Lord Weir of Ballyholme

Small businesses are the backbone of our economy and the Government will ensure the interests of small businesses are embedded into our Industrial and Trade Strategies, as part of a comprehensive approach to delivering on our economic growth mission. The Windsor Framework established a broad set of arrangements to support Great Britain-based businesses to move goods to Northern Ireland, including to small businesses based in Northern Ireland.

The Northern Ireland Retail Movement Scheme reduces checks and administrative burdens on retail agrifood movements. The Northern Ireland Plant Health Label scheme removes unnecessary costs and enables previously prohibited goods to enter Northern Ireland. The first stage of the UK internal market scheme was implemented in 2023, and ensures thousands of businesses can move goods without being subject to customs duties. Businesses can also use the Customs Duty Waiver Scheme to waive any duties entirely, regardless of the destination of the goods, subject to an overall limit. The Government works closely with industry stakeholders and trade associations on the implementation of these arrangements and will continue to do so.

The information requested falls under the remit of the UK Statistics Authority.

Please see the letter attached from the National Statistician and Chief Executive of the UK Statistics Authority.

The Lord Weir of Ballyholme

House of Lords

London

SW1A 0PW

26 March 2025

Dear Lord Weir of Ballyholme,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking how many deaths of working age people there have been as a result of cardiovascular disease in each of the past three years (HL6089).

The Office for National Statistics (ONS) publish regular statistics on deaths in England and Wales. These statistics are based on information recorded when deaths are certified and registered. They are based on when the death was registered rather than when it occurred. The number of deaths registered in England and Wales over 2021 to 2023 where the underlying cause was cardiovascular disease, and the deceased was aged 16-64, can be found in Table 1.

Table 1: Number of deaths where the underlying cause was cardiovascular disease in England and Wales, aged 16 to 64, deaths registered 2021 to 2023.

Source: Office for National Statistics

Any death assigned an underlying cause of death using the International Classification of Diseases, Tenth Revision codes I00-I99 was included. This will include deaths where the underlying cause was ischaemic heart disease, heart failure and cerebrovascular diseases. Further information on the definition can be found on the World Health Organisation (WHO) website1 .

Yours sincerely,

Professor Sir Ian Diamond

1 https://icd.who.int/browse10/2019/en#/IX

Northern Ireland is a part of the United Kingdom customs territory and internal market. We are looking closely at the retaliatory tariffs announced by the EU and any impact these might have on Northern Ireland businesses.

Under the Windsor Framework, where US imports into NI do not subsequently enter the EU, traders can reclaim any additional duties through the Duty Reimbursement Scheme in full without any limit on total claims.

Northern Ireland is a part of the United Kingdom customs territory and internal market. We are looking closely at the retaliatory tariffs announced by the EU and any impact these might have on Northern Ireland businesses.

Under the Windsor Framework, where US imports into NI do not subsequently enter the EU, traders can reclaim any additional duties through the Duty Reimbursement Scheme in full without any limit on total claims.

Since Storm Éowyn made landfall, His Majesty’s Government’s focus has rightly been on making sure that requests for support in response to its impacts across the UK, were managed quickly and effectively and delivered to whichever part of the UK they were required. It is too early to say what the financial costs of the impacts of the Storm have been.

The Windsor Framework positions Northern Ireland as a unique gateway for the sale of goods to two of the world’s largest markets, as well as access to global markets through the UK's new trade agreements.

Whilst the Government has not made an assessment of the impact of dual market access on the number of jobs or international companies created, between 2019 and 2023, Northern Ireland’s sales of goods to Great Britain increased by £4.7bn or 69%, and sales to the EU increased by £2.9bn or 54%.

The Windsor Framework is not a barrier to trade deals. The United Kingdom has secured trade agreements with 73 countries and territories, plus the EU, while ensuring compliance with the Windsor Framework. These agreements include free trade agreements with Australia and New Zealand, which entered force on 31 May 2023, and the Comprehensive and Progressive Trans-Pacific Partnership, which the United Kingdom joined on 16 July 2023, and which came into effect on 15 December 2024.

The updated GPSR largely formalises the reality of how many businesses are already operating and the measures are therefore likely to have limited impact in practice. However, we understand that for some businesses, the regulation will require changes, and we take any concerns extremely seriously.

We have issued guidance, will keep this under review and continue to engage businesses directly to ensure we are supporting them to trade freely within the UK and with the EU. We have regular discussions with businesses and consumer representatives from across the UK to hear their concerns.

The updated GPSR largely formalises the reality of how many businesses are already operating and the measures are therefore likely to have limited impact in practice. However, we understand that for some businesses, the regulation will require changes, and we take any concerns extremely seriously.

We have issued guidance, will keep this under review and continue to engage businesses directly to ensure we are supporting them to trade freely within the UK and with the EU. We have regular discussions with businesses and consumer representatives from across the UK to hear their concerns.

We have set out in the Action Plan, which was developed by Matt Clifford, our intention to deliver growth across the UK, working with local stakeholders to devise strategies suited to the UK’s regions. We are committed to working in partnership with regional and local authorities on AI Growth Zones. We are already working with devolved administrations and local authorities across the UK, and will continue to do so, to ensure all parts of the UK benefit from the investment in critical AI infrastructure.

Most AI systems should be regulated at the point of use through our existing expert regulators. In response to the Plan, the government will support regulators evaluate their AI capabilities and understand how these can be strengthened. It will also encourage pro-innovation approaches by regulators, with the new Regulatory Innovation Office playing an important role.

The BBC publishes information about the number of licences in force in its Annual Report and Accounts. For the years 2019/2020, 2020/2021, 2021/2022, 2022/2023, and 2023/2024 there has consistently been approximately 4,000 monochrome licences in force.

This Government, and the previous one, has engaged extensively with a wide range of stakeholders as the policy set out in the Football Governance Bill has developed over the last 3 years. This includes engagement with UEFA.

These discussions have been constructive, and we continue to speak to the relevant football authorities on a regular basis.

Pupils with special educational needs (SEN) and a requirement to attend a private school identified through an education, health and care (EHC) assessment are not impacted by the government’s VAT policy. Where a private school place is necessary to support a child with SEN, the local authority will fund it through an EHC plan. Local authorities can reclaim the cost of VAT added to fees for places that they fund through Section 33 of the VAT Act 1994.

Parents may make a choice that their child should attend a private school, but this is a choice like that made by any parent using the independent sector. Where parents have chosen to send their child to private school rather than a local authority deeming it necessary, VAT will apply to fees.

The government’s impact note on the removal of eligibility of private schools for business rates charitable relief estimates an extremely limited impact from the business rates policy taking effect, with any movement estimated to represent 0.03% of the total state school pupil population in England. This impact note is attached and can be found here: https://publications.parliament.uk/pa/bills/cbill/59-01/0129/ImpactNote.pdf.

Removing the eligibility for business rates charitable relief from private schools will raise approximately £140 million per year. Based on average per-pupil spending in England for the 2024/25 financial year, the government expects the revenue costs of pupils entering the state sector as a result of the business rates measure in England to steadily increase to a peak of around £20 million per annum after several years.

Education is a devolved matter, and the response outlines the information for England only.

The aim of the early adopter scheme is to test and learn what works in advance of national rollout on breakfast clubs to all primary schools. The schools taking part in the early adopter scheme were therefore selected to be broadly representative of the national picture. Across all primary schools, an estimated 22% have no breakfast club provision at all before school, and the remaining 78% have some provision, according to the 2022 School and College Panel. However, we know that provision is usually charged for or has limitations on the number of children who can attend. This figure will shortly be updated to reflect changes in provision since 2022.

Our new early adopter breakfast clubs are free, open to all pupils in the school, last at least 30 minutes and include food. This will save parents up to £450 per year, meaning more money in their pockets.

Education is a devolved matter, and the response outlines the information for England only.

The department is clear on the impact that breakfast clubs can have to support children to arrive at school ready to learn, which is why the government committed in its manifesto to introduce free breakfast clubs in every state-funded school with primary aged pupils. From April 2025, free breakfast clubs will be available in 750 early adopter schools, as part of a test and learn phase in advance on national roll out.

On 24 February 2025, the department published the list of schools that have been confirmed as early adopters of the free breakfast club scheme. The list is available at the following link: https://www.gov.uk/government/publications/breakfast-clubs-early-adopters-schools-in-the-scheme.

As part of the scheme, around 180,000 children will have access to a free breakfast club, which equates to around 4% of the overall state-funded primary aged school population.

Education is a devolved matter, and the response outlines the information for England only.

Providing free, universal breakfast clubs will remove barriers to opportunity by ensuring that every primary school child, no matter their circumstance, is well prepared with a supportive start to the school day.

Parents and carers can choose to take up the offer, although we encourage schools to promote the offer and drive take-up, particularly within disadvantaged groups.

The early adopter scheme is an important test and learn phase which will inform the national rollout. Through the scheme, the department will monitor delivery and collect data, including on take-up, to build our evidence base.

In line with the commitments we have made, as we move to our new UK internal market system, we will ensure that the only checks when goods move within the UK internal market system are those conducted by UK authorities as part of a risk-based or intelligence-led approach to tackle criminality, abuse of the scheme, smuggling and disease risks. But in order not to undermine that approach, as is the case across the UK we do not disclose the specific number or nature of interventions made by UK authorities.

The UK Government underlines its commitment to ensure the smooth flow of chemical products from Great Britain to Northern Ireland. This includes applying a consistent approach to the regulation of chemical products across the whole of the UK where it is necessary to do so.

The following table shows the tonnage of seed potatoes moved in the past five years broken down by seed classification (data from 2020 for Northern Ireland to Scotland is unavailable due to COVID related disruption):

Northern Ireland has unfettered access to the whole UK internal market, this ensures a smooth flow of goods, including in relation to chemical industries. The UK Government is steadfastly committed to continue protecting Northern Ireland’s unfettered access which has been guaranteed in perpetuity

£350m is currently allocated to the Access for All programme until 2028/29. A further £75m programme of works to install platform edge tactile strips on at stations that did not already have them is approaching its completion. These investments are in addition to accessibility enhancements delivered as part of other major projects or industry renewal activities.

Disabled people should be able to travel easily, confidently and with dignity. Ministers and officials have regular conversations with Transport for London on a variety of issues including accessibility of their network. Transport in London is devolved to the Mayor and TfL is responsible for managing the London Underground.

The recent Pathways to Work Green Paper announced our plans to abolish the Work Capability Assessment (WCA) and instead use the Personal Independence Payment assessment as the single assessment for additional financial support, subject to parliamentary approval. Once the WCA has been abolished the Department for Work and Pensions will no longer classify people as fit or unfit for work.

The Department published “Spring Statement 2025 health and disability benefit reforms – Impacts” alongside the Spring Statement.

This report contains estimated caseloads for the Universal Credit health element from 2026/27 to 2029/30, categorised by whether claimants are receiving the higher rate or the frozen rate from 2025/26.

By 2029/30 an estimated 2.25 million people, the pre-April 2026 current claimants, will still be receiving the higher rate of the UC health element, frozen at its 2025/26 level. A further 730,000 are forecast to be receiving the new lower rate of the health element. All will receive a standard allowance that has been increased by more than CPI inflation.

Table A5: Benefit units affected by UC health element change

Note: Estimates are after behavioural effects and are rounded to the nearest ten thousand. A benefit unit is a single adult or a married or cohabiting couple and any dependent children.

A further programme of analysis to support development of the proposals in the Green Paper will be developed and undertaken in the coming months.

We announced in the Pathways to Work Green Paper that we would establish a new guarantee of support for all disabled people and people with health conditions claiming out of work benefits who want help to get into or return to work. This is backed up by £1 billion of new funding across the United Kingdom, with the share of funding for devolved governments calculated in the usual way.

The UK government will respect settlements with devolved governments.

Within Great Britain, we will work closely with the Scottish and Welsh Governments to ensure all aspects of our new approach to delivering employment support partner effectively with devolved provision, including but not limited to skills, health and careers as well as Scottish and Welsh Government-funded employment support.

In Northern Ireland, health, skills, careers and all aspects of employment support are transferred matters. We will work closely with the Northern Ireland Executive, including sharing best practice with the Northern Ireland Executive’s Department for Communities about how our reforms to reduce economic inactivity and support disabled people and people with a health condition are working.

Improving health and work outcomes for the over 20 million people with musculoskeletal (MSK) conditions in the UK forms a key part of this government's missions to build an NHS fit for the future and kickstart economic growth.

Healthcare professionals play a vital prevention and early intervention role in supporting people to self-manage their musculoskeletal (MSK) condition and enabling them to get in and get on in work.

The 2025 Healthcare Professionals’ Consensus Statement for action on health and work, published 20 January 2025, commits to work over the next five years to support healthcare professionals, including allied health professionals, to engage more proactively with, and to promote ‘good work as a health outcome’ across the health and care sector. This will support patients, including with MSK conditions, to return and remain in good work.

To support people back into work, the Occupational Health Workforce Expansion Funding Scheme (launched July 2023) funded registered health professionals to undertake occupational health training and qualifications. To date, over 200 doctors and nurses have commenced training.

Government recognises the role complementary and alternative medicine treatments such as chiropractic can play in supporting people. NHS England does not currently support or commission chiropractic care in the NHS.

The department estimates that the legislation to means-test Winter Fuel Payments would generate a net saving of £1.3 billion in England and Wales for 2024/25. This reflects an expected increase in Pension Credit take-up, estimated at five percentage points. This assumption reduced the overall saving by £0.3 billion in 2024-25 in England and Wales, but there is significant uncertainty around this element of the costing. For further details, please see Economic and fiscal outlook – CP 1169.

The Government is committed to ensuring that older people receive the support to which they are entitled. That’s why we are taking significant steps to maximise the take-up of Pension Credit. The Department’s campaign to promote Pension Credit has been running since September and has included TV, radio, social media such as Facebook and Instagram, on YouTube, on advertising screens, including on GP and Post Office screens as well as in the press.

The latest phase of the campaign ran from 8 November and was aimed at friends and family - especially adult children of eligible pensioners - asking them to tell people they know about Pension Credit, encourage them to check their eligibility, as well as help them make a claim.

In November we also wrote to around 120,000 pensioners who were in receipt of Housing Benefit but not Pension Credit. We invited these pensioners to claim Pension Credit in time to make a successful backdated Pension Credit claim and qualify for a Winter Fuel Payment.

In order to promote Pension Credit through as many channels as possible, we have also engaged with key stakeholders and partners, including other government departments, local councils, housing associations, community groups, local libraries and service providers as well as charities and third sector organisations.

Our campaign has seen DWP receive around 150,000 Pension Credit applications in the 16 weeks since the Winter Fuel Payment announcement. This is compared to around 61,300 Pension Credit applications in the 16 weeks preceding the announcement – a 145% increase in applications since the 29 July.

Over the coming weeks, as part of the annual State Pension uprating exercise, around 11 million pensioners will receive a leaflet promoting Pension Credit along with their State Pension uprating letter.

The Government is committed to tackling the biggest killers, such as cardiovascular disease (CVD). Improving early detection and diagnosis of the key risk factors for CVD, including high blood pressure and raised cholesterol levels, is vital to deliver on this commitment.

The Government continues to support the NHS Health Check, England’s CVD prevention programme. For every 1.4 million NHS Health Checks delivered annually, there are 343,000 cases of high blood pressure identified, resulting in 40,000 diagnoses of hypertension, as well as 900,000 people identified with raised cholesterol levels.

To improve access to the NHS Health Check, we are developing a new NHS Health Check Online service, which people can use at a time and place convenient to them, to understand and act on their risk of CVD.

Subject to the outcomes of the NHS Health Check Online pilot, starting in spring 2025, the aim is to roll it out nationally from spring 2026, delivering approximately one million checks in the first four years.

The Department is also piloting a new programme to deliver up to 130,000 lifesaving heart health checks in the workplace. These checks can be completed quickly and easily by people at work across 48 local authorities until 31 May 2025.

For the 2025/26 contract year we have also brought in changes to shift care from sickness to prevention by incentivising general practitioners to focus on the most common killers, such as heart disease. Knowing that prevention is better than treatment, we have raised the upper threshold of CVD indicators in order to stimulate performance gains and improve CVD care for patients.

We are committed to ensuring that fewer lives are lost to the biggest killers, including from cardiovascular disease (CVD). That is why, in our Health Mission to build a National Health Service fit for the future, we have committed to reducing premature deaths from heart disease and strokes by 25% in the next 10 years.

The NHS Health Check programme, England’s CVD prevention programme, engages over 1.4 million people a year and, through behavioural and clinical interventions, prevents approximately 300 premature deaths, and 500 heart attacks or strokes a year. Data reported by local authorities shows that between April 2013 and December 2024, over 13.6 million NHS Health Checks have been delivered.

To improve access to the NHS Health Check, we are developing a new NHS Health Check Online service, which people can use at a time and place convenient to them, to understand and act on their risk of CVD.

For the 2025/26 contract year we have also brought in changes to shift care from sickness to prevention by incentivising general practitioners to focus on the most common killers, such as heart disease. Knowing that prevention is better than treatment, we have raised the upper threshold of CVD indicators in order to stimulate performance gains and improve CVD care for patients.

Our approach to personalised prevention is through the NHS Health Check, England’s cardiovascular disease (CVD) prevention programme.

The Government continues to support this programme as it assesses the top seven risk factors for CVD in people aged 40 to 74 years old. Where an individual’s NHS Health Check indicates that further action is necessary, they may be referred to either behavioural support services and/or a clinical assessment, where appropriate.

To improve access to the NHS Health Check, we are developing a new NHS Health Check Online service, which people can use at a time and place convenient to them, to understand and act on their risk of CVD.

The Department is also piloting a new programme to deliver up to 130,000 lifesaving heart health checks in the workplace. These checks can be completed quickly and easily by people at work across 48 local authorities until 31 May 2025.

The Government is committed to ensuring that everyone is able to benefit from evidence-based health care. Routine lipoprotein(a) (Lp(a)) measurement is not currently recommended by the National Institute for Health and Clinical Excellence (NICE).

The Department, and NHS England, will continue to look to the NICE for guidance on the role of Lp(a) testing. Should the NICE’s guidance change regarding the role of Lp(a) testing, the Department will assess any recommendations to inform future cardiovascular disease prevention policy.

Neither the Department nor NHS England have met with the Lipoprotein(a) (Lp(a)) Taskforce in the past six months, and there are no meetings scheduled.

Routine Lp(a) testing is not recommended by the National Institute for Health and Care Excellence’s (NICE) guidance, and there are currently no treatments available which specifically target Lp(a).

The Government continues to focus on improving the uptake of lipid lowering therapies and treatment, as per NICE targets, to manage cholesterol for the prevention of cardiovascular disease.