Asked by: Lord Truscott (Non-affiliated - 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 innovative technologies that improve the identification of heart murmurs, particularly in primary care and community pharmacies, are supported by clear commissioning guidance and sustainable reimbursement pathways to incentivise earlier diagnosis.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department encourages innovation in the health sector that helps to support the three big shifts in healthcare: moving care from hospitals to communities, transitioning from analogue to digital, and focusing on prevention over treatment, which are set out as part of the 10-Year Health Plan. As set out in the plan, we will publish a new Cardiovascular Disease Modern Service Framework (CVD MSF) in spring 2026.
The framework will support consistent, high quality and equitable care and identify current and emerging innovations across the CVD pathway. We will consider the role of Government in supporting areas where we need to go further.
The 10-Year Health Plan sets out that integrated care boards (ICBs) will be strategic commissioners of local health services, ensuring that the money available to each local care system is put to the best possible use: to improve their population’s health, reduce health inequalities and improve access to consistently high-quality services. They are expected to draw on a deep understanding of population need and will need to shape commissioning plans through deep engagement with patients and the public.
To support this, on 4 November 2025, NHS England published more detailed expectations of ICBs in the Strategic Commissioning Framework. This sets out how to make best use of the whole National Health Service budget they deploy for the population: ensuring that care models match the real needs of the population, taking action to ensure individuals access the appropriate care, rigorously pursuing improved outcomes and value for money for their public.
In terms of service innovation, NHS England currently commissions the community pharmacy NHS Hypertension Case Finding service that focusses on the detection of people at risk of cardiovascular disease from high blood pressure and where it is captured the measurement of pulse rate. The data is shared with the patient’s general practitioner who will then use this information to inform any diagnosis and clinical intervention as appropriate.
Pharmacies are central to plans to create a Neighbourhood Health Service. ICB strategic commissioning will in future assess needs of local populations, prioritise commissioning based on evidence, strengthen their understanding of the role of technology and data in how and what they commission, including digital health technology and artificial intelligence, and develop models of multi neighbourhood providers.
In relation to medical devices outside of hospital, if a newly developed medical device is deemed appropriate for prescribing in primary or community care, the manufacturer has the option to apply for inclusion in the drug tariff. Once listed, the company can formalise a supply route via community pharmacies. This arrangement ensures that the device can be prescribed and dispensed to patients, with the company receiving reimbursement for the supply of their product through the established system.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the health impacts of 'forever chemicals' in British food and drink.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Food Standards Agency (FSA) aims to keep levels of per- and polyfluoroalkyl substances (PFAS) in food as low as reasonably achievable.
The Committee on Toxicity (COT), an advisory body which provides independent scientific advice to the FSA, is currently undertaking an assessment of PFAS. This assessment will include an independent review of the available toxicological and epidemiological data, focusing on a number of biological and health effects. The COT’s assessment will also consider toxicokinetics (how the body absorbs, distributes, metabolises and excretes) of PFAS. Derivation of updated health-based guidance values where possible will also be considered.
The outcome of this assessment is expected to support human health risk assessment of PFAS by United Kingdom Government Departments and Agencies in the context of existing and legacy exposure through food, drinking water and the environment.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have estimated the cost to the NHS of implementing the Terminally Ill Adults (End of Life) Bill.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Terminally Ill Adults (End of Life) Bill impact assessment considered the impacts of the bill at the end of Committee Stage in the House of Commons and, where possible, provided indicative cost ranges to the National Health Service for illustrative purposes.
If the will of Parliament is to pass the bill, detailed work on a delivery model and its cost implications would need to be developed.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much the NHS costs each household in England per year.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The National Health Service is funded through general taxation and not as a discrete charge to individual households.
A hypothetical calculation can be done to estimate the average cost of the NHS per household using two statistics: the NHS resource (revenue) budget 2021/22, which is £150.6 billion, and the Office for National Statistics housing count for England, which is 23.4 million (at Census 2021).
Based on a division of these statistics, in 2021/22, the average cost per household computes to approximately £6,430.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what are the maximum hourly rates for NHS (1) consultants, (2) doctors, and (3) nurses.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Pay Review Body process is the established mechanism for determining pay increases in the public sector, outside of negotiating multi-year pay and contract reform deals.
For consultants and doctors, the hourly basic pay rate based on 40 hours per week at the top of the pay scale is £57.12 per hour.
The majority of National Health Service nurses are paid on the Agenda for Change contract at bands 5 to 7, although the highest band 9. Nurses at the top of band 9 earn £55.99 per hour. This refers to basic pay and does not include allowances or premiums for unsocial hours or the High Cost Area Supplement.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what are the maximum hourly rates for NHS (1) agency consultants, (2) doctors, and (3) nurses.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
For agency medical consultants, maximum hourly rates are determined by NHS England’s price cap, which includes worker pay and all expenses such as travel and accommodation. The current level is £80.61 or £107.47 for unsocial hours, defined as those outside of 7am to 7pm, Monday to Friday and bank holidays. There are exceptions, including for circumstances concerning patient safety and suitable rates for extra-contractual working hours are agreed locally.
For doctors employed on nationally agreed terms and conditions, the highest hourly pay rate is that of a medical consultant. The hourly basic pay rate based on 40 hours per week for a consultant at the maximum of the pay scale is £57.12 per hour. This does not include enhancements for working unsocial hours.
The majority of National Health Service nurses are paid on the Agenda for Change contract at bands 5 to 7, although the highest is band 9. Nurses at the maximum of band 9 earn £55.99 per hour. This refers to basic pay and does not include allowances or premiums for unsocial hours or the High Cost Area Supplement. In 2015, measures to reduce agency spend were introduced, including price caps, procurement frameworks and expenditure ceilings. These have contributed to the reduction of spending on agency staff from £3.6 billion in 2015/16 to £2.4 billion in 2020/21.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of (1) the use of agency staff in the NHS, and (2) any potential impact of the use of agency staff on existing NHS staff shortages.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The introduction of agency rules in 2016 has reduced expenditure on agency staff by approximately £1.2 billion, from £3.6 billion in 2015/16 to £2.4 billion at the end of 2020/21. Agency spend as a percentage of the total wage bill has decreased from 7.9% in 2015/16 to 3.7% in 2020/21.
Reducing the use of agency staff must be balanced with providing safe care to patients. Trusts are able to use flexible staffing to respond to situations where there is insufficient staff. In September 2022, NHS England re-established measures to address spending on agency staff, including a system expenditure limit.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have, if any, to cap NHS agency staff budgets, including for doctors and nurses.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
In 2015, the Government introduced several measures to reduce agency spend, including price caps, procurement frameworks and expenditure ceilings. These measures have contributed to the reduction in National Health Service spending on agency staff from £3.6 billion in 2015/16 to £2.4 billion in 2020/21. In September 2022, NHS England re-established measures to control spending on agency staff, including a system expenditure limit.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of reports that the city of Bath has had no COVID-19 lateral flow tests available for over two weeks; and what steps, if any, they are taking to rectify this situation.
Answered by Lord Kamall - Shadow Minister (Health and Social Care)
No specific assessment has been made. However, since Christmas 2021, the UK Health Security Agency has increased both the supply of tests and distribution capability. Since January 2022, we have delivered seven million tests a day through GOV.UK and 90 million tests a week through all delivery channels.
Asked by: Lord Truscott (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to mitigate the risk of COVID-19 transmission at (1) vaccination centres, and (2) associated transport hubs.
Answered by Lord Bethell
NHS England and NHS Improvement have stated that vaccination sites should be administering the vaccine in line with best infection prevention and control procedures, including social distancing, ventilation and wearing masks. Large scale centres should have an environmental risk assessment in place which is expected to cover requirements for ventilation in a pandemic when transmission and virus shedding is a significant concern. A copy of NHS England and NHS Improvement’s guidance COVID-19 Vaccination Centres: Operating Framework. Information and guidance on operating Vaccination Centres is attached.
The Department for Transport has produced guidance for transport operators to help them keep transport settings safe and reduce the risk of COVID-19 transmission. This includes regular disinfecting and thorough cleaning of transportation, ensuring availability of hand sanitiser and enabling social distancing at transport hubs. A copy of Coronavirus: Safer transport guidance for operators is attached.