The Government is committed to safeguarding patients as part of the shift from analogue to digital National Health Services, as set out in the 10-Year Health Plan.

The Medicines and Healthcare products Regulatory Agency regulates artificial intelligence (AI) tools that provide clinical assessment to ensure they are safe for patient use in the NHS. NHS organisations deploying such tools must also comply with risk management standards and with the Digital Technology Assessment Criteria.

NHS England is developing national triage standards setting out the clinical principles, urgency thresholds, and performance expectations against which any AI-enabled triage will be assured before use and continuously evaluated against.

The Government has also established the National Commission into the regulation of AI in healthcare, which will advise on the future regulatory framework of AI.

In October 2021, the Professional Record Standards Body (PRSB) updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient. The NHS Standard Contract states that outpatient letters should be consistent with PRSB’s standards. All National Health Service and independent sector providers are regulated by the Care Quality Commission, and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority’s Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons, and other relevant information regarding the procedure.

Our records indicate that the Paterson Inquiry Response Programme Board last met virtually in 2023. Membership included representatives from the following bodies; the Department; NHS England; the Care Quality Commission; the Academy of Medical Royal Colleges; the Competition and Markets Authority; the General Medical Council; the Independent Healthcare Providers Network; the Independent Sector Complaints Adjudication Service; the National Consultant Information Programme; NHS Digital; NHS Providers; NHS Resolution; the Professional Standards Authority; the Royal College of Surgeons; Spire; and the University Hospitals Birmingham NHS Foundation Trust. There are no current plans to publish the boards minutes.

As referenced in the answers to HL960 and HL1431, the Government accepted 13 of the 15 recommendations set out in the 2020 Paterson Inquiry Report. Of these, nine recommendations have been implemented or partially implemented, and four recommendations are in progress. While there is no timeline for full implementation, we are working with NHS England to implement the outstanding recommendations as quickly as possible.

In October 2021, the Professional Record Standards Body (PRSB) updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient. The NHS Standard Contract states that outpatient letters should be consistent with PRSB’s standards. All National Health Service and independent sector providers are regulated by the Care Quality Commission, and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority’s Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons, and other relevant information regarding the procedure.

Our records indicate that the Paterson Inquiry Response Programme Board last met virtually in 2023. Membership included representatives from the following bodies; the Department; NHS England; the Care Quality Commission; the Academy of Medical Royal Colleges; the Competition and Markets Authority; the General Medical Council; the Independent Healthcare Providers Network; the Independent Sector Complaints Adjudication Service; the National Consultant Information Programme; NHS Digital; NHS Providers; NHS Resolution; the Professional Standards Authority; the Royal College of Surgeons; Spire; and the University Hospitals Birmingham NHS Foundation Trust. There are no current plans to publish the boards minutes.

As referenced in the answers to HL960 and HL1431, the Government accepted 13 of the 15 recommendations set out in the 2020 Paterson Inquiry Report. Of these, nine recommendations have been implemented or partially implemented, and four recommendations are in progress. While there is no timeline for full implementation, we are working with NHS England to implement the outstanding recommendations as quickly as possible.

The Government takes patient safety extremely seriously. Employers, professional regulators, and system partners all have clear responsibilities to act where concerns arise about a healthcare professional’s conduct and any potential risk to patients.

Where concerns about patient safety are identified, it is for the employing organisation to take appropriate and proportionate action in line with employment law, Advisory, Conciliation and Arbitration Service guidance, and codes of practice on disciplinary procedures, including investigations. This may include restricting practice, excluding a practitioner from the workplace where necessary to protect patients. National Health Service organisations are independent employers and are responsible for their own disciplinary processes and decisions.

Practitioner Performance Advice, delivered by NHS Resolution, provides expertise to support the fair resolution of concerns, promote learning for improvement, and help preserve resources for patient care across the NHS.

Healthcare Professional Alert Notices (HPANs) are used to share concerns about practitioners who may pose a significant risk of harm across organisations. HPANs can be issued while regulatory processes are ongoing, providing a safeguard at pre‑employment and during investigations.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Many non-emergency patient transport service (NEPTS) ambulances operated by National Health Service trusts already carry a defibrillator.

The contractual requirements for the provision of NEPTS services, including carrying defibrillators, are determined by each integrated care board, based on their assessment of the needs of the local population.

The remit of the National Director of Patient Experience will include a number of immediate priorities for patient experience that were commitments in the 10-Year Health Plan, which were developed following extensive public engagement. It is expected that the National Director for Patient Experience will continue to engage widely on their work programme.

Detailed work is currently underway to finalise the role description and the process and timetable for the recruitment of the new National Director of Patient Experience. Once this work has been completed, we will be in a better position to clarify when we expect the role to be established, and to confirm the role and responsibilities of the position.

Healthwatch has played an important role in supporting patient involvement in the National Health Service, and in our 10-Year Health Plan we recognise the valuable work they have done to gather patient feedback and influence the debate around local service delivery.

Healthwatch was one of six organisations covered by Dr Penny Dash’s review of patient safety across the health and care landscape. The review found that there are too many organisations doing this type of work, which can create confusion for patients and risks limiting impact given their distance from service providers and commissioners.

In response, we have committed in our 10-Year Health Plan to bring Healthwatch England’s strategic functions ‘in house’ within a reformed Department, giving patients a stronger national voice through the creation of a new National Director of Patient Experience. At the same time, the statutory functions of Local Healthwatch will be brought together with the involvement and engagement responsibilities of integrated care boards, ensuring that patient insight is more directly connected to local decision-making and service improvement.

As set out in the Dash Report and the 10-Year Health Plan for England, the strategic functions of Healthwatch England will transfer to a new directorate for patient experience within the Department.

We are committed to ensuring that patient voice is not only heard but embedded at the highest levels of our leadership and decision-making structures. By creating clear routes for patient insight, feedback, and lived experience to directly influence senior leaders at the national level, we will ensure that policies, strategic priorities, and service design will be shaped by what matters most to the people who use health services.

To achieve this, we are proposing to abolish Healthwatch and bring patient voice ‘in-house’ by creating a new Patient Experience Directorate in the Department, which will take on the strategic functions of Healthwatch England. The health function of Local Healthwatch (LHW) will become the responsibility of integrated care boards (ICBs). ICBs will ensure the functions are incorporated in provider organisations alongside existing patient engagement work such as Patient Participation Groups. Local authorities will be responsible for the social care functions of LHW.

The abolition of both Healthwatch England and Local Healthwatch will require primary legislation and will be subject to the will of Parliament.

The National Clinical Audit and Patient Outcomes Programme (NCAPOP), is commissioned, managed, and developed by the Health Quality Improvement Partnership on behalf of NHS England, the Welsh Government, and other devolved administrations.

The programme currently consists of over 30 national clinical audits, registries, and databases as well as five clinical outcome review programmes.

The audit and registry topics include, for example, the national vascular registry, the national emergency laparotomy audit, and multiple cancer topics, all of which monitor a variety of clinical metrics including surgical outcomes.

The role of the NCAPOP is to detect unwarranted clinical variation and to feed this back to National Health Service trusts in an agile manner. Timely feedback to trusts enables them to make quick improvements to clinical practice. The NCAPOP work programme achieves this by making trust data available in near real time dynamic dashboards. The NCAPOP audits also operate a statistically rigorous outlier process with the aim of detecting negative trust outcomes. Outlier information is provided to the trust concerned, NHS England, and the Care Quality Commission.

The dashboard and outlier data can be used by trusts to influence quality governance, improve patient safety and reduce patient harm, and enable tailored clinical quality improvement programmes.

The Government is clear that patients should expect and receive the highest standard of care throughout the year, including during the busy winter period.

We started earlier and have done more than ever to prepare for winter this year. We continue to monitor the impact of winter pressures on the National Health Service over the winter months, providing additional support to services across the country as needed.

Flu is a recurring pressure that the NHS faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.

Decisions about recruitment and resourcing are a matter for individual NHS employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.

The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties.

The Government has had discussions with the GMC on this issue. The GMC’s Good Medical Practice states that professionals must act with honesty and integrity and ensure their conduct justifies patient’s trust in them and the public’s trust in the profession. They must also recognise a patient’s right to choose whether to accept their advice. It is up to individual healthcare providers, rather than the GMC, to consider patient requests for care based on sex.

The National Institute for Health and Care Excellence (NICE) is the independent body that makes evidence-based recommendations for the National Health Service on whether new medicines should be routinely funded by the NHS on the basis of an assessment of clinical and cost effectiveness. NICE develops its guidance through extensive engagement with interested parties, including patient groups.

NICE is currently evaluating vorasidenib for treating astrocytoma or oligodendroglioma with IDH1 or IDH2 mutations after surgery in people 12 years old and over. As part of the appraisal process, NICE’s independent committee was provided with evidence submissions from three patient groups. The committee also heard expert personal perspectives from two patient experts.

The draft guidance was shared with all stakeholders as well as being published on the NICE website for public comment as part of the consultation which took place between 15 October and 4 November 2025. The committee reviewed the consultation comments at the committee meeting on 20 November 2025. NICE currently expects to publish final guidance in January 2026.

The Department recognises the potential of wearable health technologies and artificial intelligence to support the earlier detection and better management of conditions such as heart damage. As set out in the 10-Year Health Plan, wearables are one of the “big bets” for the future of the health service, with a vision for these technologies to become a routine part of care by 2035.

A key ambition is for health data, including from wearables, to flow securely and seamlessly through the National Health Service over time. As part of this, by 2028 we aim to make the remote monitoring of cardiovascular disease (CVD) using wearables a standard part of care. Work to integrate wearable data into the NHS App and the single patient record is also underway as part of our broader digital transformation. This supports our broader health mission to shift care from treatment to prevention, from analogue to digital, and from hospital to community settings.

To accelerate progress towards the Government’s 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 in 2026. The Department and NHS England are engaging widely throughout its development to ensure that we prioritise ambitious, evidence-led, and clinically informed approaches to prevention, treatment, and care.

We are evaluating which devices and use cases are most clinically and cost effective, with the early detection of heart damage a key area of interest. This work aligns with the commitment to modernise CVD services through the development of a new framework that will consider the role of innovation, such as wearables and remote monitoring.

As with all emerging technologies, adoption will be guided by evidence, regulation, and robust data governance. We continue to monitor developments and will update our approach as the evidence base evolves.

Independent sector providers have a role to play in supporting the National Health Service as trusted partners to recover elective services by using additional capacity to tackle the backlog whilst delivering value for money.

Independent sector providers delivered 3,265,305 outpatient appointments in 2022/23 and 4,156,770 outpatient appointments in 2023/24, including first appointment and follow-up.

They delivered 1,523,195 tests in 2022/23 and 1,876,989 in 2023/24. This includes only the 15 key diagnostic tests and excludes activity subcontracted from NHS trusts where responsibility for the pathway remains with the trust.

There were 761,420 inpatient admissions in independent sector providers in 2022/23 and 970,865 inpatient admissions in 2023/24. This includes ordinary electives and day case electives.

NHS England has written to National Health Service trusts, integrated care boards, and primary care networks to reiterate their responsibilities to their staff as employers, including providing pastoral support where required. Importantly, NHS England has also written directly to staff most affected by the recommendations, in the Response to Recommendations from the Independent Review of Physician Associates and Anaesthesia Associates (the Leng Review), available on the NHS.UK website, setting out where they can find support if required.

Implementing the recommendations will require organisations to work together and take action. Some actions will be implemented immediately, whilst others will require wider input, with benefits being fully realised over time. The Department and NHS England will work to ensure that both patient and staff needs are met throughout this process. We will also work collaboratively with other key partners to set out a clear implementation plan for making the required changes, in advance of publishing a fuller response.