There are no plans to ask the National Institute for Health and Care Excellence (NICE) to establish a fast-track approval process for COVID-19 treatments. NICE evaluates all new licensed medicines, including COVID-19 treatments, and aims wherever possible to issue guidance close to the time of licensing to ensure that National Health Service patients can benefit from rapid access to safe and effective medicines. The aligned pathway between NICE and the Medicines and Healthcare products Regulatory Agency launched on 1 April 2026 and allows decisions on licensing and value to be published in parallel, with the aim of bringing clinically and cost-effective new medicines to patients three to six months sooner.

As the former Secretary of State for Health and Social Care told the House on 17 March in the context of the meningococcal disease outbreak in Kent, the Joint Committee on Vaccination and Immunisation (JCVI) has been asked to re-examine eligibility for meningitis vaccines to assess, for example, an expanded offer to older children and/or young adults. The JCVI will provide updated advice to the Department this summer around whether, and to what extent, a vaccine programme for older children and/or young adults would be clinically effective.

Immunocompromised individuals at highest risk of invasive meningococcal disease, i.e. individuals with asplenia, splenic dysfunction or complement disorders, are already eligible for MenB and MenACWY vaccination. Details of this can be found within ‘box 7.1 Practical schedule for immunising individuals with asplenia, splenic dysfunction or complement disorders’ of the Green Book chapter ‘Immunisation of individual with underlying medical conditions’, which is available at the following link:

https://www.gov.uk/government/publications/immunisation-of-individuals-with-underlying-medical-conditions-the-green-book-chapter-7

The JCVI gives advice to ministers based on the best evidence, reflecting current good practice and/or expert opinion. This involves a robust, transparent, and systematic appraisal of the available evidence from a wide range of sources. The JCVI aims to work with key stakeholders while maintaining the independence of committee processes and considerations.

The Pathways to Work Green Paper outlined our plan to end the link between capacity to work and additional financial support and the binary categorisation of claimants as “can or can’t work” by abolishing the Work Capability Assessment (WCA). Instead, any extra financial support for health conditions in Universal Credit (UC) will be assessed via a single assessment – the Personal Independence Payment (PIP) assessment (in England and Wales) – and be based on the impact of disability on daily living, not on capacity to work.

Due to its link with the PIP assessment, WCA abolition will not take place until after the Timms Review into PIP has reported. We are currently considering how the future system will operate and will provide further information in due course.

Statutory Sick Pay (SSP) is designed to balance support for an individual when they are unable to work due to sickness or ill health, with the costs to employers of providing this support. The Government is strengthening SSP as part of our plan to Make Work Pay, ensuring the safety net of sick pay is available to those who need it most. We are doing this through the Employment Rights Act. From 6 April this year the changes we are making include:

• Removing the Lower Earnings Limit so more low-paid employees qualify.
• Removing the waiting period so SSP is paid from the first day of sickness.

As a result, up to 1.3 million low-paid employees will become eligible for SSP. The removal of the three-day waiting period will mean that all employees receive at least £60 extra at the start of their sickness absence. According to the Government’s impact assessment, these changes will also increase the total amount of sick pay paid to employees by approximately £420 million per year.

For PIP awards, we always aim to make an award decision as quickly as possible, taking into account the need to review all available evidence, including that from the claimant.  In most instances PIP awards can be backdated to the date of claim. 

PIP waiting times have decreased since August 2021, with the latest statistics showing that the average end-to-end journey has reduced from 26 weeks in August 2021 to 16 weeks at the end of October 2025.

As part of the Government’s external engagement for Exercise PEGASUS, views from organisations advocating for immunosuppressed individuals were gathered through a series of focus groups. These groups also included a range of organisations representing disabled people, clinically vulnerable groups, and wider equality focused bodies. Given participants’ contributions directly inform the assessment of the exercise, the Government has agreed to keep the identities of these organisations anonymous.

The pandemic scenario designed in Exercise PEGASUS and given to participants was based on the emergence and spread of a novel pathogen and provided a realistic representation of its impact on the United Kingdom’s population, including those with existing conditions. The exercise included the circulation of existing pathogens such as COVID-19. Focus groups and surveys were carried out after each core exercise day to test the public reaction to the decisions taken by officials and ministers, and respondents were drawn from a broad cross-section of society, including those who were immunocompromised.

Exercise PEGASUS, the largest simulation of a pandemic in the United Kingdom’s 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 in the pharmaceutical sector and focus groups on clinically vulnerable patient populations. These groups have included the views of mental health organisations and organisations advocating for immunosuppressed individuals.

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.

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.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of severe illness, involving hospitalisation and/or death, arising from COVID-19.

The JCVI’s advice for autumn 2024 noted that in the era of high population immunity to COVID-19, and with all cases due to highly transmissible Omicron sub-variants, any protection offered by the vaccine against the transmission of infection from one person to another was expected to be extremely limited. On this basis, the JCVI did not advise offering vaccination to household contacts of people with immunosuppression. The Government accepted the JCVI’s advice for autumn 2024, with both the advice and the Government’s response available at the following link:

https://www.gov.uk/government/news/government-accepts-advice-on-2024-autumn-covid-vaccine-programme

Household contacts were therefore not offered vaccination in the autumn 2024 campaign. On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme covering vaccination in 2025 and spring 2026. In line with its advice for the autumn 2024 campaign, the JCVI did not advise COVID-19 vaccination for household contacts of people with immunosuppression. This advice is available at the following link:

https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026

The Government accepted the JCVI’s advice on eligibility for the spring and autumn 2025 COVID-19 vaccination programme. The Government is considering the advice for spring 2026 carefully and will respond in due course.

Those with concerns are advised to discuss these with their general practitioner or healthcare professional.

NHS England, in partnership with the UK Heath Security Agency and the Department, has developed a suite of communications resources to encourage eligible people to get their autumn and winter vaccinations. As part of this, NHS England has produced a variety of posters and digital-screens, as well as a factsheet specifically designed for pharmacies to support conversations with individuals about eligibility for a COVID-19 vaccine.

The COVID-19 vaccine is offered to those in the population most vulnerable to serious outcomes from COVID-19 and who are therefore most likely to benefit from vaccination. For autumn and winter 2025/26, the COVID-19 vaccination is offered to:

- residents in a care home for older adults;

- all adults aged 75 years old and over; and

- persons aged six months and over who are immunosuppressed, as defined in tables three and four of the COVID-19 chapter of the Green Book, which is available at the following link:
https://assets.publishing.service.gov.uk/media/68b5be03536d629f9c82a97d/Green-book-chapter-COVID-19_1_9_25.pdf.

The COVID-19 vaccine is offered to those in the population most vulnerable to serious outcomes from COVID-19 and who are therefore most likely to benefit from vaccination. For autumn and winter 2025/26, the COVID-19 vaccination is offered to:

- residents in a care home for older adults;

- all adults aged 75 years old and over; and

- persons aged six months and over who are immunosuppressed, as defined in tables three and four of the COVID-19 chapter of the Green Book, which is available at the following link:
https://assets.publishing.service.gov.uk/media/68b5be03536d629f9c82a97d/Green-book-chapter-COVID-19_1_9_25.pdf.

NHS England, in partnership with the UK Heath Security Agency and the Department, has developed a suite of communications resources to encourage eligible people to get their autumn and winter vaccinations. As part of this, NHS England has produced a variety of posters and digital-screens, as well as a factsheet specifically designed for pharmacies to support conversations with individuals about eligibility for a COVID-19 vaccine.

National invitations are designed to supplement local invitations, to ensure the National Health Service reaches as many people as possible who may be eligible. For COVID-19 vaccinations, everyone aged five to 74 years old whose NHS record suggests they may be immunosuppressed due to a medical condition or treatment, and all those eligible by age, are contacted.

Eligible people are able to book via the National Booking Service or by calling 119. For those that are uncertain, they can book an appointment and discuss their eligibility with a clinician at the appointment.

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert committee which reviews the latest data on COVID-19 risks, vaccine safety, and effectiveness and advises the government on eligibility for vaccination and immunisation programmes. The JCVI has published advice for future COVID-19 vaccination campaigns in autumn 2025, spring 2026, autumn 2026, and spring 2027. The government has accepted JCVI advice for autumn 2025. The Government is considering the JCVI’s advice for 2026 and spring 2027 carefully and will respond in due course.

The primary aim of the national COVID-19 vaccination programme remains the prevention of serious disease (hospitalisations and deaths) arising from COVID-19. The JCVI assessment indicates that the oldest age cohorts and individuals who are immunosuppressed are the two groups who continue to be at higher risk of serious disease.

Therefore, in autumn 2025, a COVID-19 vaccination will be offered to:

• adults aged 75 years and over;
• residents in a care home for older adults;
• individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).

The JCVI has advised that more recent data are needed to assess whether any other population groups under the age of 75 years with specific clinical comorbidities, such as type 1 diabetes, are at similar risk of serious disease as those aged 75 years and over.

The JCVI continues to review evidence and may update its advice in future.

The Department has made no assessment of the reasons for the price difference between ciclosporin and other generic immunosuppressant drugs sold in United Kingdom pharmacies compared to other countries.

The UK has well established mechanisms to control the level of spend on branded medicines. The voluntary scheme for branded medicines pricing, access, and growth and the statutory scheme for branded medicines, control the growth in sales of branded medicines, and the National Institute for Health and Care Excellence’s evaluations ensure that spend on new medicines represents a clinically and cost-effective use of National Health Service resources.

For generic medicines, the Government’s policy is freedom of pricing. Community pharmacies buy the drugs they need to dispense against NHS prescriptions and are reimbursed for these according to the prices and ‘rules’ as set out in the Drug Tariff. The reimbursement arrangements include an amount of medicines margin in 2025/26, as allowed for as part of Community Pharmacy Contractual Framework funding. The system incentivises pharmacy contractors to source items as cheaply as possible, so they individually get to keep more medicine margin. This leads to competition and downward pressure on selling prices, which in turn leads to lower reimbursement prices and lower costs to the NHS.