Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the report published by Breast Cancer Now, entitled Setting the Bar too High, what assessment his Department has made of the impact of the opportunity cost‑neutrality requirement within NICE’s severity modifier on access to treatments for secondary breast cancer.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The severity modifier was introduced by the National Institute for Health and Care Excellence (NICE) in January 2022 as part of a number of changes intended to make its methods fairer, faster, and more consistent. The severity modifier was designed on the principle of opportunity cost neutrality to ensure that introducing additional weighting for severe conditions did not increase overall National Health Service spending or displace more care than the previous end-of-life modifier.
NICE has been monitoring how the severity modifier is being applied and found that it has resulted in a greater proportion of medicines recommended than under NICE’s previous methods. The latest figures indicate 87.0% of decisions taken since the severity modifier was implemented have recommended use of the treatment, compared with 82.5% when the end-of-life modifier was being used. For advanced cancer treatments specifically, 84.8% of decisions have been positive since the introduction of the severity modifier, compared to 69.1% under NICE’s previous methods.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce waiting times for ADHD assessments for children.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has recognised that, nationally in England, demand for assessments for attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people of all ages, including children and young people, are experiencing delays accessing such assessments.
NHS England established an ADHD taskforce which brought together those with lived experience with experts from the National Health Service, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. The final report was published on 6 November 2025, and we are carefully considering its recommendations.
The Government’s 10-Year Health Plan for England will make the NHS fit for the future, recognising the need for early intervention and support, including for children and young people, such as those with special educational needs and disabilities (SEND). In 2026, the Government will bring forward a Schools White Paper, which will detail our approach to SEND reform, ensuring joined-up support, including education and healthcare providers working together.
In respect of ADHD, the National Institute for Health and Care Excellence’s guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, however it sets out best practice on providing a diagnosis.
Through the NHS Medium-term planning framework, published 24 October, NHS England has set clear expectations for local integrated care boards and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.
The Secretary of State announced on 4th December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. This independent review will inform our approach to enabling people with ADHD and autistic people to have the right support in place to enable them to live well in their communities.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will review the November 2025 decrease to the Agenda for Change mileage payments for community staff.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As set out in NHS Terms and Conditions of Service (TCS) Handbook, which is ratified by the NHS Staff Council, mileage reimbursement rates are reviewed twice a year in April and November.
The outcome of the November 2025 review resulted in a reduction of reimbursement rates due to sustained decreases in fuel prices for the 12-month period ending in October 2025. Reimbursement rates will drop to 56 pence per mile up to 3,500 miles claimed before dropping to 21 pence per mile thereafter. The revised rates will apply to mileage incurred from 1 January 2026.
These changes apply to all staff directly employed under Agenda for Change terms and conditions and Resident Doctors. There are no specific rates for community staff.
The NHS Staff Council, which is responsible for maintaining the NHS TCS, is currently negotiating a new mechanism that will determine a fair reimbursement rate for miles incurred by these staff. Further updates on their work will be made in due course.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of people initially coded with (a) pre‑diabetes and (b) type 2 diabetes who were later found to have early or established type 1 diabetes in the most recent period for which data is available; and what steps his Department is taking with NHS England to help improve diagnostic accuracy in England.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Data is not collected centrally on the numbers or proportions of people initially coded with pre-diabetes or type 2 diabetes who were later found to have type 1 diabetes. The change of patient diagnosis would be reflected by a change of diagnosis code in clinical systems. However, the way that data extraction works for national audits means that it is not possible to track these types of changes.
Published data on diabetes registrations by GP practice can be found in the quarterly National Diabetes Audit (NDA) data release. This also contains data on care process and treatment target attainment as well as the number of new diagnoses by calendar year.
The latest quarterly report is available at the following link:
The NDA supports improvements in diagnosis by assessing whether people with diabetes are receiving the recommended diagnostic checks and to identify variations and shortfalls in care delivery against National Institute for Health and Care Excellence guidelines.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the role of mayoral authorities will be within Regional Health Innovation Zones.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Collaboration between health systems and local government, including mayoral authorities, is fundamental to the design and delivery of the Regional Health Innovation Zones, as set out in the 10-Year Health Plan and the Life Sciences Sector Plan. The Government is committed to ensuring that local government leaders feel a sense of shared ownership in these plans.
The policy is currently in development. It is being designed with flexibility at its core, to ensure it accommodates the diversity of local government structures across the country. The relevant policy teams are already beginning to engage with regional leaders, in health systems and local government, to codesign the approach and to provide more clarity to regions.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the 10 Year Health Plan on the roles of mayoral authorities in delivering health and social care services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As set out in the 10-Year Health Plan, the Government is committed to making mayors, or their representatives, members of integrated care boards (ICBs), harnessing the opportunities of joined-up strategic planning between ICBs and strategic authorities, and supporting delivery of a “health in all policies” approach. Subject to the passage of the English Devolution and Community Empowerment Bill, mayors will be supported by a new health improvement and health inequalities duty, which empowers and supports strategic authorities to exercise their functions in ways that improve health and reduce health inequalities between people living in their area.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when NICE plans to review (a) guideline NG17 for Type 1 diabetes in adults and (b) guideline NG18 for Diabetes (type 1 and type 2) in children and young people; and what the timelines are for the next updates.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for translating evidence into authoritative evidence-based guidance for the health and care system on best practice, in order to drive improved outcomes for patients.
NICE currently has no plans to update guidelines NG17 and NG18. NICE takes a proactive approach to surveillance, monitoring for changes in the evidence base that may impact on its recommendations. Topics for new or updated guidance are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by an integrated, cross-organisational prioritisation board, chaired by NICE’s Chief Medical Officer.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what role mayoral authorities will play in the delivery of Neighbourhood Health Plans.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The wide range of local government responsibilities relevant to health and wellbeing, including social care, public health, and beyond, are central to our vision for Neighbourhood Health. Neighbourhood Health will move care out of hospitals and into communities, with more personalised, proactive, and integrated services starting from where and how people live their lives. This will involve building stronger links to wider local government services such as housing, family hubs, and programmes such as Pride in Place, as well as links with wider civil society including the voluntary, community, and social enterprise (VCSE) sector.
We are working closely with the Local Government Association to develop a national framework setting out how the National Health Service, local authorities, and partners should work together under the leadership of health and wellbeing boards to develop and implement local neighbourhood health plans.
NHS, local authority, and VCSE services will be co-located in neighbourhood health centres, bringing together a wide range of services to holistically meet the needs of local populations.
Neighbourhood teams and services should be designed to reflect the needs of people in their local areas, with licence to tailor the approach to local needs and with an expectation of crossing organisational boundaries.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent steps NHS England has taken to help identify (a) children and (b) adults at risk of pre‑symptomatic Type 1 diabetes; and what assessment has been made of (i) the uptake and (ii) effectiveness of those services.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Healthcare Research is funding the EarLy Surveillance for Autoimmune diabetes (ELSA) study into the feasibility of screening for type 1 diabetes in children aged three to 13 years old. The ELSA study has tested over 24,000 people and is being run through schools, general practice surgeries, as well as through online recruitment.
The UK National Screening Committee advises the National Health Service on screening programmes and, in 2019, concluded that more research and evidence for the benefits of screening for autoimmune type 1 diabetes was required.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the merits of opportunities to (a) enable earlier diagnosis of Type 1 diabetes and (b) reduce incidences of diabetic ketoacidosis; and what actions are being taken by (i) his Department and (ii) NHS England to support (A) research and (B) improved clinical practice in these areas.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The early diagnosis of type 1 diabetes is important to reducing incidences of diabetic ketoacidosis. NHS England is working with experts and relevant stakeholder organisations to monitor the outcomes of the current research on the early detection of type 1 diabetes. To support integrated care boards, NHS England has convened experts and stakeholder organisations to consider emerging evidence and articulate what a pathway of care could look like given advancements in this field.