Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will commit to appointing a new National Clinical Director for Rare Diseases.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Working under the UK Rare Diseases Framework the Government is committed to improving the lives of those living with rare diseases. NHS England and the Department are strongly supportive of clinical leadership and recognise that national clinical directors play an important role in policy development and implementation. There are over 7,000 types of rare disease which span the range of clinical specialities. As such, NHS England and the Department expect to continue to draw upon the range of clinical expertise that their national clinical directors hold to inform our work in this area, as well as that of expert clinicians delivering services for rare diseases, such as those commissioned by specialised commissioning. In addition, there is a National Medical Director for Specialised Services who provides national leadership and advice for the healthcare of rare disease and oversight for the portfolio of rare diseases which NHS England commissions services for.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he will review the current eligibility criteria for NHS-funded COVID-19 vaccinations, in light of the emergence of a new variant and rising hospitalisations.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Joint Committee on Vaccination and Immunisation carefully considered the latest evidence on the risk of hospitalisation and mortality in specific groups, as well as cost-effectiveness analysis, in order to provide the Government with advice on the autumn 2025 programme. The evidence indicates that whilst the risk from COVID-19 is now much lower for most people, adults aged 75 years old and over, residents in care homes for older adults, and those who are immunosuppressed are those at highest risk of serious COVID-19 disease.
Therefore, a more targeted vaccination programme aimed at individuals with a higher risk of developing serious disease, and where vaccination was considered potentially cost-effective, was advised for autumn 2025.
The latest UK Health Security Agency’s (UKHSA) data in the national flu and COVID-19 surveillance report supports the current eligibility, showing that there is a strong association between age and COVID-19 hospitalisation rates. The highest hospital admission rate for COVID-19 in the report published on 27 November 2025 was in those aged 85 years old and over.
Currently XFG and its sub lineages, sometimes called the ‘Stratus’ variant, are the most prevalent SARS-CoV-2 lineages in England. This lineage is closely related to previous variants that circulated in the United Kingdom. At this time there is no indication that XFG causes more serious disease, or that the vaccines being used in the autumn 2025 campaign will not be effective against it. The UKHSA will continue to monitor both COVID-19 outcomes and variant prevalence as we enter the winter season.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to respond to question 81028, tabled on 10 October 2025.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
I refer the hon. Member to the answer I gave on 1 December 2025 to Question 81028.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
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 availability of NHS dental services in the Bracknell Forest wards of Maidenhead constituency; and what steps he is taking to improve access to NHS dentistry in the Ascot, Binfield with Warfield, and Winkfield and Cranbourne areas.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend. Some dental practices may operate local waiting list arrangements. Therefore, data is not available on the number of people who are unable to register with a dentist in the Maidenhead constituency.
The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Maidenhead constituency, this is the Frimley ICB.
The data for the NHS Frimley ICB shows that 40% of adults were seen by an NHS dentist in the previous 24 months up to June 2025, which is the same as the average for England, and 56% of children were seen by an NHS dentist in the previous 12 months up to June 2025, compared to 57% in England.
We are aware of the challenges faced in accessing a dentist, particularly in underserved areas, and the Government is taking action to improve this. We have asked ICBs to commission extra urgent dental appointments across the country, with appointments more heavily weighted towards those areas where they are needed the most. The Government is also considering the outcomes of the consultation on immediate improvements to dental care and will publish a response shortly.
ICBs are also recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.
We are committed to reforming the dental sector and we will deliver fundamental contract reform before the end of this Parliament.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
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 people in the Bracknell Forest wards of Maidenhead constituency who are unable to register with an NHS dentist.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend. Some dental practices may operate local waiting list arrangements. Therefore, data is not available on the number of people who are unable to register with a dentist in the Maidenhead constituency.
The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Maidenhead constituency, this is the Frimley ICB.
The data for the NHS Frimley ICB shows that 40% of adults were seen by an NHS dentist in the previous 24 months up to June 2025, which is the same as the average for England, and 56% of children were seen by an NHS dentist in the previous 12 months up to June 2025, compared to 57% in England.
We are aware of the challenges faced in accessing a dentist, particularly in underserved areas, and the Government is taking action to improve this. We have asked ICBs to commission extra urgent dental appointments across the country, with appointments more heavily weighted towards those areas where they are needed the most. The Government is also considering the outcomes of the consultation on immediate improvements to dental care and will publish a response shortly.
ICBs are also recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.
We are committed to reforming the dental sector and we will deliver fundamental contract reform before the end of this Parliament.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the suitability of the National Institute for Health and Care Excellence’s approach to evaluating the cost-effectiveness of rare disease medicines.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.
NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.
NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.
The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
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 people living with rare diseases in England have timely access to innovative medicines.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.
NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.
NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.
The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
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 in response to research by the UK BioIndustry Association published on 6 November 2025 showing that around half of rare disease medicines approved by the European Medicines Agency (EMA) are not being reimbursed for patients in England.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.
NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.
NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.
The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of trends in the level of regional variations in the proportion of NHS Continuing Healthcare applications that are approved; and what steps he is taking to ensure consistency in decision making across Integrated Care Boards.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The Department works closely with NHS England to monitor levels of regional variation in eligibility for NHS Continuing Healthcare (CHC). This includes NHS England implementing an operational assurance regime across regions which promotes accurate assessment, equal access, standardisation, and consistency within CHC funding.
This assurance regime has a specific focus on reducing unwarranted variation in CHC across the country. To support this further during 2025/26, NHS England has increased their regional assurance meetings from every three months to every two months.
To support improved patient experience in relation to CHC, the NHS Performance and Assessment Framework for 2025/26 also includes an assurance standard for Integrated Care Boards to monitor the percentage of Standard CHC referrals completed within 28 days.
Asked by: Joshua Reynolds (Liberal Democrat - Maidenhead)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to allow inhalers to be sold over the counter without a prescription.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
At present, inhalers used for conditions such as asthma and chronic obstructive pulmonary disease are authorised as prescription-only medicines (POM). This classification reflects the clinical need for a healthcare professional to confirm diagnosis, advise on correct inhaler technique, determine appropriate dosing, monitor treatment response, and detect any adverse reactions. The prescription requirement also supports the systematic recording of use and helps prevent inappropriate or excessive use.
It is also important to note that inhalers themselves are not a class of medicine per se but a delivery device for a range of medicines.
If a manufacturer or marketing authorisation holder wishes to pursue POM to pharmacy medicine reclassification for any type of medicine or their mode of delivery, the appropriate route is to submit a major reclassification application to the Medicines and Healthcare products Regulatory Agency (MHRA). This is a formal dossier that must present a robust evidential case in support of reclassification.
The MHRA publishes guidance on the requirements for reclassification applications, including what constitutes a “major” reclassification. The MHRA is open to early dialogue with sponsors to clarify expectations and help focus application efforts via the provision of scientific advice. Until such an application is received and assessed under the statutory framework, the prescription requirement remains in place.
Should a comprehensive dossier be submitted, the MHRA will consider it in line with its public-health mandate. The MHRA remains open to innovations that improve patient access and convenience, provided they uphold safety, clinical outcomes, and quality of care.