Question to the Department for Work and Pensions:

To ask His Majesty's Government, further to the answer by Baroness Sherlock on 1 September (HL Deb col 7), what plans they have to work with not-for-profit microfinance organisations such as Purple Shoots to support unemployed people to start their own businesses.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

The Government recognises that self-employment can be a suitable and sustainable route into work for some people, including those who are unemployed.

Through Jobcentre Plus, work coaches can provide self-employment information and support to customers and signpost them to specialist national or local organisations that provide advice to support people to start a business. This includes the Start Up Loans scheme run by the British Business Bank, the Business Support Helpline, Local Growth Hubs in England, Business Wales and Find Business Support and Business Gateway in Scotland, which offer support, advice and guidance to new and existing businesses.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the contractual requirement introduced on 1 October 2025 requires GP practices to provide (1) an online consultation system, (2) an online appointment booking system, or (3) both; and what percentage of GP practices currently provide each.

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

I refer the Noble Lord to the answer provided on 6 July in response to Question HL1318, which, for ease of reference, is reproduced below.

General practices (GPs) are independent business that hold contracts with the National Health Service to perform essential services to the public. We require practices to provide online consultation tools. From 1 October 2025, GPs have been required to offer access to online services throughout core hours, 8:00am to 18:30pm, bringing online access in line with walk-in and phone access. This change aims to improve patient access, reduce long phone queues, and help GPs manage demand more effectively

NHS England collects data on GP appointments, online consultation submissions, and cloud-based telephony. This data shows that 99% of practices have reported having an online consultation system in place. Where a practice does not comply with these contractual requirements, it may be in breach of contract. Patients who have concerns should contact their practice in the first instance, or raise the matter with their local integrated care board.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many GP practices have been assessed as not complying with the contractual requirement to provide online access during core hours since 1 October 2025; and what action is being taken to increase compliance.

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

I refer the Noble Lord to the answer provided on 6 July in response to Question HL1318, which, for ease of reference, is reproduced below.

General practices (GPs) are independent business that hold contracts with the National Health Service to perform essential services to the public. We require practices to provide online consultation tools. From 1 October 2025, GPs have been required to offer access to online services throughout core hours, 8:00am to 18:30pm, bringing online access in line with walk-in and phone access. This change aims to improve patient access, reduce long phone queues, and help GPs manage demand more effectively

NHS England collects data on GP appointments, online consultation submissions, and cloud-based telephony. This data shows that 99% of practices have reported having an online consultation system in place. Where a practice does not comply with these contractual requirements, it may be in breach of contract. Patients who have concerns should contact their practice in the first instance, or raise the matter with their local integrated care board.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in the light of the publication of the British Journal of General Practice study Diagnosing in the dark, published on 31 May, what discussions have they had with NHS England and GP organisations to (1) ensure that GPs receive appropriate guidance and training in diagnosing both post-natal post-traumatic stress disorder and post-natal depression and the difference between them, and (2) agree and approve a framework for assessing women’s risk of having PTSD.

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

NHS England has developed eLearning on trauma-informed care and Perinatal Mental Health Birth Trauma to support professionals involved in perinatal care.

The National Maternity and Neonatal Taskforce is developing a National Maternity and Neonatal Action Plan, within which maternal mental health is an area of focus, reflecting Baroness Amos’ recommendation for further consideration.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when they expect the National Institute for Health and Care Research review into the scope of the NHS Health Check programme to conclude; whether they intend to publish its findings; and what plans they have to respond to its recommendations.

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

The evidence review is expected to be completed during the second half of 2027, and the findings will be published shortly thereafter. We will consider the evidence as appropriate to inform future policy development.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the role of speech and language therapy in the (1) diagnosis, and (2) treatment, of rare dementias.

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

NHS England does not have specific guidance on the use of speech and language therapy for individual dementia subtypes. Similarly, the National Institute for Health and Care Excellence guideline on dementia does not make any recommendations regarding the provision of speech and language therapy for people based on dementia subtype. Referral to appropriate specialist services including speech and language therapy should be undertaken according to individual clinical presentation and need, clinical judgement, and in line with local pathways.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the forthcoming Cancer Manuals will address inequalities in care for patients with low-grade glioma.

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

The Department and NHS England are reviewing the process for developing cancer manuals, including the criteria to use in relation to rare tumour types where survival improvements have been the slowest, as well as accountability mechanisms and consultation processes. We will provide further updates in the usual way in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress has been made regarding talks taking place between AstraZeneca, Daiichi Sankyo, NHS England and NICE about the HER2-low metastatic breast cancer treatment Enhertu.

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

I am pleased to confirm that, on 17 September, the National Institute for Health and Care Excellence (NICE) announced that it is recommending Enhertu for use on the National Health Service for the treatment of certain types of breast cancer.

This is the result of an improved pricing arrangement from the companies, together with the impact of (a) recent changes to NICE's cost-effectiveness thresholds, arising from the UK-US Pharmaceutical Partnership announced on 2 April, and (b) new methods adopted by NICE for assessing quality of life, published on 27 August. Taken together, these changes mean the treatment can now be recommended for routine NHS use.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, what action they are taking to ensure Enhertu, for HER2-low metastatic breast cancer, is being made available to those who need it.

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

I am pleased to confirm that, on 17 September, the National Institute for Health and Care Excellence (NICE) announced that it is recommending Enhertu for use on the National Health Service for the treatment of certain types of breast cancer.

This is the result of an improved pricing arrangement from the companies, together with the impact of (a) recent changes to NICE's cost-effectiveness thresholds, arising from the UK-US Pharmaceutical Partnership announced on 2 April, and (b) new methods adopted by NICE for assessing quality of life, published on 27 August. Taken together, these changes mean the treatment can now be recommended for routine NHS use.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to reduce duplication in local clinical safety and implementation assurance processes for AI-enabled clinical tools that have already been assessed through a national evaluation route, such as the NHS England Ambient Voice Technology Supplier Registry.

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

NHS England's Ambient Voice Technology (AVT) Supplier Registry is designed to support National Health Service organisations in local procurement and assurance activities. It provides information on suppliers' capabilities and supporting evidence against NHS and regulatory requirements, including clinical safety, information governance, technology, and interoperability standards. The registry supports local assurance processes by providing reusable evidence and helping to reduce duplication in implementation and assurance activities.

Procurement and deployment decisions remain the responsibility of individual NHS organisations, in line with their local governance and assurance processes. Whether or not a product appears on the registry, organisations must ensure compliance with relevant legal, regulatory, and NHS requirements, including clinical safety standards, data protection legislation, cyber security requirements, and, where applicable, medical device regulations.

NHS England has established national interoperability and data standards to support the secure exchange of clinical information across settings, and is supporting both AVT and Electronic Health Record suppliers to develop these capabilities. As part of a test-and-learn approach to the adoption of AVT, NHS England is establishing a national AVT Centre of Excellence to support the sharing of learning, evidence, and implementation experience.

The Medicines and Healthcare products Regulatory Agency (MHRA) is continuing its programme of regulatory reform in relation to medical devices to protect patient safety while supporting innovation. The Post Market Surveillance regulations came into force on 16 June 2025, strengthening requirements for monitoring devices once they are placed on the market in Great Britain. Further pre-market reforms are expected in 2026.

Finally, in September 2025, the MHRA also launched the independent National Commission into the Regulation of AI in Healthcare, and the Government will consider its recommendations following publication of the report.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many appraisals by the National Institute for Health and Care Excellence for medicines indicated for kidney disease have (1) received a positive recommendation, (1) received a negative recommendation, and (3) been terminated, between June 2021 and July 2026.

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

From June 2021 to July 2026 the National Institute for Health and Care Excellence has appraised a total of seven new active substances licensed for kidney disease, seven of which were positive and zero were negative. There was one further appraisal of a kidney disease medicine that was terminated. There were no appraisals of medicines with a licence extension for kidney disease, including for rare kidney disease.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the forthcoming mental health strategy for England will address the safety of medicines with psychiatric risk profiles when prescribed for physical health indications; and how the strategy's alignment with the suicide prevention strategy for England will reflect the findings of the Health Services Safety Investigation Body's investigation into the risk of harm from propranolol.

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

The Government is developing a new cross-Government mental health strategy for England, to be published later this year. The detailed content of the mental health strategy is still being developed.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of how NHS England's Ambient Voice Technology Supplier Registry is being used in practice by NHS organisations; and whether they plan to take any steps to ensure that AI-enabled scribing tools not included on the Registry, including those provided by incumbent electronic health record suppliers, are not deployed in place of Registry-assessed tools without meeting equivalent governance and clinical safety standards.

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

NHS England's Ambient Voice Technology (AVT) Supplier Registry is designed to support National Health Service organisations in local procurement and assurance activities. It provides information on suppliers' capabilities and supporting evidence against NHS and regulatory requirements, including clinical safety, information governance, technology, and interoperability standards. The registry supports local assurance processes by providing reusable evidence and helping to reduce duplication in implementation and assurance activities.

Procurement and deployment decisions remain the responsibility of individual NHS organisations, in line with their local governance and assurance processes. Whether or not a product appears on the registry, organisations must ensure compliance with relevant legal, regulatory, and NHS requirements, including clinical safety standards, data protection legislation, cyber security requirements, and, where applicable, medical device regulations.

NHS England has established national interoperability and data standards to support the secure exchange of clinical information across settings, and is supporting both AVT and Electronic Health Record suppliers to develop these capabilities. As part of a test-and-learn approach to the adoption of AVT, NHS England is establishing a national AVT Centre of Excellence to support the sharing of learning, evidence, and implementation experience.

The Medicines and Healthcare products Regulatory Agency (MHRA) is continuing its programme of regulatory reform in relation to medical devices to protect patient safety while supporting innovation. The Post Market Surveillance regulations came into force on 16 June 2025, strengthening requirements for monitoring devices once they are placed on the market in Great Britain. Further pre-market reforms are expected in 2026.

Finally, in September 2025, the MHRA also launched the independent National Commission into the Regulation of AI in Healthcare, and the Government will consider its recommendations following publication of the report.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the outcome of NHS England's gap analysis on fresh-frozen tissue preservation capacity; and what is the timetable for implementing any recommendations arising from it.

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

NHS England is currently considering the sites requiring additional freezer capacity as a result of its gap analysis. Further details will be published in the usual way in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the National Institute for Health and Care Excellence plans to develop guidelines on rare dementias.

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

There are no such plans at present, but the National Institute for Health and Care Excellence continues to consider any new proposals for guidance development in line with its normal prioritisation process.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to improve access to allied health professionals for people living with rare diseases.

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

Integrated care boards are responsible for planning and commissioning health services for their local population, and this will include services provided by allied health professionals for people living with rare diseases.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to require electronic health record systems to support open, standards-based interoperability, so that clinical documentation generated by AI-enabled tools can be exchanged securely across NHS settings.

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

NHS England's Ambient Voice Technology (AVT) Supplier Registry is designed to support National Health Service organisations in local procurement and assurance activities. It provides information on suppliers' capabilities and supporting evidence against NHS and regulatory requirements, including clinical safety, information governance, technology, and interoperability standards. The registry supports local assurance processes by providing reusable evidence and helping to reduce duplication in implementation and assurance activities.

Procurement and deployment decisions remain the responsibility of individual NHS organisations, in line with their local governance and assurance processes. Whether or not a product appears on the registry, organisations must ensure compliance with relevant legal, regulatory, and NHS requirements, including clinical safety standards, data protection legislation, cyber security requirements, and, where applicable, medical device regulations.

NHS England has established national interoperability and data standards to support the secure exchange of clinical information across settings, and is supporting both AVT and Electronic Health Record suppliers to develop these capabilities. As part of a test-and-learn approach to the adoption of AVT, NHS England is establishing a national AVT Centre of Excellence to support the sharing of learning, evidence, and implementation experience.

The Medicines and Healthcare products Regulatory Agency (MHRA) is continuing its programme of regulatory reform in relation to medical devices to protect patient safety while supporting innovation. The Post Market Surveillance regulations came into force on 16 June 2025, strengthening requirements for monitoring devices once they are placed on the market in Great Britain. Further pre-market reforms are expected in 2026.

Finally, in September 2025, the MHRA also launched the independent National Commission into the Regulation of AI in Healthcare, and the Government will consider its recommendations following publication of the report.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many appraisals by the National Institute for Health and Care Excellence for follow-on indications for (1) kidney disease and (2) rare kidney disease have (a) received a negative recommendation, or (b) been terminated, between June 2021 and July 2026.

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

From June 2021 to July 2026 the National Institute for Health and Care Excellence has appraised a total of seven new active substances licensed for kidney disease, seven of which were positive and zero were negative. There was one further appraisal of a kidney disease medicine that was terminated. There were no appraisals of medicines with a licence extension for kidney disease, including for rare kidney disease.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they intend to publish regular national and integrated care board-level progress reports against the metrics set out in the Cardiovascular Disease Modern Service Framework.

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

The Cardiovascular Disease Modern Service Framework, published in July 2026, sets out metrics for each of its 12 priority actions. These metrics will underpin performance monitoring and accountability for delivery of the framework.

The Department and NHS England will publish performance data routinely, using it to identify variation and outliers and drive improvement at system and provider level. We will say more about the timelines for these publications in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 15 July (HL1814), what evidence they relied on when describing reviews conducted using the Perinatal Mortality Review Tool as “high-quality”, “objective” and “robust”; and how that description is reconciled with the finding of the December 2023 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK state of the nation report that, of 66 local PMRT reviews considered, only three were assessed as being of “good” quality.

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

The Government recognises the concerns raised about how perinatal mortality reviews are carried out. The Perinatal Mortality Review Tool provides a framework which needs to also be supported by effective implementation to deliver the objectives of these reviews.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, is chairing the Maternity and Neonatal Taskforce to develop a national action plan to reform maternity and neonatal services. As Baroness Amos’ report makes clear, there is a pressing need to improve the quality, transparency, oversight, and accountability of investigations and we are working with the taskforce to review this.

With regard to coronial investigation of stillbirth, I refer the Noble Lord to the answer provided on 15 July in response to Question HL1814, which, for ease of reference, has been reproduced below:

“All bereaved parents have the option to be involved in a high-quality review of the death of their baby, from 22 weeks' gestation up to 28 days post birth, through a perinatal mortality review. While this is carried out by the hospital or hospitals where the mother and baby were looked after, a national tool is in place, namely the national Perinatal Mortality Review Tool, to ensure such reviews are objective, robust, and standardised.

“There are a range of views on how stillbirths should be investigated, and it is important that the Government’s conclusions on coronial investigations of stillbirths reflect the recommendations Baroness Amos has made through the final report of her independent investigation into National Health Service maternity and neonatal care, and supports the most effective model for maternity investigations.

“As recommended in Baroness Amos’ report, we will publish the Government’s response to the 2019 consultation, jointly with the Ministry of Justice, in due course.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 15 July (HL1814), which specific findings or recommendations in the final report of the National Maternity and Neonatal Investigation they consider relevant to determining whether coroners should be permitted to investigate stillbirths, other than the recommendation that the Government publish its response to the consultation conducted in 2019; and when that response will be published.

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

The Government recognises the concerns raised about how perinatal mortality reviews are carried out. The Perinatal Mortality Review Tool provides a framework which needs to also be supported by effective implementation to deliver the objectives of these reviews.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, is chairing the Maternity and Neonatal Taskforce to develop a national action plan to reform maternity and neonatal services. As Baroness Amos’ report makes clear, there is a pressing need to improve the quality, transparency, oversight, and accountability of investigations and we are working with the taskforce to review this.

With regard to coronial investigation of stillbirth, I refer the Noble Lord to the answer provided on 15 July in response to Question HL1814, which, for ease of reference, has been reproduced below:

“All bereaved parents have the option to be involved in a high-quality review of the death of their baby, from 22 weeks' gestation up to 28 days post birth, through a perinatal mortality review. While this is carried out by the hospital or hospitals where the mother and baby were looked after, a national tool is in place, namely the national Perinatal Mortality Review Tool, to ensure such reviews are objective, robust, and standardised.

“There are a range of views on how stillbirths should be investigated, and it is important that the Government’s conclusions on coronial investigations of stillbirths reflect the recommendations Baroness Amos has made through the final report of her independent investigation into National Health Service maternity and neonatal care, and supports the most effective model for maternity investigations.

“As recommended in Baroness Amos’ report, we will publish the Government’s response to the 2019 consultation, jointly with the Ministry of Justice, in due course.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 15 July (HL1814), whether they consider a review conducted by the hospital or hospitals responsible for the care under review to constitute an independent investigation; and, if not, what independent investigatory route is available following an antepartum stillbirth where the parents do not dispute that the baby was stillborn.

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

The Government recognises the concerns raised about how perinatal mortality reviews are carried out. The Perinatal Mortality Review Tool provides a framework which needs to also be supported by effective implementation to deliver the objectives of these reviews.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, is chairing the Maternity and Neonatal Taskforce to develop a national action plan to reform maternity and neonatal services. As Baroness Amos’ report makes clear, there is a pressing need to improve the quality, transparency, oversight, and accountability of investigations and we are working with the taskforce to review this.

With regard to coronial investigation of stillbirth, I refer the Noble Lord to the answer provided on 15 July in response to Question HL1814, which, for ease of reference, has been reproduced below:

“All bereaved parents have the option to be involved in a high-quality review of the death of their baby, from 22 weeks' gestation up to 28 days post birth, through a perinatal mortality review. While this is carried out by the hospital or hospitals where the mother and baby were looked after, a national tool is in place, namely the national Perinatal Mortality Review Tool, to ensure such reviews are objective, robust, and standardised.

“There are a range of views on how stillbirths should be investigated, and it is important that the Government’s conclusions on coronial investigations of stillbirths reflect the recommendations Baroness Amos has made through the final report of her independent investigation into National Health Service maternity and neonatal care, and supports the most effective model for maternity investigations.

“As recommended in Baroness Amos’ report, we will publish the Government’s response to the 2019 consultation, jointly with the Ministry of Justice, in due course.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 15 July (HL1814), what safeguards exist to prevent uncertainty or error in the assessment of gestational age, or in the retrospective classification of a stillbirth as antepartum or intrapartum, from determining whether bereaved parents have access to an independent investigation.

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

The Government recognises the concerns raised about how perinatal mortality reviews are carried out. The Perinatal Mortality Review Tool provides a framework which needs to also be supported by effective implementation to deliver the objectives of these reviews.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, is chairing the Maternity and Neonatal Taskforce to develop a national action plan to reform maternity and neonatal services. As Baroness Amos’ report makes clear, there is a pressing need to improve the quality, transparency, oversight, and accountability of investigations and we are working with the taskforce to review this.

With regard to coronial investigation of stillbirth, I refer the Noble Lord to the answer provided on 15 July in response to Question HL1814, which, for ease of reference, has been reproduced below:

“All bereaved parents have the option to be involved in a high-quality review of the death of their baby, from 22 weeks' gestation up to 28 days post birth, through a perinatal mortality review. While this is carried out by the hospital or hospitals where the mother and baby were looked after, a national tool is in place, namely the national Perinatal Mortality Review Tool, to ensure such reviews are objective, robust, and standardised.

“There are a range of views on how stillbirths should be investigated, and it is important that the Government’s conclusions on coronial investigations of stillbirths reflect the recommendations Baroness Amos has made through the final report of her independent investigation into National Health Service maternity and neonatal care, and supports the most effective model for maternity investigations.

“As recommended in Baroness Amos’ report, we will publish the Government’s response to the 2019 consultation, jointly with the Ministry of Justice, in due course.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to apply the core pillars of the renewed women’s health strategy for England to the treatment of migraine, in light of its higher prevalence in women than men.

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

Improving care for people with migraine, including those whose symptoms are associated with menopause, is supported through a range of National Health Service initiatives. National Institute for Health and Care Excellence guidance provides evidence-based recommendations on the diagnosis and management of migraine, while NHS England supports improvements in headache and migraine services through initiatives such as the NHS RightCare Headache and Migraine Toolkit, which aims to improve pathways between primary and specialist care and ensure patients receive the right intervention at the earliest opportunity.

NHS England announced on 10 September that migraine would be added to the list of conditions for which individuals can get further support from participating prescribing pharmacies under the Pharmacy First programme, later this autumn. While migraine affects a higher proportion of women than men, the services referred to above are available to both men and women in need of support.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to improve the care pathway for migraines associated with menopause.

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

Improving care for people with migraine, including those whose symptoms are associated with menopause, is supported through a range of National Health Service initiatives. National Institute for Health and Care Excellence guidance provides evidence-based recommendations on the diagnosis and management of migraine, while NHS England supports improvements in headache and migraine services through initiatives such as the NHS RightCare Headache and Migraine Toolkit, which aims to improve pathways between primary and specialist care and ensure patients receive the right intervention at the earliest opportunity.

NHS England announced on 10 September that migraine would be added to the list of conditions for which individuals can get further support from participating prescribing pharmacies under the Pharmacy First programme, later this autumn. While migraine affects a higher proportion of women than men, the services referred to above are available to both men and women in need of support.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what training is provided to NHS staff on the prevention of migraine and on the workplace adjustments that should be made for staff who experience migraine.

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

Improving care for people with migraine, including those whose symptoms are associated with menopause, is supported through a range of National Health Service initiatives. National Institute for Health and Care Excellence guidance provides evidence-based recommendations on the diagnosis and management of migraine, while NHS England supports improvements in headache and migraine services through initiatives such as the NHS RightCare Headache and Migraine Toolkit, which aims to improve pathways between primary and specialist care and ensure patients receive the right intervention at the earliest opportunity.

NHS England announced on 10 September that migraine would be added to the list of conditions for which individuals can get further support from participating prescribing pharmacies under the Pharmacy First programme, later this autumn. While migraine affects a higher proportion of women than men, the services referred to above are available to both men and women in need of support.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what criteria NHS England will use to determine which planned treatment areas are suitable for inclusion in NHS Online.

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

NHS Online is being built using existing virtual outpatient models, learning from the delivery of virtual consultations carried out during the COVID-19 pandemic, and from other examples in the United Kingdom and overseas. Clinical experts are helping to assess planned care pathways against several criteria to understand their suitability for virtual delivery, including diagnostic complexity, and assessments of safety and risk.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of existing virtual outpatient models in the development of NHS Online.

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

NHS Online is being built using existing virtual outpatient models, learning from the delivery of virtual consultations carried out during the COVID-19 pandemic, and from other examples in the United Kingdom and overseas. Clinical experts are helping to assess planned care pathways against several criteria to understand their suitability for virtual delivery, including diagnostic complexity, and assessments of safety and risk.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in light of the NHS Oversight Framework including vaccination metrics for only the measles, mumps, rubella and varicella and healthcare worker influenza vaccination programmes, what steps they will take to ensure robust accountability for all national vaccination programmes following the transfer of commissioning responsibilities to Integrated Care Boards from April 2027.

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

We have established a programme that will, alongside closer working and a safe transfer checklist, help to ensure that integrated care boards (ICBs) are ready to take on their new responsibilities for vaccination from April 2027. We will also ensure there is appropriate accountability for vaccination services after the responsibility for their commissioning is delegated to ICBs. Work is ongoing and aligned to the merger of the Department of Health and Social Care and NHS England.

No changes in the current reporting frameworks in this area are planned, but we keep all such matters under regular review.

The Department does not collect data on the costs of responding to outbreaks of vaccine-preventable infectious disease, but the methodology for assessing the cost-effectiveness of vaccination programmes routinely accounts for benefits such as avoided National Health Service and social care costs, as well as improved health outcomes.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what consideration they gave to placing a statutory duty on the Secretary of State to lay before Parliament an annual report on the performance of national immunisation programmes, including health inequalities and progress towards national targets, when developing the Health Bill.

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

We have established a programme that will, alongside closer working and a safe transfer checklist, help to ensure that integrated care boards (ICBs) are ready to take on their new responsibilities for vaccination from April 2027. We will also ensure there is appropriate accountability for vaccination services after the responsibility for their commissioning is delegated to ICBs. Work is ongoing and aligned to the merger of the Department of Health and Social Care and NHS England.

No changes in the current reporting frameworks in this area are planned, but we keep all such matters under regular review.

The Department does not collect data on the costs of responding to outbreaks of vaccine-preventable infectious disease, but the methodology for assessing the cost-effectiveness of vaccination programmes routinely accounts for benefits such as avoided National Health Service and social care costs, as well as improved health outcomes.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the costs associated with responding to outbreaks of vaccine-preventable diseases in 2025–26; whether they collect data on the costs of vaccine procurement and deployment, and outbreak response by disease; and, if so, whether they intend to publish this information.

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

We have established a programme that will, alongside closer working and a safe transfer checklist, help to ensure that integrated care boards (ICBs) are ready to take on their new responsibilities for vaccination from April 2027. We will also ensure there is appropriate accountability for vaccination services after the responsibility for their commissioning is delegated to ICBs. Work is ongoing and aligned to the merger of the Department of Health and Social Care and NHS England.

No changes in the current reporting frameworks in this area are planned, but we keep all such matters under regular review.

The Department does not collect data on the costs of responding to outbreaks of vaccine-preventable infectious disease, but the methodology for assessing the cost-effectiveness of vaccination programmes routinely accounts for benefits such as avoided National Health Service and social care costs, as well as improved health outcomes.