Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps are being taken by NHS England to improve the performance of integrated care boards that are making inadequate progress in increasing funding for community care.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what measures they have put in place to enable assessment of the performance of integrated care boards in prioritising community care services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the (1) number and (2) scale of deficits currently being reported by integrated care boards.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will publish a comprehensive list of NHS-commissioned placenta accreta spectrum specialist centres that have been established since 2020, including the (1) location, and (2) referral pathways, of each centre.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

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.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of whether all integrated care boards adhere to NHS England's national guidance on 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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure an equitable distribution of general medical practitioners in England between regions.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to meet representatives of Thyroid UK and The Thyroid Trust to discuss the prescribing of liothyronine in primary care.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of whether the Care Quality Commission's 8 January assessment of Orchard Nursing Home, Huyton (1) took into full account of concerns that had been expressed to the Care Quality Commission about the care people received in the home, (2) measured the degree to which care plans were being followed, and (3) sufficiently evaluated the extent to which complaints were properly investigated.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they are satisfied that in the Care Quality Commission's 8 January assessment of Orchard Nursing Home, Huyton, residents, relatives of residents, and relatives of previous residents had an opportunity to discuss their experiences with the Care Quality Commission.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to include primary healthcare chaplaincy as one of the options on which primary care networks can choose to spend additional roles reimbursement scheme funds.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

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.