Asked by: Lord Shinkwin (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 of regional disparities in gastroparesis treatment on (1) patient outcomes, (2) the financial costs and benefits of gastroparesis treatment as compared to the costs to the NHS of frequent hospital admissions, and (3) the wider costs to the economy of absence from work due to medical complications related to the non-provision of gastroparesis treatment.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.
The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.
NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of comparative patient outcomes in England and Scotland relative to their respective NHS provision of gastroparesis services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.
The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.
NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what engagement they have had with patient groups about improving gastroparesis services.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.
The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.
NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether full coverage of fracture liaison services across England by 2030 is deliverable without additional funding; and what assumptions they made in that assessment.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030. Integrated care boards remain well-placed to make decisions according to local need.
The Renewed Women’s Health Strategy sets an expectation that integrated care boards prioritise community-based models when commissioning new fracture prevention services.
The Department continues to work closely with NHS England to explore a range of options to provide better quality and access to these important preventative services.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to protect the workforce pipeline for small and vulnerable allied health professions from the risk of university programme closures or reductions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care works closely with the Department for Education to support the availability of a diverse range of training routes into health and care careers. While the Government is committed to ensuring sustainable training pathways for small and vulnerable healthcare professions, higher education institutions are independent providers and are responsible for making their own decisions about course delivery and viability.
NHS England has a focussed programme for small and vulnerable professions, including Allied Health Professions. This programme helps maintain and strengthen training and education pathways for pre‑registration learners, including apprenticeship routes, to support a national strategic approach to placement capacity and to build awareness of healthcare careers.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what oversight they exercise over the commissioning of prosthetic and orthotic services to ensure that they are appropriately funded and that investment is linked to measurable patient outcomes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Prosthetics is a specialised service, with commissioning transferring to integrated care boards on 1 April 2025, ensuring service providers must adhere to the national service specification and national clinical commissioning policies. Orthotic services are locally commissioned by integrated care boards or National Health Service trusts. It is the responsibility of local employers to ensure they have the right people with the right skills to meet local population needs. The Department remains committed to working with stakeholders, including the British Association of Prosthetics and Orthotics, to support service improvements and meet patient demand.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what preparations they have made to ensure there is a sufficient workforce of prosthetists and orthotists to meet the anticipated demand for prosthetic and orthotic rehabilitation in the event of a conflict situation.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care, the National Health Service, and the Ministry of Defence continue to ensure health services, including prosthetic and orthotic services, can respond effectively to meet the demands of conflict situations through regularly reviewing system-wide capacity.
The Department of Health and Social Care’s commitment to longer term workforce planning through the 10 Year Workforce Plan will also ensure that the NHS has the right people in the right places, with the right skills to care for patients, when they need it.
Asked by: Lord Shinkwin (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what strategic workforce planning is in place to ensure that prosthetic and orthotic services are resilient to both national security demands and systemic pressures on the healthcare workforce.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department of Health and Social Care, the National Health Service, and the Ministry of Defence continue to ensure health services, including prosthetic and orthotic services, can respond effectively to meet the demands of conflict situations through regularly reviewing system-wide capacity.
The Department of Health and Social Care’s commitment to longer term workforce planning through the 10 Year Workforce Plan will also ensure that the NHS has the right people in the right places, with the right skills to care for patients, when they need it.
Asked by: Lord Shinkwin (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 risk that university programme closures or reductions could pose to the future supply of prosthetists and orthotists; and what contingency plans are in place to sustain education and training provision for these professions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As a small and vulnerable profession, course closures or reductions pose a considerable risk to the future supply of prosthetists and orthotists.
The Department of Health and Social Care works closely with the Department for Education to support the availability of a diverse range of training routes into health and care careers. While the Government is committed to ensuring sustainable training pathways for the future supply of prosthetics and orthotists, higher education institutions are independent providers and are responsible for making their own decisions about course delivery and viability.
NHS England has a focussed programme for small and vulnerable professions, including prosthetics and orthotics, and has recently commissioned the British Association of Prosthetists and Orthotists to help maintain and strengthen training and education pathways for pre‑registration learners.
Asked by: Lord Shinkwin (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 Scottish Orthotic Services Review, published by NHS Scotland in 2005, and the relevance of its findings to the current commissioning and delivery of orthotic services in England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
No such assessment has been made. The commissioning and delivery of orthotic services are devolved matters. In England, responsibility rests with local integrated care boards and National Health Service trusts in line with the non-specialised commissioning status of orthotic services. In 2015, NHS England introduced national guidance to support more consistent and higher-quality orthotics provision.