Lord Scriven

The Manchester Task Force (MTF) began meeting in February 2020, made up of Department for Transport, Network Rail, train operators, Rail North Partnership, Transport for the North and Transport for Greater Manchester. Through gathering evidence, developing options and publicly consulting, the task force identified a range of short and long-term actions to improve the performance of the railway in Manchester/across the North and support future growth in passengers.

The task force identified the Sheffield-Manchester Airport service, which reversed at Manchester Piccadilly, consuming two train paths in each direction, as one of the worst performing, with a significant impact on delays across the network.

The new timetable developed by MTF has delivered improvements in reliability of around 30 per cent, and the task force concept is now being used to resolve issues on the East Coast main line. As new infrastructure is realised and longer trains allow for a greater capacity with less congestion, we will look at services that could be reintroduced, possibly including direct services from Sheffield to the Airport, although there could be other towns and cities making a case for their pre-2022 direct connections to be restored as well.

This service was withdrawn in December 2022 in the timetable developed by the Manchester Task Force, a cross-industry group comprising of Transport for the North, train operators and Network Rail, to deliver more reliable services through Manchester.

The task force identified the Sheffield-Manchester Airport service, which reverses at Manchester Piccadilly, consuming two train paths in each direction, as one of the worst performing, with a significant impact on delays across the network.

The new timetable has delivered improvements in reliability of around 30 per cent, and the task force concept is now being used to resolve issues on the East Coast main line. As new infrastructure is realised and longer trains allow for a greater capacity with less congestion, we will look at services that could be reintroduced, possibly including direct services from Sheffield to the Airport, though there could be other towns and cities making a case for their pre-2022 direct connections to be restored as well.

I wrote to the Noble Lord in July, explaining this service was withdrawn in December 2022 as part of the Manchester Task Force’s proposals to address the challenges of Manchester’s constrained capacity. We remain committed to improved rail connectivity in growing the Northern and national economy.

East Midlands Railway’s (EMR’s) new Aurora bi-mode trains (electric and diesel) are currently being built by Hitachi at its Newton Aycliffe factory in County Durham. The first three trains are doing test runs on the East Coast and Midland Main Lines. EMR currently expect that the trains will start to be introduced on intercity services in 2025 with the full fleet of trains coming into service during 2025 and 2026.

Deploying revenue protection staff to deter ticketless travel, and doing so in a reasonable and efficient manner, is a matter for train operating companies.

Revenue protection offers passengers an additional level of safety and security whilst travelling on the rail network.

While there has been no specific assessment into the functionality of air conditioning during the recent hot weather, a sample of EMR's trains are independently inspected each month to assess overall ambience, and this includes the temperature of the carriage.

EMR advises that, on the occasion in question, the air conditioning failed in one carriage. All other carriages on the train had functioning air conditioning and staff offered passengers the opportunity to move to a different carriage, as well as providing water. New trains are due to replace the current train fleet from 2025.

NHS England is not currently doing a review of the issues raised by Health Services Safety Investigations Body regarding electronic patient records. NHS England will not manage the timetable for implementation of safety standards and best practices, as this falls to trusts, each of whom have their own statutory duty to deliver safe care.

NHS England is actively considering the issues raised by the Health Services Safety Investigations Body regarding electronic patient records (EPRs).

EPRs are already improving safety and care to patients, helping to detect conditions such as sepsis more quickly and preventing medication errors. Analysis shows that highly digitised trusts have a 17.5% reduction in sepsis mortality.

The National Health Service has well-established systems in place for reporting, investigating, and learning from any patient safety incidents. We are working closely with NHS trusts to ensure EPRs are used to the highest quality and safety standards.

The Quality and Outcomes Framework (QOF) indicator relating to the learning disability register was retired for the 2025/26 contract year. Only people aged 14 years old and over on a general practice (GP) learning disability register are eligible for a learning disability annual health check.

The following table shows the most recent data for those on a learning disability register who have received an annual health check in England for the last three calendar years, up until March 2025, as well as the percentage of patients on a learning disability register who are eligible for an annual health check:

The annual statistics publication of Health and Care of People with Learning Disabilities sets out the key differences in healthcare between people with a learning disability and those without. This includes data on key health issues for people who are recorded on their GP learning disability register, such as uptake of annual health checks. The 2024 to 2025 statistics is scheduled for publication on 4 December 2025.

NHS England publishes monthly NHS Hospital and Community Health Service Workforce Statistics for England. These include staff working for hospital trusts and core organisations but excludes staff working for other providers such as in primary care, general practice, or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service. The following table shows the number of full-time equivalent learning disability nurses in hospital trusts and core organisations across England as of 30 September for each of the years 2022 to 2025:

NHS England published data every quarter on vacancies in National Health Service trusts. However, the data is not granular enough to identify rates for learning disability nurses.

The Quality and Outcomes Framework indicator relating to the learning disability register was retired for the 2025/26 contract year.

National published data is recorded on a financial year basis from April to March. This published data shows that, at the end of October 2025, there were 342,928 people aged 14 years old and over on a general practice learning disability register. This is approximately a quarter of the estimated number of adults with a learning disability in England.

The remits of the National Director of Patient Experience, the National Quality Board, and the forthcoming Quality Strategy will encompass all patient groups, including those with learning disabilities. The remit of the National Director of Patient Experience will include listening to the experiences of people with learning disabilities and understanding their priorities for improvement.

The Government is committed to driving service improvements and reducing health inequalities for people with a learning disability. There are currently no plans to introduce a specific modern service framework for learning disability services.

A wide range of work is underway to improve the care of people with a learning disability. The NHS Learning Disability Improvement Standard supports National Health Service trusts by setting guidance on safe, personalised, and high-quality care provision. The standards are designed to support organisations in assessing the quality of their services and to promote uniformity across the NHS in the care and treatment provided to people with a learning disability.

People with a learning disability are identified as a priority cohort in the national Core20PLUS5 programme, which seeks to drive local action on health inequalities. NHS England has developed and embedded indicators to monitor access, experience, and outcomes for Core20PLUS populations.

Integrated care boards (ICBs) are required to have an Executive Lead for learning disability and autism, ensuring there is senior oversight and accountability for tackling health inequalities. Every ICB has a requirement to consider and demonstrate how they will reduce the health inequalities faced by people with a learning disability and autistic people within their local populations within the five year strategic plans required as part of the Medium-Term Planning Framework issued by NHS England in October 2025.

The NHS Act 2006 requires ICBs to have regard to the need to reduce health inequalities and NHS England produces a Statement of Information on Health Inequalities setting out advice for ICBs on how they can achieve this duty. Published in November 2025, this year the statement includes specific reference to people with a learning disability and autistic people.

As set out in the Written Answer on 10 November, there are regular conversations between the relevant minister, Department officials, and senior clinical and managerial leads at NHS England in relation to improving overall health outcomes for people with a learning disability and autistic people.

Several meetings have taken place since July 2024 and the publication of the recent annual Learning from Lives and deaths, people with a learning disability and autistic people report was discussed. The Parliamentary Under Secretary of State for Health Innovation and Safety, who recently assumed responsibility for this, has met senior managers and discussed key findings from the report and the wider work underway to tackle health inequalities and improve access to, and the quality of, services for people with a learning disability.

The Government is committed to improving care for people with a learning disability and has recognised within our new 10-Year Health Plan the unacceptable inequalities and poor life expectancy this group of people faces.

Integrated care boards (ICBs) are held accountable for the care of people with a learning disability through existing governance processes, such as the NHS Operating Framework and annual assessment of ICB delivery. ICBs are expected to have an Executive Lead for learning disability and autism to support the board in planning to meet the needs of its local population of people with a learning disability and autistic people and to have effective oversight of, and support improvements in, the quality of care.

Findings from learning from lives and deaths reviews (LeDeR) are a crucial tool for identifying systemic failures in the care of people with a learning disability and autistic people, as well as driving local service improvements. This is why ICBs are expected to have an Executive Lead on LeDeR and NHS England’s national LeDeR policy sets out the clear expectation that ICBs prioritise LeDeR reviews in their delivery plans and ensure that actions are implemented to improve services and reduce premature mortality.

In the recently published Medium-Term Planning Framework, published 24 October 2025, the Government reaffirmed its commitment to reducing the health inequalities faced by people with a learning disability and autistic people, setting up ambitious targets for ICBs and health care providers. This includes reducing admission rates to mental health hospitals for people with a learning disability and autistic people, and optimising existing resources to reduce long waits for autism and attention deficit hyperactivity disorder assessments.

Learning from lives and deaths reviews (LeDeR) play a vital role in identifying learning from the notified deaths of people with a learning disability and autistic people, and the recommendations made in individual reviews, as well as the annual report, are key drivers for national and local service improvement. LeDeR reviews incorporate more than just the last episode of care before a person’s death, as they also include the key health and social care experiences the person had. The Government remains committed to reviewing every death notified to LeDeR and sharing the learning from these reviews widely to inform change.

There are no plans to mandate aspects of the LeDeR programme. Integrated care boards (ICBs) are held accountable for the care of people with a learning disability through existing governance processes, such as the NHS Operating Framework and annual assessment of ICB delivery. ICBs are expected to have an Executive Lead on LeDeR and NHS England’s national LeDeR policy sets out the clear expectation that ICBs prioritise LeDeR in their delivery plans and produce an annual report on their findings and actions taken.

Integrated care boards (ICBs), as set out in NHS England statutory guidance published 9 May 2023, are expected to assign an executive lead role for learning disability and autism to a suitable board member. The named lead is expected to support the board in planning to meet the needs of its local people with a learning disability and its local autistic people and to have effective oversight of, and support improvements in, the quality of care for people in a mental health, learning disability and autism.

There are clear expectations of ICBs in relation to care and support provision for people with a learning disability and autistic people, and they are held accountable through existing governance processes. The Medium-Term Planning Framework, published 24 October, sets out priorities for ICBs and providers on learning disability and autism, including reducing health inequalities and reliance on mental health inpatient care. ICBs report their spend on Learning Disability and Autism Services as part of routine financial reporting, monitored by NHS England. The Model ICB Blueprint sets out the direction of travel for the role and functions of ICBs in relation to commissioning services for the needs of their local population. There is a range of best practice guidance available and published to support ICBs to commission services for people with a learning disability.

No formal assessment has been made, although the Department recognises that the current process of transition to new integrated care board (ICB) structures and roles directly impacts staff. As the Secretary of State for Health and Social Care acknowledged in his speech at the NHS Providers conference on 12 November, there has been uncertainty for staff for too long but funding arrangements for voluntary redundancy arrangements have now been confirmed and that will help to provide certainty for people. NHS England is working to support ICBs as part of the change process.

The Government is committed to the modernisation of the National Health Service as set out in the 10-Year Health Plan, including refocusing the role of ICBs to strategic commissioning. This will help to support the delivery of the three shifts, from hospital to community, from analogue to digital, and from sickness to prevention, that are needed to build a health service fit for the future.

The Government has no plans to make changes to the regulatory framework for unanaesthetised non-therapeutic circumcision of boys. No recent evidence-based assessment has been conducted in relation to the regulatory oversight of unanaesthetised non-therapeutic circumcision of boys.

The Government has no plans to make changes to the regulatory framework for unanaesthetised non-therapeutic circumcision of boys. No recent evidence-based assessment has been conducted in relation to the regulatory oversight of unanaesthetised non-therapeutic circumcision of boys.

There have been regular conversations between the relevant minister, Department officials, and senior clinical and managerial leads at NHS England in relation to improving overall health outcomes for people with a learning disability and autistic people. Insights from the programme of learning from the lives and deaths of people with a learning disability and autistic people plays an important role in shaping these broader conversations about tackling health inequalities and improving identification, access to, and the quality of services.

Neither the Department or NHS England have any plans to introduce an activity-based payment scheme for all community and mental health services. However, it may be appropriate to introduce activity-based payment for some community and mental health services in the future.

NHS England is developing standard currencies for community and mental health services that can be used as the basis for future payment models. The development of community and mental health tariffs will be dependent on the availability of good quality costing and activity data.

We inherited two head offices for the National Health Service, one for NHS England and one for the Department of Health and Social Care, and with two organisations comes two sets of corporate IT systems.

This two-year contract will maximise efficiency and boost productivity by designing and integrating the Department and NHS England’s corporate IT functions to create one single system following the merger.

All Government contracts are robustly assessed to ensure they deliver value for the taxpayer.

The Core20PLUS5 is a national approach to inform action to reduce healthcare inequalities at a system level. The approach defines a target population, the Core20PLUS, and five clinical areas to focus on that require accelerated improvement. PLUS population groups should be identified at a local level. NHS England expects to see learning disability identified as a priority cohort.

The Healthcare Inequalities Improvement Programme has worked closely with NHS England’s clinical programmes to develop and embed indicators which enable the monitoring of the access, experience, and outcomes for Core20PLUS populations, and this includes people with a learning disability. The Core20PLUS5 indicator for learning disability is the Percentage of patients aged 14+ on GP learning disability registers who received an annual health check.

NHS England has published a Statement on Information on Health Inequalities which sets out the data that integrated care boards (ICBs) are expected to collect. This includes that ICBs should publish in their 2023/24 and 2024/25 annual reports relating to learning disability annual health checks and adult mental health inpatient rates for people with a learning disability and autistic people. Within these annual reports, it is expected that ICBs should explain how the information has been used to guide action.

In addition, each ICB must have an executive lead for learning disability and autism who will support the board in addressing health inequalities, supporting equal access to care across all health services, and improving overall health outcomes.

The Core20PLUS5 is a national approach to inform action to reduce healthcare inequalities at a system level. The approach defines a target population, the Core20PLUS, and five clinical areas to focus on that require accelerated improvement. PLUS population groups should be identified at a local level. NHS England expects to see learning disability identified as a priority cohort.

The Healthcare Inequalities Improvement Programme has worked closely with NHS England’s clinical programmes to develop and embed indicators which enable the monitoring of the access, experience, and outcomes for Core20PLUS populations, and this includes people with a learning disability. The Core20PLUS5 indicator for learning disability is the Percentage of patients aged 14+ on GP learning disability registers who received an annual health check.

NHS England has published a Statement on Information on Health Inequalities which sets out the data that integrated care boards (ICBs) are expected to collect. This includes that ICBs should publish in their 2023/24 and 2024/25 annual reports relating to learning disability annual health checks and adult mental health inpatient rates for people with a learning disability and autistic people. Within these annual reports, it is expected that ICBs should explain how the information has been used to guide action.

In addition, each ICB must have an executive lead for learning disability and autism who will support the board in addressing health inequalities, supporting equal access to care across all health services, and improving overall health outcomes.