Department of Health and Social Care

Shifting the focus from sickness to prevention is one of the three shifts in the Government’s mission for a National Health Service fit for the future, and is a cornerstone of supporting people to live healthier lives. We are working collaboratively across Government to deliver a resilient food system that promotes health and food security, protects the environment, and champions British farming.

Consuming fruit and vegetables are critical parts of the Government’s dietary recommendations under the Eatwell Guide. Consumers in the United Kingdom would need to eat at least 30% more of a variety of fruits and vegetables by weight to meet the Government’s dietary recommendations. For fruits and vegetables, the Department for Environment Food and Rural Affair’s data suggest UK farms provide 53% of vegetables that are sold domestically, as well as 16% of the fruit. This means the farming sector plays a critical role in the sustainable and resilient food and nutrition security of the country, with a direct impact in preventing obesity and improving diet-related health.

The food strategy will work to provide healthier, more easily accessible food to help people live longer healthier lives, and will support the Farming Roadmap to reduce the impact of farming on nature and biodiversity.

Access to nature, including green spaces provided by farms, plays a crucial role in preventative healthcare. Studies have shown that exposure to natural environments can reduce stress, improve mental well-being, and lower the risk of conditions such as heart disease and obesity. Green spaces linked to farming, such as walking trails, woodlands, and agricultural land, help encourage physical activity, and foster social well-being.

There are no current plans to make such an assessment. The National Institute for Health and Care Excellence’s (NICE) guidance on cerebral palsy in under 25 year olds, guidance code NG62, includes recommendations on the transition from children to adult services and stresses the requirement to ensure that an individual's developmental, social, and health needs are addressed when planning and delivering the transition. The guidance also sets out key considerations to be made around transition planning, including: clear pathways involving both the young person's general practitioner and named clinicians in adult services; ensuring sufficient training for the professionals involved in the care; clear communication at each point of transition; and a named worker to support continuity of care.

Further NICE guidance on cerebral palsy in adults, code NG119, recommends that adults with cerebral palsy should be offered an annual review of their clinical and functional needs, as part of ongoing care, carried out by a healthcare professional with expertise in neurodisabilities.

NHS England has worked with key stakeholder organisations, including children and young people, and their families and carers, to develop a framework targeted at integrated care systems to be used as a supportive tool to aid in the commissioning of high-quality services for children and young people with cerebral palsy, including those in the transition period to adult services.

In the NHS Long Term Plan, NHS England committed to delivering a service model for zero to 25-year-olds to improve young people’s experiences and health outcomes. To aid implementation of this model, the Children and Young People’s Transformation programme collaborated with key partners to develop national guidance on how the National Health Service can better support young people’s transfer into adolescent and adult services. The guidance is due to be published shortly and will be hosted on the NHS England website. The policy aligns with existing NICE guidelines, code NG43, and outlines the principles and steps of a zero to 25-year-old service model, along with best practice examples from across the country.

The Children and Young People’s Transformation programme is working with the NHS Youth Forum to gather the experiences and ideas of young people on adolescent healthcare. The forum will develop recommendations to inform future policies on healthcare transition, including how to deliver developmentally appropriate and person-centred care.

The estimated familiarisation and staff training costs included in the Tobacco and Vapes Bill impact assessment are assumed to be one-off costs, and individual estimates are provided for each specific policy.

The bill will gradually end the sale of tobacco products across the country, so an individual born on or after 1 January 2009 will never be legally sold these products, including through proxy purchasing. Although it will mean the legal age of sale effectively increases by one year each year, the regulations will not change every year. This means it will be a one-off cost for retailers in terms of training staff.

Some indicative estimates for staff training are included for secondary legislation. This, however, will be subject to consultation and, where proportionate, further work will be completed to assess the costs and benefits of these measures.

We will continue to work closely with retailers to support them in implementing the smoke-free generation policy in the future.

Seven of the nine recommendations have been previously accepted by the Government, in full, in part, or in principle, and four of these have been successfully implemented, including:

- issuing an unreserved apology on behalf of the healthcare system;

- appointing Dr Henrietta Hughes as the first ever Patient Safety Commissioner in England in respect of medicines and medical devices; and

- establishing nine specialist mesh centres, which are in operation across England.

Work is ongoing in respect of the remaining recommendations, including working across the Government to consider the recommendations in the Hughes Report, which looked into and provided advice on redress for those affected by sodium valproate and pelvic mesh.

The Government has amended the Human Medicines Regulations 2012 to expand access to naloxone. This means that more professionals and services than ever before can give out take-home supplies of naloxone to those at-risk of overdose. This follows the Department’s public consultation, published on 24 January 2024, in which the responses were overwhelmingly supportive of our proposals. The legislation came into force on 2 December 2024.

The legislation also enables the development of a new registration service, which will further expand the number of professionals and services able to give out naloxone. This will take longer to implement, and work is ongoing across the devolved administrations to ensure alignment where appropriate.

This legislation is United Kingdom wide, and we will continue to work closely with colleagues in the devolved administrations to share learning and align our approaches where appropriate.

Health is a devolved issue, and as a result there are currently different existing arrangements for naloxone supply across the UK and each administration takes its own decisions on the provision and funding of naloxone. I have therefore not had discussions on UK wide Government-funded naloxone programmes.

These legislative changes are enabling only, meaning it will be a choice for individuals or organisations to decide whether they want to use this power and give out naloxone, which will be based on local need and capacity. Local authorities are responsible for commissioning drug treatment services as part of their public health responsibilities, and they provide funding for naloxone supplied through drug treatment services based on their assessment of local need.

The Government has amended the Human Medicines Regulations 2012 to expand access to naloxone. This means that more professionals and services than ever before can give out take-home supplies of naloxone to those at-risk of overdose. This follows the Department’s public consultation, published on 24 January 2024, in which the responses were overwhelmingly supportive of our proposals. The legislation came into force on 2 December 2024.

The legislation also enables the development of a new registration service, which will further expand the number of professionals and services able to give out naloxone. This will take longer to implement, and work is ongoing across the devolved administrations to ensure alignment where appropriate.

This legislation is United Kingdom wide, and we will continue to work closely with colleagues in the devolved administrations to share learning and align our approaches where appropriate.

Health is a devolved issue, and as a result there are currently different existing arrangements for naloxone supply across the UK and each administration takes its own decisions on the provision and funding of naloxone. I have therefore not had discussions on UK wide Government-funded naloxone programmes.

These legislative changes are enabling only, meaning it will be a choice for individuals or organisations to decide whether they want to use this power and give out naloxone, which will be based on local need and capacity. Local authorities are responsible for commissioning drug treatment services as part of their public health responsibilities, and they provide funding for naloxone supplied through drug treatment services based on their assessment of local need.

The Government has amended the Human Medicines Regulations 2012 to expand access to naloxone. This means that more professionals and services than ever before can give out take-home supplies of naloxone to those at-risk of overdose. This follows the Department’s public consultation, published on 24 January 2024, in which the responses were overwhelmingly supportive of our proposals. The legislation came into force on 2 December 2024.

The legislation also enables the development of a new registration service, which will further expand the number of professionals and services able to give out naloxone. This will take longer to implement, and work is ongoing across the devolved administrations to ensure alignment where appropriate.

This legislation is United Kingdom wide, and we will continue to work closely with colleagues in the devolved administrations to share learning and align our approaches where appropriate.

Health is a devolved issue, and as a result there are currently different existing arrangements for naloxone supply across the UK and each administration takes its own decisions on the provision and funding of naloxone. I have therefore not had discussions on UK wide Government-funded naloxone programmes.

These legislative changes are enabling only, meaning it will be a choice for individuals or organisations to decide whether they want to use this power and give out naloxone, which will be based on local need and capacity. Local authorities are responsible for commissioning drug treatment services as part of their public health responsibilities, and they provide funding for naloxone supplied through drug treatment services based on their assessment of local need.

The Government has amended the Human Medicines Regulations 2012 to expand access to naloxone. This means that more professionals and services than ever before can give out take-home supplies of naloxone to those at-risk of overdose. This follows the Department’s public consultation, published on 24 January 2024, in which the responses were overwhelmingly supportive of our proposals. The legislation came into force on 2 December 2024.

The legislation also enables the development of a new registration service, which will further expand the number of professionals and services able to give out naloxone. This will take longer to implement, and work is ongoing across the devolved administrations to ensure alignment where appropriate.

This legislation is United Kingdom wide, and we will continue to work closely with colleagues in the devolved administrations to share learning and align our approaches where appropriate.

Health is a devolved issue, and as a result there are currently different existing arrangements for naloxone supply across the UK and each administration takes its own decisions on the provision and funding of naloxone. I have therefore not had discussions on UK wide Government-funded naloxone programmes.

These legislative changes are enabling only, meaning it will be a choice for individuals or organisations to decide whether they want to use this power and give out naloxone, which will be based on local need and capacity. Local authorities are responsible for commissioning drug treatment services as part of their public health responsibilities, and they provide funding for naloxone supplied through drug treatment services based on their assessment of local need.

In 2025/26, £57 million will be made available to 75 local authorities with high levels of deprivation to provide a range of Start for Life services.

Due to the challenging fiscal context, we have had to make difficult decisions for 2025/26, and only those areas currently in the scheme will receive Start for Life funding. We will continue to evaluate the programme and assess evidence to support wider rollout in future financial years.

Since June 2022, 42 integrated care boards (ICBs) across England have been responsible for arranging National Health Service healthcare services to meet the needs of their respective populations, reflecting the diversity of the needs within these populations. The local ICB is therefore responsible for ensuring that NHS services are accessible in their area.

NHS England is responsible for funding allocations to ICBs. This process is independent of the Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation (ACRA).

The ACRA endorsed the introduction of a new community services formula, that they believe will better recognise needs for much older populations with higher needs for certain community services, which on average tend to be in some rural, coastal, and remote areas.

Work is also underway across the Department and with NHS England and the regional Directors of Public Health to develop approaches to address regional health inequalities. In line with the Government’s Health Mission, the Department’s goal is to create a more equitable healthcare system that leaves no person or community behind.

The NHS Health Check programme, England’s cardiovascular disease (CVD) prevention programme, aims to prevent CVD in people aged 40 to 74 years old, and is offered every five years. During 2023/24, over 1.4 million people received an NHS Health Check, and through behavioural and clinical interventions, the programme prevents approximately 500 heart attacks and strokes a year.

To improve access and engagement with the NHS Health Check, we are developing a new digital service which will complement the existing face to face programme and enable people to undertake the NHS Health Check in the comfort of their own home.

The Department is developing policy proposals and advice to ministers on options to improve the uptake and impact of the NHS Health Check programme. The work will consider the recommendations of the recent National Audit Office’s report, Progress on CVD Prevention.

The Government has pledged to reform the National Health Service so that it better meets the needs of patients. This includes the current engagement exercise, which will help to shape the 10-Year Health Plan. This will be published in spring 2025 and is expected to underline the large shifts in how healthcare is provided.

The NHS North East and North Cumbria Integrated Care Board (ICB) has begun a programme of work with our partners to consider the future efficiency requirements and potential areas of investment for the future. While a Tourette's syndrome service may be considered within this process, it is likely that we will review the alignment of specialist support within the wider children and young people's mental health service pathways, including the links with local authorities on special educational needs and disability provision.

As commissioners, the ICB also undertakes an annual planning exercise to identify pathways that may require review. The pathway for the diagnosis and management of Tourette's syndrome, not only in County Durham, but across the North East and North Cumbria, will be identified through this exercise as an area for potential review in 2025/26. This will help us to understand where there are gaps in the provision of this specialist service that may potentially need to be addressed across the region. This planning exercise will require a prioritisation exercise to consider the clinical and cost benefits of a range of potential investment opportunities.

The Thalidomide Health Grant is awarded to meet the health and wellbeing needs, present and future, of thalidomide survivors living in England.

In 2023, the Department put in place a new four-year grant agreement with the Thalidomide Trust, to administer the grant of approximately £40 million. The grant was made in recognition of the complex and highly specialised needs of people affected by thalidomide in England, particularly as they approach old age. The funding helps beneficiaries of the Thalidomide Trust to maintain control over their own health, enabling them to personalise the way their health and care needs are met, maintain independence, and minimise any further deterioration in their health.

Consultation with Community Pharmacy England for the 2025/26 Community Pharmacy Contractual Framework has started and will include reviewing the allowance for medicine margin as part of funding, and any further changes to the reimbursement arrangements.

The Department has previously reviewed the reimbursement arrangements for community pharmacies which lead to a consultation on several improvements in 2019. The consultation response was published in November 2021, and is available at the following link:

https://www.gov.uk/government/consultations/community-pharmacy-drug-reimbursement-reform/outcome/community-pharmacy-drug-reimbursement-reform-consultation-response

There are currently no plans to review the reimbursement system for general practices (GPs) dispensing medicines. Dispensing practices receive a dispensing fee, approximately £2.00 to £2.30 per item, which is intended to cover dispensing costs. This fee is calculated based on forecasted volumes of prescriptions to be dispensed and the size of the funding envelope, according to a methodology agreed by the Department, the General Practitioners Committee (GPC), NHS Employers, and the Welsh Government.

An updated methodology was agreed between the British Medical Association and NHS England to address the issue of continuing fluctuation between over and underspend year on year, the alternating pattern of over and under spends, and implemented in October 2023.

The Department and NHS England started consulting with the GPC England, of the British Medical Association, on the 2025/26 GP Contract on 19 December and will consider all proposed policy changes, including dispensing practices. An announcement will be made before April 2025.

General practitioners (GPs) are responsible for ensuring their own clinical knowledge, including on brain tumours, remains up-to-date, and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence, to ensure that they can continue to provide high quality care to all patients.

The training curricula for postgraduate trainee doctors is set by the Royal College of General Practitioners (RCGP), and has to meet the standards set by the General Medical Council. The RCGP provides a number of resources on cancer prevention, diagnosis, and care for GPs, relevant for the primary care setting.

The Government aims to ensure that the National Health Service diagnoses cancer earlier and treats it faster, so more patients survive, and improves patients’ experience across the system.

The Assuring Transformation data set records information about people with a learning disability and autistic people who are receiving treatment or care as inpatients in a mental health hospital.

Patients in assessment and treatment units (ATUs) in England are recorded in the Assuring Transformation data set under the bed type Acute Mental Health Unit for Adults with a Learning Disability and/or Autism.

We are only able to identify ATUs in Assuring Transformation from April 2024. Therefore, we are unable to determine the how many patients were in ATUs, including those detained under the Mental Health Act and informal patients, for the requested periods of December 2023, 2022, and 2021.

The Assuring Transformation data set records information about people with a learning disability and autistic people who are receiving treatment or care as inpatients in a mental health hospital. Patients in assessment and treatment units (ATUs) in England are recorded in the Assuring Transformation data set under the bed type Acute Mental Health Unit for Adults with a Learning Disability and/or Autism.

We are only able to identify ATUs in Assuring Transformation from April 2024. Therefore, we are unable to determine the how many patients were in ATUs, including those detained under the Mental Health Act and informal patients, for the requested periods of December 2023, 2022, and 2021.

In December 2024 there were 160 inpatients detained in Acute Mental Health Units for Adults with a Learning Disability and/or Autism under the Mental Health Act. In addition to this, there were 15 informal patients in such settings at this time. These figures include patients in in ATUs, but may also include some patients who were in other inpatient mental health settings.

The Care Quality Commission (CQC) Fundamental Standard on Visiting and Accompanying (Regulation 9A) came into force on 6 April 2024 to strengthen requirements for CQC registered care homes, hospitals, and hospices to facilitate visiting, unless there are exceptional circumstances which mean that it is not safe to do so. This can be a visit from a family member, a friend, or a person visiting to provide companionship or support, for example, a care supporter.

We will conduct a review of Regulation 9A from April 2025, 12 months on from the legislation coming into force, to assess whether the legislation has been effective in addressing concerns about visiting in health and care settings. Depending on the outcome of the review, we will consider whether further action is needed.

Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.

The 10-Year Health Plan will address the challenges diagnosed by Lord Darzi, and set the vision for what good joined-up care looks like for people with a combination of complex health and care needs. It will set out how we support and enable health and social care services to work together better to provide that joined-up care.

The Government is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission, which is expected to begin in April 2025, will form a key part of the Government’s Plan for Change, recognising the importance of adult social care in its own right, as well as its role in supporting the National Health Service.

It is a once in a generation opportunity to transcend party politics and engage in genuine debate on how we can deliver a National Care Service, ensuring all voices are heard, and putting the voices of those with lived experience at the heart of the conversation.

The National Institute of Health and Care Excellence (NICE) published guidance in 2019 that recommended cerliponase alfa, brand name Brineura, for treating neuronal ceroid lipofuscinosis type 2, within a managed access agreement. This was due to the uncertainty in the evidence base, particularly around the long-term clinical benefits and assumptions about disease stabilisation.

During this period of managed access, cerliponase alfa has been available to eligible patients while further data was collected to address the clinical uncertainties. The NICE is now carrying out a new evaluation of cerliponase alfa to determine whether it can be recommended for routine National Health Service funding, taking account of the real-world evidence collected during the managed access period. If this evaluation shows that the treatment is a clinically effective and cost-effective use of NHS resources, it will be recommended for routine use in the NHS. All parties are working together to ensure a conclusion to the ongoing evaluation as swiftly as possible.

The National Institute of Health and Care Excellence (NICE) published guidance in 2019 that recommended cerliponase alfa, brand name Brineura, for treating neuronal ceroid lipofuscinosis type 2, within a managed access agreement. This was due to the uncertainty in the evidence base, particularly around the long-term clinical benefits and assumptions about disease stabilisation.

During this period of managed access, cerliponase alfa has been available to eligible patients while further data was collected to address the clinical uncertainties. The NICE is now carrying out a new evaluation of cerliponase alfa to determine whether it can be recommended for routine National Health Service funding, taking account of the real-world evidence collected during the managed access period. If this evaluation shows that the treatment is a clinically effective and cost-effective use of NHS resources, it will be recommended for routine use in the NHS. All parties are working together to ensure a conclusion to the ongoing evaluation as swiftly as possible.

The Department does not hold the information requested.

For professions such as dentists, who do NHS commissioned work but who are not directly employed by NHS bodies, the Department does not hold detailed staffing information.

The Department set a deadline of 28 June 2024 for the completion of National Health Service provider audits, for the year that ended 31 March 2024. 38 NHS providers did not meet the deadline. NHS providers do not receive revenue allocations, and instead revenue is earned through the provision of services. A table showing the 38 NHS providers and their total operating income is attached.

We want to ensure general practice (GP) online booking services are available to those who need them. That’s why we have committed to implementing a modern appointment booking system, designed to eliminate the 8:00am rush for appointments. All practices in England are required to offer online and video consultation tools, secure electronic communication methods, and online facilities to provide and update personal information.

Subject to consultation with the British Medical Association, the Government proposes requiring GPs to be accessible to patients via electronic communications throughout core hours, as well as over the phone, helping more people book an appointment or speak to a GP, and supporting the Government’s aim to shift care from analogue to digital.

99.4% of the primary care estate are now live with digital telephony and 90% have been enrolled to use online registration systems.

We recognise the impact that long waits to access speech and language therapy can have on the individual, and their families and carers. The Department and NHS England are committed to reducing long waits and improving timely access to community health services, including speech and language therapy.

We continue to improve access to speech and language therapy by including the Early Language and Support for Every Child pathfinder project within the Department for Educations’ existing Change Programme, in partnership with NHS England.

It is the responsibility of integrated care boards to make available appropriate provision to meet the health and care needs of their local population.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines. It is the responsibility of ICBs to work within their geographical area to offer services that meet the needs of their population.

Local authorities are required to provide or arrange services that meet the social care needs of the local population under the Care Act 2014.

NHS England is committed to delivering high quality care and support for every person with dementia, and central to this is the provision of personalised care and support planning for post diagnostic support.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Increased volumes of PERT are expected for 2025, and specialist importers have sourced unlicensed stock to assist in covering the gap in the market. In December, the Department issued further management advice to healthcare professionals. This directs clinicians to unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure local mitigation plans are implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest updates on PERT availability and easily accessible prescribing advice.

There are no plans to assess the impact of prescription charges on people who have undergone a kidney transplant.

There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with long term or chronic conditions may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.

People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.

The Health Mission sets out our plan to shift the National Health Service away from a model geared towards late diagnosis and treatment, to one where the NHS focuses on prevention, and where more services are delivered in local communities. Our core objective is to shorten the amount of time spent in ill-health and prevent premature deaths, which will in turn reduce pressure on the NHS, boost the economy, and prevent the vicious cycle of ill health and poverty.

We are taking action across the Government to tackle the biggest drivers of ill health, including legislation to make this country smoke-free and to protect future generations from the harms of addiction, as well as working closely with local government to address the underlying social determinants of health.

Within the health and care system, the 10-Year Health Plan will describe a shared vision for the health and care system in 2035, drawing directly from the extensive engagement underway with the public, patients, and staff. It will set out how the NHS will deliver the shift from sickness to prevention, which will be one of the central tenets of the plan. This includes a working group focused on the preventative healthcare model for the future.

To support the shift to prevention within primary care, we have proposed providing financial incentives to reward general practitioners who go above and beyond to prevent the most common killers, like heart disease, for the next contract year. This is subject to the contract consultation currently underway with the General Practitioners Committee England.

NHS England has published NHS Planning Guidance for 2025/26, setting out the first steps for reform and the immediate actions we are asking systems to take to deliver, including on the shift from sickness to prevention. In South Derbyshire our Regional Director of Public Health is working with local government and the Joined Up Care Derbyshire Integrated Care Board (ICB) to support the shift to prevention. The Joined Up Care Derbyshire ICB is responsible for considering the impact of its preventative healthcare model on local primary care providers.

NHS England commissions Op COURAGE, the integrated mental health and wellbeing service, which allows veterans to make self-referrals. The Op COURAGE North service, run by the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, covers the Hexham area.

The service, which is available across England, has been designed to support veterans from all areas, and is delivered from a range of locations, including National Health Service trusts, general practices (GPs), Poppy Shops, veteran hubs, and drop-in centres. Elements of the service may also be provided online if this is clinically appropriate. The Government recognises that not all veterans want to use veteran-specific mental health services, and they can instead choose to use mainstream NHS services, such as Talking Therapies, which are available to both veterans and civilians.

GPs are able to participate in the Veteran Friendly Practice Accreditation Scheme, which is a free support programme for GPs in England that enables GPs to easily identify, understand, and support veterans and, where appropriate, refer them to specialist healthcare services designed especially for them, such as Op COURAGE. Over 99% of Primary Care Networks have at least one GP accredited as Veteran Friendly.

For Op COURAGE, between April and November 2024, Op COURAGE North received 2,040 referrals. Across all Op COURAGE services in England, there were over 5,000 referrals in the same time period. For NHS Talking Therapies, between April and November 2024, NHS Talking Therapies in the North of England received 5,100 referrals from veterans. Across all NHS Talking Therapies there were over 13,400 referrals over the same period.

NHS England commissions Op COURAGE, the integrated mental health and wellbeing service, which allows veterans to make self-referrals. The Op COURAGE North service, run by the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, covers the Hexham area.

The service, which is available across England, has been designed to support veterans from all areas, and is delivered from a range of locations, including National Health Service trusts, general practices (GPs), Poppy Shops, veteran hubs, and drop-in centres. Elements of the service may also be provided online if this is clinically appropriate. The Government recognises that not all veterans want to use veteran-specific mental health services, and they can instead choose to use mainstream NHS services, such as Talking Therapies, which are available to both veterans and civilians.

GPs are able to participate in the Veteran Friendly Practice Accreditation Scheme, which is a free support programme for GPs in England that enables GPs to easily identify, understand, and support veterans and, where appropriate, refer them to specialist healthcare services designed especially for them, such as Op COURAGE. Over 99% of Primary Care Networks have at least one GP accredited as Veteran Friendly.

For Op COURAGE, between April and November 2024, Op COURAGE North received 2,040 referrals. Across all Op COURAGE services in England, there were over 5,000 referrals in the same time period. For NHS Talking Therapies, between April and November 2024, NHS Talking Therapies in the North of England received 5,100 referrals from veterans. Across all NHS Talking Therapies there were over 13,400 referrals over the same period.

As part of the New Hospital Programme announcement on 20 January, it was confirmed that the Royal Berkshire Hospital scheme is part of Wave 3, and would not begin main construction until 2037/39. We will continue to engage with trusts to establish the activities that should be progressed ahead of their main construction start.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

It is for local National Health Service organisations to adopt digital health technologies and services which best meet the needs of their local populations. However, digital health tools should be part of a wider offering that includes face-to-face support with appropriate help for people who struggle to access digital services. The GP Contract is also clear that patients should always have the option of visiting their practice in person. NHS England successfully ran a number of programmes to support patients, carers, and health service staff with their digital skills. These include:

• the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online;
• the Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation and means to access health information and services online; and
• the NHS App Spoken Word Pilot project, designed to test the efficacy of promoting NHS digital health products and services in languages other than English.

NHS England has also published a framework for NHS action on digital inclusion and is developing further resources to support practical actions. All digital programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion.

There have been no recent discussions with Cabinet Office colleagues on increasing the United Kingdom’s manufacturing capacity of pancreatic enzyme replacement therapy (PERT) or increasing access to the raw ingredients required for the production of PERT. However, we have established incentives to encourage UK life sciences manufacturing, including via the Life Science Innovative Manufacturing Fund (LSIMF). The LSIMF is now live and open to Expressions of Interest from all life science manufacturers, with formal application windows open on a quarterly basis, the next being in February 2025. The Government has committed up to £520 million to support businesses investing in life science manufacturing projects in the UK, and this would be open to applicants interested in setting up PERT manufacture in the UK.

Department officials continue to engage with all suppliers of PERT to boost production to mitigate the supply issue. Increased volumes of PERT are expected for 2025, and specialist importers have sourced unlicensed stock to assist in covering the gap in the market. In December, the Department issued further management advice to healthcare professionals. This directs clinicians to unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice.

There have been no recent discussions with Cabinet Office colleagues on increasing the United Kingdom’s manufacturing capacity of pancreatic enzyme replacement therapy (PERT) or increasing access to the raw ingredients required for the production of PERT. However, we have established incentives to encourage UK life sciences manufacturing, including via the Life Science Innovative Manufacturing Fund (LSIMF). The LSIMF is now live and open to Expressions of Interest from all life science manufacturers, with formal application windows open on a quarterly basis, the next being in February 2025. The Government has committed up to £520 million to support businesses investing in life science manufacturing projects in the UK, and this would be open to applicants interested in setting up PERT manufacture in the UK.

Department officials continue to engage with all suppliers of PERT to boost production to mitigate the supply issue. Increased volumes of PERT are expected for 2025, and specialist importers have sourced unlicensed stock to assist in covering the gap in the market. In December, the Department issued further management advice to healthcare professionals. This directs clinicians to unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice.

The merits of including Jewish or Sikh as an option when recording ethnicity in National Health Service data, and other issues relating to how the NHS records information on protected characteristics, are being considered by the Unified Information Standard for Protected Characteristics programme. This programme will help inform a view on next steps.

Information is not held centrally on the number of NHS services which allow patients to identify as Jewish or Sikh under ethnicity questions, or to record Judaism or Sikhism as their religion. There are SNOMED CT codes, the terminology used for recording patient information consistently across the NHS, for Judaism and Sikhism under religion.

The merits of including Jewish or Sikh as an option when recording ethnicity in National Health Service data, and other issues relating to how the NHS records information on protected characteristics, are being considered by the Unified Information Standard for Protected Characteristics programme. This programme will help inform a view on next steps.

Information is not held centrally on the number of NHS services which allow patients to identify as Jewish or Sikh under ethnicity questions, or to record Judaism or Sikhism as their religion. There are SNOMED CT codes, the terminology used for recording patient information consistently across the NHS, for Judaism and Sikhism under religion.

The merits of including Jewish or Sikh as an option when recording ethnicity in National Health Service data, and other issues relating to how the NHS records information on protected characteristics, are being considered by the Unified Information Standard for Protected Characteristics programme. This programme will help inform a view on next steps.

Information is not held centrally on the number of NHS services which allow patients to identify as Jewish or Sikh under ethnicity questions, or to record Judaism or Sikhism as their religion. There are SNOMED CT codes, the terminology used for recording patient information consistently across the NHS, for Judaism and Sikhism under religion.

The merits of including Jewish or Sikh as an option when recording ethnicity in National Health Service data, and other issues relating to how the NHS records information on protected characteristics, are being considered by the Unified Information Standard for Protected Characteristics programme. This programme will help inform a view on next steps.

Information is not held centrally on the number of NHS services which allow patients to identify as Jewish or Sikh under ethnicity questions, or to record Judaism or Sikhism as their religion. There are SNOMED CT codes, the terminology used for recording patient information consistently across the NHS, for Judaism and Sikhism under religion.

NHS dentists are required to keep their NHS.UK website profiles up to date so that patients can find a dentist more easily. This includes information on whether they are accepting new patients. This information is available at the following link:

https://www.nhs.uk/service-search/find-a-dentist

The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

The Department continues to advise patients to follow National Health Service guidance on reducing the risk of skin cancer. This advice is available publicly on the National Health Service website, at the following link:

https://www.nhs.uk/conditions/melanoma-skin-cancer/

The Department is not taking any additional steps, currently or within the last three years, to specifically fund skin cancer awareness campaigns.

NHS England run Help Us Help You campaigns to increase knowledge of cancer symptoms and address the barriers to acting on them, to encourage people to come forward as soon as possible to see their general practitioner. The campaigns focus on a range of symptoms as well as encouraging body awareness to help people spot symptoms across a wide range of cancers at an earlier point.

The National Health Service in England has been gradually reducing the age for bowel screening from 60 years old down to 50 years old, since 2021/22. The extension to 50 years old is expected to be completed by 31 March 2025.

The level of the National Health Service sight test fee is considered annually and takes into account discussions with the Optical Fee Negotiating Committee, consideration of patient access to sight testing services, which continue to be widely available, and affordability for the NHS.