Question to the Department of Health and Social Care:

To ask His Majesty's Government how the template service specification for mild and moderate myalgic encephalomyelitis (ME) will address the needs of people with severe and very severe ME; and whether a separate specification will be developed for those groups.

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

As part of the development of the template service specification for mild and moderate myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), which was committed to in the final delivery plan on ME/CFS, published in July 2025, officials have engaged with a sub-group of the ME/CFS post-publication stakeholder engagement group. As part of this engagement, officials from the Department, together with NHS England, have made the decision to include reference to severe ME/CFS in that template service specification based on feedback received from this group. It will also include a reminder that integrated care boards are expected to commission services that meet the needs of the local population, including for all levels of severity of ME/CFS.

There are currently no plans to develop a separate specification for severe and very severe ME/CFS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance they have issued to integrated care boards about commissioning appropriate provision for patients with myalgic encephalomyelitis/chronic fatigue syndrome before specialist services are established.

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

Officials in the Department and NHS England, together with stakeholders, are currently considering interim measures to support patients with very severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This is ahead of my Rt Hon. Friend, the Secretary of State for Health and Social Care, considering whether a specialised service should be prescribed for very severe ME/CFS.

These measures include referencing severe and very severe ME/CFS in a new template service specification that is being developed for mild and moderate ME/CFS. This template service specification, therefore, aims to provide support for ME/CFS service providers and commissioners to improve care and support for people living with all levels of severity of ME/CFS.

Integrated care boards (ICBs) are expected to commission services for people with ME/CFS across all levels of severity, including those with severe and very severe ME/CFS, in line with national standards, service specifications, and clinical access policies set by NHS England. Prioritisation and funding remain at the discretion of ICBs.

Additionally, the National Institute for Health and Care Excellence (NICE) has developed guidance on the diagnosis and management of ME/CFS, including mental health support for people with ME/CFS and their families. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. Although NICE guidelines are not mandatory, so ICBs are not routinely monitored on their compliance, healthcare professionals are expected to take them fully into account.

NHS England, with support from the Department, has developed an e-learning programme to support healthcare professionals in the care of people with ME/CFS of all levels of severity. All four sessions of the e-learning programme are now available, with sessions one, two, and three having universal access, whilst the fourth session, which includes support and clinical management of severe ME/CFS, is only available to healthcare professionals. Further information is available on the NHS.UK website. As the e-learning programme is not mandatory, take-up at healthcare professional level is not routinely monitored.

The Medical Schools Council will promote the e-learning programme to all United Kingdom medical schools and will encourage those medical schools to provide undergraduates with direct patient experience of ME/CFS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance is in place for hospitals, community services and integrated care boards about the care and management of people with severe and very severe myalgic encephalomyelitis; and how compliance with the guidance is monitored.

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

Officials in the Department and NHS England, together with stakeholders, are currently considering interim measures to support patients with very severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This is ahead of my Rt Hon. Friend, the Secretary of State for Health and Social Care, considering whether a specialised service should be prescribed for very severe ME/CFS.

These measures include referencing severe and very severe ME/CFS in a new template service specification that is being developed for mild and moderate ME/CFS. This template service specification, therefore, aims to provide support for ME/CFS service providers and commissioners to improve care and support for people living with all levels of severity of ME/CFS.

Integrated care boards (ICBs) are expected to commission services for people with ME/CFS across all levels of severity, including those with severe and very severe ME/CFS, in line with national standards, service specifications, and clinical access policies set by NHS England. Prioritisation and funding remain at the discretion of ICBs.

Additionally, the National Institute for Health and Care Excellence (NICE) has developed guidance on the diagnosis and management of ME/CFS, including mental health support for people with ME/CFS and their families. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. Although NICE guidelines are not mandatory, so ICBs are not routinely monitored on their compliance, healthcare professionals are expected to take them fully into account.

NHS England, with support from the Department, has developed an e-learning programme to support healthcare professionals in the care of people with ME/CFS of all levels of severity. All four sessions of the e-learning programme are now available, with sessions one, two, and three having universal access, whilst the fourth session, which includes support and clinical management of severe ME/CFS, is only available to healthcare professionals. Further information is available on the NHS.UK website. As the e-learning programme is not mandatory, take-up at healthcare professional level is not routinely monitored.

The Medical Schools Council will promote the e-learning programme to all United Kingdom medical schools and will encourage those medical schools to provide undergraduates with direct patient experience of ME/CFS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what interim measures they plan to put in place to support people with severe and very severe myalgic encephalomyelitis following the delay to the establishment of specialist services.

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

Officials in the Department and NHS England, together with stakeholders, are currently considering interim measures to support patients with very severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This is ahead of my Rt Hon. Friend, the Secretary of State for Health and Social Care, considering whether a specialised service should be prescribed for very severe ME/CFS.

These measures include referencing severe and very severe ME/CFS in a new template service specification that is being developed for mild and moderate ME/CFS. This template service specification, therefore, aims to provide support for ME/CFS service providers and commissioners to improve care and support for people living with all levels of severity of ME/CFS.

Integrated care boards (ICBs) are expected to commission services for people with ME/CFS across all levels of severity, including those with severe and very severe ME/CFS, in line with national standards, service specifications, and clinical access policies set by NHS England. Prioritisation and funding remain at the discretion of ICBs.

Additionally, the National Institute for Health and Care Excellence (NICE) has developed guidance on the diagnosis and management of ME/CFS, including mental health support for people with ME/CFS and their families. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. Although NICE guidelines are not mandatory, so ICBs are not routinely monitored on their compliance, healthcare professionals are expected to take them fully into account.

NHS England, with support from the Department, has developed an e-learning programme to support healthcare professionals in the care of people with ME/CFS of all levels of severity. All four sessions of the e-learning programme are now available, with sessions one, two, and three having universal access, whilst the fourth session, which includes support and clinical management of severe ME/CFS, is only available to healthcare professionals. Further information is available on the NHS.UK website. As the e-learning programme is not mandatory, take-up at healthcare professional level is not routinely monitored.

The Medical Schools Council will promote the e-learning programme to all United Kingdom medical schools and will encourage those medical schools to provide undergraduates with direct patient experience of ME/CFS.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what discussions they have had with life sciences sector organisations about accelerating research into myalgic encephalomyelitis; and what steps they plan to take to support that work by 2027.

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

The Government is committed to funding high-quality research to understand the causes, consequences, and treatment of myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). We recognise the value of collaborating across the life sciences sector to deliver the most impactful research. The Department funds research through the National Institute for Health and Care Research (NIHR).

The Government has outlined its approach to supporting research into ME/CFS in the Final Delivery Plan, published in July 2025. Since this was published, the NIHR and the Medical Research Council (MRC) has hosted a showcase on post-acute infection conditions, bringing together people with lived experience, researchers, clinicians, funders, and the life sciences sector to stimulate further research.

Recently, £4.75 million of Government funding has been invested in SequenceME, which will carry out whole genome sequencing for up to 6,000 patients with ME/CFS. SequenceME brings together the University of Edinburgh, Action for ME, the European Bioinformatics Institute, and Oxford Nanopore Technologies, demonstrating the value of collaboration across the life sciences sector. We hope that this study will build a high-resolution genetic map of ME/CFS, paving the way for better diagnostics, including biomarkers, and future treatments. SequenceME builds on the £3.2 million investment from the NIHR and MRC in DecodeME.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government what plans they have, if any, to amend the Highways Act 1980 to give local highway authorities the powers they need to install more accessible structures on public rights of way.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

This Government recognises the importance of access to the outdoors for people’s health and wellbeing. Public rights of way are a treasured national asset and play a vital role in enabling access to the countryside.

This Government recognises that physical barriers on public rights of way can limit access, particularly for disabled people, older people and those with reduced mobility. While there are currently no plans to amend the Highways Act 1980, officials will continue to keep the issue under consideration as part of wider work on improving access to the public rights of way network.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government what steps they are taking to ensure that the review of maps in England required under section 9A of the Countryside and Rights of Way Act 2000 is completed by the deadline of 1 January 2031.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

The Department is working with Natural England to prepare for the review of the conclusive maps of open access land required under section 9A of the Countryside and Rights of Way Act 2000.

Planning for this work is ongoing, including consideration of the arrangements needed to meet the statutory deadline of 1 January 2031. Further details will be announced in due course.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government what legislation they will use to deliver their commitment, as set out in the Environmental Impact Plan 2025, to repeal the deadline for recording historic rights of way.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

This Government remains committed to repealing the cut-off date for recording historic rights of way. This will save hundreds of miles of unregistered historic rights of way from the threat of extinguishment in 2031, ensuring that they can continue to be enjoyed by the public for years to come.

Defra is reviewing the rights of way reform programme alongside wider policies to improve access to nature for all users and, as part of that work, are considering the most appropriate legislative vehicle to deliver this commitment. Further details will be set out in due course.

Question to the Department for Environment, Food and Rural Affairs:

To ask His Majesty's Government what steps they are taking to fulfil commitment 87 in the Environmental Improvement Plan 2025 to reduce physical barriers to accessing green and blue spaces.

Answered by Baroness Hayman of Ullock - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

This Government is committed to reducing physical and intangible barriers to accessing nature and ensuring everyone lives within a 15-minute walk of a green or blue space.

As set out in the Environmental Improvement Plan (EIP), progress towards meeting these commitments is being made through work happening across government to both increase available natural space and make it more accessible. For example, the Ministry of Housing, Communities & Local Government's National Planning Policy Framework reform and Natural England’s Green Infrastructure Framework.

Actions being delivered by Defra include: the launch of the Wainwright Coast to Coast route and the King Charles III England Coast Path, creating nine new National River Walks, establishing three new National Forests, and publishing an Access to Nature Green Paper to explore further opportunities to enhance and expand access to green and blue spaces. Defra is also strengthening legislation to give National Parks and National Landscapes a clear mandate to widen the public’s access to nature by the end of this Parliament and publishing further details on supporting access to woodlands in a new Trees Action Plan.

Progress on delivery of the EIP will be set out in due course.

Found: year 5/5 Baroness Pitkeathley OBE Full year 4/5 Lord Purvis of Tweed From July 2025 4/4 Baroness Scott of Needham Market

Found: MP (delegate for Steve Barclay MP), Bobby Dean MP, Shrin Honap, Lord McLoughlin and Baroness Scott of Needham Market

Found: (external member) • Lord Morse • Baroness Pitkeathley • Lord Purvis of Tweed • Baroness Scott of Needham Market