Safety is key, and so are the experiences of women and their families. The noble Baroness and the House will be well aware of the national maternity and neonatal plan, which will drive proper, sustained improvement across the system. This is what I believe we have been lacking for years, and it is why we asked the noble Baroness, Lady Amos, to conduct an independent review. She has reported on that and the maternity and neonatal plan will be announced by the end of this year. I certainly look forward to that; it is being worked on as we speak, involving both clinicians and those with lived experience, as well as campaigning organisations and all those with an interest. I am feeling positive about how we move forward, and the point made by the noble Baroness about staffing and ratios will of course be part of that.

NHS England has not entered into any commercial agreements involving indication-specific pricing for kidney conditions, or for rare kidney conditions, between June 2021 and July 2026. However, during this period, NHS England has entered into three commercial agreements involving indication-specific pricing for kidney cancer indications, including renal cell carcinoma indications.

NHS England regularly engages with patient groups, including the Charity Medicines Access Coalition, Genetic Alliance UK, and the Neurological Alliance, whose members represent people living with a wide range of rare conditions. More recent engagement has included patient groups representing people with conditions such as spinal muscular atrophy, muscular dystrophy, and motor neurone disease, where National Institute for Health and Care Excellence technology appraisals have been undertaken or are ongoing.

As part of the upcoming consultation on updates to the NHS Commercial Framework for New Medicines, NHS England will seek views from a broad range of patient organisations, including those representing people with rare diseases.

The NHS England Genomics Education Programme provides education and training to support healthcare professionals in the use of genomic medicine. Working with the NHS Genomic Medicine Service, it delivers a national education programme designed to build genomic knowledge and skills across the healthcare workforce.

As part of this offer, the programme has developed GeNotes, a multi-professional clinical resource that supports clinicians to identify when genomic testing is appropriate, order the correct test, interpret results, and communicate them to patients. GeNotes aligns with the National Genomic Test Directory and provides both point-of-care guidance and more in-depth learning opportunities.

The resource includes educational material relevant to pancreatic cancer, including guidance to support clinicians managing patients with pancreatic cancer who may benefit from genomic testing and the interpretation of genomic results.

NHS England continues to work with healthcare professionals, academics, and professional organisations to ensure genomic education and training resources remain up to date and support the appropriate use of genomics across healthcare services.

NHS England has not entered into any commercial agreements involving indication-specific pricing for kidney conditions, or for rare kidney conditions, between June 2021 and July 2026. However, during this period, NHS England has entered into three commercial agreements involving indication-specific pricing for kidney cancer indications, including renal cell carcinoma indications.

NHS England regularly engages with patient groups, including the Charity Medicines Access Coalition, Genetic Alliance UK, and the Neurological Alliance, whose members represent people living with a wide range of rare conditions. More recent engagement has included patient groups representing people with conditions such as spinal muscular atrophy, muscular dystrophy, and motor neurone disease, where National Institute for Health and Care Excellence technology appraisals have been undertaken or are ongoing.

As part of the upcoming consultation on updates to the NHS Commercial Framework for New Medicines, NHS England will seek views from a broad range of patient organisations, including those representing people with rare diseases.

It has historically been difficult to gather accurate and comprehensive data on miscarriages. While data is collected on those miscarriages that occur during hospital stays, the majority occur outside of healthcare settings, and it is the choice of the woman affected whether she discloses that information to healthcare professionals.

The planned introduction of the new Single Patient Record (SPR) is an important step towards one, comprehensive health record for every patient, and this will start with maternity. The SPR will initially capture some, though not all, miscarriage data, and we will continue to consider this as implementation progresses.

It has historically been difficult to gather accurate and comprehensive data on miscarriages. While data is collected on those miscarriages that occur during hospital stays, the majority occur outside of healthcare settings, and it is the choice of the woman affected whether she discloses that information to healthcare professionals.

The planned introduction of the new Single Patient Record (SPR) is an important step towards one, comprehensive health record for every patient, and this will start with maternity. The SPR will initially capture some, though not all, miscarriage data, and we will continue to consider this as implementation progresses.

Yes, I am very pleased to do that. I point to the National Healthtech Access Programme, which is exactly what the noble Baroness is seeking. It is a route for cost-effective and clinically effective technologies, such as the one the noble Baroness describes, so that we can see the best benefit to patients and the best value, and that supports more equitable access. NICE is currently assessing three projects, including using AI in histopathology for the diagnosis of prostate cancer and breast cancer, to give two examples, and we will shortly see the publication of those results.

Whilst it is possible, it is not mandatory for trusts to record second trimester miscarriage through the Maternity Services Data Set (MSDS). The requirements for the next iteration for the MSDS include more detailed data collection around pregnancy outcomes, including on miscarriage. Timescales for this next iteration are yet to be confirmed.

There are no specific plans to update the Digital Maternity Record Standard at present, as the current version has yet to be fully implemented by all maternity system suppliers. However, this will be considered as part of wider maternity data architecture design work, which will also support the MSDS and the Single Patient Record.

Whilst it is possible, it is not mandatory for trusts to record second trimester miscarriage through the Maternity Services Data Set (MSDS). The requirements for the next iteration for the MSDS include more detailed data collection around pregnancy outcomes, including on miscarriage. Timescales for this next iteration are yet to be confirmed.

There are no specific plans to update the Digital Maternity Record Standard at present, as the current version has yet to be fully implemented by all maternity system suppliers. However, this will be considered as part of wider maternity data architecture design work, which will also support the MSDS and the Single Patient Record.

There are a number of aspects to that area. We have greatly increased the mandatory training requirement and the numbers who have been trained. The noble Baroness also points to the importance of a multidisciplinary approach. We have seen an increase in nursing staff in that regard. It is a matter for the local provider to decide, but the workforce plan, which we will be seeing soon, will be very helpful in this regard.

National Highways committed to add over 150 new emergency areas on existing All Lane Running smart motorways by the end of March 2025, prioritising locations where these would provide the greatest benefit and could be delivered within the £390 million budget. The table below sets out the number of additional emergency areas delivered on each relevant motorway section.

On average, across the programme, an emergency area costs approximately £2.6 million to construct (pending final accounts). Individual emergency areas have varying design requirements, including topography, requirement for supporting structures, drainage, and technology, which mean they can cost less or more than the expected average to construct.

National Highways has recently commenced work on the M1 between junctions 16 and 19 to undertake remedial works to strengthen embankments adjacent to four new emergency areas. These works are expected to be completed by August 2026. As a result, programme close-out activities have been extended and final costs for the National Emergency Area Retrofit programme are now expected to be available in Spring 2027, subject to final accounting and internal governance.

In October 2025, NHS England set out the expectation, through the Medium Term Planning Framework, for trusts to implement the National Bereavement Care Pathway for stillbirth and neonatal death. In practice, some of these standards will also be applicable in the context of miscarriage, ectopic pregnancy, and molar pregnancy, offering support for these women and families.

While miscarriage and other types of pregnancy loss were not explicitly covered in Baroness Amos’ final report into National Health Service maternity and neonatal care, she did make a recommendation around fundamentally reforming care, including through the development of a new modern service framework. The taskforce will consider all stages of maternity and neonatal care when developing its new national action plan, and we anticipate that the taskforce may wish to include pregnancy loss.

We are also working closely with NHS England to improve the availability of Early Pregnancy Assessment Units, and have extended the Baby Loss Certificate scheme, which provides recognition of pre-24-week loss.

In October 2025, NHS England set out the expectation, through the Medium Term Planning Framework, for trusts to implement the National Bereavement Care Pathway for stillbirth and neonatal death. In practice, some of these standards will also be applicable in the context of miscarriage, ectopic pregnancy, and molar pregnancy, offering support for these women and families.

While miscarriage and other types of pregnancy loss were not explicitly covered in Baroness Amos’ final report into National Health Service maternity and neonatal care, she did make a recommendation around fundamentally reforming care, including through the development of a new modern service framework. The taskforce will consider all stages of maternity and neonatal care when developing its new national action plan, and we anticipate that the taskforce may wish to include pregnancy loss.

We are also working closely with NHS England to improve the availability of Early Pregnancy Assessment Units, and have extended the Baby Loss Certificate scheme, which provides recognition of pre-24-week loss.

In developing the Modern Service Framework for Frailty and Dementia, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with dementia.

As part of this exercise, we will consider what interventions should be supported to improve diagnosis waiting times, which we know are too long in many areas. We are considering all options to help reduce variation, including reviewing metrics and targets.

The modern service framework will identify the best evidenced interventions that would support progress towards an outcome goal and set standards on how those interventions should be used.

We have rolled this out further, as we inherited a more limited coverage of fracture liaison services than we have currently, and we are looking at how to improve access. As I said to the noble Lord, 23 out of 25 ICBs have at least one fracture liaison service. We will push this forward

through various means, including the Best Practice Guide for NHS Frailty Pathways, which recommends comprehensive neighbourhood-level frailty plans, and the modern service framework, to mention a couple of ways. I have to emphasise that this is about a complete change in the delivery of NHS services, from which fracture liaison will greatly benefit.