Question to the Cabinet Office:

To ask the Minister for the Cabinet Office, what recent discussions he has had with the Department of Health and Social Care on the governance and accountability of the NHS Business Services Authority.

Answered by Anna Turley - Minister without Portfolio (Cabinet Office)

Cabinet Office Ministers have not met with DHSC to discuss the governance and accountability of the NHS Business Services Authority.

Question to the Cabinet Office:

To ask the Minister for the Cabinet Office, what timetable the Cabinet Office has set for considering departmental submissions on arm’s length body reform and accountability following Statement UIN HCWS1467 of 26 March 2026.

Answered by Anna Turley - Minister without Portfolio (Cabinet Office)

The ALB review is ongoing and results will be communicated in due course.

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 help ensure that patients are offered a choice of five providers at the point of referral where appropriate.

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

The Government is committed to giving patients greater control and choice over their care. Patients have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient.

The Elective Reform Plan, published January 2025, sets out plans to improve patient choice, empowering people to take control of their health by making the NHS App and Manage Your Referral website the default route for patients to choose their provider. We are improving the information available to patients, such as waiting times. The 10-Year Health Plan sets out a transformed vision for elective care, that will ensure the National Health Service is receptive and reactive to patient preference, voice, and choice.

In May 2023, NHS England asked all referrers to ensure they shortlist on average five choices from which the patient may choose, where this is practicable, clinically appropriate, and preferred by the patient. Integrated care boards have responsibility to ensure that their patients are aware of the choices available to them and are able to exercise their legal right to choose a provider following an elective care referral, and this is underpinned in Part 8 of the NHS Standing Rules, which are available at the following link:

https://www.legislation.gov.uk/uksi/2012/2996/part/8

NHS England has regulatory oversight responsibilities to ensure patient choice operates effectively in the NHS and has published Patient Choice Guidance, which includes guidance for referrers, and which is available at the following link:

https://www.england.nhs.uk/long-read/patient-choice-guidance/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make it his policy to maintain patient choice.

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

The Government is committed to giving patients greater control and choice over their care. Patients have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient.

The Elective Reform Plan, published January 2025, sets out plans to improve patient choice, empowering people to take control of their health by making the NHS App and Manage Your Referral website the default route for patients to choose their provider. We are improving the information available to patients, such as waiting times. The 10-Year Health Plan sets out a transformed vision for elective care, that will ensure the National Health Service is receptive and reactive to patient preference, voice, and choice.

In May 2023, NHS England asked all referrers to ensure they shortlist on average five choices from which the patient may choose, where this is practicable, clinically appropriate, and preferred by the patient. Integrated care boards have responsibility to ensure that their patients are aware of the choices available to them and are able to exercise their legal right to choose a provider following an elective care referral, and this is underpinned in Part 8 of the NHS Standing Rules, which are available at the following link:

https://www.legislation.gov.uk/uksi/2012/2996/part/8

NHS England has regulatory oversight responsibilities to ensure patient choice operates effectively in the NHS and has published Patient Choice Guidance, which includes guidance for referrers, and which is available at the following link:

https://www.england.nhs.uk/long-read/patient-choice-guidance/

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 integrated care boards and NHS England on ensuring that contracting decisions uphold the principles of patient choice.

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

The Government is committed to giving patients greater control and choice over their care. Patients have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient.

Patients’ right to choose is set out in legislation. It is the responsibility of integrated care boards (ICBs) to make appropriate provision to meet the health and care needs of their local population and to meet their statutory obligations to promote choice and enable patients' legal rights.

There is guidance for the use and implementation of the contractual levers available to ICBs, detailed in the NHS Standard Contract Technical Guidance. Use of these must not restrict patients' choice for provider.

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 and Integrated Care Board commissioners on the (a) fairness and (b) transparency of Indicative Activity Plans.

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

Indicative Activity Plans (IAPs) are non-binding, forecasted schedules under the NHS Standard Contract that define expected service volumes between commissioners for integrated care boards (ICBs) and providers. In setting these volumes, ICBs and providers are responsible for ensuring they do so with fairness and transparency.

ICBs have contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set IAPs to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds, or falls short of the agreed plan, and therefore the funding agreed, an Activity Management Plan can be agreed to bring activity back in line.

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 integrated care boards and NHS England on ensuring that sufficient capacity is commissioned from independent sector providers to facilitate patient choice.

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

Integrated care boards (ICBs) have the flexibility to commission services across specialties within a fixed financial envelope and may use contract levers to manage that activity. This represents good management of public money to achieve the outcomes we want to see.

Patients have a legal right to choose any qualified provider holding a contract with an ICB to deliver the services patients need. This right applies irrespective of levels of activity outlined in indicative activity plans contained in contracts.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has undertaken an impact assessment of the potential impact of the changes introduced in December 2025 to accreditation requirements for counsellors on the level of waiting times for patients seeking access to counselling services.

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

The Department does not set the qualification requirements for psychotherapy and counselling and was not involved in the changes to accreditation requirements introduced in December 2025. The Department does not receive any revenue or financial benefits arising from those changes.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department plans to assess the potential impact of changes to accreditation and registration requirements for counsellors introduced in December 2025 on (a) counsellors’ businesses, including their level of income and (b) waiting times for accreditation from professional bodies.

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

The Department does not set the qualification requirements for psychotherapy and counselling and was not involved in the changes to accreditation requirements introduced in December 2025. The Department does not receive any revenue or financial benefits arising from those changes.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department received any revenue or financial benefit arising from the accreditation requirements for counsellors introduced in December 2025.

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

The Department does not set the qualification requirements for psychotherapy and counselling and was not involved in the changes to accreditation requirements introduced in December 2025. The Department does not receive any revenue or financial benefits arising from those changes.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what evidence his Department used to inform the decision to change accreditation requirements for counsellors in December 2025.

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

The Department does not set the qualification requirements for psychotherapy and counselling and was not involved in the changes to accreditation requirements introduced in December 2025. The Department does not receive any revenue or financial benefits arising from those changes.

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