Department of Health and Social Care

The Tobacco and Vapes Bill, which will put us on track towards a smoke-free UK, was introduced to Parliament on 5 November 2024. On 26 March 2025, MPs voted overwhelmingly in favour of advancing the Bill to the next Parliamentary stage and it has now entered the House of Lords.

The Bill allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. However, we have been very clear that in England, we intend to consult on extending smoke-free places to outside schools, children’s playgrounds and hospitals but not outdoor hospitality settings or wider open spaces like beaches. Private outdoor spaces are out of scope of the powers in the Bill.

We do not intend to extend these powers further than this at this time and recognise that now would not be the right time to consult on making outdoor hospitality settings smoke-free in England.

The Tobacco and Vapes Bill, which will put us on track towards a smoke-free UK, was introduced to Parliament on 5 November 2024. On 26 March 2025, MPs voted overwhelmingly in favour of advancing the Bill to the next Parliamentary stage and it has now entered the House of Lords.

The Bill allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. However, we have been very clear that in England, we intend to consult on extending smoke-free places to outside schools, children’s playgrounds and hospitals but not outdoor hospitality settings or wider open spaces like beaches. Private outdoor spaces are out of scope of the powers in the Bill.

We do not intend to extend these powers further than this at this time and recognise that now would not be the right time to consult on making outdoor hospitality settings smoke-free in England.

The Government and NHS England are committed to implementing the recommendations of the Cass Review in full. This includes the recommendation for a pathway to be established for individuals who wish to detransition. The formative stages of this work will involve a process of evidence gathering in the spring of 2025, focused on individuals and clinicians with experience of detransition, and professional bodies. NHS England will engage stakeholders on a proposed service specification for the new pathway, including through public consultation.

The PATHWAYS study, which was also recommended by the Cass Review, has several elements, including a longitudinal observational study of children and young people attending NHS Gender Services, charting their development over time, and longitudinal qualitative interviews to explore the needs and care experiences of children, young people, and their families, and how these change over the course of time and the treatment.

The Government recognises that pharmacies are an integral part of the fabric of our communities. They provide an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.

We have now concluded the consultation on funding for 2024/25 and 2025/26, and have agreed with Community Pharmacy England (CPE) to increase the community pharmacy contractual framework to £3.073 billion. CPE represents all pharmacy contractors in England, including independent community pharmacies. This deal represents the largest uplift in funding of any part of the NHS, at over 19% across 2024/25 and 2025/26. This shows a first step in delivering stability for the future and a commitment to rebuilding the sector.

Officials have been working to develop the Down Syndrome Act 2022 statutory guidance, including engaging with sector partners and the relevant departments.

We expect to issue the draft guidance of the public consultation by the summer of 2025. The guidance will be published at the earliest opportunity following the consultation.

We have committed to developing a 10-Year Health Plan to deliver a National Health Service fit for the future. It will set the vision for what good joined-up care looks like for people with a combination of health and care needs.

The independent commission into adult social care, to be chaired by Baroness Casey, is part of our critical first steps towards delivering a National Care Service. The commission will start a national conversation about what people expect from adult social care. The commission will be split over two phases. The first phase, reporting in 2026, will focus on how we can make the most of existing resources to improve people’s lives over the medium term. Phase two, reporting by 2028, will then consider the long-term transformation of adult social care, setting us on the road to fundamental reform that will build a social care system fit for the future.

The Department has provided the biggest investment in a generation for hospices, with £100 million to help hospices this year and next, to provide the best end of life care to patients and their families in a supportive and dignified physical environment. Hospices for children and young people will also receive a further £26 million of revenue funding for 2025/26 through what until recently was known as the Children’s Hospice Grant.

The decision to bring NHS England and Department together into one team will have no impact on this, or future funding decisions around hospices.

Ministers are working with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. Hospices will continue to have a clear point of contact within the centre.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care, and work is underway to ensure that patients can access the 700,000 additional urgent dental appointments, with integrated care boards (ICBs) asked to make these available from 1 April 2025.

The most common reason children aged five to nine years old are admitted to hospital is for tooth decay. We have confirmed an investment of £11 million to rollout a national supervised toothbrushing programme for three to five year olds. This will reach up to 600,000 children in the most deprived areas of England.

The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the ICBs across England. For the North Devon constituency, this is the NHS One Devon ICB.

ICBs have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.

The UK Health Security Agency (UKHSA) has not made an assessment of the potential impact of fly-tipping and uncollected rubbish on public health.

During specific incidents, for instance with the Birmingham City Council, the UKHSA has provided standard guidance to the local authority on the public health risk associated with household waste. The UKHSA is also part of a multi-agency response Strategic Commissioning Group (SCG), and has contributed to a risk assessment concerning the potential health impacts of uncollected waste. The UKHSA will continue to provide advice and support to Birmingham City Council, as part of this SCG.

The Department for Environment Food and Rural Affairs and the Environment Agency produce the Statutory guidance for Waste duty of care: code of practice, which is available at the following link:

https://www.gov.uk/government/publications/waste-duty-of-care-code-of-practice/waste-duty-of-care-code-of-practice

Guidance for waste planning policy is published by the Ministry of Housing, Communities and Local Government, and is available at the following link:

https://www.gov.uk/guidance/waste

NHS Pension Scheme members, including general practitioners (GPs), can access information about their pension via My NHS Pension, an online portal from the NHS Pension Service, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/my-nhs-pension

To provide accurate pension information for practitioners, the NHS Business Services Authority needs a fully up to date record in respect of their NHS Pension Scheme membership. This means practitioners must submit their Annual Certificate(s) of Pensionable Profits to Primary Care Support England (PCSE), so that PCSE can keep their record updated.

PCSE launched the PCSE Online GP Pensions system in 2021 to provide GPs and practices with greater convenience, and more transparency and security when it comes to their pension contributions data. Supporting GPs to accurately submit current and historic Type 1 or Type 2 annual certificates remains a priority for NHS England and PCSE. Since the PCSE Online solution for submitting Type 1 and Type 2 certificates electronically went live in 2021, PCSE have developed user guides and held webinars to educate GPs on how to complete forms accurately.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £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.

General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services.

We are investing an additional £889 million through the GP Contract to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

Global sum payments to general practices (GPs) are based on the Carr-Hill formula. The staff market forces factor is based on earnings data from 1999 to 2001. For the rurality component, the GP expenses data is from 2000 to 2001. The patient data used to calculate the distance from patients’ homes to the GP surgery uses patients’ current addresses. The population density data used in the rurality adjustment is from 2001.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has a duty to monitor the effects of water fluoridation schemes on health, and to publish reports at intervals no greater than four years. Health monitoring reports published in 2014, 2018, and 2022, taken alongside the existing wider research, show that there is no convincing evidence for adverse outcomes, including for bladder cancer or osteosarcoma, due to fluoridation schemes. These findings are consistent that water fluoridation, at levels recommended in the United Kingdom, is a safe and effective public health measure to reduce dental cavities. The next health monitoring report will be published in 2026.

Integrated care boards (ICBs) are responsible for the commissioning of palliative and end of life care services, including for children and young people, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year, and to publish a summary of its findings. This assessment must include how well the ICB has discharged its functions.

National Health Service dentists are required to update their NHS website profiles at least every 90 days to ensure patients have up-to-date information on where they can access care. This includes information on whether they are accepting new patients. The NHS.UK website was updated in April 2024 to include the ‘when availability allows’ option to reflect that the availability of appointments may change over time, which is more reflective of the way NHS dentists work.

Integrated care boards can review which practices in their area have not updated their profile in a 90-day period, and work with practices to ensure that their websites are up to date.

Patients in England are not registered with an NHS dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend.

We know that too many children and young people, including those with special educational needs and disabilities, are not receiving the mental health care they need, and that waits for mental health services are too long across England, including in Huddersfield. We are determined to change that.

As part of our mission to build a National Health Service that is fit for the future, we will provide access to a specialist mental health professional in every school in England, introduce open access Young Futures hubs in communities, and recruit an additional 8,500 mental health workers to cut wait times and provide faster treatment.

It is unacceptable that too many people are not receiving the mental health care they need, and we know that waits for mental health services are far too long, including for people with bipolar disorder. We are determined to change that.

As part of our mission to build a National Health Service that is fit for the future, we will provide access to a specialist mental health professional in every school in England, create a network of open access community Young Futures hubs, recruit an additional 8,500 mental health workers to cut wait times and provide faster treatment, and modernise the Mental Health Act.

We are also committed to new models of care for mental health, including reforming care for people experiencing a mental health crisis. We are testing neighbourhood mental health centres for people aged 18 years old and over with serious mental illness. These six pilot schemes are based in Tower Hamlets, Lewisham, Sheffield, York, Birmingham, and Whitehaven.

These models will offer 24/7 open access care closer to home, with an integrated service which includes healthcare providers, local authorities, and the voluntary sector. These pilots build on international evidence that shows that similar models have led to a reduction in hospitalisation and waiting times, and support our efforts to move more care into the community.

Since 2021, all areas of the country have been transforming and increasing access to community mental health services for all people with severe mental illness, including people with bipolar disorder. The vision for the transformation programme was set out in the Community Mental Health Framework, which included ensuring that services were needs led, rather than requiring people to have a specific diagnosis to access care.

NHS England is working with the integrated care boards with the aim of increasing the capacity of eating disorder services, to provide community and day treatment services. By improving care in the community, the National Health Service aims to improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce the length of time that people have to stay in hospital.

NHS England has commissioned the Royal College of Psychiatrists to deliver a national, all-age eating disorders audit. This aims to drive improvement in the identification and appropriate management of eating disorders, and the quality and consistency of services for all ages in England. This will help ensure that services across the country, including in rural areas, are safe, effective, patient centred, timely, efficient, and equitable.

In addition, NHS England is currently refreshing the guidance on children and young people's eating disorders to highlight the importance of awareness and the early recognition of eating disorders within schools, colleges, primary care, and broader children and young peoples’ mental health services.

NHS England is working with the integrated care boards with the aim of increasing the capacity of eating disorder services, to provide community and day treatment services. By improving care in the community, the National Health Service aims to improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce the length of time that people have to stay in hospital.

NHS England has commissioned the Royal College of Psychiatrists to deliver a national, all-age eating disorders audit. This aims to drive improvement in the identification and appropriate management of eating disorders, and the quality and consistency of services for all ages in England. This will help ensure that services across the country, including in rural areas, are safe, effective, patient centred, timely, efficient, and equitable.

In addition, NHS England is currently refreshing the guidance on children and young people's eating disorders to highlight the importance of awareness and the early recognition of eating disorders within schools, colleges, primary care, and broader children and young peoples’ mental health services.

All interventions delivered by mental health practitioners, including those in mental health support teams, are evidence-based and use a range of clinical evidence.

An early evaluation of the children and young people’s mental health trailblazer programme examined the development, implementation, and early progress of the 25 ‘trailblazer’ mental health support teams created as the first step of the programme. The interim report was published in January 2023, and highlights the impacts of the mental health support teams on improving pupil mental health and improving teacher mental health. The report is available at the following link:

https://www.rand.org/randeurope/research/projects/2023/children-and-young-people-s-mental-health-trailblazer-programme.html

There are currently no plans to commission an independent review on the impact of different mental health practitioners on children and young people’s well-being.

The fee that has been put in place to underpin the service is aligned to other fees paid for domiciliary sight testing services. NHS England has committed to investing up to £12.7 million annually on the provision of sight tests and the associated optical vouchers in special educational settings. This provides the potential for these services to reach approximately 165,000 children and young people in over 2,000 educational settings, ensuring sight tests are provided in a familiar environment whilst minimising disruption to the school day.

NHS England has engaged with key stakeholders throughout the life of the programme and continues to work closely with local integrated care board commissioners, and the ophthalmic and voluntary sector, to scale up and roll out sight tests for patients in a special educational setting.

It is the responsibility of the integrated care boards (ICBs) in England to make available appropriate provision to meet the health and care needs of their local population, including assessments for attention deficit hyperactivity disorder (ADHD) and autism, in line with relevant National Institute for Health and Care Excellence guidelines.

Lord Darzi’s independent review of the National Health Service, published September 2024, highlighted that demand for assessments for ADHD and autism have grown significantly in recent years, and highlighted the severe delays for accessing such assessments.

The report noted that nationally the growth in demand for ADHD assessments over recent years has been so significant that it risks completely overwhelming the available resources. NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the NHS, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer.

In respect of autism, the latest Autism Waiting Times Statistics published by NHS England show that, in December 2024, there were 212,964 patients with an open referral for suspected autism. Of these, 191,656 had a referral that had been open at least 13 weeks. On 5 April 2023, NHS England published a national framework and operational guidance to deliver improved outcomes in all-age autism assessment pathways. This guidance aims to help ICBs and the NHS to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.

Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend. Dental practices may operate local waiting list arrangements. Patients unable to access an urgent dental appointment directly through an NHS dental practice are advised to contact NHS 111 for assistance.

The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England. For the York Central constituency, this is the NHS Humber and North Yorkshire ICB.

NHS England collects data on patient discharge episodes, including for children. Discharge data does not represent the number of individual children with a hospital stay, as a child may have more than one discharge from hospital within the reporting period.

Between April 2023 and March 2024, 67,421 discharge episodes were recorded where the patient was in hospital for more than seven days and was aged between zero and 17 years old when admitted into National Health Service care.

The following table shows a count of finished discharge episodes where the patient was aged between zero and 17 years old, including both total discharges and episodes where the patient was in hospital for more than seven days, each discharge month for 2023/24, for activity in English NHS hospitals and English NHS commissioned activity in the independent sector:

Source: Hospital Episode Statistics (HES), NHS England.

Notes:

1. a discharge episode is the last episode during a hospital stay, or spell, where the patient is discharged from the hospital or transferred to another hospital. Discharges do not represent the number of patients, as a person may have more than one discharge from hospital within the period;
2. the patient age is recorded at the point of admission, and this is used to determine the most appropriate setting for the patient. For the purposes of this data, we have only included discharges where the patient was aged zero to 17 years old at the point of admission;
3. total discharges are a count of the total number of finished discharge episodes;
4. discharge month episodes have been counted against the month in which the discharge occurred. It is possible that a patient may have been admitted in a month prior to their discharge; and
5. for the financial year 2023/24, the data in the HES is held by the financial year in which the episode ends. This is to ensure that all clinical and administrative data relevant to the episode is available at the time of collection.

It is unacceptable that there are such inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and for those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth.

The Department continues to work closely with the NHS as it delivers these initiatives.

The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

Across 2023/24, the latest data available, 2.5 million, or 64.6% of, patients on the asthma register received a review. Further information is available at the following link:

https://fingertips.phe.org.uk/profile/respiratory-disease/data#page/4/gid/8000009/pat/159/par/K02000001/ati/15/are/E92000001/iid/93790/age/314/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

In addition, the most recent asthma hospital admissions data for England is available at the following link:

https://fingertips.phe.org.uk/search/asthma

Furthermore, the Organization for Economic Cooperation and Development holds international comparison data for asthma hospital admissions, up to 2022, which is available at the following link:

https://data-explorer.oecd.org/vis?fs[0]=Topic%2C1%7CHealth%23HEA%23%7CHealthcare%20quality%20and%20outcomes%23HEA_HCQ%23&pg=0&fc=Topic&snb=11&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_HCQO%40DF_HCQO&df[ag]=OECD.ELS.HD&df[vs]=1.0&dq=.A.ADMRASTH..._T.OBS%2BVALUEW&pd=2014%2C&to[TIME_PERIOD]=false&vw=tb

There is no published international comparison data for asthma hospital admissions available for the past 12 months, and the Department currently has no plans to make an assessment of this.

Across 2023/24, the latest data available, 2.5 million, or 64.6% of, patients on the asthma register received a review. Further information is available at the following link:

https://fingertips.phe.org.uk/profile/respiratory-disease/data#page/4/gid/8000009/pat/159/par/K02000001/ati/15/are/E92000001/iid/93790/age/314/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

In addition, the most recent asthma hospital admissions data for England is available at the following link:

https://fingertips.phe.org.uk/search/asthma

Furthermore, the Organization for Economic Cooperation and Development holds international comparison data for asthma hospital admissions, up to 2022, which is available at the following link:

https://data-explorer.oecd.org/vis?fs[0]=Topic%2C1%7CHealth%23HEA%23%7CHealthcare%20quality%20and%20outcomes%23HEA_HCQ%23&pg=0&fc=Topic&snb=11&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_HCQO%40DF_HCQO&df[ag]=OECD.ELS.HD&df[vs]=1.0&dq=.A.ADMRASTH..._T.OBS%2BVALUEW&pd=2014%2C&to[TIME_PERIOD]=false&vw=tb

There is no published international comparison data for asthma hospital admissions available for the past 12 months, and the Department currently has no plans to make an assessment of this.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Equity and Equality Action Plans are published online to ensure public accountability.

NHS England has published technical guidance to monitor compliance and to determine the success measures that are used to monitor the outcomes and progress in achieving the key objectives of the plan. The guidance is available at the following link:

https://www.england.nhs.uk/long-read/three-year-delivery-plan-for-maternity-and-neonatal-care-technical-guidance/

The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

National Health Service organisations are not expected to individually submit carbon emissions data. Estimates are made at a national level, based on energy consumption data submitted by trusts through the annual Estates Return Information Collection. Further information on the annual Estates Return Information Collection is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection

Total NHS carbon emissions estimates are published in NHS England’s Annual Report. A copy of a table showing total secondary care emissions by energy source and rounded to nearest 10 ktCO2e, from 2018/19 to 2023/24, the most recent data available, is attached.

The annual Estates Return Information Collection (ERIC) collects data on the energy costs of National Health Service organisations. This data has been consistently reported since 2018/19. The following table shows the cost of energy bills for NHS trusts as reported in ERIC, from 2018/19 to 2023/24:

We are committed to ensuring that women, including those living in rural areas, receive safe and equitable care, regardless of where they live or give birth.

NHS England’s guidance sets out that all women who have given birth should be offered a postnatal check-up with their general practitioner (GP) after six to eight weeks. This check-up provides an important opportunity for women to be listened to by their GP in a discreet, supportive environment, and for women to be assessed and supported not just in their physical recovery post-birth, but also in their mental health.

For women with, or at risk of, mental health problems, who are planning a pregnancy, are pregnant, or who have a baby up to two years old, specialist perinatal mental health services provide care in all 42 integrated care system (ICS) areas of England. For women experiencing mental health difficulties directly arising from, or related to, their maternity or neonatal experience, Maternal Mental Health Services provide care in 41 of the 42 ICS areas in England, with the last being supported by NHS England to ensure it is up and running as soon as possible.

The Government is committed to addressing the stark inequalities for women and babies, so that everyone can receive the high-quality care they deserve regardless of their background, circumstance, or ethnicity.

The Department is working with NHS England, other Government departments, and the wider sector to identify and embed the right actions and interventions that will help deliver improvements. For example, we are working closely with the Ministry of Housing, Communities and Local Government to develop non-statutory guidance to support the implementation of Awaab’s Law from October 2025. This law introduces additional hazards, such as excess cold, which increase health risks for pregnant women, as well as for unborn and born children.

To find new ways to tackle maternity disparities, the National Institute for Health and Care Research, funded by the Department, launched the first challenge on maternity inequalities in March 2024. Over the subsequent five years, funding of up to £50 million will be made available to develop research and evidence that will drive action to reduce maternity inequalities and improve outcomes for women.

We are keen to draw on the lessons from the National Programme for IT in delivering the Federated Data Platform and the single patient record.

NHS England publishes information each quarter on the benefits being realised by the Federated Data Platform, with further information available at the following link:

https://www.england.nhs.uk/digitaltechnology/nhs-federated-data-platform/solution-exchange/fdp-uptake-and-benefits/

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.

Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.

For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.

Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.

Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.

For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.

Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.

The Department recognises the significant physical and psychological consequences of birth trauma and the devastating impact this can have on some women. We are fully committed to improving the quality and consistency of care for women throughout pregnancy, birth, and the critical months that follow, and to ensuring that when a woman experiences a traumatic birth, there is a broad range of support available

In relation to the psychological impact, bespoke mental health pathways support women who experience mental health difficulties as a result of labour. These services are provided through specialist perinatal mental health services, maternal mental health services, and mother and baby units. Mother and baby units are specialist, in-patient units for some women with mental health problems, designed to keep mothers and their babies together. Specialist staff nurture and support the mother infant relationship on the ward, while at the same time the mother receives treatment and care. 165 mother and baby unit beds have now been commissioned, and maternal mental health services have been set up in 41 out of the 42 local areas across England to provide care for women with moderate to severe or complex mental health difficulties, arising from birth trauma or loss in the maternity/neonatal context.

With regards to physical health, NHS England’s national service specification for perinatal pelvic health services sets out the expected standards of care to improve the prevention and identification of pelvic health issues, and to increase access to physiotherapy for pelvic health issues during pregnancy and for at least one year after birth. These services work with maternity services across England to implement the Royal College of Obstetricians and Gynaecologists’ Obstetric Anal Sphincter Injuries care bundle, to reduce rates of anal sphincter, or perineal, injuries resulting from labour and vaginal birth.

All women are now offered a general practitioner (GP) check six to eight weeks after birth that should focus on the mothers physical and mental health needs. This is an opportunity for GPs to listen to women in a discrete, supportive environment, in order to provide personalised postnatal care for their physical and mental health, and includes an explicit reference to birth trauma for the first time.

The Government recognises that experiencing a miscarriage can be an extremely difficult time, and we are determined to make sure all women and babies receive safe, personalised, and compassionate care, particularly when things go wrong. It is vital that women seeking support, including in early pregnancy, get the care they need.

We have launched the Baby Loss Certificate Service, which enables those who have experienced any pregnancy loss to record and receive a certificate to provide recognition of a baby loss, if they wish to do so. The Human Tissue Authority has also updated the guidance on the sensitive handling of pregnancy remains. We are continuing to work with NHS England to improve the Early Pregnancy Assessment Units’ services, by improving their availability and level of support. NHS England has also published a policy to support National Health Service employees and provide managers with advice on how to support people affected by baby loss, including paid leave.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.

NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.

In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.

For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.

NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.

In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.

For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.

NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.

In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.

For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. To deliver this, it is important that those working in maternity and neonatal services receive the required training needed to deliver culturally competent care.

While it is the responsibility of employers in the health system to ensure that their staff are trained to the required standards to deliver safe and effective treatment for patients, NHS England is taking steps to ensure that maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and through provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Over 15,400 maternity staff have completed the e-learning module, which supports staff to better understand and meet the needs of diverse communities.

NHS England has also embedded equity-focused leadership development through the Perinatal Culture and Leadership Programme. All 150 maternity and neonatal units in England have participated in the programme. No assessment has been made on the effectiveness of these steps.

The Government is committed to tackling the retention and recruitment challenges that face the National Health Service. Bringing in the staff we need will take time, but this is an absolute priority for the Government.

NHS England is leading a range of initiatives to boost retention of existing staff and ensure that the NHS remains an attractive career choice for new recruits. This includes building a compassionate and inclusive culture, supporting staff wellbeing, and promoting flexible working opportunities.

Targeted retention work for midwives is being undertaken by NHS England, led by the Chief Nursing Officer. This work contains a range of measures, including creation of a midwifery and nursing retention self-assessment tool, mentoring schemes, strengthened advice and support on pensions, and embedding flexible retirement options. NHS England has also invested in unit-based retention leads which, alongside investment in workforce capacity, has seen a reduction in vacancy, leaver, and turnover rates.

Decisions around local recruitment remain the responsibility of individual NHS trusts, who are responsible for ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.

Data on a woman’s ethnic background is routinely collected by services at multiple points throughout maternity care. This data is used to disaggregate reporting of adverse outcomes, like maternal mortality, by ethnicity. Differences by ethnicity are also reported as part of the Care Quality Commission’s annual survey, which asks a sample of pregnant women and new mothers about their experience of National Health Service maternity services.

NHS trusts are incentivised to collect this information through the Maternity Incentive Scheme, which is a financial incentive program designed to enhance maternity safety within NHS trusts. Safety Action 2 of the Maternity Incentive Scheme incentivises trusts to submit digital information, including ethnicity data, to the Maternity Services Data Set.

The levels of completeness are high, and gaps are rare. 95% of women who gave birth in 2023/24 had their ethnic background recorded.

The Government expects to publish the impact assessment before Members consider the bill on Report.