Written questions by Moran.

What functions set out in the May 2025 Model ICB document are being transferred out of ICBs in 2026-27; and if he will publish the updated NHS England document entitled Model ICB functions.

Under the Health and Care Act 2022, integrated care boards (ICBs) have flexibility to delegate their statutory functions, their duties and powers, to other statutory bodies, subject to secondary legislation and NHS England’s guidance. While ICBs can delegate responsibility for discharge of the statutory function, accountability remains with them. Currently, the focus of ICBs is realising the administrative efficiencies required of them, rather than delegating their statutory functions. No changes have been made to the existing statutory responsibilities which ICBs must continue to meet. There is a consultation underway on restructuring the NHS England regional teams which will confirm those additional activities previously undertaken by some ICBs. This includes, for example, oversight of National Health Service trusts and foundation trusts against the national oversight framework. We have no current plans to publish additional guidance on this currently.

How much was spent by NHS England on (a) each Section 7A service, (b) immunisation programmes within Section 7A services, (c) childhood immunisations within Section 7A services and (d) school-age immunisations within Section 7A services under the National Health Service Act 2006 in each financial year since 2019-20.

Funding for public health functions delegated by my Rt Hon. Friend, the Secretary of State for Health and Social Care, to NHS England, known as section 7A services, is allocated as part of NHS England’s mandate funding total. The following table shows the spend for section 7A services by NHS England for the financial years 2019/20, 2020/21, 2021/22, 2022/23, and 2023/24:Section 7A service area/programme2019/20 (£, million)2020/21 (£, million)2021/22 (£, million)2022/23 (£, million)2023/24 (£, million)Childhood immunisations125.494.462.984.295.6School age immunisations41.141.136.542.655.4Flu vaccination260.2345.8388.6448.1403.9Other immunisations32.222.18.025.129.2COVID-19 immunisation0.0554.61,080.2386.2268.4National immunisation programmes total458.91,058.01,576.2986.2852.5National population screening programmes total644.6668.5675.8647.4701.2Child health information services total46.531.425.252.253.4Public health services in secure and detained settings total95.584.590.882.082.1Sexual assault referral centres (SARCs) total33.239.042.348.152.8Grand total1,278.71,881.42,410.31,815.81,742.0Source: NHS England.Notes:the above section 7A expenditure is as reported by NHS England regions from 2019/20 to 2023/24. These figures relate to deployment costs for commissioning individual services to patients;in 2020/21 and 2021/22, some capacity normally dedicated to public health programmes was redeployed to support the response to the pandemic. As a result, funding for section 7A services was not ring-fenced, and has not since been ring-fenced, and the costs of delivering section 7A services could not be quantified accurately;from 2020/21, COVID-19 immunisation expenditure represents a material amount of the immunisations total and the section 7A expenditure total. Section 7A expenditure on vaccinations increased in 2022/23, driven by post-pandemic catch up activity;flu vaccination expenditure figures include drugs and activity reimbursement;all figures for public health in secure and detained settings and sexual assault referral centres are based on data collection done in arrears;2019/20 expenditure for public health in secure and detained settings are an estimate. The first data collection was in 2020/21; andthe costs listed for sexual assault referral centres includes minor costs from the wider sexual assault and abuse services pathway, for instance services related to supporting victims of sexual assault and abuse that sit outside of a SARC.Expenditure for 2024/25 and 2025/26 is not yet published.

What assessment his Department made of the potential merits of including a Director of Midwifery on the National Maternity and Neonatal Taskforce.

When setting up the National Maternity and Neonatal Taskforce, careful consideration has been given to ensuring a diversity of experience, region, and discipline across the maternity and neonatal system.We recognise that the inclusion of midwifery perspectives and expertise is vital to developing an action plan that drives real, lasting change. For example, its membership includes the Chief Executive of the Royal College of Midwives, and the Chief Midwifery Officer at the Norwegian Directorate of Health.The taskforce will also be supported by a wider range of experts as part of expert reference groups that will bring broader views and perspectives. This includes a dedicated workforce, clinical, and academic group, bringing together Directors of Midwifery with other senior and frontline professionals, ensuring the taskforce benefits from a wide range of perspectives. Other groups span charitable and grassroots organisations, families and seldom heard voices, and regulatory and investigatory bodies.

With reference to the Answer of 1 May 2024 to Question 19413 on NHS: Expenditure, how much NHS England, clinical commissioning groups and integrated care boards spent in aggregate on (a) mental health services, (b) acute health services, (c) NHS community health services (d) social care services, (e) primary medical services, (f) specialised services, (g) NHS continuing healthcare, and all other recorded spending categories in each financial year since 2015-16; and how much those organisations plan to spend in aggregate in each of those areas in the 2025-26 financial year.

The table attached sets out the spend categories for the specified services commissioned by NHS England and the integrated care boards, formerly the clinical commissioning groups, using audited figures between 2015/16 to 2024/25. Information for 2025/26 is unvalidated and not quality assured. In-year data is not routinely reported on with the breakdown of spend used this answer and would be subject to material change between plan and outturn as a result. 75% of NHS England commissioned social services are within the community services line.

When his Department plans to release an impact assessment for changes to the NICE cost-effectiveness threshold.

There are no plans to publish an impact assessment or details of the modelling in relation to changes to the National Institute for Health and Care Excellence cost-effectiveness threshold. Information included in the impact assessment is commercially sensitive.The United Kingdom and United States’ pharmaceutical deal is a vital investment that builds on the strength of our National Health Service and world leading life sciences sector.

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.

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.

What training and guidance is provided to GPs and other frontline clinicians on recognising and managing lipoedema; and whether he plans to review undergraduate, postgraduate and continuing professional development provision relating to that condition.

Doctors are responsible for maintaining their clinical knowledge, including on lipoedema, throughout their careers, and are responsible for identifying learning needs as part of their continuing professional development.All doctors registered in the United Kingdom are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. In 2012, the GMC introduced revalidation, which supports doctors in regularly reflecting on how they can develop or improve their practice, giving patients confidence that doctors are up to date with their practice, and promoting improved quality of care by driving improvements in clinical governance.The training curricula for postgraduate trainee doctors are set by the relevant medical royal college and have to meet the standards set by the GMC. Whilst curricula do not necessarily highlight specific conditions for doctors to be aware of, they do emphasise the skills and approaches that a doctor must develop to ensure accurate and timely diagnoses and treatment plans for their patients.Resources for frontline health professionals are available from a number of professional and patient organisations to improve the diagnosis, treatment, and management of patients presenting with lipoedema.

Whether lipoedema has a diagnostic code within NHS data systems; what steps he is taking to improve the collection of data on prevalence, diagnosis and outcomes for people with lipoedema; and what assessment he has made of the potential impact of improved data collection on future commissioning and service planning.

Lipoedema does not currently have a unique standalone diagnostic code within the National Health Service’s primary coding systems. In clinical practice, it is often recorded under broader World Health Organization International Classification of Diseases Tenth Revision categories relating to disorders of subcutaneous tissue or lymphatic disease.NHS England is taking forward a wide programme of work to improve how data is recorded and coded across the health service by expanding the use of modern electronic patient record systems, strengthening national coding standards, and supporting staff to record information consistently and accurately. This includes better use of SNOMED CT in primary care, clearer guidance for hospitals, and investment in shared care records so that patient information is captured once and used safely across services. These improvements are helping to ensure that clinical data is more reliable, more complete, and better able to support high‑quality care, earlier diagnosis, and effective service planning.

What assessment he has made of the potential merits of increasing funding for epilepsy research.

I refer the Hon. Member to the answer I gave to the Hon. Member for Knowsley on 6 January to Question 101055.

Whether he plans to request that NICE conduct an exceptional (expedited) partial review of the NICE Depression guideline (NG222) to consider the inclusion of intravenous racemic ketamine as an option for patients for whom electroconvulsive therapy is being considered.

The Department has no plans to ask the National Institute for Health and Care Excellence (NICE) to conduct a review of the NICE guideline on the treatment and management of depression, reference code NG222.NICE is an independent body and is responsible for taking decisions on whether its guidelines should be updated in light of new evidence and changes in clinical practice. NICE operates an active surveillance programme and when new evidence emerges, it proactively considers whether existing guidance should be reviewed and, if appropriate, updated. Decisions as to whether NICE will create new, or update existing, guidance are overseen by an integrated, cross-organisational prioritisation board. NICE has no current plans to review intravenous racemic ketamine in the context of the depression guideline.

If he will consider specific funding for mesothelioma nursing posts.

Decisions about recruitment are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.Funding provided to NHS trusts is not ringfenced for specific items such as staffing levels. Hospitals receive funding allocations which they can use at their discretion, based on local priorities.The 10 Year Workforce Plan will ensure that the NHS has the right people in the right places, with the right skills to care for patients, when they need it.

If he will consider establishing a national clinical audit for people living with mesothelioma to understand a) the need for preventative measures and b) the scale of treatment needed.

I refer the Hon. Member to the answer I gave to the Hon. Member for Loughborough on 12 May 2025 to Question 46503.

What assessment he has made on the potential merits of statutory regulation of therapy titles.

Titles can only be protected for statutorily regulated professions. Some regulated professions include the term ‘therapist’ and as such have protected title status, for example Art therapist, Dental therapist, and Occupational therapist. Therapists in general are not a statutorily regulated profession in the United Kingdom. The Government has not made an assessment on the merits of protecting all therapy titles.The Government is clear that the professions protected in law must be the right ones and that the level of regulatory oversight must be proportionate to the risks to the public.

What steps his Department is taking to introduce screening for asymptomatic heart conditions in young people in sports settings.

I refer the Hon. Member to the answer I gave on 27 October 2025 to Question 78454.

What steps his Department is taking to help raise awareness among young people of the risks of sudden cardiac death in (a) grassroots sports clubs and (b) higher education settings.

To reduce the risks of sudden cardiac death, NHS England has a published a national service specification for Inherited Cardiac Conditions that covers patients who often present as young adults with previously undiagnosed cardiac disease or as families requiring follow up due to a death from this cause. This describes the service model and guidance that should be followed to support the diagnosis and treatment of patients or family members. It also includes the requirement for specialised Inherited Cardiac Conditions services to investigate suspected cases.

What steps he is taking to gather additional data on the (a) effectiveness and (b) safety of the Respiratory Syncytial Virus vaccination in people that are over 80.

The UK Health Security Agency (UKHSA) undertakes monitoring and evaluation of immunisation programmes, including the effectiveness of vaccines. The Medicines and Healthcare Products Regulatory Agency (MHRA) monitors vaccine safety. The UKHSA and the MHRA are in regular contact with manufacturers over new and emerging data from their products.Evidence of effectiveness and safety in relevant age groups in the United States of America, which implemented older adult vaccination a season ahead of the United Kingdom, was used to inform the Joint Committee on Vaccination and Immunisation’s (JCVIs) considerations on extending the UK programme to adults aged 80 years old and older. The JCVI’s meeting minutes and statement of 16 July 2025 advising an extension to the UK respiratory syncytial virus (RSV) programme are available at the following link:https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisationThe JCVI keeps the RSV programme under regular review. Evidence on the safety and effectiveness of RSV vaccines in all age groups in all countries where data has been made available is used to inform JCVI advice.

What steps his Department is taking to introduce screening for asymptomatic heart conditions in young people in sports settings.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening and which supports implementation.The UK NSC last reviewed screening for sudden cardiac death (SCD) in people under the age of 39 years old in 2019 and concluded that population screening should not be offered. Further information is available at the following link:https://view-health-screening-recommendations.service.gov.uk/sudden-cardiac-death/The UK NSC is currently examining the evidence for SCD screening and will open a public consultation to seek comments from members of the public and stakeholders on this in due course.

What steps his Department is taking to help raise awareness among young people of the risks of sudden cardiac death in (a) grass roots sports clubs and (b) higher education settings.

To reduce the risks of sudden cardiac death, NHS England has published a national service specification for inherited cardiac conditions that covers patients who often present as young adults with previously undiagnosed cardiac disease or families requiring follow-up due to a death from this cause. This describes the service model and guidance that should be followed to support diagnosis and treatment of patients or family members. It also includes the requirement for specialised inherited cardiac conditions services to investigate suspected cases.

What steps he is taking to improve (a) early diagnosis and (b) treatment of genetic haemochromatosis.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service (GMS) and directed by the National Genomic Test Directory which sets out the eligibility criteria for patients to access testing as well as the genomic targets to be tested.Genomic testing for haemochromatosis is available through the NHS GMS for people who show unexplained iron overload suggestive of hereditary haemochromatosis. Testing is available for all eligible patients across England and any healthcare professional who suspects their patient may have haemochromatosis can refer their patient for testing via their local NHS Clinical Genomic Service.Treatment for genetic haemochromatosis is commissioned by local integrated care boards, including venesection, also known as phlebotomy, to remove some blood to reduce blood iron levels. In a small number of cases where regular phlebotomies are not possible, a chelation therapy may be used.

What steps he is taking to integrate mental health support into weight management services.

The National Institute for Health and Care Excellence (NICE) produces evidence-based guidance for service commissioners, providers, and health and care practitioners on best practice for weight management. Its guidance on weight management makes a number of recommendations about mental health support. For example, it recommends that:- For adults, providers of weight management services discuss with a person accessing weight management services whether their individual circumstances such as psychological factors may affect their ability to lose weight, and whether referral to another service (such as mental health support) may be appropriate.- For children, practitioners make a referral to the local mental health pathway if there are concerns that the child or young person's mental wellbeing is affected by their weight, that mental health is affecting their weight or the circumstances that influence their weight, or an eating disorder is suspected.- Specialist weight management services, commissioned by NHS integrated care boards, should be provided by multidisciplinary teams, with psychological and behavioural support.More recently, NHS England has issued commissioning guidance for the use of tirzepatide for the management of obesity. It states that prescribers should carefully consider the patient’s overall wellbeing, particularly when eating disorders, body dysmorphia, or mental health status are factors in the request and consideration for treatment. Onward referral to dedicated services may be made where appropriate, in line with local guidelines and existing NICE guidance.