Asked by: Clive Jones (Liberal Democrat - Wokingham)
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 NHS organisations and contracted wheelchair service providers are subject to more rigorous, mandatory regulation.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.
This includes publishing a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:
https://www.england.nhs.uk/long-read/wheelchair-quality-framework/
NHS England also introduced personal wheelchair budgets, including legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.
Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:
The Medium-Term Planning Framework sets a requirement for all providers and ICBs to actively manage long waits for community health services reducing the proportion of all waits over 18 weeks. This will be monitored via the NHS’s usual regional and national assurance processes.
The Community Health Services Situation Report, which will be used to monitor ICB performance against waiting time targets in 2026/27, currently monitors waiting times for both children and young people, and adult waiting times under the ‘Wheelchair, Orthotics, Prosthetics and Equipment’ line. These targets will guide systems to reduce the longest waits, and improvement initiatives to meet these targets may affect waits that are over 18-weeks and 52-weeks.
Asked by: Clive Jones (Liberal Democrat - Wokingham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to make the recently developed service specification guidelines for wheelchair services mandatory across England.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.
This includes publishing a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards and statutory requirements for ICBs. The framework is available at the following link:
https://www.england.nhs.uk/long-read/wheelchair-quality-framework/
NHS England also introduced personal wheelchair budgets, including legal rights in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided.
Since July 2015, NHS England has collected quarterly data from ICBs on wheelchair provision, including waiting times, to enable targeted action if improvement is required. The latest figures from the Quarter 2 2025/26 National Wheelchair Data Collection showed that 84% of adults and 78% of children received their equipment within 18 weeks. Further information on the National Wheelchair Data Collection is available at the following link:
The Medium-Term Planning Framework sets a requirement for all providers and ICBs to actively manage long waits for community health services reducing the proportion of all waits over 18 weeks. This will be monitored via the NHS’s usual regional and national assurance processes.
The Community Health Services Situation Report, which will be used to monitor ICB performance against waiting time targets in 2026/27, currently monitors waiting times for both children and young people, and adult waiting times under the ‘Wheelchair, Orthotics, Prosthetics and Equipment’ line. These targets will guide systems to reduce the longest waits, and improvement initiatives to meet these targets may affect waits that are over 18-weeks and 52-weeks.
Asked by: Layla Moran (Liberal Democrat - Oxford West and Abingdon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how lipoedema is classified within NICE guidance and NHS commissioning frameworks; and whether he plans to review the categorisation of lipoedema-related interventions to ensure they reflect clinical need.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Lipoedema services in England are commissioned locally by integrated care boards (ICBs), which are responsible for assessing the needs of their local populations and determining the most appropriate services to support people with long‑term conditions such as lipoedema.
There is no single national specification for lipoedema services. Instead, ICBs draw on a range of national guidance and best‑practice resources when designing care pathways. These include guidance from the National Institute for Health and Care Excellence (NICE) and best‑practice frameworks produced by bodies such as Wounds UK and the Royal College of General Practitioners. This helps ensure that services are safe, effective, and based on the best available evidence.
Most people with lipoedema are supported through primary and community care services, including assessment by local lymphoedema teams, compression therapy, advice on skin care and movement, and support with self‑management. These services aim to help people manage symptoms and maintain mobility and quality of life.
NICE classifies lipoedema within its interventional procedures guidance on the use of liposuction for chronic lipoedema, reference code HTG618, as a chronic, often painful, and progressive condition characterised by the abnormal, symmetrical accumulation of fat in the legs, hips, buttocks, and sometimes arms. In this guidance, NICE concluded that current evidence on both safety and effectiveness is limited and, therefore, recommends that liposuction should only be undertaken within the context of research or under rigorous governance arrangements. This guidance informs, but does not mandate, local commissioning decisions. NICE will review this guidance once the full results of the ongoing LIPLEG clinical trial are available, and will update its recommendations if new evidence supports doing so.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the potential benefits of incorporating wider societal impacts into health technology assessments on the assessment of value for money and long term return on investment for vaccination programmes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to strengthen the evidence base for assessing the wider economic and societal impacts of vaccination; and what assessment they have made of the potential benefits for evidence generation of explicitly incorporating such impacts into health technology assessment frameworks.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the economic and societal costs of maintaining a health technology assessment framework for vaccines that does not explicitly account for wider impacts beyond the health system, including potential losses to productivity.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Lord Weir of Ballyholme (Democratic Unionist Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to promote best practice in data collection and service standards for early identification and treatment of patients with cardiovascular disease.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is strengthening best practice in cardiovascular disease prevention through CVDPREVENT, a national primary care audit that enables general practices (GPs) and primary care networks (PCNs) to extract data held by GPs to identify gaps in diagnosis, and management of people who are at risk of cardiovascular disease. The aim is to improve patient care, reduce inequalities, and optimise treatment.
Furthermore, this year, we will publish a new cardiovascular disease modern service framework (CVD MSF). The Department and NHS England are engaging widely with stakeholders to co-produce the CVD MSF, ensuring that experts, people, and communities are at the heart of its development. The CVD MSF will support evidence-led, consistent, high quality and equitable care whilst fostering innovation across the cardiovascular disease pathway.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Joint Committee on Vaccination and Immunisation’s (JCVI’s) advice in November 2024 to expand eligibility for the shingles vaccination programme to include people aged 80 and over, what assessment they have made of the impact of delays in implementation on those with comorbidities who are at highest risk of severe shingles disease; what steps they are taking to prioritise protection for these high-risk individuals; and whether they will commit to implementing the JCVI advice before this winter.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Currently, adults become eligible for their shingles vaccination when they turn 65 or 70 years of age, and they remain eligible until their 79th birthday. Adults who are severely immunosuppressed, and therefore most at risk of serious illness and complications from shingles, are eligible from 18 years old and do not have an upper age limit.
The shingles vaccination programme has been in place since 2013, and therefore there will be a significant portion of adults currently aged 80 years old and over who were offered, and received, Zostavax, the previous shingles vaccine. All those who were born after 1 September 1933 would have been offered a vaccine in the programme.
In November 2024, the Joint Committee on Vaccination and Immunisation provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over. The Government is carefully considering this advice as it sets the policy on who should be offered shingles vaccinations in the future.
Asked by: Lord Kamall (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of Health Innovation Network Impact Report 2024–25, published on 18 September 2025, in relation to the use of point-of-care diagnostic testing technologies for cardiovascular disease prevention in the NHS.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government welcomes the Health Innovation Network (HIN) Impact Report 2024/25, and the network's focus on cardiovascular disease as a strategic priority. We recognise the significant impact of the HINs in driving innovation into the National Health Service, benefitting 4.9 million patients and leveraging £3 billion of investment since 2018. This is why the Government’s 10-Year Health Plan and the Life Sciences Sector Plan make explicit commitments to continue funding and empowering them.
As set out in the 10-Year Health Plan, to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within a decade, we will publish a new cardiovascular disease modern service framework later this year.
Asked by: Lord Weir of Ballyholme (Democratic Unionist Party - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what support they are giving to clinicians to provide a standardised approach to effective interventions for treatment of cardiovascular disease conditions.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
As set out in the 10-Year Health Plan, to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within a decade, we will publish a new cardiovascular disease modern service framework (CVD MSF) later this year.
The Department and NHS England are engaging widely with stakeholders to co-produce the CVD MSF, ensuring that experts, people, and communities are at the heart of its development. These frameworks will identify the best evidenced interventions that would support progress towards this goal, with a focus on those with the best means to drive up value and equity. Furthermore, they will set standards on how those interventions should be used, alongside a clear strategy to support and oversee uptake by clinicians and providers.