain clear, up to date, and effective.
NHSBT is actively progressing work to ensure that their family approach processes use clear, affirmative language that supports a family’s understanding of their loved one’s recorded donation decision. As part of this, NHSBT are reviewing their operational guidance and training materials for specialist nurses in organ donation to strengthen support offered to families by focussing on building trust and rapport with the family to explore the patient’s beliefs and values as a central reference point for the donation decision, rather than focusing on any last known expressed wishes.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what discussions they have held with the Human Tissue Authority regarding the final report of the Evaluation of the Organ Donation (Deemed Consent) Act 2019, published by McLaughlin et al on 1 January 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has not held discussions with the Human Tissue Authority (HTA) regarding the final report of the Evaluation of the Organ Donation (Deemed Consent) Act 2019.
The Organ Donation Joint Working Group, jointly chaired by the Department and NHS Blood and Transplant (NHSBT), made recommendations which ministers have noted, and which action owners are working together to implement. As part of this work, the Department, NHSBT, and HTA have met to discuss the report’s findings and actions. The HTA is currently at an early stage of reviewing its current statutory codes of practice and will revise them where necessary to ensure they remain clear, up to date, and effective.
NHSBT is actively progressing work to ensure that their family approach processes use clear, affirmative language that supports a family’s understanding of their loved one’s recorded donation decision. As part of this, NHSBT are reviewing their operational guidance and training materials for specialist nurses in organ donation to strengthen support offered to families by focussing on building trust and rapport with the family to explore the patient’s beliefs and values as a central reference point for the donation decision, rather than focusing on any last known expressed wishes.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what threshold NHS England applies when determining whether to take action against an integrated care board under section 14Z61 of the National Health Service Act 2006.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England’s published enforcement guidance sets out how it uses its enforcement powers and the regulatory and statutory processes in the event of enforcement action. The guidance states that directions under section 14Z61 should only be issued as a last resort where voluntary action has not proved possible and NHS England must be satisfied that the integrated care board is failing or has failed to discharge its functions, or that there is a significant risk it will do so.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to recover the reported deficit of the Kent and Medway Integrated Care Board.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
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.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether any integrated care boards make exceptional funding requests for liothyronine; and whether the exceptional funding request process is intended to be used for rationed treatments, such as liothyronine.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social 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.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to remove liothyronine from the guidance Items which should not routinely be prescribed in primary care, updated on 19 August 2025.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social 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.