Asked by: Lord Mott (Conservative - Life peer)
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 May (HL7354), what factors the UK Health Security Agency's forum has identified impacting the decline in uptake; and what immediate actions the forum has suggested to improve access to services and to address other potential barriers.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In 2023, at the request of the Joint Committee on Vaccination and Immunisation (JCVI), a forum for the four nations of the United Kingdom on inequalities and declining coverage across the routine immunisation programmes was set up. This time-limited group brought together relevant stakeholders from across the UK nations of England, Scotland, Wales, and Northern Ireland. Ten deep dives took place in total, ending in June 2025.
These forums facilitated sharing experiences and learning within and across each nation. They explored possible contributing factors to declining coverage across the UK routine immunisation programmes. Areas for further activity included data collection systems, attitudinal work, delivery models, system leadership and coordination, commonalities and difference with other public health programmes.
Immediate actions have included expanding annual attitudinal surveys of parents of infants from England to UK wide, to further strengthen understanding of barriers and facilitators to vaccination uptake. Updating and strengthening training and quality standards for healthcare professionals providing clear expectations and guidance. Sharing expertise to improve data systems and data collection as well as strengthening collaboration with the Department of Education to improve uptake in educational settings.
A final report from the outputs of the UK Forum will be compiled and presented to a future JCVI meeting.
Asked by: Lord Mott (Conservative - Life peer)
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 May (HL7354), how many meetings the UK Health Security Agency (UKHSA) forum will have in 2025–26; and what engagement UKHSA has planned with stakeholders.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In 2023, at the request of the Joint Committee on Vaccination and Immunisation (JCVI), a forum for the four nations of the United Kingdom on inequalities and declining coverage across the routine immunisation programmes was set up. This time-limited group brought together relevant stakeholders from across the UK nations of England, Scotland, Wales, and Northern Ireland. Ten deep dives took place in total, ending in June 2025.
These forums facilitated sharing experiences and learning within and across each nation. They explored possible contributing factors to declining coverage across the UK routine immunisation programmes. Areas for further activity included data collection systems, attitudinal work, delivery models, system leadership and coordination, commonalities and difference with other public health programmes.
Immediate actions have included expanding annual attitudinal surveys of parents of infants from England to UK wide, to further strengthen understanding of barriers and facilitators to vaccination uptake. Updating and strengthening training and quality standards for healthcare professionals providing clear expectations and guidance. Sharing expertise to improve data systems and data collection as well as strengthening collaboration with the Department of Education to improve uptake in educational settings.
A final report from the outputs of the UK Forum will be compiled and presented to a future JCVI meeting.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many children received flu vaccinations in school nurseries in the 2024–25 pilot run; and what plans they have to scale this initiative.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
School based vaccination is provided by School Age Immunisation Services (SAISs). In January 2025, some SAIS providers trialled expanding their flu vaccination offer by running catch up clinics in nurseries located in primary schools. This was to encourage flu vaccine uptake for two to three year-olds who had not already been vaccinated via their general practices (GPs). As these were local pilots, delivered by some providers in Yorkshire and the East of England, NHS England does not hold this data nationally.
Ahead of the flu 2025/26 season, the SAIS Service Specification 2025/26 is currently being improved. This will enable SAIS providers to support flu vaccination for two to three year olds, in a variety of different settings, and any plans, supplementary to the core GP offer, will be based on if there is a need locally. Evaluations will be undertaken at a local level by NHS England’s regional commissioning teams as part of their contract and performance management.
This initiative aligns with broader efforts to strengthen the childhood vaccination offer and improve vaccine uptake, including exploring the role of community pharmacies, as outlined in the NHS Vaccination Strategy, and trialling the use of health visitors to administer childhood immunisations, thereby increasing access for underserved families across selected areas.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government following the joint statement released on 9 June by the British Association of Urological Surgeons and Prostate Cancer UK regarding the poor utility of the digital rectal examination as a test for prostate cancer, whether they will review the current clinical guidelines and referral criteria to remove “outdated” testing and ensure men at highest risk of prostate cancer can be diagnosed faster, fairer and better.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to ensuring that all patients with cancer, including prostate cancer, are diagnosed faster and with the best diagnostic approaches. The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based guidance on best practice for health and social care professionals in England.
Current NICE guidance does not recommend digital rectal examination for diagnosing prostate cancer. NICE does recommend digital rectal examination as part of the physical examination that should be offered to all men with lower urinary tract symptoms as part of their initial assessment. If their prostate is assessed as likely malignant, they should be referred using a suspected cancer pathway referral for prostate cancer. To date, NICE has found no evidence that affects these recommendations or the need to review the current guidelines.
NICE is monitoring studies relating to the identification of prostate cancer in primary care and will consider the findings, when available, to assess if its recommendations need to be reviewed.
To further improve how we diagnose prostate cancer, the Government has invested £16 million in the United Kingdom-wide TRANSFORM trial, aimed at helping to find the best ways of detecting prostate cancer in men, even if they are not displaying any symptoms.
Furthermore, NHS England has introduced a best-practice timed pathway for prostate cancer so that those suspected of prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures that only those men most at risk of having cancer undergo an invasive biopsy. The AI in Health and Care Award has also been established, which aims to accelerate the testing and development of artificial intelligence (AI) technologies that align with the NHS Long Term Plan. £113 million has already allocated to support 86 AI technologies, and three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford.
We will also publish a new National Cancer Plan later this year, which will include further details on how we will improve diagnostics, access to treatments, and outcomes for all tumour types, including prostate cancer.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how they plan to reflect the proposals set out in the NHS vaccination strategy in the 10 Year Health Plan.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department and NHS England are working collaboratively on the development of the 10-Year Health Plan, including through independent investigation, a public engagement exercise, and wider policy development.
It is too early to say exactly what the 10-Year Health Plan will look like, but what is certain is that delivering on prevention will remain a priority as part of the plan’s three shifts to get the health service and the nation’s health thriving once again.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the causes of the fall in childhood vaccination coverage rates since 2013–14.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Recent data from the UK Health Security Agency (UKHSA) and NHS England indicates a decline in coverage for childhood vaccination programmes. The extent of these changes varies depending on the specific vaccination programme and the age group being considered.
Public concerns about the level of preschool vaccination uptake prompted the National Audit Office to investigate the reasons behind the decline. The report identified several structural issues, including fragmented program delivery, difficult access for parents, and inconsistencies in professional communication. The copy of the full report is attached.
The Government is committed to having high uptake in all our vaccination programmes, and has an established independent scientific advisory group, the Joint Committee on Vaccination and Immunisation (JCVI), which is responsible for advising United Kingdom health departments on immunisations for the prevention of infections and/or disease.
The UKHSA has also established a forum bringing together the four UK nations to review factors impacting the decline in uptake, and to identify actions and shared learning to improve access to services and to address other potential barriers.
The UKHSA conducts research to assess public confidence in national vaccination programmes. Annual surveys consistently show that confidence in vaccination remains high.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the average NHS waiting time for cataract surgery; and how many patients are currently waiting.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently 80,935 patients waiting for cataract surgery. The average National Health Service waiting time for this procedure is 15.6 weeks.
The Government is committed to putting patients first. We will ensure 92% of patients return to waiting no longer than 18 weeks from referral to treatment by March 2029, a standard which has not been met consistently since September 2015.
We are proceeding with our commitment to cutting NHS waiting lists and ensuring people have the best possible experience during their care. We have delivered a reduction in the list of 160,000 pathways as well as provided over two million extra appointments, including for ophthalmology.
NHS England is also testing how improved IT connectivity between primary care optometry and secondary eye care services could improve the referral process and allow for the virtual triage of patients. This also includes looking at whether patients can be managed in the community, freeing up hospital eye clinic capacity for patients that need face to face specialist input.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the average NHS waiting time for hip replacement surgery; and how many patients are currently waiting.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently 31,323 patients waiting for a hip replacement. The average mean National Health Service waiting time for hip replacement surgery is 27.4 weeks.
The Government is working to reduce the number of patients awaiting treatment across the country. The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS Constitutional Standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment RTT by the end of this Parliament and also ensure patients have the best possible experience of care.
We have set an ambition for 2025/26 that we reach 65% of patients waiting no longer than 18 weeks nationally, and for all trusts to deliver a minimum five percentage point improvement by March 2026.
The Elective Reform Plan has committed to providing quicker access for patients to common surgical procedures by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.
Dedicated and protected surgical hubs are transforming the way the NHS providers elective care by focusing on high volume low complexity surgeries. There are currently 113 elective surgical hubs that are operational across England as of February 2025. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the average NHS waiting time for knee replacement surgery; and how many patients are currently waiting.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently 49,509 patients waiting for a knee replacement. The mean average National Health Service waiting time for this procedure is 28.7 weeks.
The Government is working to reduce the number of patients awaiting treatment across the country. The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS constitutional standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment by the end of this Parliament, and will also ensure that patients have the best possible experience of care.
We have set an ambition for 2025/26 that we reach 65% of patients waiting no longer than 18 weeks nationally, and for all trusts to deliver a minimum 5% improvement by March 2026.
The Elective Reform Plan has committed to providing quicker access for patients to common surgical procedures by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out. Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries.
There are currently 113 elective surgical hubs that are operational across England as of February 2025. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the cost to the NHS of (1) hip replacement surgery, (2) knee replacement surgery, and (3) cataract surgery.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In the financial year 2023/24, there were 120,172 hip procedures performed at a total cost of £1,241,784,028.35, with an average unit cost of £10,333.39. There were 86,781 knee procedures performed at a total cost of £737,241,451.39, with an average unit cost of £8,495.42. There were an additional 13,811 complex cases for hip or knee procedures performed at a total cost of £220,792,075.13, with an average unit cost of £15,986.68. The total cost for 246,995 cataract procedures was £363,849,348.97, with an average unit cost of £1,473.10.