Asked by: Lord Scriven (Liberal Democrat - 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 1 July (HL1068), what plans they have to establish independent or statutory audits to monitor whether acute trusts are consistently involving family carers from admission to discharge rather than relying on the advisory information hosted on the NHS England website.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards are responsible for assessing local need and commissioning services to best meet the needs of their local population, including determining how services are delivered locally to reduce the health inequalities. Therefore, staffing models may differ between areas to reflect local needs and existing provision. All staff within health and social care must have learning disability and autism training specific to their role as set out in the Health and Care Act 2022, which means that staff who see patients should be better able to meet the needs of people who have a learning disability.
We are committed to ensuring that, under the Reasonable Adjustment Digital Flag Information Standard 2025, all publicly funded health and social care service providers are able to share, read, and write reasonable adjustment data by 30 September 2026. The Information Standard is mandated across all publicly funded health and social care providers, commissioners, and IT suppliers. Should issues of non-compliance arise, commissioners of health and publicly funded social care services will be able to enact contractual sanctions at their discretion.
The Government continues to recognise the value of involving patients and family carers in decisions about the care of people with a learning disability. The Health and Care Act 2022 sets duties for involving carers in healthcare. Acute trusts are responsible for determining how best to involve family carers in the delivery of care, taking account of the needs of their patients and local circumstances. There are currently no plans to establish independent or statutory audits to monitor whether acute trusts are consistently involving family carers from admission to discharge. The Friends and Family Test is an important feedback tool that supports the fundamental principle that people who use National Health Services should have the opportunity to provide feedback on their experience.
NHS England has previously published guidance to support primary care to identify people with a learning disability, titled Improving identification of people with a learning disability: guidance for general practice. This information can be shared with other health providers if a patient gives their permission. The Summary Care Record is a national database that holds electronic records of important patient information such as current medication, allergies, and details of any previous bad reactions to medicines, created from general practice medical records. It can be seen and used by authorised staff involved in the patient's direct care, including in other organisations such as an acute trust, with the patient’s consent. We expect acute hospitals to have appropriate arrangements in place to record learning disability information, including through the use of SNOMED codes, which are mandated for use across the NHS including in acute trusts.
Asked by: Lord Scriven (Liberal Democrat - 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 1 July (HL1070), what specific contractual or regulatory penalties will be applied from 1 October 2026 to NHS trusts that fail to meet the mandatory compliance deadline for the Reasonable Adjustment Digital Flag Information Standard.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards are responsible for assessing local need and commissioning services to best meet the needs of their local population, including determining how services are delivered locally to reduce the health inequalities. Therefore, staffing models may differ between areas to reflect local needs and existing provision. All staff within health and social care must have learning disability and autism training specific to their role as set out in the Health and Care Act 2022, which means that staff who see patients should be better able to meet the needs of people who have a learning disability.
We are committed to ensuring that, under the Reasonable Adjustment Digital Flag Information Standard 2025, all publicly funded health and social care service providers are able to share, read, and write reasonable adjustment data by 30 September 2026. The Information Standard is mandated across all publicly funded health and social care providers, commissioners, and IT suppliers. Should issues of non-compliance arise, commissioners of health and publicly funded social care services will be able to enact contractual sanctions at their discretion.
The Government continues to recognise the value of involving patients and family carers in decisions about the care of people with a learning disability. The Health and Care Act 2022 sets duties for involving carers in healthcare. Acute trusts are responsible for determining how best to involve family carers in the delivery of care, taking account of the needs of their patients and local circumstances. There are currently no plans to establish independent or statutory audits to monitor whether acute trusts are consistently involving family carers from admission to discharge. The Friends and Family Test is an important feedback tool that supports the fundamental principle that people who use National Health Services should have the opportunity to provide feedback on their experience.
NHS England has previously published guidance to support primary care to identify people with a learning disability, titled Improving identification of people with a learning disability: guidance for general practice. This information can be shared with other health providers if a patient gives their permission. The Summary Care Record is a national database that holds electronic records of important patient information such as current medication, allergies, and details of any previous bad reactions to medicines, created from general practice medical records. It can be seen and used by authorised staff involved in the patient's direct care, including in other organisations such as an acute trust, with the patient’s consent. We expect acute hospitals to have appropriate arrangements in place to record learning disability information, including through the use of SNOMED codes, which are mandated for use across the NHS including in acute trusts.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in light of the National Confidential Enquiry into Patient Outcome and Death's report Learning Together, published 11 June, what immediate steps they are taking to ensure frontline NHS staff use accurate clinical terminology in electronic patient records.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards are responsible for assessing local need and commissioning services to best meet the needs of their local population, including determining how services are delivered locally to reduce the health inequalities. Therefore, staffing models may differ between areas to reflect local needs and existing provision. All staff within health and social care must have learning disability and autism training specific to their role as set out in the Health and Care Act 2022, which means that staff who see patients should be better able to meet the needs of people who have a learning disability.
We are committed to ensuring that, under the Reasonable Adjustment Digital Flag Information Standard 2025, all publicly funded health and social care service providers are able to share, read, and write reasonable adjustment data by 30 September 2026. The Information Standard is mandated across all publicly funded health and social care providers, commissioners, and IT suppliers. Should issues of non-compliance arise, commissioners of health and publicly funded social care services will be able to enact contractual sanctions at their discretion.
The Government continues to recognise the value of involving patients and family carers in decisions about the care of people with a learning disability. The Health and Care Act 2022 sets duties for involving carers in healthcare. Acute trusts are responsible for determining how best to involve family carers in the delivery of care, taking account of the needs of their patients and local circumstances. There are currently no plans to establish independent or statutory audits to monitor whether acute trusts are consistently involving family carers from admission to discharge. The Friends and Family Test is an important feedback tool that supports the fundamental principle that people who use National Health Services should have the opportunity to provide feedback on their experience.
NHS England has previously published guidance to support primary care to identify people with a learning disability, titled Improving identification of people with a learning disability: guidance for general practice. This information can be shared with other health providers if a patient gives their permission. The Summary Care Record is a national database that holds electronic records of important patient information such as current medication, allergies, and details of any previous bad reactions to medicines, created from general practice medical records. It can be seen and used by authorised staff involved in the patient's direct care, including in other organisations such as an acute trust, with the patient’s consent. We expect acute hospitals to have appropriate arrangements in place to record learning disability information, including through the use of SNOMED codes, which are mandated for use across the NHS including in acute trusts.
Asked by: Lord Scriven (Liberal Democrat - 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 16 June (HL696), whether the access of Palantir contractors to identifiable patient data was always part of the operational arrangements; and why the National Data Guardian was left unaware of this arrangement until it was exposed by external pressure.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Data Guardian (NDG) highlighted that the published Data Protection Impact Assessment (DPIA) for the National Data Integration Tenant (NDIT) was not fully reflective of current access arrangements, including limited administrative access by supplier staff.
Access by supplier staff has been part of the operational model for the NHS Federated Data Platform (NHS FDP) where necessary to support, maintain and assure the system. This access is strictly controlled, limited, and subject to contractual, technical and organisational safeguards.
The DPIA did include information on supplier data processing obligations and considered the risks associated with access to data. However, it was not sufficiently explicit about the nature and extent of limited administrative access by supplier staff. NHS England recognised this and has taken steps to improve transparency in how these arrangements are described. NHS England has also set out in its public communications that suppliers act only under the instructions of National Health Service organisations.
Whilst there is no statutory requirement for NHS England to notify the NDG of specific access arrangements to NDIT, NHS England engages regularly with the NDG through established governance routes as part of routine oversight of the NHS FDP Programme. This matter was discussed at the Data Transformation Check and Challenge Group; the NDG subsequently wrote to NHS England and has received an update in response. NHS England has also published an updated Privacy Notice on the NHS website in an online-only format.
NHS England acts as the data controller for the NHS FDP at the national level, including NDIT. NHS organisations using the platform act as data controllers for their own data and use of the system. Access to data is strictly controlled; any access by external contractors is limited, role-based and time-bound, requires appropriate security clearance and senior approval, and is fully logged and auditable. Data remains under the control of NHS organisations, and suppliers act only under the instruction of those organisations.
NHS England and the Department will continue to engage with the NDG through established governance routes on this matter.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many NHS pensioners flagged for manual reconciliation due to their lifetime allowance are experiencing delays in receiving their annual inflation increases; what is the average wait time for those cases to be resolved; and what is the longest recorded wait time for an affected individual to receive their statutory increase.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Business Services Authority (NHSBSA), which administers the NHS Pension Scheme on behalf of the Secretary of State for Health and Social Care, has confirmed that as of 22 June 2026, there are 1,715 open inflation-related pension increase cases waiting for manual calculation and payment. These are known as ‘second bite’ payments and the average wait time for a case is 155 days, with the shortest wait time being one day and the longest wait time being 1,338 days.
The vast majority of second bites are paid automatically soon after the April pensions increase effective date by the NHSBSA, with 83,074 pensioners receiving their second bite payments over the last four years, April 2023 to April 2026. Manual intervention is necessary for the small number of pensioners at risk of exceeding the HM Revenue and Customs (HMRC) lump sum allowance due to their second bite payment. Members are requested to complete a declaration form, to enable the NHSBSA to determine if there is tax to be deducted and paid to HMRC when the second bite is paid so that the member receives the amount due net of tax. Delays by members in returning this form to the NHSBSA extend the time that a case remains open.
The NHSBSA, which administers the NHS Pension Scheme for almost four million members, recognises the importance of timely second bite payments and that delays are frustrating for members. The NHSBSA is taking a range of steps to process and pay second bite payments as quickly as possible after the declaration form is returned and to regularly monitor and remind members whose form remains outstanding.
The Department is working with the NHSBSA to oversee their development of a recovery plan that expediates the processing and payment of the delayed second bite payments.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when they plan to publish the new code of practice under the Mental Health Act 2025; and which organisations advocating for people with learning disabilities have been consulted during its drafting.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has prioritised introducing these reforms through the Mental Health Act 2025, and is committed to implementing this legislation so that people with serious mental illness and people with a learning disability and autistic people see real improvements in their care and outcomes as soon as possible.
We are working to develop the revised Code of Practice to enable the commencement of the first major set of reforms, phase 1, in 2028/29. We will be engaging extensively on this and particularly we are keen to ensure that we reflect the views of clinicians and other professionals, as well as those with lived experience, their families and carers, and other organisations, including organisations advocating for people with a learning disability and autistic people.
To support this work, we are running an open tender process for an external organisation to lead engagement with people with lived experience, including people with a learning disability, autistic people, and their families and carers to ensure their perspectives are informing the development of the updated statutory guidance. As part of our governance structures to support drafting of the Code of Practice, we have established an Expert Reference Group which includes representatives from Mencap and the National Autistic Society.
We intend to go to public consultation on the revised Code of Practice in the first half of 2027. We will then need to train the workforce on the reforms and the new Code of Practice, ahead of the code being laid before Parliament. We intend for the new code to come into force in parallel with phase 1 reforms.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the South Yorkshire Integrated Care Board (ICB) was ever formally designated for abolition or merger under the framework to reduce ICBs from 42 to 26; and on what date it was agreed to keep South Yorkshire ICB as a standalone entity; and who made that decision.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In response to NHS England’s announcement on 1 April 2025 reducing integrated care board (ICB) running costs, some smaller ICBs considered clustering arrangements and some proposed legal merger. The South Yorkshire ICB was not formally designated for abolition or merger under this process but did consider options including shared leadership.
NHS England took decisions on changes to ICB boundaries, after consulting ministers, during Summer 2025, and ministers announced the outcome of that process in a Written Ministerial Statement on 9 September 2025. The South Yorkshire ICB was not included in the announced mergers and remained a standalone ICB.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether the business case approving the redundancy payment of the former chief executive of South Yorkshire Integrated Care Board (ICB) in August 2025 was entirely contingent on the successful implementation of a shared leadership arrangement with another ICB.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has advised that restructuring considerations in the South Yorkshire Integrated Care Board (ICB) included potential shared leadership, in the context of a wider national requirement to reduce the number of ICB Chief Executive posts.
NHS England has further advised that approval of the redundancy payment was not solely contingent on the successful implementation of shared leadership, and approval of the redundancy payment was given on the basis that it would avoid the need for further redundancies, either through redeployment or new leadership arrangements.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the Department of Health and Social Care ensures compliance with Treasury guidance on public sector exit payments and value for money protocols if the department does not assess whether interim chief executive post cover at South Yorkshire Integrated Care Board performed the same statutory duties as a redundant role.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Contractual National Health Service redundancy payments are managed through local governance arrangements, in line with the relevant contractual terms and conditions, including Agenda for Change, where applicable, and with the employer’s internal approval, accountability, and value for money processes. In general, additional departmental or HM Treasury approval is associated with non-contractual or exceptional payments, such as special severance payments, rather than standard contractual redundancy payments.
NHS England has advised that, in the South Yorkshire Integrated Care Board (ICB), this was treated as a contractual compulsory redundancy case within a wider restructuring context and was considered in the context of wider changes affecting ICB Chief Executive arrangements. NHS England has further advised that approval of the redundancy payment was given on the basis that it would avoid the need for further redundancies, either through redeployment or new leadership arrangements.
The Department does not centrally reassess individual local post structures, including whether interim cover performed the same statutory duties as an earlier role.
Asked by: Lord Scriven (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the redundancy of the previous chief executive post at the South Yorkshire Integrated Care Board (ICB) satisfies the legal and Treasury definition of a redundancy given that a substantive, full-time chief executive was appointed to the same ICB on 8 April 2025.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There was a wider national requirement to reduce the number of integrated care board Chief Executive Officer roles. NHS England has advised that, in South Yorkshire, the case was treated as a contractual compulsory redundancy case, within that wider restructuring context, with approval being given on the basis that the post would be used for redeployment or other arrangements avoiding a further redundancy.
The subsequent appointment of a substantive Chief Executive does not in itself determine the status of the earlier post or the local redundancy decision.