Department of Health and Social Care

The proposed amendments to the National Institute for Health and Care Excellence regulations were subject to a public consultation, which ran from 9 December 2025 to 13 January 2026. The Department is currently analysing consultation responses and will shortly finalise a statutory instrument (SI) to bring forward secondary legislation to amend the regulations.

The SI will be laid before Parliament and will be subject to the negative parliamentary procedure. The policy merits of the SI will be scrutinised by the Secondary Legislation Scrutiny Committee, in line with its terms of reference at the following link:

https://committees.parliament.uk/committee/255/secondary-legislation-scrutiny-committee/content/120278/slsc-terms-of-reference/

As is conventional, the SI will be laid before Parliament at least 21 days before coming into force to ensure Parliament has adequate time to consider it.

The Pharmacogenomics and Medicine Optimisation NHS Genomic Network of Excellence convened a multidisciplinary meeting in November 2023 to support an impact assessment of potential testing for APOE-4 for prediction of risk of adverse events for lecanemab and donanemab. This group considered the evidence for expanding genomic testing for the APOE gene variants, including to inform other dementia related risk factors and concluded that there was insufficient evidence to offer genomic testing for the APOE gene variants as part of routine dementia care, risk assessment, or to first degree relatives of those with an already identified APOE variant to inform risk estimates of developing future Alzheimer's disease.

The current Parliamentary Under-Secretary of State for Women's Health and Mental Health, Baroness Merron, the previous minister with responsibility for sodium valproate and pelvic mesh redress policy, held a roundtable with representatives of the sodium valproate patient groups in December 2024.

Since then, I met with relevant stakeholders at various parliamentary events. I also met with the Patient Safety Commissioner in December 2025, to discuss progress following the Hughes Report and have made clear the Department’s expectation of continued, proactive engagement with the Patient Safety Commissioner and key stakeholders.

The Department continues to take forward work to explore redress for those affected by pelvic mesh and sodium valproate, which includes recommendations made by the Patient Safety Commissioner in the Hughes Report. We recognise the importance of these issues for all those affected. This remains a cross-Government policy area involving multiple organisations, and given the complexity of the issues involved, it is important we get this right. A timetable for a response has not yet been finalised.

I met with the Patient Safety Commissioner in December 2025, to discuss progress following the Hughes Report and have made clear the Department’s expectation of continued, proactive engagement with the Patient Safety Commissioner and key stakeholders.

The Department does not hold information regarding the number of children that have been harmed by sodium valproate use during pregnancy, or those who have received a diagnosis of foetal valproate spectrum.

The National Disease Registration Service in NHS England collects and quality assures data about people with congenital conditions and rare conditions across the whole of England.

In the most recent official statistics on congenital conditions in England, the 2022 Congenital Condition Official Statistics Report, which contains information on congenital conditions detected in babies delivered in England between 1 January and 31 December 2022, as well as in previous publications of this series back to its inception in 2018, there were no foetus' or babies reported to have a diagnosis of fetal sodium valproate syndrome.

It is likely that while some of the individual conditions, for instance neural tube defects, cardiac, oro-facial clefts, and/or limb difference, that can be associated with this condition are recorded on the register, the overarching diagnosis of fetal sodium valproate syndrome may not yet be registered because fetal sodium valproate syndrome may take more than a year after birth to be confirmed as a diagnosis, so the number reported in any year is the minimum level in the population.

The National Disease Registration Service is assessing the feasibility and reliability of better ascertainment of fetal sodium valproate syndrome by linking the congenital condition register to primary care prescription data.

Though the Patient Safety Commissioner’s report covered England-only, we recognise that any response by the Government to the recommendations of the Hughes Report in England will likely have implications for the devolved administrations and their constituents.

Government officials are therefore working closely with officials across the United Kingdom in considering the recommendations in the Hughes Report. I recently met with my counterparts across the four nations and will continue productive engagement as we progress work in this area.

The Department continues to take forward work to explore redress for those affected by pelvic mesh and sodium valproate, which includes recommendations made by the Patient Safety Commissioner in the Hughes Report.

We recognise the importance of these issues for all those affected. This remains a cross-Government policy area involving multiple organisations, and given the complexity of the issues involved, it is important we get this right.

I also met with the Patient Safety Commissioner in December 2025, to discuss progress following the Hughes Report and have made clear the Department’s expectation of continued, proactive engagement with the Patient Safety Commissioner and key stakeholders.

Everyone who has been harmed from sodium valproate has our deepest sympathies.

The Independent Medicines and Medical Devices Safety Review, First Do No Harm, identified significant shortcomings in National Health Service care pathways for people harmed by sodium valproate. NHS England has acknowledged variation in the availability and adequacy of care pathways, the impact of delayed diagnosis and misdiagnosis on long-term outcomes, and the need for improved care coordination for those requiring lifelong support, including co-ordination with non-health care services.

In response, NHS England has commissioned a Fetal Exposure to Medicines Services Pilot, being delivered by the NHS in Newcastle and Manchester. The pilot provides multidisciplinary diagnostic assessment and is informing the development of improved care pathways, better coordination of care, and reduced reliance on emergency care. Findings from the pilot will inform future decisions on the commissioning of services, subject to funding.

In addition, we work closely with the Department for Education and across the Government to ensure co-ordination between health, education, and social care services for children and their families. The Health and Opportunity Missions of the Government highlight the importance of joined up working and integrated delivery.

The Government is currently developing the Tuberculosis National Action Plan for 2026 to 2031. The content of the plan, including any associated funding requirements, has not yet been finalised. Any proposals with financial implications will be subject to the usual cross‑Government processes, including agreement with HM Treasury. Details, with funding commitments, will be included when the plan is published.

Currently alcohol advertisements follow voluntary codes, regulated by the Advertising Standards Authority (ASA). The ASA’s Advertising Codes contain specific rules about how alcohol can be advertised, as they recognise the social imperative of ensuring that alcohol advertising is responsible.

The Department of Health and Social Care will continue to work with the Department for Digital, Culture, Media and Sport, as the lead Government department responsible for advertising, to consider if additional statutory restrictions on marketing and advertising are needed to reduce alcohol related harms.

The National Cancer Plan was published on the 4 February 2026.

The Department received more than 11,000 responses to a Call for Evidence alongside significant engagement with patients, families, carers, clinicians, researchers, cancer charities and voluntary groups.

Now that the National Cancer Plan is published, the Department, NHS England and the Cancer Alliances will continue to work together with partners across the healthcare landscape to ensure it is delivered, to transform cancer care and save lives.

The Government has committed to a clear accountability structure for the plan, where Cancer Alliances play a leading role to deliver it, working with local systems. A reformed National Cancer Board, jointly chaired by the Department and an independent representative, will track progress against the Plans commitments and provide regular updates to ministers. The plan includes tables at the end of each chapter, setting out when commitments should be delivered and which organisation will be responsible.

As set out in our 10-Year Health Plan for England: fit for the future, we will take decisive action on the obesity crisis, easing the strain on our National Health Service and creating the healthiest generation of children ever. As part of this, the Government committed to updating the standards behind the restrictions on advertising ‘less healthy’ food or drink products on television before 9:00pm and online at any time, as well as the restrictions on the promotion of ‘less healthy’ food and drink products by location and volume price by applying the new Nutrient Profiling Model (NPM).

The advertising and promotions restrictions currently rely on the outdated NPM 2004/05. The new NPM has been updated in line with the latest dietary advice from the United Kingdom’s Scientific Advisory Committee on Nutrition, particularly in relation to free sugar and fibre. Applying it to the restrictions will strengthen these policies by bringing more products of concern for children’s health into scope.

The Government published the new NPM on 27 January. Application of the new NPM to the advertising and promotions restrictions would be subject to a full public consultation and an impact assessment of the costs to businesses and intended health outcomes.

Integrated care boards (ICBs) are responsible for assessing local population need and commissioning appropriate diagnostic and treatment pathways for neurological conditions, including Tourette syndrome. While the Department has not undertaken a national assessment of provision across ICBs, we recognise the concerns raised about variation in diagnosis and support. To help address this, NHS England’s Getting It Right First Time (GIRFT) programme is working with ICBs to develop clear, consistent diagnostic and treatment pathways. The programme has appointed a clinical lead for children and young people's neurodevelopmental services, focusing on improving the assessment and management of Tourette syndrome.

The Independent Review into mental health conditions focuses on mental health conditions, ADHD and autism. Tourette’s is a neurological disorder and, therefore, it will be at the chair's discretion as to how far the review considers Tourette syndrome.

The Government recognises the harms associated with alcohol consumption and has taken crucial steps in the 10-Year Health Plan to support people to make healthier choices. There is a balance to be struck, and the Government continues to consider carefully what other measures might be needed to turn the tide on alcohol harms, while continuing to support economic growth.

Currently, alcohol advertisements follow voluntary codes, regulated by the Advertising Standards Authority (ASA). The ASA’s Advertising Codes contain specific rules about how alcohol can be advertised, as they recognise the social imperative of ensuring that alcohol advertising is responsible.

The Department of Health and Social Care continues to work with the Department for Digital, Culture, Media and Sport, as the lead Government department responsible for advertising, to consider if additional statutory restrictions on marketing and advertising are needed to reduce alcohol related harms.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions including amending the product information.

The MHRA has received a total of four United Kingdom reports through the Yellow Card scheme associated with the reaction term Post 5-Alpha Reductase Inhibitor Syndrome from 1 January 2019 up to and including 4 February 2026. The following table shows a yearly breakdown of reports associated with Post 5-Alpha Reductase Inhibitor Syndrome:

In addition, the following table shows a yearly breakdown of reports received by substance associated with Post 5-Alpha Reductase Inhibitor Syndrome:

Please note that each report may list more than one suspect drug. Therefore, the total number of reports received cannot be accurately derived from the figures presented in the above table.

It is important to note that anyone can report to the MHRA’s Yellow Card scheme and the recording of these reports in the Yellow Card database does not necessarily mean that the adverse reactions have been caused by the suspect drug. Many factors must be considered in assessing causal relationships, including temporal association, the possible contribution of concomitant medication, and the underlying disease. We encourage reporters to report suspected adverse reaction reports, as the reporter does not have to be sure of a causal association between the drug and the reactions, a suspicion will suffice.

The number of reports received cannot be used as a basis for determining the incidence of a reaction, as neither the total number of reactions occurring, nor the number of patients using the drug, is known.

The National Cancer Plan, published on 4 February 2026, will ensure that young cancer patients and their families receive better support, across diagnosis, treatment, and patient experience.

The Department has worked closely with the Children and Young People (CYP) Cancer Taskforce, to develop ambitious commitments on CYP cancer in the National Cancer Plan. The taskforce brought together experts across a range of fields to identify ways to improve outcomes and patient experience for young cancer patients and has been committed to ensuring the voices of key charity stakeholders and patients are included.

That’s why the Government assembled a Charity Sub-Group and Patient Experience Panel to ensure this expertise fed directly into the work of the taskforce.

The Government is committed to continuing its work with key cancer partners to deliver the commitments outlined in the National Cancer Plan.

The consultation for proposals to extend medicines responsibilities for paramedics, physiotherapists, operating department practitioners, and diagnostic radiographers closed on 28 October 2025. Our team is currently analysing the large number of respondents received and a Government response detailing next steps will be published in due course.

Non-medical prescribing remains a keen area of interest since the Government took office in 2024, and we support the expansion of professional groups being able to use legal mechanisms to supply, administer, and prescribe medicines to patients, where it is safe to do so, within their scope of practice.

The new NHS Quality Strategy will build on the 10-Year Health Plan and Dr Penny Dash’s review of patient safety across the health and care landscape. The 10-Year Health Plan commits to using sharper financial incentives to deliver value and improve outcomes. We expect the NHS Quality Strategy will reference, alongside other interventions, how the Department and NHS England will develop these incentives to ensure they drive high quality care across the National Health Service.

Numbers of respiratory syncytial virus (RSV) admissions in infants are reported by a sentinel network of approximately 15 to 20 National Health Service trusts in England to the Severe Acute Respiratory Infections-Watch Surveillance at the UK Health Security Agency. Participation in this surveillance is completely voluntary for NHS trusts. Therefore, the number of participating trusts can vary from week to week, and comparisons based on simple counts may be misleading.

To provide appropriate context for reported weekly data, weekly admission rates are calculated to monitor trends over time. This uses trust catchment populations published by the Office for Health Improvement and Disparities, which are estimated for under five-year-olds, but which have not been estimated specifically for the under one year old age group, or infants.

Therefore, published rates are based on the available denominator data for the under five-year-olds, and these are publicly available in the national surveillance weekly reports and corresponding datafile at the GOV.UK website.

Further surveillance data and a programme impact assessment will be included in the annual surveillance report on RSV, due to be published in summer 2026. Please refer to the 2024/25 annual surveillance report for a summary of the previous winter season, which is available at the GOV.UK website.

Surveillance reports use hospital admission data and the Office for National Statistics’ mid-year estimates to model catchment populations for hospital trusts. Modelled catchment populations use hospital data, aggregated over three years and resident populations in five-year age bands.

The Department knows that the cost of travel is an important issue for many young cancer patients and their families across the United Kingdom.

Through the National Cancer Plan, the Government is committing up to £10 million a year to a new fund open to all children and young people in England with cancer and their families regardless of income, to support them with the cost of travelling to and from treatment. This commitment sits alongside wider action to transform cancer care for children and young people.

The Department has worked closely with the Children and Young People (CYP) Cancer Taskforce, to develop ambitious commitments on CYP cancer in the National Cancer Plan. The taskforce brought together experts across a range of fields to identify ways to improve outcomes and patient experience for young cancer patients and has been committed to ensuring the voices of key charity stakeholders and patients are included.

That’s why the Government assembled a Charity Sub-Group and Patient Experience Panel to ensure this expertise fed directly into the work of the taskforce.

The Government is committed to continuing its work with key cancer partners, including Young Lives vs Cancer, to deliver the commitments outlined in the National Cancer Plan.

It is important that community health teams can access the information they need to provide quality care, including for people who are experiencing homelessness. NHS England and the Phoenix Partnership (TPP), the company that provides SystemOne, already offer several routes for some clinicians to view records outside of GP settings.

These include national services such as GP Connect and the National Care Records Service (NCRS), which allow clinicians to see key information from GP records. NCRS can also be used on mobile devices such as iPads. Integrated care systems are rolling out Shared Care Records, which give clinicians wider access to both GP and secondary care records, where appropriate.

More broadly, the Government’s commitments to improve health outcomes for people experiencing homelessness are set out in the cross-government strategy, A National Plan to End Homelessness. Through this strategy, we are working with NHS England, local authorities, and third sector partners to strengthen integrated care pathways. This includes improving collaboration between primary care, outreach teams, and community services. More information about the strategy is available at the following link:

https://www.gov.uk/government/publications/a-national-plan-to-end-homelessness/a-national-plan-to-end-homelessness

The Single Patient Record will enable improvements as it will provide a comprehensive view of health and care information across care settings. It will give both patients and professionals secure access to a single, accurate and up-to-date record – wherever and whenever it's needed.

On 4 February 2026, NHS England and the Department published a National Cancer Plan for England. The National Cancer Plan is part of our work to build a National Health Service that is fit for the future and will make England a world-leader for cancer survival.

The orphan drug designation is assessed by the Medicines and Healthcare products Regulatory Agency and is granted at the same time as the marketing authorisation. It provides a period of market exclusivity during which similar competitor medicines cannot enter the United Kingdom market. The orphan drug regulations are designed to support the development of medicines to treat rare diseases including rare cancers.

All new licensed medicines, including orphan medicines, are evaluated by the National Institute for Health and Care Excellence (NICE), which makes recommendations for the NHS on whether they represent a clinically and cost-effective use of NHS resources. NICE aims wherever possible to issue recommendations on new medicines close to the time of licensing, and the NHS in England is legally required to fund medicines recommended by NICE. NICE has a strong track record in recommending orphan medicines for use on the NHS and many thousands of patients with rare diseases have benefitted from access to new medicines as a result.

The Rare Cancers Bill, currently going through the House of Lords, places a duty on the Government to publish a review of the law related to marketing authorisation for rare cancer drugs, for instance orphan drugs for cancer, comparing the UK’s approach to other approaches internationally. Through the National Cancer Plan the Government has committed to full implement of the Rare Cancers Bill to streamline trial pathways and review regulatory barriers that prevent access to promising new treatments.

The final delivery plan on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), published in July 2025, includes an action for the Department and NHS England to explore whether a specialised service should be prescribed by my Rt. Hon. Friend, the Secretary of State for Health and Social Care, for severe ME/CFS. Officials from the Department have commenced discussions with NHS England on how best to take forward this action.

The third and final session in NHS England’s newly-developed ME/CFS e-learning series, Managing Severe ME/CFS, is now live on the NHS Learning Hub. This session provides practical, evidence-based guidance for healthcare professionals to support people living with severe and very severe ME/CFS.

Additionally, as set out in the Plan for Change, we are committed to returning to the NHS constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. We exceeded our pledge to deliver an extra two million appointments, tests, and operations in our first year of government, having delivered 5.2 million additional appointments between July 2024 and June 2025. This will help people with severe ME/CFS to get support sooner.

The 10-Year Health Plan sets out a transformed vision for elective care by 2035, where most interactions no longer take place in a hospital building, instead happening virtually or via neighbourhood services. We will empower patients by giving them greater choice and control and establishing expected standards for making their experience of planned NHS care as smooth, supportive and convenient as possible, including for people with severe ME/CFS.

The Department already has established arrangements in place to manage conflicts of interest for both ministers and civil servants, including where these relate to the alcohol industry.

Ministerial conduct is governed by the Ministerial Code, which sets out requirements on the declaration and handling of ministers’ interests. Civil servants are bound by the Civil Service Code, and by departmental policies that set out how actual, potential, or perceived conflicts of interest must be identified, declared, and managed.

The Department keeps its internal guidance under regular review to ensure it remains aligned with cross-Government standards and supports transparent and accountable decision-making.

The Department already has established arrangements in place to manage conflicts of interest for both ministers and civil servants, including where these relate to engagement with representatives of unhealthy commodity industries.

Ministerial conduct is governed by the Ministerial Code, which sets out requirements on the declaration and handling of ministers’ interests. Civil servants are bound by the Civil Service Code, and by departmental policies that set out how actual, potential, or perceived conflicts of interest must be identified, declared, and managed.

The Department keeps its internal guidance under regular review to ensure it remains aligned with cross-Government standards and supports transparent and accountable decision-making.

We do not know what ‘MRS’ refers to in this context. The Department funds research through the National Institute for Health and Care Research (NIHR). A limited amount of mechanistic research is funded through the NIHR, but the majority of mechanistic research is funded through the Medical Research Council (MRC), a UK Research and Innovation Council sponsored by the Department for Science, Innovation and Technology. Mechanistic research into myalgic encephalomyelitis, also known as chronic fatigue syndrome, is within the remit of the MRC.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.

This includes the introduction of personal wheelchair budgets, including through legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.

NHS England also published a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:

https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhse-national-wheelchair-data-collection/q2-2025-26

Local authorities in England have a statutory duty under various legislations, including the Care Act 2014, and the Children and Families Act 2014, to make arrangements for the provision of disability aids and community equipment, to meet the assessed eligible needs of individuals who are resident in their area. Some local authorities deliver this themselves, but a significant number have external contracts for an integrated community equipment service.

NHS England is also responsible for determining allocations of financial resources to ICBs. NHS England’s allocations policy aims to support equal opportunity of access for equal need, alongside NHS England’s duties to reduce health inequalities that are amenable to healthcare.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has marked 2025/26 as a financial reset year with the publication of Planning Guidance 2025/26. He has been clear that systems must live within their means, exhausting all opportunities to improve productivity, tackle waste, and take decisions on how to prioritise resources to best meet the health needs of their local population.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.

This includes the introduction of personal wheelchair budgets, including through legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.

NHS England also published a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:

https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhse-national-wheelchair-data-collection/q2-2025-26

Local authorities in England have a statutory duty under various legislations, including the Care Act 2014, and the Children and Families Act 2014, to make arrangements for the provision of disability aids and community equipment, to meet the assessed eligible needs of individuals who are resident in their area. Some local authorities deliver this themselves, but a significant number have external contracts for an integrated community equipment service.

NHS England is also responsible for determining allocations of financial resources to ICBs. NHS England’s allocations policy aims to support equal opportunity of access for equal need, alongside NHS England’s duties to reduce health inequalities that are amenable to healthcare.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has marked 2025/26 as a financial reset year with the publication of Planning Guidance 2025/26. He has been clear that systems must live within their means, exhausting all opportunities to improve productivity, tackle waste, and take decisions on how to prioritise resources to best meet the health needs of their local population.

Lipoedema services in England are commissioned locally by integrated care boards (ICBs), which are responsible for assessing the needs of their local populations and determining the most appropriate services to support people with long‑term conditions such as lipoedema.

There is no single national specification for lipoedema services. Instead, ICBs draw on a range of national guidance and best‑practice resources when designing care pathways. These include guidance from the National Institute for Health and Care Excellence (NICE) and best‑practice frameworks produced by bodies such as Wounds UK and the Royal College of General Practitioners. This helps ensure that services are safe, effective, and based on the best available evidence.

Most people with lipoedema are supported through primary and community care services, including assessment by local lymphoedema teams, compression therapy, advice on skin care and movement, and support with self‑management. These services aim to help people manage symptoms and maintain mobility and quality of life.

NICE classifies lipoedema within its interventional procedures guidance on the use of liposuction for chronic lipoedema, reference code HTG618, as a chronic, often painful, and progressive condition characterised by the abnormal, symmetrical accumulation of fat in the legs, hips, buttocks, and sometimes arms. In this guidance, NICE concluded that current evidence on both safety and effectiveness is limited and, therefore, recommends that liposuction should only be undertaken within the context of research or under rigorous governance arrangements. This guidance informs, but does not mandate, local commissioning decisions. NICE will review this guidance once the full results of the ongoing LIPLEG clinical trial are available, and will update its recommendations if new evidence supports doing so.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.

This includes publishing a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:

https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

NHS England also introduced personal wheelchair budgets, including legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.

Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhse-national-wheelchair-data-collection/q2-2025-26

The Medium-Term Planning Framework sets a requirement for all providers and ICBs to actively manage long waits for community health services reducing the proportion of all waits over 18 weeks. This will be monitored via the NHS’s usual regional and national assurance processes.

The Community Health Services Situation Report, which will be used to monitor ICB performance against waiting time targets in 2026/27, currently monitors waiting times for both children and young people, and adult waiting times under the ‘Wheelchair, Orthotics, Prosthetics and Equipment’ line. These targets will guide systems to reduce the longest waits, and improvement initiatives to meet these targets may affect waits that are over 18-weeks and 52-weeks.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.

This includes publishing a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:

https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

NHS England also introduced personal wheelchair budgets, including legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.

Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhse-national-wheelchair-data-collection/q2-2025-26

The Medium-Term Planning Framework sets a requirement for all providers and ICBs to actively manage long waits for community health services reducing the proportion of all waits over 18 weeks. This will be monitored via the NHS’s usual regional and national assurance processes.

The Community Health Services Situation Report, which will be used to monitor ICB performance against waiting time targets in 2026/27, currently monitors waiting times for both children and young people, and adult waiting times under the ‘Wheelchair, Orthotics, Prosthetics and Equipment’ line. These targets will guide systems to reduce the longest waits, and improvement initiatives to meet these targets may affect waits that are over 18-weeks and 52-weeks.

The safety of all patients, whether they are treated in the National Health Service or the independent sector, is a top priority for the Government. There are a range of providers of NHS wheelchair services across England. Integrated care boards (ICBs) are responsible for monitoring service provision and effectively managing contracts with their commissioned providers.

NHS England are aware there have been a number of separate complaints about the quality of services provided by AJM Healthcare, which are being dealt with on an individual basis by the Ombudsman’s office. NHS England has flagged this to the relevant ICBs, who are responsible for the provision and commissioning of local wheelchair services. NHS England supports ICBs to make improvements and commission effective, efficient, and personalised wheelchair services. Actions taken include:

- establishing a national wheelchair dataset, where data has been collected quarterly from ICBs, formerly clinical commissioning groups, since July 2015 and which supports the drive for improvements in wheelchair services. This data looks at waiting times across the pathway to enable targeted action if improvement is required. Further information is available at the following link:
https://www.england.nhs.uk/statistics/statistical-work-areas/national-wheelchair/

- the Wheelchair Quality Framework, which was published on the 9 April 2025, and which was co-produced with key stakeholders, including Whizz Kids. The framework sets out quality standards and statutory requirements for ICBs, such as offering personal wheelchair budgets, with further information available at the following link:
https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

- personal wheelchair budgets, with NHS England having introduced personal wheelchair budgets, including in legal rights, in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided, with further information available at the following link:
https://www.england.nhs.uk/publication/guidance-on-the-legal-rights-to-have-personal-health-budgets-and-personal-wheelchair-budgets/

This deal is a vital investment that builds on the strength of our National Health Service and world leading life sciences sector to increase access to life-changing medicines without taking essential funding from our frontline NHS services.

We will always prioritise the needs of NHS patients and at the Spending Review we delivered record real terms increase for day-to-day spending for the NHS in England up to April 2029.

This deal will be funded by allocations made at the Spending Review, where front line services will remain protected through the record funding secured. Future year funding will be settled at the next Spending Review.

The Department has received the Hon. Member’s letter and I will respond shortly.

Poor air quality is a major public health risk in the United Kingdom. An estimated 29,000 to 43,000 deaths were attributable to long-term exposure to ambient air pollution in the UK in 2019 among adults aged 30 years old and over.

Indoor residential exposure to damp and mould was associated with approximately 5,000 cases of asthma and 8,500 lower respiratory infections among children, those who are aged between zero to 14 years old, and adults, those who are aged between 15 to 49 years old, in England in 2019.

The UK Health Security Agency (UKHSA) contributed to a report by the Royal College of Physicians in 2025. This contained data on new cases of mortality, myocardial infarction, asthma, lung cancer, and other conditions, attributable to a range of air pollutants in 2019 and predicted for 2040, among children, those over 30 years old, over 60 years old, and at all ages. The report is available at the following link:

https://www.rcp.ac.uk/policy-and-campaigns/policy-documents/a-breath-of-fresh-air-responding-to-the-health-challenges-of-modern-air-pollution/

The Department’s 10-Year Health Plan sets out how the Government will act to reduce the health harms of air pollution. This includes action to reduce harm from ambient air pollution and tackling poor indoor air by improving the standard of rented homes with relation to damp and mould.

The United Kingdom’s world leading life sciences sector is central to our Industrial Strategy, driving growth, investment, and high-quality jobs. As set out in the Life Sciences Sector Plan, which we developed while working closely with the sector, there is an opportunity for the National Health Service to save £1 billion over five years through biosimilars uptake, delivering value for patients and the NHS. The Life Sciences Council is an important forum that brings together senior industry and Government leaders to shape the sector’s future. The Government remains committed to this partnership and is looking to convene the council in due course.

Medicines UK and its members are represented on the Single National Formulary Industry Task and Finish Group. In addition, the Government is working to convene further task and finish groups to drive forward defined areas of the Life Sciences Sector Plan, including in the generic and biosimilars space. These groups will direct focused ministerial and official attention toward a clear set of priorities and will work closely with industry to deliver tangible progress within a set timeframe.

The United Kingdom’s world leading life sciences sector is central to our Industrial Strategy, driving growth, investment, and high-quality jobs. As set out in the Life Sciences Sector Plan, which we developed while working closely with the sector, there is an opportunity for the National Health Service to save £1 billion over five years through biosimilars uptake, delivering value for patients and the NHS. The Life Sciences Council is an important forum that brings together senior industry and Government leaders to shape the sector’s future. The Government remains committed to this partnership and is looking to convene the council in due course.

Medicines UK and its members are represented on the Single National Formulary Industry Task and Finish Group. In addition, the Government is working to convene further task and finish groups to drive forward defined areas of the Life Sciences Sector Plan, including in the generic and biosimilars space. These groups will direct focused ministerial and official attention toward a clear set of priorities and will work closely with industry to deliver tangible progress within a set timeframe.

The United Kingdom’s world leading life sciences sector is central to our Industrial Strategy, driving growth, investment, and high-quality jobs. As set out in the Life Sciences Sector Plan, which we developed while working closely with the sector, there is an opportunity for the National Health Service to save £1 billion over five years through biosimilars uptake, delivering value for patients and the NHS. The Life Sciences Council is an important forum that brings together senior industry and Government leaders to shape the sector’s future. The Government remains committed to this partnership and is looking to convene the council in due course.

Medicines UK and its members are represented on the Single National Formulary Industry Task and Finish Group. In addition, the Government is working to convene further task and finish groups to drive forward defined areas of the Life Sciences Sector Plan, including in the generic and biosimilars space. These groups will direct focused ministerial and official attention toward a clear set of priorities and will work closely with industry to deliver tangible progress within a set timeframe.

The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.

Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.

If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.

The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.

Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.

If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.

The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.

Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.

If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.

The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.

Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.

If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.

We are proud to have one of the most comprehensive vaccination programmes in the world. Our approach to evaluating vaccination programmes, underpinned by recommendations and advice from the Joint Committee on Vaccination and Immunisation (JCVI), is grounded in rigorous and evidence-led cost-effectiveness analysis, and ensures that decisions are objective, consistent, and based on high-quality data on health benefits and costs.

Basing our approach on these factors avoids the uncertainty of less direct benefits, where the evidence and therefore the decision is likely to be less defensible. This approach is also informed by previous work on this topic.

For example, earlier work by the independent Cost-Effectiveness Methodology for Immunisation Programmes and Procurement (CEMIPP) considered, amongst other things, whether wider socio-economic impacts should be included in the framework used to assess the cost-effectiveness of vaccines. CEMIPP conducted a consultation as part of their wider work and drew upon a broad body of expert opinion. The group concluded that wider socio-economic impacts should not be included in vaccine cost-effectiveness assessments unless doing so becomes standard practice across all health technology assessments.

Additionally, in 2022, the National Institute for Health and Care Excellence (NICE) undertook a detailed appraisal of whether it should broaden the perspective it uses in its economic evaluations, including consideration of wider societal impacts. Following this review, and after examining both international comparisons, and the significant methodological and ethical challenges involved, NICE’s Board concluded that it should retain its current approach of using a health-sector perspective routinely, but with the flexibility to include wider societal benefits when they are especially relevant.

Whilst the expertise of the JCVI rightly centres on disease burden, vaccine efficacy, health outcomes and health-related costs, as outlined this is not a key reason for why the cost-effectiveness methodology for vaccines does not formally take into consideration wider socio-economic benefits.

The Government is strengthening best practice in cardiovascular disease prevention through CVDPREVENT, a national primary care audit that enables general practices (GPs) and primary care networks (PCNs) to extract data held by GPs to identify gaps in diagnosis, and management of people who are at risk of cardiovascular disease. The aim is to improve patient care, reduce inequalities, and optimise treatment.

Furthermore, this year, we will publish a new cardiovascular disease modern service framework (CVD MSF). The Department and NHS England are engaging widely with stakeholders to co-produce the CVD MSF, ensuring that experts, people, and communities are at the heart of its development. The CVD MSF will support evidence-led, consistent, high quality and equitable care whilst fostering innovation across the cardiovascular disease pathway.

NHS England has a National Clinical Director for Cardiovascular Disease (CVD) Prevention.

We are committed to reducing premature mortality from heart disease and stroke by 25% in the next ten years and are prioritising ambitious, evidence-led and clinically informed approaches to CVD prevention and care to tackle one of the country’s biggest killers head-on.

To accelerate progress towards this ambition, we will publish a CVD Modern Service Framework (CVD MSF) later this year. The framework will support consistent, high quality and equitable care whist fostering innovation across the CVD pathway. The Department and NHS England are engaging widely with stakeholders to co-produce the CVD MSF, ensuring that experts, people and communities are at the heart of its development.