The referral mechanism in the Financial Services and Markets Bill is designed to ensure consistent application of the standards set by the Financial Conduct Authority (FCA) in Financial Ombudsman Service (FOS) determinations. It will support the efficient resolution of complex complaints where the FOS considers there is ambiguity in a relevant FCA rule and that is relevant to its determination of a complaint, while preserving the FOS’s ability to resolve the vast majority of complaints without making a referral.

The exact number of referrals will depend on the issues which arise in FOS casework and the extent to which it considers these raise ambiguity or wider implications for financial services firms and consumers. The Government expects that there may be relatively more referrals initially, which will then reduce as clarifications are provided by the FCA – with only a very small proportion of cases being referred even in the early stages.

To prepare for the changes, the FCA and the FOS are operating a trial version of the referral mechanism, which is limited to issues with wider implications. Since July 2025, when they updated their Memorandum of Understanding to agree the trial version, the FOS has made three referrals to the FCA. While the Government would expect more referrals once the new framework covering ambiguity is in place, this supports an assessment that overall volumes will be manageable.

The Bill allows HM Treasury to specify further conditions that must be met for the FOS to make a referral through a statutory instrument. This will allow the Government to address any potential issues that arise during implementation, including making sure that the volume of referrals remains reasonable and supports efficient resolution of cases.

The Bill provides for HM Treasury to set in regulations a timeframe for the FCA to respond to a referral to avoid unnecessary delays. The Government’s consultation response, published on 16 March 2026, confirms its intention is to set this timeframe at 30 days in most cases.

Data related to the performance of specialised services is factored into other performance processes undertaken by the National Health Service. In 2025/26, this will include monitoring performance using the NHS Performance Assessment Framework. A consultation on the draft NHS Performance Assessment Framework was launched on 12 May 2025. Further information on the framework is available on the NHS.UK website, in an online only format.

The framework will monitor the performance of NHS organisations and will publish an assessment of how well each organisation is considered to be delivering against the framework’s metrics. The proposed metrics include organisational performance in meeting certain NHS Constitution rights, such as the right to start consultant led treatment within 18 weeks, which applies equally to specialised and non-specialised NHS services.

NHS England receives monthly management information on commissioner and provider expenditure. This identifies spend on specialised services, both where they are delegated to integrated care boards or retained by NHS England.

NHS England's Executive has commissioned a review of all direct commissioning functions to determine where accountability and responsibility should sit in future and how these functions can most effectively be supported. The review is due to be completed by the end of June 2025 following which decisions and next steps will be publicly communicated.

NHS England is committed to working closely with stakeholders on the future of all its direct commissioning functions and will use strong and well-established patient and public involvement mechanisms to secure engagement and involvement.

With the review to be completed by the end of June 2025, NHS England direct commissioning teams will meet directly with charities, patient organisations and professional organisations, including through the Specialised Services Stakeholder Forum, to engage and seek advice on the review.

NHS England’s specialised commissioning uses a range of data to support quality oversight and assurance, which includes Specialised Services Quality Dashboards (SSQDs), National Clinical Audits for some services, and the triangulation of other clinical quality and safety information. The metadata for the SSQDs is already publicly available on NHS England’s website. National Clinical Audit reports, which are commissioned and managed by NHS England, are also publicly available on the Healthcare Quality Improvement

Partnership’s website, and cover some specialised services.

NHS England is actively exploring ways to publish metrics from SSQDs, ensuring that they align with the development and release of service specifications, and are updated regularly. Publication decisions on SSQDs will continue to consider information governance requirements, for example, where patient numbers are small and potentially identifiable.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.

Joint forward plans (JFPs) are produced by integrated care boards (ICBs) and are publicly available on the respective websites of the ICBs. The Government does not hold any central records of these JFPs and there are no plans to place copies of the JFPs in the Library of the House.

As we take forward the work to integrate NHS England into the Department, we will continue to analyse and assess impacts of all kinds. This will include putting in place plans to ensure continuity of specialised services, with patient safety at the forefront of our work.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. NHS England and the Department are strongly supportive of clinical leadership and recognise the critical need to incorporate clinical expertise into our work. The national clinical directors are a key part of this approach and play an important role in policy development and implementation.

We are currently in the initial phases of scoping and designing a new integrated Department that aims to enhance the efficiency and effectiveness of our healthcare system. As part of this process, we are carefully considering the future role of national clinical directors. While no specific decisions have been made yet, we are open to considering the benefit of appointing a National Clinical Director for Rare Diseases following the integration of NHS England into the Department, subject to funding arrangements.

The Department funds research and research infrastructure, which supports patients and the public to participate in high-quality research across the United Kingdom, through the National Institute of Health and Care Research (NIHR).

Development and delivery of research in the pharmaceutical sector is supported and enabled nationwide through NIHR infrastructure, including the NIHR Research Delivery Network, the NIHR Clinical Research Facilities, the NIHR Biomedical Research Centres, and the newly designated NIHR Commercial Research Delivery Centres. These all support the delivery of clinical research through facilities, staff resource, collaborations, and funding.

In order to maximise our potential to be a world leader and develop a more competitive, efficient, and accessible clinical research system, the Department is committed to implementing recommendations from the Lord O'Shaughnessy independent review of commercial clinical trials in full. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the UK, to provide innovative treatment options for patients.

My Lords, we are committed to delivering an alternative student finance product that is compatible with Islamic finance principles as quickly as we can. We are making good progress to achieve this. This month we are reconvening the alternative student finance working group for its first meeting since the election, which I am grateful to the noble Lord for being part of. We have also appointed a secretariat to take forward the sharia certification of the product.

Assessments regarding the effectiveness of competition on cross-Solent ferry services are a matter for the Competition and Markets Authority, which is independent of the Government. Decisions on which markets to investigate sit with its board.

The Department continues to engage directly with key stakeholders, including Islanders and ferry companies.

On 16 January 2024, under the previous Government, HM Treasury published a consultation proposing changes to the Capital Gains Tax (CGT) rules that apply to alternative financial arrangements. The consultation closed on 9 April 2024 and this Government is carefully considering all responses. A response document will be published in due course.

The government is aware of a difference in tax treatment when a commercial or residential property is refinanced using alternative rather than conventional finance methods. In these situations, a capital gains liability may arise for those using alternative financing, when this would not have been the case for those using conventional financing. The refinancing of main homes is unaffected as Private Residence Relief (PRR) applies.

On 16 January 2024, the government published the Tax Simplification for Alternative Finance consultation to seek views on reforms that would address the capital gains issue. The consultation closed on 9 April 2024 and all responses will be carefully considered and a summary of responses will be published in due course together with details of the next steps.

The government seeks to ensure that there is a fair and robust migration policy, whilst maintaining the UK’s place as a top destination for the best and brightest students from around the world. The department remains committed to the ambitions set out in the government’s International Education Strategy to host 600,000 international students per year and to increase the value of our education exports to £35 billion per year, both by 2030.

The department expects the UK to remain a highly attractive study destination. The UK has four universities in the top 10, and 17 in the top 100. The UK has a highly sought after higher education (HE) experience, which is respected by students across the globe. The department is hugely proud to have met its international student recruitment ambition two years running.

However, the level of legal migration remains too high. As a result, on 4 December 2023, the government announced a new package of measures to reduce net migration and curb abuse and exploitation of the country’s immigration system. The department continues to work closely with the Home Office, Department for Business and Trade, and other governmental departments to assess the impact of these changes on HE providers.

HE providers are autonomous bodies, independent from government. As such, they are responsible for their own admissions decisions. The government takes a close interest in ensuring that the HE admissions system is fair and works closely with HE providers and sector bodies to make sure the system works well for students.

The Treasury has statutory powers to issue directions to the Bank of England, which can only be used under specific conditions or circumstances. None of the powers outlined below have ever been used.

• Under section 4 of the Bank of England Act 1946, the Treasury may direct the Bank, after consultation with the Governor, to action that is deemed to be necessary in the public interest. This power of direction applies to all of the Bank’s activities, with the exception of monetary policy and the exercise of the Bank’s functions as the Prudential Regulation Authority (PRA).

• Under section 19 of the Bank of England Act 1998, the Treasury may by order, after consultation with the Governor, direct the Bank with respect to monetary policy if it is deemed to be in the public interest and required by extreme economic circumstances.

• Under section 410 of the Financial Services and Markets Act 2000, the Treasury may direct the PRA and the Bank to not take an action that would be incompatible with the UK’s international obligations.

• Under Section 61 of the Financial Services Act 2012, the Treasury may direct the Bank on specific measures relating to the assistance to or stabilisation of financial institutions.

The Bank of England also has powers to direct the Prudential Regulation Authority (PRA), Financial Conduct Authority (FCA) and Payment Systems Regulator (PSR).

• Under section 9H of the Bank of England Act 1998, the Bank of England’s Financial Policy Committee (FPC) has powers of direction over the PRA and FCA (limited to the use of specific macroprudential tools). To date, the FPC has only ever used this power to implement the Leverage Ratio.

• Under sections 9Y and 9Z of the Bank of England Act 1998, the Bank may direct the FCA to provide documents or information that the Bank reasonably requires for its financial stability functions. This power has never been used.

• Under section 100 of the Financial Services (Banking Reform) Act 2013, the Bank has the power to direct the PSR not to exercise its powers, under specific circumstances. This power has never been used.

The Treasury has statutory powers to issue directions to the Bank of England, which can only be used under specific conditions or circumstances. None of the powers outlined below have ever been used.

• Under section 4 of the Bank of England Act 1946, the Treasury may direct the Bank, after consultation with the Governor, to action that is deemed to be necessary in the public interest. This power of direction applies to all of the Bank’s activities, with the exception of monetary policy and the exercise of the Bank’s functions as the Prudential Regulation Authority (PRA).

• Under section 19 of the Bank of England Act 1998, the Treasury may by order, after consultation with the Governor, direct the Bank with respect to monetary policy if it is deemed to be in the public interest and required by extreme economic circumstances.

• Under section 410 of the Financial Services and Markets Act 2000, the Treasury may direct the PRA and the Bank to not take an action that would be incompatible with the UK’s international obligations.

• Under Section 61 of the Financial Services Act 2012, the Treasury may direct the Bank on specific measures relating to the assistance to or stabilisation of financial institutions.

The Bank of England also has powers to direct the Prudential Regulation Authority (PRA), Financial Conduct Authority (FCA) and Payment Systems Regulator (PSR).

• Under section 9H of the Bank of England Act 1998, the Bank of England’s Financial Policy Committee (FPC) has powers of direction over the PRA and FCA (limited to the use of specific macroprudential tools). To date, the FPC has only ever used this power to implement the Leverage Ratio.

• Under sections 9Y and 9Z of the Bank of England Act 1998, the Bank may direct the FCA to provide documents or information that the Bank reasonably requires for its financial stability functions. This power has never been used.

• Under section 100 of the Financial Services (Banking Reform) Act 2013, the Bank has the power to direct the PSR not to exercise its powers, under specific circumstances. This power has never been used.