Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to increase the minimum age for access to adult gender clinics.

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

On 18 December, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. The review provides a strong basis for action to improve adult gender services.

As set out in the Written Ministerial Statement published alongside the Review, NHS England and the Department are taking forward a set of immediate priorities. This includes raising the referral threshold to 18 years old, aligning it with the age of discharge from the NHS Children and Young People’s Service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the reasons why annual referrals to adult gender clinics have doubled since 2022–23; and whether they have made an assessment of the impact of social media and educational settings on referral patterns of young people.

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

The review into the operation and delivery of NHS Adult Gender Dysphoria Clinics (GDCs), led by Dr Levy, was published on 18 December 2025 and undertook a comprehensive examination of all nine National Health Service-commissioned adult GDCs in England. The review specifically considered issues of access to clinics, reviewing both the volume of referrals and the length of waiting times for initial assessment and treatment. Dr Levy identified that waiting times for first appointments remain lengthy, with a significant increase in the number of people awaiting assessment, as annual referrals have doubled since 2022/23. The review attributed these extended waits to several factors, including improved reporting as more clinics have joined the national system, as well as a backlog from referrals deferred during the COVID-19 pandemic.

The review also set out that surgery waiting times also contribute to the problem, as some masculinising procedures have waits of approximately eight to nine years. As a result, many patients require extra GDC appointments because the current service specification mandates follow-up reviews every six months for those waiting for surgery.

NHS England has established a National Portfolio Board, in line with Dr Levy’s recommendation, to build and develop a full implementation plan. This will address each of the review’s recommendations in turn and be aligned with the ambitions of the Government’s 10-Year Health Plan for England.

Baroness Cass’s Independent Cass Review of Gender Identity Services for children and young people published in 2024 and observed social factors, including social media and links with children and young people experiencing gender dysphoria.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what research they have commissioned, if any, to assess whether peer-group clustering occurs in gender clinics, in particular among adolescent girls; and what clinical protocols are in place to assess the influence of social factors in referrals to gender services.

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

The new, regional children and young people (CYP) services provide holistic care, centred on psychosocial support. This will include thorough mental health support that takes account of the child and young person's individual circumstances, including social factors.

More widely, the Independent Cass Review published in 2024, of which the new National Health Service CYP Gender Services are based, sets out the role social factors, including the role of social media and family mental health problems have in CYP experiencing gender dysphoria.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that NHS adult gender clinics maintain comprehensive patient data and outcomes records.

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

On 18 December 2025, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. This review provides a strong basis for action to improve adult gender services.

Recommendation 13 of the review states that NHS England should work with adult gender dysphoria clinics (GDCs) to establish a national minimum dataset so medium and long-term patient outcomes can be understood following treatment by the adult GDCs, and to develop a national research strategy for adult gender dysphoria services.

NHS England, in full partnership with the Department, will now take forward the implementation of the review’s recommendations.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance they have issued to NHS adult gender clinics about the assessment and management of patients with mental health comorbidities; and what proportion of patients prescribed cross-sex hormones have comorbidities.

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

The approach for assessment, diagnosis, and care planning, including patients with other presentations, are described in NHS England's published service specification for National Health Service adult gender clinics, which was adopted in April 2020 following a comprehensive public consultation, respondents to which included medical bodies, professional associations, and regulatory bodies. There is currently no specific data field that records the number of patients who are prescribed cross-sex hormones and who have comorbidities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress they have made towards implementing the recommendations of the Levy Review into adult gender services; and when they plan to publish a full implementation report.

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

The review into the operation and delivery of NHS Adult Gender Dysphoria Clinics (GDCs), led by Dr Levy, was published on 18 December 2025 and forms the basis for improving adult gender services.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, laid a Written Ministerial Statement following the review’s publication. This set out that in response to the findings of this review, the Department and NHS England are taking forward a set of immediate priorities that includes:

- creating a new single, national waiting list for adult gender services to be implemented in April 2026;

- raising the referral threshold to 18 years old to align with the age of discharge from the NHS Children and Young People’s Service;

- bringing an end to self-referrals into the service and, in parallel, providing advice and guidance for those finding it difficult to secure a referral; and

- establishing challenging but achievable productivity goals for every service which can then guide and inform the commissioning of additional services, underpinned by a clear understanding of the regional demand through the national waiting list.

In addition to this, NHS England has established a National Portfolio Board, in line with Dr Levy’s recommendation, to build and develop a full implementation plan for the Adult Gender Services review.

We are making progress beyond this review, as NHS England has increased the number of adult GDCs in England from seven to 12 since 2020, and has established a national Quality Improvement Network for Adult Gender Services. In order to support the well-being of patients awaiting their first appointment with a GDC, we are rolling out a ‘waiting well’ pilot for patients on the waiting list for the GDC in the South West.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what spending is allocated across all departments to supporting individuals who are defined by themselves or others as neurodiverse.

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

This specific data is not held centrally. The 2025 Spending Review prioritised health, with record investment in the health and social care system. The Spending Review announced that annual National Health Service day-to-day spending will increase by £29 billion in real terms, a £53 billion cash increase, by 2028/29 compared to 2023/24. This will take the NHS resource budget to £226 billion by 2028/29, the equivalent to a 3% average annual real terms growth rate over the Spending Review period.

However, the Government has been clear that this investment must come with reform. We will completely reorient the NHS’s operating model, so it is focussed on the most important things, better outcomes for patients.

NHS England is responsible for determining allocations of financial resources to integrated care boards (ICBs). Funding for attention deficit hyperactivity disorder (ADHD) and autism assessments are included within NHS England’s financial allocations to ICBs. The process of setting allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time. ICB allocations for 2026/27 to 2028/29 were published on 17 November 2025 and are available on the NHS England website.

Through the Medium-term planning framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

On Monday 23 February, the Government published the Schools White Paper, Every child achieving and thriving, and a consultation document on Special Educational Needs and Disabilities (SEND) reforms, with both documents being available on the GOV.UK website. SEND reforms begin with significant upfront investment, joint planning, and a lead in period to build system capacity ahead of legislation. As part of these reforms, £4 billion is being invested over the next three years to make schools more inclusive, including £1.8 billion over three years for the new Experts at Hand offer which will bring health and education professionals into schools to upskill education staff and enable earlier intervention.

The Experts at Hand offer builds on the emerging evidence from programmes such as Partnerships for Inclusion of Neurodiversity in Schools, which show the benefits of embedding health and other specialist professionals in mainstream settings to support settings to be more inclusive and to de-escalate need.

Question to the Ministry of Housing, Communities and Local Government:

To ask His Majesty's Government, further to the Written Statement by Baroness Taylor of Stevenage on 21 November 2024 (HLWS240), in which clauses of the Leasehold and Freehold Reform Act 2024 (1) the loophole which means the Act goes beyond its intended reforms to valuation, and (2) the omission that would deny shared ownership leaseholders the right to extend their lease with their direct landlord, are found.

Answered by Baroness Taylor of Stevenage - Baroness in Waiting (HM Household) (Whip)

The valuation loophole is contained in Schedule 4, paragraph 17(2) of the Leasehold and Freehold Reform Act 2024. The omission related to shared ownership will require new provisions to be added to the Act.

As set out in the WMS of 27 January 2026 HLWS1278 (attached), the government will rectify these flaws in primary legislation.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 5 February (HL13750), what is the evidence base that there is a stigma around mental health in schools that requires intervention by the Government.

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

The importance of reducing the stigma around mental health is widely recognised, backed up by evidence such as the Lancet Commission on Ending Stigma and Discrimination in Mental Health, published in 2022, and is frequently highlighted as a key issue by stakeholders and service users. The findings are available on the Lancet Commission’s website.

The initial Mental Health Support Team (MHST) evaluation, the Early evaluation of the Children and Young People's Mental Health Trailblazer programme from 2023, and the more recently published Findings from surveys of schools and colleges and Mental Health Support Teams from 2025, both found overwhelmingly positive support for MHSTs from education staff. This data is available on page 21 of the attached document.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what proportion of people who use the Access to Work scheme for mental health support have a diagnosed condition.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

The information requested is not held centrally and extracting this information would require manual examination of individual records and exceed the cost limit.

Question to the Department for Work and Pensions:

To ask His Majesty's Government how much has been spent on mental health support as part of the Access to Work scheme in each of the past five years, broken down by mental health condition.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

The information requested is not readily available and to provide it would incur disproportionate cost.

Although the Department holds information on the mental health conditions of Access to Work customers and the specific types of support they receive, information on specific mental health conditions and how much has been spent on mental health support is not readily accessible. The required information is recorded as descriptive free-text information and extracting it would require manual review of individual records.

While we cannot provide total expenditure on mental health support, the Access to Work official statistics do report expenditure for customers whose primary medical condition is a mental health condition, as well as for the Mental Health Support Service, as seen in the table below.