Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, whether he has made an assessment of the potential merits of uprating Pension Protection Fund compensation for members who lost indexation from April 1997, to reflect the value their pensions would have held if index-linking had been preserved.

Answered by Torsten Bell - Parliamentary Secretary (HM Treasury)

Indexation in the Pension Protection Fund (PPF) on pensions built up on or after 6 April 1997 (post-1997 indexation) broadly reflects the statutory requirements for Defined Benefit schemes more generally, which are in line with the consumer prices index, capped at 2.5%.

This may be different to the increases that would have been provided under the rules of the original scheme. The PPF is a compensation scheme and, as such, was never intended to replicate the benefits of schemes which were unable to secure their liabilities.

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 potential impact of changes to Indicative Action Plans and the introduction of minimum waiting times on patients with ongoing care needs, including those at risk of serious complications such as irreversible sight loss.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) 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 activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.

The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.

The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve 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.

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. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.

While IAPs and AMPs are implemented to ensure this financial balance, all providers 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.

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 Integrated Care Boards do not (a) implement minimum waiting times and (b) make reductions to Indicative Action Plans in ways that could risk patient harm.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) 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 activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.

The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.

The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve 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.

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. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.

While IAPs and AMPs are implemented to ensure this financial balance, all providers 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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether (a) his Department and (b) NHS England has issued guidance to Integrated Care Boards on the use of minimum waiting times for elective care.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) 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 activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.

The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.

The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve 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.

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. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.

While IAPs and AMPs are implemented to ensure this financial balance, all providers 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.

Question to the Department for Education:

To ask the Secretary of State for Education, what steps her Department is taking to ensure that Plan 2 student loan borrowers are informed of the changes to repayment thresholds due to take effect in April 2027.

Answered by Josh MacAlister - Parliamentary Under-Secretary (Department for Education)

The government announced on 26 November 2025, as part of Autumn Budget 2025, the repayment threshold to apply to English Plan 2 student loans from April 2027 to April 2030.

The Student Loans Company (SLC) publish confirmation of the repayment threshold to apply in the upcoming financial year annually on GOV.UK. Further, SLC have extensive guidance on the operation of the student loan repayments system available on GOV.UK, including confirmation of the current repayment threshold.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what his Department’s policy is on managing NHS trusts that are not meeting elective recovery targets where services are delivered under block contract arrangements.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

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 block contract arrangements on elective care performance by NHS trusts.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

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 potential impact of block contract arrangements on the level of NHS productivity.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

No formal assessment of the impact of block contract arrangements on National Health Service productivity has been made. However, the 10‑Year Health Plan sets out the Government’s intention to move away from block contracts, paid irrespective of how many patients are seen or the quality of care, and to realign funding with activity and performance.

Under these reforms, payment for poor‑quality care will be withheld, high‑quality care will attract additional reward, and new incentives will be introduced for the most effective NHS leaders, clinicians, and teams. These changes are designed to support clearer accountability, improve productivity over time, and ensure that NHS resources are targeted where they deliver the greatest value for patients.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what his Department’s policy is on NHS trusts delivering elective care under block contract arrangements.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many NHS trusts are paid for the delivery of elective treatment through block contract arrangements.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many exit payments of £150,000 and more were made by integrated care boards in the 2024-25 financial year.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Data reported in the Department’s Annual Report and Accounts for 2024/25 is limited to providing high-level data on the total number and cost of exit payments, including non-contractual severance payments. This data is not broken down to identify the name or type of specific organisations or payment types. The data provided in the Department’s accounts use consolidated data from NHS England.

NHS England has confirmed that during 2024/25, there were 33 exit payment cases disclosed by integrated care boards which were of a value of £150,001 or more. This means that an exit package might be agreed, approved, and accrued in one financial year, and so disclosed in that year, but the actual payment may, in some cases, fall into the next financial year. NHS England does not hold information to identify where this is the case.

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 implications for his policies of responses to the consultation on the draft statutory guidance under the Down Syndrome Act 2022.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Through the implementation of the Down Syndrome Act 2022, the Government is striving to improve life outcomes for people with Down syndrome, raise awareness and understanding of their needs, and break down barriers to opportunity that they, and other disabled people, face.

The Down Syndrome Act 2022 requires my Rt Hon. Friend, the Secretary of State for Health and Social Care, to give guidance to relevant authorities in health, social care, education, and housing services on the actions they should be taking to support the needs of people with Down syndrome.

The public consultation on the draft guidance was launched on 5 November 2025 and will remain open until 30 March 2026. Once the consultation has closed, the Government will consider all consultation responses to inform the final guidance to be published.