Lord Sharkey

Assessments regarding the effectiveness of competition on cross-Solent ferry services are a matter for the Competition and Markets Authority, which is independent of the Government. Decisions on which markets to investigate sit with its board.

The Department continues to engage directly with key stakeholders, including Islanders and ferry companies.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. NHS England and the Department are strongly supportive of clinical leadership and recognise the critical need to incorporate clinical expertise into our work. The national clinical directors are a key part of this approach and play an important role in policy development and implementation.

We are currently in the initial phases of scoping and designing a new integrated Department that aims to enhance the efficiency and effectiveness of our healthcare system. As part of this process, we are carefully considering the future role of national clinical directors. While no specific decisions have been made yet, we are open to considering the benefit of appointing a National Clinical Director for Rare Diseases following the integration of NHS England into the Department, subject to funding arrangements.

As we take forward the work to integrate NHS England into the Department, we will continue to analyse and assess impacts of all kinds. This will include putting in place plans to ensure continuity of specialised services, with patient safety at the forefront of our work.

Joint forward plans (JFPs) are produced by integrated care boards (ICBs) and are publicly available on the respective websites of the ICBs. The Government does not hold any central records of these JFPs and there are no plans to place copies of the JFPs in the Library of the House.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

On 16 January 2024, under the previous Government, HM Treasury published a consultation proposing changes to the Capital Gains Tax (CGT) rules that apply to alternative financial arrangements. The consultation closed on 9 April 2024 and this Government is carefully considering all responses. A response document will be published in due course.