Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the HM Treasury:
To ask His Majesty's Government what assessment they have made of (1) the estimated annual volume of cases referred from the Financial Ombudsman Service to the Financial Conduct Authority under the referral mechanism contained in the Financial Services and Markets Bill currently before the House, (2) the Financial Conduct Authority's operational capacity to handle these referrals efficiently, and (3) the overall effect of this process on the timeliness of dispute resolution for consumers.
Answered by Lord Pitt-Watson - Parliamentary Secretary (HM Treasury)
The referral mechanism in the Financial Services and Markets Bill is designed to ensure consistent application of the standards set by the Financial Conduct Authority (FCA) in Financial Ombudsman Service (FOS) determinations. It will support the efficient resolution of complex complaints where the FOS considers there is ambiguity in a relevant FCA rule and that is relevant to its determination of a complaint, while preserving the FOS’s ability to resolve the vast majority of complaints without making a referral.
The exact number of referrals will depend on the issues which arise in FOS casework and the extent to which it considers these raise ambiguity or wider implications for financial services firms and consumers. The Government expects that there may be relatively more referrals initially, which will then reduce as clarifications are provided by the FCA – with only a very small proportion of cases being referred even in the early stages.
To prepare for the changes, the FCA and the FOS are operating a trial version of the referral mechanism, which is limited to issues with wider implications. Since July 2025, when they updated their Memorandum of Understanding to agree the trial version, the FOS has made three referrals to the FCA. While the Government would expect more referrals once the new framework covering ambiguity is in place, this supports an assessment that overall volumes will be manageable.
The Bill allows HM Treasury to specify further conditions that must be met for the FOS to make a referral through a statutory instrument. This will allow the Government to address any potential issues that arise during implementation, including making sure that the volume of referrals remains reasonable and supports efficient resolution of cases.
The Bill provides for HM Treasury to set in regulations a timeframe for the FCA to respond to a referral to avoid unnecessary delays. The Government’s consultation response, published on 16 March 2026, confirms its intention is to set this timeframe at 30 days in most cases.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to publish data regarding the performance of specialised services (1) delegated to integrated care boards, and (2) retained by NHS England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Data related to the performance of specialised services is factored into other performance processes undertaken by the National Health Service. In 2025/26, this will include monitoring performance using the NHS Performance Assessment Framework. A consultation on the draft NHS Performance Assessment Framework was launched on 12 May 2025. Further information on the framework is available on the NHS.UK website, in an online only format.
The framework will monitor the performance of NHS organisations and will publish an assessment of how well each organisation is considered to be delivering against the framework’s metrics. The proposed metrics include organisational performance in meeting certain NHS Constitution rights, such as the right to start consultant led treatment within 18 weeks, which applies equally to specialised and non-specialised NHS services.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will publish the results of NHS England's review of direct commissioning functions which is scheduled to report back by the end of June.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England's Executive has commissioned a review of all direct commissioning functions to determine where accountability and responsibility should sit in future and how these functions can most effectively be supported. The review is due to be completed by the end of June 2025 following which decisions and next steps will be publicly communicated.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to consult patients and patient organisations as part of NHS England's review of direct commissioning functions which is scheduled to report by the end of June.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England is committed to working closely with stakeholders on the future of all its direct commissioning functions and will use strong and well-established patient and public involvement mechanisms to secure engagement and involvement.
With the review to be completed by the end of June 2025, NHS England direct commissioning teams will meet directly with charities, patient organisations and professional organisations, including through the Specialised Services Stakeholder Forum, to engage and seek advice on the review.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to monitor spending on specialised services (1) delegated to integrated care boards, and (2) retained by NHS England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England receives monthly management information on commissioner and provider expenditure. This identifies spend on specialised services, both where they are delegated to integrated care boards or retained by NHS England.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
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.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
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.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
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.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
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.
Asked by: Lord Sharkey (Liberal Democrat - Life peer)
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.