Written questions by Baxter.

Whether his department is carrying out work alongside other Government departments to address health and employment impacts of migraines.

We recognise the substantial economic and National Health Service burden of migraines, and there are an estimated 16,500 emergency admissions per year for migraines that could be avoided, costing the NHS £11.5 million. The Department for Health and Social Care and the Department for Work and Pensions are committed to supporting disabled people and people with health conditions, including migraines, and have a range of support available so individuals can stay in work and get back into work. Measures include Employment Advisors in NHS Talking Therapies and WorkWell, as well as support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants. At the national level, there are a number of initiatives supporting service improvement and better care for patients with migraine such as the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Headache and Migraine Toolkit, and the Neurology Transformation Programme. The GIRFT Programme is also working to standardise care, promote better use of preventive treatments, and reduce reliance on accident and emergency for migraine crises by empowering general practices to manage headache disorders effectively.

Whether his department has plans to strengthen national policy recognition of migraine as a serious neurological condition.

The Government recognises that migraine is a serious and often debilitating neurological condition, with a wide range of symptoms that go far beyond a headache. Migraine attacks can be a whole-body experience that can make it very difficult to function normally.At the national level, there are a number of initiatives supporting service improvement and better care for patients with migraine such as the Getting It Right First Time (GIRFT) Programme for Neurology and the RightCare Headache and Migraine Toolkit. NHS England’s Neurology Transformation Programme also developed a new model of integrated care for neurology services, to support integrated care boards to deliver the right service, at the right time for all neurology patients, including for those with migraine.The GIRFT programme for Neurology published a National Speciality Report, which makes several recommendations in relation to improving recognition and diagnosis of migraine. Additionally, the RightCare Headache and Migraine Toolkit set out key priorities for improving care for patients with migraine, which includes correct identification and diagnosis of headache disorders.The National Institute for Health and Care Excellence guideline, Headaches in over 12s: diagnosis and management, sets out best practice for healthcare professionals in the care, treatment, and support of people who suffer from headaches, including migraine. It aims to improve the recognition and management of headaches and migraine.In August 2025, NHS England updated its service specification for specialised adult neurology services. It outlines a number of minimum service requirements for key specialties, including complex headache services.

What engagement did Exercise Pegasus have with providers in the procurement of adequate Personal Protective Equipment for immunocompromised patients.

Exercise PEGASUS, the largest simulation of a pandemic in United Kingdom history, involved thousands of participants across different parts of the exercise. Multiple other non-Governmental organisations representing the breadth of society were engaged and will continue to be in advance of phase four of the exercise in 2026. This includes engagement with partners from across the pharmaceutical industry, a focus group with those who are clinically vulnerable, and engagement with our key personal protective equipment (PPE) delivery partner SCCL on the PPE requirements across health and social care on the core anchor days of the exercise.

What engagement did Exercise Pegasus have with pharmaceutical providers on the procurement of vaccinations.

Exercise PEGASUS, the largest simulation of a pandemic in United Kingdom history, involved thousands of participants across different parts of the exercise. Multiple other non-Governmental organisations representing the breadth of society were engaged and will continue to be in advance of phase four of the exercise in 2026. This includes engagement with partners from across the pharmaceutical industry, a focus group with those who are clinically vulnerable, and engagement with our key personal protective equipment (PPE) delivery partner SCCL on the PPE requirements across health and social care on the core anchor days of the exercise.

Which health bodies from England, Wales, Scotland and Northern Ireland were involved in Exercise Pegasus.

Exercise PEGASUS, the largest simulation of a pandemic in the United Kingdom’s history, involved all four nations and thousands of participants across different parts of the exercise. Participants that are health bodies included, but were not limited to:the Department of Health and Social Care;the Welsh Government, via the Health, Social Care and Early Years Group;the Scottish Government, via the Directorate General, Health and Social Care;Northern Ireland’s Department of Health;the UK Health Security Agency;Public Health Wales;Public Health Scotland;the Northern Ireland Public Health Agency;NHS England, including all seven regions;NHS Supply Chain;NHS Wales, including the Performance and Improvement, and Shared Servies Partnership;NHS Scotland, including all 14 territorial health boards;NHS Blood and Transplant;the Scottish Ambulance Service;Antimicrobial Resistance and Healthcare Associated Infection Scotland;the Office for Life Sciences;the Food Standards Agency;the Medicines and Healthcare Regulatory Agency;the Health Research Authority;the Health and Safety Executive; andthe Care Quality Commission.

What engagement did Exercise Pegasus have with pharmaceutical providers on the procurement of pre-prophylactic drugs for immunocompromised patients.

Exercise PEGASUS, the largest simulation of a pandemic in United Kingdom history, involved thousands of participants across different parts of the exercise. Multiple other non-Governmental organisations representing the breadth of society were engaged and will continue to be in advance of phase four of the exercise in 2026. This includes engagement with partners from across the pharmaceutical industry, a focus group with those who are clinically vulnerable, and engagement with our key personal protective equipment (PPE) delivery partner SCCL on the PPE requirements across health and social care on the core anchor days of the exercise.

Whether Exercise Pegasus involved consultation with clinically vulnerable patient groups.

Exercise PEGASUS, the largest simulation of a pandemic in United Kingdom history, involved thousands of participants across different parts of the exercise. Multiple other non-Governmental organisations representing the breadth of society were engaged and will continue to be in advance of phase four of the exercise in 2026. This includes engagement with partners from across the pharmaceutical industry, a focus group with those who are clinically vulnerable, and engagement with our key personal protective equipment (PPE) delivery partner SCCL on the PPE requirements across health and social care on the core anchor days of the exercise.

Which minister will be responsible for implementing the findings from Exercise Pegasus.

Live participation in Exercise PEGASUS has now concluded, although a fourth phase, centred around recovery, is planned to be exercised in 2026. A published post-exercise report will include learning and findings from this and all preceding phases and this will be delivered in due course following detailed evaluation. The United Kingdom uses a Lead Government Department model to cover all phases of emergency planning, response, recovery, and risk assessment. Ministers within the Department, as the Lead Government Department for a pandemic response, will continue to actively consider the implementation of the findings from Exercise PEGASUS.

When his Department will publish the report findings from Exercise Pegasus.

Live participation in Exercise PEGASUS has now concluded, although a fourth phase, centred around recovery, is planned to be exercised in 2026. A published post-exercise report will include learning and findings from this and all preceding phases and this will be delivered in due course following detailed evaluation. The United Kingdom uses a Lead Government Department model to cover all phases of emergency planning, response, recovery, and risk assessment. Ministers within the Department, as the Lead Government Department for a pandemic response, will continue to actively consider the implementation of the findings from Exercise PEGASUS.

What timeframes his Department will set out to implement the findings of Exercise Pegasus.

Live participation in Exercise PEGASUS has now concluded, although a fourth phase, centred around recovery, is planned to be exercised in 2026. A published post-exercise report will include learning and findings from this and all preceding phases and this will be delivered in due course following detailed evaluation. The United Kingdom uses a Lead Government Department model to cover all phases of emergency planning, response, recovery, and risk assessment. Ministers within the Department, as the Lead Government Department for a pandemic response, will continue to actively consider the implementation of the findings from Exercise PEGASUS.

Which Minister is responsible for vulnerable groups and pandemics.

As the Parliamentary Under-Secretary of State for Public Health and Prevention, responsibility for health inequalities and vulnerable groups as well as pandemic preparedness falls within my Ministerial portfolio.

How many Integrated Care Boards in England provide Covid Medicines Delivery Units.

The Department and NHS England do not collect or hold this information centrally. Integrated care boards (ICBs) are responsible for making funding available and for arranging access to the National Institute for Health and Care Excellence recommended COVID-19 therapeutics, in line with its Rapid guideline: managing COVID-19, which is available at the following link:https://www.nice.org.uk/guidance/ng191ICBs will establish services to meet the needs of their local populations, which might include COVID-19 Medicines Delivery Units, but could also include other access options such as primary and community care, or outreach services. Patients can find out about local services at the following link:https://www.nhs.uk/conditions/covid-19/treatments-for-covid-19/

What assessment he has made of the potential impact of changes to National Institute for Health and Care Excellence guidance in May 2025 on supporting patients in accessing lateral flow tests for covid-19.

The National Institute for Health and Care Excellence (NICE) updated its recommendations on the use of nirmatrelvir plus ritonavir for the treatment COVID‑19 in adults in May 2025. The update followed a decision by the company to set a new list price for nirmatrelvir plus ritonavir which meant that it is no longer a cost-effective treatment for people with diabetes, obesity, or heart failure, or for those aged 70 years old or over. Nirmatrelvir plus ritonavir continues to be recommended by NICE for people who have an increased risk for progression to severe COVID‑19 as defined in NICE’s guidance, at the following link:https://www.nice.org.uk/guidance/ta878/chapter/5-Supporting-information-on-risk-factors-for-progression-to-severe-COVID19Rapid lateral flow tests for COVID-19 are available free of charge to people who are eligible for COVID-19 treatment as defined by NICE’s guidance.

Whether his Department has plans to take steps to streamline approvals processes for the (a) Medicines and Healthcare products Regulatory Agency and (ii) National Institute for Health and Care Research.

The Medicines and Healthcare products Regulatory Agency (MHRA) continues to optimise its performance in delivering efficient and predictable services which meet stakeholders’ expectations, for the benefit of patients and public health and the Life Sciences. The Agency has been working in close collaboration with health system partners and industry to ensure that robust, appropriate and prompt decisions are made. In March 2024, the MHRA published new guidance in how medicines will be assessed to improve the robustness and rapid decisions, which it can be seen, has a significantly positive effect.The Agency has an ongoing system for review of licencing pathways and has recently launch the consultation for Personalised Immunotherapies for Cancer which can be used to drive discussion forward as to how to enable fast patient benefit of new and novel technologies.The National Institute for Health and Care Research (NIHR) continues to work collaboratively across Government and with key stakeholders to ensure it has optimal systems and processes to support the delivery of impactful and timely research for patient and public benefit. For example, the NIHR has recently launched a new single awards management system for the NIHR underpinned by optimised processes which will streamline operations, enable data sharing and reduce duplicate information requests.

When did his Department last issue guidance to patients that are immunocompromised.

NHS England Specialised Commissioning has recently updated the specialist immunology service specification for adults with deficient immune systems, named the Specialist immunology services for adults with deficient immune systems. This sets out the standards of care that providers of specialist immunology services are expected to meet, including with regards to treatment and monitoring. Further information on the service specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/12/specialist-immunology-adults-service-specification.pdfThe clinical commissioning policy for the use of therapeutic immunoglobulin in England has also recently been updated. The updated document describes all conditions for which therapeutic immunoglobulin is commissioned, including autoimmune conditions, and provides details on the role, dose, and place of therapeutic immunoglobulin in the treatment pathway for individual indications, alongside possible alternative treatment options for use of therapeutic immunoglobulin in both adults and children. Further information on the policy is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2021/12/ccp-for-the-use-of-therapeutic-immunoglobulin-england-2025.pdf Sub Regional Immunoglobulin Assessment Panels (SRIAPs) are in place to provide immunoglobulin stewardship and oversight in line with this policy. In April 2025, a new framework for the supply of immunoglobulin will begin. In March 2025, NHS England Specialised Commissioning provided advice to the SRIAPs regarding patient access to immunoglobulin products, with the introduction of the new framework. Neither the Department nor NHS England hold data centrally on the exact numbers of those who are clinically defined as immunocompromised. However, a recently published paper in the Journal of Infection identified 477,335 immunocompromised individuals aged 12 years old and over in England. This research paper is available at the following link:https://www.sciencedirect.com/science/article/pii/S016344532500026XNHS England Specialised Commissioning is developing a patient information sheet to outline the changes to the range of immunoglobulin products available on the National Health Service. It is intended to support patients who rely on immunoglobulin treatment and may be required to switch to a different immunoglobulin product. This will be shared with patient organisations and clinical teams in April 2025.The UK Health Security Agency (UKHSA) is committed to working with partners, including NHS England and the Department, to protect the health of immunocompromised patients in the context of infectious disease hazards. Engaging with the Immunocompromised Coalition and other charities supporting vulnerable individuals, in partnership with the Department and the NHS as part of pandemic preparedness, is an important activity for the UKHSA. It enables the prompt implementation of appropriate protective measures with relevant, scalable additional support in the event of a pandemic or another emergency. The UKHSA has also published COVID-19 guidance, last updated in May 2024, for those individuals whose immune system means they are at higher risk. The guidance is available at the following link: https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk No assessment has been made of the potential merits of establishing a cross-departmental taskforce for immunocompromised patients.

What steps his Department is taking to support immunocompromised people.

NHS England Specialised Commissioning has recently updated the specialist immunology service specification for adults with deficient immune systems, named the Specialist immunology services for adults with deficient immune systems. This sets out the standards of care that providers of specialist immunology services are expected to meet, including with regards to treatment and monitoring. Further information on the service specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/12/specialist-immunology-adults-service-specification.pdfThe clinical commissioning policy for the use of therapeutic immunoglobulin in England has also recently been updated. The updated document describes all conditions for which therapeutic immunoglobulin is commissioned, including autoimmune conditions, and provides details on the role, dose, and place of therapeutic immunoglobulin in the treatment pathway for individual indications, alongside possible alternative treatment options for use of therapeutic immunoglobulin in both adults and children. Further information on the policy is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2021/12/ccp-for-the-use-of-therapeutic-immunoglobulin-england-2025.pdf Sub Regional Immunoglobulin Assessment Panels (SRIAPs) are in place to provide immunoglobulin stewardship and oversight in line with this policy. In April 2025, a new framework for the supply of immunoglobulin will begin. In March 2025, NHS England Specialised Commissioning provided advice to the SRIAPs regarding patient access to immunoglobulin products, with the introduction of the new framework. Neither the Department nor NHS England hold data centrally on the exact numbers of those who are clinically defined as immunocompromised. However, a recently published paper in the Journal of Infection identified 477,335 immunocompromised individuals aged 12 years old and over in England. This research paper is available at the following link:https://www.sciencedirect.com/science/article/pii/S016344532500026XNHS England Specialised Commissioning is developing a patient information sheet to outline the changes to the range of immunoglobulin products available on the National Health Service. It is intended to support patients who rely on immunoglobulin treatment and may be required to switch to a different immunoglobulin product. This will be shared with patient organisations and clinical teams in April 2025.The UK Health Security Agency (UKHSA) is committed to working with partners, including NHS England and the Department, to protect the health of immunocompromised patients in the context of infectious disease hazards. Engaging with the Immunocompromised Coalition and other charities supporting vulnerable individuals, in partnership with the Department and the NHS as part of pandemic preparedness, is an important activity for the UKHSA. It enables the prompt implementation of appropriate protective measures with relevant, scalable additional support in the event of a pandemic or another emergency. The UKHSA has also published COVID-19 guidance, last updated in May 2024, for those individuals whose immune system means they are at higher risk. The guidance is available at the following link: https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk No assessment has been made of the potential merits of establishing a cross-departmental taskforce for immunocompromised patients.

How many people in the United Kingdom are clinically defined as immunocompromised.

NHS England Specialised Commissioning has recently updated the specialist immunology service specification for adults with deficient immune systems, named the Specialist immunology services for adults with deficient immune systems. This sets out the standards of care that providers of specialist immunology services are expected to meet, including with regards to treatment and monitoring. Further information on the service specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/12/specialist-immunology-adults-service-specification.pdfThe clinical commissioning policy for the use of therapeutic immunoglobulin in England has also recently been updated. The updated document describes all conditions for which therapeutic immunoglobulin is commissioned, including autoimmune conditions, and provides details on the role, dose, and place of therapeutic immunoglobulin in the treatment pathway for individual indications, alongside possible alternative treatment options for use of therapeutic immunoglobulin in both adults and children. Further information on the policy is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2021/12/ccp-for-the-use-of-therapeutic-immunoglobulin-england-2025.pdf Sub Regional Immunoglobulin Assessment Panels (SRIAPs) are in place to provide immunoglobulin stewardship and oversight in line with this policy. In April 2025, a new framework for the supply of immunoglobulin will begin. In March 2025, NHS England Specialised Commissioning provided advice to the SRIAPs regarding patient access to immunoglobulin products, with the introduction of the new framework. Neither the Department nor NHS England hold data centrally on the exact numbers of those who are clinically defined as immunocompromised. However, a recently published paper in the Journal of Infection identified 477,335 immunocompromised individuals aged 12 years old and over in England. This research paper is available at the following link:https://www.sciencedirect.com/science/article/pii/S016344532500026XNHS England Specialised Commissioning is developing a patient information sheet to outline the changes to the range of immunoglobulin products available on the National Health Service. It is intended to support patients who rely on immunoglobulin treatment and may be required to switch to a different immunoglobulin product. This will be shared with patient organisations and clinical teams in April 2025.The UK Health Security Agency (UKHSA) is committed to working with partners, including NHS England and the Department, to protect the health of immunocompromised patients in the context of infectious disease hazards. Engaging with the Immunocompromised Coalition and other charities supporting vulnerable individuals, in partnership with the Department and the NHS as part of pandemic preparedness, is an important activity for the UKHSA. It enables the prompt implementation of appropriate protective measures with relevant, scalable additional support in the event of a pandemic or another emergency. The UKHSA has also published COVID-19 guidance, last updated in May 2024, for those individuals whose immune system means they are at higher risk. The guidance is available at the following link: https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk No assessment has been made of the potential merits of establishing a cross-departmental taskforce for immunocompromised patients.

Whether his Department has made an assessment of the potential merits of establishing a cross-departmental taskforce for for immunocompromised patients.

NHS England Specialised Commissioning has recently updated the specialist immunology service specification for adults with deficient immune systems, named the Specialist immunology services for adults with deficient immune systems. This sets out the standards of care that providers of specialist immunology services are expected to meet, including with regards to treatment and monitoring. Further information on the service specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/12/specialist-immunology-adults-service-specification.pdfThe clinical commissioning policy for the use of therapeutic immunoglobulin in England has also recently been updated. The updated document describes all conditions for which therapeutic immunoglobulin is commissioned, including autoimmune conditions, and provides details on the role, dose, and place of therapeutic immunoglobulin in the treatment pathway for individual indications, alongside possible alternative treatment options for use of therapeutic immunoglobulin in both adults and children. Further information on the policy is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2021/12/ccp-for-the-use-of-therapeutic-immunoglobulin-england-2025.pdf Sub Regional Immunoglobulin Assessment Panels (SRIAPs) are in place to provide immunoglobulin stewardship and oversight in line with this policy. In April 2025, a new framework for the supply of immunoglobulin will begin. In March 2025, NHS England Specialised Commissioning provided advice to the SRIAPs regarding patient access to immunoglobulin products, with the introduction of the new framework. Neither the Department nor NHS England hold data centrally on the exact numbers of those who are clinically defined as immunocompromised. However, a recently published paper in the Journal of Infection identified 477,335 immunocompromised individuals aged 12 years old and over in England. This research paper is available at the following link:https://www.sciencedirect.com/science/article/pii/S016344532500026XNHS England Specialised Commissioning is developing a patient information sheet to outline the changes to the range of immunoglobulin products available on the National Health Service. It is intended to support patients who rely on immunoglobulin treatment and may be required to switch to a different immunoglobulin product. This will be shared with patient organisations and clinical teams in April 2025.The UK Health Security Agency (UKHSA) is committed to working with partners, including NHS England and the Department, to protect the health of immunocompromised patients in the context of infectious disease hazards. Engaging with the Immunocompromised Coalition and other charities supporting vulnerable individuals, in partnership with the Department and the NHS as part of pandemic preparedness, is an important activity for the UKHSA. It enables the prompt implementation of appropriate protective measures with relevant, scalable additional support in the event of a pandemic or another emergency. The UKHSA has also published COVID-19 guidance, last updated in May 2024, for those individuals whose immune system means they are at higher risk. The guidance is available at the following link: https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk No assessment has been made of the potential merits of establishing a cross-departmental taskforce for immunocompromised patients.

When his Department last issued guidance for clinicians on treating immunocompromised patients in health settings.

NHS England Specialised Commissioning has recently updated the specialist immunology service specification for adults with deficient immune systems, named the Specialist immunology services for adults with deficient immune systems. This sets out the standards of care that providers of specialist immunology services are expected to meet, including with regards to treatment and monitoring. Further information on the service specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2024/12/specialist-immunology-adults-service-specification.pdfThe clinical commissioning policy for the use of therapeutic immunoglobulin in England has also recently been updated. The updated document describes all conditions for which therapeutic immunoglobulin is commissioned, including autoimmune conditions, and provides details on the role, dose, and place of therapeutic immunoglobulin in the treatment pathway for individual indications, alongside possible alternative treatment options for use of therapeutic immunoglobulin in both adults and children. Further information on the policy is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2021/12/ccp-for-the-use-of-therapeutic-immunoglobulin-england-2025.pdf Sub Regional Immunoglobulin Assessment Panels (SRIAPs) are in place to provide immunoglobulin stewardship and oversight in line with this policy. In April 2025, a new framework for the supply of immunoglobulin will begin. In March 2025, NHS England Specialised Commissioning provided advice to the SRIAPs regarding patient access to immunoglobulin products, with the introduction of the new framework. Neither the Department nor NHS England hold data centrally on the exact numbers of those who are clinically defined as immunocompromised. However, a recently published paper in the Journal of Infection identified 477,335 immunocompromised individuals aged 12 years old and over in England. This research paper is available at the following link:https://www.sciencedirect.com/science/article/pii/S016344532500026XNHS England Specialised Commissioning is developing a patient information sheet to outline the changes to the range of immunoglobulin products available on the National Health Service. It is intended to support patients who rely on immunoglobulin treatment and may be required to switch to a different immunoglobulin product. This will be shared with patient organisations and clinical teams in April 2025.The UK Health Security Agency (UKHSA) is committed to working with partners, including NHS England and the Department, to protect the health of immunocompromised patients in the context of infectious disease hazards. Engaging with the Immunocompromised Coalition and other charities supporting vulnerable individuals, in partnership with the Department and the NHS as part of pandemic preparedness, is an important activity for the UKHSA. It enables the prompt implementation of appropriate protective measures with relevant, scalable additional support in the event of a pandemic or another emergency. The UKHSA has also published COVID-19 guidance, last updated in May 2024, for those individuals whose immune system means they are at higher risk. The guidance is available at the following link: https://www.gov.uk/government/publications/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk/covid-19-guidance-for-people-whose-immune-system-means-they-are-at-higher-risk No assessment has been made of the potential merits of establishing a cross-departmental taskforce for immunocompromised patients.