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 5 June (HL108), what steps they are taking to ensure that improvements to the NHS Health Check programme are targeted towards communities experiencing the greatest health inequalities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check (NHS HC) aims to improve the health and wellbeing of adults aged 40 to 74 years old through the promotion of early awareness, assessment, and management of the major risk factors for cardiovascular disease (CVD), risk factors that are associated with premature death, disability, and health inequalities in England. Improving uptake of the programme, including for people at the highest risk and experiencing inequalities, is a priority for the programme.
The NHS Health Check Online is currently being tested in 11 local authorities across England and aims to increase access and engagement with the programme for all population groups, by allowing people to undertake their NHS Health Check at home, at a time and place convenient to them, freeing up in-person NHS HCs for those who want or need more support.
The recently published Cardiovascular Disease Modern Service Framework (CVD MSF) sets out the 10-year ambition to systematically identify individuals with established or emerging cardiovascular, kidney, and metabolic risk factors, including via the NHS HC, whilst reducing the variation in the number of people receiving a check between the best and worst performing areas nationally. A delivery plan will be published later this year to support local implementation of the CVD MSF.
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 5 June (HL108), what steps they are taking to strengthen lipid management pathways, including diagnosis, referral, treatment optimisation and long-term monitoring, for people at risk of cardiovascular disease.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check programme, a core component of England's cardiovascular disease (CVD) prevention programme, assesses the top risk factors for CVD, including raised cholesterol, in eligible people and refers them to further support through behavioural interventions, clinical assessment, and treatment where appropriate. For every 1.4 million NHS Health Checks delivered annually, 900,000 people are found to have raised cholesterol level. We are also developing the NHS Health Check Online to improve access and help more people understand and act on their risk factors.
Furthermore, NHS England is strengthening lipid management by improving identification of people at risk of CVD through risk assessment, case finding, and community-based initiatives, including pharmacy-led approaches and cholesterol point of care testing.
The Government recently published the Cardiovascular Disease Modern Service Framework, which sets out priorities for the health and care system to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within the next decade. Identifying people with high cholesterol and optimising lipid management for people with high cholesterol are amongst the priorities for the health and care system.
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 5 June (HL108), what steps they are taking to ensure that delivery of NHS Health Checks is better incentivised across primary care and local systems.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check (NHS HC) programme is commissioned by local authorities who are responsible for offering 100% of their eligible resident population a check every five years.
The Government's Public Health Grant to local authorities is used to enable the programme's provision and allows local authorities to ensure that delivery of the NHS HC is aligned with local public health services and fits their local population.
The programme's Best Practice Guidance provides commissioners and their providers with information on how to deliver the programme effectively, and how to adopt a proportionate universalist approach to ensure that checks are delivered in a way that prioritises resources and effort towards engaging people at higher risk of cardiovascular disease.
Department officials are considering options to improve the NHS HC programme.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether data from cholesterol and lipid testing undertaken through the NHS Health Check Online pilot will be recorded in patient records and used to support follow-up care, including lipid optimisation where clinically indicated.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check Online (NHSHC-O) is in the private Beta testing phase and is being piloted in 11 local authorities across England. As part of the NHSHC-O, users receive a self-sampling capillary blood testing kit, delivered to their home, to measure cholesterol, and, if appropriate, HbA1c. Samples are then sent to a United Kingdom Accreditation Service accredited laboratory for assessment.
All results from the NHSHC-O are automatically written back into the patient's electronic health record. General practices are notified if a patient's results indicate that further assessment is necessary and, if required, undertake further clinical investigation and treatment where appropriate, in line with existing clinical pathways.
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 to reduce disparities in timely access to diagnostic testing at community-based facilities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Community diagnostic centres (CDCs) offer patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially speeding up the start of treatment. CDCs are part of the Government’s aim to shift care out of hospitals and into communities.
NHS England publishes guidance to integrated care boards (ICBs) on CDCs. The 2026 version of the guidance will be published imminently. The guidance sets out the core tests for a CDC. The following table shows the overall type of core diagnostic tests available, as well as the individual modalities:
Modality | Requirements |
Imaging |
|
Pathology |
|
Physiological science | Full range of cardiology tests, for example:
|
Full range of respiratory tests, for example:
| |
Other | Outpatient clinic room capacity |
In addition, the following table shows the overall type of optional diagnostic tests available, as well as the individual modalities:
Modality | Test |
Imaging |
|
Physiological science |
|
Pathology |
|
Endoscopy |
|
Other |
|
Data is not collected on timely access to diagnostic services for those from underrepresented groups including women, and those from poorer socioeconomic backgrounds.
One of the central priorities for CDCs is to offer tests for underserved populations. That is why the vast majority of CDCs are located in, or within easy public transport access from, the areas with the most deprivation and health inequalities in each ICB.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government which diagnostic tests they require to be available at individual community diagnosis centres.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Community diagnostic centres (CDCs) offer patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially speeding up the start of treatment. CDCs are part of the Government’s aim to shift care out of hospitals and into communities.
NHS England publishes guidance to integrated care boards (ICBs) on CDCs. The 2026 version of the guidance will be published imminently. The guidance sets out the core tests for a CDC. The following table shows the overall type of core diagnostic tests available, as well as the individual modalities:
Modality | Requirements |
Imaging |
|
Pathology |
|
Physiological science | Full range of cardiology tests, for example:
|
Full range of respiratory tests, for example:
| |
Other | Outpatient clinic room capacity |
In addition, the following table shows the overall type of optional diagnostic tests available, as well as the individual modalities:
Modality | Test |
Imaging |
|
Physiological science |
|
Pathology |
|
Endoscopy |
|
Other |
|
Data is not collected on timely access to diagnostic services for those from underrepresented groups including women, and those from poorer socioeconomic backgrounds.
One of the central priorities for CDCs is to offer tests for underserved populations. That is why the vast majority of CDCs are located in, or within easy public transport access from, the areas with the most deprivation and health inequalities in each ICB.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether directions issued by the Secretary of State to Integrated Care Boards will include measurable outcomes for vaccination programmes such as internationally recognised WHO benchmarks; and how commissioning performance against those outcomes will be assessed.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.
The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.
Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.
We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the function currently undertaken by NHS England in collecting and disseminating best practice in vaccination delivery will be maintained under the proposed new commissioning arrangements.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.
The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.
Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.
We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to ensure that newly introduced vaccination programmes are supported by clear, time-bound delivery expectations to enable timely and equitable uptake.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.
The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.
Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.
We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.
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 impact of the 2025 Highly Specialised Technologies routing criteria updates on the number of orphan medicines being diverted to the Standard Technology Appraisal (STA) pathway; and what steps they are taking to ensure that medicines for populations of 300 to 500 patients are not unfairly penalised by lower cost-effectiveness thresholds under the STA route.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) highly specialised technologies programme (HST) is reserved for the evaluation of a small number of medicines licensed for the treatment of very rare, very severe diseases. Decisions on whether medicines are routed to the HST programme are taken against a set of published criteria that were updated in April 2025 following public and stakeholder engagement. The purpose of the new criteria is not to change the number or nature of the topics evaluated through the HST programme, but to ensure that the criteria are sufficiently clear and predictable for companies and patient groups and are aligned to the HST vision.
The Government has recently announced a number of pilots and projects following the United States and Untied Kingdom partnership on pharmaceuticals that will shape a commercial environment that actively encourages innovation and improves patient access. As part of that work, NICE will review the approach to valuing rare disease medicines through its Health Technology Assessment Innovation Laboratory. This research will consider both technology appraisal and highly specialised technologies routes. The review will assess a range of both radical and incremental options to improve the current framework.