Neighbourhood Health and Social Care
Baroness Pidgeon Excerpts(2 days, 6 hours ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
The noble Baroness is quite right to talk about people having more complex needs, and, indeed, we are also living longer. However, the current health system is organised around institutions and services that are complex, disjointed and difficult to navigate, as she said. On housing, for example, I know that the health and well-being boards, which are the key to this, can design themselves to bring in services. I can think of a number which have already done that and included people from housing in the way that she describes. It is absolutely encouraged and health and well-being boards across the country are already doing that.
Baroness Pidgeon (LD)
My Lords, a recent workforce assessment by Skills for Care found that adult social care in England still had around 96,000 vacancies and projected that a further 410,000 posts will be needed by 2040 to meet demand. What are the Government doing to address these shortages and deliver genuine integrated patient services?
Baroness Merron (Lab)
We recognise the continuing challenge that we inherited in terms of workforce, but that is why we are investing in the adult social care workforce. In 2028, the first ever fair pay agreement will come in, which will be backed by £500 million of funding. It will improve pay and conditions for the workforce, which is crucial. We are also implementing the first ever universal career structure for the adult social care workforce, as well as investing up to £10 million this year in the learning and development support scheme. This, along with all the other changes, will make a massive difference to the workforce in terms of retention, recruitment and development.
NHS: Agency Medical Staff
Baroness Pidgeon Excerpts(1 week, 1 day ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Anderson of Stoke-on-Trent) (Lab)
My Lords, we will hear from the Liberal Democrats.
Baroness Pidgeon (LD)
My Lords, CQC inspections repeatedly warn that caring for unmonitored patients in hospital corridors carries severe safety risks. What assessment have the Government made of the use of agency staff in corridor areas and the clinical risks of deploying such staff in non-designated care areas?
Integrated Care Boards: Access to Services
Baroness Pidgeon Excerpts(1 week, 2 days ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Pidgeon
To ask His Majesty’s Government what assessment they have made of access to primary and community health services by integrated care boards.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, access to primary care is improving. The year June 2025 to June 2026 saw nearly 14 million more GP appointments compared with the same period in the previous year, and satisfaction when contacting a GP increased by over 14% compared with July 2024. For the first time, we have introduced a waiting time standard for community health services, and 37.6 million NHS dental treatment courses were delivered in 2025-26, which is 6.2% higher than in 2024-25.
Baroness Pidgeon (LD)
My Lords, more than 600,000 people are waiting for hospital eye appointments, yet on our high streets there are optometrists who can provide urgent and minor eye care services, ensuring faster, more convenient access for patients. Will the Government require all ICBs to commission these basic community health services?
Baroness Merron (Lab)
The requirement on ICBs now is to focus on the strategic commissioning of health services and to be responsible for all but the most specialised services. Looking particularly at improvement of access to eye care, which is extremely important, the Government recently announced some £20 million to improve digital connectivity between primary care, optometry and secondary eye care. In all these ways, people will be far better served in their eye care.
Neighbourhood Health Services
Baroness Pidgeon Excerpts(1 week, 3 days ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
The noble Baroness set out exactly what the plan is, and I am grateful to her for doing so, but I emphasise that the whole point of the independent national evaluation is that it will evaluate the whole breadth of neighbourhood health. It started in April and will run for three years. I further emphasise that it is about continual engagement and developing different ways that neighbourhood health can be successful. It will also model what the long-term outcomes and improvements can be, depending on how you do it. All that will mean working with the local ICBs to see about their progress, but they are well aware of the expectations upon them, and they will set their own ways forward.
Baroness Pidgeon (LD)
My Lords, if neighbourhood health services are to succeed, more care will be delivered through general practice and community settings, yet NHS funding allocated to general practice has fallen over the last decade. Will the Government consider introducing a primary care investment standard to ensure primary care can grow in line with this ambition?
Baroness Merron (Lab)
We do not intend to bring forward the investment standard that the noble Baroness seeks. I am aware that a discussion is going on—probably as we speak—through the Health Bill, which is about to be introduced to your Lordships’ House. That is about increasing accountability and responsiveness to local needs and improving outcomes. I say to the noble Baroness that our fear is that bringing in yet another approach, through an investment standard, risks undermining that.
Childbirth-related Post-traumatic Stress Disorder
Baroness Pidgeon Excerpts(2 weeks, 1 day ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
While I cannot give the specifics here and now, I will be pleased to get that information to the noble Baroness. She is right to highlight the need to make sure that all women have access and that all women who have PTSD or experience of birth trauma are identified. Record numbers of women are now accessing specialist perinatal mental health services—66,500 women last year in England alone. The figures I can get the noble Baroness will, however, give a much better flavour of how we are reaching groups who may well be marginalised in the way that she describes.
Baroness Pidgeon (LD)
My Lords, given that six out of 10 maternity units have been assessed as unsafe by the Care Quality Commission, it is not surprising that this research identifies thousands of women experiencing birth trauma. Will the Government now guarantee one-to-one midwifery care during labour and a consultant on every maternity ward 24/7 to support women giving birth?
Baroness Merron (Lab)
Safety is key, and so are the experiences of women and their families. The noble Baroness and the House will be well aware of the national maternity and neonatal plan, which will drive proper, sustained improvement across the system. This is what I believe we have been lacking for years, and it is why we asked the noble Baroness, Lady Amos, to conduct an independent review. She has reported on that and the maternity and neonatal plan will be announced by the end of this year. I certainly look forward to that; it is being worked on as we speak, involving both clinicians and those with lived experience, as well as campaigning organisations and all those with an interest. I am feeling positive about how we move forward, and the point made by the noble Baroness about staffing and ratios will of course be part of that.
Healthcare Sector: Clinicians
Baroness Pidgeon Excerpts(1 month, 3 weeks ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
That is exactly the reason why we need to encourage innovation and take advantage of all the improvements now available to us, including AI. It is by modernising our approach that we will move forward greatly. That is why we are building the practicalities, as I described in my Answer just now, as well as a culture of innovation. We are also providing the ability to see adoption, because people are rightly concerned if time is spent on innovation but the product or service never comes forward. We are changing a number of points to improve that.
Baroness Pidgeon (LD)
My Lords, in a growing number of hospitals, clinicians are using at-home bladder cancer testing to reduce the number of cystoscopies and speed up diagnosis. Can the Minister expand on how the Government will help clinician-led innovations such as this to spread across the NHS, so that access does not depend on where a patient lives?
Baroness Merron (Lab)
Yes, I am very pleased to do that. I point to the National Healthtech Access Programme, which is exactly what the noble Baroness is seeking. It is a route for cost-effective and clinically effective technologies, such as the one the noble Baroness describes, so that we can see the best benefit to patients and the best value, and that supports more equitable access. NICE is currently assessing three projects, including using AI in histopathology for the diagnosis of prostate cancer and breast cancer, to give two examples, and we will shortly see the publication of those results.
People with Learning Disabilities: Acute Illness
Baroness Pidgeon Excerpts(1 month, 4 weeks ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Pidgeon (LD)
My Lords, specialist training in the care of people with a learning disability is critical to reducing avoidable mortality. Will the Government fund dedicated senior clinician roles in learning disability medicine across community, acute and mental health settings to provide the leadership that is necessary to improve healthcare outcomes for this population?
Baroness Merron (Lab)
There are a number of aspects to that area. We have greatly increased the mandatory training requirement and the numbers who have been trained. The noble Baroness also points to the importance of a multidisciplinary approach. We have seen an increase in nursing staff in that regard. It is a matter for the local provider to decide, but the workforce plan, which we will be seeing soon, will be very helpful in this regard.
Modern Service Framework for Dementia and Frailty
Baroness Pidgeon Excerpts(2 months, 1 week ago)
Grand CommitteeRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Pidgeon (LD)
My Lords, I am grateful to the noble Lord, Lord Weir of Ballyholme, for tabling this Question for Short Debate and for his comprehensive opening words which set the tone for this short but perfectly formed debate, giving us the opportunity to consider what the modern service framework for dementia and frailty needs to deliver. If it is to succeed, it should set clear national standards backed by funding and accountability so that a diagnosis opens the door to real support and access to new treatments as they become available.
As we have heard, dementia is the UK’s leading cause of death, with almost 1 million people currently living with the condition. This is projected to rise to 1.4 million by 2040. The noble Baroness, Lady Nargund, pointed out that two-thirds of them are women and referred to the interesting research on hormonal changes, the menopause and its links to developing dementia. That is important and something that we need to consider.
Research is advancing rapidly. There are, I understand, 158 drugs in 192 clinical trials globally. The first disease-modifying treatments are now licensed in the UK. However, people can access trials for innovative treatments only when they are diagnosed early—making diagnosis at the earliest stages increasingly important. It would be good to hear from the Minister what work the Government are undertaking to ensure easier access to trials. Alzheimer’s Research UK estimates that close to one-third of people over 65 living with dementia in England still do not have a recorded diagnosis, so closing that diagnostic gap is critical.
A UCL-led trial—supported by the Alzheimer’s Society, Alzheimer’s Research UK, the National Institute for Health and Care Research, Gates Ventures and players of the Postcode Lottery—began testing a blood test for Alzheimer’s disease in NHS memory services last year, offering a simpler, less invasive route to diagnosis than current methods. If this proves reliable, the framework should be ready to support its rollout across the NHS.
As we have heard, Alzheimer’s Research UK has launched a new policy report today, Ready for the Cure: A Blueprint for UK Leadership in Dementia Research, which sets out a series of recommendations to address the key structural barriers to advancing dementia research. I hope to hear, perhaps, an initial reflection on that report when we hear from the Minister.
However, a diagnosis on its own is not enough. NHS England’s data shows that more than one-quarter of people living with a dementia diagnosis did not receive a care plan in the past year and that specialist support, such as Admiral nurses, remains patchy and dependent on where someone lives. That gap matters most in the weeks after diagnosis, when families are trying to understand what has changed and what support is available to them. The noble Baroness, Lady Wyld, set out her family’s personal experience. As for others, with that diagnosis of dementia, the question is: where should we turn? What happens next? It is a picture about which we hear so often from many families.
Dementia UK and others have called for specialist dementia nursing to be part of every neighbourhood health team. If the framework is genuinely to modernise dementia care, diagnosis, treatment, care planning and support for carers, which is so important, it must be designed and funded as a single pathway. As the ageing population grows and new dementia treatments emerge, the demand for diagnosis will inevitably rise. The forthcoming framework presents a clear opportunity for standardising the pathways for referral, assessment and treatment, for robust data capture and reporting and for reducing the variation in service across the country, which we hear about so often. As the noble Lord, Lord Weir, rightly stressed, we need to get this right. Our discussion on prevention is also an important part of this.
I turn to frailty, which makes up the other half of this framework. Around one in 10 people over 65 live with it, and the figure rises to as many as half of those aged over 85. Last month, the Commons Public Accounts Committee reported that only 17% of patients aged over 65 had had a frailty assessment recorded by their GP in the past year, well short of what is needed to ensure that those living with frailty have access to treatment. For those already identified as being most at risk, only 16% had had a medication review and 18% had had a falls risk assessment. This is in a service that is meant to reach everyone in that group. If frailty is to sit alongside dementia in the framework, it deserves the same focus on early identification, consistent standards and timely intervention. Bringing these two conditions together in one framework creates a real opportunity to establish common principles across both. If the framework is going to achieve everything, it must make a meaningful difference to people living with dementia and frailty, as well as to their families and the support networks that care for them.
I look forward to the Minister’s reply to this debate and hope to hear of a timescale and resource commitment to this important area.
National Maternity and Neonatal Investigation
Baroness Pidgeon Excerpts(2 months, 1 week ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Kamall (Con)
My Lords, I thank the Minister for the Statement and the noble Baroness, Lady Amos, and her team for the thoroughness and compassion with which they have conducted this important investigation. Above all, our thoughts must be and are with the women, babies and families whose experiences lie at the heart of this report. Many have had to revisit the most painful moments of their lives when some want to simply move on. But after years of fighting, they must be heard. Their courage, dignity, determination and persistence place a responsibility on all of us in this House. We owe it to them not simply to listen, but to ensure that their experiences finally lead to lasting change.
Only last week the House considered Donna Ockenden’s devastating findings in Nottingham. Here, the noble Baroness, Lady Amos, presents us with a wider national picture. Once again, we see the same troubling themes emerge—women whose concerns were dismissed, staff who felt unable to speak up, inequalities that remained unchallenged, and organisations that failed to learn from previous mistakes. As Donna Ockenden herself observed, much of what is contained in this report is sadly already known to us, as it was to Governments of all political colours in previous years. That is perhaps the most disturbing and sobering conclusion of all.
The challenge before us is no longer one of evidence. We have had inquiry after inquiry, report after report and recommendation after recommendation. The challenge now is implementation. Families have every right to expect that this report will become the catalyst for sustained improvement across maternity and neonatal services. I am sure that all noble Lords welcome the fact that work is beginning immediately in a number of critical areas, including maternity triage, tackling discrimination, strengthening staffing and addressing urgent estate risks. It is right that today’s expectant mothers be given assurance and reassurance about what will change immediately, not only at the end of the year when the wider plan is due.
A few outstanding questions arise from the Statement. First, can the Minister update the House on the timetable for the Leeds and Sussex reviews? How will the Government ensure that concerns which have already been identified in those services are acted on before these reviews conclude? Secondly, it is welcome that the Secretary of State will publish the new maternity triage standards next week, but by when does the Minister expect every NHS trust to have implemented these standards and will Parliament receive regular updates on trust-by-trust progress so that families can see that improvements are generally being delivered? Thirdly, the Government propose establishing a statutory maternity and neonatal commissioner. Can the Minister explain what powers the commissioner will have to hold trusts, regulators and national bodies to account? How will local leaders remain accountable for the safety of the services that they are supposed to oversee?
The additional midwifery posts announced today are also welcome, but the report from the noble Baroness, Lady Amos, like those before it, identifies workforce pressures as a fundamental challenge to safe maternity care. Do the Government intend to address this issue immediately, or will we have to wait for the long-awaited workforce plan? If it is the latter, can the Minister update the House on when it will be published and whether it will specifically address maternity and neonatal services? I can understand her perhaps raising an eyebrow here, as she rightly and persistently challenged me on this when I was a Minister in her place.
Since the report’s publication, concerns have been raised by Dr Bill Kirkup about the removal of references to so-called normal birth ideology from the final report. Previous maternity inquiries have identified this as a contributory factor. It would not be fair of me to ask for comment on the editorial process, but can the Minister reassure the House that all relevant evidence—including from Morecambe Bay, which found that midwives were pursuing normal birth at any cost—will be fully considered?
Finally, the Secretary of State is right that culture lies at the heart of this challenge. Often, while policy changes and restructures are visible, it can be more difficult to bring about cultural change. Where the Government act with the urgency that this report demands, they will have our support. However, women and families will judge today’s Statement not by new structures, new titles or another report, but by what happens when a woman says that something is wrong. Is she heard? Are warning signs acted on? Is help from senior colleagues available when needed? Are maternity units safely staffed and can staff speak up without fear? Do families receive honesty and compassion when harm occurs? Above all, are we reducing the number of mothers and babies coming to harm?
Families have told their stories. The evidence is clear. We will support and, where appropriate, challenge the Government and the NHS as they seek to bring about this much-needed change. The Minister in the other place has made a good start, and we hope to see further progress.
Baroness Pidgeon (LD)
My Lords, this is another week and another traumatic and difficult-to-read report about the state of maternity services. Behind it are thousands and thousands of women and families deeply affected by these service failures. I thank them all for their contributions to this report, as well as the noble Baroness, Lady Amos.
Women are not being listened to, heard or believed, with serious consequences for safety and quality of care. Racism and discrimination are embedded throughout the maternity and neonatal system. Services are not responsive to the changing profile of women giving birth and the increase in medical interventions during birth. Antenatal, birth and labour, neonatal and postnatal services are just not joined up. From Somerset to Blackpool, the safety of having a baby has become a lottery. Women are silenced and staff who raise the alarm on unsafe care or systemic discrimination are crushed by a culture of fear. We need to see genuine accountability throughout the NHS and the investment necessary to make Britain the safest country in the world to have a baby.
I have a number of questions for the Minister. I welcome the Government’s commitment to a national maternity commissioner, but can the Minister confirm that this post will go to an independent expert and not a political appointee? Will the Minister reassure us that action will be taken before December, rather than waiting for the taskforce to report on its plans? Will the Government guarantee safe staffing at all hours in every maternity ward in the country, so that no woman has to give birth in an unsafe unit?
This inquiry has, once again, raised the issue of poor bereavement support across the NHS after pregnancy or baby loss. The national bereavement care pathway seeks to resolve this by ensuring high-quality and consistent bereavement care across the UK. The trauma of baby death and pregnancy loss can last a lifetime. Parents’ memories of the care they receive at that moment will stay with them for ever. Good bereavement care can help parents and families navigate their bereavement journey, while poor care can just add to the trauma of loss.
The first moments after a baby dies can be the only opportunity parents have to make memories with their baby, and there is only once chance to get this right. After a baby dies, parents often face really tough decisions, and they cannot make informed decisions about their baby without clear and compassionate communication from healthcare professionals. I therefore ask: will the Government roll out all five national bereavement care pathways, including for miscarriage, and actively monitor implementation across the health system? Will they ensure that suitable bereavement rooms are available in all trusts, not as a “nice to have” but as part of dignified trauma-informed care? This would be a step change for so many families.
There is so much more I could say on a topic that has shocked us all. All families, wherever they live and whatever their ethnicity, must be supported to have their babies safely. This has clearly not been the case for too many years. This is the point where things must change, and I really look forward to the Minister’s response.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, we know—and we can never acknowledge it enough—that women, babies and families across the country are being harmed, traumatised and let down by a broken system. I am grateful to both Front Benches for the way in which they have received this report and for their support, and their acknowledgement of the role we have taken in government.
The noble Baroness, Lady Pidgeon, talked about trauma lasting a lifetime, and that is indeed the case. When I have met women and families who have been affected, that is what has stuck with me: the trauma never goes away. I also accept the correct challenge from the noble Lord, Lord Kamall, that the judgment will be on what has changed, not on what is written. We are very conscious of that, and I am grateful to him for reminding me of it.
Before turning to the helpful questions from the noble Baroness and the noble Lord, I will make a few comments. I too want to express my gratitude to every woman, family member and member of staff who came forward to give evidence to the noble Baroness, Lady Amos, and her team, who heard from thousands of people who showed great courage and determination to share their experiences, painful though they were, and conducted their investigation with immense sensitivity and care. The noble Baroness, Lady Amos, diligently brought together evidence from families, staff, 12 local investigations and all the past reviews, and her review shows systemic, repeated failures by our maternity and neonatal system. It has also given us the opportunity and determination to break that cycle.
As I know your Lordships’ House will agree, it is also important that we acknowledge the very positive role that so many staff and families have played in providing the necessary care.
It was most helpful that some of our immediate actions were acknowledged. But, on top of those immediate actions, some of which have been mentioned today, we have ongoing actions. We have been tackling avoidable brain injuries and maternal deaths through dedicated programmes and packages. We have already begun the expansion of Martha’s rule to all maternity and neonatal units, to give families and patients the right to request a second opinion where there are concerns.
Among other things, we have also introduced a perinatal culture and leadership programme, which is important to develop a safety culture and a learning and support culture for the leadership across all units, and an early warning system to better identify safety concerns. Importantly, because continuity of care is something that has been highlighted a lot, we are providing £10 million of recurrent funding to ICBs for this very purpose, in particular to provide midwifery continuity of care for those women who live in the most deprived neighbourhoods and who are at risk of poor outcomes.
I will do my best to answer the questions asked by noble Lords. The noble Lord, Lord Kamall, asked about the timeline for Leeds and Sussex. Donna Ockenden, who will be chairing those reviews, is currently engaging with the families on terms of reference, which will include timelines. We will not be waiting for the publication of the findings to make changes. As they emerge, those issues will be shared with us, so that we can act.
In answer to the question from the noble Lord, Lord Kamall, the new maternity triage standards will be implemented by June 2027. There must be clear board oversight in place of the operation of the triage system, including regular reviews of waiting times and actions to improve the necessary services. The role and remit of the maternity commission is being urgently considered by the National Maternity and Neonatal Taskforce. The commissioner will co-chair the taskforce, which will drive all the change as well as setting it out.
On workforce pressures, we are not waiting. There is £10.6 million investment funding in an additional 1,000 temporary roles to help newly qualified midwives to join the NHS, which is extremely important. So, we are not waiting for the 10-year workforce plan. However, the taskforce will take into consideration wider work, including the 10-year workforce plan.
With regard to concerns raised by Bill Kirkup about what is referred to as “normal birth ideology”, women have to be able to make the right decision about what is safest and best for them. No woman should ever feel pushed into a particular type of care. The words “normal” and “natural” are perhaps not particularly helpful in this setting. We are talking about vaginal births; what matters is what is best and what is safest, and I am certainly very grateful to Bill Kirkup for all this work.
The noble Baroness, Lady Pidgeon, asked further questions about the commissioner, which were helpful. The selection and appointment process will be considered as part of the process of establishing the role.
Questions were asked on action being taken before December, when the report of the taskforce will be available. As I mentioned, immediate actions are already being driven forward. These actions were already under way over the last two years and as part of the immediate response to the recommendations of the noble Baroness, Lady Amos. Where we can, we have already actioned work, and, where we need further work done, that will be developed over the next few months, at pace.
The noble Baroness raised a good point about the rollout of bereavement pathways, including for miscarriage. We are rolling out all five strands of the national bereavement care pathway. All trusts in England have signed up to implement the core standards of the national bereavement care pathway. That is relevant in this case and, across other areas of bereavement, is of particular concern.
As I draw my remarks in this section to a close, let me give noble Lords a sense of the urgency. The taskforce and its supporting expert reference groups are meeting tomorrow to discuss the findings of both the Donna Ockenden report, on which we had a Statement last week, and the report by the noble Baroness, Lady Amos. Next Tuesday, the taskforce—which is spearheading all this and chaired personally by the Secretary of State—will be meeting to discuss next steps for the action plan. To the questions from the noble Baroness, Lady Pidgeon, about the commissioner’s role, the Secretary of State has already said that he wishes that the maternity and neonatal commissioner will co-chair the taskforce with him. That would be a very welcome move.
I hope that I have dealt with the questions and, more than that, given a sense of the pace and seriousness, as well as the action that I know we all seek.
Fracture Liaison Services
Baroness Pidgeon Excerpts(2 months, 1 week ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
The noble Lord does not need to apologise for raising this extremely important matter. I am grateful for his campaigning on this, as I am to other noble Lords. There has been a lot of progress. In answer to his first question, I believe that it is possible, not least because all but two ICBs in the new, reconfigured groups have fracture liaison services already, with some having more than one. With respect to his specific request, as with other policies, I cannot give him exactly what he asks for, but I have already referred to some of the Government’s actions. We are looking, through the UK National Screening Committee, at screening women for osteoporosis, and a public consultation is about to start. We are cutting waiting times, and we have expanded community diagnostic centres and DEXA scanners. These, along with a whole range of other measures, show real commitment to tackling the matter that the noble Lord rightly raises, which affects lives and costs lives.
Baroness Pidgeon (LD)
My Lords, people from deprived areas have a 25% higher risk of fractures, spend longer in hospital recovering and die in greater numbers after hip fractures. The rollout of fracture liaison services is important to help tackle health inequalities. The Minister mentioned 2030, but how can this be rolled out faster to make sure that we help all these communities?
Baroness Merron (Lab)
We have rolled this out further, as we inherited a more limited coverage of fracture liaison services than we have currently, and we are looking at how to improve access. As I said to the noble Lord, 23 out of 25 ICBs have at least one fracture liaison service. We will push this forward through various means, including the Best Practice Guide for NHS Frailty Pathways, which recommends comprehensive neighbourhood-level frailty plans, and the modern service framework, to mention a couple of ways. I have to emphasise that this is about a complete change in the delivery of NHS services, from which fracture liaison will greatly benefit.