I refer the Hon Member to the answer provided on 16 June in response to Question HL316, and to the answer provided on 3 July in response to Question 10258. There is no further update to provide at present.

The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans. Faster diagnosis is a priority under the framework. Patients with suspected gastroparesis typically undergo blood tests and imaging to exclude other causes, followed, where necessary, by a gastroscopy and tests to assess how quickly food passes through the stomach. Integrated care boards commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation, which falls within the remit of nationally commissioned services.

Addressing health inequalities for people living with rare conditions is a priority under the UK Rare Diseases Framework. In the 2026 England Rare Diseases Action Plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. However, there has not been a formal comparative assessment across the four nations in relation to their respective National Health Service provision of gastroparesis services and treatment.

The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans. Faster diagnosis is a priority under the framework. Patients with suspected gastroparesis typically undergo blood tests and imaging to exclude other causes, followed, where necessary, by a gastroscopy and tests to assess how quickly food passes through the stomach. Integrated care boards commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation, which falls within the remit of nationally commissioned services.

Addressing health inequalities for people living with rare conditions is a priority under the UK Rare Diseases Framework. In the 2026 England Rare Diseases Action Plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. However, there has not been a formal comparative assessment across the four nations in relation to their respective National Health Service provision of gastroparesis services and treatment.

The Government is committed to improving the lives of those living with rare diseases, such as gastroparesis under the UK Rare Diseases Framework. We published the fifth annual England action plan in February 2026, where we report on the steps we have taken to advance the priorities of the framework.

NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on gastroelectrical stimulation for gastroparesis. This included three evidence papers: a prospectively collected database summary from national gastroparesis registries from the US; a paper comparing surgical treatment (pyloric surgery) with gastric electric stimulation; and an outcome paper from 2011, assessing the long-term clinical outcomes of gastric electrical stimulation therapy using a single manufacturers device.

The evidence considered was more recent than that included in the original 2016 evidence review. However, NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.

NHS England does not hold data identifying the number of patients who have received gastric electrical stimulation in each of the past five years. There are a small number of patients who had an electrical stimulator inserted before the ‘not for routine commissioning’ policy was published, who will have presented to services for battery changes.

The Government is committed to improving the lives of those living with rare diseases, such as gastroparesis under the UK Rare Diseases Framework. We published the fifth annual England action plan in February 2026, where we report on the steps we have taken to advance the priorities of the framework.

NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on gastroelectrical stimulation for gastroparesis. This included three evidence papers: a prospectively collected database summary from national gastroparesis registries from the US; a paper comparing surgical treatment (pyloric surgery) with gastric electric stimulation; and an outcome paper from 2011, assessing the long-term clinical outcomes of gastric electrical stimulation therapy using a single manufacturers device.

The evidence considered was more recent than that included in the original 2016 evidence review. However, NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.

NHS England does not hold data identifying the number of patients who have received gastric electrical stimulation in each of the past five years. There are a small number of patients who had an electrical stimulator inserted before the ‘not for routine commissioning’ policy was published, who will have presented to services for battery changes.

Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.

The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.

NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.

Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.

The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.

NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.

Integrated care boards (ICBs) commission all services for patients with gastroparesis, with the exception of gastro-electrical stimulation (GES), which falls with the remit of nationally commissioned services. As these services are ICB commissioned, engagement is therefore determined at the local level.

The Government remains committed to improving outcomes for people living with rare diseases, including gastroparesis, through the UK Rare Diseases Framework and England Rare Diseases Action Plans to deliver a health and care system that works for all. In the 2026 action plan, we introduced a new and important action to address health inequalities for rare diseases through the Core20PLUS5 Framework. In addition, NHS England has published a Health Inequalities Toolkit for Highly Specialised Services.

NHS England’s Clinical Panel considered evidence submitted to review the existing commissioning policy on GES for gastroparesis. NHS England concluded that the additional evidence was limited and did not constitute a sufficiently robust clinical evidence base to support any revision to the current policy position, under which the procedure is not routinely commissioned. Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published.

NHS England does not routinely commission gastric pacemaker surgery, also known as gastro electrical stimulation, for the treatment of gastroparesis. This is because a detailed evidence review conducted in 2016 concluded that there was insufficient robust clinical evidence to demonstrate that the procedure is both clinically effective and cost‑effective for patients.

In 2021, NHS England reviewed the position relating to the surgical insertion of gastric electrical stimulators for the treatment of refractory gastroparesis. The Clinical Panel noted that whilst the evidence base presented was newer, it was still not a strong enough clinical evidence base to prompt a review of the existing policy position.

NHS England continues to keep the evidence base for specialised treatments under review, and any future commissioning decisions would be informed by new, high‑quality evidence demonstrating clear clinical and cost‑effectiveness.

In 2016, NHS England conducted a detailed evidence review and concluded that there was insufficient robust evidence to justify the routine commissioning of gastroelectrical stimulation, also referred to as a gastric pacemaker, for the treatment of gastroparesis. A copy of the policy statement which NHS England published is attached. The reason for this decision was that there was insufficient clinical evidence that the procedure is both clinically effective and cost-effective.

In April 2021, NHS England reviewed the position relating to the surgical insertion of gastric electrical stimulators for the treatment of refractory gastroparesis. The Clinical Panel noted that whilst the evidence base presented was newer, it was still not a strong enough clinical evidence base to prompt a review of the existing policy position.

Clinicians may trigger a review of NHS England’s commissioning policies if new evidence is published. NHS England remains committed to funding clinically effective treatments where they are supported by strong evidence and are affordable for the National Health Service.