Department of Health and Social Care

The following table shows the available data for the number of National Health Service urgent dental treatments and total courses of dental treatments delivered each month from July 2024 to October 2025:

Source: Monthly National Dental Activity data – England July 2023 to October 2025, available at the following link:
https://opendata.nhsbsa.net/dataset/dental-activity-data-england-july-2023-to-october-2025

Data for April 2025 to October 2025 should be treated as provisional. Final data for 2025/26 will be published in August 2026. Data for dentistry is measured in courses of treatment, not appointments. One course of treatment can be more than one appointment.

1.8 million additional courses of NHS dental treatment have been delivered in the seven months between April and October 2025, compared to the same period before the general election, nearly half of which were delivered to children.

We are broadening the scope of the commitment to deliver additional appointments so that they can be used for more patients, not just those who meet the clinical criteria for “urgent” care.

We will ensure a continued urgent care safety net by requiring, from April 2026, high street dentists to deliver 8.2% of their total contract value as urgent or unscheduled care.

No central assessment has been made of the adequacy of Dementia Assessment Services in Shropshire. The provision of dementia health care services is the responsibility of local integrated care boards and ensuring they are responsive to the needs of local communities.

However, NHS England does collect and publish data about people with dementia at each general practice (GP) in England, including those in Shropshire, to enable National Health Service GPs and commissioners to make informed choices about how to plan their dementia services around patients’ needs.

GPs also provide a count of patients up to the end of the reporting period who have received an assessment for dementia and who have received or declined an initial memory assessment, a referral to a memory clinic, a care plan, a care plan review, and/or a medication review.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). Therefore no central assessment has been made of the adequacy of care for people who have received dementia diagnoses in the context of the contribution of continued activity and social engagement for slowing the progression of dementia. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines, and oversee the quality of the services they commission.

We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. The Modern Service Framework for Frailty and Dementia will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.

The Government will consider the capital funding needs of adult social care as part of the next Spending Review. We have recently announced an additional £50 million for the Disabled Facilities Grant (DFG) in 2025/26. This could fund approximately 5,000 home adaptations supporting older and disabled people to live more independently in their homes, and brings the total DFG amount this year to £761 million. We have also confirmed £723 million for the DFG in 2026/27. The DFG budget across 2025/26 and 2026/27 is £150 million more than the total budget across the previous two years, 2023/24 and 2024/25. This represents an 11% increase that exceeds inflation.

Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people. This includes assessing current and future local provision of adult social care services and working with their local market to ensure that both present and anticipated demand can be met.

This data is not held by the Department or NHS England.

The Government is committed to transparency in reporting patient harm in the National Health Service. The Learn from Patient Safety Events (LFPSE) service allows frontline workers in NHS providers to record and analyse their own patient safety incidents in order to identify trends. At the national level, NHS England reviews hundreds of incidents each week via LFPSE, looking for risks that can be acted on, including by issuing National Patient Safety Alerts and collaborating with partners to address issues identified.

We recognise that urgent and emergency care performance has not consistently met expectations in recent years and are committed to restoring the waiting standards set out in the NHS Constitution by the end of this Parliament, as outlined in the Medium-Term Planning Framework, which is available at the following link:

https://www.england.nhs.uk/publication/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29/

NHS England has also published guidance on the Model Emergency Department, setting out core principles and pathways for high-performing emergency departments, which is available at the following link:

https://www.england.nhs.uk/long-read/the-model-emergency-department-high-performing-urgent-and-emergency-care-pathways/

We are also taking action to tackle corridor care by introducing new reporting arrangements and committing to publishing data on its prevalence for the first time, improving transparency and driving operational improvement. Where corridor care cannot be avoided, updated guidance has been published to support trusts to deliver it safely, while maintaining patient dignity and privacy. The updated guidance is available at the following link:

https://www.england.nhs.uk/long-read/principles-for-providing-patient-care-in-corridors/

NHS England commissions all services across the prison estate to be equivalent with those expected to be received in the community, including for cancer care.

All people received into prison have an initial health screen on arrival into prison. This assessment focuses on initial risks and key medicines required and any referrals to other services for immediate assessment. Any concerns regarding failures in cancer care for people in prison should be escalated by prison healthcare to the local National Health Service Health and Justice Commissioner.

NHS England expects all providers and healthcare professionals providing any NHS funded or commissioned service to have appropriate and relevant qualifications and work within the scope of their professional registration, including clinicians working to treat people in prison. Any women with a cancer diagnosis who require secondary or tertiary care should have access to these services as they would if they were in the community.

More information regarding assessments in relation to women diagnosed with cancer in prison can be found in the report, The health of people in prison, on probation and in the secure NHS estate in England, published in November 2025 by Professor Chris Whitty, the Chief Medical Officer. A copy of this report is attached.

Through the National Cancer Plan, published on 4 February 2026, we are committed to supporting all people living with or recovering from cancer.

The Government has committed to guarantee a face-to-face appointment for all those who want one. The National Health Service is clear that general practices must provide face-to-face appointments, alongside remote consultations, and patients’ input into consultation type should be sought and their preferences for face-to-face care respected unless there are good clinical reasons to the contrary.

We are boosting capacity in general practice so patients can get the appointments they need, including face‑to‑face. We have invested £160 million through the Additional Roles Reimbursement Scheme to bring over 2,000 extra General Practitioners (GPs) into Primary Care Networks, increasing appointment availability across England.

We are investing a further £485 million in 2026/27, bringing the total spend on the GP contract to over £13.8 billion and introducing a new practice‑level GP reimbursement scheme. The scheme, worth £292 million, will fund additional GPs or more GP sessions with existing GPs, equivalent to around 1,600 full‑time GPs nationally. This will strengthen capacity, improve access to face-to-face appointments and improve patient satisfaction.

The following table shows the number of National Health Service dental treatments delivered in the first seven months of the 2025/26 financial year, in the Lincolnshire Integrated Care Board:

Source: Monthly National Dental Activity data – England July 2023 to October 2025, available at the following link:
https://opendata.nhsbsa.net/dataset/dental-activity-data-england-july-2023-to-october-2025

In addition, the following table shows the available data for the number of NHS dental treatments delivered in 2023/24 and 2024/25, in the Lincolnshire Integrated Care Board:

Source: dental statistics for England 2024/25 and 2023/24, available at the following link:
https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202425

Data for dentistry is measured in courses of treatment, not appointments. One course of treatment can be more than one appointment. Data on the number of NHS dental appointments cancelled is not held.

The data for 2023/24 and 2024/25 are not directly comparable with the 2025/26 data due to the 2025/26 data being provisional. Final data for 2025/26 will be published in August 2026. Furthermore, the 2025/26 data covers 7 months of activity, but the 2023/24 and 2024/25 data covers the full 12-month period.

The number of patients per full time equivalent (FTE) fully qualified general practitioner (GP) was 1,938 in September 2015 compared to 2,133 in January 2026, including GPs employed by primary care networks. To reach the same number of patients per fully qualified GP today, we would need an additional 3,012 FTE GPs. However, the GP workforce has changed significantly since 2015 with a wider range of professionals working in GPs. There’s currently an additional 38,265 FTE direct patient care staff working in primary care, including nurses, physiotherapists, and pharmacists.

Thanks to actions taken by the Government, we currently have the highest number of fully qualified GPs since 2015, and steps are being taken to grow the GP workforce further.

As part of the 2026/27 GP Contract, we are increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner.

Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level GP reimbursement scheme which ring-fences and repurposes £292 million of funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions with existing GPs to improve access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment.

The Government wants a society where every person with dementia receives high-quality, compassionate care from diagnosis through to the end of life.

The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care.

Under the 10-Year Health Plan, those living with dementia and frailty will benefit from improved care planning and better services.   We will deliver the first ever Frailty and Dementia MSF to deliver rapid and significant improvements in quality of care and productivity.

The Frailty and Dementia MSF will seek to reduce unwarranted variation and narrow inequality for those living with dementia and frailty. It will support this by setting national standards for dementia and frailty care and redirecting NHS and adult social care priorities to provide the best possible care and support. In developing the Frailty and Dementia MSF, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with dementia.

The Government assesses the funding required for adult social care, which considers a wide range of factors. This assessment is considered alongside other Government priorities through the Spending Review process to inform decisions about how available public sector funding is distributed.

Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people. This includes commissioning a diverse range of care and support services that enable people to access quality care. Conditions in local care markets can vary across the country and local authorities are best placed to understand and respond to these local market conditions. The Department has not carried out a specific assessment on the barriers to private sector capital investment in social care and any regional variations. While private adult social care providers are individual businesses and the Government does not intervene in their operations, we have been clear that the expectation is for adult social care providers to behave responsibly, including through sustainable financial arrangements that support the sector and meet needs as required.

The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England, for publication later this year.

The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in last year’s 10-Year Health Plan.

Further information about the MSF is set out in my Written Statement HCWS1087, made on 24 November 2025.

The following table shows the number of National Health Service dental treatments delivered in the first seven months of the 2025/26 financial year, in the Lancashire and South Cumbria Integrated Care Board, which includes Preston and Lancashire:

Source: Monthly National Dental Activity data – England July 2023 to October 2025, available at the following link:
https://opendata.nhsbsa.net/dataset/dental-activity-data-england-july-2023-to-october-2025

In addition, the following table shows the available data for the number of NHS dental treatments delivered in 2023/24 and 2024/25 in the Lancashire and South Cumbria Integrated Care Board:

Source: Dental statistics for England for 2023/24 and 2024/25, available at the following link:
https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202425

Data for dentistry is measured in courses of treatment, not appointments. One course of treatment can be more than one appointment. Data on the number of NHS dental appointments cancelled is not held.

The data for 2023/24 and 2024/25 are not directly comparable with the 2025/26 data due to the 2025/26 data being provisional. Final data for 2025/26 will be published in August 2026. Furthermore, the 2025/26 data covers seven months of activity, but the 2023/24 and 2024/25 data covers the full 12-month period.

The Modern Service Framework for Frailty and Dementia will reduce unwarranted variation and narrow inequality in diagnosis and care for those living with dementia. It will set national standards and redirect National Health Service priorities to provide the best care and support.

Central to this modern service framework will be improved care and support and access to a timely and accurate diagnosis.

We are still developing plans for the Modern Service Framework for Frailty and Dementia and, in doing so, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with dementia.

As part of this exercise, we are considering all options to help reduce variation, including reviewing existing guidance and pathways. This will include the D100: Pathway Assessment Tool and the Dementia Care Pathway, covering all elements of the Well Pathway from Prevention through to Dying Well.

We are working to develop the content as soon as possible and we will keep partners updated on progress and timings as this work unfolds.

The 10-Year Health Plan sets out that the NHS App will also allow patients to book appointments, communicate with professionals, receive advice, draft or view their care plan, and self-refer to local tests and services. These developments will streamline how patients move through the system and support clearer navigation of their care.

We are also improving digital access in general practices (GPs), including online request routes, modernising triage models, and strengthening care navigations. GPs are responsible for their own clinical knowledge and advising patients on the most appropriate care pathways. To support this, we are delivering the recommendations of the Red Tape Challenge to remove unnecessary administrative burdens between primary and secondary care. The new Advice and Guidance scheme gives GPs specialist advice, reducing unnecessary referrals and helping patients reach the right care first time.

There are no current plans to make training in palliative care and end-of-life care mandatory for health and care professionals.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. To ensure the health and social care workforce is equipped and well supported to deliver personalised care to people at the end of life, Health Education England, now part of NHS England, hosts the End of Life Care for All e-learning training programme, which includes nine modules on improving care for people at the end of life.

Independent statutory regulatory bodies such as the General Medical Council (GMC) and the Nursing and Midwifery Council have the general function of promoting high standards of education and coordinating all stages of education to ensure that health and care students and newly qualified healthcare professionals are equipped with the knowledge, skills, and attitudes essential for professional practice.

The training curricula for postgraduate specialty training, including palliative care and end-of-life care, is set by the relevant royal college and have to meet the standards set by the GMC.

For general practitioners (GPs), the Royal College for General Practice has established the GP with Extended Roles (GPwER) in Palliative and End of Life Care Framework. The GpwER framework sets out standards, capabilities, training requirements, supervision and governance for GPs working beyond core practice, including in palliative and end-of-life care.

The Government is committed to ensuring that people at the end of life can access the medicines they need, including outside of normal pharmacy opening hours.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end-of-life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

NHS England’s statutory guidance states that ICBs work with community pharmacies, out-of-hours providers and palliative care teams to ensure timely access to medicines, including through locally commissioned services that make end of life medicines available on a 24/7 basis.

Additionally, those nearing the end of life who are likely to need symptom control can be prescribed anticipatory medicines with written instructions for how to use or administer treatment. These medicines are often called 'just in case' medicines and may be provided in a specially marked container called a 'just in case' box. The medicines are prescribed in advance so that they can be obtained during local pharmacy opening hours and kept safely at home, or at a care home, so that the person or their carer has access to them if they develop symptoms. Providing medicines in advance means that there is no delay in getting medicines that might be needed quickly to help with symptoms. The use of anticipatory prescribing is recommended in the National Institute for Health and Care Excellence guideline, Care of dying adults in the last days of life.

Furthermore, the Government will publish a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England later this year. The MSF will drive improvements in the services that patients and their families receive at the end of life and enable ICBs to address challenges in access, quality and sustainability through the delivery of high-quality, personalised care.

NHS England commissions all services across the prison estate to be equivalent with those expected to be received in the community, including for cancer care.

All people received into prison have an initial health screen on arrival into prison. This assessment focuses on initial risks and key medicines required and any referrals to other services for immediate assessment. Any concerns regarding failures in cancer care for people in prison should be escalated by prison healthcare to the local National Health Service Health and Justice Commissioner.

NHS England expects all providers and healthcare professionals providing any NHS funded or commissioned service to have appropriate and relevant qualifications and work within the scope of their professional registration, including clinicians working to treat people in prison. Any women with a cancer diagnosis who require secondary or tertiary care should have access to these services as they would if they were in the community.

More information regarding assessments in relation to women diagnosed with cancer in prison can be found in the report, The health of people in prison, on probation and in the secure NHS estate in England, published in November 2025 by Professor Chris Whitty, the Chief Medical Officer. A copy of this report is attached.

Through the National Cancer Plan, published on 4 February 2026, we are committed to supporting all people living with or recovering from cancer.

NHS England commissions all services across the prison estate to be equivalent with those expected to be received in the community, including for cancer care.

All people received into prison have an initial health screen on arrival into prison. This assessment focuses on initial risks and key medicines required and any referrals to other services for immediate assessment. Any concerns regarding failures in cancer care for people in prison should be escalated by prison healthcare to the local National Health Service Health and Justice Commissioner.

NHS England expects all providers and healthcare professionals providing any NHS funded or commissioned service to have appropriate and relevant qualifications and work within the scope of their professional registration, including clinicians working to treat people in prison. Any women with a cancer diagnosis who require secondary or tertiary care should have access to these services as they would if they were in the community.

More information regarding assessments in relation to women diagnosed with cancer in prison can be found in the report, The health of people in prison, on probation and in the secure NHS estate in England, published in November 2025 by Professor Chris Whitty, the Chief Medical Officer. A copy of this report is attached.

Through the National Cancer Plan, published on 4 February 2026, we are committed to supporting all people living with or recovering from cancer.

NHS England commissions all services across the prison estate to be equivalent with those expected to be received in the community, including for cancer care.

All people received into prison have an initial health screen on arrival into prison. This assessment focuses on initial risks and key medicines required and any referrals to other services for immediate assessment. Any concerns regarding failures in cancer care for people in prison should be escalated by prison healthcare to the local National Health Service Health and Justice Commissioner.

NHS England expects all providers and healthcare professionals providing any NHS funded or commissioned service to have appropriate and relevant qualifications and work within the scope of their professional registration, including clinicians working to treat people in prison. Any women with a cancer diagnosis who require secondary or tertiary care should have access to these services as they would if they were in the community.

More information regarding assessments in relation to women diagnosed with cancer in prison can be found in the report, The health of people in prison, on probation and in the secure NHS estate in England, published in November 2025 by Professor Chris Whitty, the Chief Medical Officer. A copy of this report is attached.

Through the National Cancer Plan, published on 4 February 2026, we are committed to supporting all people living with or recovering from cancer.

Our 10-Year Health Plan commits to expanding robotic assisted surgery (RAS) adoption over the next decade. We will establish national registries for robotic surgery data from 2029 and telesurgery networks to support geographical equity of access of RAS. The national robotic surgery registry will support evidence generation, and will enable future reporting and decision making. Last year, NHS England published the first national guidance for the implementation of RAS in the National Health Service, offering guidance on procurement, commissioning, implementation, training, and evaluation.

A national steering committee, with representation from across the Department of Health and Social Care, NHS England, the Office for Life Sciences, NHS Supply Chain, and the Department for Science, Innovation and Technology, is already in place to support the RAS programme to deliver Government commitments. This will help to set the pace and scale in relation to targets of RAS numbers. Decisions to offer RAS are agreed at an integrated care board and trust level, in line with local population need.

The Department and NHS England are working closely with NHS trusts and regions to understand the key barriers and facilitators to adoption. The RAS steering committee is working together to identify provider trusts and regional alliances that are planning further expansion of RAS.

The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards (ICBs) to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in last year’s 10-Year Health Plan.

Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality.

The MSF will put in place a clear and effective mechanism to deliver a fundamental improvement to the care provided. This will enable the adoption of evidence-based interventions that are proven to make a difference to patients and their families. Examples include earlier identification of need, care delivered closer to home by integrated generalist and specialist teams, and strengthened out-of-hours community health support, including dedicated telephone advice.

Last year’s Strategic Commissioning Framework and Medium-Term Planning Guidance for the National Health Service also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.

By law, all health and social care services must have a procedure for dealing efficiently with complaints, and anyone who has seen or experienced poor-quality care has the right to complain to the organisation that provided or paid for the care.

If an individual has raised a complaint and is not satisfied with the way a provider has dealt with their complaint, they may escalate it to the Local Government and Social Care Ombudsman (LGSCO) who can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care.

The Government has continued discussions with the LGSCO and the Care Quality Commission about how the regulator can most effectively support the signposting of self-funders to the LGSCO by private providers.

By law, all health and social care services must have a procedure for dealing efficiently with complaints, and anyone who has seen or experienced poor-quality care has the right to complain to the organisation that provided or paid for the care.

If an individual has raised a complaint and is not satisfied with the way a provider has dealt with their complaint, they may escalate it to the Local Government and Social Care Ombudsman (LGSCO) who can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care.

The Government has continued discussions with the LGSCO and the Care Quality Commission about how the regulator can most effectively support the signposting of self-funders to the LGSCO by private providers.

We are progressing towards a National Care Service based on greater choice and control, joined up services, and higher quality of care, with over £4.6 billion of additional funding available for adult social care by 2028/29 compared to 2025/26. We have no direct plans designed to incentivise private investment.

Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people and are responsible for deciding how they spend the funding made available to them for adult social care, unless it is ringfenced for a particular purpose.

While private adult social care providers are individual businesses and the Government does not intervene in their operations, we have been clear that the expectation is for adult social care providers to behave responsibly, including through sustainable financial arrangements that support the sector and meet need as required.

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.

The Government is carefully considering the valuable work done by the Patient Safety Commissioner and the resulting Hughes Report, which sets out options for redress for those harmed by sodium valproate and pelvic mesh. This is a complex issue, and the Government's priority is to ensure that any response is fair, balanced and sensitive to those affected.

The Department is carefully considering the recommendations within the Hughes Report, including the merits of any potential redress scheme, in collaboration with relevant departments, and we aim to provide an update in due course.

To understand the rises in prevalence and demand on mental health services, the Government has launched an independent review into mental health conditions, attention deficit hyperactivity disorder, and autism. The review will examine the evidence around what is driving rising demand, including determining which trends reflect real increases in disorder, which reflect changes in awareness or access, and which are artefacts of measurement or definition.

The review will look at prevalence, early intervention, and treatment, and the current challenges facing clinical services. It will also explore the extent to which diagnosis, medicalisation, and treatment improve outcomes. In addition, the review will look beyond the National Health Service to examine data across education, employment, housing, and digital culture to understand how they interact and where intervention can make the greatest difference.

The Department funds research and research infrastructure through the National Institute for Health and Care Research (NIHR). The NIHR is funding the BEST4 trial with over £3 million funding contributed through the NIHR Health Technology Assessment Programme and a further £3 million funding from Cancer Research UK. This includes funding for the research team to engage with the patient community.

The study is also supported by NIHR Research Delivery Network (RDN) portfolio adoption to enable the recruitment of eligible participants and support research delivery. The NIHR RDN is raising awareness of the trial and supporting eligible patients to participate through National Health Service Research text messaging, providing secure mobile screening vans and engaging clinicians to connect them with the study.

Additionally, recruitment for the BEST4 trial is being supported by Be Part of Research, a free service that allows people across the UK to find and sign up to research relevant to them. The NIHR has also supported the trial with proactive communications, including a news item on 08/04/2025.

The latest published annual statistics for NHS Talking Therapies services in England for 2024/25 show that the mean average waiting time in days between the date the referral request was received and the date of first appointment, where the referral had a first attended appointment in the year, was 21.5 days.

As of 31 December 2025, there were 118,988 open referrals to NHS Talking Therapies services in England yet to have a first appointment.

The latest published annual statistics for NHS Talking Therapies services in England for 2024/25 show that the mean average waiting time in days between the date the referral request was received and the date of first appointment, where the referral had a first attended appointment in the year, was 21.5 days.

As of 31 December 2025, there were 118,988 open referrals to NHS Talking Therapies services in England yet to have a first appointment.

In 2023, NHS England produced a guide for frontline staff as they support people with a learning disability which asks staff to be aware of diagnostic overshadowing, and which is available at the following link:

https://www.england.nhs.uk/long-read/clinical-guide-for-front-line-staff-to-support-the-management-of-patients-with-a-learning-disability-and-autistic-people-relevant-to-all-clinical-specialties/

NHS England does not hold data on the extent of diagnostic overshadowing for people with Down syndrome, nor is the data held centrally.

Through the implementation of the Down Syndrome Act 2022, the Government is striving to improve life outcomes for people with Down syndrome, raise awareness and understanding of their needs, and break down barriers to opportunity that they, and other disabled people, face.

Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to support the needs of people with Down syndrome. The draft guidance, which was published for public consultation on 5 November 2025, acknowledges that the care of people with Down syndrome may be affected by diagnostic overshadowing and recognises its impact on the care and treatment that people receive. Once the consultation has closed on 30 March 2026, the Government will consider all consultation responses to inform the final guidance to be published.

Relevant authorities, as defined in the schedule to the act, have a duty to have due regard to the final guidance once it is published. The act does not create any new functions beyond this duty. Rather, it brings together existing statutory requirements and guidance that relevant authorities must and/or should already be complying with to support people with Down syndrome and people with other conditions and/or a learning disability who have similar needs.

Under existing legislation, Care Quality Comision registered providers must ensure that staff receive appropriate professional development which is necessary for them to carry out their duties and must receive specific training on learning disability and autism appropriate to their role, as per Section 20 of the Health and Social Care Act 2008, Section 181(7) of the Health and Care Act 2022 and Regulation 18 of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014. We expect that providers should be considering whether specific training on Down syndrome is required for their staff, and the draft guidance under the Down Syndrome Act sets out that some staff who work frequently with people with Down syndrome may require additional training on Down syndrome.

There are a range of legislative and operational safeguards in place to support patient choice and facilitate co-decision between clinicians and patients regarding stoma appliances. In terms of legislation, the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 aim to ensure that pharmaceutical services are delivered in a manner that is not conflicted with inducements that may be provided.

Guidance on Managing conflicts of interest in the NHS, updated in 2024, outlines that in services like stoma, where staff may be sponsored by industry, then such post holders must not promote or favour the sponsor’s specific products, and information about alternative products and suppliers should be provided. In addition, the British Healthcare Trade Association agreed a Code of Practice with its members who are involved in the dispensing of these appliances. The code aims to ensure ethical conduct and to safeguard patient interests in the dispensing process.

How compliance with the safeguards is monitored is a decision for the integrated care systems. Some areas have introduced central prescribing hubs in order to avoid any undue influence from sponsored posts or the dispensing contractors. Under the prescribing hubs a patient can use any dispensing contractor, but the prescription cannot be changed by them.

Being on a general practice’s (GP) learning disability register is crucial to ensuring that people receive the right support at the right time, including access to annual health checks. Our approach focuses both on encouraging eligible patients to join the register and on supporting GPs to identify and register people with a learning disability.

Work is currently underway to increase uptake, including encouraging children and young people to join the learning disability register at 14 years old, and to support people who do not have a confirmed learning disability diagnosis to access the register and appropriate services.

NHS England monitors uptake of the learning disability register and publishes data routinely. Information on the number of people on GP learning disability registers is in the table attached.

NHS England is also working with people with lived experience, clinical professionals, and commissioners to produce guidance on improving identification of learning disability and developing a quality framework setting expectations for annual health checks and health action plans. My Rt Hon. Friend, the Secretary of State for Health and Social Care, wrote to all GPs in October 2025, emphasising the importance of the learning disability register and the need to deliver high-quality annual health checks.

Being on a general practice’s (GP) learning disability register is crucial to ensuring that people receive the right support at the right time, including access to annual health checks. Our approach focuses both on encouraging eligible patients to join the register and on supporting GPs to identify and register people with a learning disability.

Work is currently underway to increase uptake, including encouraging children and young people to join the learning disability register at 14 years old, and to support people who do not have a confirmed learning disability diagnosis to access the register and appropriate services.

NHS England monitors uptake of the learning disability register and publishes data routinely. Information on the number of people on GP learning disability registers is in the table attached.

NHS England is also working with people with lived experience, clinical professionals, and commissioners to produce guidance on improving identification of learning disability and developing a quality framework setting expectations for annual health checks and health action plans. My Rt Hon. Friend, the Secretary of State for Health and Social Care, wrote to all GPs in October 2025, emphasising the importance of the learning disability register and the need to deliver high-quality annual health checks.

The Department works closely with NHS England on reducing long-stay hospital delays including those caused by social care capacity. Though the Better Care Fund (BCF) the Government provides over £9 billion to be used jointly by the National Health Service and local authorities towards achieving agreed goals for reducing discharge delays.

Local systems have been asked to place a particular focus on reducing bed occupancy and improving patient flow. We have asked National Health Service trusts to work with local authorities on eliminating the longest days, including those caused by waiting for care packages. Areas facing the most significant pressures are receiving targeted support to improve discharge performance.

Updated BCF guidance published in February sets out arrangements to further support timely discharge from hospital including focussing on services that help people regain independence. The updated BCF guidance is available at the following link:

https://www.gov.uk/government/publications/better-care-fund-framework-2026-to-2027/better-care-fund-framework-2026-to-2027

Under the Down Syndrome Act 2022, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to meet the needs of people with Down syndrome.

We considered a range of evidence from our Call for Evidence and engagement when developing the draft Down syndrome guidance, currently out for public consultation, including research on speech and language therapy (SLT).

The draft guidance highlights that people with Down syndrome are likely to have communication needs and sets out support that can be provided, including that people with Down syndrome should be able to access speech and language assessment and support in a timely manner. The guidance is also clear that NHS commissioners and providers may offer people with Down syndrome, and their families and carers, a range of SLT services and interventions to support their communication, tailored to their specific needs. This should include early intervention services starting from birth, continuing through early years to support a good start in life, and then into primary and secondary school and transition to adulthood, including transitions from child to adult care and support.

Relevant authorities, as defined in the schedule to the act, have a duty to have due regard to the final guidance once it is published. The act does not create any new functions beyond this duty. Rather, it brings together existing statutory requirements and guidance that relevant authorities must and/or should already be complying with to support people with Down Syndrome and people with other conditions and/or a learning disability who have similar needs.

NHS England published statutory guidance on 9 May 2023 which says that every integrated care board (ICB) should identify a member of its board to lead on supporting the ICB to perform its functions effectively in the interest of people with Down syndrome. The statutory guidance sets out NHS England’s expectations about fulfilling executive lead functions and outlines the responsibilities of these roles in more detail at the following link:

https://www.england.nhs.uk/publication/executive-lead-roles-within-integrated-care-boards/

Medicine supply chains are complex, global, and highly regulated and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes, or distribution issues and regulatory issues. There are approximately 14,000 licensed medicines and the overwhelming majority are in good supply.

The Department is currently not aware of any supply issues affecting Tegretol prolonged-release tablets.

The Department is aware of a recent disruption to the supply of aspirin tablets due to manufacturing issues and knock-on increased demand. The issues have been addressed, and we are working with suppliers to aid a return to normal supply as soon as possible with stock regularly being made available for pharmacies to order.

We continue to work with manufacturers and United Kingdom distributors to maximise supply to pharmacies and hospitals across the country. The Department is closely monitoring the situation and expects supplies to return to normal in the coming weeks.

In August 2025, the Department published a policy paper, Managing a robust and resilience supply of medicines, setting out our actions to strengthen supply chain resilience, which is available at the following link:

https://www.gov.uk/government/publications/managing-a-robust-and-resilient-supply-of-medicines/managing-a-robust-and-resilient-supply-of-medicines#next-steps

The Department has committed to providing a published update on progress in 2026.

Central procurement processes through NHS Supply Chain include a range of measures to prevent the dependency on single suppliers of medical products.

When designing strategies, at category and sourcing strategy stages, NHS Supply Chain completes a category risk analysis which highlights sole source or supplier dominance risk and is analysed before being accepted or rejected.

Unless there is a requirement for a unique product, NHS Supply Chain tries to avoid sole sourcing. Occasionally, a tender will only produce one response for a product, so market constraints may result in sole source. In this case NHS Supply Chain will review the market and seek new entrants where possible and relevant.

Where the procurement of a product from a sole source is unavoidable, NHS Supply Chain will conduct enhanced due diligence on sole source suppliers which could include:

- business continuity management assurances;

- tailored selection criteria; and

- contingency planning in the event that the sole supplier is unable to supply.

Government responsibility for delivering cancer research is shared between the Department for Health and Social Care, with research delivered by the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI), which includes the Medical Research Council (MRC). The Department for Health and Social Care and UKRI officials meet regularly to discuss a range of research investments to drive the maximum collective research impact on policy, practice, and individual lives.

The MRC and the NIHR are committed to supporting the development of fundable research proposals in lobular breast cancer and continues to encourage researchers to submit high quality funding applications to funding programmes in this area.

To further stimulate research in this area, in November 2025, the NIHR issued a highlight notice encouraging applications for new research into lobular breast cancer, to improve the detection, diagnosis, treatment, and long-term surveillance of patients.

The Government recognises the crucial need for research into all forms of cancer, including lobular breast cancer. It remains committed to the role of research to drive a stronger collective understanding of the biology behind lobular breast cancer and to improve outcomes for women.

No discussions have taken place between the Department of Health and Social Care and Department for Culture, Media and Sport about young people with Down syndrome in Surrey and the role of sport in health outcomes.

The UK Chief Medical Officers’ physical activity guidelines for disabled young people sets out the benefits of movement and strength activities, which includes helping to support disabled young people’s well-being, mood, development of healthy muscles, balance, and motor skills.

Through our 10-Year Health Plan, Government departments are working together to break down the barriers people face and help get more people moving. This includes development of a national plan for physical activity and a new way to deliver physical education, sport, and physical activity in schools. This work provides us with opportunities to improve ways for disabled young people to enjoy and benefit from sport, play and physical activity, whether in school, through local sports clubs, or in leisure centres and play spaces, making use of parks and nature.

The Department does not intend to commission a specific comparative review into the relative level of National Institute for Health and Care Research (NIHR) or Medical Research Council funding for research into myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), compared with other long-term conditions. We recognise that ME/CFS is an under-researched area, and we are committed to working with the ME/CFS community to identify and address barriers to research, with the ambition of supporting and funding more research and capacity-building programmes.

As outlined in the ME/CFS Final Delivery Plan, there has historically been a relatively low amount of biomedical research funded on ME/CFS, compared with disease burden. Our efforts are focussed on delivering the actions outlined in the ME/CFS Final Delivery Plan to support and increase research in this area. Since our answer to Question 86003, we have hosted a showcase on post‑acute infection conditions, bringing together people with lived experience, researchers, clinicians, and funders to stimulate further research. A summary of this showcase has been published on NIHR Open Research. We have also made progress with our new funding opportunity for development awards focussed on the feasibility of a phase 2 platform clinical trial. This would test multiple repurposed pharmaceutical interventions and/or non-pharmacological interventions for the treatment of post-viral conditions including ME/CFS. The committee will now consider the applications, and shortlisting decisions will be shared with the researchers in March.

Local authorities are best placed to understand and plan for the needs of their population. That is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people.

In performing that duty, a local authority must have regard to current and likely future demand for such services and consider how providers might meet that demand. This includes ensuring sufficient rehabilitation and recovery capacity to support timely and safe discharge for people with more complex needs, including those who may require a new nursing or residential home placement where appropriate.

The Government is making over £4.6 billion of additional funding available for adult social care in 2028/29 compared to 2025/26, to support the sector in making improvements. Additionally, through the Better Care Fund, over £9 billion is provided for 2025/26 for the National Health Service and local authorities to work jointly towards agreed goals on reducing discharge delays.