Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will appoint a National Clinical Director for Rare Diseases following the integration of NHS England into the Department of Health and Social Care.

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

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. NHS England and the Department are strongly supportive of clinical leadership and recognise the critical need to incorporate clinical expertise into our work. The national clinical directors are a key part of this approach and play an important role in policy development and implementation.

We are currently in the initial phases of scoping and designing a new integrated Department that aims to enhance the efficiency and effectiveness of our healthcare system. As part of this process, we are carefully considering the future role of national clinical directors. While no specific decisions have been made yet, we are open to considering the benefit of appointing a National Clinical Director for Rare Diseases following the integration of NHS England into the Department, subject to funding arrangements.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the commissioning of specialised services is not adversely affected by the abolition of NHS England.

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

As we take forward the work to integrate NHS England into the Department, we will continue to analyse and assess impacts of all kinds. This will include putting in place plans to ensure continuity of specialised services, with patient safety at the forefront of our work.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will place in the Library of the House a copy of refreshed Joint Forward Plans from each integrated care board.

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

Joint forward plans (JFPs) are produced by integrated care boards (ICBs) and are publicly available on the respective websites of the ICBs. The Government does not hold any central records of these JFPs and there are no plans to place copies of the JFPs in the Library of the House.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they will take to ensure that the abolition of NHS England does not adversely affect the oversight of patient and public involvement in decisions on specialised services delegated to integrated care boards.

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

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will ensure that staff transferred from NHS England to integrated care boards to support the commissioning of specialised services are protected from headcount reductions.

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

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the commissioning of specialised services is not adversely affected by the requirement for integrated care boards to reduce their running costs by 50 per cent.

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

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the timeline for publishing specialised services quality dashboards data to ensure transparency.

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

NHS England’s specialised commissioning uses a range of data to support quality oversight and assurance, which includes Specialised Services Quality Dashboards (SSQDs), National Clinical Audits for some services, and the triangulation of other clinical quality and safety information. The metadata for the SSQDs is already publicly available on NHS England’s website. National Clinical Audit reports, which are commissioned and managed by NHS England, are also publicly available on the Healthcare Quality Improvement

Partnership’s website, and cover some specialised services.

NHS England is actively exploring ways to publish metrics from SSQDs, ensuring that they align with the development and release of service specifications, and are updated regularly. Publication decisions on SSQDs will continue to consider information governance requirements, for example, where patient numbers are small and potentially identifiable.