Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the answer by Baroness Merron on 24 June (HL Deb col 657), what steps they are taking to ensure resistant hypertension is addressed as part of the cardiovascular disease modern service framework implementation, given that the framework published on 7 July does not reference resistant hypertension as a distinct, high-risk subgroup.

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

The Cardiovascular Disease Modern Service Framework sets 12 immediate priorities for the next three years, each with measures and three- and ten-year ambitions. These include treating people with hypertension, including resistant hypertension, to evidence-based targets, with progress tracked through the accompanying measure.

The delivery model set out in the published framework directs systems to use population health data to identify and manage underserved and high-risk populations.

Clinicians are advised to follow the National Institute for Health and Care Excellence’s guidelines for the management of resistance hypertension.

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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in light of the UK expert clinical consensus statement on renal denervation published in Heart journal in November 2025 that found 93 per cent of surveyed UK clinicians support the NHS and National Institute for Health and Care Excellence to update their respective commissioning policy and guidance, what plans they have to update current guidance to enable the routine commissioning of renal denervation.

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

NHS England is reviewing the clinical evidence for the commissioning of renal denervation treatment. The National Institute for Health and Care Excellence is an independent body with its own processes for reviewing and updating its guidance, taking account of the best available evidence of both clinical and cost effectiveness.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the case for establishing a reimbursement pathway for renal denervation as a treatment for resistant hypertension, given that it is approved and commercially available in a number of comparable healthcare systems internationally but is not routinely commissioned by the NHS.

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

NHS England is reviewing the clinical evidence for the commissioning of renal denervation treatment. The National Institute for Health and Care Excellence is an independent body with its own processes for reviewing and updating its guidance, taking account of the best available evidence of both clinical and cost effectiveness.

Question to the Department for Work and Pensions:

To ask His Majesty's Government, further to the Written Answer by Baroness Sherlock on 15 September (HL3068), given that of the organisations mentioned only British Bank provides start-up funding, and given that they reject large numbers of unemployed applicants, what conversations they have had with microfinance organisations that provide mentoring and loans between £500 and £5,000 to unemployed people to help start their own businesses.

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

As referenced in the response to HL3068 on 15 September 2026, 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, including in relation to finance, to support people to start a business.

The Department for Work and Pensions does not offer financial advice about business loans or advise customers about specific loan providers. Therefore, the department has not engaged with specific microfinance organisations that provide loans to unemployed people to help them start their own business.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the number of eye-related attendances at emergency departments in England that could be safely managed in community optometry settings.

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

I refer the Noble Lord to the answer provided in the House of Commons on 11 September in response to Question 26418 which, for ease of reference, is reproduced below:

“Integrated care boards are responsible for deciding whether to commission enhanced eye care services from high street optical practices to meet the needs of their local populations. This is in line with the 10-Year Health Plan’s commitment to local decision making.

“As part of our 10-Year Health Plan, the Department is investing £20 million to equip high street optometrists with the digital tools they need to refer patients faster and more accurately, helping more people get convenient eye care closer to home.

“Accident and emergency departments should still be used for genuine emergencies, and we expect patients to be assessed and directed to the service that best meets their needs.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to increase public awareness of community optometry services as an alternative to emergency departments for urgent eye conditions.

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

I refer the Noble Lord to the answer provided in the House of Commons on 11 September in response to Question 26418 which, for ease of reference, is reproduced below:

“Integrated care boards are responsible for deciding whether to commission enhanced eye care services from high street optical practices to meet the needs of their local populations. This is in line with the 10-Year Health Plan’s commitment to local decision making.

“As part of our 10-Year Health Plan, the Department is investing £20 million to equip high street optometrists with the digital tools they need to refer patients faster and more accurately, helping more people get convenient eye care closer to home.

“Accident and emergency departments should still be used for genuine emergencies, and we expect patients to be assessed and directed to the service that best meets their needs.”

Question to the Department of Health and Social Care:

To ask His Majesty's Government, following the reply by Baroness Merron on 15 September (HL Deb col 1073) that health and well-being boards "are responsible for drawing up the local plans for what the locality needs" to whom the health and well-being board is accountable if they do not deliver sufficient social care at the neighbourhood level

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

Health and wellbeing boards are statutory committees of local authorities with a strategic role in assessing local needs and developing plans for improving health and wellbeing. They are not responsible for delivering adult social care services.

Neighbourhood health plans set out the agreed strategy for meeting health and care needs of a local population. As set out in guidance, these plans are developed jointly by local government, the National Health Service, and their partners, and form part of a continuous process of strategic assessment and planning.

Responsibility for the commissioning and delivery of adult social care remains with local authorities. Under the Care Act 2014, local authorities have duties to shape their local and ensure the availability of services that meet the needs of their population.

Local authorities are accountable for the discharge of those statutory responsibilities through the established local government accountability framework.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the virtual triage model used at Barking, Havering and Redbridge University Hospitals NHS Trust; and whether they plan for this to inform the development of NHS Online.

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

NHS Online is being developed using evidence and learning from existing virtual outpatient services and wider digital healthcare models across the National Health Service and internationally. It is being designed with input from patients and clinical experts to ensure services are safe, effective, and appropriate for virtual delivery. The impact of NHS Online will be monitored as the programme develops and is implemented.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to publish an evaluation framework for NHS Online to assess its impact on waiting times, outpatient attendance, diagnostic turnaround times, patient outcomes and health inequalities.

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

NHS Online is being developed using evidence and learning from existing virtual outpatient services and wider digital healthcare models across the National Health Service and internationally. It is being designed with input from patients and clinical experts to ensure services are safe, effective, and appropriate for virtual delivery. The impact of NHS Online will be monitored as the programme develops and is implemented.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to support integrated care boards to adopt virtual outpatient pathways before NHS Online launches in 2027.

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

NHS Online is being developed using evidence and learning from existing virtual outpatient services and wider digital healthcare models across the National Health Service and internationally. It is being designed with input from patients and clinical experts to ensure services are safe, effective, and appropriate for virtual delivery. The impact of NHS Online will be monitored as the programme develops and is implemented.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they consider the factual summary of consultation responses published on 7 December 2023 to constitute the report required by section 4 of the Civil Partnerships, Marriages and Deaths (Registration etc.) Act 2019; on what basis they consider the statutory duty to have been fulfilled; and on what date the five-year period provided for by section 4 began.

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

The Department of Health and Social Care and the Ministry of Justice jointly consulted on proposals to provide coroners with new powers to investigate term stillbirths in 2019. The factual summary of responses to the consultation, published in 2023, set out the feedback received from respondents but did not give a Government view on whether, and if so how, the law ought to be changed to enable or require coroners to investigate stillbirths.

Following the publication of Baroness Amos’ independent investigation into National Health Service maternity and neonatal services, the Government has committed to publishing a response to the 2019 consultation in due course. The five-year period provided for by section 4 of the 2019 act begins on the date when the Government publishes its report into whether and how to change the law on coronial investigations of stillbirths.

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Found: After Clause 3 LORD KAMALL EARL HOWE _ After Clause 3, insert the following new Clause— “Abolition

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Found: 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] After Clause 3 LORD KAMALL

Found: 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] After Clause 3 LORD KAMALL

Found: 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] After Clause 3 LORD KAMALL

Found: 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] After Clause 3 LORD KAMALL

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