Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 7 March 2025 to Question 35541 and and the Answer of 12 May to Question 50770 on Hormone Replacement Therapy, (a) what progress has been made and (b) what further steps are being taken to ensure a continued supply of HRT implants for patients.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is continuing to work closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure safe access to oestrogen and testosterone hormone replacement therapy (HRT) implants, which are not licensed in the United Kingdom.
The MHRA has been working closely with the current importers of the product and is also looking to encourage other applications for a licensed medicinal product. The MHRA is currently assured that there are over 13 months of product in the UK based on currently available stocks and usage rates.
As oestrogen and testosterone HRT implants are not licensed in the UK, we are encouraging applications to supply products through the licensed medicines route.
The Department is working closely with the MHRA to ensure safe access to these products. The Department have also reached out to specialist importers, who can source unlicensed medicines, to find alternative sources of both HRT implants for UK patients. The Department will continue to work closely with the MHRA and the National Health Service to ensure that suitable alternatives are available for patients.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
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 ensure that NICE appraisals for (a) Duchenne muscular dystrophy and (b) other rare, progressive conditions take into account urgency of access.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) aims wherever possible to issue guidance on new medicines close to the time of licensing to ensure that patients can benefit from rapid access to clinically and cost-effective new medicines. NICE’s ability to do so is contingent on the company notifying NICE of its launch plans at an early stage and providing a timely evidence submission.
The Life Sciences Sector Plan sets out the measures we are taking that will mean that patients are able to access medicines three to six months faster, including improved alignment between decisions from the Medicines and Healthcare products Regulatory Agency and NICE guidance publication.
The Life Sciences Sector Plan is available at the following link:
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
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 ensure that the impact on carers is included in NICE technology appraisals for rare and progressive diseases.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
NICE’s technology appraisal process allows its independent committees to take societal benefits, such as health-related quality-of-life for carers and impact on personal social services, into account. NICE’s methods are set out in its published health technology evaluations manual, which is available at the following link:
https://www.nice.org.uk/process/pmg36.
Evaluations should consider all health effects for patients, and, when relevant, carers. When presenting health effects for carers, evidence should show when the condition is associated with a substantial effect on carer’s health-related quality of life and how the technology affects carers. This applies for all therapies, including therapies for rare diseases. NICE appraisals specifically consider health-related quality of life, for both patients and carers, rather than quality of life as a whole.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 14 July 2025 to Question 64336 on Vamorolone, what the consequences are for (a) Integrated Care Boards and (b) NHS Trusts for not making NICE recommended medicines available within 90 days of publication of relevant guidance.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Commissioners have a statutory responsibility to make funding available for a medicine or treatment recommended by a National Institute of Health and Care Excellence (NICE) technology appraisal (TA) or highly specialised technology evaluation (HST) within the timeframe recommended in that guidance, usually within three months of the TA or HST being published.
Under the National Health Service Constitution, patients have a right to receive all medicines and treatments recommended by NICE if they and their healthcare professional think that the medicine is right for them. In practical terms, the effect of this legal obligation and the NHS constitution is that all NICE-approved treatments must be included in local formularies for use in line with the TA or HST recommendations and with no additional funding or formulary restrictions.
The only exception is if the technology is not relevant to the care provided by the organisation; for example, cancer treatments would not need to be included in the formulary of a mental health trust, and treatments for dementia would not need to be included in the formulary of a specialist children’s hospital. There is no provision to take affordability into account when adding NICE-approved medicines to local formularies.
NHS enforcement guidance relating to its statutory accountability and oversight role, under the NHS Act 2006, the 2012 Act and the 2022 Act is available at the following link:
https://www.england.nhs.uk/long-read/nhs-enforcement-guidance/
The evolving NHS operating model will strengthen capabilities and clarify roles in overseeing performance. As set out in the 10-Year Health Plan for England, we will move to a Single National Formulary (SNF) for medicines within the next two years. The SNF will play a role in driving rapid and equitable adoption of clinically and cost-effective innovations.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 27 January to Question 25553 on Methylphenidate Shortages, if he will make an assessment of the adequacy of the current supply of methylphenidate for ADHD.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has worked closely with industry stakeholders, and, following extensive collaborative efforts, previous issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, guanfacine prolonged-release tablets and methylphenidate prolonged-release tablets and prolonged-release capsules are now available.
We continue to support the NHS England Attention Deficit Hyperactivity Disorder (ADHD) taskforce, which brings together expertise from the National Health Service, education, and justice sectors to coordinate a system-wide response to rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we are developing future growth forecasts to support improved demand planning. These forecasts will be shared with industry to help ensure a more responsive and sustainable supply of ADHD medicines.
In parallel, we are also engaging with new suppliers for ADHD medicines to increase supply capacity and resilience.
The Department also maintains and regularly updates a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website. This resource supports prescribers and dispensers in making informed decisions with patients. The list is available at the following link:
www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, which NHS Trusts will be involved in the Rapid National Investigation into maternity and neonatal services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
On 14 August 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced the appointment of Baroness Amos as Chair of the Independent Maternity and Neonatal Investigation, with further information available at the following link:
https://www.gov.uk/government/news/baroness-amos-to-spearhead-maternity-and-neonatal-investigation#
The investigation will carry out rapid reviews of up to ten trusts with specific issues. The Chair is working closely with families to finalise the terms of reference, including the selection criteria to select the trusts, which will be announced as soon as possible.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
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 merits of ensuring that the national review of Maternity Services (a) includes representations from (i) patients and (ii) campaign groups and (b) encourages their active involvement.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
On 23 June, my Rt Hon. Friend, the Secretary of State for Health and Social Care announced an independent investigation into National Health Service maternity and neonatal services to understand the systemic issues behind why so many women, babies, and families experience unacceptable care. He has held a series of meetings with harmed and bereaved families from across the country and has committed to ensuring that the voices of women and families are at the heart of improving standards.
In addition, on 14 August, the appointment was announced of the Rt Hon. the Baroness Amos as chair of the independent maternity and neonatal investigation. Further information is available at the following link:
https://www.gov.uk/government/news/baroness-amos-to-spearhead-maternity-and-neonatal-investigation
The Rt. Hon. the Baroness Amos was selected after feedback from bereaved families who expressed a preference for someone with distance from the NHS. Support will be given by a team of esteemed expert advisors, who will be selected following further engagement with families. The chair is working with families to finalise the terms of reference for the investigation, and these will be published shortly.
The Government is also establishing a National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care, and this is to be made up of a panel of experts and family, charity, and staff representatives.
The taskforce will use the recommendations from the independent investigation to develop a national plan to drive improvements across maternity and neonatal care. The taskforce will work closely with families in developing the action plan, ensuring their voices are central to this work.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to respond to the letter of 10 July 2025 from the hon. Member for Henley and Thame on maternity services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The letter has been passed to Baroness Amos as chair of the independent investigation into National Health Service maternity and neonatal care, and she will respond directly in due course.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 15 July to Question 66814 on Health Services: Oxfordshire, what steps he is taking to ensure that Oxford University Hospitals NHS Foundation Trust is able to recruit and retain midwives in the context of efficiency savings.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to ensuring the National Health Service can both recruit and retain staff. We recently announced the Graduate Guarantee for nurses and midwives, which will ensure that there are enough positions available for every newly qualified midwife in England, and includes £8 million to support the temporary conversion of vacant maternity support worker posts to band 5 registered midwifery roles.
Additionally, NHS England is undertaking targeted retention programme for midwives, led by the Chief Nursing Officer. This includes: a midwifery and nursing retention self-assessment tool; mentoring schemes; strengthened advice and support on pensions and flexible retirement options; and the publication of menopause policies and guidance. NHS England has also invested in unit-based leads in every trust who focus on retention and provide pastoral support to midwives. This initiative, alongside investment in workforce capacity, has seen a reduction in vacancy, leaver and turnover rates.
Asked by: Freddie van Mierlo (Liberal Democrat - Henley and Thame)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many (a) births and (b) elective c-sections occurred in each NHS trust in England in 2024.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Health Service routinely publishes data on maternity activity for NHS hospitals, including data relating to the number of births, the method of onset of labour, delivery methods, and places of delivery. An annual publication for this data, covering the financial year ending March 2024, is available at the following link:
A monthly breakdown of statistics is also available, at the following link: