Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 23 March (HL15676), when the independent evaluation of the Core Competency Framework for maternity and neonatal staff commissioned through the National Institute for Health and Care Research will be completed and its findings published; and whether it includes an assessment of the availability of protected training time, staffing and resource constraints, and variation in training provision across NHS trusts.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Institute for Health and Care Research commissioned an independent evaluation of the Core Competency Framework for maternity and neonatal staff. Data collection was completed in August 2026, and the research team is now analysing and disseminating its findings. Two papers have been published to date, with further findings being prepared for publication.

The evaluation is examining the implementation and impact of the framework across maternity and neonatal services in England, including variation in training provision and the barriers and facilitators to its implementation. This includes consideration of organisational and workforce factors affecting implementation.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 17 July (HL2263), whether they now intend to issue guidance to safeguarding leads in local authorities on how to respond when a parent disagrees with a child or young adult's wish to undergo social or medical transition; and if not, why not.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 1 April, NHS England published an updated service specification for NHS Children and Young People’s Gender Services, reflecting the findings and recommendations of the Cass Review. The specification makes clear that clinicians should consider safeguarding needs as part of the holistic assessment framework.

Additionally, on 1 September, the Department for Education published updated statutory Keeping Children Safe in Education guidance, which details how schools and colleges should support children and young people who are questioning their gender.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 17 July (HL2263), what guidance, if any, they plan to issue to safeguarding leads in local authorities about situations where a parent disagrees with a child or young person's desire to undergo social or medical transition.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 1 April, NHS England published an updated service specification for NHS Children and Young People’s Gender Services, reflecting the findings and recommendations of the Cass Review. The specification makes clear that clinicians should consider safeguarding needs as part of the holistic assessment framework.

Additionally, on 1 September, the Department for Education published updated statutory Keeping Children Safe in Education guidance, which details how schools and colleges should support children and young people who are questioning their gender.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the answer by Baroness Merron on 24 June (HL Deb col 657), what steps they are taking to ensure resistant hypertension is addressed as part of the cardiovascular disease modern service framework implementation, given that the framework published on 7 July does not reference resistant hypertension as a distinct, high-risk subgroup.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Cardiovascular Disease Modern Service Framework sets 12 immediate priorities for the next three years, each with measures and three- and ten-year ambitions. These include treating people with hypertension, including resistant hypertension, to evidence-based targets, with progress tracked through the accompanying measure.

The delivery model set out in the published framework directs systems to use population health data to identify and manage underserved and high-risk populations.

Clinicians are advised to follow the National Institute for Health and Care Excellence’s guidelines for the management of resistance hypertension.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 9 September (HL2184), what steps they are taking to improve outcomes for people currently living with peripheral arterial disease, in addition to action on the cardiovascular risk factors associated with the disease.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England does not hold a specific, routinely produced dataset providing the number of major lower-limb amputations, surgical bypass procedures, and endovascular revascularisation procedures for patients with peripheral arterial disease (PAD), broken down by integrated care board and year.

Published information on vascular procedures is available through the National Vascular Registry. This is available through the GOV.UK website.

NHS England commissions vascular arterial care from a number of specialist centres to ensure appropriate management of PAD at a national level. The Vascular Disease Clinical Reference Group works closely with Getting It Right First Time and the respective professional societies to review patient outcomes and support commissioned providers in the delivery of high-quality care for patients.

The Department has published a new Cardiovascular Disease Modern Service Framework, which prioritises ambitious, evidence-led, and clinically informed approaches to prevention, treatment, and care, supporting consistent and equitable access across the cardiovascular disease pathway.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 20 July (HL1920), on what date NHS England now expects to publish its proposed clinical commissioning policies for the use of masculinising and feminising hormones in adult gender services for public consultation; and what the expected timetable is for finalising those policies once the consultation closes.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

A period of consultation on the proposed clinical commissioning policies is expected to begin in the coming months, with a final decision expected in spring 2027.

Regarding NHS England’s work to develop a clinical pathway for detransitioners, more information for stakeholders is also expected to be published in the coming months, following the Call for Evidence to which the Noble Baroness has referred.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 16 July (HL1829), what progress NHS England has made in reviewing responses to its call for evidence on the clinical pathway for detransitioners, which closed in December 2025; and when they expect to publish their conclusions or a service specification.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

A period of consultation on the proposed clinical commissioning policies is expected to begin in the coming months, with a final decision expected in spring 2027.

Regarding NHS England’s work to develop a clinical pathway for detransitioners, more information for stakeholders is also expected to be published in the coming months, following the Call for Evidence to which the Noble Baroness has referred.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the written answer by Baroness Merron on 17 September (HL3339), how many NHS referrals for (1) mastectomy, and (2) genital, surgery as treatment for gender dysphoria, were made in each of the past ten years, broken down by sex and age group.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Data was not collected nationally until 2023/24, so the only data collected and available was that provided in the previous response to which the Noble Baroness has referred.

Found: BARONESS MERRON 1_ Clause 2, page 1, line 16, at end insert— “(1A) The Secretary of State may not make

Found: BARONESS MERRON 1_ Clause 2, page 1, line 16, at end insert— “(1A) The Secretary of State may not make

Found: Schedule 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] Clause 2 BARONESS MERRON

Found: Schedule 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] Clause 2 BARONESS MERRON

Found: Schedule 6 Title Clauses 40 to 44 [Amendments marked ★ are new or have been altered] Clause 2 BARONESS MERRON

Found: Return Nil Return James Frith Nil Return Nil Return Nil Return Nil Return Nil Return Nil Return Baroness Merron

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Found: Suicide Prevention Week, including accompanying hospitality in the Premier League box No 949 Baroness Merron

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