Question to the Department of Health and Social Care:

To ask His Majesty's Government, following reports that several NHS organisations have informed hospitals they will only finance procedures after a patient has waited more than three months, what guidance they have issued to NHS organisations regarding the use of minimum waiting times for treatment performed by hospitals.

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

The NHS Standard Contract 2025/26 Technical Guidance states that commissioners may choose to include minimum waiting times in Activity Planning Assumptions to ensure the delivery of targets within agreed financial allocations. A copy of the NHS Standard Contract 2025/26 Technical Guidance is attached.

We will work closely with all systems to ensure they deliver the expected level of improvement in waiting times as set out in the 2025/26 Planning Guidance, which is the first step in delivering on our commitment that by March 2029, 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 28 June (HL8464), which data areas King's College London was asked to review by NHS England or the Department of Health and Social Care in the unpublished LeDeR report, and the reasons for each request.

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

NHS England works with Kings College London, the academic partner for LeDeR, to produce the LeDeR annual report. Since they submitted their draft report, NHS England has collaborated with them on further iterations with the aim to finalise as soon as possible.

The Department has provided feedback on later iterations of the report on practical data issues with the aim to ensure findings were accurately presented and could be clearly interpreted by the public. Feedback related to definition of technical language, additional context for demographic statistics, and apparent inconsistencies. A final version of the report addressing feedback was shared with the Department on 25 June 2025.

We are committed to publishing the latest report soon after Parliament returns alongside a Written Ministerial Statement.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what measures are in place to ensure that learning disabilities mortality reviews are completed in a timely manner following notification, and what steps they are taking to address any delays in the process.

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

Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) is a service improvement programme established and led by NHS England. NHS England is committed to ensuring that all deaths notified to LeDeR are reviewed in a timely manner. This commitment has been maintained since a pilot scheme was introduced in 2016, nationwide in 2017. There is a national, published LeDeR policy in place clearly setting out requirements and expectations across England.

Integrated care systems are responsible for ensuring that LeDeR reviews are completed in their local area, and that actions are implemented to improve the quality of services and reduce health inequalities and premature mortality for autistic people and people with a learning disability.

The LeDeR policy sets the expectation that reviews are completed within six months of them being notified to LeDeR unless statutory processes prevent that being possible or family members of those bereaved have asked for the review to be delayed.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what quality assurance and oversight is undertaken by NHS England on learning disabilities mortality review reports before publication, and which minister or official is responsible for approval of the final report before publication.

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

NHS England works with an academic partner, Kings College London, to produce the Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) annual report. NHS England provides oversight in relation to LeDeR policy, process and wider National Health Service policy, and commissions the annual report.

The report is independent and provides analysis of LeDeR review data. NHS England and the Department check findings are clearly and consistently presented to ensure transparency for the public.

The 2023 report was approved by NHS England’s Chief Executive.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what basis they used to calculate that it is value for money to make a performance-related bonus of up to £114,000 available for the role of Director General for Commercial and Growth.

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

The remuneration for senior Government Commercial Organisation (GCO) roles is set centrally to ensure a consistent, cross-government approach that allows us to attract and retain commercial leaders within the specialised skills needed to manage complex challenges and deliver value for money.

This ‘invest to save’ model includes a performance-related pay element which is not guaranteed; it is strictly contingent on meeting stretching objectives designed to deliver significant taxpayer savings. Such payment is approved by the GCO Remuneration Committee and the Chief Secretary to the Treasury as per central guidance.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what learning disabilities mortality review report recommendations have been mandated for NHS or social care organisations to implement by NHS England or the Department of Health and Social Care in each year between 2018 and 2022.

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

Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) is a service improvement programme established and led by NHS England. LeDeR is a crucial source of evidence that helps to identify the key improvements needed to tackle health disparities and prevent avoidable deaths of people with a learning disability and autistic people.

The recommendations within LeDeR reports are not mandated but are intended to inform and guide action by health and social care organisations to improve the quality of care and services for patients, locally and nationally. Alongside each LeDeR report publication, NHS England publishes its Action from Learning Report which highlights local action directly driven by LeDeR findings.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many learning disabilities mortality reviews (1) are yet to be started, and (2) have been started but not completed.

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

Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) is a service improvement programme established and led by NHS England.

As of 1st September 2025, there were 3,836 LeDeR reviews for people with a learning disability and autistic people in the LeDeR system which had not been completed. Of these, 1,626 (42%) have not been started.

508 (13%) of the reviews that have not been completed are currently on hold awaiting the completion of statutory processes such as coroner’s investigations or safeguarding reviews. 2,155 (56%) of the reviews that have not been completed are for people who died in 2025.

1,842 (48%) of the reviews were received within the last 6 months. The LeDeR policy sets the expectation that reviews are completed within six months of them being notified to LeDeR, unless statutory processes prevent that being possible or family members of those bereaved have asked for the review to be delayed. As of August 2025, 94% of all LeDeR reviews have been completed since the start of the programme in 2017.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, with regard to the LeDeR Annual Report 2023, published on 2 September, what the "unforeseen pressures" on the NHS were that resulted in fewer completed learning disabilities mortality reviews than expected.

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

Pressure on NHS services remain high due to a combination of factors including high demand across all services; ongoing recovery efforts after the pandemic and industrial action, recruitment and retention challenges in the NHS workforce and the need to reduce running costs of Integrated Care Boards.

Integrated Care Systems are expected both to complete LeDeR reviews and to implement improvement initiatives in response to reviews to reduce health inequalities and premature and avoidable deaths of people with a learning disability and autistic people. This remains a priority despite pressures on NHS services. NHS England’s Action from Learning Report highlights improvement action being taken locally which is directly driven by LeDeR findings.

As of August 2025, 94% of all LeDeR reviews have been completed since the start of the programme in 2017.

Question to the Department for Science, Innovation & Technology:

To ask His Majesty's Government what assessment they have made of the impact on jobs in life sciences and access to new medicines of Merck's decision to cancel a planned £1 billion expansion of its UK operations.

Answered by Lord Vallance of Balham - Minister of State (Department for Energy Security and Net Zero)

The decision by Merck, or MSD, not to progress its investment, is part of a broader effort by MSD to optimise its resources. It announced in July that it would cut $3 billion per year by 2027 and that 6,000 jobs would go worldwide. MSD continues to employ over 1,600 staff in the UK across other operations, including more than 40 collaborative working agreements with the NHS, the Our Future Health project and UK clinical trials. This decision will not impact UK access to new medicines.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how much money from the Frontline Digitisation programme was allocated to the NHS App in the financial year 2024–25.

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

NHS England’s Frontline Digitisation programme was introduced in 2021 to support healthcare organisations to transition from paper-based to digital systems for patient information, clinical notes and access to data.

Its aim is to reach a core level of digitisation following minimum digital foundations, where the health service and the people who use it have digital services and access to the data that they need to effectively manage and improve health and wellbeing. NHS England is providing £2 billion to National Health Service trusts through to 2025/26 to ensure trusts meet a core level of digitisation and have electronic patient records in place.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what the functions of the new NHS model regions will be, including which responsibilities will be delegated from (1) the Department of Health and Social Care, (2) NHS England, and (3) integrated care boards; and whether they will publish the detail of the timescale for those new models to be in place.

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

The proposed core functions of the National Health Service regional teams are set out in the Model Region Blueprint which has been widely cascaded to the service. It forms one part of the wider changes to the NHS operating model. NHS regions will have three core functions:

• strategic regional leadership, which involves leading the regional health system to support delivery of reform, oversee planning, investment and reconfiguration, support innovation, and ensure effective regional leadership strategy and talent pipelines;
• performance management, which involves holistic oversight of performance in line with national frameworks including understanding board and leadership capability, understanding early warning, and managing risk; and
• improvement and intervention, which involves a regional approach to improvement support and intervention to ensure high quality and sustainable care, developing capability, addressing underperformance, and overseeing regulatory interventions as required.

NHS regional teams are currently a core part of NHS England and work together with national teams to discharge the functions of the organisation. There are currently no plans to delegate additional responsibilities to regional teams from the Department or the integrated care boards.

In March 2025, it was announced that NHS England would be abolished, and its duties and functions combined with the Department, pending legislation. The future organisation will continue to have seven regional teams aligned to the current NHS England regional footprints. In the future organisation, we want our seven regional teams to be leaner and more empowered, working as an integral part of the new centre. Work is underway to consider the role that regional teams should play in the future once NHS England and the Department have been brought together as a single organisation.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what estimate they have made of the savings that would be made by NHS England setting up an NHS at risk pool instead of providing payments to individuals facing redundancy as a result of reductions to NHS England and integrated care board staff in this financial year.

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

Following the announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as scaling back integrated care board running costs and National Health Service provider corporate cost reductions in order to reduce waste and bureaucracy.

Good progress is being made with the Department and NHS England having announced voluntary exit and expressions of interes,t respectively. Departmental exits are expected this calendar year so number of exits can be confirmed in the next few months. NHS England is running to a later timeframe, and we do not expect to be able to confirm numbers before the next financial year. No individuals have yet received redundancy or severance payments, and no assessment of an NHS at-risk pool has been made.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many individuals have received redundancy or severance payments and been offered a new post in the NHS as part of the reduction in integrated care board staff in this financial year.

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

Following the announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as scaling back integrated care board running costs and National Health Service provider corporate cost reductions in order to reduce waste and bureaucracy.

Good progress is being made with the Department and NHS England having announced voluntary exit and expressions of interes,t respectively. Departmental exits are expected this calendar year so number of exits can be confirmed in the next few months. NHS England is running to a later timeframe, and we do not expect to be able to confirm numbers before the next financial year. No individuals have yet received redundancy or severance payments, and no assessment of an NHS at-risk pool has been made.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many individuals have received redundancy or severance payments and have been offered a new post in the NHS as part of the reduction in NHS England staff in this financial year.

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

Following the announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as scaling back integrated care board running costs and National Health Service provider corporate cost reductions in order to reduce waste and bureaucracy.

Good progress is being made with the Department and NHS England having announced voluntary exit and expressions of interes,t respectively. Departmental exits are expected this calendar year so number of exits can be confirmed in the next few months. NHS England is running to a later timeframe, and we do not expect to be able to confirm numbers before the next financial year. No individuals have yet received redundancy or severance payments, and no assessment of an NHS at-risk pool has been made.

Found: Baroness Berger, Baroness Finlay of Llandaff, Baroness Hollins, Lord Kamall of Edmonton and Lord Scriven

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 July [HL8983] about the paybill of the Department for Health and Social Care, why they did not make the provision of high quality palliative care a major priority.

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

As set out in the Government’s recently published 10-Year Health Plan, we are determined to shift more care out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the Plan as being an integral part of neighbourhood teams.

Additionally, I refer the noble Lord to the Written Ministerial Statement (HLWS875) that was made to the House on 22 July 2025, which stated:

“It has been brought to my attention that a written answer given to Lord Scriven contained inaccurate information related to the work of the Department for Health and Social Care.

The reply to written Parliamentary Question HL8983, tabled by Lord Scriven on 30 June 2025, stated that “the Department’s staff numbers have needed to increase to ensure the right skills and capability to deliver several of the Government’s major priorities.” The answer then went on to list a number of areas which have required additional staff resource within the Department. The Assisted Dying Bill has required additional resource but should not have been referred to as a Government priority given the Government’s neutrality on the issue.

For clarity, the answer should read:

“The Department’s total paybill and staffing costs have not risen by £20 million since July 2024; rather, they have risen, but by £2.5 million in that time.

Since the General Election, the Department’s staff numbers have needed to increase to ensure the right skills and capability to deliver several of the Government’s major priorities. During this period, payroll costs have also increased because of annual pay increases.

Given the scale of the challenges facing the health and social care system, as part of the Spending Review, the Department is working on reducing its headcount down to pre-election levels during 2025/26. This is a key step towards a streamlined centre, to support continued prioritisation towards front-line services.”

I would like to apologise for any confusion.”

Found: LORD MAWSON LORD YOUNG OF COOKHAM LORD SCRIVEN LORD HUNT OF KINGS HEATH 185SG_ After Clause 52, insert

Found: Planning and Infrastructure Bill 34 LORD MAWSON LORD YOUNG OF COOKHAM LORD HUNT OF KINGS HEATH LORD SCRIVEN

Found: Planning and Infrastructure Bill 60 LORD MAWSON LORD YOUNG OF COOKHAM LORD HUNT OF KINGS HEATH LORD SCRIVEN

Found: LORD MAWSON LORD YOUNG OF COOKHAM LORD HUNT OF KINGS HEATH LORD SCRIVEN 185I_ After Clause 52, insert

Found: Planning and Infrastructure Bill 70 LORD MAWSON LORD YOUNG OF COOKHAM LORD HUNT OF KINGS HEATH LORD SCRIVEN

Found: LORD MAWSON LORD YOUNG OF COOKHAM LORD HUNT OF KINGS HEATH LORD SCRIVEN 185I_ After Clause 52, insert