The evidence review is expected to be completed during the second half of 2027, and the findings will be published shortly thereafter. We will consider the evidence as appropriate to inform future policy development.

The NHS Health Check Online is in the private Beta testing phase and is being piloted in local authorities across England. Insights from the testing phase will inform decisions on next steps such as whether further development is needed.

Department officials are considering opportunities to improve the NHS Health Check programme as part of ongoing policy work for the programme. We continue to engage with the programme’s dedicated Advisory Group and its Scientific and Clinical subgroup, ensuring expert advice is at the centre of any future proposals.

Alongside this, as announced in the recently published Cardiovascular Disease Modern Service Framework, we have commissioned the National Institute for Health and Care Research to conduct an evidence review on the scope of the NHS Health Check to inform future policy decisions.

The NHS Health Check (NHS HC) programme is commissioned by local authorities who are responsible for offering 100% of their eligible resident population a check every five years.

The Government's Public Health Grant to local authorities is used to enable the programme's provision and allows local authorities to ensure that delivery of the NHS HC is aligned with local public health services and fits their local population.

The programme's Best Practice Guidance provides commissioners and their providers with information on how to deliver the programme effectively, and how to adopt a proportionate universalist approach to ensure that checks are delivered in a way that prioritises resources and effort towards engaging people at higher risk of cardiovascular disease.

Department officials are considering options to improve the NHS HC programme.

The NHS Health Check Online (NHSHC-O) is in the private Beta testing phase and is being piloted in 11 local authorities across England. As part of the NHSHC-O, users receive a self-sampling capillary blood testing kit, delivered to their home, to measure cholesterol, and, if appropriate, HbA1c. Samples are then sent to a United Kingdom Accreditation Service accredited laboratory for assessment.

All results from the NHSHC-O are automatically written back into the patient's electronic health record. General practices are notified if a patient's results indicate that further assessment is necessary and, if required, undertake further clinical investigation and treatment where appropriate, in line with existing clinical pathways.

The NHS Health Check (NHS HC) aims to improve the health and wellbeing of adults aged 40 to 74 years old through the promotion of early awareness, assessment, and management of the major risk factors for cardiovascular disease (CVD), risk factors that are associated with premature death, disability, and health inequalities in England. Improving uptake of the programme, including for people at the highest risk and experiencing inequalities, is a priority for the programme.

The NHS Health Check Online is currently being tested in 11 local authorities across England and aims to increase access and engagement with the programme for all population groups, by allowing people to undertake their NHS Health Check at home, at a time and place convenient to them, freeing up in-person NHS HCs for those who want or need more support.

The recently published Cardiovascular Disease Modern Service Framework (CVD MSF) sets out the 10-year ambition to systematically identify individuals with established or emerging cardiovascular, kidney, and metabolic risk factors, including via the NHS HC, whilst reducing the variation in the number of people receiving a check between the best and worst performing areas nationally. A delivery plan will be published later this year to support local implementation of the CVD MSF.

The NHS Health Check programme, a core component of England's cardiovascular disease (CVD) prevention programme, assesses the top risk factors for CVD, including raised cholesterol, in eligible people and refers them to further support through behavioural interventions, clinical assessment, and treatment where appropriate. For every 1.4 million NHS Health Checks delivered annually, 900,000 people are found to have raised cholesterol level. We are also developing the NHS Health Check Online to improve access and help more people understand and act on their risk factors.

Furthermore, NHS England is strengthening lipid management by improving identification of people at risk of CVD through risk assessment, case finding, and community-based initiatives, including pharmacy-led approaches and cholesterol point of care testing.

The Government recently published the Cardiovascular Disease Modern Service Framework, which sets out priorities for the health and care system to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within the next decade. Identifying people with high cholesterol and optimising lipid management for people with high cholesterol are amongst the priorities for the health and care system.

The National Health Service has a national infrastructure in place to deliver genomic testing through the NHS Genomic Medicine Service (NHS GMS), including a national network of seven NHS Genomic Laboratory Hubs (NHS GLHs). These hubs deliver testing as set out in the National Genomic Test Directory, which includes tests for over 200 cancer clinical indications, including whole genome sequencing and other genomic tests.

The National Cancer Plan commits to ensuring that all cancer patients who would benefit receive a genomic test within a clinically relevant timeframe. Delivery of this ambition will be supported through the continued expansion and integration of the NHS GMS across cancer pathways.

As set out in the plan, over the next five years the service will extend circulating tumour DNA and other biomarker testing to additional cancers. The scope of testing will continue to be reviewed, with additional biomarker tests brought into routine use where clinically appropriate and cost effective.

NHS England has also undertaken procurement for NHS GMS Lead Providers from 2026 to support a new delivery model and strengthen genomic testing capacity. In addition, the NHS Genomics Education Programme is supporting workforce planning to ensure the NHS has the capacity and skills required to deliver genomic medicine.

The UK National Screening Committee has undertaken several reviews of the evidence on screening for vasa praevia (VP), with the latest in 2023. These have included international evidence. The committee has also undertaken, and published, a modelling exercise to explore the way in which the findings from international evidence might play out in the United Kingdom’s population, titled The impact of ultrasound-based antenatal screening strategies to detect vasa praevia in the United Kingdom: An exploratory study using decision analytic modelling methods. This concluded that testing for VP in one of the known risk groups might help reduce VP in the UK while providing an opportunity to find out more about the condition.

The UK NSC has not previously considered the ethical implications of requiring randomised controlled trial (RCT) evidence for VP, as it has not insisted on this level of evidence. Even in the absence of screening, VP is a rare outcome.

The committee recognises the challenges of generating robust evidence in the context of rare conditions, for example, the criterion relating to RCT evidence is not applied rigidly in evaluations of rare diseases. Nevertheless, the committee requires an appropriate level of evidence to be confident that a screening programme would deliver more benefit than harm.

The committee remains open to ongoing dialogue with researchers and clinicians on how best to strengthen the evidence base and improve understanding of this condition.

The UK National Screening Committee has undertaken several reviews of the evidence on screening for vasa praevia (VP), with the latest in 2023. These have included international evidence. The committee has also undertaken, and published, a modelling exercise to explore the way in which the findings from international evidence might play out in the United Kingdom’s population, titled The impact of ultrasound-based antenatal screening strategies to detect vasa praevia in the United Kingdom: An exploratory study using decision analytic modelling methods. This concluded that testing for VP in one of the known risk groups might help reduce VP in the UK while providing an opportunity to find out more about the condition.

The UK NSC has not previously considered the ethical implications of requiring randomised controlled trial (RCT) evidence for VP, as it has not insisted on this level of evidence. Even in the absence of screening, VP is a rare outcome.

The committee recognises the challenges of generating robust evidence in the context of rare conditions, for example, the criterion relating to RCT evidence is not applied rigidly in evaluations of rare diseases. Nevertheless, the committee requires an appropriate level of evidence to be confident that a screening programme would deliver more benefit than harm.

The committee remains open to ongoing dialogue with researchers and clinicians on how best to strengthen the evidence base and improve understanding of this condition.

Yes, I can give that commitment.

The NHS Health Check aims to detect those at risk of chronic kidney disease (CKD) by testing for key risk factors such as high blood pressure. The programme does not undertake the tests required to diagnose CKD. As a result, data on the number of individuals who are subsequently tested for CKD is not currently collected.

However, general practitioners (GPs) assess the results of an individual’s NHS Health Check and then undertake further clinical investigation, such as urine albumin to creatinine ratio tests for CKD, if required.

Information regarding CKD treatment pathways is collected via a national auditing tool of GP records called ‘CVDPREVENT’. Department officials are carefully considering opportunities to enhance data monitoring for the NHS Health Check as part of the National Audit Office recommendation.

Alongside this, we plan to publish the Cardiovascular Disease Modern Service Framework shortly. During the framework’s development, Department officials are considering opportunities for earlier detection, diagnosis, and management of cardiovascular, kidney, and metabolic risk factors strongly associated with cardiovascular disease.

The NHS Health Check aims to detect those at risk of chronic kidney disease (CKD) by testing for key risk factors such as high blood pressure. The programme does not undertake the tests required to diagnose CKD. As a result, data on the number of individuals who are subsequently tested for CKD is not currently collected.

However, general practitioners (GPs) assess the results of an individual’s NHS Health Check and then undertake further clinical investigation, such as urine albumin to creatinine ratio tests for CKD, if required.

Information regarding CKD treatment pathways is collected via a national auditing tool of GP records called ‘CVDPREVENT’. Department officials are carefully considering opportunities to enhance data monitoring for the NHS Health Check as part of the National Audit Office recommendation.

Alongside this, we plan to publish the Cardiovascular Disease Modern Service Framework shortly. During the framework’s development, Department officials are considering opportunities for earlier detection, diagnosis, and management of cardiovascular, kidney, and metabolic risk factors strongly associated with cardiovascular disease.

The National Cancer Plan commitment for all cancer patients who would benefit from a genomic test to receive one to inform treatment decisions applies specifically to genomic testing. While the Plan supports the wider use of biomarker testing, including non-genomic tests, these are being expanded and integrated across cancer pathways rather than subject to a similar universal guarantee.

The Plan commits to the wider integration of biomarker testing across cancer services to improve treatment selection and outcomes. Non-genomic biomarker tests form part of wider diagnostic pathways, alongside histopathology, imaging such as magnetic resonance imaging and computed tomography scans, and other laboratory investigations, all of which contribute to multidisciplinary team decisions on the most appropriate treatment.

Through the National Cancer Plan, more equitable access to precision cancer treatments will be supported by reducing unwarranted variation, reviewing the scope of testing, and bringing additional biomarker tests, both genomic and non-genomic, into routine use where clinically appropriate. This will be supported by national guidance and commissioning processes to ensure consistent access across the National Health Service.

The National Cancer Plan commitment for all cancer patients who would benefit from a genomic test to receive one to inform treatment decisions applies specifically to genomic testing. While the Plan supports the wider use of biomarker testing, including non-genomic tests, these are being expanded and integrated across cancer pathways rather than subject to a similar universal guarantee.

The Plan commits to the wider integration of biomarker testing across cancer services to improve treatment selection and outcomes. Non-genomic biomarker tests form part of wider diagnostic pathways, alongside histopathology, imaging such as magnetic resonance imaging and computed tomography scans, and other laboratory investigations, all of which contribute to multidisciplinary team decisions on the most appropriate treatment.

Through the National Cancer Plan, more equitable access to precision cancer treatments will be supported by reducing unwarranted variation, reviewing the scope of testing, and bringing additional biomarker tests, both genomic and non-genomic, into routine use where clinically appropriate. This will be supported by national guidance and commissioning processes to ensure consistent access across the National Health Service.

The UK National Screening Committee (UK NSC), which advises Ministers on all screening matters, is working with partners to develop rolling evaluation to safely build the evidence needed to add more rare diseases to the NHS newborn blood spot screening programme. The evaluation would consider conditions that can be tested using mass spectrometry, an analytical technique used for detecting abnormal molecules in the blood which might indicate important disorders, as well as those requiring genomic tests. The rolling evaluation would help the UK NSC make timely evidence-based recommendations on multiple rare conditions.

The Generation Study which launched in 2024 is evaluating the effectiveness of using whole genome sequencing to test 100,000 newborns for genetic mutations associated with more than 200 rare genetic conditions. The study is due to be completed by summer 2027.

The evaluation part of the study will then be completed and shared with the UK NSC who will assess the findings to determine whether any newborn genomic screening can be recommended. Where more research is required, the rolling evaluation will assist in securing evidence.

The Department provided an update on the four recommendations made in the National Audit Office’s (NAO) report, Progress in preventing cardiovascular disease, earlier this year and this was published on the NAO’s recommendation tracker website at the end of March. Work is underway to review and take forward the recommendations.

Work is ongoing to improve access and engagement to the NHS Health Check, including the development of the NHS Health Check Online, which will allow people to undertake their NHS Health Check at home, at a time and place convenient to them. The NHS Health Check Online is currently being piloted in multiple local authorities, and the findings from the evaluation will inform decisions on whether further development is needed and if the online service should be rolled out across England.

The Government is committed to ensuring fewer lives are lost to the biggest killers, including cardiovascular disease (CVD), and the 10-Year Health Plan sets out our intention to publish a CVD Modern Service Framework (CVD MSF) in Spring. The CVD MSF will support consistent, high quality, and equitable care across the CVD pathway while fostering innovation, and will help to improve the detection and management of cardiovascular risk factors.

I reassure the noble Lord that all these factors are taken into account. I would warn against complacency. To go back to my personal experience, my sister had regular breast screening and it was not picked up because of the type of cancer that she had. I am delighted that the noble Lord, Lord Vallance, is leading the work on looking at how we can better screen women and make sure that the work we do is the most effective and reaches the highest number of women possible.

We hope to get the trial up and running within the next year; we really are ready to go. I will have to write to the noble Lord on the specific detail for his first question—I do not have that to hand—but everyone wants to get moving on this. It has been a long time coming, and we are delighted that we have the go-ahead today to move forward.