Asked by: Steve Yemm (Labour - Mansfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he expects treatments for fatty liver disease to be approved for use on the NHS; what assessment he has made of the readiness of the NHS to make such treatments available; and what steps he is taking to ensure eligible patients will receive these treatments once approved.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Newly licensed medicines are appraised by the National Institute for Health and Care Excellence (NICE), which is the independent body responsible for developing evidence-based guidance for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE aims wherever possible to issue draft guidance on new medicines close to the time of licensing. The NHS in England is legally required to fund drugs recommended by NICE, usually within three months of final guidance.
NICE is currently evaluating potential new treatments for metabolic dysfunction-associated steatohepatitis (MASH) in anticipation of the medicines being granted a marketing authorisation by the Medicines and Healthcare Products Regulatory Agency (MHRA) with guidance expected later this year. NHS England is actively preparing to support the potential introduction of new treatments for MASH, including fatty liver disease with fibrosis, alongside the ongoing NICE appraisal process.
The Department and NHS England will continue to work to ensure that, once approved, effective new treatments for fatty liver disease are introduced in a way that is fair, affordable and protects the wider NHS, while ensuring that patients with the greatest clinical need are able to benefit as quickly as possible.
Asked by: Lee Anderson (Reform UK - Ashfield)
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 improve (a) diagnosis time and (b) medical care for people with non-alcoholic fatty liver disease.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Non-alcoholic fatty liver disease is now commonly referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), although the terms are still often used interchangeably.
While the Department has not had any recent discussions with medical professionals about care for people with MASLD, NHS England has recently commenced a programme for the transformation of liver services. This programme is being led by the NHS England Hepatobiliary and Pancreas Clinical Reference Group (HPB CRG). HPB CRG is working with partners to co-produce resources to raise public knowledge and awareness of all forms of liver disease. In time, this may include incorporating liver health checks into the NHS Making Every Contact Count and NHS Health Checks initiatives.
The HPB CRG is also aiming to improve early diagnosis and intervention through developing evidence-based best-practice pathways for both primary care and referral to secondary care services. The HPB CRG is looking at access and equity of access to diagnostic tests across England and exploring the applicability of automated Fib4 tests and Intelligent Liver Function Testing, potentially utilising community diagnostic centres.
The British Society for Gastroenterology is currently updating its pathways and guidance for MASLD for both primary and secondary care, diagnostics, and treatment, which we anticipate will be published soon. There are also a number of ongoing National Institute for Health and Care Excellence assessments looking at new treatments for MASLD, including Resmetirom and Semaglutide. Outputs and recommendations are expected to be published in mid-2026.
Clinical teams also have access to NHS England’s Getting it Right First Time Advice and Guidance toolkit and templates for gastroenterology, which feature advice on managing abnormal liver function tests and MASLD. These templates enable general practitioners to seek timely advice from secondary care specialists, helping to reduce unnecessary delays.
Asked by: Lee Anderson (Reform UK - Ashfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent discussions his Department has had with medical professionals about care for people with non-alcoholic fatty liver disease.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Non-alcoholic fatty liver disease is now commonly referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), although the terms are still often used interchangeably.
While the Department has not had any recent discussions with medical professionals about care for people with MASLD, NHS England has recently commenced a programme for the transformation of liver services. This programme is being led by the NHS England Hepatobiliary and Pancreas Clinical Reference Group (HPB CRG). HPB CRG is working with partners to co-produce resources to raise public knowledge and awareness of all forms of liver disease. In time, this may include incorporating liver health checks into the NHS Making Every Contact Count and NHS Health Checks initiatives.
The HPB CRG is also aiming to improve early diagnosis and intervention through developing evidence-based best-practice pathways for both primary care and referral to secondary care services. The HPB CRG is looking at access and equity of access to diagnostic tests across England and exploring the applicability of automated Fib4 tests and Intelligent Liver Function Testing, potentially utilising community diagnostic centres.
The British Society for Gastroenterology is currently updating its pathways and guidance for MASLD for both primary and secondary care, diagnostics, and treatment, which we anticipate will be published soon. There are also a number of ongoing National Institute for Health and Care Excellence assessments looking at new treatments for MASLD, including Resmetirom and Semaglutide. Outputs and recommendations are expected to be published in mid-2026.
Clinical teams also have access to NHS England’s Getting it Right First Time Advice and Guidance toolkit and templates for gastroenterology, which feature advice on managing abnormal liver function tests and MASLD. These templates enable general practitioners to seek timely advice from secondary care specialists, helping to reduce unnecessary delays.
Asked by: Helen Maguire (Liberal Democrat - Epsom and Ewell)
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 merits of removing the exceptionality requirement for Individual Funding Requires for Chemosaturation therapy and comparable intervention for people whose lives are at risk.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department and the National Health Service in England are committed to ensuring that cancer patients have timely access to treatment and tailored medical support. In 2016, NHS England concluded that there was insufficient evidence to make chemosaturation treatment available to patients on the NHS. NHS England is currently in the early stages of policy development for chemosaturation to treat metastatic uveal melanoma where surgery to remove or destroy affected cells and tissue in the liver is not feasible.
National Institute for Health and Care Excellence (NICE) guidance recommends that chemosaturation can be used for patients with secondary liver metastases resulting from a primary ocular melanoma, provided special arrangements are in place. A special arrangements recommendation states that clinicians using the procedure should inform the clinical governance lead in their trust, tell the patient about the uncertainties regarding the safety and efficacy of the procedure, and collect further data by means of audit or research. NICE is in the process of updating its guidance, with final guidance expected on 15 October 2026. The first committee meeting, to discuss the evidence, is expected to take place on 16 April 2026. Further information is available at the following link:
https://www.nice.org.uk/guidance/indevelopment/gid-ipg10448
Asked by: Helen Maguire (Liberal Democrat - Epsom and Ewell)
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 the publication date for the draft commissioning policy for Chemosaturation therapy.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department and the National Health Service in England are committed to ensuring that cancer patients have timely access to treatment and tailored medical support. In 2016, NHS England concluded that there was insufficient evidence to make chemosaturation treatment available to patients on the NHS. NHS England is currently in the early stages of policy development for chemosaturation to treat metastatic uveal melanoma where surgery to remove or destroy affected cells and tissue in the liver is not feasible.
National Institute for Health and Care Excellence (NICE) guidance recommends that chemosaturation can be used for patients with secondary liver metastases resulting from a primary ocular melanoma, provided special arrangements are in place. A special arrangements recommendation states that clinicians using the procedure should inform the clinical governance lead in their trust, tell the patient about the uncertainties regarding the safety and efficacy of the procedure, and collect further data by means of audit or research. NICE is in the process of updating its guidance, with final guidance expected on 15 October 2026. The first committee meeting, to discuss the evidence, is expected to take place on 16 April 2026. Further information is available at the following link:
https://www.nice.org.uk/guidance/indevelopment/gid-ipg10448
Asked by: James McMurdock (Independent - South Basildon and East Thurrock)
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 raise public awareness of the risks of taking multiple doses of different over-the-counter medicines which contain the same active ingredient.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department with responsibility for ensuring medicines meet appropriate standards of quality, efficacy, and safety. The Human Medicines Regulations 2012 lays out the conditions of the licencing and marketing of a medicine. This includes the information which must be provided with the medicinal product.
Schedule 24 specifies that the outer and immediate packaging of medicinal products must display the name of the medicinal product, the strength and pharmaceutical form, and when the product contains more than three active substances, the common name for the active substances. In addition, regulation 259 states that packaging or outer label should present the name in braille for the blind or partially sighted. In addition, schedule 24 states that the labelling should display the contents, for instance the number of tablets, where to store, expiry date, the manufacturers name, and any special precautions relating to the product.
The MHRA has recently updated voluntary Best Practice Guidance on the general sale of medicines for pain, to further highlight the risks of overdose, to address public concerns and recognise current sales techniques. Links are also provided to patient support groups, including Papyrus for young people. The update was undertaken in collaboration with retailers, stakeholders and healthcare professionals, and the updated guidance is avaiable at the following link:
Most retailers adhere to the guidelines on not promoting multiple purchases and have introduced in store measures such as till bars that restrict sales to a maximum of two packs across a range of products containing aspirin, paracetamol, or ibuprofen. The aim of these voluntary measures is to balance the need of people for access to pain relief medicines against the dangers for vulnerable individuals and to reduce the opportunity for customers to purchase on impulse excessive quantities of any single analgesic, like paracetamol, aspirin, or ibuprofen.
Paracetamol and ibuprofen are well-known medicines for pain, which when taken as recommended, have well-established safety profiles. The vast majority of patients use these medicines responsibly as effective pain-relievers.
The use of paracetamol and accidental overdose is a safety concern, especially in relation to the many trade names of non-prescription and prescription medicines containing paracetamol. Therefore, the Human Medicines Regulations 2012 contain a number of conditions for the presentation of these medicines to highlight the presence of paracetamol in a medicine.
Schedule 25, Part 4 of the Human Medicines Regulations sets out statutory labelling requirements for paracetamol medicines to highlight the presence of paracetamol in that product. Paragraph 14 states that, except where the name of the product includes the word “paracetamol” and appears on the outer and immediate packaging, the words “contains paracetamol” should be displayed.
Paragraph 15 states that the labelling must highlight paracetamol on the front face of the carton or label and should also contain the warning: “Do not take more medicine than the label tells you to. If you do not get better, talk to your doctor”, which must appear adjacent to either the directions for use or the recommended dosage.
Further to this, if the product contains a leaflet, paragraph 16 states that if the product contains paracetamol, unless the product is wholly or mainly intended for children aged 12 years old or younger, the words “Do not take anything else containing paracetamol while taking this medicine” and the warning “Talk to a doctor at once if you take too much of this medicine, even if you feel well” must be included. If the product does not contain a leaflet, then the words “Talk to a doctor at once if you take too much of this medicine, even if you feel well. This is because too much paracetamol can cause delayed, serious liver damage” should be displayed.
Schedule 8 of the regulations also set out the material which must accompany any application for the marketing of a medicine. The Summary of Product Characteristics (SmPC) as referenced in part 2, for healthcare professionals, provides a summary of the clinical particulars in the use of a medicine, including the recommended maximum daily dose. In addition, particulars in reference to overdose are provided. This includes the potential dose over which liver damage may occur and potential risk factors which may elevate the risk of overdose, including medical history, concomitant medicines, or alcohol intake. A summary of the symptoms of overdose and management are also provided.
The market authorisation holders are obligated under the Human Medicines Regulations to continually review the safety of their medicines and to inform the MHRA of any serious adverse reactions. The MHRA continues to monitor the safety of all medicines and if necessary, will take advice from our independent experts on recommended regulatory action. The MHRA provides a list of the SmPCs and patient leaflets for all medicines at the following link:
Additional resources on product information and the treatment of overdose are available from the British National Formulary (BNF), the electronic medicines compendium, the National Poisons Information Service, and National Health Service, with further information available at the following link:
https://www.nhs.uk/medicines/paracetamol-for-adults/
The Human Medicines Regulations and the BNF highlight the information that is required in general and electronic prescriptions.
Asked by: Sarah Pochin (Reform UK - Runcorn and Helsby)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how learning from serious incidents involving accidental Clozapine withdrawal is being recorded and shared nationally across NHS mental health services.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Clozapine is used to treat people with schizophrenia in whom other medicines have not worked. It is also used to treat severe disturbances in the thoughts, emotions, and behaviour of people with Parkinson’s disease in whom other medicines have not worked.
The known side effects of clozapine are outlined in the product information, the Summary of Product Characteristics (SPC) for healthcare professionals, and the Patient Information Leaflet which is provided in each pack of the medicine. The SPC states that clozapine should be stopped in a number of clinical situations including after developing a low white blood cell count, fever above 38oC, high blood glucose, also known as hyperglycaemia, as well as jaundice or clinically relevant increases in liver enzymes. If clozapine is restarted it must be carefully titrated and monitoring requirements followed.
Inadvertent withdrawal of clozapine is an issue that is included in the National Health Service’s Time Critical Medicines Safety Improvement Programme, with further information avaiable at the following link:
https://www.sps.nhs.uk/articles/safer-use-of-time-critical-medicines-programme/
The programme is supporting over 50 NHS hospitals to improve the reliability of administration of Time Critical Medicines such as clozapine.
In July 2024 a thematic review of clozapine safety conducted in the North West of England was shared with the NHS England National Medication Safety Officer Network. This included a range of clozapine safety resources published online, such as:
- Managing the risks associated with patients prescribed clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-the-risks-associated-with-patients-prescribed-clozapine/;
- Clinical considerations for patients prescribed clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/clinical-considerations-for-patients-prescribed-clozapine/;
- Managing constipation in people taking clozapine, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-constipation-in-people-taking-clozapine/;
- Clozapine use in adults with swallowing difficulties, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/clozapine-use-in-adults-with-swallowing-difficulties/;
- Managing specific interactions with smoking, which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-specific-interactions-with-smoking/; and
- Managing complexities of medication use across care boundaries, which includes a podcast on clozapine safety and which is avaiable at the following link:
https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/.
As with all medicines, the safety of clozapine is kept under continual review by the Medicines and Healthcare products Regulatory Agency (MHRA) using a number of data sources. The MHRA is currently reviewing the blood monitoring requirements associated with clozapine.
Asked by: Scott Arthur (Labour - Edinburgh South West)
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 timely access to chemosaturation for patients with metastatic ocular (uveal) melanoma.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department remains committed to ensuring that cancer patients, including those with metastatic ocular melanoma, have timely access to treatment and tailored medical support.
In 2016, NHS England concluded that there was insufficient evidence to make chemosaturation treatment available to patients on the National Health Service. NHS England is currently in the early stages of policy development for chemosaturation to treat metastatic uveal melanoma where surgery to remove or destroy affected cells and tissue in the liver is not feasible.
The National Institute for Health and Care Excellence has published an Interventional Procedure Guidance for this treatment, and while this does allow NHS trusts to offer the treatment locally, they can only do so if they put in place special arrangements for clinical governance, consent, audit, or research, because further evidence of benefit and safety is needed. The 2016 NHS England Clinical Commissioning policy is currently under review, and we expect that a new draft policy will be shared with stakeholders over the coming months. If NHS England’s clinical panel makes the treatment routinely available across the NHS in England it will require further consideration through relative prioritisation and investment before full roll out.
The development of a Clinical Commissioning policy will determine both if the evidence is now sufficient to enable making the treatment routinely available and, if it is, whether to allocate service development funding to implement it across the NHS in England.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people have received liver transplants in each of the last 3 years in each region.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS Blood and Transplant (NHSBT) is the organisation responsible for organ donation in the United Kingdom, they also manage the NHS Organ Donor Register and National Transplant Register.
NHSBT publishes an annual Organ and Tissue Donation and Transplantation Activity Report which gives a comprehensive update about organ donors, transplant waiting lists, and transplant activity for the UK for the latest financial year. Section 8.4 of the report details liver transplant activity, data on transplants by country/National Health Service region of residence, in Table 8.8, and by transplant centre, in Table 8.9. NHSBT Annual Activity reports are available at the following link:
https://www.odt.nhs.uk/statistics-and-reports/annual-activity-report/
Asked by: Preet Kaur Gill (Labour (Co-op) - Birmingham Edgbaston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he is planning to introduce targeted measures to tackle the specific challenges for patients with less survivable cancers through the National Cancer Plan.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Reducing the number of lives lost to cancer is a key aim of the National Cancer Plan, which will be published in the new year. The plan will include further details on how we will improve outcomes for patients with cancer, including less survivable cancers, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates.
The Department has been working closely with members of the Less Survivable Cancers Taskforce as part of the development of the plan to understand the specific challenges and to identify how to improve diagnosis, treatment, and outcomes for less survivable cancers, which includes lung, pancreatic, liver, brain, oesophageal, and stomach cancer.