Question to the HM Treasury:

To ask His Majesty's Government when they expect to publish the conclusions of the review of VAT for public bodies under Section 41 of the Value Added Tax Act 1994.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

Under Section 41 of the VAT Act 1994 Government departments, NHS Trusts and some wider public bodies can claim VAT refunds on certain outsourced services. Their remaining irrecoverable VAT is funded through Departmental Expenditure Limits. The Government is exploring reforming this system into a ‘Full Refund Model’ which would enable Section 41 bodies to recover VAT on all goods and services incurred during the course of non-business activities.

To ensure the reform is fiscally neutral, the departmental budgets of Section 41 bodies must be adjusted by an amount corresponding to the additional VAT they will be refunded for. HM Treasury is currently analysing data provided by Section 41 bodies on their irrecoverable VAT and will set out the next steps to the reforms in due course.

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.

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.

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.

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.