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 many NHS GP practices in (a) England, (b) Coventry & Warwickshire, and (c) Stratford-on-Avon have declined to enter into shared care arrangements for ADHD medication prescribed by private providers in each integrated care board area in the most recent 12-month period for which data is available.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The data requested is not held centrally. The Coventry and Warwickshire Integrated Care Board has also confirmed that it does not hold the relevant data.
The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has issued guidance on prescribing and managing medicines, which helps general practitioners (GPs) decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.
The GMC has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, which applies to both National Health Service and private medical care.
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 has made an assessment of compliance by GP practices with their obligations under (a) NICE guideline NG87, (b) the Equality Act 2010 and (c) section 42 of the Children and Families Act 2014 in relation to children with ADHD or autism.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is an independent body and part of their responsibility is for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources.
NICE guidelines provide recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services. Although not mandatory, guidelines describe best practice and NHS organisations are expected to take them fully into account in designing services to meet the needs of their local populations.
In terms of the guidance NG87, which is on the diagnosis and management of attention deficit hyperactivity disorder (ADHD), the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, although it does set out best practice on providing a diagnosis. As stated in the Medium Term Planning Framework, all integrated care boards and providers must optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published, including NICE guidelines. The Medium Term Planning Framework is available at the following link:
Under the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that people with disabilities are not disadvantaged. To make it easier for everyone to use health services, NHS England published guidance for NHS commissioners and providers in July 2025. Further information is available at the following link:
https://www.england.nhs.uk/long-read/health-inequalities-equality-legal-duties/
NHS England is rolling out the Reasonable Adjustments Digital Flag, which helps healthcare and social care providers identify and implement necessary adjustments for disabled people including autistic people and people with ADHD. This tool support care teams to be aware of individual needs, facilitating appropriate care.
On the duty to secure special education provision and health care provision in accordance with education, health and care plans, if the plan specifies health care provision, the responsible commissioning body must arrange the specified health care provision for the child or young person. According to the Children and Families Act 2024 section 42, an education, health and care plan will specify the health care provision, the responsible commissioning body, referred to as the integrated care board, and must arrange the specified health care provision for the child or young person.
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 children with ADHD and autism who are assessed and treated privately as a result of long NHS waiting times are able to access shared care prescribing arrangements through their NHS GP pursuant to section 42 of the Children and Families Act 2014.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.
Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).
The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.
The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.
If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.
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 assessment he has made of the adequacy of current NHS (a) guidance and (b) contractual arrangements for ensuring consistent GP prescribing practices for children with ADHD whose treatment has been initiated by a private provider.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.
Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).
The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.
The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.
If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.
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 assessment he has made of the potential impact of permanently removing in-patient beds from the Ellen Badger Hospital in Shipston on Stour on acute hospital discharges.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
This is a matter for the Coventry and Warwickshire Integrated Care Board (ICB). That is because it is for ICBs to consider, working in partnership with local National Health Service providers and adult social care services, the right configuration of capacity locally to minimise delayed discharges from acute hospitals. In doing so, ICBs must consider the interests of their whole population and value for the taxpayer.
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, if he will make an assessment of the potential merits of issuing new guidance to integrated care boards on ensuring that children with Education, Health and Care Plans receive equitable access to ADHD medication regardless of whether their initial assessment was provided (a) privately or (b) through the NHS.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
It is the responsibility of the integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism assessment and support services, in line with relevant National Institute for Health and Care Excellence guidelines.
Shared care with the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).
The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds.
The GMC has issued guidance on prescribing and managing medicines, which helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.
If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, and this applies to both NHS and private medical care.
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 discussions he has had with NICE on (a) reviewing and (b) updating (i) clinical guidelines and (ii) guidance on diagnosing Type 1 Diabetes and Eating Disorders.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for determining whether its guidelines should be reviewed or updated in the light of new evidence. 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 a prioritisation board, chaired by NICE’s chief medical officer.
NICE’s guidelines on the diagnosis and management of type 1 diabetes in adults, with the reference code NG17, diabetes, including both type 1 and type 2, in children and young people, with the reference code NG18, and the recognition and treatment of eating disorders, with the reference code NG69, will be reviewed if there is new evidence that is likely to change the recommendations. NICE currently has no plans to update NG17, NG18, or NG69.
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, if he will have discussions with his international counterparts on the potential merits of creating an international symposium of experts on Type 1 Diabetes and Eating Disorders to (a) share best practice and (b) agree consensus guidance on diagnosis and treatment.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
There are regular opportunities for ministers to meet with their international colleagues on a range of health issues to discuss best practice and learning. For this reason, there are no current plans to arrange a specific symposium on diabetes.
NHS England will continue its type 1 diabetes and disordered eating (T1DE) pilots, which have demonstrated that integrating diabetes and other health services, including mental health services, can significantly enhance the quality of life for people with T1DE and ultimately save lives.
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, if he will publish a national strategy for palliative and end of life care.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.
We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.
We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, from 2026/27 to 2028/29 inclusive, to be distributed again via integrated care boards. This amounts to approximately £80 million over the next three years.
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 discussions he has had with NHS England on ensuring adequate numbers of NHS employees are available to administer Tofersen.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
I have had no such discussions. The National Institute for Health and Care Excellence (NICE) has selected tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of National Health Service resources. If a positive recommendation is made, then NHS commissioners will be under a legal duty to fund the treatment for all eligible patients in England.