Question to the Department of Health and Social Care:

To ask His Majesty's Government what support they are providing to integrated care boards to develop effective multidisciplinary care pathways for primary biliary cholangitis, ensuring consistent and equitable care across different regions.

The initial management of primary biliary cholangitis is through secondary care liver services, known as hepatology, and is commissioned by integrated care boards (ICBs). ICBs are responsible for arranging National Health Service services which meet the needs of their respective populations. A proportion of patients do not respond well to first line medical treatments and should be referred to specialised hepatology centres for advanced, second line therapies. These are commissioned by NHS England from specialised centres. Through the England rare diseases action plans, we are working to address sources of inequity and build a fairer system. Work is ongoing to include rare diseases in NHS England’s Core20PLUS5 framework, to support ICBs in addressing inequalities. In the 2025 action plan, we have introduced an action to incentivise providers to run clinics for multi-system disorders, which recognises the importance of a multidisciplinary approach and reduces the burden of co-ordination of care on families.