Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 5 June (HL108), what steps they are taking to ensure that delivery of NHS Health Checks is better incentivised across primary care and local systems.

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

The NHS Health Check (NHS HC) programme is commissioned by local authorities who are responsible for offering 100% of their eligible resident population a check every five years.

The Government's Public Health Grant to local authorities is used to enable the programme's provision and allows local authorities to ensure that delivery of the NHS HC is aligned with local public health services and fits their local population.

The programme's Best Practice Guidance provides commissioners and their providers with information on how to deliver the programme effectively, and how to adopt a proportionate universalist approach to ensure that checks are delivered in a way that prioritises resources and effort towards engaging people at higher risk of cardiovascular disease.

Department officials are considering options to improve the NHS HC programme.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 5 June (HL108), what steps they are taking to ensure that improvements to the NHS Health Check programme are targeted towards communities experiencing the greatest health inequalities.

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

The NHS Health Check (NHS HC) aims to improve the health and wellbeing of adults aged 40 to 74 years old through the promotion of early awareness, assessment, and management of the major risk factors for cardiovascular disease (CVD), risk factors that are associated with premature death, disability, and health inequalities in England. Improving uptake of the programme, including for people at the highest risk and experiencing inequalities, is a priority for the programme.

The NHS Health Check Online is currently being tested in 11 local authorities across England and aims to increase access and engagement with the programme for all population groups, by allowing people to undertake their NHS Health Check at home, at a time and place convenient to them, freeing up in-person NHS HCs for those who want or need more support.

The recently published Cardiovascular Disease Modern Service Framework (CVD MSF) sets out the 10-year ambition to systematically identify individuals with established or emerging cardiovascular, kidney, and metabolic risk factors, including via the NHS HC, whilst reducing the variation in the number of people receiving a check between the best and worst performing areas nationally. A delivery plan will be published later this year to support local implementation of the CVD MSF.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 5 June (HL108), what steps they are taking to strengthen lipid management pathways, including diagnosis, referral, treatment optimisation and long-term monitoring, for people at risk of cardiovascular disease.

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

The NHS Health Check programme, a core component of England's cardiovascular disease (CVD) prevention programme, assesses the top risk factors for CVD, including raised cholesterol, in eligible people and refers them to further support through behavioural interventions, clinical assessment, and treatment where appropriate. For every 1.4 million NHS Health Checks delivered annually, 900,000 people are found to have raised cholesterol level. We are also developing the NHS Health Check Online to improve access and help more people understand and act on their risk factors.

Furthermore, NHS England is strengthening lipid management by improving identification of people at risk of CVD through risk assessment, case finding, and community-based initiatives, including pharmacy-led approaches and cholesterol point of care testing.

The Government recently published the Cardiovascular Disease Modern Service Framework, which sets out priorities for the health and care system to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within the next decade. Identifying people with high cholesterol and optimising lipid management for people with high cholesterol are amongst the priorities for the health and care system.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 13 July (HL1811), what topics relating to health and social care Alan Milburn is recused from.

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

There is an established system in place for the declaration and management of Non-Executive Director’s interests. Mr Milburn’s declarations of interest are published on the GOV.UK website and are as referenced in the previously given answer of 16 June 2026 to Question HL106, which is in line with the Cabinet Office guidance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the speech by Baroness Merron on 3 March 2026 on the proposed retail licensing scheme for tobacco, vaping and nicotine products, Official Report, House of Lords, columns 1169 to 1171, when he plans to consult on that scheme; and what assessment his Department has made of the implications for the enforcement of restrictions on the packaging, appearance and retail display of vaping and nicotine products.

Answered by Sharon Hodgson

On 10 July, we launched a United Kingdom-wide consultation on new proposals to restrict tobacco, vape, and nicotine product packaging, flavour descriptors, device appearance, and changing where and how vapes and nicotine products are displayed in shops. Enforcement authorities will be able to take proportionate enforcement action against non-compliance with future regulations made under the Tobacco and Vapes Act 2026.

A future retail licensing scheme for tobacco, vapes, and nicotine products will strengthen enforcement and support law-abiding retailers, while tackling those who break the law. Those found to be in breach of a condition of their licence, or other statutory requirements, could face potential licence revocation. Whilst the specific grounds on which a licence may be granted, suspended, revoked, or varied will be subject to consultation, we want to ensure retailers are operating responsibly and in line with legal requirements.

We intend to consult on our proposals for a retail licensing scheme for tobacco, vapes, and nicotine products in 2027.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 8 October 2025 (HL10538), whether the NHS Supply Chain procurement exercises, including the Total Cardiology and Vascular Solutions Framework, are being developed in line with the draft Value Based Procurement Standard Guidance; and what assessment they have made of whether the evaluation criteria in that guidance include sufficient thresholds for non-price value criteria in particular (1) clinical outcomes, (2) patient quality of life, (3) innovation, (4) sustainability, and (5) whole system efficiencies.

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

NHS Supply Chain has worked closely with the Department to support the implementation of its value based procurement (VBP) guidance. Within the Total Cardiology and Vascular Solutions Framework, the Department’s methodology has been piloted on a national procurement and integrated into the non-financial evaluation criteria, with appropriate adaptations made to reflect the specific clinical and operational requirements of the specialty. Value-based assessment criteria and associated non-financial questions have been included where supplier claims can be objectively assessed ensuring a fair, transparent, and equitable evaluation process.

Extensive pre-market engagement was undertaken between March 2025 and September 2025, providing suppliers, customers, clinical associations, and professional bodies with the opportunity to share insights, feedback, and observations on the proposed procurement strategy and overall approach. Communication has been conducted in forms such as team meetings, face to face meetings, and email exchanges with all stakeholders, including clinicians. Draft versions of the VBP questions were circulated during this period to support supplier readiness and to enable meaningful challenge and feedback in advance of tender publication. NHS Supply Chain clinical and category teams engaged extensively with key clinical stakeholder groups, including members of the British Heart Rhythm Society, members of the British Cardiovascular Intervention Society, and NHS England Device Working Groups, to inform the development and refinement of the VBP criteria. The final questions focus on areas where value can be clearly evidenced, including clinical outcomes, innovation, sustainability, social value, and whole-system costs and efficiencies.

While the NHS Supply Chain has successfully incorporated VBP principles into the cardiology and vascular framework evaluation, a key challenge remains the limited availability of standardised Patient Reported Outcome Measures, clinical registries, and other robust outcome datasets to enable consistent and comparable assessment of supplier value claims. Consequently, VBP evaluation has been focused on evidence that can be objectively assessed at the tender stage, with a clear commitment to further validate and measure value throughout the lifetime of the framework as more comprehensive clinical, operational, and patient outcome data becomes available. This approach balances fairness and transparency in procurement with the longer-term ambition of embedding a mature, evidence-based value assessment model across the specialty.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Statement by Baroness Merron on 2 June (HLWS82), which stated £2.8 million in capital funding will be made available to strengthen and expand provision of focal therapy for prostate cancer, what projects will be funded.

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

The investment in focal therapies, announced on 2 June 2026, will strengthen existing provision in line with the expansion of the TRANSFORM trial for prostate cancer screening.

Any expansion of focal therapy provision to new sites will include appropriate clinical and market engagement. Officials at the Department are working closely with clinicians and researchers to optimise the planned investment of up to £2.8 million in focal therapy. Further details of this investment will be announced in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the remarks by Baroness Merron on 15 April (HL Deb, cols 27GC-28GC), what consideration they have given to exempting the provision of treatment to those in the performing arts, elite athletes, and their teams, from the list of regulated activities for the purposes of the Health and Social Care Act 2008.

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

The Government has heard from a range of industry and medical stakeholders and will consider the range of views provided in relation to potential exemptions. There will be close liaison with the Care Quality Commission (CQC) to ensure that everyone either participating in or attending cultural or sporting events receive safe and effective care. The CQC continues to engage with providers to ensure minimal impact on them whilst achieving those aims.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the remarks by Baroness Merron on 15 April (HL Deb, cols 27GC–28GC), whether they intend the provision of treatment by foreign medical teams to those in the performing arts, elite athletes, and their teams, temporarily visiting the UK to constitute a “regulated activity” for the purposes of the Health and Social Care Act 2008 upon the coming into force of regulation two of the Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026 (SI 2026/495); and if not, what assessment they have made of the implications of any difference in requirements for foreign and domestic medical staff.

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

The Care Quality Commission (CQC) is the regulator for health and social care in England. Providers of health and adult social care who are wholly based outside England would typically not register with the CQC.

This is because the CQC does not hold jurisdiction to regulate providers outside England and therefore cannot inspect and take enforcement action against them if the service being provided fails to meet the necessary standards as set out in the regulations.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the remarks by Baroness Merron on 15 April (HL Deb, cols 27GC–28GC), whether they consider that the Care Quality Commission has the requisite (1) knowledge, and (2) financial resources, to regulate the provision of treatment to those in the performing arts, elite athletes, and their teams.

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

The Care Quality Commission (CQC) regulates the treatment of disease, disorder, and injury across a range of industries, which includes pre-hospital care. The CQC continues to engage with providers of event healthcare directly, and has worked with the Government to meet with industry and medical leaders. This engagement continues.

In accordance with its normal ways of working, the CQC will recruit a team of specialist advisors who are experts in their field to join the inspections of providers. The purpose of that inclusion is to ensure that all regulatory decisions are based upon current best practice. The CQC continues to monitor the implementation of the review of regulations to ensure that financial matters have due attention.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the answer by Baroness Merron on 6 July (HL Deb col 2), how many Integrated Care Boards (ICBs) do not have a fracture liaison service in each of the NHS hospitals within the ICB.

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

Analysis of 2025 Fracture Liaison Services (FLS) data shows that the number of FLS’ in England has increased since 2024, from 80 to 83. These 83 services are based in 23 out of the 25 integrated care board (ICB) clusters.

Analysis of the 2025 data suggests that no ICB clusters had an FLS in each of the NHS hospitals within the ICB clusters. The number of FLS’ per ICB cluster ranged from one to eight.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 April (HL16567), whether the National Consultant Information Programme (1) is publicly accessible to patients, (2) includes data on consultants practising in the independent sector, and (3) records the practising privileges held by consultants; and what assessment they have made of that Programme's compliance with the Paterson Inquiry's recommendation for a single repository of information about consultants across England.

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

The National Consultant Information Programme (NCIP) is publicly accessible to patients on the Getting It Right First Time website.

The NCIP portal is a free data platform containing consultant and provider-level activity and outcomes data for over 500 procedures in 13 surgical specialties. It covers National Health Service practices, NHS funded work in the independent sector, and privately funded work carried out in the NHS. Over time, the ambition is to add independent sector data, to provide a single repository of whole practice. Currently, patients are not able to access this data.

NCIP allows consultants in 13 surgical specialties to access their individual outcomes data, for personal learning, clinical governance, and appraisals. NCIP does not record practising privileges in the independent sector.

NCIP is a critical part of the response to the Paterson Inquiry, which recommended that there should be a single repository of the whole practice of consultants across England. By sharing high-quality outcome data, consultants, their appraisers, and responsible officers can compare outcomes for their practice or use peer review to improve their performance in a way that is measurable and objective, leading to better safety and efficiency across the NHS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 6 July (HL1488), how the Medicines and Healthcare products Regulatory Agency will communicate the conclusions of its review of mental health risks for migraine prophylaxis medications; whether that Agency will consider a drug safety update or other national safety communication; and whether any resulting changes to product information would be reflected in national electronic prescribing and medicines decision-support systems.

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

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department with responsibility for ensuring medicines meet appropriate standards of quality, efficacy, and safety.

The MHRA has plans to gather the currently available evidence on mental health and other related risks for licensed migraine prophylaxis medications, as referenced in the separate responses to questions HL1488 and HL1543. A formal timeline for this review has not yet been agreed, and consequently we are unable to provide an expected completion date at this stage.

The MHRA is committed to communicating any findings that may have implications for patient safety or the safe use of medicines. The MHRA will sometimes issue communications, such as drug safety updates, after the conclusion of a review. However, the review is at an early stage, and it would be premature to comment on any potential communication plans. In addition, any product information changes that may arise as a result of this review would be reflected in the published product information available at locations such as the MHRA website or the Electronic Medicines Compendium website.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 6 July (HL1488), when they expect the Medicines and Healthcare products Regulatory Agency to complete its review of evidence on mental health and related risks for licensed migraine prophylaxis medications.

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

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department with responsibility for ensuring medicines meet appropriate standards of quality, efficacy, and safety.

The MHRA has plans to gather the currently available evidence on mental health and other related risks for licensed migraine prophylaxis medications, as referenced in the separate responses to questions HL1488 and HL1543. A formal timeline for this review has not yet been agreed, and consequently we are unable to provide an expected completion date at this stage.

The MHRA is committed to communicating any findings that may have implications for patient safety or the safe use of medicines. The MHRA will sometimes issue communications, such as drug safety updates, after the conclusion of a review. However, the review is at an early stage, and it would be premature to comment on any potential communication plans. In addition, any product information changes that may arise as a result of this review would be reflected in the published product information available at locations such as the MHRA website or the Electronic Medicines Compendium website.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 22 June (HL816), how the "similar functionality" commitment applies to (1) the "native code and native interfaces" re-implementation of the NHS app with any new minimal compatibility requirements; (2) services in the current NHS app; and (3) future updates to the NHS app which will not be compatible with older devices which remain in active use by patients.

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

The Government is fully committed to developing the NHS App for the benefit of patients and services in the National Health Service, in line with the 10-Year Health Plan.

We have consistently minimised any divergence between code bases and will continue to do so in the future as we develop the NHS App. This helps to optimise the service for patients.

We are continuing to fully develop the NHS App for users as an iOS app, an Android app, and as a website. Where there are any differences between these formats, this can be due to natural differences in design due to different operating systems and conventions or it can also occur as new features are rolled out across formats, one at a time. In the case of the latter, this means any differences may only be temporary.

We are committed to making the NHS App as accessible as possible, whilst at the same time ensuring the software remains safe and secure for use by patients. We review the operating system and browser version policy annually, to determine how best to strike this balance.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 April (HL16569), when they expect the information explaining to patients how care in the independent sector differs from NHS care to be published; and what has caused the delay in fulfilling this recommendation of the Paterson Inquiry report Report of the Independent Inquiry into the Issues raised by Paterson, published on 4 February 2020.

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

The Department recognises the importance of ensuring that patients have clear information about their care in the National Health Service, whether delivered by NHS providers or independent sector providers. We have recently published a set of patient experience minimum standards setting out our expectations of providers of NHS funded elective care while patients are on the waiting list.

We will provide an update on this commitment in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Statement by Baroness Merron on 2 July (HLWS179), why the redundancy of the former Chief Executive of the South Yorkshire Integrated Care Board can be classified as a compulsory redundancy given the statement that NHS England’s approval was conditional on potential shared leadership arrangements which did not materialise.

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

As set out in the Written Ministerial Statement of 2 July, NHS England has advised that the relevant condition was that the former Chief Executive role should not be filled through external recruitment but should instead be addressed through redeployment or other leadership arrangements to avoid an additional redundancy and that this condition was met. The redundancy was therefore classified as a compulsory redundancy.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 2 July 2026 (HL232), what mechanisms they use to ensure compliance with HM Treasury guidance on public sector exit payments, given the statement that the Department of Health and Social Care does not centrally reassess whether an interim post holder performed the same statutory duties as a redundant role.

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

As set out in the answer of 2 July 2026 to Question HL232, compliance with HM Treasury’s guidance on public sector exit payments and value for money protocols is secured through the relevant employer governance and assurance processes, with NHS England oversight where required. Departmental and HM Treasury approval is generally required where the payment relates to a special severance payment or other non-contractual payment.

Responsibility for ensuring that any redundancy decision is lawful, contractual, and represents value for money rests with the employing integrated care board, supported by NHS England’s assurance role where applicable.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 2 July (HL231), what were the reasons for progressing the contractual compulsory redundancy of the former Chief Executive of the South Yorkshire Integrated Care Board (ICB) in August 2025, in light of the statement that ministers had determined during summer 2025 that the South Yorkshire ICB would remain a standalone entity.

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

NHS England has advised that the decision for the South Yorkshire Integrated Care Board (ICB) to remain a standalone statutory body did not remove the wider restructuring context in which the Chief Executive role was considered. NHS England considered the case in the context of proposed changes to ICB Chief Executive roles and local senior leadership arrangements. Its approval was conditional on the Chief Executive role not being filled through external recruitment but instead be addressed through redeployment or other leadership arrangements intended to avoid creating an additional redundancy. On that basis, NHS England progressed as a contractual compulsory redundancy.

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 effectiveness of the implementation of Tommy's Graded Model of Miscarriage Care.

Answered by Preet Kaur Gill

Baroness Merron has met with Tommy’s regarding the Graded Model, and officials meet with the charity regularly. We are carefully assessing the findings of their recent report as part of a broader range of measures under consideration to improve miscarriage care for women and families.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has had discussions with the Tommy's campaign to discuss their Graded Model of Miscarriage Care.

Answered by Preet Kaur Gill

Baroness Merron has met with Tommy’s regarding the Graded Model, and officials meet with the charity regularly. We are carefully assessing the findings of their recent report as part of a broader range of measures under consideration to improve miscarriage care for women and families.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 April (HL16570), what data they hold on compliance with the General Medical Council's guidance Decision making and consent; how many fitness to practise cases since November 2020 have involved a failure to give patients adequate time to reflect before consenting to surgical procedures; and what audits of consent practice have been undertaken in (1) the NHS, and (2) the independent sector, since the publication of the report by the Paterson Inquiry Report of the Independent Inquiry into the Issues raised by Paterson, published on 4 February 2020.

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

The General Medical Council (GMC) is independent of the Government, directly accountable to Parliament, and is responsible for operational matters concerning the discharge of its statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government.

The Department does not hold national datasets on what audits of consent practice have been undertaken in the National Health Service or in the independent sector, since the publication of the Paterson Inquiry Report published on 4 February 2020.

NHS England has integrated decision support tools into elective pathways of care. These tools support two stage shared decision making, which introduces a period of reflection for patients when deciding on treatment options and giving consent. This allows patients to take the time to fully understand the benefits and risks of treatment, talk with friends and family, and decide whether it is the most suitable option for them.

The Medical Practitioners Assurance Framework (MPAF) was developed by the Independent Healthcare Providers Network in response to reviews, including the Paterson Inquiry. The MPAF is designed to provide a basis from which all independent providers can work, giving confidence to patients and regulators, such as the Care Quality Commission, on what good looks like. The MPAF advises that policies need to provide for patients to be given specific time to reflect and make decisions.

Found: OBE MP will remain as Parliamentary Under-Secretary of State in the Department for Education Baroness Merron

Found: OBE MP will remain as Parliamentary Under-Secretary of State in the Department for Education Baroness Merron

Found: Letter dated 15/07/2026 from Baroness Merron to Lord Grayling regarding clarification about the TRANSFORM

Found: Following the meeting and the one year anniversary, the Minister wrote to Baroness Merron in February