Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
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 facilitate access on the NHS to baricitinib for children and young people with juvenile idiopathic arthritis (JIA); and whether he has considered alternative commissioning or funding routes for that treatment in the absence of a NICE appraisal.
Answered by Preet Kaur Gill
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of NHS resources. The NHS in England is legally required to fund medicines recommended by NICE.
NICE has unfortunately been unable to develop guidance for the NHS on the use of baricitinib for treating juvenile idiopathic arthritis in people two years old and over because the company, Eli Lilly, did not provide an evidence submission. NICE will review its decision if the company decides to make a new evidence submission.
Decisions on whether to fund medicines in the absence of NICE guidance are for NHS commissioners. NHS England does not fund medicines where the company has not engaged with NICE. This is to avoid a potential pathway for circumventing the NICE appraisal process. NHS England’s policy on non-submission of data to NICE is available at the following link:
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
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 improve access to clinical trials for patients with pancreatic cancer by ensuring that eligible patients are automatically identified and referred to appropriate clinical trials; increase access to personalised treatment through routine tumour profiling and testing, where clinically appropriate; and increase funding for pancreatic cancer research, including the development of new treatments and the expansion of clinical trials, to improve survival outcomes for patients with pancreatic cancer.
Answered by Preet Kaur Gill
The Department is committed to ensuring that all patients, including those with pancreatic cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.
The National Cancer Plan sets out the Government’s ambition to deliver world class cancer care through world class research, including delivering breakthroughs for rare and less survivable cancers. Throughout the lifetime of this plan, we will ensure that every cancer patient gets the opportunity to access relevant clinical trials quickly, fairly, and easily.
As set out in this plan, the Government will implement the Rare Cancers Act 2026, including Section 3 of the act which will involve developing a service to ensure rare cancer patients, including those with pancreatic cancer, can be automatically contacted about clinical trials. Implementing the provisions of the Rare Cancers Act will make it easier for clinical trials on pancreatic cancer to take place in England.
The plan also sets out clear actions to expand genomic testing, sometimes referred to as tumour profiling, and confirms that every cancer patient who would benefit from genomic testing, including those with rare cancers like pancreatic cancer, will receive it within a clinically relevant timeframe. The plan also commits to ensuring this is matched by access to targeted therapies.
To support timely access to treatments identified through genomic testing, the National Institute for Health and Care Excellence (NICE) and Medicines and Healthcare products Regulatory Agency (MHRA) aligned pathway process was launched in April 2026. The process accelerates licensing and appraisal so that National Health Service funding recommendations can be made more quickly. The expansion of the NHS Genomic Medicine Service will also help identify suitable targeted therapies, connect patients to clinical trials faster, and integrate genomic data into the Single Patient Record by 2028.
Government responsibility for delivering cancer research is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation, including the Medical Research Council.
The NIHR continues to welcome high-quality applications for research into any aspect of human health and care, including pancreatic cancer.
As well as funding research itself, the Department of Health and Social Care invests significantly in research expertise and capacity, specialist facilities, support services, and collaborations to support and deliver research in England, known as NIHR infrastructure. One example of this is the CRISTAL-APC trial to improve treatment for people living with stage four pancreatic cancer, supported by the NIHR's Cambridge Biomedical Research Centre and Clinical Research Facility.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when the new framework for the commissioning and funding of hospice services by integrated care boards will be published; and whether it will be in force before 1 April 2027.
Answered by Stephen Kinnock - Secretary of State for Wales
The Government is developing a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care, and published an interim update on 4 June 2026 in the form of a Written Ministerial Statement, which is available at the following link:
https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88
The final MSF is due to be published in Autumn 2026 and will embed palliative care and end-of-life care within a strategic commissioning model centred on clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups.
Work to implement the MSF is already underway. A letter from NHS England’s National Director for Primary Care and Community Services has been issued to systems asking integrated care boards to undertake integrated needs assessments and move towards the sustainable contracting of hospice services. Initially, this will involve moving away from short-term grant funding for adult hospice services from 2027/28. NHS England’s letter is available at the following link:
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department will reimburse hospices in England for the increase in employer National Insurance contributions introduced in April 2025.
Answered by Stephen Kinnock - Secretary of State for Wales
The Department has no plans to reimburse hospices in England for the increase in employer National Insurance contributions (ENICs) introduced in April 2025. The planning guidance, published on 30 January 2025, sets out the funding available to integrated care boards (ICBs) and the overall approach to funding providers in this financial year. The planning guidance is available at the following link:
https://www.england.nhs.uk/publication/2025-26-priorities-and-operational-planning-guidance/
It takes into account a variety of pay and non-pay factors and pressures on providers of secondary healthcare, including charitable hospices.
Our approach to ENICs exemptions has been consistent with the approach taken by previous administrations. This does not include an exemption for independent contractors, including charities like hospices.
We recognise the financial pressures facing hospices, including those arising from increases in employment costs. That is why the Government has supported the hospice sector with a £125 million capital funding boost for adult and children and young people’s hospices in England, and is providing approximately £80 million in revenue funding for children and young people’s hospices over the three financial years 2026/27 to 2028/29.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what information his Department holds on the proportion of the operating costs of (a) The Myton Hospices and (b) The Shakespeare Hospice is met by NHS Coventry and Warwickshire; and what assessment he has made of trends in the level of variation between integrated care boards in the share of hospice costs they fund.
Answered by Stephen Kinnock - Secretary of State for Wales
As hospices are independent charitable organisations, neither the Department nor NHS England collect data on their financial accounts, therefore, we do not hold information on what proportion of operating costs are met by the NHS Coventry and Warwickshire Integrated Care Board (ICB) for either The Myton Hospice or The Shakespeare Hospice.
We know that the amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.
We recognise that there is currently a mix of contracting models in the hospice sector, with some ICBs using NHS standard contracts and others using grant funding, and sometimes a combination of both. We want to shift towards the strategic commissioning of hospice services and away from short term grants.
We are developing a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care and recently published an interim update on how it is progressing.
In the interim update, we set out that we expect all ICBs to complete an integrated needs assessment, to gain a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life care needs. We are asking ICBs to move to sustainable contracting of adult, and children and young people’s, hospice services, based on their integrated needs assessment. Initially, this will involve the move away from short-term grant funding for adult hospice services from 2027/28.
The MSF will embed palliative care and end-of-life care within a strategic commissioning model that is centred on clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how the move of care from hospital to community set out in the 10 Year Health Plan will be funded for hospices providing community and hospice-at-home care.
Answered by Stephen Kinnock - Secretary of State for Wales
The 10-Year Health Plan sets out the Government’s ambition to shift more care from hospitals into the community. Hospices have an important role to play in this shift, including through community and hospice-at-home services.
Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. Whilst the majority of palliative care and end-of-life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.
We are developing a modern service framework (MSF) for Palliative Care and End-of-Life Care in England, which will support more strategic commissioning and sustainable contracting of hospice services by ICBs. An interim update has now been published in the form of a Written Ministerial Statement, at the following link:
https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88
Further metrics and associated targets will build on the 2029 ambitions set out in the Neighbourhood Health Framework, which includes increasing the number of people identified as approaching the end of life by 10% and reducing non-elective admissions and hospital bed days by 10% for that cohort.
The MSF will not be accompanied by new national funding, as its primary purpose is to set the strategic direction for improving palliative care and end-of-life care, including reducing variation in access, quality, and outcomes by using existing resources across the systems.
The Government has supported the hospice sector with a £125 million capital funding boost for adult and children and young’s hospices in England. We are also providing approximately £80 million of revenue funding for children and young people’s hospices over three financial years, from 2026/27 to 2028/29, giving them the stability they need to plan ahead.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what revenue funding his Department will provide to adult hospices in England in 2026/27; and when that funding will be confirmed.
Answered by Stephen Kinnock - Secretary of State for Wales
Whilst the majority of palliative care and end-of-life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.
Palliative care services are included in the list of services an integrated care board (ICB) must commission. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.
Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.
We recognise the difficult financial situation that many hospices are facing due to a range of concurrent cost pressures. That is why we have supported the sector with a £125 million capital funding boost for adult and children’s hospices to ensure they have the best physical environment for care. We are also providing approximately £80 million of revenue funding for children and young people’s hospices over three financial years, from 2026/27 to 2028/29 inclusive, giving them the stability they need to plan ahead.
The Government is developing a Modern Service Framework for Palliative Care and End‑of‑Life Care. An interim update has now been published in the form of a Written Ministerial Statement, with the full report due to be published in Autumn 2026.
In the interim update, we set out that we expect all ICBs to complete an integrated needs assessment, to gain a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life care needs. We are asking ICBs to move to sustainable contracting of adult, and children and young people’s, hospice services, based on their integrated needs assessment. Initially, this will involve the move away from short-term grant funding for adult hospice services from 2027/28.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to ensure that the Modern Service Framework for Palliative and End of Life Care recognises dementia as a life-limiting condition that requires a constant palliative approach from diagnosis.
Answered by Stephen Kinnock - Secretary of State for Wales
The Government recognises that people living with dementia can have significant palliative care and end-of-life care needs. We are working closely with a range of stakeholders, including Dementia UK, on the development of a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care. We recently published an interim update on the MSF, which is available at the following link:
https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88
The MSF is a clinically-led, evidence-based framework to support sustained improvement in outcomes for patients and carers, including for those living with dementia, by systematically identifying, measuring, and reducing health inequalities, and reducing unwarranted variation in access, experience, and outcomes.
This work is being closely aligned with the development of the MSF for Frailty and Dementia, to ensure a joined-up approach for people living with dementia.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
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 the Modern Service Framework for Frailty and Dementia establishes care co-ordination as a minimum national expectation for people living with dementia, and if this will include associated outcome measures.
Answered by Stephen Kinnock - Secretary of State for Wales
We are engaging with a wide group of partners to understand what should be included in the modern service framework to ensure the best outcomes for people living with dementia. We continue to engage key professional groups, including people with lived experience, to create a framework that supports greater national coordination.
We are considering all options, including reviewing data, metrics, and targets, and will identify the best evidenced interventions to support progress towards an outcome goal.
Asked by: Manuela Perteghella (Liberal Democrat - Stratford-on-Avon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department has taken to identify the causes of the increase in the (a) incidence and (b) mortality rates of cholangiocarcinoma (bile duct cancer) in England.
Answered by Sharon Hodgson
The Department recognises the importance of understanding trends in rare cancers, including cholangiocarcinoma.
The Department supports research into cancer prevention, diagnosis, and treatment through the National Institute for Health and Care Research (NIHR) and works closely with NHS England, researchers, and cancer charities to improve understanding of cancer risk factors and outcomes.
The Government recognises that cholangiocarcinoma is a rare and aggressive cancer. The National Cancer Plan for England identifies rare and less common cancers as a priority and includes actions to improve earlier diagnosis, treatment, research, and patient outcomes for people affected by these cancers. The plan makes clear that improving survival for rare and less survivable cancers is a priority over the lifetime of the plan, with a focus on addressing the historic lack of progress in these conditions. It includes measures to strengthen early diagnosis through improved support for primary care, including the use of artificial intelligence driven decision‑support tools and enhanced safety‑netting to help identify harder‑to‑diagnose cancers more quickly.
The plan also commits to ensuring patients with rare cancers can access specialist expertise through dedicated multidisciplinary teams and more coordinated care pathways. In addition, it sets out actions to improve the evidence base through better data collection and more granular reporting on rare cancers, alongside increased opportunities to participate in research and clinical trials.
Through this work, the Government is supporting efforts to strengthen the evidence base on risk factors, including liver disease, infection, and other underlying conditions, and to improve data collection and research on rare cancers.