Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking at the national level to ensure that International Classifications of Diseases for Mortality and Morbidity Statistics-11 coding practices in the NHS capture the role of psychiatric illness in cases of organ failure or suicide.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Office for National Statistics (ONS) is responsible for coding causes of death using the International Classification of Diseases, Tenth Revision (ICD‑10). This is separate from hospital morbidity coding undertaken within the National Health Service. The response below therefore relates to morbidity coding and applies to cases of attempted suicide and organ failure for patients admitted to hospital alive.
ICD-11 is the International Classification of Diseases for Mortality and Morbidity Statistics, Eleventh Revision, and is not yet approved as an Information Standard under section 250 of the Health and Social Care Act, and so ICD‑10 remains the mandated classification for NHS morbidity data.
Under current national coding guidance, all conditions identified in the medical record by the responsible consultant as relevant to the episode of care are coded. Where a clinical link has been established between a psychiatric condition and outcomes such as organ failure or an episode of attempted suicide, each of these conditions is coded in line with this guidance.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have considered the development of a national testing "cancer manual" to support the consistent delivery, governance and expansion of genomic and non-genomic biomarker testing within routine cancer pathways.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Cancer Plan for England sets out the Government’s commitment to expand and integrate biomarker testing, including blood-based biomarkers known as liquid biopsies and genomic testing, across cancer services to improve treatment selection and outcomes. In particular, the plan commits that every cancer patient who needs a genomic test to guide their treatment will receive one, with the results returned in time to inform clinical decisions. To achieve this, the National Health Service is integrating testing across pathology networks and the Genomic Medicine Service, ensuring that multidisciplinary teams (MDTs) have timely access to test results when determining the best treatment options. Ongoing investments in diagnostic infrastructure, for example, in digital pathology and comprehensive molecular profiling of cancers, will support this integration and enable earlier use of precision medicines in routine pathways. This joined-up approach means that genomic and other biomarker test results will directly inform MDT decision-making and help clinicians match patients to the most effective therapies.
The NHS Genomic Laboratory Hubs deliver testing as directed by the National Genomic Test Directory (the Test Directory), which includes tests for over 7,000 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The Test Directory outlines the nationally commissioned genomic testing offer, including the eligibility for testing, the test method, and target genes. NHS England, supported by a Genomics Clinical Reference Group and expert Test Evaluation Working Groups, reviews the Test Directory to keep pace with scientific and technological advances, while delivering value for money for the NHS. A robust and evidence based process and policy is in place to routinely review the Test Directory and ensure that genomic testing continues to be available for all patients for whom it would be of clinical benefit.
The National Cancer Plan also confirms that over the next five years, the NHS Genomic Medicine Service will extend ctDNA and other biomarker testing to other cancers beyond lung, colorectal, and breast cancer, subject to efficacy and value for money, further embedding precision diagnostics into routine care.
As part of a new approach to quality in cancer care, the National Cancer Plan introduces the development of new cancer manuals. These manuals will set out national standards for cancer care by tumour type. NHS England is working with clinical experts and stakeholders on the scope of these cancer manuals. Further details on their implementation, including specific guidance on diagnostics and testing, will be set out in due course.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how biomarker testing, as set out in the National Cancer Plan, will be integrated across pathology, genomics services, and multidisciplinary team decision-making to ensure it directly informs treatment selection.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Cancer Plan for England sets out the Government’s commitment to expand and integrate biomarker testing, including blood-based biomarkers known as liquid biopsies and genomic testing, across cancer services to improve treatment selection and outcomes. In particular, the plan commits that every cancer patient who needs a genomic test to guide their treatment will receive one, with the results returned in time to inform clinical decisions. To achieve this, the National Health Service is integrating testing across pathology networks and the Genomic Medicine Service, ensuring that multidisciplinary teams (MDTs) have timely access to test results when determining the best treatment options. Ongoing investments in diagnostic infrastructure, for example, in digital pathology and comprehensive molecular profiling of cancers, will support this integration and enable earlier use of precision medicines in routine pathways. This joined-up approach means that genomic and other biomarker test results will directly inform MDT decision-making and help clinicians match patients to the most effective therapies.
The NHS Genomic Laboratory Hubs deliver testing as directed by the National Genomic Test Directory (the Test Directory), which includes tests for over 7,000 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The Test Directory outlines the nationally commissioned genomic testing offer, including the eligibility for testing, the test method, and target genes. NHS England, supported by a Genomics Clinical Reference Group and expert Test Evaluation Working Groups, reviews the Test Directory to keep pace with scientific and technological advances, while delivering value for money for the NHS. A robust and evidence based process and policy is in place to routinely review the Test Directory and ensure that genomic testing continues to be available for all patients for whom it would be of clinical benefit.
The National Cancer Plan also confirms that over the next five years, the NHS Genomic Medicine Service will extend ctDNA and other biomarker testing to other cancers beyond lung, colorectal, and breast cancer, subject to efficacy and value for money, further embedding precision diagnostics into routine care.
As part of a new approach to quality in cancer care, the National Cancer Plan introduces the development of new cancer manuals. These manuals will set out national standards for cancer care by tumour type. NHS England is working with clinical experts and stakeholders on the scope of these cancer manuals. Further details on their implementation, including specific guidance on diagnostics and testing, will be set out in due course.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 20 January 2026 (HL13591), whether the ambition set out in the National Cancer Plan for all cancer patients to receive a genomic test within a clinically relevant timeframe includes the full range of biomarker tests, both genomic and non-genomic molecular, used to determine eligibility for cancer precision medicines.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The ambition set out in the National Cancer Plan for all cancer patients to receive a genomic test within a clinically relevant timeframe reflects the Government’s commitment to expanding access to precision diagnostics that inform treatment decisions.
The NHS Genomic Medicine Service is currently focused on delivering genomic testing in line with the National Genomic Test Directory. As set out in the plan, over the next five years the service will extend circulating tumour DNA and other biomarker testing to additional cancers, subject to evidence of clinical efficacy and value for money.
The scope of testing will continue to be reviewed, and additional biomarker tests, both genomic and non-genomic, will be brought into routine use where clinically appropriate and cost effective.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what recent guidance they have issued to medical practitioners about the requirement to record eating disorders as a contributory or underlying cause on medical certificates of cause of death.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Medical Examiner produces the Good Practice Series, a topical collection of focused summary documents, designed to be easily read and digested by busy front-line staff, including medical practitioners, with links to further reading, guidance, and support. The collection is published online by the Royal College of Pathologists.
In June 2022, the National Medical Examiner’s Good Practice Series No. 7 - Mental health and eating disorders was published, and a copy is attached. The paper explores the role medical examiners can play in identifying links between mental health disorders and causes of death, notifying others when lessons can be learned so that care of future patients with mental health conditions is improved, and ensuring medical certificates of cause of death are completed appropriately.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 23 February (HL14441), what assessment they have made of the impact of the National Institute for Health and Care Excellence guidelines on generalised anxiety and panic disorder on access to treatment for marginalised groups.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has made no assessment of the impact of the National Institute for Health and Care Excellence (NICE) guidelines on generalised anxiety and panic disorder or on access to treatment for marginalised groups.
NICE keeps its published guidelines under active surveillance and decisions on whether they should be updated in light of new evidence are taken by the NICE prioritisation board in line with its published prioritisation framework. NICE’s prioritisation board will be considering whether the guideline on generalised anxiety and panic disorder should be updated following a letter from the UK Council for Psychotherapy.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of the NHS new-born blood spot programme; and what steps they have taken to bring the UK in line with other European countries on the number of conditions screened for.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Newborn Blood Spot Programme consistently achieves very high coverage with the most recent figure at 98% in Quarter 2 of 2025/26. This not only indicates that eligible babies are being screened, but also that conclusive results are recorded on the Child Health Information Service system before or at 17 days of age, indicating that the programme is effective at reaching almost the entire eligible population and delivering results early enough to influence outcomes.
Coverage of babies who move into the area after birth is lower at 83%, so the programme is less effective for this subgroup, but numbers are much smaller.
A total of 570,865 babies were screened in 2024/25, demonstrating the programme is operating effectively at scale, and the system is robust enough to deliver screening across a large cohort.
Over one million babies have been screened for severe combined immunodeficiency since the launch of the in-service evaluation (ISE) in 2017. NHS England’s report on the 30-month ISE evaluation period found that screening detected 10 babies with the condition who would otherwise have gone undetected until infections developed, thus preventing serious illness.
It is important to note that comparisons of screening programmes with other health systems can be misleading. Some countries or regions reportedly screen for a condition when it is only at the pilot or research stage. Some ‘screening programmes’ just test for a condition rather than being end-to-end quality-assured programmes that include diagnosis, treatment, and care. And screening in some countries is delivered regionally, or even just by individual hospitals, rather than nationally. They are therefore not directly comparable to the national screening programmes offered in the United Kingdom.
For very rare conditions it is difficult to generate robust evidence to demonstrate the value of screening, because so few babies are affected. The UK National Screening Committee, which advises the Government on all screening matters, is working with experts and partner organisations to look at how to make it easier to develop the evidence needed to make robust recommendations on the addition of more rare diseases to the NHS Newborn Blood Spot Programme.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 16 February (HL14437), what evidence they have reviewed on the economic value and cost-effectiveness of point-of-care diagnostic testing technologies for cardiovascular disease prevention.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We recognise the value of point-of-care diagnostics in enabling earlier detection, reducing avoidable hospital admissions, and supporting more personalised care.
The National Institute for Health and Care Excellence (NICE) has produced clinical guidelines and heath technology guidance which make recommendations on the use of point-of-care testing (POCT) for a range of conditions and diseases. Decisions as to whether NICE will create new, or update existing, guidance are overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.
Decisions on the use and implementation of POCT are made locally by integrated care boards and providers, who design services in line with local population health needs and priorities.
The Cardiovascular Disease (CVD) Modern Service Framework will be published later this year and will prioritise ambitious, evidence-led, and clinically informed approaches to prevention, treatment, and care. As part of its development, we are engaging widely to identify and consider the role of emerging innovations across the CVD pathway.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the remarks by Baroness Merron on 9 March (HL Deb col 9), what steps they plan to take to ensure the integration of care between the proposed National Care Service and the National Health Service.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to ensuring joined up health and care services. While the Independent Commission will inform the long-term direction of a national care service, the Government is already progressing reforms to strengthen the join up between services, so people experience more integrated and person-centred care.
We are developing Neighbourhood Health Services, which will allow more integrated working within the National Health Service, as well as between the NHS, local government, and a wide range of public services, including the voluntary, community, and social enterprise sector. The National Care Service and the Neighbourhood Health Service will play a critical role in helping people stay independent for longer, minimising the time that they need to spend in hospital or in long-term residential care.
Alongside this, we are improving national data and digital infrastructure, including driving the adoption of digital and social care records so people get the right care quicker, without needing to repeat their care needs or medical history.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will publish separate, individual-level performance data for (1) brain, (2) liver, (3) lung, (4) stomach, (5) pancreatic, and (6) oesophageal, cancers under the Get Data Out programme.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Improving outcomes for rare cancer patients is a priority for the National Cancer Plan. The National Disease Registration Service (NDRS) in NHS England, as the national cancer registry, collects diagnosis, treatment, and outcome data on cancer patients in England. All these cancer sites, such as brain, liver, lung, stomach, pancreatic, and oesophageal, are already included in NDRS’ Get Data Out (GDO) programme. Performance data is not included in GDO but incidence, treatment, survival, and routes to diagnosis statistics are available for the clinically meaningful groups of cancers included.