Question to the Department for Transport:

To ask His Majesty's Government what discussions they have had with the Maritime and Coastguard Agency regarding the contamination risk and clearance operation following the collision between two ships in the North Sea on 10 March.

Answered by Lord Hendy of Richmond Hill - Minister of State (Department for Transport)

His Majesty's Government has had regular discussions with the Maritime and Coastguard Agency (MCA) throughout this incident. HM Coastguard has provided bespoke operational updates to the Department and MCA officials have attended cross-Government meetings. DfT and MCA personnel also attend daily meetings with the Secretary of State’s Representative for Maritime Salvage and Intervention (SoSRep). Ministers have been kept informed throughout.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether the NHS 10 Year Health Plan will include a long-term strategic approach to managing long-term conditions.

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

We have committed to developing a 10-Year Health Plan to deliver a National Health Service fit for the future. While it’s too soon to say exactly what will be in the plan, it will set the vision for what good joined-up care looks like for people with long-term complex health needs.

The 10-Year Health Plan will deliver the three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions closer to home. Earlier diagnosis of conditions will help prevent deterioration and improve survival rates. All of these are relevant to managing and improving long-term conditions in all parts of the county.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they will take towards a decision on the expansion of the shingles national immunisation programme for adult cohorts aged 80 and over, as recommended by the Joint Committee on Vaccination and Immunisation in November 2024, and what is their timeline for that decision.

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

In November 2024, the Joint Committee on Vaccination and Immunisation provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over, as well as severely immunosuppressed adults aged 18 years old and over.

The Department is considering this advice as it sets the policy on who should be offered shingles vaccinations, and will update in due course. A timeline for decision-making has not been formally agreed.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure primary care clinicians receive training to distinguish symptoms of primary biliary cholangitis from perimenopause, and to support early diagnosis and timely referral for women affected by the condition.

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

We remain committed to improving the lives of people living with rare diseases, such as primary biliary cholangitis. One of the four priorities of the UK Rare Diseases Framework is increasing awareness of rare diseases among healthcare professionals. Our fourth England action plan, published in February 2025, reports on progress.

The Royal College of General Practitioners (RCGP) has a holistic curriculum of training, with a specific section on women’s health, including menopause. To support practicing general practitioners, the RCGP has developed a Women’s Health Library with educational resources and guidelines on women’s health, which includes a specific section on menopause.

Primary biliary cholangitis has a set of commonly found symptoms, and work is underway to raise awareness of them. NHS England, through the Hepatobiliary and Pancreas Clinical Reference Group, is working closely with partners to raise awareness and understanding of primary biliary cholangitis and its treatments. Plans include the production of a treatment algorithm for use by emergency departments, which may also be helpful for general practitioners.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure greater primary care awareness and early identification of primary biliary cholangitis.

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

We remain committed to improving the lives of people living with rare diseases, such as primary biliary cholangitis. One of the four priorities of the UK Rare Diseases Framework is increasing awareness of rare diseases among healthcare professionals.  Our fourth England action plan, published in February 2025, reports on progress.

GeNotes is an online resource for clinicians, providing educational information as needed. This year the specialty of gastro-hepatology was launched in GeNotes, and includes resources for clinicians on primary biliary cholangitis.

NHS England, through the Hepatobiliary and Pancreas Clinical Reference Group, is working with partners to raise awareness and understanding of primary biliary cholangitis and its treatments. Plans include production of a treatment algorithm for use by emergency departments, which may also be helpful for general practitioners.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the adequacy of current care pathways for patients diagnosed with primary biliary cholangitis.

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

The NHS.UK website has a conditions page on primary biliary cholangitis, available in an online only format, which provides an overview of the care pathway. NHS England commissions a specialist paediatric liver service from three hospitals, the Birmingham Women's and Children's Hospital NHS Foundation Trust, the King's College Hospital NHS Foundation Trust, and the Leeds Teaching Hospitals NHS Trust. This service provides assessment, diagnosis, and management of children with all forms of liver disease, including primary biliary cholangitis.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to assess the impact of NICE’s severity modifier on people with secondary breast cancer.

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

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that it uses in its evaluations independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022, as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024 and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis and hepatitis D.

The NICE has commissioned research to better understand societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to review the requirement for opportunity cost neutrality in NICE's severity modifier.

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

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes that it uses in its evaluations independently and in consultation with stakeholders. The severity modifier is based on evidence of societal preferences and was introduced in 2022, as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement.

The NICE carried out a review of the severity modifier in 2024 and found that it is operating as intended. Since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines compared to the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis and hepatitis D.

The NICE has commissioned research to better understand societal preferences that will inform future method reviews, but there is no prospect of any change until it concludes, and any future changes would need to be consistent with the principle of cost neutrality.

Question to the HM Treasury:

To ask His Majesty's Government what assessment they have made of the recommendations set out in the report The nature of our economy: Implementing the Dasgupta Review, published by the Green Alliance on 18 March.

Answered by Lord Livermore - Financial Secretary (HM Treasury)

The Government agrees with the central conclusion of the Dasgupta Review that nature, and the biodiversity that underpins it, sustains our economies, livelihoods and wellbeing. It is therefore committed to integrating nature into economic and financial decision-making, and the institutions and systems that underpin it.

The Treasury continues to make progress and explore ways to strengthen processes for assessing the climate and environmental impacts of fiscal decisions and improve the Green Book in line with emerging evidence and best practice. For example, building on the extensive guidance already provided for evaluating and monetising natural capital impacts, the Government has published updated supplementary guidance to the Green Book on Enabling a Natural Capital Approach, including additional guidance on valuing biodiversity.

The UK was one of the first countries to publish natural capital accounts as part of its National Accounts, and the Office for National Statistics will continue to implement its roadmap to ensure the further development of the natural capital accounts through to 2026.

As set out in the Budget last October, the Government is continuing to invest in the natural environment, confirming £5 billion over two years to support the transition to a more productive and environmentally sustainable agricultural sector in England, and at least £400 million for tree planting and peatland restoration to protect soils, rivers and biodiversity. To help deliver its environmental ambitions, the Government is also seeking to create the conditions to mobilise additional private finance into nature, including by driving the development of high-integrity nature markets for the UK.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to ensure that guidance published by the 'Getting It Right First Time' programme is implemented across England.

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

The Getting It Right First Time (GIRFT) programme is a national NHS England programme designed to improve the treatment and care of patients through an in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change and remove variation in health services across England. It is a non-mandatory programme, approved by the royal colleges and professional bodies.

The GIRFT team is working with systems and regions to help the National Health Service embed best practice in elective care, to reduce waiting times, improve patient outcomes and, ultimately, to support delivery of the commitment that 92% of all patients will wait no longer than 18 weeks from referral to treatment by March 2029.

Guidance is delivered to teams all over England via national reports and best practice guidance products. While guidance is not mandatory, GIRFT tracks the audiences, downloads, and uptake of best practice guidance at a national level, ensuring that reports are driving change across the health landscape.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to raise awareness among patients of patient-initiated follow-up appointments and how the system works.

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

The Government is expanding the use of Patient Initiated Follow Up (PIFU) as part of our broad package of elective reform, to ensure patients have greater choice and control, with more responsive and accessible follow up care. We have committed to offering PIFU to patients with long-term conditions as standard in all appropriate pathways by March 2026, and to increasing PIFU to at least 5% of all outpatient appointments by March 2029.

Shared decision-making is at the heart of our PIFU approach. To ensure that patients are empowered to make an informed decision, clinicians will discuss patients’ suitability and willingness to sit on a PIFU pathway. To help patients understand the process of PIFU and its aims, NHS England’s national guidance for trusts includes examples of quality communication resources to share with patients, including patient information leaflets and videos. Trusts are expected to include PIFU service details and contact information on their websites, and they should inform the patient’s general practitioner when they choose PIFU. Along with our broader reforms to enhance two-way communication between patients and their healthcare teams, we will ensure all patients can readily access information on PIFU and feel thoroughly supported to use it.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have, if any, to engage stakeholders in local health services in adopting shared decision-making practices to improve patient choice and care outcomes for blood cancer.

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

As part of the National Cancer Plan, we are committed to working closely with partners and patient groups to shape the long-term vision for cancer, including for blood cancer. The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care. It will seek to improve every aspect of cancer care, including the design of services and the experience and outcomes for people with cancer. The Department does not currently have plans to engage in shared decision-making for blood cancer services specifically.

The Department is planning to engage blood cancer partners, charities, and those within the cancer community, seeking the views of individuals, professionals, and organisations to understand how we can do more to achieve this ambition. You may wish to share your views on the new online platform, which can be done via an online only format.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what action they are taking to ensure that care for people living with long-term conditions is provided in their local area.

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

Most services for long-term conditions are commissioned locally by integrated care boards (ICBs). ICBs have a statutory responsibility to commission services which meet the needs of their local population. It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop services and care pathways that are convenient and meet patients’ needs.

We have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future. While it’s too soon to say exactly what will be in the plan, it will set the vision for what good joined-up care looks like for people with long-term complex health needs.

The 10-Year Health Plan will deliver three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions closer to home.

As of December 2024, community diagnostic centres (CDCs) are now delivering additional tests and checks at 168 sites across the country. Since July 2021, CDCs have delivered over 12.2 million additional tests.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that patients at higher risk of severe illness from respiratory syncytial virus infection, such as those with pre-existing conditions or children who were born prematurely, are protected ahead of winter.

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

In line with independent expert advice from the Joint Committee on Vaccination and Immunisation (JCVI), respiratory syncytial virus (RSV) vaccination programmes were introduced in England in September 2024 to protect infants, via maternal vaccination, and older adults at the greatest risk of harm from RSV infection. The JCVI did not provide advice on other groups, as the analysis that informed their advice looked at burden by age.

When advising on the introduction of the RSV programmes, the JCVI said that an extension to the initial programmes would be considered when there was more certainty about protection for patients at higher risk of severe illness from RSV, including people aged 80 years old and older, and the real-world impact of the programme for 75 to 80 year olds. Advice for individuals less than 75 years old in clinical risk groups, including the immunocompromised and those with chronic obstructive pulmonary disease, would be guided by emerging evidence on disease incidence.

At their October 2024 main committee meeting, the JCVI agreed that it would need to formally review the evidence for a potential extension to the programme for people aged 80 years old and older and those in clinical risk groups. During the main committee meeting of 5 February 2025, the JCVI noted that it planned further discussions on potential advice towards extending the programme to those over 80 years old. JCVI meeting minutes are publicly available on the GOV.UK website, in an online only format. The Department will consider any further JCVI advice on who should be offered an RSV vaccine in due course.

The National Health Service also offers high-risk eligible infants a monoclonal antibody called palivizumab over the RSV season. Palivizumab is typically reserved for premature infants with specific major underlying medical conditions. In February 2023, the JCVI advised that existing infant risk groups eligible for RSV monoclonal antibody immunisation should preferentially be protected with nirsevimab over palivizumab. In October 2024, the committee supported work being taken forward for such a programme for all very/extremely premature infants, ideally from 2025/26. However, to date it has not been possible for the NHS to obtain a supply of nirsevimab for the programme. We are continuing to explore all options to ensure there is effective protection against severe RSV illness for this high-risk group.

Question to the Department for Work and Pensions:

To ask His Majesty's Government when they will provide the Office for Budget Responsibility with the necessary information to enable an assessment of the impact on poverty of the measures announced in the Spring Statement on 26 March that includes those aimed at increasing employment.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

The government’s impact assessment regarding Health and Disability reform is available at: Spring Statement 2025 health and disability benefit reforms – Impacts.

This assessment does not include the impact of the £1 billion a year, by 2029/30, funding for measures to support those with disabilities and long-term health conditions into employment, which we expect to mitigate the poverty impact among people it supports into work.

We are engaging with the OBR to enable them to make a full assessment of the policies including employment impacts ahead of the next fiscal event.

Question to the Department of Health and Social Care:

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

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

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

Question to the Department for Work and Pensions:

To ask His Majesty's Government, following their Pathways to Work: Reforming Benefits and Support to Get Britain Working Green Paper, what steps they will take to upscale resources to accommodate the proposed increase in face-to-face Personal Independence Payment assessments.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

The Green Paper sets out measures to make improvements to the PIP assessment, including looking again at our safeguarding processes, moving back to having more face-to-face assessments while continuing to meet the needs of people who may require different assessment methods, recording more assessments to increase trust in the process, and exploring ways to use evidence from eligibility for other services to reduce the need for some people with very severe health conditions to undergo a full PIP functional assessment. The Department will consider its commitment to ensure resources are in place to carry out more face to face PIP assessments alongside other plans for reform laid out within Pathways to Work.

We also plan to review the PIP benefit assessment, working closely with stakeholders and those with lived experience, with an ambition of shaping a system of active support that helps people manage and adapt to their condition in ways that expand their functioning and improve their independence.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made, if any, of the impact of announced 50 per cent cuts to the running costs of integrated care boards on the provision of support to blood cancer patients, particularly in relation to patient experience and shared decision-making initiatives.

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

As part of the necessary changes to support the National Health Service to recover, NHS England has indicated that integrated care boards (ICBs) should reduce in size. The Government is supportive of NHS England’s decision and will work with NHS England to make the tough choices that are needed to get the NHS back on its feet. We expect ICBs to deliver on all of their commissioning responsibilities, including the provision of support for blood cancer patients. The Department has not carried out an assessment in regard to this area.

Question to the Cabinet Office:

To ask His Majesty's Government what assessment they have made of the tariffs imposed on the United Kingdom and European Union by the United States of America with regard to the Windsor Framework.

Answered by Baroness Anderson of Stoke-on-Trent - Baroness in Waiting (HM Household) (Whip)

We continue to closely monitor the impact on Northern Ireland of any tariffs. This government will always act in the best interests of all UK businesses which of course includes those in Northern Ireland.

Northern Ireland is a part of the United Kingdom customs territory and internal market. Northern Ireland exporters will face 10% US tariffs like exporters elsewhere in the UK.

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