Department of Health and Social Care

Recommendation 36 relates to the expansion of the Veterans’ Covenant Healthcare Alliance (VCHA) accreditation scheme to include care homes and hospices. In July 2024, a pilot was launched by the Royal Star and Garter, supported by the VCHA. An evaluation of the pilot, led by the Royal British Legion, commenced in summer 2025. The evaluation findings will assess the practical viability of the scheme and will be accompanied by a full analysis of the options and associated financial costs.

Recommendation 38 relates to treatment for addiction. Veterans can access all substance misuse services available to non-veterans. In addition, the National Health Service has commissioned Op COURAGE, the veterans’ mental health and wellbeing service which provides support to veterans with substance misuse and mental health issues. NHS England are developing plans to provide training and education about the needs of the Armed Forces community to NHS staff through the National Armed Forces training and education programme. This will include NHS services that provide support to veterans with addiction issues.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.  The statutory guidance states that ICBs, including the Buckinghamshire, Oxfordshire and Berkshire West ICB, must work to ensure that there is sufficient provision of care services to meet the needs of their local populations. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population.

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

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

Officials will present further proposals to ministers over the coming months, outlining the drivers and incentives that are required in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care. The Hospice of the St Francis and Rennie Grove Peace Hospice Care, which both serve people in the Aylesbury constituency, are receiving £486,476 and £1,114,316 from this funding respectively.

The routine vaccination programme for gonorrhoea prevention is targeted towards gay, bisexual, and other men who have sex with men (GBMSM), as this group is disproportionately affected by gonorrhoea infection, accounting for nearly half of all diagnoses in England.

The Government recognises that gonorrhoea and its complications can also disproportionately affect minority groups, including women from ethnic minority communities, particularly in urban and more deprived areas, where longstanding inequalities in sexually transmitted infection rates persist.

Vaccination is offered nationally through sexual health services (SHSs), which are skilled in identifying individuals who should be vaccinated, trusted by eligible cohorts, and understand the local populations they serve. SHSs can perform individual risk assessments to identify those at equivalent risk of gonorrhoea infection to GBMSM and offer vaccination where appropriate. Many services also undertake innovative and effective outreach programmes to reach those less able to access mainstream services.

The Joint Committee on Vaccination and Immunisation continues to keep all vaccination programmes under review as further evidence and epidemiological data emerge. Anyone concerned about their own risk should consult their local sexual health clinic for tailored advice and testing.

The latest National Diet and Nutrition Survey showed that iodine levels in urine in women of reproductive age, 16 to 49 years old, were below the World Health Organisation threshold for adequacy, indicating insufficient iodine intake. Similar findings were seen in men aged 19 to 64 years old and girls aged 11 to 18 years old.

The Scientific Advisory Committee on Nutrition (SACN) maintains a watching brief on emerging evidence on iodine and health, including the iodine status of women of reproductive age in the United Kingdom. The SACN considered the topic of iodine at its horizon scans in 2022 and 2024 and agreed to add this topic to its work programme, with work on iodine due to start in 2026.

Government advice remains that individuals should be able to obtain all the iodine they need from a balanced diet, as depicted in The Eatwell Guide.

The health and wellbeing of National Health Service staff, including those working in accident and emergency departments is a top priority. NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive.

As set out in the 10-Year Health Plan, we will roll out staff treatment hubs to ensure all staff have access to high quality occupational health support, including for mental health. To further support this ambition, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism, and sexual harassment in the workplace.

The written answer for HL10420, stating that no individuals have yet received redundancy or severance payments, relates to the Department and NHS England. The schemes are being managed by the human resource departments of both organisations, who hold the supporting documentation, including the financial offers that will be made to individuals who progress to exit. It remains the case that no individuals have yet left under these schemes, with no costs having therefore been incurred.

In the case of integrated care board staff, the associated records will be held locally. At a national level we continue to work with HM Treasury on how to prioritise funding for redundancy payments ahead of the medium-term planning framework being published.

As of July 2025, there is a total system overspend of £172 million, which includes some of the impact of industrial action and reflects held back deficit support funding. The issues are very concentrated, with six systems accounting for more than half of the total overspend. At the same point last year, systems had overspent by £487 million, so we are seeing strong signs of improvement following the changes made as part of the NHS Financial Reset.

Overspends must be addressed through improved financial management and they should not undermine the National Health Service’s ability to respond to winter pressures. As set out in the 2025/26 Urgent and Emergency Care Plan, the NHS is focused on improvements that will see the biggest impact on urgent and emergency care performance this winter, including improved hospital flow, reduced ambulance handover times, and improved vaccination uptake among frontline staff.

Radiotherapy is vital in cancer care, and it remains a key priority for the Government to provide the highest quality of treatment available. This is why the Government has invested £70 million of central funding on 28 new LINAC radiotherapy machines across the country to replace older, less efficient radiotherapy machines.

The mental health of all National Health Service staff is a high priority, including ambulance staff as responders to emergency incidents. At a national level ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction. Additionally, ambulance trusts and the Association of Ambulance Trust Chief Executives have worked closely with NHS England to develop an ambulance sector specific suicide prevention pathway to provide immediate, 24/7 support for staff experiencing suicidal ideation.

Significant work is also underway to strengthen the quality and consistency of suicide training across the health system. NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management, to support the Government’s work to reduce suicide and improve mental health services. Further information on this guidance is available at the following link:

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

The mental health of all National Health Service staff is a high priority, including ambulance staff as responders to emergency incidents. At a national level ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction. Additionally, ambulance trusts and the Association of Ambulance Trust Chief Executives have worked closely with NHS England to develop an ambulance sector specific suicide prevention pathway to provide immediate, 24/7 support for staff experiencing suicidal ideation.

Significant work is also underway to strengthen the quality and consistency of suicide training across the health system. NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management, to support the Government’s work to reduce suicide and improve mental health services. Further information on this guidance is available at the following link:

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

The Department must comply with the legal requirements under the Public Contracts Regulations 2015 and, since February 2025, the Procurement Act 2023 in taking forward all procurement exercises leading to the award of a contract to a supplier. Compliance is managed by a professional procurement official within the Department’s Commercial Directorate who is assigned to each procurement exercise.

Business cases following the Government’s standard five-case model, setting out the strategic, economic/value for money, financial, commercial, and management case, are required for all procurements over £5 million. The Department’s Commercial Assurance Board (CAB) considers and approves high value, from £10 million to £30 million of capital or £50 million in revenue, business cases or high-risk commercial cases across the Department and its Arms’ Length Bodies. In addition, the CAB acts as commercial ‘keyholders’ for the business cases presented to the committees below, ensuring that commercial factors are considered when recommendations are made by:

• the Department of Health and Social Care Investment Committee;
• the Joint Department of Health and Social Care and NHS Investment Committee;
• the Joint Investment subcommittee; and
• the Digital Investment subcommittee.

Suppliers are invited to bid for contracts using the standard contract terms and conditions in use by the Department and across the Government. These include intellectual property (IP) clauses which grant the buyer a licence to use the supplier’s IP in the context of receiving and benefiting from the deliverables being bought. These typically allow sub-licensing under certain conditions and restrictions designed to avoid unfair exploitation of supplier IP. Standard terms and conditions are available on the GOV.UK website. By submitting a bid, suppliers are accepting the Department’s standard terms and conditions as set out above.

The Department must comply with the legal requirements under the Public Contracts Regulations 2015 and, since February 2025, the Procurement Act 2023 in taking forward all procurement exercises leading to the award of a contract to a supplier. Compliance is managed by a professional procurement official within the Department’s Commercial Directorate who is assigned to each procurement exercise.

Business cases following the Government’s standard five-case model, setting out the strategic, economic/value for money, financial, commercial, and management case, are required for all procurements over £5 million. The Department’s Commercial Assurance Board (CAB) considers and approves high value, from £10 million to £30 million of capital or £50 million in revenue, business cases or high-risk commercial cases across the Department and its Arms’ Length Bodies. In addition, the CAB acts as commercial ‘keyholders’ for the business cases presented to the committees below, ensuring that commercial factors are considered when recommendations are made by:

• the Department of Health and Social Care Investment Committee;
• the Joint Department of Health and Social Care and NHS Investment Committee;
• the Joint Investment subcommittee; and
• the Digital Investment subcommittee.

Suppliers are invited to bid for contracts using the standard contract terms and conditions in use by the Department and across the Government. These include intellectual property (IP) clauses which grant the buyer a licence to use the supplier’s IP in the context of receiving and benefiting from the deliverables being bought. These typically allow sub-licensing under certain conditions and restrictions designed to avoid unfair exploitation of supplier IP. Standard terms and conditions are available on the GOV.UK website. By submitting a bid, suppliers are accepting the Department’s standard terms and conditions as set out above.

The Department has already committed to the Public Accounts Committee that it will report to Parliament on the COVID-19 personal protective equipment contract dissolution outcomes once work is completed.

Outcomes and details of individual cases are expected to be published wherever possible so long as any such release of information does not breach commercial interests, harm public finances, or exacerbate legal sensitivities.

NHS England publishes data on hospital admissions, which is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/hospital-accident--emergency-activity

To show admission data by age, finished consultant episodes (FCEs) have been used as a proxy for the number of admissions.

The information requested for Surrey is collected at integrated care board (ICB) level. Therefore, the total number of FCEs in Surrey was generated by adding the FCEs of the two Surrey ICBs, namely Frimley and Surrey Heartlands.

The following table shows the number of hospital FCEs for each category for 2024/25 as the information is not available for the calendar year:

Source: NHS England Digital

The number of full-time equivalent staff working on the Terminally Ill Adults (End of Life) Bill has fluctuated since January 2025; there was not a team working on this bill prior to this, and any work on assisted dying was delivered through existing policy teams. The primary function of the team now in place is to fulfil the Government’s duty to the statute book, with regards to the legal and technical coherence of the bill. This includes providing technical drafting support and advising on workability of the legislation, as well as supporting Ministers to fulfil their duties to Parliament, such as responding to questions and correspondence and Parliamentary debates and committee hearing. Matters of policy have remained solely for the Sponsoring Members, Kim Leadbeater MP in the House of Commons and Lord Falconer in the House of Lords, to determine.

As of 1 September 2025, there were 11.8 full-time equivalent (FTE) officials in the Department of Health and Social Care Bill Team, at its largest the Bill Team was 16.8 FTEs. Where required, contributions on specific issues may have been sought from other teams, however the FTE cannot be accurately quantified for these issues.

NHS England considered abiraterone as an off-label treatment for hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process, NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication and it was ranked as the top priority for routine commissioning. This position is being kept under review, although currently there is no requirement for another meeting of the Clinical Priorities Advisory Group to reprioritise this policy, and the policy will be progressed as soon as recurrent funding is identified.

We are committed to reducing long waits and improving timely access to community health services, including for children’s community services. We are working closely with NHS England to improve access to community health services and on actions to reduce waiting times for these services.

NHS England continues to monitor community service waiting times via the Community Health Services SitRep data collection, to assess the number of people on them and the length of time they wait for services. Data is published monthly and is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/

The National Health Service has also published an overview of the core community health services that integrated care boards, service providers, and their partners should consider when planning services for their local population, which is available at the following link:

https://www.england.nhs.uk/long-read/standardising-community-health-services/

The new guidance for Medical Practitioners Tribunal Service tribunals includes more detail about assessing the seriousness of an allegation and the features that may increase the seriousness. The guidance now also includes sanction bandings. These indicate the range of outcomes that can be expected in different case types, once a tribunal has decided whether a doctor poses a low, medium, or high level of risk to the public.

In cases relating to sexual misconduct, because the level of current and ongoing risk to public protection will generally be considered medium or high, tribunals should consider suspension or erasure. The guidance sets out that in cases where misconduct is found to be sexually motivated, the inherent seriousness is likely to be high, and that makes any outcome short of erasure from the register inappropriate.

The Department monitors how regulators perform their duties and will continue to engage with the General Medical Council, including assessing how the new guidance impacts the outcomes of tribunal findings in cases of sexual misconduct.

The Department invests over £1.6 billion per year in research through the National Institute for Health and Care Research (NIHR).

The NIHR is continuing to invest in brain tumour research. Working with stakeholders from across the research community, in September 2024 the NIHR launched a package of support to stimulate high-quality research applications through: establishing a national Brain Tumour Research Consortium to bring together researchers from different disciplines to drive scientific advancements in how to prevent, detect, manage, and treat brain tumours; a dedicated funding call for research into wraparound care and rehabilitation for people living with brain tumours; and a partnership with the Tessa Jowell Brain Cancer Mission to fund the next generation of researchers through the Allied Health Professionals Brain Tumour Research Fellowship programme.

The NIHR continues to welcome high quality funding applications for research into any aspect of human health and care, including low-grade glioma.

The Government wants to ensure that every penny we allocate for dentistry is spent on dentistry, and that the ringfenced dental budget is spent on the patients who need it most.

Integrated care boards are responsible for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local populations and to determine the priorities for investment.

Adult social care is part of our vision for a Neighbourhood Health Service that shifts care from hospitals to communities, with more personalised, proactive, and joined-up health and care services that help people stay independent for as long as possible.

We are empowering people and giving them more choice and control over their care, for instance by promoting greater use of direct payments. We are also expanding care options to boost independent living at home through an additional £172 million for the Disabled Facilities Grant over two years, enabling approximately 15,600 extra home adaptations, and are introducing care technology standards to help people choose the right support.

This year's Spending Review allows for an increase of over £4 billion of funding available for adult social care in 2028/29 compared to 2025/26, to support the sector in making improvements.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence guidelines.

A minimum Unit of Dental Activity (UDA) value of £28 is in place to support practices with historically low UDA rates. There are differential UDA rates across England, and integrated care boards have the flexibility to set the UDA rate locally, which may help to support local interventions. The current differential UDA rates allow providers to use differing pay rates to reflect the local market rates.

We recently held a public consultation on a package of changes to improve access to, and improve the quality of, National Health Service dentistry, which will deliver better care for the diverse oral health needs of people across England. The consultation closed on 19 August, and the Government is considering the outcomes of the consultation and will publish a response in due course, with the expectation of implementing the reforms from April 2026.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability. The Government is committed to achieving fundamental contract reform by the end of this Parliament.

Community health services are an essential building block in developing a neighbourhood health service, working closely with primary care, social care, and other community services to provide more care in the community to spot problems early.

We are committed to reducing long waits and improving timely access to community health services, including for children’s services. We are working closely with NHS England to improve access to community health services and on actions to reduce waiting times for these services.

NHS England continues to monitor community services waiting times via the Community Health Services (CHS) SitRep data collection which collects monthly data on waiting lists and waiting times for community health services, to assess the number of people on them and the length of time they wait for services. Data is published monthly, and is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/

A metric on waits of over 52 weeks for CHS is included in the 2025/26 National Oversight Framework, which is available at the following link:

https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/

As part of our work to improve access to children’s CHS, NHS England commissioned NHS Benchmarking to undertake an analysis of provider data on Community Paediatrics to develop a detailed understanding of activity and the opportunities for improvement and transformation. The report is available at the following link:

https://www.nhsbenchmarking.nhs.uk/publications/transforming-children-and-young-peoples-community-services

Community health services are an essential building block in developing a neighbourhood health service, working closely with primary care, social care, and other community services to provide more care in the community to spot problems early.

We are committed to reducing long waits and improving timely access to community health services, including for children’s services. We are working closely with NHS England to improve access to community health services and on actions to reduce waiting times for these services.

NHS England continues to monitor community services waiting times via the Community Health Services (CHS) SitRep data collection which collects monthly data on waiting lists and waiting times for community health services, to assess the number of people on them and the length of time they wait for services. Data is published monthly, and is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/

A metric on waits of over 52 weeks for CHS is included in the 2025/26 National Oversight Framework, which is available at the following link:

https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/

As part of our work to improve access to children’s CHS, NHS England commissioned NHS Benchmarking to undertake an analysis of provider data on Community Paediatrics to develop a detailed understanding of activity and the opportunities for improvement and transformation. The report is available at the following link:

https://www.nhsbenchmarking.nhs.uk/publications/transforming-children-and-young-peoples-community-services

Community health services are an essential building block in developing a neighbourhood health service, working closely with primary care, social care, and other community services to provide more care in the community to spot problems early.

We are committed to reducing long waits and improving timely access to community health services, including for children’s services. We are working closely with NHS England to improve access to community health services and on actions to reduce waiting times for these services.

NHS England continues to monitor community services waiting times via the Community Health Services (CHS) SitRep data collection which collects monthly data on waiting lists and waiting times for community health services, to assess the number of people on them and the length of time they wait for services. Data is published monthly, and is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/

A metric on waits of over 52 weeks for CHS is included in the 2025/26 National Oversight Framework, which is available at the following link:

https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/

As part of our work to improve access to children’s CHS, NHS England commissioned NHS Benchmarking to undertake an analysis of provider data on Community Paediatrics to develop a detailed understanding of activity and the opportunities for improvement and transformation. The report is available at the following link:

https://www.nhsbenchmarking.nhs.uk/publications/transforming-children-and-young-peoples-community-services

The provision and maintenance of premises are typically the responsibility of general practice (GP) partners, who are either owner-occupiers or tenants of their surgery buildings. This includes addressing any building or maintenance issues identified after the planning and construction phases. The National Health Service reimburses partners for the recurring costs of operating in the property, for instance rent, notional rent, or mortgage costs, and funds services in the GP Contract.

GP owner-occupiers are responsible for all maintenance and repair of their property. For GPs that rent their premises, their lease agreement sets out who is responsible for maintenance. A Full Repairing and Insuring lease requires the practice to handle all repairs, while a Tenant's Internal Repairing lease means the landlord covers external and structural issues.

Commissioners may award improvement grants to GPs to fund extensions, improvements, and enhanced physical access. This can be up to 100% of a project’s value, subject to discretion and the integrated care boards available budget, under provisions of the NHS (General Medical Services) Premises Costs Directions 2024.

The £102 million Primary Care Utilisation and Modernisation Fund, announced at the 2024 Autumn Budget, is upgrading more than a thousand GP surgeries across England by April 2026.

Where facilities are an issue, it is imperative that GPs work with the local commissioner. There may be capital or revenue solutions to GP premises and facilities’ needs.

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 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 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.

Experiencing pregnancy or baby loss can be extremely difficult and traumatic. We are determined to make sure all bereaved parents, regardless of where they live, have access to specialist psychological support, free of charge through the National Health Service.

Following the loss of a baby, all parents should receive timely, equitable, and culturally competent care. To support this, NHS England has provided funding to all integrated care boards to establish seven-day-a-week bereavement services across maternity settings in England, so that support is always available when families need it most. Currently, 38 out of 42 integrated care boards offer a seven day a week bereavement service, with coverage in 115 out of 120 trusts.

Every trust in England has signed up to the National Bereavement Care Pathway. This pathway is designed to improve the quality and consistency of bereavement care for parents and families experiencing pregnancy or baby loss. NHS England is working closely with Sands to agree what steps are necessary to support faster and more consistent implementation of the pathway so that all parents, no matter where they are, receive the support they need at such a difficult time.

As of July 2025, maternal mental health services are now available in all areas of England. These services provide specialist psychological support for women with moderate/severe or complex mental health difficulties arising from birth trauma or baby loss. More mothers than ever before, including those sadly affected by the loss of their baby or child, were able to access maternal mental health services or specialist community perinatal mental health services in the year to April 2025.

Fathers and partners can receive evidence-based assessments and support through specialist perinatal mental health services, and some NHS trusts also work with Home Start UK’s Dad Matters project to support paternal mental health. Where mothers and partners may have a need for mental health support, but it is not a moderate or severe mental health condition, it is important they can be signposted to other forms of support through their general practitioner and NHS Talking Therapies.

There are currently no national communication campaigns on National Health Service dentistry and oral health initiatives to improve patient access and therefore no assessment has been made of the effectiveness of the communications and public advertising on NHS dentistry and oral health initiatives aimed at improving patient access to NHS dental services.

Integrated care boards are responsible for commissioning primary care services, including NHS dentistry, to meet the needs of the local populations and to determine the priorities for investment. They are also responsible for deciding how best to communicate about their services for patients.

NHS England is responsible for maintaining and updating the NHS.uk website for England, which provides information and services to help patients manage their health including on dentistry.

Individual employers and professionals are responsible for ensuring that patients and other healthcare professionals understand their role.

Professor Leng published her review into the safety of the physician assistants and physician assistants in anaesthesia (still legally known as physician associate and anaesthesia associate roles) and their contributions to multidisciplinary healthcare teams in July. Recommendation 7 sets out the importance of being able to identify roles and as part of taking this recommendation forward, NHS England is working with stakeholders, including NHS Employers, to review existing guidance for employers.

The Department and NHS England will work closely and collaboratively with partners from across the National Health Service, the clinical professions, and their representative bodies to implement the Leng Review recommendations whilst ensuring that patients receive safe, effective, and compassionate care in line with the relevant legal and clinical processes.

Following the publication of the review, NHS England published a ‘Frequently Asked Questions’ document, setting out what the Leng Review recommendations mean for employees and employers, both in the immediate and longer term. This is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2025/07/leng-review-nhs-england-faqs-on-actions-for-nhs-organisations.pdf

The National Cancer Plan, which will be published in early 2026, will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention and research and innovation. It will seek to improve every aspect of cancer care to better the experiences and outcomes for people with cancer. The National Cancer Plan will build on the three shifts set out by the 10-Year Health Plan. These shifts will enable rapid progress on the prevention, diagnosis, and treatment of cancer, as well as supporting those living with cancer to better manage their condition and improve their quality of life.

The National Cancer Plan will aim to improve how the physical and psychosocial needs of people with cancer can be met, with a focus on personalised care to improve quality of life. It will address how the experience of care can be improved for those diagnosed, treated, and living with and beyond cancer.

The Department does not centrally hold data on the employment contracts of individual salaried general practitioners (GPs), as GP practices are self-employed contractors to the National Health Service.

The Government is committed to tackling malnutrition, including in the Fylde constituency and Lancashire. In the United Kingdom, the primary causes of malnutrition are clinical. Most cases will be secondary to another health condition which may impact on nutritional needs or impact on a person’s ability to eat and drink. As such, poor or inadequate dietary intake is unlikely to be the primary cause.

The Department does not hold malnutrition data at the constituency or local authority level. While NHS England has previously published information on malnutrition from National Health Service providers at the Government Office Region of Treatment, this is a primary or secondary diagnosis and is a count of admissions not people; the same person may have had more than one admission episode within same time period. The most recent malnutrition data published by NHS England in October 2024 is available by NHS hospital trusts.

Diagnosis and detection are key, and health staff are trained to spot the early warning signs of malnutrition so effective individual treatment can be put in place. All NHS services are recommended to adhere to the National Institute for Health and Care Excellence clinical guideline CG32, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. NHS England’s Nursing Directorate is also leading on a review and refresh of the National Nutrition and Hydration guidance.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.

I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.

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

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

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.

I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.

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

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

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.

I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.

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

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

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.

I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.

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

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

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.

I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.

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

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

From September 2023, the routine shingles vaccination programme changed from the Zostavax vaccine to the two-dose Shingrix vaccine, to better protect individuals from the effects of shingles, provide better clinical outcomes, and reduce pressures on the health system. The programme was also expanded, and as a result, almost one million more people became eligible for the shingles vaccination.

The expansion is being rolled out in phases to maximise cost-effectiveness and population benefit, ensure consistent messaging to maximise coverage, and take account of National Health Service capacity, all while being consistent with the approach taken by all four nations in the United Kingdom. During the first phase, which commenced in September 2023, those who reach the ages of 65 or 70 years old will be called in for vaccination on or after their 65th or 70th birthday. During the second phase, from September 2028, individuals will be called in for vaccination on or after their 60th or 65th birthday. From 1 September 2033 onwards, vaccination will be routinely offered to those turning 60 years of age on or after their 60th birthday.

Separately, in November 2024, the Joint Committee on Vaccination and Immunisation provided advice on eligibility for the shingles vaccination programme for adults aged 80 years old and over. The Department is considering this advice as it sets the policy on who should be offered shingles vaccinations.

In addition, as of September 2025, all severely immunosuppressed individuals aged 18 years old and over are now eligible for the shingles vaccine in order to protect those who are most at risk of serious illness and complications from shingles.

The UK Health Security Agency (UKHSA) ensures commissioners, providers, and relevant healthcare professionals have access to the necessary resources to communicate accurate information on eligibility for all national vaccination programmes. For example, comprehensive guidance on shingles vaccination is provided for healthcare professionals on GOV.UK website, at the following link:

https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals/shingles-immunisation-programme-information-for-healthcare-practitioners

Additionally, to strengthen awareness of the programme amongst health professionals and the wider public, the UKHSA provides a comprehensive suite of public facing resources and assets. This includes information leaflets on shingles vaccination in multiple languages and accessible formats, for instance easy read, British Sign Language, and braille, with further information available at the following link:

https://find-public-health-resources.service.gov.uk/filter?diseases=Shingles&diseases=Varicella&vaccinations=Shingles+vaccine

This is a relatively newly expanded programme, and anyone unsure if they are eligible for the shingles vaccination should check online, on the NHS.UK website, or should speak to their general practice.

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

We have asked ICBs to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available from 1 April 2025. The Surrey Heartlands ICB is expected to deliver 6,585 additional urgent dental appointments as part of the scheme.

We recently held a full public consultation on a package of changes to improve access to, and the quality of, NHS dentistry, which will deliver better care for the diverse oral health needs of people across England. The consultation closed on 19 August 2025. The Government is considering the outcomes of the consultation and will publish a response in due course.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability. The Government is committed to achieving fundamental contract reform before the end of this Parliament.

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

We have asked ICBs to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available from 1 April 2025. The Surrey Heartlands ICB is expected to deliver 6,585 additional urgent dental appointments as part of the scheme.

We recently held a full public consultation on a package of changes to improve access to, and the quality of, NHS dentistry, which will deliver better care for the diverse oral health needs of people across England. The consultation closed on 19 August 2025. The Government is considering the outcomes of the consultation and will publish a response in due course.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability. The Government is committed to achieving fundamental contract reform before the end of this Parliament.

The Government is setting up the Health Data Research Service (HDRS) to help improve healthcare for everyone in the United Kingdom. The National Health Service has collected health information from millions of people over 75 years old and has a unique set of data which could hold the secret to curing and better treating major illnesses.

HDRS will safely and responsibly capitalise on the UK's rich health and care datasets to unlock breakthroughs in the prevention, diagnosis, and treatment of disease, including cancers. With streamlined access to this data, researchers will be able to carry out research that will prevent illness and benefit patients sooner, with improved and tailored treatments.

HDRS will be open to a diverse range of customers with a legal and ethical research project and will be designed to support the broadest spectrum of research topics, including rare diseases.