Department of Health and Social Care

It is the responsibility of the integrated care boards (ICBs) to ensure that the National Health Service estate is fit for purpose, in order to meet the needs of the local population.

General practices (GPs) are independent contractors, which, alongside ICBs, are responsible for ensuring their premises are up to standard. Most practice premises are privately owned or leased.

The Department and NHS England requested that ICBs develop estates infrastructure strategies. These have been developed to create a long-term plan for future estate requirements and investment for each local area and its needs. These strategies must take existing and future GP and primary care estate into account when considering how best to deliver local services. To support them in doing this, we provide an annual capital allocation, operational capital, which ICBs are free to use as they see fit, working with healthcare providers in their area including GPs, to deliver their estates and infrastructure priorities.

At a national level, we continue to work closely with the Ministry of Housing, Communities and Local Government on the National Planning Policy Framework to ensure all new and existing developments have an adequate level of healthcare infrastructure for the community.

In Autumn 2024, the Government announced the Primary Care Utilisation and Modernisation Fund, a nationally controlled fund which will deliver upgrades this financial year to GP surgeries across England. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care. ICBs were invited to submit funding proposals that align with local integrated care system infrastructure strategies and the Primary Care Network Estates Toolkit, prioritising high-quality, fit-for-purpose estates over poorly maintained assets.

It is the responsibility of the integrated care boards (ICBs) to ensure that the National Health Service estate is fit for purpose, in order to meet the needs of the local population.

General practices (GPs) are independent contractors, which, alongside ICBs, are responsible for ensuring their premises are up to standard. Most practice premises are privately owned or leased.

The Department and NHS England requested that ICBs develop estates infrastructure strategies. These have been developed to create a long-term plan for future estate requirements and investment for each local area and its needs. These strategies must take existing and future GP and primary care estate into account when considering how best to deliver local services. To support them in doing this, we provide an annual capital allocation, operational capital, which ICBs are free to use as they see fit, working with healthcare providers in their area including GPs, to deliver their estates and infrastructure priorities.

At a national level, we continue to work closely with the Ministry of Housing, Communities and Local Government on the National Planning Policy Framework to ensure all new and existing developments have an adequate level of healthcare infrastructure for the community.

In Autumn 2024, the Government announced the Primary Care Utilisation and Modernisation Fund, a nationally controlled fund which will deliver upgrades this financial year to GP surgeries across England. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care. ICBs were invited to submit funding proposals that align with local integrated care system infrastructure strategies and the Primary Care Network Estates Toolkit, prioritising high-quality, fit-for-purpose estates over poorly maintained assets.

As part of the £1.65 billion for investment to improve National Health Service performance against constitutional standards in 2025/26, £600 million was allocated to diagnostics. Final allocation of this funding will be agreed via national panels upon receipt and review of business cases.

To date, the Department has approved £2,267,000 capital to Lancashire Teaching Hospitals NHS Foundation Trust from this overall allocation.

The 10-Year Health Plan detailed our ambition to deliver a National Health Service fit for the future through three big shifts: from hospital to community, from analogue to digital, and from sickness to prevention.

Regarding infrastructure, the plan set out our aim to establish neighbourhood health centres in every community over the course of the next 10 years, transforming healthcare access and delivering healthcare closer to home for those that need it most. We are also increasing health capital budgets to over £14.6 billion by the end of the Spending Review period, namely 2029/30, to invest in the NHS and wider health infrastructure, a £2.3 billion real terms increase from 2023/24 to 2029/30.

To better our understanding of patients with complex health needs, we will set a new standard that, by 2027, 95% of people with complex needs will have an agreed care plan. As outlined in the 10-Year Health Plan, we will expect all care plans to be co-created with patients and cover their holistic needs, not just their treatment. They will align with national standards for high quality care but, within that, give patients significant choice and freedom.

As set out in the plan, the Government is committed to making the NHS the best place to work, by supporting and retaining our hardworking and dedicated healthcare professionals. We will roll out staff treatment hubs that will ensure staff have access to high quality support for occupational health, including support for mental health and back conditions. We will also work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism and sexual harassment in the workplace.

In 2024, there was a 20% vacancy rate for NHS dentists in the Surrey Heartlands Integrated Care Board (ICB), which includes the Epsom and Ewell constituency. We do not hold data at constituency level. More data is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/dental-workforce/

The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to ICBs across England. For the Epsom and Ewell constituency, this is Surrey Heartlands ICB.

We will deliver 700,000 extra urgent dental appointments per year, and ICBs have been making extra appointments available from 1 April 2025. Surrey Heartlands ICB is expected to deliver 6,585 additional urgent dental appointments as part of the scheme.

The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament.

The Government is neutral on the principle of assisted dying and whether the Bill becomes law. Officials are working to fulfil the Government’s duty to the statute book, providing technical drafting support and workability advice.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:

https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensing

To support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.

We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24

It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.

This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:

https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensing

To support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.

We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24

It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.

This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

Integrated care boards (ICBs), as commissioners of primary medical services, are responsible for the quality, safety, and performance of services delivered by providers within their areas. Large general practitioner (GP) practices spanning multiple commissioner areas will ordinarily hold individual contracts within each commissioning area they operate in and will therefore be held to account for the quality, safety, and performance of services by the responsible commissioner in each area.

The Department does not collect information on all guidance that is issued by ICBs.

Local authorities have duties to support unpaid carers and are required to deliver sustainable, high-quality care and support services. The Government’s Better Care Fund provides support to unpaid carers, including short breaks and respite services.

The Department regularly engages with local authorities, including Surrey County Council, on matters relating to unpaid carers and wider social care issues. According to data from NHS Digital, in 2023/24, Surrey County Council supported 760, or 19%, of unpaid carers through respite or other forms of carer support delivered to the cared-for person. We do not hold data to assess trends in the level of burnout among unpaid carers in the Surrey Heath constituency.

Independent research funded by the National Institute for Health and Care Research suggests that high intensity unpaid care is associated with an increased likelihood of poorer outcomes, including loneliness and social isolation, when compared to people who do not provide unpaid care. The severity of these outcomes differs based on factors such as age, gender, and ethnicity.

The Office for National Statistics has estimated, using the 2021 Census and adjusting for age, that the proportion of residents of the Surrey Heath Borough District providing unpaid care is slightly lower than in the Southeast region or England as a whole. This is especially true for the proportion of residents providing higher levels of unpaid care.

Local authorities have duties to support unpaid carers and are required to deliver sustainable, high-quality care and support services. The Government’s Better Care Fund provides support to unpaid carers, including short breaks and respite services.

The Department regularly engages with local authorities, including Surrey County Council, on matters relating to unpaid carers and wider social care issues. According to data from NHS Digital, in 2023/24, Surrey County Council supported 760, or 19%, of unpaid carers through respite or other forms of carer support delivered to the cared-for person. We do not hold data to assess trends in the level of burnout among unpaid carers in the Surrey Heath constituency.

Independent research funded by the National Institute for Health and Care Research suggests that high intensity unpaid care is associated with an increased likelihood of poorer outcomes, including loneliness and social isolation, when compared to people who do not provide unpaid care. The severity of these outcomes differs based on factors such as age, gender, and ethnicity.

The Office for National Statistics has estimated, using the 2021 Census and adjusting for age, that the proportion of residents of the Surrey Heath Borough District providing unpaid care is slightly lower than in the Southeast region or England as a whole. This is especially true for the proportion of residents providing higher levels of unpaid care.

Local authorities have duties to support unpaid carers and are required to deliver sustainable, high-quality care and support services. The Government’s Better Care Fund provides support to unpaid carers, including short breaks and respite services.

The Department regularly engages with local authorities, including Surrey County Council, on matters relating to unpaid carers and wider social care issues. According to data from NHS Digital, in 2023/24, Surrey County Council supported 760, or 19%, of unpaid carers through respite or other forms of carer support delivered to the cared-for person. We do not hold data to assess trends in the level of burnout among unpaid carers in the Surrey Heath constituency.

Independent research funded by the National Institute for Health and Care Research suggests that high intensity unpaid care is associated with an increased likelihood of poorer outcomes, including loneliness and social isolation, when compared to people who do not provide unpaid care. The severity of these outcomes differs based on factors such as age, gender, and ethnicity.

The Office for National Statistics has estimated, using the 2021 Census and adjusting for age, that the proportion of residents of the Surrey Heath Borough District providing unpaid care is slightly lower than in the Southeast region or England as a whole. This is especially true for the proportion of residents providing higher levels of unpaid care.

Integrated care boards (ICBs) are responsible for undertaking health needs assessments, including any data collection, to understand the health and wellbeing needs of their local populations, including identifying inequalities and planning services accordingly. NHS England has issued guidance to ICBs on developing an intelligence function to ensure locally tailored, evidence-based decisions are made that address health inequalities and support personalised, population-focused care planning.

The 10 Year Health Plan shifts care from hospitals into communities, with neighbourhood health services led by multidisciplinary teams offering preventative and personalised support closer to where people live with increased access to services and information for people with allergies and long-term health conditions.

The plan also commits expanding the use of digital technology. By 2035, two thirds of outpatient care will take place digitally or in the community closer to home, with patients, including those with allergies and long-term conditions, able to access the best of their local hospital in a much more responsive way at home via their phones.

General practitioners (GPs) are responsible for ensuring that their own clinical knowledge, including on endometriosis and women’s health issues in general, remains up-to-date, and for identifying learning needs as part of their continuing professional development.

All United Kingdom registered doctors are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. The training curriculum for postgraduate trainee doctors is set by the Royal College of General Practitioners, and must meet the standards set by the GMC.

The GMC has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK. The content map for this assessment includes several topics relating to women’s health including menstrual problems, endometriosis, menopause and urinary incontinence. This will encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK. Endometriosis is also included in the core curriculum for trainee GPs, and for obstetricians and gynaecologists.

In November 2024, the National Institute for Health and Care Excellence updated their guideline on endometriosis which makes firmer recommendations for healthcare professionals on referral and investigations for women with suspected diagnosis. This guidance is available at the following link:

https://www.nice.org.uk/guidance/ng73

Integrated care boards (ICBs) and health professionals should have due regard to National Institute for Health and Care Excellence (NICE) guidelines when commissioning and providing health care services, including autism assessment services. NICE guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with stakeholders. In June 2024, NICE’s prioritisation board decided to prioritise updating the current NICE guidelines on autism assessment and diagnosis, namely Autism spectrum disorder in adults: diagnosis and management, and Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Both guidelines are available, respectively, at the following two links:

https://www.nice.org.uk/guidance/cg142

https://www.nice.org.uk/guidance/cg128

Although NICE has committed to updating these guidelines, this work has not yet been scheduled into NICE’s work programme.

Under the Health and Care Act 2022, providers registered with the Care Quality Commission are required to ensure their staff receive specific training on learning disability and autism, appropriate to their role. To support this, we have been rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce. The first part of this training has now been completed by over three million people. Staff with responsibility for providing care, support, or healthcare, including social care and other professionals with a high degree of autonomy, are expected to complete Tier 2 of Oliver’s Training, which includes content on avoiding diagnostic overshadowing. Oliver's Training has been developed with reference to the Core Capabilities Frameworks on Learning Disability and Autism, co-produced alongside people with a learning disability and autistic people, and based on learning from the independently evaluated trials of the training in 2021. A long-term evaluation is now underway.

In addition, 5,000 trainers have been trained as part of the National Autism Trainer Programme, which covers autism presentation in women and girls. These trainers will cascade their training to teams across mental health services. NHS England has also published guidance on meeting the needs of autistic adults in mental health services, which makes specific references to the possible role of masking.

Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas, including the North East London ICB and the North Central London ICB. This will vary depending on the demand in that ICB area but will also be dependent on the totality and type of palliative care and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.

The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.

We will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.

NHS England has published statutory guidance on palliative and end of life care and a service specification for children and young people. This sets out the expectations and responsibilities placed on integrated care boards (ICBs) in relation to the commissioning of children’s palliative care.

The NHS Futures platform offers ICB commissioners the opportunity to share examples of best practice amongst each other and with healthcare professionals and researchers. The NHS Futures platform also offers access to upcoming and past webinars and a clinical excellence workstream, among other resources, to support ICB commissioners and clinical staff to support outstanding clinical care based on the best available evidence.

The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.

We will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access and quality.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department is £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025.

The Government committed to recruiting over 1,000 recently qualified general practitioners (GPs) in primary care networks (PCNs) through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified GPs for which PCNs are claiming reimbursement via the ARRS show that since 1 October 2024, over 2,000 GPs were recruited through the scheme. Newly qualified GPs employed under the ARRS will continue to receive support under the scheme in the coming year as part of the 2025/26 contract. A number of changes have been confirmed to increase the flexibility of the ARRS. This includes GPs and practice nurses included in the main ARRS funding pot, an uplift of the maximum reimbursable rate for GPs in the scheme, and no caps on the number of GPs that can be employed through the scheme.

We are boosting practice finances by investing an additional £1.1 billion in GPs to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest cash increase in over a decade, and aims to support GPs to build capacity, reduce bureaucracy, and deliver more care in the community.

Primary care providers, including GPs, are valued independent contractors who provide nearly £20 billion worth of NHS services. Every year we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract.

It is difficult to quantify the total provision of, or spend on, palliative and end of life care at either a national or local, integrated care board level, because it is delivered every day by a wide range of specialist and generalist health and care workers providing care for a wide range of needs that include, but are not always exclusive to, palliative care.

Palliative care is provided across multiple settings, including in primary care, community care, in hospitals, hospices, and care homes, and in people’s own homes. Therefore, not all palliative and end of life care will be recorded or coded as such.

We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant.

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department with responsibility for the regulation of medicinal products in the United Kingdom. The MHRA ensures that medicines are efficacious and acceptably safe, and that information to aid the safe use of a medicine, including possible side effects, is appropriately described in the authorised product information.

The MHRA’s approved patient information leaflets for the most commonly prescribed antidepressants contain warnings about sexual side effects whilst taking the drug, and for some antidepressants there is a warning about sexual side effects which may continue after stopping the medicine. These warnings are under review by an expert working group of the Commission on Human Medicines, and the findings of this review are due to report in the Autumn.

Persistent genital arousal disorder (PGAD) is not specifically listed as a possible side effect in the patient information leaflets for any antidepressants. PGAD remains poorly defined and requires research into several proposed causal factors.

A total of 13 reports that describe PGAD suspected to be associated with an antidepressant have been received through the Yellow Cared scheme. The reports were received between 2017 and 2025 for sertraline, with six reports, citalopram, with three reports, fluoxetine, with three reports, and reboxetine, with one report.

The MHRA continuously monitors the safety of these medicines. However, the data currently available is considered insufficient to list PGAD as a possible side effect of antidepressants. Any emerging data will be carefully considered and regulatory action taken as needed.

The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether abortion medicine was sent via the post, and so the Department does not hold this information.

The HSA4 form does capture whether the medicine was administered at the patient’s usual place of residence. This information is published in the Abortion Statistics for England and Wales for the years 2018 to 2022. However, publication of the abortion statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.

The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether the form was returned by a general practice.

The HSA4 form does capture information on the hospital or clinic where the termination took place, and whether any medicine was administered at the patient’s usual place of residence. However, the publication of the Abortion Statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.

The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether the form was returned by a general practice.

The HSA4 form does capture information on the hospital or clinic where the termination took place, and whether any medicine was administered at the patient’s usual place of residence. However, the publication of the Abortion Statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.

The Department has a responsibility to work with United Kingdom medicine license holders to help ensure continuity of supply. We monitor and manage medicine supply issues at a national level so that stocks remain available to meet regional and local demand and therefore measures are not specific to the east of England.

We are aware of a supply issue with mefenamic acid 50 milligram/5 millilitre oral suspension which is expected to resolve in December 2025. Alternative formulations of mefenamic acid remain available, including capsules and tablets.

The Department will continue to work closely with the manufacturer to resolve the issue as soon as possible and to ensure patients have continuous access to medicines. Any patient who is worried about their condition should speak to their clinician in the first instance.

The NHS Sussex Integrated Care Board is responsible for commissioning services to meet the mental health needs of the people in Chichester.

People with post-traumatic stress disorder can self-refer to NHS Talking Therapies or their general practitioner can refer them.

Nationally, the Government is investing an extra £688 million this year to transform mental health services. We have chosen to prioritise funding to expand NHS Talking Therapies, so that the number of people completing a course of treatment is expected to increase by 384,000 by 2028/29.

We are also delivering on our commitment to recruit an additional 8,500 mental health workers for children and adults by the end of this Parliament. We are more than halfway towards this target, which will help to ease pressure on busy mental health services.

The Equality Act 2010 defines disability as ‘a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities’. The Act defines ‘long-term’ in this context as having lasted, or being likely to last for, at least 12 months, or likely to last for the rest of the life of the person.

This could cover individual people who have Essential Tremor, where the condition has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities.

There is, at present, no single, established dataset that can be used to monitor waiting times for assessment and diagnosis for attention deficit hyperactivity disorder (ADHD) for individual organisations or geographies in England. Although the data requested is not held centrally, it may be held locally by individual National Health Service trusts or commissioners.

For the first time, NHS England published management information on ADHD waits at a national level on 29 May 2025 as part of its ADHD data improvement plan. NHSE England has also released technical guidance to integrated care boards (ICBs) to improve recording of ADHD data, with a view to improving the quality of ADHD waits data and publishing more localised data in future. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.

NHS England established an ADHD taskforce which brought together those with lived experience with experts from the NHS, education, charity and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim report was published on 20 June 2025, with the final report expected later this year, and we will carefully consider its recommendations.

The 10-Year Health Plan set out an ambition to offer newborn genomic testing as part of routine care within the next decade. Delivering against this ambition will be subject to evidence gathered through the Generation Study. This research programme is evaluating the effectiveness of using whole genome sequencing to test 100,000 newborns for more than 200 rare genetic conditions.

Participation in the Generation Study is voluntary, with parental consent required to store genomic and health data securely. Consent is an ongoing process, and parents can withdraw their child at any time before age 16, when the child will be asked to re-consent. If genomic testing becomes part of routine screening, parental consent will still be required, as with the current NHS screening programmes for newborn babies.

We estimate there are around 450 independent sector providers that are providing National Health Service services via the NHS e-Referral Service (e-RS). There is no classification of private healthcare or independent sector in the e-RS Directory of Services. Patients can already access referrals to these private healthcare providers via the NHS App where they have been shortlisted by their GP.

The Department is committed to cutting the current time it takes to get a clinical trial set up, to under 150 days by March 2026 with the aim of making the United Kingdom a world leader in clinical trials. We are streamlining the set-up and delivery of clinical research through the UK Clinical Research Delivery (UKCRD) programme as set out in our recent publication, Transforming the UK clinical research system: August 2025 update, which is available at the following link:

https://www.gov.uk/government/publications/transforming-the-uk-clinical-research-system-august-2025-update

The UKCRD programme has rapidly implemented a Study Set-Up Plan, co-led by the Department and NHS England to address the delays affecting clinical research set-up through reducing unnecessary bureaucracy, by standardising commercial contracts and removing duplicative steps at sites to create a standardised pathway, for example in pharmacy set-up, to free up workforce capacity. The second phase of the Plan was completed in June 2025, with mandatory use of the new processes and templates for commercial trials by October 2025. The successful implementation of the Plan will be closely monitored for impact.

Company-led early access programmes (EAPs) are not endorsed by the Department or NHS England and no assessment has been made of whether there are regional inequities in the provision of early access programmes for innovative treatments and people living with SOD1 motor neurone disease.

Participation in company-led schemes is decided at an individual NHS trust level. Under these programmes, the cost of the drug is free to both patients taking part in it, and to the National Health Service, but NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP.

NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes, providing advice on potential financial, resourcing, and clinical risks. ICSs should use the guidance to help determine whether to implement any free of charge scheme including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:

https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

Data is not held on how many payments under the Dental Recruitment Incentive Scheme have been allocated at the constituency level. The responsibility for commissioning primary care dentistry to meet the needs of the local population is delegated to integrated care boards (ICBs) across England.

ICBs have started to recruit posts through the Golden Hello scheme. This recruitment incentive will see up dentists receiving payments of £20,000 to work in those areas that need them most for three years.

Further information on the dental recruitment process can be found in guidance issued by NHS England, which is available at the following link:

https://www.england.nhs.uk/long-read/dental-recruitment-incentive-scheme-2024-25/

The independent complaints advocacy service in the National Health Service is covered by a wider grant for Local Reform and Community Voices and is not a requirement of Healthwatch England or Local Healthwatch. This grant provides funding to local authorities which assists them in meeting statutory duties. This funding will continue to be provided. This grant has not been ringfenced to date and there are no plans to ringfence it, moving forward.

NHS England has commissioned Solutions for Public Health (SPH) to complete a compliance audit report of the Multi-grip prosthetic hand (all ages) clinical commissioning policy, a copy of which is attached. The audit report from SPH will be available to commissioners by the end of October 2025.

NHS England will use the audit report to inform the evidence base for any proposed changes to the current commissioning policy.

Following the Prime Minister’s announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as scaling back integrated care board running costs and National Health Service provider corporate cost reductions to reduce waste and bureaucracy.

Good progress is being made, with the Department and NHS England having announced voluntary exit and expressions of interest schemes respectively.

The Union Flag was flown 360 days on the Department’s main building in 2024 and, as of 10 September 2025, has been flown 242 days in 2025.

The remuneration for senior Government Commercial Organisation (GCO) roles is set centrally to ensure a consistent, cross-government approach that allows us to attract and retain commercial leaders within the specialised skills needed to manage complex challenges and deliver value for money.

This ‘invest to save’ model includes a performance-related pay element which is not guaranteed; it is strictly contingent on meeting stretching objectives designed to deliver significant taxpayer savings. Such payment is approved by the GCO Remuneration Committee and the Chief Secretary to the Treasury as per central guidance.

NHS England works with an academic partner, Kings College London, to produce the Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) annual report. NHS England provides oversight in relation to LeDeR policy, process and wider National Health Service policy, and commissions the annual report.

The report is independent and provides analysis of LeDeR review data. NHS England and the Department check findings are clearly and consistently presented to ensure transparency for the public.

The 2023 report was approved by NHS England’s Chief Executive.

In June 2025, the Secretary of State for Health and Social Care announced an independent investigation into National Health Service maternity and neonatal services, which will be chaired by Baroness Amos.

The investigation will produce an initial set of national recommendations by December 2025. These recommendations will take previous recommendations into consideration and will therefore take primacy over previous recommendations.

In June 2025, the Secretary of State for Health and Social Care announced an independent investigation into National Health Service maternity and neonatal services, which will be chaired by Baroness Amos.

The investigation will produce an initial set of national recommendations by December 2025. These recommendations will take previous recommendations into consideration and will therefore take primacy over previous recommendations.

Departmental colleagues met with representatives of the University on 12 August 2025 to discuss the future of the Global Surgery Network. These discussions took place following the announcement from the Prime Minister in February 2025 to reduce Official Development Assistance (ODA) to the equivalent of 0.3% of gross national income by 2027. After this announcement, and the outcome of the 2025 Spending Review, the Department has taken the decision to focus new ODA research funding on global health security and particular diseases of poverty.

The National Institute for Health and Care Research (NIHR)-funded Global Health Research Unit on Global Surgery was originally awarded over £6.9 million in Global Health Research’s inaugural Units call in 2017 and, following a second NIHR funding competition, received a further award of £7 million in 2021 to establish a sustainable network of surgical research. This latest award is due to conclude in June 2026. The Department will honour all on-going research commitments.

We continue to recognise the critical importance of global health research to drive the health and well-being of the poorest and most vulnerable. Any updates on our funding opportunities will be reflected on the NIHR website.

In 2024/25, we provided £106 million in funding to children’s eating disorder services, an increase of £10 million over 2023/24. This increase is helping clinicians to support more young people.

Between April and June 2025, 3,138 children and young people successfully entered treatment in community eating disorder services. This is the highest figure on record since 2021. At the same time, waiting lists to begin routine eating disorder treatment have shortened by 20% from the year before and we are working with NHS England to meet the waiting time standards for eating disorder services for children and young people.

NHS England is currently seeking to expand the capacity of children’s community eating disorder services, to allow for crisis care and intensive home treatment. Improved care in the community will give young people early access to evidence-based treatment involving families and carers, improving outcomes and preventing relapse.

We have also committed to expanding mental health support teams to cover 100% of pupils in England by December 2030, aiding school staff in recognising eating disorders and providing early intervention for children at risk.

Early intervention is also a priority for adults with eating disorders, as set out in the community mental health framework. NHS England has established 15 provider collaboratives focusing on adult eating disorders, which are working to redesign care pathways and focus resources on community services.

Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) is a service improvement programme established and led by NHS England.

As of 1st September 2025, there were 3,836 LeDeR reviews for people with a learning disability and autistic people in the LeDeR system which had not been completed. Of these, 1,626 (42%) have not been started.

508 (13%) of the reviews that have not been completed are currently on hold awaiting the completion of statutory processes such as coroner’s investigations or safeguarding reviews. 2,155 (56%) of the reviews that have not been completed are for people who died in 2025.

1,842 (48%) of the reviews were received within the last 6 months. The LeDeR policy sets the expectation that reviews are completed within six months of them being notified to LeDeR, unless statutory processes prevent that being possible or family members of those bereaved have asked for the review to be delayed. As of August 2025, 94% of all LeDeR reviews have been completed since the start of the programme in 2017.

Privately owned health apps do not interfere with the operation of the NHS App because they are separate systems that do not share data directly or integrate with the NHS App's core functionalities.

These apps offer different services and information, and some patients might use both to supplement the core functionalities of the NHS App, such as managing personal health data or accessing private healthcare providers.