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 is he taking to reduce the level of medicine access inequalities in England; and what discussions he has had with his counterparts in the devolved Administrations on this matter.
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 that develops authoritative, evidence-based guidance on whether new medicines should be routinely funded by the National Health Service in England based on an evaluation of clinical and cost effectiveness. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance, which supports consistent access for NHS patients wherever in England they live.
Fit for the future: 10 Year Health Plan for England, published on 3 July 2025, describes the creation of a single national formulary (SNF) for medicines to supersede the current process by which each local area decides which medicines, in addition to those recommended by NICE, are available to its patients. A SNF is expected to supersede these local processes with a formulary oversight board responsible for sequencing products included in the SNF based on clinical and cost effectiveness, supported by NICE. The intention is to drive rapid and equitable adoption of the most clinically and cost-effective medicines.
Work will now begin on design and delivery planning, and we will work collaboratively with key stakeholders including NICE and industry on the plans.
The devolved administrations are responsible for the arrangements that they put in place to make decisions on access to medicines for NHS patients, however, this Department’s officials engage and meet with them regularly in a spirit of collaboration and mutual learning. At the political level, health ministers from the four nations also meet quarterly.
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 discussions he has had with his international counterparts on (a) the suitability of country-level forecasts of supply needs for medicines up to three years in advance and (b) the steps needed to reduce medicine shortages from unexpected rises in demand including for (i) Attention Deficit Hyperactivity Disorder and (ii) hormone replacement therapy.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Given the inherent global nature of medical supply chains, international collaboration is key to strengthening supply resilience. The United Kingdom is committed to working with international partners to enhance the resilience and security of medical supply chains. We regularly engage with international partners, bilaterally and multilaterally, to exchange information on approaches to strengthen medical supply chains including approaches to manage and reduce shortages.
The Department and the Medicines and Healthcare products Regulatory Agency (MHRA) both participate in the Drug Shortages Global Regulatory Working Group, an international forum of medicine regulatory authorities from the UK alongside Australia, Canada, Japan, the United States and the European Medicines Agency, with the World Health Organisation as an observer. Information is shared about shortages of medicines with a global impact, including medicines used for Attention Deficit Hyperactivity Disorder (ADHD), and actions are taken to prevent, monitor and mitigate their impact.
While we cannot always prevent supply issues from occurring, we have a range of well-established processes and tools to manage them when they arise and mitigate risks to patients. We continue to work closely with suppliers and other stakeholders such as the National Health Service and MHRA to maintain supply of medicines used for ADHD and Hormone Replacement Treatment (HRT) across the UK during any shortages. This includes working to expedite resupply dates of the disrupted products to resolve issues as soon as possible and engaging with new suppliers of medicines to increase supply capacity and resilience, to help fill supply gaps and prevent future shortages. As a result of intensive work, the supply issues affecting medicines used for ADHD and HRT are now largely resolved.
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 recent assessment he has made of the robustness of protections for patient advocates' (a) personal care interactions with NHS services and (b) their advocacy for patients.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
For people who find it difficult to understand their care or find it hard to speak up, ‘Someone to speak up for you advocates’ are available to act as a spokesperson for them. They can help with a wide range of support needs, including understanding the care and support process, helping with decisions and standing up for a patient’s rights. People can access this support through their local council.
Advocacy support is also available for anyone who wants to make a complaint about the National Health Service. Local authorities have a legal obligation to provide an Independent Complaints Advocacy Service to support people who are making or thinking about making a complaint. An NHS complaints advocate can provide support at any stage of the complaints process. The Government is providing approximately £15 million of grant funding to local authorities this year towards this service.
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 impact of IVF age limits on women who delay starting families for (a) educational, (b) career and (c) financial reasons.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand the offer around NHS-funded fertility services. This work will take time to develop, and the Department is keen to ensure there will be stakeholder engagement during this process, beginning in the new year.
Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their population. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.
NICE develops its guidelines independent of the Government, based on the best available clinical evidence. The age limits recommended by NICE are informed by the chance of a live birth following in vitro fertilisation treatment falling with rising female age.
NICE is currently reviewing the fertility guidelines and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. A consultation on revised guidelines was published on 10 September.
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 he is taking to ensure that Integrated Care Boards implement National Institute for Health and Care Excellence guidance on access to NHS-funded IVF treatment.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand the offer around NHS-funded fertility services. This work will take time to develop, and the Department is keen to ensure there will be stakeholder engagement during this process, beginning in the new year.
Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their population. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.
NICE develops its guidelines independent of the Government, based on the best available clinical evidence. The age limits recommended by NICE are informed by the chance of a live birth following in vitro fertilisation treatment falling with rising female age.
NICE is currently reviewing the fertility guidelines and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. A consultation on revised guidelines was published on 10 September.
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 she has made of the adequacy of national funding allocations to Integrated Care Boards to support the delivery of levels of IVF treatment recommended by NICE.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No assessment has been made. Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their population. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence guidelines, ensuring equal access to fertility treatment across England.
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 support NHS patient transport for (a) elderly people and (b) other patients.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Non-Emergency Patient Transport Services (NEPTS) are designed to provide transport for patients who have particular clinical or mobility needs that necessitate such support, which may include elderly or vulnerable patients. The eligibility criteria for NEPTS have been set nationally by NHS England, and the details are available at the following link:
https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdf
The Healthcare Travel Cost Scheme (HTCS) is available for eligible patients and provides financial support to facilitate journeys to and from National Health Service funded secondary care. Details on the eligibility for HTCS is available at the following link:
https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/.
Local integrated care boards (ICBs) hold responsibility for the implementation of patient transport services at a local level, including monitoring and improving against performance targets. ICBs are best placed to work and consult with their local stakeholders, health and care organisations, and local authorities to decide how to best meet and deliver for the needs of their local population.
NHS England is funding and co-ordinating a range of Patient Transport Pathfinder projects to explore more effective approaches to supporting patients with their NHS travel needs.
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, If he will make an assessment of the adequacy of his Department's processes for (a) forecasting, (b) alerting and (c) responding to medicine shortages.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Medicine supply chains are complex, global and highly regulated and there are a number of reasons why supply can be disrupted – many of which are not specific to the United Kingdom and are outside of government control. This includes manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues, and regulatory issues.
The resilience of UK supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. In August, the government published a policy paper, ‘Managing a robust and resilient supply of medicines’, which provides transparency of the supply chains we rely on, the actions we take to protect patients from medicines shortages when they occur, and the steps the Department and NHS England are taking to enhance resilience in our supply chains. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver these actions.
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 effectiveness of the fortnightly notification provided to medicine suppliers regarding medicine shortages.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England’s medicines frameworks contain a contractual ask that requires all suppliers to update NHS England on their ability to supply their products to National Health Service hospitals.
This information is requested fortnightly and the responses are the basis by which NHS England’s medicines supply chain team assess current or potential upcoming medicines shortages.
This is a process designed to ensure the continuity of medicines supply for NHS hospitals and the information is not shared openly, but rather is only shared with specific relevant suppliers, who may be able to assist with the proposed mitigation plan.
A compilation of the mitigations is shared with all NHS hospitals and regional pharmacy procurement leads in order to support the implementation of the agreed actions locally.
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, if he will make an assessment of the potential impact of NHS tariff thresholds on pharmacies' ability to source medicines.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Evaluations by the National Institute for Health and Care Excellence (NICE) ensure that spend on new medicines represents a clinically and cost-effective use of National Health Service resources.
NICE thresholds should not have any impact on pharmacies’ ability to source medicines. Community pharmacies source the drugs they need to dispense against NHS prescriptions and will be reimbursed according to the prices and arrangements set out in the Drug Tariff. The United Kingdom has well established ways of managing the cost of medicines, ensuring pharmacies are appropriately reimbursed and clear processes in place to protect against risks to supply.