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 current overspends in systems in the NHS, and the impact of those overspends on winter resilience.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As of July 2025, there is a total system overspend of £172 million, which includes some of the impact of industrial action and reflects held back deficit support funding. The issues are very concentrated, with six systems accounting for more than half of the total overspend. At the same point last year, systems had overspent by £487 million, so we are seeing strong signs of improvement following the changes made as part of the NHS Financial Reset.
Overspends must be addressed through improved financial management and they should not undermine the National Health Service’s ability to respond to winter pressures. As set out in the 2025/26 Urgent and Emergency Care Plan, the NHS is focused on improvements that will see the biggest impact on urgent and emergency care performance this winter, including improved hospital flow, reduced ambulance handover times, and improved vaccination uptake among frontline staff.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many times the Secretary of State for Health and Social Care has met the NHS Staff Council since 1 January.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Secretary of State for Health and Social Care and the Minister of State for Health meet regularly with individual Agenda for Change (AfC) trade union leaders and with representatives of NHS organisations to discuss matters affecting the NHS workforce.
It is not usual practice for Ministers to attend NHS Staff Council meetings, which are used to discuss policy issues affecting the AfC workforce and to maintain the NHS terms and conditions of service. Accordingly, there have been no meetings between the Secretary of State and the NHS Staff Council as a whole since 1 January.
Both ministers have written to the NHS Staff Council on issues relating to AfC pay, terms, and conditions since 1 January, and Department officials continue to attend meetings of the NHS Staff Council.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will publish the results of the "war game" exercise carried out as part of the NHS's winter preparations.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There are no plans to publish individual National Health Service system's plans or the outcomes of stress-testing centrally. System winter plans are locally owned and created in order to meet specific local needs and circumstances and are best communicated by NHS organisations locally. Nationally, the actions being taken to prepare for this coming winter are set out in the Urgent and Emergency Care Plan for 2025/26. A copy of this plan is attached.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to increase the number of mental health practitioners employed in primary care through the Additional Roles Reimbursement Scheme.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Through the Additional Roles Reimbursement Scheme (ARRS), Primary Care Networks (PCNs) recruit additional staff including mental health practitioners (MHPs), pharmacists, physiotherapists, and social prescribing link workers. There are a wide range of clinicians that are well suited to providing care in general practice as part of a multi-disciplinary team, and these roles are in place to assist doctors in general practice in reducing their workload, assisting patients directly with their needs, allowing doctors to focus on more complex patients and other priorities, including continuity of care.
As of 30 June 2025, there were 1,158 full time equivalent (FTE) MHPs working across practices and PCNs in England, an increase of 314 FTE compared with June 2023, when the time series in the collated data began.
While there are no specific plans to increase the number of MHPs employed through the ARRS, under changes to the GP contract announced earlier in the year the scheme will become more flexible to allow PCNs to respond better to local workforce needs. The two ARRS pots will be combined to create a single pot for reimbursement of patient facing staff costs. There will be no restrictions on the number or type of staff covered, including mental health practitioners.
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 impact on (1) the number of individuals on the NHS elective waiting list, and (2) the average waiting times, of each strike day by resident doctors.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We know that industrial action has hugely damaging impacts on hospital care, including elective waiting times. National Health Service industrial action cost taxpayers £1.7 billion in the 2023/24 financial year. Nearly 1.5 million appointments were rescheduled due to strikes between December 2022 and July 2024.
Planning and mitigation for any prospective strikes are underway, supported by internal assessments of the possible impact based on previous industrial action.
NHS England has published data on the impact from previous industrial action on completed pathways for consultant-led elective services on the days of, and immediately surrounding, the strikes, with further information available on the NHS England website.
Asked by: Lord Mott (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many instances of debt write-off for NHS treatment of overseas visitors there have been in the past 12 months.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does not hold or collect the information requested.
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.