Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, how many Full‑Time Equivalent staff are engaged via the Managed Service Provider, broken down by business area.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
HMRC is currently using Managed Service Providers (MSPs) to provide additional customer service capacity, equivalent to around 500 FTE, focused on routine work. This includes support for the Online Services Helpdesk and handling simple PAYE enquiries.
HMRC are currently in an initial approximately 18 month ‘proof of value’ phase using existing Government contracts. This will allow them to test, learn and ensure quality and value for money before wider implementation.
HMRC has been clear that no HMRC colleague will be made redundant as a result of this initiative.
HMRC will continue to use a range of resourcing models, alongside the use of MSPs, to meet variable customer demand.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, what modelling HMRC has undertaken on the displacement risk from the Managed Service provider model to existing HMRC roles, including surge staff and fixed‑term employees.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
HMRC is currently using Managed Service Providers (MSPs) to provide additional customer service capacity, equivalent to around 500 FTE, focused on routine work. This includes support for the Online Services Helpdesk and handling simple PAYE enquiries.
HMRC are currently in an initial approximately 18 month ‘proof of value’ phase using existing Government contracts. This will allow them to test, learn and ensure quality and value for money before wider implementation.
HMRC has been clear that no HMRC colleague will be made redundant as a result of this initiative.
HMRC will continue to use a range of resourcing models, alongside the use of MSPs, to meet variable customer demand.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, whether Managed Service Provider staffing levels are expected to increase beyond peak‑demand coverage for each function.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
HMRC is currently using Managed Service Providers (MSPs) to provide additional customer service capacity, equivalent to around 500 FTE, focused on routine work. This includes support for the Online Services Helpdesk and handling simple PAYE enquiries.
HMRC are currently in an initial approximately 18 month ‘proof of value’ phase using existing Government contracts. This will allow them to test, learn and ensure quality and value for money before wider implementation.
HMRC has been clear that no HMRC colleague will be made redundant as a result of this initiative.
HMRC will continue to use a range of resourcing models, alongside the use of MSPs, to meet variable customer demand.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, what HMRC’s projected Managed Service Provider headcount is for the (a) next 12 months and (b) Spending Review period.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
HMRC is currently using Managed Service Providers (MSPs) to provide additional customer service capacity, equivalent to around 500 FTE, focused on routine work. This includes support for the Online Services Helpdesk and handling simple PAYE enquiries.
HMRC are currently in an initial approximately 18 month ‘proof of value’ phase using existing Government contracts. This will allow them to test, learn and ensure quality and value for money before wider implementation.
HMRC has been clear that no HMRC colleague will be made redundant as a result of this initiative.
HMRC will continue to use a range of resourcing models, alongside the use of MSPs, to meet variable customer demand.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, whether HMRC plans to maintain Customer Services Group headcount and total productive hours as Managed Service Provider capacity increases.
Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)
HMRC is currently using Managed Service Providers (MSPs) to provide additional customer service capacity, equivalent to around 500 FTE, focused on routine work. This includes support for the Online Services Helpdesk and handling simple PAYE enquiries.
HMRC are currently in an initial approximately 18 month ‘proof of value’ phase using existing Government contracts. This will allow them to test, learn and ensure quality and value for money before wider implementation.
HMRC has been clear that no HMRC colleague will be made redundant as a result of this initiative.
HMRC will continue to use a range of resourcing models, alongside the use of MSPs, to meet variable customer demand.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of and the capacity in the specialist spinal cord injury service.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.
NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.
All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.
The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.
Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.
Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the adequacy of service specifications and commissioning plans for spinal cord injury.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.
NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.
All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.
The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.
Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.
Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will commit to making the 2022 SCI Rehabilitation Standards mandatory.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Specialised spinal cord injury services are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group. This translates to 385 spinal cord injury beds commissioned from eight providers in England. NHS England provides annual funding of approximately £80 million to spinal cord injury centres to deliver inpatient care and outreach to secondary care prior to admission and to community services following discharges to support transition.
NHS England recognises that services have experienced increasing referrals alongside complexity of presentations. NHS England plans to undertake work during 2026/27 to assess the adequacy of treatment pathways within specialised spinal injury services and will consider if any further updates are required to the national service specification based on the findings.
All spinal cord injury providers are required to submit outcome data to the Specialised Services Quality Dashboard. These data enable the National Health Service to monitor of the quality of care, including clinical outcomes and equitability of access. The data is linked to the national spinal cord injury (SCI) registry, which provides audit data.
The dashboard is a key tool in monitoring the quality of services, enabling comparison between service providers, and supporting improvements over time in the outcomes of services commissioned by NHS England.
Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.
Spinal Cord Injury services in England are commissioned against the published national service specification, which sets out the mandated standards that all providers are required to meet for all patients, including in relation to rehabilitation. The service specification mandates that spinal cord injury centres must provide restorative rehabilitation and re-enablement, and support patients’ reintegration into the community. When a patient is admitted to a spinal cord injury centre, there must be a focus on rehabilitation from the outset, with treatment by a co-ordinated multidisciplinary team. The specification is available at the following link:
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he has taken to consult specialist healthcare professionals and people with lived experience of spinal cord injury in determining changes to commissioning structures for specialist spinal cord injury services.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Ahead of its planned abolition, NHS England has been considering whether any specialised services currently retained for national commissioning by NHS England should transfer to integrated care boards (ICBs) or become the commissioning responsibility of the Department. This process, which has included engagement with NHS England’s regional commissioning teams and relevant national clinical leads, has identified 11 services, including spinal cord injury services, which would benefit from a more integrated approach to commissioning achieved through the transfer of commissioning responsibility to ICBs. A final decision on which specialised services will transfer and become the commissioning responsibility of ICBs will need approval by Parliament for the necessary changes in primary legislation and, where required, secondary legislation.
Changes to the commissioning architecture will not themselves result in any service change. Where commissioning plans would result in service change, commissioners have a statutory duty to involve and consult the public, which would provide an opportunity to hear from people with lived experience. We recognise that where responsibility for commissioning specialised services is transferred to ICBs, it will be important to maintain expert commissioning knowledge and capability. That is why we are taking steps to establish an office for Pan-ICB Commissioning within each of the seven National Health Service regions to support all ICBs across a region in commissioning specialised services, including the planning and commissioning of services ‘at scale’ where this is appropriate.
The Government fully recognises the importance of maintaining a national framework of standards and clinical commissioning policies to ensure equitable access to specialised services for all patients. This will apply to all specialised services regardless of whether they become the commissioning responsibility of ICBs or the Department in the future.
We are committing to addressing geographic variation in the access to and the quality of rehabilitation services for people with spinal cord injury. In October 2025, the National Institute for Health and Care Excellence (NICE) published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. The Government expects commissioners and service providers to take NICE guidance fully into account when designing services that meet the needs of their local population and work towards implementation over time.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he has taken to consult specialist healthcare professionals and people with lived experience of spinal cord injury in determining changes to commissioning structures for specialist spinal cord injury services to address geographic variations in (a) access and (b) quality of rehabilitation services for people with spinal cord injury.
Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)
Ahead of its planned abolition, NHS England has been considering whether any specialised services currently retained for national commissioning by NHS England should transfer to integrated care boards (ICBs) or become the commissioning responsibility of the Department. This process, which has included engagement with NHS England’s regional commissioning teams and relevant national clinical leads, has identified 11 services, including spinal cord injury services, which would benefit from a more integrated approach to commissioning achieved through the transfer of commissioning responsibility to ICBs. A final decision on which specialised services will transfer and become the commissioning responsibility of ICBs will need approval by Parliament for the necessary changes in primary legislation and, where required, secondary legislation.
Changes to the commissioning architecture will not themselves result in any service change. Where commissioning plans would result in service change, commissioners have a statutory duty to involve and consult the public, which would provide an opportunity to hear from people with lived experience. We recognise that where responsibility for commissioning specialised services is transferred to ICBs, it will be important to maintain expert commissioning knowledge and capability. That is why we are taking steps to establish an office for Pan-ICB Commissioning within each of the seven National Health Service regions to support all ICBs across a region in commissioning specialised services, including the planning and commissioning of services ‘at scale’ where this is appropriate.
The Government fully recognises the importance of maintaining a national framework of standards and clinical commissioning policies to ensure equitable access to specialised services for all patients. This will apply to all specialised services regardless of whether they become the commissioning responsibility of ICBs or the Department in the future.
We are committing to addressing geographic variation in the access to and the quality of rehabilitation services for people with spinal cord injury. In October 2025, the National Institute for Health and Care Excellence (NICE) published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. The Government expects commissioners and service providers to take NICE guidance fully into account when designing services that meet the needs of their local population and work towards implementation over time.