Asked by: Mims Davies (Conservative - East Grinstead and Uckfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment has been made of the impact of his Department’s requirement for opportunity cost neutrality in NICE’s severity modifier on investment in treatments for more severe conditions.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is responsible for the methods and processes that it uses in the development of its recommendations. The severity modifier was introduced in January 2022 as part of a number of changes intended to make NICE’s methods fairer, faster and more consistent.
The design of the NICE severity modifier was based on the principle of opportunity cost neutrality to ensure that introducing additional weighting for severe conditions did not increase overall National Health Service spending or displace more care than the previous end-of-life modifier. This approach protects the finite NHS budget by preventing inflationary effects on costs, ensuring that prioritising severe conditions does not reduce health benefits for other patients elsewhere in the system.
NICE carried out a review of the implementation of the severity modifier in September 2024 and found that it is operating as intended with a greater proportion of medicines recommended than under NICE’s previous methods. Since then, NICE has continued to monitor how the severity modifier is being applied. The latest figures include data from technology appraisals published up until the end of September 2025 and show that the proportion of positive decisions has increased since the severity modifier was implemented and since data was published in September 2024. 87.0% of decisions taken since the severity modifier was implemented, compared with 82.5% when the end-of-life modifier was being used.
NICE has commissioned research to gather further evidence on societal preferences that will inform future methods reviews.
Asked by: Mims Davies (Conservative - East Grinstead and Uckfield)
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 people living with incurable secondary breast cancer have timely access to new and effective medicines, including treatments such as Enhertu and Trodelvy.
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 makes recommendations on whether new licensed medicines should be routinely funded by the National Health Service based on an assessment of clinical and cost effectiveness.
NICE has recommended Enhertu, also named trastuzumab deruxtecan, for use in the Cancer Drugs Fund for the treatment of women with HER2-positive secondary breast cancer and it is now available for the treatment of eligible patients while further data on its effectiveness is being collected that will inform a NICE decision on routine funding. NICE did not recommend Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer as a clinically and cost-effective use of NHS resources.
NICE terminated its appraisal of Trodelvy, also named sacituzumab govitecan, for treating hormone receptor-positive HER2-negative metastatic breast cancer after two or more treatments in August 2025, as the company, Gilead, did not provide an evidence submission.
Asked by: Mims Davies (Conservative - East Grinstead and Uckfield)
Question to the Department for Transport:
To ask the Secretary of State for Transport, what assessment has the Department made of trends in seasonal variations in train reliability in the East Grinstead and Uckfield constituency, particularly during winter months.
Answered by Keir Mather - Parliamentary Under-Secretary (Department for Transport)
The performance of the rail network is affected by the weather throughout the year. This is reflected both in actual performance and the targets the department sets train operators.
Operators are expected to mitigate the impacts of seasonal variations and Govia Thameslink Railway operates a winter preparedness plan to respond to specific challenges in the East Grinstead and Uckfield area.
Asked by: Mims Davies (Conservative - East Grinstead and Uckfield)
Question to the Department for Transport:
To ask the Secretary of State for Transport, how does the Department plan to monitor and improve passenger satisfaction following recent timetable changes in East Grinstead and Uckfield Constituency.
Answered by Keir Mather - Parliamentary Under-Secretary (Department for Transport)
The December timetable change, which saw an increase in off-peak services between East Grinstead and London Victoria, is an example of the train operator planning services to meet passenger demand.
The Department regularly monitors passenger satisfaction and holds operators and Network Rail accountable for improvements to passenger satisfaction in East Grinstead and Uckfield.