Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that the 18-week waiting time target can be met.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to returning, by March 2029, to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.
In November 2025, performance against the standard was at 61.8%, 2.6% higher than a year earlier. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369 despite 30.1 million referrals being added onto the waiting list.
As set out in the Elective Reform Plan, we’ve set ambitious targets, and are investing in modernisation, and reforming and simplifying pathways, increasing surgical and diagnostic capacity, and empowering patients with faster and more convenient access to care. We’ve made good progress, through there remains lots more to do.
We will empower patients by giving them more choice and control, reform delivery by working more consistently, and in many cases differently, to deliver more elective care, ensure care takes place in the right place, and implement robust and regular oversight of performance with clear expectations.
In September last year, we announced a new “online hospital”, through NHS Online, which will help to reduce patient waiting times, delivering the equivalent of up to 8.5 million appointments and assessments in its first three years, four times more than an average trust, while enhancing patient choice and control over their care. The first patients will be able to use the service from 2027.
We are investing £6 billion of additional capital over five years for diagnostic, elective, urgent, and emergency capacity in the NHS. This includes £1.65 billion of capital funding in 2025/26 to support both immediate winter capacity and infrastructure transformation, for instance new surgical hubs, community diagnostic centres, and beds to increase capacity for elective and emergency care.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of patients whose treatment has been delayed as a result of restrictions placed on private providers delivering NHS services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.
Integrated care boards have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. Commissioners’ use of these powers support systems to live within their means and deploy better financial discipline than previous years where systems have overspent. As these powers are exercised by local systems, no national assessment has been made.
We expect use of activity management provisions by local systems to support efforts achieving the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.
All trusts are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
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 potential impact of activity management plans on patient waiting times for elective surgery.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set Indicative Action Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.
The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also living within financial budgets set for 2025/26.
Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18 week standard. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what support for training and resources his Department is providing to integrated care boards to help implement the NHS England Maternal Care Bundle, published on 6 January 2026.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Maternity care remains a top priority for NHS Providers, as demonstrated in the planning guidance.
Maternity services in England are commissioned by integrated care boards (ICBs), and maternity funding, which formed part of the System Development Funding in 2024/25, has been transferred to ICB core allocations for 2025/26. This is to allow local leaders more flexibility to serve the needs of their population.
The Maternity Care Bundle codifies best practice standards and therefore the implementation of the Maternity Care Bundle will be absorbed through ICB core allocations.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions has he had to help conclude the dialogue between NHS England and the manufacturer of givinostat as part of the NICE appraisal.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has had no such discussions. NHS England is responsible for any commercial discussions with companies whose products are undergoing a National Institute for Health and Care Excellence evaluation.
Following discussions in November 2025, NHS England invited the manufacturer, ITF Pharma UK and Ireland, to submit a written proposal to progress a potential commercial agreement in December, with a range of ideas being offered by NHS England that could form the basis of a deal.
NHS England is still awaiting a proposal from the company and has continued to press ITF Pharma on the need to make progress as patients and campaigners deserve certainty on the next steps regarding access to this treatment.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he is taking steps to ensure that all patients with suspected leukaemia symptoms can access a full blood count test within 48 hours, as recommended by the NICE NG12 guidelines.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is determined to take all the necessary steps to improve early diagnosis for all cancers, including blood cancers such as leukaemia.
To accomplish this, the National Health Service is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.
The National Institute for Health and Care Excellence (NICE) has a guideline on suspected cancer called ‘recognition and referral’ which aim to support the identification of children, young people and adults with symptoms that could be caused by cancer’. The guideline provides guidance on appropriate investigations in primary care, and the selection of people to refer for a specialist opinion. The guideline recommends that people with specific symptoms should be offered a very urgent full blood count to assess for leukaemia. Local NHS organisations are expected to take NICE guidelines fully into account in ensuring that their services meet the needs of their local populations. The NHS is held to account to deliver guidelines, which include all NICE directions, at local and regional level.
The National Cancer Plan for England will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention. The plan will seek to improve every aspect of cancer care to better the experience and outcomes for all patient groups, including leukaemia patients.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to support the development of gene therapy treatments for rare genetic diseases such as tyrosinemia and Gaucher disease.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to improving the lives of those living with rare diseases, such as tyrosinemia and Gaucher disease. Through the UK Rare Diseases Framework, the Government supports access to specialist care, treatment, and drugs as a priority. This has included NHS England developing a strategic approach to commissioning advanced therapy medicinal products (ATMPs) to facilitate rapid access to National Institute for Health and Care Excellence approved therapies.
We recognise the transformative potential of gene therapies and other advanced therapy medicinal products (ATMPs) for rare diseases and have stood up an advanced therapies co-ordination group spanning public sector partners. This group aims to create a joined-up ecosystem that will support the development, regulation, and delivery of ATMPs in the United Kingdom. We continue to invest in ATMPs through initiatives such as the Cell and Gene Therapy Catapult. With £17.9 million of new funding via the National Institute of Health and Care Research (NIHR), the Advanced Therapy Treatment Centres is driving forward work to enhance the UK’s environment for ATMP clinical trials and to progress research within the National Health Service to ensure patients can get safe access to these innovative therapies.
NIHR’s ‘Be Part of Research’ allows individuals to find and take part in current research. There are currently a number of studies on tyrosinemia and Gaucher disease where researchers are actively looking for participants. Further information on NIHR’s ‘Be Part of Research’ is avaiable at the following link:
https://bepartofresearch.nihr.ac.uk/
This includes a clinical trial assessing the safety of a gene therapy for those with peripheral manifestations of Gaucher disease, with further information avaiable at the following link:
https://bepartofresearch.nihr.ac.uk/trial-details/trial-detail?trialId=55560&location=&distance=
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
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 the time taken by NICE to assess Givinostat.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) aims wherever possible to publish recommendations on new medicines close to the point of licensing. NICE’s appraisal of givinostat has been more complex and has required additional work to ensure that it is able to make a recommendation on its use for the NHS. The timeline was extended following discussions with the company in order to facilitate a suitably comprehensive and robust submission and to incorporate a four-week targeted call for evidence from stakeholders. This call was to address specific areas where additional evidence was required to support the NICE appraisal committee to make a fully informed decision. NICE’s Appraisal Committee met to consider its recommendations on 23 October 2025. Stakeholders in the appraisal will be kept informed of the outcome and the next steps for the appraisal of givinostat as it progresses.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that the National Maternity Taskforce includes balanced representation between (a) professional bodies and (b) families with lived experience of maternity services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care, will be made of up a breadth of expertise. This will include people who bring clinical and international perspectives, those who can speak to the inequalities within maternal health, workforce representatives, and families with lived experience.
We are currently engaging with families, including service user representatives, as well as other individuals and organisations in the maternity and neonatal sector, on the make-up of the taskforce and its terms of reference, and we will carefully consider their feedback.
My Rt Hon. Friend, the Secretary of State for Health and Social Care is committed to ensuring the voices of women and families are at the heart of improving maternity and neonatal care.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to help ensure that diagnostic imaging in the NHS is reported within 4 weeks.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Ensuring patients receive their diagnostic test results quickly is a priority for the Government. NHS England’s guidance, published in August 2023, sets out that imaging reports must be provided within four weeks, or 28 days, of image acquisition. All National Health Service providers and imaging networks are expected to meet this standard. The guidance is available at the following link:
https://www.england.nhs.uk/long-read/diagnostic-imaging-reporting-turnaround-times/
Achieving this relies on good digital connectivity, IT infrastructure, home working solutions, and approved insourcing models established across imaging departments and networks. That is why the Government is investing in digital diagnostic transformation through NHS England’s Diagnostics Digital Capability Programme, which ensures that networks have a core set of digital capabilities to improve the quality, safety, and productivity of care.
The 2025 Spending Review settlement commits to a major transformation of care delivery, moving from analogue to digital systems, hospital to community-based care, and from treatment to prevention. To support this, the NHS productivity plan is backed by a nearly 50% increase to NHS technology and digital transformation spend in 2025/26, totalling up to £10 billion by 2028/29.
NHS England has also formed 22 imaging networks across the country to improve the quality, safety, and productivity of care, and to accelerate test reporting through digital investment.
The Elective Reform Plan, published on 6 January 2025, sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament including transforming and expanding diagnostic services to reduce waits for test results.