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 adequacy of the availability of diagnostic and treatment pathways for Spinal Cord Injury across Integrated Care Boards.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

While no formal assessment has been made of the adequacy of the availability of diagnostic and treatment pathways for spinal cord injury across integrated care boards (ICBs), NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for rehabilitation and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG.

In March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

The Getting It Right First Time (GIRFT) Programme for spinal services is also driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from.

The National Institute for Health and Care Excellence (NICE) also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:

https://www.nice.org.uk/guidance/ng41

Additionally, last year, NICE published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. While NICE guidelines are not mandatory, the Government expects ICB commissioners to take them fully into account in designing services that meet the needs of their local population and to work towards their implementation over time.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made progress on improving spinal cord injury services following the 2016 service review.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

While no formal assessment has been made of the potential merits of commissioning local spinal cord injury services, specialist services for spinal cord injury are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group.

Progress has been made on improving spinal cord injury services following the 2016 review, through, for example, the development of the Getting It Right First Time (GIRFT) Programme for spinal services, which is driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from.

Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

More recently, in October 2025, the National Institute for Health and Care Excellence published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury.

Our 10-Year Health Plan also sets out a vision for a health and care system that delivers more personalised, integrated, and proactive care for people with long-term and complex conditions, including spinal cord injury. More tests and scans are delivered in the community, better, joined-up working between services, and greater use of technology will all support people in the management of their spinal cord injuries.

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 commissioning specialist local spinal cord injury services.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

While no formal assessment has been made of the potential merits of commissioning local spinal cord injury services, specialist services for spinal cord injury are currently commissioned by NHS England Specialised Commissioning, in line with the service specification published by the Clinical Reference Group.

Progress has been made on improving spinal cord injury services following the 2016 review, through, for example, the development of the Getting It Right First Time (GIRFT) Programme for spinal services, which is driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from.

Additionally, in March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

More recently, in October 2025, the National Institute for Health and Care Excellence published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury.

Our 10-Year Health Plan also sets out a vision for a health and care system that delivers more personalised, integrated, and proactive care for people with long-term and complex conditions, including spinal cord injury. More tests and scans are delivered in the community, better, joined-up working between services, and greater use of technology will all support people in the management of their spinal cord injuries.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he has taken to ensure that providers of spinal cord injury services are (a) guided by national care pathways, (b) subject to national care standards and (c) report on national outcome measures.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

While no formal assessment has been made of the adequacy of the availability of diagnostic and treatment pathways for spinal cord injury across integrated care boards (ICBs), NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for rehabilitation and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG.

In March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

The Getting It Right First Time (GIRFT) Programme for spinal services is also driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from.

The National Institute for Health and Care Excellence (NICE) also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:

https://www.nice.org.uk/guidance/ng41

Additionally, last year, NICE published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. While NICE guidelines are not mandatory, the Government expects ICB commissioners to take them fully into account in designing services that meet the needs of their local population and to work towards their implementation over time.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance he has issued to ICBs on commissioning pathways on access to spinal cord injury services for patients with a spinal cord injury.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

While no formal assessment has been made of the adequacy of the availability of diagnostic and treatment pathways for spinal cord injury across integrated care boards (ICBs), NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for rehabilitation and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG.

In March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

The Getting It Right First Time (GIRFT) Programme for spinal services is also driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from.

The National Institute for Health and Care Excellence (NICE) also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:

https://www.nice.org.uk/guidance/ng41

Additionally, last year, NICE published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. While NICE guidelines are not mandatory, the Government expects ICB commissioners to take them fully into account in designing services that meet the needs of their local population and to work towards their implementation over time.

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 expert commissioning knowledge is maintained within the Offices for Pan-ICB Commissioning; and what steps he has taken to prevent a loss of specialist expertise during the staff transfer process.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England is responsible for the design and operation of offices for pan-integrated care board commissioning and for managing associated workforce changes. In implementing these arrangements, NHS England has sought to retain experienced commissioning staff and specialist knowledge to support consistent, high‑quality commissioning across systems. Staff transfers have been managed in line with established employment and transfer arrangements, with a focus on continuity and skills retention. The Department continues to engage with NHS England on the implementation of commissioning reforms.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress has been made by his Department in encouraging more reclassification applications to the Medicines and Healthcare products Regulatory Agency (MHRA); whether reclassification applications will form part of the MHRA's forthcoming strategy; and what assessment he has made of the potential impact of reclassification applications on (a) the NHS, (b) patients and (c) the Exchequer.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government supports the reclassification of medicines where it is safe and appropriate to do so, as this can improve patient access and support selfcare while maintaining high standards of public health protection. The Medicines and Healthcare products Regulatory Agency (MHRA) actively engages with industry to encourage well evidenced reclassification applications and has updated its guidance and processes to provide greater clarity and efficiency.

Reclassification forms part of the MHRA’s wider strategic work to support proportionate regulation and improve access to medicines, including through closer engagement with industry and the use of scientific advice to support high quality applications.

Where successful, reclassification can benefit the National Health Service by reducing pressure on primary care services, enable patients to access appropriate treatments more conveniently through pharmacies or over the counter supply, and deliver wider economic benefits by supporting selfcare and reducing unnecessary healthcare utilisation. Each application is assessed on its individual merits to ensure that any reclassification maintains patient safety and delivers overall public benefit.

However, reclassification is not appropriate in all circumstances. In particular, where the need for ongoing clinical oversight remains important, or where cost or ability to pay could create barriers to equitable access for some patients, prescription supply through the NHS may remain the most appropriate route. Consideration of patient affordability and health inequalities forms part of the overall assessment of whether reclassification is in the public interest.

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 reclassifying medicines from prescription-only to over-the-counter on costs to the NHS.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government supports the reclassification of prescription only medicines (POMs) to over the counter (OTC) medicines, including for cost savings to the National Health Service, where it is safe and appropriate to do so, as this can improve patient access and support selfcare while maintaining high standards of public health protection.

Decisions on whether POMs can be safely reclassified for OTC sale are taken by the Medicines and Healthcare products Regulatory Agency following an assessment of the safety, quality, and efficacy of the medicine and whether it can be appropriately used without the direct supervision of a prescriber.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, when she expects the Office for Budget Responsibility to publish its first set of areas of research interest, as stated in the Economic and Fiscal Outlook - November 2025, published on 26 November 2025.

Answered by Torsten Bell - Parliamentary Secretary (HM Treasury)

The Office for Budget Responsibility (OBR) has full discretion over the timing of its own publication programme.

Found: John Glen: That is very kind. Kate Pender: Indeed.

Found: ) 73 of 82 (89.0%) Jim Dickson (Labour, Dartford) (added 27 Oct 2025) 23 of 23 (100.0%) John Glen

Found: John Glen: We have discussed this numerous times.

Found: Q534 John Glen: We have discussed this numerous times.

Found: meeting Members present: Dame Meg Hillier (Chair); Dame Harriett Baldwin; Chris Coghlan; Bobby Dean; John Glen

Found: present: Dame Meg Hillier (Chair); Dame Harriett Baldwin; Chris Coghlan; Bobby Dean; Jim Dickson; John Glen