NHS England has a published service specification that covers the provision of surgical interventions for individuals on the National Health Service pathway of care for the treatment of gender dysphoria. Providers are expected to follow this service specification.

The Department recognises the importance of ensuring that patients and their families are appropriately informed about treatment and tissue retention options where clinically suitable.

Consent and tissue retention arrangements are subject to requirements set out by the Human Tissue Authority and other relevant guidance. NHS England will continue to consider whether there are opportunities to improve guidance and patient information, ensuring any future approach remains clinically appropriate, legally compliant, and aligned with existing regulatory frameworks.

As set out in the Plan for Change, we are committed to returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. We met our interim target of 65% of pathways involving waits of less than 18 week in March 2026 and, as of May 2026, 65.6% are waiting less than 18 weeks. For patients waiting for ophthalmology services, 74.1% of pathways are waiting less than 18 weeks as of May 2026, an improvement on 66.1% at the start of July 2024.

We are 18 months into our Elective Reform Plan and through setting ambitious targets, investing in modernisation, reforming and simplifying pathways, increasing surgical and diagnostic capacity, and empowering patients with faster and more convenient access to care, we are seeing results. The waiting list currently stands at 7.28 million patient pathways as of May 2026, down by over 340,000 since the start of July 2024. Patients on the waiting list are prioritised at a local level based on clinical need, in line with the NHS’s core principle.

The General Medical Council (GMC) is independent of the Government, directly accountable to Parliament, and is responsible for operational matters concerning the discharge of its statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government.

The Department does not hold national datasets on what audits of consent practice have been undertaken in the National Health Service or in the independent sector, since the publication of the Paterson Inquiry Report published on 4 February 2020.

NHS England has integrated decision support tools into elective pathways of care. These tools support two stage shared decision making, which introduces a period of reflection for patients when deciding on treatment options and giving consent. This allows patients to take the time to fully understand the benefits and risks of treatment, talk with friends and family, and decide whether it is the most suitable option for them.

The Medical Practitioners Assurance Framework (MPAF) was developed by the Independent Healthcare Providers Network in response to reviews, including the Paterson Inquiry. The MPAF is designed to provide a basis from which all independent providers can work, giving confidence to patients and regulators, such as the Care Quality Commission, on what good looks like. The MPAF advises that policies need to provide for patients to be given specific time to reflect and make decisions.

NHS England has always worked with general practices to regularly review their lists and improve their accuracy. Where there is evidence that a patient may no longer be resident in the United Kingdom, NHS England initiates the standard process under which patients are contacted and given up to five months to respond before any removal action is taken.

Where a patient is identified as potentially no longer resident in England, they are contacted and given multiple opportunities to confirm or update their details. Contact may take place through a combination of letter, email, and SMS, depending on the information available. Patients can respond through a number of routes and are given sufficient time to do so before any further steps are taken. Patients are not removed from a practice list solely because they do not respond to a single communication.

The current programme ensures that patients with evidence of recent National Health Service activity are excluded before progressing further through the process. NHS England currently applies an 18‑month activity check as part of these arrangements, helping to ensure that patients actively accessing NHS services are not inappropriately identified.

I am proud of the fact that the waiting list for NHS services is more than 340,000 less than when we took office two years ago. People are being treated faster than ever before, satisfaction with GP services is increasing and we are making progress for people across this country. There is a lot more work to do, but we have laid the right foundations and are moving in the right direction.

Is the number of patients waiting for admission for an operation or procedure today higher or lower than when this Government took office?

The vast majority of people who come off the waiting list do so because they are receiving the care they need. I am confused: is the right hon. Gentleman advocating that people should stay on the waiting lists when they no longer need NHS care? Are the Opposition advocating that we should spend NHS resources chasing people who no longer need care, or should we keep the waiting lists up to date, as previous Governments have done, and ensure that everyone who needs care gets it?

Well, that was clearly no answer to my question, so let me give it: the Government’s own figures show that the number is higher. Additionally, in response to concerns that I have raised, the Office for Statistics Regulation confirmed that the published figures do not clearly distinguish between patients who are treated and those who are removed from waiting lists without treatment. With consultants now taking strike action and the situation potentially getting worse, how can the Secretary of State prove that patients are actually being seen faster, rather than that statistics are being massaged?

Left atrial appendage occlusion (LAAO) is a prescribed specialised service and is commissioned in accordance with NHS England’s published national clinical commissioning policy, which is available at the following link:

https://www.england.nhs.uk/publication/clinical-commissioning-policy-left-atrial-appendage-occlusion-for-patients-with-atrial-fibrillation-and-relative-or-absolute-contraindications-to-anticoagulation-adults/

NHS England’s regional specialised commissioners and integrated care boards are responsible for the monitoring of activity, reviewing of equity of access for their populations, and addressing variation through local oversight and clinical networks. Therefore, assessment would best be made at local levels.

For the same reason, information on the number of patients eligible for LAAO in Slough or the South East is not held centrally by the Department.

Left atrial appendage occlusion (LAAO) is a prescribed specialised service and is commissioned in accordance with NHS England’s published national clinical commissioning policy, which is available at the following link:

https://www.england.nhs.uk/publication/clinical-commissioning-policy-left-atrial-appendage-occlusion-for-patients-with-atrial-fibrillation-and-relative-or-absolute-contraindications-to-anticoagulation-adults/

NHS England’s regional specialised commissioners and integrated care boards are responsible for the monitoring of activity, reviewing of equity of access for their populations, and addressing variation through local oversight and clinical networks. Therefore, assessment would best be made at local levels.

For the same reason, information on the number of patients eligible for LAAO in Slough or the South East is not held centrally by the Department.

In April 2026, for ophthalmology, performance against the standard for 92% of patients to start first treatment within 18 weeks of referral was 73.1%, 5.3% higher than a year earlier.

In most cases, contracts will have to comply with National Health Service unit prices, a set of prices and rules used by providers of NHS care and commissioners to deliver the most efficient, cost-effective care to patients. These unit prices are consistent across independent sector providers and NHS providers. Productivity rate information is not held centrally by the Department. Integrated care boards are the primary bodies responsible for commissioning care from healthcare providers and ensuring value for money is achieved.

The Hospital Admitted Patient Care Activity dataset, published by NHS England, can be used to identify procedure types, including those undertaken as part of cataract operations. Data for the 2025/26 financial year is not yet currently published. This is currently due for publication in September 2026.

The following table shows a count of cataract operations in 2025, both those in an admitted setting, or Finished Consultant Episodes (FCEs), and outpatient settings, split by NHS and non-NHS providers where there was any cataract procedure:

Source: Hospital Episode Statistics.

A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are typically counted against the year in which they end, which is the approach we have taken here. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year. Admitted outpatient appointments include first and follow-up attendances and telephone consultations, and excludes did not attends and cancellations. The below procedure codes are those which are considered under cataract operations:

• C71: Extracapsular extraction of lens;

• C72: Intracapsular extraction of lens;

• C73: Incision of capsule of lens;

• C74: Other extraction of lens;

• C75: Prosthesis of lens; and

• C77: Other operations on lens.

“Never Events”, including wrong-site surgery, are serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations.

Providers are urged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

The NHS Never Event policy and framework, explains what a Never Event is and how staff providing and commissioning National Health Service-funded services should identify, investigate, and manage the response to a Never Event. The Care Quality Commission assess the occurrence of Never Events as an indicator to review a healthcare providers safety culture, leadership, and fundamental safety processes, using its inspection framework to undertake a systemic safety assessment when a Never Event occurs.

The National Safety Standards for Invasive Procedures were published by NHS England in September 2015 to improve the safety of invasive procedures and to reduce surgical Never Events. In 2023, the Centre for Perioperative Care updated the standards to cover a wider range of interventional specialties and place greater emphasis on organisational culture, teamwork, and human factors.

“Never Events”, including wrong-site surgery, are serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations.

Providers are urged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

The NHS Never Event policy and framework, explains what a Never Event is and how staff providing and commissioning National Health Service-funded services should identify, investigate, and manage the response to a Never Event. The Care Quality Commission assess the occurrence of Never Events as an indicator to review a healthcare providers safety culture, leadership, and fundamental safety processes, using its inspection framework to undertake a systemic safety assessment when a Never Event occurs.

The National Safety Standards for Invasive Procedures were published by NHS England in September 2015 to improve the safety of invasive procedures and to reduce surgical Never Events. In 2023, the Centre for Perioperative Care updated the standards to cover a wider range of interventional specialties and place greater emphasis on organisational culture, teamwork, and human factors.

Oversight of left atrial appendage occlusion (LAAO) activity and delivery sits with integrated care boards (ICBs) and NHS England regional commissioning teams, who work in close collaboration with cardiac networks to monitor activity and equity of access for patients across England.

NHS England therefore has not undertaken a formal national assessment of regional access to LAAO. The original Commissioning through Evaluation programme estimated demand and future growth in LAAO activity, but it was not a commissioning target. Actual activity is lower than estimated demand, reflecting the impact of COVID-19 and wider system constraints.

NHS England commissioned the National Institute for Cardiovascular Outcomes Research to develop a national LAAO registry, which is publicly available and supports transparency of activity and outcomes. Further information on the LAAO registry is available at the following link:

https://www.nicor.org.uk/interactive-reports/left-atrial-appendage-occlusion-laao-registry

Left atrial appendage occlusion is a prescribed specialised service and is commissioned in accordance with NHS England’s published national clinical commissioning policy, with further information available at the following two links:

https://www.nice.org.uk/guidance/ipg349

https://www.nice.org.uk/guidance/ng196

NHS England’s regional specialised commissioners and integrated care boards are responsible for the monitoring of activity, reviewing of equity of access for their populations, and addressing variation through local oversight and clinical network.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has had no discussions with integrated care board (ICB) leaders regarding the delivery of left atrial appendage occlusion (LAAO) since he was appointed on 14 May 2026.

NHS England’s regional specialised commissioners and ICBs are responsible for the monitoring of activity, reviewing of equity of access for their populations, and addressing variation through local oversight and clinical networks.

LAAO is a prescribed specialised service and is commissioned in accordance with NHS England’s published national clinical commissioning policy, with further information available at the following two links:

https://www.nice.org.uk/guidance/ipg349

https://www.nice.org.uk/guidance/ng196