Lord Scriven

The Manchester Task Force (MTF) began meeting in February 2020, made up of Department for Transport, Network Rail, train operators, Rail North Partnership, Transport for the North and Transport for Greater Manchester. Through gathering evidence, developing options and publicly consulting, the task force identified a range of short and long-term actions to improve the performance of the railway in Manchester/across the North and support future growth in passengers.

The task force identified the Sheffield-Manchester Airport service, which reversed at Manchester Piccadilly, consuming two train paths in each direction, as one of the worst performing, with a significant impact on delays across the network.

The new timetable developed by MTF has delivered improvements in reliability of around 30 per cent, and the task force concept is now being used to resolve issues on the East Coast main line. As new infrastructure is realised and longer trains allow for a greater capacity with less congestion, we will look at services that could be reintroduced, possibly including direct services from Sheffield to the Airport, although there could be other towns and cities making a case for their pre-2022 direct connections to be restored as well.

This service was withdrawn in December 2022 in the timetable developed by the Manchester Task Force, a cross-industry group comprising of Transport for the North, train operators and Network Rail, to deliver more reliable services through Manchester.

The task force identified the Sheffield-Manchester Airport service, which reverses at Manchester Piccadilly, consuming two train paths in each direction, as one of the worst performing, with a significant impact on delays across the network.

The new timetable has delivered improvements in reliability of around 30 per cent, and the task force concept is now being used to resolve issues on the East Coast main line. As new infrastructure is realised and longer trains allow for a greater capacity with less congestion, we will look at services that could be reintroduced, possibly including direct services from Sheffield to the Airport, though there could be other towns and cities making a case for their pre-2022 direct connections to be restored as well.

I wrote to the Noble Lord in July, explaining this service was withdrawn in December 2022 as part of the Manchester Task Force’s proposals to address the challenges of Manchester’s constrained capacity. We remain committed to improved rail connectivity in growing the Northern and national economy.

East Midlands Railway’s (EMR’s) new Aurora bi-mode trains (electric and diesel) are currently being built by Hitachi at its Newton Aycliffe factory in County Durham. The first three trains are doing test runs on the East Coast and Midland Main Lines. EMR currently expect that the trains will start to be introduced on intercity services in 2025 with the full fleet of trains coming into service during 2025 and 2026.

Deploying revenue protection staff to deter ticketless travel, and doing so in a reasonable and efficient manner, is a matter for train operating companies.

Revenue protection offers passengers an additional level of safety and security whilst travelling on the rail network.

While there has been no specific assessment into the functionality of air conditioning during the recent hot weather, a sample of EMR's trains are independently inspected each month to assess overall ambience, and this includes the temperature of the carriage.

EMR advises that, on the occasion in question, the air conditioning failed in one carriage. All other carriages on the train had functioning air conditioning and staff offered passengers the opportunity to move to a different carriage, as well as providing water. New trains are due to replace the current train fleet from 2025.

This information is not held centrally. Spend on very senior managers (VSM) pay is locally determined by individual National Health Service organisations within their local budget positions. VSM pay arrangements are subject to the decisions of local remuneration committees, which are ordinarily based on the provisions in the VSM pay framework and the independent recommendations of the Senior Salaries Review Body (SSRB). Future spending on VSM pay will depend on the outcomes of SSRB recommendations, and individual NHS trusts’ decisions are dependent on their financial position at a local level.

The 10-Year Health Plan for England sets out how the National Health Service will continue leading the world in genomics as it increasingly becomes part of routine care over the next 10 years. The statement that “by 2035, we anticipate half of all healthcare interactions will be informed by genomic insights and other predictive analytics” is part of Genomics England’s shared vision with the NHS on the potential of genomics in healthcare. Routine use of pharmacogenomics in the NHS could achieve this vision, as over 98% of people carry at least one relevant pharmacogenomic variant, and in a recent study, 80% of patients in an acute setting were exposed to a medicine for which there is pharmacogenetic prescribing guidance available.

The Hertfordshire and West Essex Integrated Care System was allocated funding from the national Elective Recovery Fund in 2025/26. Hertfordshire and West Essex’s Surgical Centre Programme Board undertook a full options appraisal to consider how to get the best use out of the new surgical centre facilities within their financial envelope for 2025/26.

The programme board agreed that when it first opens in November, the surgical centre will be used primarily by the West Hertfordshire Teaching Hospitals Trust for treating patients. The Princess Alexandra Hospital Trust is also planning to use the facility to operate over the winter months.

The availability of the surgical centre for patients across Hertfordshire will continue to be reviewed alongside future funding announcements. Subject to future funding, the system will look to accelerate full opening in 2026/27.

The 10-Year Health Plan is a plan to make the National Health Service fit for the future.

It sets out a wide range of commitments to be delivered over both the short and long term, the implementation of which is already underway, supported by the financial framework set out in the recent Spending Review. The plan will deliver the three shifts from hospital to community, from analogue to digital, and from sickness to prevention. The first year will include immediate actions to, for example, develop neighbourhood health services and the app, a workforce plan, and a suite of actions on prevention as well as actions which lay the foundation for future commitments.

Implementation of the 10-Year Health Plan is already underway; waiting lists have already fallen by over 232,000 since July 2024 and is the lowest in two years. Between October 2024 and April 2025, we recruited more than 1,900 extra general practitioners and in June 2025, we published the Urgent and Emergency Care Plan.

Delivery expectations are embedded throughout the plan, which will shift care from hospital to community, analogue to digital, and sickness to prevention. Over the remainder of 2025/26, we will put in place key next steps to deliver the plan, build the foundations for the shifts from hospital to community, analogue to digital and sickness to prevention, and roll out current best practice across the whole country.

Following the Plan’s publication, we have already launched the National Neighbourhood Health Implementation Programme (NNHIP). The NNHIP will support systems across the country to test new ways of working, share learning, and scale what works, making Neighbourhood Health the norm, not the exception. Integrated care boards have also been invited to submit their proposals for sites to form the first Neighbourhood Health Teams.

Following the Prime Minister’s announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as reducing integrated care board running costs and National Health Service provider corporate costs, in order to deliver value for money for the public and empower our health system to improve health and care for patients. Good progress is being made, with the Department and NHS England having announced voluntary exit or redundancy schemes.

We have recently announced the Spending Review settlement, which provides an additional £29 billion of annual day-to-day spending in real terms by 2028/29, compared to 2023/24. Ahead of asking the NHS to commence a multi-year planning round we are now carefully reviewing how the settlement is prioritised, including making provision for redundancy costs. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while transition planning is ongoing.

Decisions on integrated care board funding allocations and the pace of convergence to fair shares for the next three years have not yet been taken. We expect to set out allocations alongside multi-year planning guidance in the autumn.

Decisions on integrated care board funding allocations and the pace of convergence to fair shares for the next three years have not yet been taken. We expect to set out allocations alongside multi-year planning guidance in the autumn.

The Department is working closely with NHS England to manage financial risk in 2025/26, and to assure the delivery of agreed financial plans. We recognise the aggregate £1.5 billion of risk in plans, which is a top-down estimate. The Department has not made an estimate of that risk by individual trust and integrated care board. Work to manage and mitigate the risk includes derisking efficiency plans, and robust performance management, including a Financial Performance Improvement Programme. We are confident that overall financial balance of the National Health Service budget will be achieved.

Capital funding for the Hertfordshire and West Essex Surgical Centre at St Albans City Hospital remains in place, and building work is being supported through to completion.

Although there are no current plans for the patients of the East and North Hertfordshire Hospitals Trust to use the West Essex Surgical Centre when it opens, the integrated care board intends the centre to support the Princess Alexandra Hospital Trust with their orthopaedic capacity over winter, and the centre will be used by West Hertfordshire Teaching Hospitals Trust patients while existing theatres at St Albans City Hospital are refurbished.

Having this high-quality new resource in the system will also give the trust the flexibility to scale up capacity in the future if needed, and will benefit patients for years to come.

The NHS Oversight Framework 2025/26 will not be used to score integrated care boards’ (ICBs) performance or to assign them to performance categories or segments. This is to allow them to focus on the substantial changes to their organisational function and form, alongside efforts to meet their running cost reduction plans.

However, ICB data will continue to be collected, monitored, and reported against the full suite of metrics. These will be used during NHS England’s regular performance conversations with ICBs and to inform the use of intervention powers, should NHS England deem this necessary to support improvement.

The Care Quality Commission (CQC) regulates surgical procedures, including male circumcision for therapeutic and non-therapeutic reasons, where the procedure is carried out by a health care professional.

The CQC has developed guidance with other professional organisations entitled Additional guidance and prompts: non-therapeutic male circumcision, a copy of which is attached.

The Government has no current plans to bring forward legislation or further guidance on non-therapeutic male circumcision.

The Department’s total paybill and staffing costs have not risen by £20 million since July 2024; rather, they have risen, but by £2.5 million in that time.

Since the General Election, the Department’s staff numbers have needed to increase to ensure the right skills and capability to deliver several of the Government’s major priorities. These include the 10-Year Health Plan, the Assisted Dying Bill, ending the longest-running pay dispute with resident doctors, publishing an elective reform plan, and publishing a new NHS Mandate, as well as ensuring we can continue to deliver vital services across the health system. During this period, payroll costs have also increased because of annual pay increases.

Given the scale of the challenges facing the health and social care system, as part of the Spending Review, the Department is working on reducing its headcount down to pre-election levels during 2025/26. This is a key step towards a streamlined centre, to support continued prioritisation towards front-line services.

We expect the report will be published shortly, and the delay has been due to practical data issues.

NHS England commissions Kings College London and its partners to analyse data from Learning from Lives and Deaths, reviews about people with a learning disability and autistic people (LeDeR). The LeDeR report is published by Kings College London, who are currently working on the next report, and will publish it soon. The last report was published in November 2023, a copy of which has been placed in the Library due to the size of the document.

The National Institute for Health and Care Excellence (NICE) recommends that general practitioners (GPs) should offer an annual health check to all adults, children and young people with a learning disability. The Government expects integrated care boards (ICBs) and health professionals to have due regard to NICE guidelines when making commissioning decisions. NHS Operational Planning Guidance for 2025/26 requires ICBs to report on the number of people on the quality outcome framework learning disability register aged 14 years old and over who receive an annual health check during the quarter.

Work is progressing at pace to develop the design and operating model for the new integrated organisation, and to plan for the smooth transfer of people, functions, and responsibilities

It is only right that with such significant reform, we commit to carefully assessing and understanding the potential impacts, as is due process. These ongoing assessments will inform our programme as appropriate.

The Government is committed to transparency and will consider how best to ensure that the public and parliamentarians are informed of the outcomes.

NHS England commissions Kings College London and its partners to analyse data from the Learning from Lives and Deaths - people with a learning disability and autistic people (LeDeR) reports. The annual LeDeR report is published by Kings College London, who are currently working on the next annual report, and NHS England has advised that they will publish this shortly. The last report was published in November 2023 and is available on the King’s College London website.

The data is not available in the format requested. Data is collected on admissions with a primary diagnosis code of routine and ritual circumcision. This data is available for 2023/24, by age group, on the NHS.UK website, in an online only format.

Ministers and senior Department officials are working with the new executive team at the top of NHS England, led by Sir Jim Mackey, to jointly lead the formation of a new joint centre.

At this stage, while we are scoping the transformation programme, it is too early to share details of any programmes to reduce staff costs, but we are looking closely at areas of duplication between NHS England and the Department. The reductions will be achieved through a mix of efficiencies, removing duplication between the Department and NHS England and stopping functions at the centre that will support our aim of empowering the frontline.

The Government is committed to transparency and will consider how best to ensure the public and parliamentarians are informed.

Ministers and senior Department officials are working with the new executive team at the top of NHS England, led by Sir Jim Mackey, to jointly lead the formation of a new joint centre. It is only right that with such significant reform, we commit to carefully assessing and understanding the potential impacts, as is due process. Evidence from these ongoing assessments will inform our programme as appropriate.

The new centre will operate in a leaner, more agile, and more efficient way and will empower staff at all levels of the health system, including local and regional, to deliver better care for patients, drive productivity up, and get waiting times down. This change will set local National Health Service providers free to innovate, develop new productive ways of working, and focus on what matters most.

The Government is committed to transparency and will consider how best to ensure the public and parliamentarians are informed of the outcomes.

Funding for Cancer Alliances is set nationally by NHS England. The place-based allocation is calculated on a population basis, and is flexible funding that Alliances use to support the delivery of NHS-wide priorities for cancer in ways that reflect local circumstances.

We have set stretching targets for the National Health Service to improve cancer performance next year and taken tough decisions to fix the foundations in the public finances at the Autumn Budget. These decisions have enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26.

The following tables show information from the NHS Cancer Programme about the funding allocated to Cancer Alliances in 2024/25 and 2025/26, across both place based and targeted allocations; these are inclusive of NHS cost uplift factors which adjusts for inflation and other cost increases:

Source: NHS Cancer Programme

Source: NHS Cancer Programme

The Care Quality Commission (CQC), the independent regulator of health and social care, is assessing how well local authorities in England are delivering adult social care. This means that the CQC is looking at how local authorities are performing against their duties under Part 1 of the Care Act 2014, including their duties relating to the provision of care and support for autistic people. Ratings and reports are published on the CQC’s website. To date, the CQC has published over twenty assessments, with ratings of Outstanding, Good, and Requires Improvement.

The Office for Standards in Education, Children’s Services and Skills (Ofsted) and the CQC also commenced a strengthened local inspection framework in January 2023 to maintain a focus on high standards in the Special Educational Needs and Disabilities (SEND) system across all partners. In 2023/24, approximately one in three pupils with an Education, Health and Care Plan had autism as their primary need. However, it should be noted that these figures do not include children and young people with an Education, Health and Care Plan (EHCP) who are not in state funded schools or non-maintained special schools. This may be because they are in independent schools, hospital schools, are missing education, are educated somewhere other than in school, or are above compulsory school age. Data on the number of children and young people with an EHCP who are not in state funded schools or non-maintained special schools is not available. Ofsted reports are published on their website, and further information is also available on the GOV.UK website, in an online format.

Where a council does not meet its SEND-related duties, the Department for Education can take action that prioritises children’s needs and supports local areas to bring about rapid improvement. Ofsted and the CQC are reviewing local area SEND inspections in response to the Ofsted Big Listen consultation, which asked for views from school staff, education organisations, and parents on the inspection process.

Tobacco is the single most important entirely preventable cause of ill health, disability, and death in this country, and is responsible for 80,000 deaths in the United Kingdom each year. The majority of smokers start in their youth and are then addicted for life. More than four in five smokers start before the age of 20 years old.

As a result of Government action, smoking rates have declined in all ages since the 1970s, but there is still much further to go. Legislation has been an important driver of this decline, including raising the age of sale for smoking from 16 to 18 years old, which reduced prevalence in this age group by 30%.

The available data does not allow us to estimate the number of people under 18 years old that smoke and vape in England, and the data that is available is not comparable as it covers different age groups and countries. However, using the NHS Smoking Drink and Drugs survey data, we estimate that the number of 11 to 15 year olds regularly smoking in England is 42,000 in 2023. We do not have similar data for years 2022 and 2024. Using the Action on Smoking and Health GB survey data, we estimate that the number of children aged 11 to 17 years old that regularly use a vape in Great Britain, which can also be called an e-cigarette, is 169,000 in 2022, 206,000 in 2023, and 234,000 in 2024.

Our modelling of the estimated impact of the Smokefree Generation (SFG) policy on smoking rates is presented in the Tobacco and Vapes Bill Impact Assessment. In the central scenario we modelled, smoking prevalence among those aged 18 years old and over is estimated to fall from 11.6% in 2023 to 1.6% in 2056. In terms of the number of smokers, we estimate this is equivalent to approximately 700,000 smokers aged 18 years old and over in 2056 when SFG is implemented, compared to approximately 2.4 million smokers aged 18 years old and over if not implemented.