Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure the safety of North West Ambulance Service personnel in the context of a trends in the number of violent and abusive incidents directed at frontline NHS staff.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Everyone working in the National Health Service has a fundamental right to be safe at work, including those in the ambulance setting. Trends in violence towards NHS staff have generally stayed at the same levels in recent years and there is in place a zero-tolerance approach to any violent and abusive incidents.

Individual employers are responsible for the health and safety of their staff, and they put in place measures, including, security, training, and emotional support for staff affected by violence. These measures will be strengthened by the introduction of a new set of staff standards, as detailed in the 10-Year Health Plan, which will cover issues that matter most to NHS staff including tackling violence in the NHS workplace.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of changes to PET-CT procurement in England on diagnostic access for patients from Northern Ireland who rely on specialist capacity elsewhere in the UK.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England is in the process of reprocuring some positron emission tomography computed tomography (PET-CT) services to replace current contracts that are due to expire at the end of March 2027. The geographies covered by the existing contracts will continue to be covered under the new arrangements, so no impact on diagnostic access is expected for patients from Northern Ireland who rely on specialist capacity elsewhere in the United Kingdom. The current arrangements for patients travelling to England for PET-CT and other treatments remains unchanged.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 27 November 2025 to Question 92091 on NHS England: Carbon Emissions, what estimate has been made of the cost to the NHS of delivering the net zero targets; and whether those costs have been broken down between capital spending, operational changes and procurement requirements.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

These targets are system–led and were set by NHS England, in collaboration with its Net Zero Expert Panel, to support the United Kingdom’s legislative target in a way that is ambitious but achievable. NHS England has been clear that its approach is designed to align with different sectoral pathways, and to be consistent with the UK's overall approach on decarbonisation. No National Health Service specific cost-estimate of achieving Net Zero has been made, and both NHS England and Department are clear that NHS budgets will only be used to support the targets where this can deliver better value for money for the taxpayer and better care for patients.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help avoid creating a single point of failure in PET-CT diagnostic services.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England’s specialised commissioning function commissions positron emission tomography computed tomography (PET-CT) diagnostic services and is responsible for ensuring that there is sufficient capacity across England to meet planned demand. To avoid creating a single point of failure in these services, NHS England has ensured that PET-CT services in England are delivered by a range of different organisations, including National Health Service trusts, the independent sector, and charities, often working in partnership. They help to provide resilience across the system.

NHS England is in the process of reprocuring some PET-CT services to replace current contracts that are due to expire at the end of March 2027. NHS England has recently concluded a round of market engagement on its proposals. NHS England has not yet finalised its proposals for the procurement, as the point of market engagement is to receive feedback and take this into account in the final design.

PET-CT scans use isotopes from a comprehensive network of United Kingdom based cyclotrons. The Government has made up to £520 million available through the Life Sciences Innovative Manufacturing Fund to support UK manufacture of medicine and medical technology products. This includes applications looking to establish, expand, or improve UK-based manufacture of medical radioisotopes for diagnostic or therapeutic applications.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how admissions for chronic obstructive pulmonary disease have changed since the start of the winter season; and what geographical variation there has been in those admissions.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The information requested is not collected centrally. NHS England publishes annual data on the number of admissions with a primary diagnosis of chronic obstructive pulmonary disease. In 2024/25, there were 121,506 admissions. This data is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2024-25

NHS England also publishes winter situation reports, which are available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/uec-sitrep/urgent-and-emergency-care-daily-situation-reports-2025-26/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of embedding routine and cross-system commissioning and provision of post-pregnancy contraception in post-partum care.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

No assessment has been made. The renewed Women’s Health Strategy will set out how the Government will take the next steps to improve women's healthcare as part of the 10-Year Health Plan and create a system that listens to women. Steps to improve contraception access are being fully considered as part of the renewal.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what plans his Department has to address multiple sclerosis in the updated Women’s Health Strategy; and whether there will be discussions on how this can inform development of the Northern Ireland Women’s Health Action Plan.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

We know that women can be impacted by a range of different health conditions at the same time, including those that only affect women, those that affect women differently or more severely to men, or those that affect everyone equally. This is why the renewed Women’s Health Strategy will set out how we are improving experiences and outcomes for all women as we deliver the 10-Year Health Plan.

At the national level, there are a number of initiatives supporting service improvement and better care for patients with multiple sclerosis (MS), including the RightCare Progressive Neurological Conditions Toolkit and the Getting It Right First Time Programme for Neurology.

We have set up a United Kingdom-wide Neuro Forum, facilitating formal, biannual meetings across the Department, NHS England, the devolved administrations and health services, and Neurological Alliances of all four nations. The new forum brings key stakeholders together, to share learnings across the system and discuss challenges, best practice examples and potential solutions for improving the care of people with neurological conditions, including MS.

Health policy and delivery are devolved to the administration of Scotland, Wales, and Northern Ireland. As a UK Government department, the Department of Health and Social Care engages constructively and works collaboratively with the devolved administrations on areas of shared interest, including information sharing, coordination, and issues that have UK wide or cross-border implications.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure the NHS, ICBs and local authorities collaboratively commission women’s health and contraceptive services.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Local integrated care systems are responsible for the collaborative commissioning of women’s health and contraceptive services.

The Women’s Health Programme Board provides direction and strategic oversight to NHS England’s Women’s Health Programme.

The board monitors progress and delivery of the Women’s Health Programme, and delivers the ambitions of the Women’s Health Strategy, reflecting the vision to improve health outcomes, reduce disparities, and amplify women’s voices in healthcare.

The board is also responsible for ensuring alignment with wider interdependencies, including the 10-Year Health Plan, and neighbourhood health models, as well as ensuring the delivery, oversight, and performance management of women’s health provision are consistent across the seven regions of England.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of creating a permanent and protected ICB role for the appointed Women’s Health Champion in every Integrated Care System.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards are responsible for the planning, commissioning, and delivery of women’s health services, including oversight of the dedicated Women’s Health Champion role.

The network of women’s health champions brings together senior leaders in women’s health from integrated care systems and local authorities to share best practice to improve women’s health outcomes across the life course and reduce health inequalities. The role is a voluntary commitment, and the Government has no plans to change this.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department records how many patients are experiencing delays of more than 12 months before being added to a consultant led elective care waiting list following GP referral.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance his Department has issued to NHS England and integrated care boards on the recording, monitoring and reporting of delays between referral and formal waiting list entry.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many patients have received a GP referral but who have not yet been allocated an NHS number on a consultant led waiting list.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the average length of time patients are currently waiting between GP referral and being added to an NHS consultant-led elective care waiting list; and whether any such waiting periods are included in official waiting list statistics.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether NHS England includes the period between receipt of a GP referral and the issuing of the first appointment offer within published consultant led referral to treatment waiting time data.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what targeted support his Department is providing people with asthma during the winter period.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England has provided £2.61 million of funding in 2025/26 to support people with respiratory conditions this winter, including improving access to diagnostic tests such as spirometry to support early and accurate diagnosis of asthma.

The funding builds on the work of NHS England to improve asthma outcomes, including the publication of commissioning standards for spirometry and the inclusion of Quality and Outcomes Framework indicators to support asthma diagnosis and management. These measures will support asthma patients to manage their condition throughout the year, including during the winter period.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential impact of extended pre-listing delays on patient outcomes and clinical risk in high-volume specialities.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department monitors variation between NHS trusts in the time taken to convert GP referrals into entries on consultant led elective waiting lists.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the period between GP referral and a patient being added to an elective waiting list has increased or decreased in the past five years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department monitors variation between NHS trusts in the time taken to convert GP referrals into entries on consultant led elective waiting lists.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

In line with referral to treatment rules, a patient's waiting time clock starts from the moment they are referred for consultant-led elective treatment. According to these rules, there should be no time between a general practice referral and entry onto a consultant-led elective waiting list. The complete time elapsed between referral and treatment will be recorded on the published consultant led referral to treatment waiting time data, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

Guidance is provided to NHS England and integrated care boards through the Referral to treatment consultant-led waiting times: rules suite, which is available at the following link:

https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18-weeks/referral-to-treatment-consultant-led-waiting-times-rules-suite-october-2022

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department records how many patients have withdrawn from treatment or deteriorated clinically while waiting to be added to an elective care waiting list.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department does not hold the data in this format.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many domestically trained applicants were (a) accepted and (b) rejected for (i) nursing and (ii) midwife positions with NHS providers in each year since 2020.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department does not hold data on the number of applicants, whether domestically trained or overseas trained, that were accepted or rejected for nursing and midwife positions with National Health Service providers. NHS trusts will undertake local processes to manage recruitment to nursing and midwifery vacancies.

NHS England publish monthly information on the annual numbers of nurses and midwives joining the NHS, including information on the self-reported nationality of these staff but this will not necessarily be the same as the place of training. Joiners’ data will include staff returning from breaks in service and is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics

On 11 August 2025, the Government announced the Graduate Guarantee for nurses and midwives. The Guarantee will ensure there are enough positions for every newly qualified nurse and midwife in England. The package of measures will unlock thousands of jobs and will ensure thousands of new posts are easier to access by removing barriers for NHS trusts, creating opportunities for graduates and ensuring a seamless transition from training to employment.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has recently proposed measures to ensure that fines against NHS trusts are ringfenced for spending on health matters.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Care Quality Commission (CQC) has criminal enforcement powers to fine a health or social care provider where they identify a breach of regulations. The CQC can directly serve a fixed penalty notice to a provider, or a fine may be issued by the court following prosecution brought by the CQC.

Any fixed penalty paid to the CQC is not retained but must be passed on by the CQC to my Rt Hon. Friend, the Secretary of State for Health and Social Care. The CQC transfers the penalties received to the Department on a quarterly basis.

The size of the fine following prosecutions brought by the CQC is a decision made by the court and is informed by sentencing guidelines. The CQC does not have influence over this decision. The money raised by court fines is paid to HM Treasury.

The Department has not recently proposed any measures to change this.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of proposed reductions in Integrated Care Board funding on their ability to establish and run Women’s Health Hubs.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The 10-Year Health Plan set out the ambition for high autonomy to be the norm across every part of the country. Integrated care boards (ICBs) are responsible for commissioning services that meet the healthcare needs of their local population and have the freedom to do so, which includes women's health hubs and delivering the direction of women's health strategy. The Government is backing ICBs to do this through record funding. The Spending Review 2025 prioritised health, with record investment in the health and social care system.

We have heard from integrated care systems the positive impacts that women’s health hubs have on both women's access to care in the community and their experience. Our cost benefit analysis demonstrated £5 benefit for every £1 spent on women’s health hubs.

The Women’s Health Programme Board provides direction and strategic oversight to NHS England’s Women’s Health Programme. It monitors progress and delivery of the programme, and delivers the ambitions of the Women’s Health Strategy, reflecting the vision to improve health outcomes, reduce disparities and amplify women’s voices in healthcare.

The board is also responsible for ensuring alignment with wider interdependencies including the 10-Year Health Plan, and neighbourhood health models, as well as ensuring the delivery, oversight, and performance management of women’s health provision are consistent across the seven regions of England.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many applicants trained overseas were (a) accepted and (b) rejected for (i) nursing and (ii) midwife positions with NHS providers in each year since 2020.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department does not hold data on the number of applicants, whether domestically trained or overseas trained, that were accepted or rejected for nursing and midwife positions with National Health Service providers. NHS trusts will undertake local processes to manage recruitment to nursing and midwifery vacancies.

NHS England publish monthly information on the annual numbers of nurses and midwives joining the NHS, including information on the self-reported nationality of these staff but this will not necessarily be the same as the place of training. Joiners’ data will include staff returning from breaks in service and is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics

On 11 August 2025, the Government announced the Graduate Guarantee for nurses and midwives. The Guarantee will ensure there are enough positions for every newly qualified nurse and midwife in England. The package of measures will unlock thousands of jobs and will ensure thousands of new posts are easier to access by removing barriers for NHS trusts, creating opportunities for graduates and ensuring a seamless transition from training to employment.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much did (a) Health Education England and (b) NHS England pay Hill Dickinson in (i) costs and (ii) fees for legal services between 2012 and 2023.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, when he plans to respond substantively to Question 90841 tabled by the hon. Member for South Cambridgeshire on 13 November 2025.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will provide funding to help increase staffing levels at (a) James Paget University Hospital and (b) Northgate Hospital.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Decisions about recruitment are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.

Funding provided to NHS trusts, including James Paget University Hospital and Northgate Hospital, is not ringfenced for specific items such as staffing levels. Hospitals receive funding allocations which they can use at their discretion, based on local priorities.

The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the public health risks posed by illegal online sales of optical appliances, particularly for children and other vulnerable groups.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicines for human use, medical devices, and blood products for transfusion in the United Kingdom. This includes applying the legal controls on the retail sale, supply, and advertising of medicines which are set out in the Human Medicines Regulations 2012.

Sourcing medicines from unregulated suppliers significantly increases the risk of getting a product which is either falsified or not authorised for use. Products purchased in this way will not meet the MHRA’s strict quality and safety standards and could expose patients to incorrect dosages or dangerous ingredients.

Public safety is the number one priority for the MHRA, and its Criminal Enforcement Unit works hard to prevent, detect, and investigate illegal activity involving medicines and medical devices and takes robust enforcement action where necessary. It works closely with other health regulators, customs authorities, law enforcement agencies, and private sector partners, including e-commerce and the internet industry to identify, remove, and block online content promoting the illegal sale of medicines and medical devices.

The MHRA seeks to identify and, where appropriate, prosecute online sellers responsible for putting public health at risk. Last year, the MHRA and its partners seized more than 17 million doses of illegally traded medicines, including those usually issued on prescription. Additionally, the MHRA has also disrupted thousands of links to websites and social media pages selling medical products to the public illegally.

The MHRA’s FakeMeds campaign provides advice to people in the UK who are considering buying medication online, outlining how products can be accessed from safe and legitimate source.

Anyone who believes they’ve had a side effect from a medicine, or who believes they’ve received falsified stock, can report it to the MHRA’s Yellow Card scheme.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure a level playing field for UK-based optometry practices and regulated optical business that provide compliant contact lens sales, in the light of unregulated overseas websites selling lenses in the UK.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) ensures that medical devices placed on the market and put into service in the United Kingdom meet these regulatory requirements by:

- assessing all allegations of non-compliance brought to us, using a risk-based system;

- monitoring the activity of the UK approved bodies we designated to assess the compliance of manufacturers; and

- investigating medical devices as a result of adverse incident reports or intelligence indicating a potential problem.

If the MHRA considers a product to be breaching the medical devices regulations, typically, the MHRA’s Devices Compliance Unit will contact the manufacturer or, if the manufacturer is based outside of the UK, The UK Responsible Person, outlining our concerns and requesting further information with a view to bringing them into compliance.

If a manufacturer fails to co-operate with our requests and continues to place a non-compliant product on the market, or there is a serious risk to public health, the MHRA may consider using our enforcement powers. Guidance on how we enforce medical device regulations can be accessed on the GOV.UK website, in an online only format.

In addition to our investigatory and enforcement activities, the MHRA maintains ongoing relationships with external stakeholders, including other Government enforcement agencies and major online selling platforms to address non-compliant listings of medical devices available on the UK market, including those listed on overseas websites. This collaboration typically involves reporting mechanisms and proactive engagement with external online platforms to identify, address, and prevent non-compliant listings.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to (1) extend regulatory powers, (2) improve reporting mechanisms, and (3) work with (a) online platforms, (b) manufacturers, (c) professional bodies, and (d) enforcement agencies, to address the illegal online sale of optical appliances.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusions on the market in the United Kingdom are safe, effective, and manufactured to the highest standards of quality. The Medical Devices Regulations 2002 (MDR 2002) establish the statutory framework that medical devices must meet in order to comply with these standards.

Optical appliances as medical devices must comply with the MDR 2002, which include bearing the UKCA or CE marking on the packaging or labelling of the device. Manufacturers or their UK representatives must also monitor the use of these devices when used in the UK and report serious incidents to the MHRA. Allegations of deficiencies and incidents that do not meet these standards must be reported to the MHRA through the Yellow card scheme or informed though published guidance around enforcement and compliance.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to strengthen enforcement against the illegal online sale of optical appliances, including by overseas suppliers operating in the UK market.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusions on the market in the United Kingdom are safe, effective, and manufactured to the highest standards of quality. The Medical Devices Regulations 2002 establish the statutory framework that medical devices must meet in order to comply with these standards.

Optical appliances as medical devices must comply with requirements set out in the regulatuons, which include bearing the UKCA or CE marking on the packaging or labelling of the device. Manufacturers based outside of the United Kingdom must have a UK responsible person, and all devices must be registered with the MHRA prior to being placed on the market. Manufacturers or their UK representatives must also monitor use of these devices when used in the UK and report serious incidents to the MHRA.

The MHRA ensure that medical devices placed on the market and put into service in the UK meet these regulatory requirements by: assessing all allegations of non-compliance brought to us, using a risk-based system; monitoring the activity of UK approved bodies we designate to assess the compliance of manufacturers; and investigating medical devices as a result of adverse incident reports or intelligence indicating a potential problem.

If the MHRA considers that a product is breaching the medical devices regulations, typically, the MHRA Devices Compliance Unit will contact the manufacturer or, if the manufacturer is based outside of the UK, the UK Responsible Person, outlining the agency’s concerns and requesting further information with a view to bringing them into compliance.

If a manufacturer fails to co-operate with our requests and continues to place a non-compliant product on the market, or there is a serious risk to public health, the MHRA may consider using our enforcement powers. Guidance on how we enforce medical device regulations is available at the following link:

https://www.gov.uk/government/publications/report-a-non-compliant-medical-device-enforcement-process/how-mhra-ensures-the-safety-and-quality-of-medical-devices

In addition to our investigatory and enforcement activities, the MHRA maintain ongoing relationships with external stakeholders including major online selling platforms to address non-compliant listings of medical devices available on the UK market, including those listed on overseas websites. This collaboration typically involves reporting mechanisms and proactive engagement with external online platforms to identify, address and prevent non-compliant listings.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce gynaecology waiting lists.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to cutting waiting times across all specialities, including gynaecology. We have committed to return to the National Health Service constitutional standard, that 92% of patients wait no longer than 18 weeks from referral to treatment, by March 2029.

We are making good progress, with waiting lists cut by over 230,000 since the Government came into office, including nearly 14,000 fewer waits for gynaecology treatment.

We also delivered 5.2 million additional appointments between July 2024 and June 2025, exceeding our pledge of two million. However, we know there is more to do, and have confirmed over £6 billion of additional capital investment to expand capacity across diagnostics, electives, and urgent care. This includes expanding the number of surgical hubs, which provide valuable and protected capacity across elective specialities, including gynaecology. As of November 2025, over half of the 123 operational elective surgical hubs in England provide gynaecology services.

The Elective Reform Plan, published in January 2025, also committed to:

• increasing the relative funding available to support gynaecology procedures with the largest waiting lists;
• ensuring that independent sector providers play a greater role in providing support for the most challenged specialities, such as gynaecology; and
• reforming and optimising clinical pathways across a number of specialities. In gynaecology, this includes supporting the delivery of innovative models offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the withdrawal of the Learning Disabilities Mortality Review (LeDeR) report 2023 due to data quality issues; what were the specific data technicalities or defects that were not identified by NHS England or the Department of Health and Social Care; and what steps they plan to take to strengthen data collection and validation protocols during future LeDeR publications to ensure timely and reliable reporting.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We know that families and stakeholders will be frustrated by the withdrawal of the most recent 2023 Learning from Lives and Deaths of People with a Learning Disability and Autistic People (LeDeR) report, published in September 2025 by King’s College London. We apologise for the upset this has caused to families and loved ones, and we will make sure lessons are learned so that this cannot happen again. We remain committed to ensuring learning from LeDeR is shared and used to drive tangible service improvements.

The report was temporarily withdrawn after a technical issue was identified by NHS England after its publication. Some data used in the LeDeR report comes from Medical Certificate Cause of Death data. This was due to a technical issue related to a new automated process introduced in spring 2023, which meant that some of this data was not updated properly in the LeDeR dataset. This means that some data on cause of death was not included in the 2023 LeDeR report when it should have been, which has subsequently impacted some of the published analysis in the 2023 LeDeR report.

In line with ethical research and statistical practice, King’s College London has now withdrawn the report and has issued a notice setting out the reason why. An updated version is being prepared for publication in January 2026.

A correction has been applied to ensure that the specific automated processing error cannot happen again. NHS England is working with King’s College London to implement a more robust data checking protocol for the next LeDeR report, which will be an analysis of reviews of deaths for people who died in 2024 and whose deaths were notified to LeDeR in that year.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many prisoners are (1) eligible for support, and (2) receiving support, under section 117 of the Mental Health Act 1983.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The eligibility criteria for Section 117 applies to those who have been discharged from hospital following detention under the Mental Health Act, including those who have been remitted to prison. This is to help meet their needs and reduce the risk of their mental health condition worsening, which could lead to another hospital admission. Where prisoners are remitted back to prison, their right to receive Section 117 aftercare should be dealt with in the same way as it would be in the community, apart from any provisions which do not apply in custodial settings, such as direct payments and choice of accommodation. We do not hold centralised data on the number of prisoners receiving support under Section 117.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help reduce gynaecology waiting lists in Lancashire and South Cumbria ICB.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to cutting waiting times across all specialities and integrated care boards (ICBs). We have committed to returning to the National Health Service constitutional standard, that 92% of patients wait no longer than 18 weeks from referral to treatment, by March 2029. We are making good progress, with waiting lists cut by over 230,000 since the Government came into office, including nearly 14,000 fewer waits for gynaecology treatment.

We also delivered 5.2 million additional appointments between July 2024 and June 2025, exceeding our pledge of two million. However, we know that there is more to do and have confirmed over £6 billion of additional capital investment to expand capacity across diagnostics, electives, and urgent care. This includes expanding the number of surgical hubs, which provide valuable and protected capacity across elective specialities, including gynaecology. As of November 2025, there are 123 operational elective surgical hubs in England, three of which are in the NHS Lancashire and South Cumbria ICB. Over half of the 123 provide gynaecology services. The Elective Reform Plan, published in January 2025, also committed to:

• increasing the relative funding available to support gynaecology procedures with the largest waiting lists;
• ensuring that independent sector providers play a greater role in providing support for the most challenged specialities, such as gynaecology; and
• reforming and optimising clinical pathways across a number of specialities. In gynaecology, this includes supporting the delivery of innovative models offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what proportion of patients waited more than four hours in Basildon Hospital’s Accident and Emergency Department in the past year.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

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

https://www.england.nhs.uk/wp-content/uploads/2025/10/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29.pdf

Basildon Hospital is part of Mid and South Essex NHS Foundation Trust. In the financial year 2024/25, 29.1% of patients at Mid and South Essex NHS Foundation Trust waited for more than four hours from arrival to admission, transfer or discharge.

We are putting significant funding into expanding urgent and emergency service access for those most in need, including new Urgent Treatment Centres and Same Day Emergency Care facilities. Nationally, this will mean 800,000 fewer accident and emergency patients waiting over four hours this year.

The information is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2025-26/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many patients were admitted to A&E in England and seen within a) four hours and b) 12 hours after 5pm in the (a) 2021-22, (b) 2022-23, (c) 2023-24 and (d) 2024-25 financial years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

I refer the Hon. Member to the answers provided on 11 November to Questions 87614 and 87615. Otherwise, we do not hold data at this level of granularity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many patients were admitted to A&E in England and seen within a) four hours and b) 12 hours at the weekend in the (a) 2021-22, (b) 2022-23, (c) 2023-24 and (d) 2024-25 financial years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

I refer the Hon. Member to the answers provided on 11 November to Questions 87614 and 87615. Otherwise, we do not hold data at this level of granularity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment the Department has made of the potential impact of puberty suppression on levels of likelihood of progression to cross sex hormones.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Cass Review recommended that there is a need to build a more robust evidence base for the use of puberty suppressing hormones as a response to gender dysphoria in childhood, through a carefully considered research programme. The PATHWAYS Trial Study has been established for that purpose, in which puberty suppression will be offered solely within the context of the comprehensive assessment and psychosocial support now offered by the National Health Service.

Kings College London University, which is leading the research, has advised that it is not possible to know before starting puberty suppressing hormones what the treatment plan for any single young person will be at the end of the trial. This will depend on several factors, including their experience of puberty suppressing hormones, their mental and physical health, and their preferences for future care.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the impact of alterations to indefinite leave to remain rules on NHS staffing levels.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

There have been no recent alterations to indefinite leave to remain rules. However, the Government has launched a consultation on proposals to reform the current settlement rules in favour of an “earned settlement” model, that considers factors such as contribution, integration, and conduct. The consultation, which runs until February 2026, seeks views on how these reforms should apply to different groups, including health and care workers. The consultation is available at the following link:

https://www.gov.uk/government/consultations/earned-settlement

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has had discussions with the Secretary of State for Energy, Security and Net Zero on the potential impact of changes to funding for the Energy Company Obligation scheme in March 2026 on cold-related health issues.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Ministers and officials from the Department of Health and Social Care and the Department for Energy Security and Net Zero engage regularly on policy issues of interest to both departments. We will continue working together to ensure that cold-related health impacts are considered when implementing the Fuel Poverty Strategy for England and the Warm Homes Plan, and that more health-vulnerable households get the help they need to improve their homes.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many yellow card reports of aphantasia (Medical Dictionary for Regulatory Activities code 10090610) the Medicines and Healthcare products Regulatory Agency received in each year since 2021; and what medications those reports were linked to.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions, including amending the product information.

The MHRA has received a total of eight United Kingdom reports through the Yellow Card scheme associated with the reaction term aphantasia, from 1 January 2021 up to and including 12 December 2025. The following table shows a yearly breakdown of reports associated with aphantasia received from 1 January 2021 up to and including 12 December 2025:

In addition, the following table shows a yearly breakdown of reports received by substance associated with aphantasia from 1 January 2021 up to and including 12 December 2025:

Please note that each report may list more than one suspect drug. Therefore, the total number of reports received cannot be accurately derived from the figures presented in the above table.

It is important to note that anyone can report to the MHRA’s Yellow Card scheme and the recording of these reports in the Yellow Card database does not necessarily mean that the adverse reactions have been caused by the suspect drug. Many factors must be considered in assessing causal relationships, including temporal association, the possible contribution of concomitant medication, and the underlying disease. We encourage reporters to report suspected adverse reaction reports. The reporter does not have to be sure of a causal association between the drug and the reactions, as a suspicion will suffice.

The number of reports received cannot be used as a basis for determining the incidence of a reaction, as neither the total number of reactions occurring, nor the number of patients using the drug, is known.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, which (a) individuals and (b) organisations have been appointed to governance structures responsible for developing the Modern Service Frameworks for Dementia and Frailty.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

We intend to engage with a range of partners over the coming months to enable us to build a modern service framework which is both ambitious and practical, to ensure we can improve system performance for people with dementia and frailty both now and in the future.

No specific individuals or organisations have been appointed at this time. However, we intend to formalise a governance structure for the development of the modern service framework shortly which we will share with partners in due course.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what consideration they are giving, as part of the 10 Year Health Plan for England, to whether wider use of longer-duration, non-invasive ambulatory electrocardiogram monitoring could (1) help reduce waits for arrhythmia diagnosis, and (2) support earlier detection of atrial fibrillation.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The 10-Year Health Plan recognises that there is more that can be done to improve timely diagnosis closer to the patient’s home. The plan’s commitment to the three big shifts, and the further development of facilities such as community diagnostic centres, are central to delivering the Government’s commitment to achieve a 25% reduction in premature mortality due to cardiovascular disease and stroke across England, including people with arrythmias. For further information, a copy of our plan Reforming elective care for patients is attached.

The use of novel digital health and technology, such as non-invasive ambulatory electrocardiogram monitoring in the community, will facilitate the earlier diagnosis and treatment of conditions such as cardiac arrythmias and atrial fibrillation.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to update medical device regulations to bring UK-based online contact lens retailers under a clear regulatory framework; and whether they plan to introduce measures including (1) a recognised compliance mark, (2) stronger border controls, and (3) oversight to ensure customers identify lawful suppliers and reduce the risk of eye infections.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusions on the market in the United Kingdom are safe, effective, and manufactured to the highest standards of quality. The Medical Devices Regulations 2002 (MDR 2002) establish the statutory framework that medical devices must meet in order to comply with these standards.

Opthalmic medical devices must comply with the MDR 2002, which include bearing the UKCA or CE marking on the packaging or labelling of the device. Manufacturers or their UK representatives must also monitor use of these devices when used in the UK. Allegations of deficiencies that do not meet these standards must be reported to the MHRA through the Yellow card scheme or informed though published guidance, with further information available on the GOV.UK website.

The MHRA is not responsible for the movement of medical devices across borders.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 4 December (HL12450), what timetable has been set for the completion of the review by NHS England of the issues raised by the Health Services Safety Investigations Body regarding electronic patient records, and the implementation of the safety standards and best practices that arise from that review.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England is not currently doing a review of the issues raised by Health Services Safety Investigations Body regarding electronic patient records. NHS England will not manage the timetable for implementation of safety standards and best practices, as this falls to trusts, each of whom have their own statutory duty to deliver safe care.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the British Medical Association's allegations of bullying and harassment of Dr Tim Noble by Doncaster and Bassetlaw Teaching Hospitals Foundation Trust.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Whilst it would not be appropriate for ministers to comment on individual cases, the Government is clear that bullying is unacceptable in any workplace and has no place in the National Health Service. All employers across the NHS should have a robust policy on bullying outlining how it should be handled and the support available to staff.

NHS England has developed an NHS Civility and Respect programme which provides national guidance, training, and resources to help organisations build positive workplace cultures, tackle bullying and harassment, and ensure staff feel safe and supported in all work environments.

NHS staff should have the confidence to speak out and come forward if they have concerns. There is support in place for staff who wish to raise concerns, including a network of more than 1,200 local Freedom to Speak Up Guardians across healthcare in England, whose role is to help and support NHS workers.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many clinical trials offering CAR-T therapy for low-grade lymphoma have closed in the last three years, and what the reasons were in each case.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Answering this question would require Medicines and Healthcare products Regulatory Agency staff to go through a vast volume of protocol documents manually. This is because the information is not held in such a way to be able to filter electronically by the requested category.

The Guide to Parliamentary Work sets out that there is an advisory cost limit known as the disproportionate cost threshold which is the level above which departments can decide not to answer a written question. The current disproportionate cost threshold is £850.

The Guide to Parliamentary Work is published online and is available on the GOV.UK website.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce transmission of influenza in Lancashire.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Our flu vaccination campaign started in September, and is helping to keep people out of hospital.

The UK Health Security Agency is also working closely with colleagues in NHS North West and local integrated care boards (ICBs). There continues to be sustained multi-agency communications and marketing across the localised area and work is ongoing to promote and amplify prevention measures. Work continues to encourage prevention through targeted communications using local data to both the public and stakeholders whilst work is ongoing, as in every winter season, to show trends locally to allow the local health family to act accordingly via shared data and intelligence.

The ICB has stepped up public messaging around getting the flu vaccine for eligible groups and the importance of choosing the right service. This has included promoting a bespoke winter campaign in the local area as well as press releases, social media, and broadcast interviews at a local and regional level.

Some local hospitals have made it mandatory for staff to wear a surgical mask in any areas with suspected or confirmed influenza patients, and those patients who are suspected as having influenza on triage may also be asked to wear a mask. Masks are also available to patients and relatives in waiting areas.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the extension to the Healthy Start scheme to families with no recourse to public funds.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department ran a consultation, Eligibility for Healthy Start for groups that have no recourse to public funds or are subject to immigration controls, which provided examples of the potential impacts of extending Healthy Start to families with no recourse to public funds. The consultation has now closed, and the Department is currently considering options following the consultation. Further information will be available in due course.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the capacity of the specialist Parkinson’s workforce to meet increasing demand for care and diagnosis.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.

As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.

The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.

NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.

The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.

The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that Integrated Care Boards do not cut essential services for people living with Parkinson’s.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.

As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.

The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.

NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.

The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.

The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many neurologists have specialist training in Parkinson’s disease; and if he will estimate the espected number of neurologists with specialist training in Parkinson’s over the next five years.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.

As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.

The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.

NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.

The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.

The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to prevent sudden cardiac deaths in people aged 35 and under.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

To reduce the risks of sudden cardiac death, NHS England has published a national service specification for inherited cardiac conditions which includes services for young adults with previously undiagnosed cardiac disease.

NHS England is currently reviewing this service specification and is working with a broad range of stakeholders as part of the review.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many geriatricians have specialist training in Parkinson’s disease; and what plans he has to increase their numbers.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.

As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.

The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.

NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.

The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.

The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many specialist Parkinson’s nurses are employed in the NHS; and how their distribution is monitored nationally.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.

As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.

The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.

NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.

The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.

The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to increase collaboration between his Department and Drinkaware.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

External engagement is a fundamental part of what United Kingdom ministerial Government departments do.  We recognise the importance of promoting transparency through engagement and the need to take a balanced and proportionate approach.

In Fit for the Future: 10-Year Health Plan for England, the Government has committed to some crucial steps to help people make healthier choices about alcohol, for instance making it a legal requirement for alcohol labels to display health warnings and consistent nutritional information. The plan can be accessed online at the following link:

https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future

In the development and progression of the 10-Year Health Plan’s commitments and other policies, Department officials have met a wide range of stakeholders and are making plans for further stakeholder engagement to take place shortly. Stakeholder insights will help shape the Department’s work to ensure that are policies are most effective.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to modernise whole system appointments to (a) improve patient access and (b) avoid missed appointments.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Digital transformation is revolutionising access to healthcare by putting patients at the centre of a modern, personalised, and data-driven service. The goal is to empower individuals with greater choice, transparency, and control over their care, while helping to reduce systemic health inequalities and drive digital modernisation across the National Health Service.

There are a range of changes that improve patient access to appointments and avoid missed appointments. Steps that we are taking to improve access include:

• enabling patients in England to submit online consultation submissions for help from their general practitioners (GPs) via the NHS App or their GP’s website. In October 2025, eight million online consultation submissions were made;
• rolling out cloud-based telephony to GP services, improving access via phone lines for those who struggle with digital solutions. This includes time-saving features such as call-backs and diversion into specialist services. These changes are already reducing call waiting times and improving patient experience;
• improving the ability to manage conditions outside GPs to support more timely access to care, including through Pharmacy First and Digital Referrals initiatives; and
• offering outpatient electronic referrals through the NHS App with 100% of acute trusts now offering first outpatient electronic referrals through the NHS App, with 89% allowing patients to manage follow up appointments too, with 100% expected in 2026.

To avoid missed appointment we sent over 130 million appointment invitations and reminders via the NHS App in the last year, replacing paper letters and reducing delays. Digital reminders and the ability for patients to reschedule at the swipe of a button are helping to cut Did Not Attend rates, supporting elective recovery, and improving GP access. Analysis shows that these measures are contributing to reductions in hospital waiting lists and improving patient satisfaction.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has plans to launch a public awareness campaign to help tackle suicide.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department currently has no specific plans to launch a public awareness campaign to help tackle suicide.

The Suicide Prevention Strategy for England, published in 2023, identifies eight priority groups for targeted and tailored support at a national level. The strategy also identifies key risk factors for suicide, providing an opportunity for effective early intervention.

The purpose of the Suicide Prevention Strategy is to set out our aims to prevent suicide through action by working across government and other organisations. One of the key visions of the strategy is to reduce stigma surrounding suicide and mental health, so people feel able to seek help – including through the routes that work best for them. This includes raising awareness that no suicide is inevitable.

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. The guidance requires all mental health practitioners to align their practice to the latest evidence in suicide prevention, and is available at the following link:

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

The NHS England Medium Term Planning Framework states that in 2026/27, all integrated care boards must ensure mental health practitioners across all providers undertake training and deliver care in line with the ‘Staying safe from suicide’ guidance.

The 10-Year Health Plan sets out ambitious plans to boost mental health support across the country. This includes transforming mental health services into neighbourhood mental health centres, improving assertive outreach, expanding talking therapies and giving patients better access to support directly through the NHS App, available 24 hours a day, seven days a week.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 2 December 2025 to Question 93696, what recent steps he has taken to implement the UK Rare Diseases Framework commitment to faster diagnosis; and how this is reflected in changes to the newborn screening programme.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government is committed to improving the lives of those living with rare diseases. Helping patients get a final diagnosis faster is one of the four priorities of the UK Rare Diseases Framework. We published the annual England action plan in February 2025, where we report on the steps we have taken to advance this priority. This year's plan updated on research we have commissioned to better understand what causes delays in diagnosis; the Generation Study to pilot whole genome sequencing of newborns in the National Health Service; and the work of the NHS Genomic Medicine Service.

The current NHS Newborn Blood Spot Screening Programme enables early identification, referral and treatment of babies with 10 rare but serious conditions. In the United Kingdom, new screening programmes and modifications to existing screening programmes are recommended by the UK National Screening Committee (UK NSC). The UK NSC recommended newborn screening for hereditary tyrosinaemia type 1 in June 2022. The NHS began to offer it routinely in October 2025. An in-service evaluation (ISE) of screening for Severe Combined Immunodeficiency was launched in 2021 and closed on 27 October 2025. At the June 2023 UK NSC meeting, the Committee supported the need for a new independent model for spinal muscular atrophy (SMA) and agreed to plan for the SMA ISE. Evidence was published in August 2025, and is available at the following link:

https://nationalscreening.blog.gov.uk/2025/08/07/uk-nsc-publishes-sma-screening-evidence-documents/

Planning and development work to shape the ISE of newborn screening for SMA is ongoing.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the potential implications for his policies of changes in the diagnosis rates of mental health conditions and neurodivergence in England in the last five years.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

No assessment has been made. The independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder, and autism will examine the similarities and differences between these conditions, focusing on prevalence, prevention, treatment, and current challenges in clinical services.

It will assess how diagnosis, medicalisation, and treatment impact individual outcomes, including the risks and benefits of medicalisation, and will identify approaches to provide varied support models and pathways, both within and beyond the National Health Service, that promote prevention and early intervention alongside clinical care.

The report will include recommendations for responding to rising need, both within the Government and across the health system and wider public services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will take steps to establish a centralised dataset on localised ADHD assessment waiting times.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government has recognised that, nationally, demand for assessments for attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future and recognises the need for early intervention and support.

For the first time, NHS England published management information on ADHD assessment waiting times at a national level on 29 May 2025 as part of its ADHD data improvement plan. Data is now released each quarter with the latest release in August 2025.

Data on ADHD waiting times at an integrated care board (ICB) level is not currently held centrally. NHS England has released technical guidance to ICBs to improve the recording of ADHD data, with a view to improving data quality and publishing more localised data. NHS England intends to publish data at an ICB level in 2026/27.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD, and Autism. This independent review will inform our approach to enabling people with ADHD to have the right support in place to enable them to live well in their communities.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of provision of independent advocacy services for patients in Wiltshire.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Advocacy services play an important role in helping patients' voices to be heard and in ensuring their legal rights are protected. Guidance issued by the National Institute for Health and Care Excellence indicates that advocacy can provide several benefits, including helping to uphold individuals’ rights, supporting vulnerable individuals, involvement in decision-making, and promoting continuity of care.

There are several different types of patient advocacy services, and it is for local commissioning bodies to plan and commission advocacy services, in line with relevant legislation.

Specifically on complaints advocacy services, whilst National Health Service organisations must have their own complaints procedures, they are not required to provide complaints advocacy services. The legal duty to provide this service rests with local authorities, who are required by the Health and Social Care Act 2012 to make arrangements for the provision of independent advocacy services in their area. Each year the Government provides approximately £15 million of grant funding to local authorities towards this service.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has been made of the potential merits of providing training to mental health teams on adapting their support to children with lifelong speech and language difficulties.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department of Health and Social Care is working closely with the Department for Education and NHS England to improve access to community health services, including speech and language therapy, for children and young people with special educational needs and disabilities.

In addition to the undergraduate degree route, speech and language therapists can now also train via a degree apprenticeship. This route is going into its fourth year of delivery and offers an alternative pathway to the traditional degree route into a successful career as a speech and language therapist.

In partnership with NHS England, the Department for Education has extended the Early Language and Support for Every Child programme, trialling new ways of working to better identify and support children with Speech, Language and Communication Needs in early years settings and primary schools.

At the Spending Review, we confirmed that we will deliver on our commitment to recruit an additional 8,500 mental health workers by the end of this Parliament, roll out mental health support teams to cover all schools in England by 2029/30 and expand NHS Talking Therapies and Individual Placement and Support schemes.

We have also already started piloting Neighbourhood Mental Health Centres. These pilots aim to provide open access care for anyone with a severe mental illness 24 hours a day, seven days a week. Our aim is to have one Neighbourhood Health Centre in each community that brings together National Health Service, local authority and voluntary sector services in one building to help create a holistic offer that meets the needs of local populations including children with lifelong speech and language difficulties.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has been made of the potential merits of providing training to mental health teams on support to children with lifelong speech and language difficulties.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department of Health and Social Care is working closely with the Department for Education and NHS England to improve access to community health services, including speech and language therapy, for children and young people with special educational needs and disabilities.

In addition to the undergraduate degree route, speech and language therapists can now also train via a degree apprenticeship. This route is going into its fourth year of delivery and offers an alternative pathway to the traditional degree route into a successful career as a speech and language therapist.

In partnership with NHS England, the Department for Education has extended the Early Language and Support for Every Child programme, trialling new ways of working to better identify and support children with Speech, Language and Communication Needs in early years settings and primary schools.

At the Spending Review, we confirmed that we will deliver on our commitment to recruit an additional 8,500 mental health workers by the end of this Parliament, roll out mental health support teams to cover all schools in England by 2029/30 and expand NHS Talking Therapies and Individual Placement and Support schemes.

We have also already started piloting Neighbourhood Mental Health Centres. These pilots aim to provide open access care for anyone with a severe mental illness 24 hours a day, seven days a week. Our aim is to have one Neighbourhood Health Centre in each community that brings together National Health Service, local authority and voluntary sector services in one building to help create a holistic offer that meets the needs of local populations including children with lifelong speech and language difficulties.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of possible generational links to suicide; and what support is available to children of people who have taken their own lives.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government has not made an assessment of possible generational links to suicide. The Suicide Prevention Strategy for England, published in 2023, identifies eight priority groups, including children and young people, for targeted and tailored support at a national level. Another key priority area is to improve support for people bereaved by suicide.

The purpose of the Suicide Prevention Strategy is to set out our aims to prevent suicide through action by working across Government and other organisations. One of the key visions of the strategy is to reduce the stigma surrounding suicide and mental health, so people feel able to seek help through the routes that work best for them. This includes raising awareness that no suicide is inevitable.

The Government is expanding access to mental health support teams in all schools and colleges to reach all pupils by 2029, ensuring that every pupil has access to early support services. This expansion will ensure that up to 900,000 more children and young people will have access to support from trained education mental health practitioners in 2025/26.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what discussions he has had with Welsh Government counterparts about sharing best practice around increasing screening uptake for breast cancer.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The UK National Screening Committee (UK NSC) advises ministers and the National Health Service in the four nations of the United Kingdom about all aspects of screening. The implementation of any UK NSC screening recommendation is a devolved matter.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to expand (a) early intervention and (b) targeted mental health support for women at risk of suicide in (i) Surrey and (ii) Surrey Heath constituency.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The 10-Year Health Plan sets out ambitious plans to boost mental health support across the country, including in Surrey and the Surrey Heath constituency, for both men and women. This includes transforming mental health services into 24/7 neighbourhood mental health centres, improving assertive outreach, expanding talking therapies, and giving patients better access to 24/7 support directly through the NHS App.

The Suicide Prevention Strategy for England, published in 2023, identifies eight priority groups, including middle-aged men and pregnant women and new mothers, for targeted and tailored support at a national level. The strategy also identifies key risk factors for suicide, providing an opportunity for effective early intervention.

The purpose of the Suicide Prevention Strategy for England is to set out our aims to prevent suicide through action by working across the Government and other organisations. One of the key visions of the strategy is to reduce stigma surrounding suicide and mental health, so people feel able to seek help, including through the routes that work best for them. This includes raising awareness that no suicide is inevitable.

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. The guidance requires all mental health practitioners to align their practice to the latest evidence in suicide prevention and is available at the following link:

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

Through the Men’s Health Strategy, we are launching a groundbreaking partnership with the Premier League to tackle male suicide and improve mental health literacy, by embedding health messaging into the matchday experience.

We also announced the Suicide Prevention Support Pathfinders programme for middle-aged men. This program will invest up to £3.6 million over three years in areas of England where middle-aged men are at most risk taking their own lives and will tackle the barriers that they face in seeking support.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to expand (a) early intervention and (b) targeted mental health support for men at risk of suicide in (i) Surrey and (ii) Surrey Heath constituency.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The 10-Year Health Plan sets out ambitious plans to boost mental health support across the country, including in Surrey and the Surrey Heath constituency, for both men and women. This includes transforming mental health services into 24/7 neighbourhood mental health centres, improving assertive outreach, expanding talking therapies, and giving patients better access to 24/7 support directly through the NHS App.

The Suicide Prevention Strategy for England, published in 2023, identifies eight priority groups, including middle-aged men and pregnant women and new mothers, for targeted and tailored support at a national level. The strategy also identifies key risk factors for suicide, providing an opportunity for effective early intervention.

The purpose of the Suicide Prevention Strategy for England is to set out our aims to prevent suicide through action by working across the Government and other organisations. One of the key visions of the strategy is to reduce stigma surrounding suicide and mental health, so people feel able to seek help, including through the routes that work best for them. This includes raising awareness that no suicide is inevitable.

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. The guidance requires all mental health practitioners to align their practice to the latest evidence in suicide prevention and is available at the following link:

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

Through the Men’s Health Strategy, we are launching a groundbreaking partnership with the Premier League to tackle male suicide and improve mental health literacy, by embedding health messaging into the matchday experience.

We also announced the Suicide Prevention Support Pathfinders programme for middle-aged men. This program will invest up to £3.6 million over three years in areas of England where middle-aged men are at most risk taking their own lives and will tackle the barriers that they face in seeking support.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to WPQ 87435 answered on 26 November, if he will publish copies of the modules about close relative marriage and genetic risk for midwives and health visitors and guidance on how to submit data around consanguinity and pregnancy to the Maternity Services Dataset.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has already published training modules about close relative marriage and genetic risk for midwives and health visitors, as well as guidance on how to submit data around consanguinity and pregnancy to the Maternity Services Dataset. The training modules have been published for health professionals to access and there are no plans to publish them more widely.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what geographic barriers there are to accessing independent advocacy services for patients in rural areas, including Wiltshire; and what steps he is taking to help tackle those barriers.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Advocacy services play an important role in helping patients' voices to be heard and in ensuring their legal rights are protected. Guidance issued by the National Institute for Health and Care Excellence indicates that advocacy can provide several benefits, including helping to uphold individuals’ rights, supporting vulnerable individuals, involvement in decision-making, and promoting continuity of care.

There are several different types of patient advocacy services, and it is for local commissioning bodies to plan and commission advocacy services, in line with relevant legislation.

Specifically on complaints advocacy services, whilst National Health Service organisations must have their own complaints procedures, they are not required to provide complaints advocacy services. The legal duty to provide this service rests with local authorities, who are required by the Health and Social Care Act 2012 to make arrangements for the provision of independent advocacy services in their area. Each year the Government provides approximately £15 million of grant funding to local authorities towards this service.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what requirements are placed on NHS trusts and integrated care boards on the publication of independent NHS complaints advocacy services to patients, including in Wiltshire.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Advocacy services play an important role in helping patients' voices to be heard and in ensuring their legal rights are protected. Guidance issued by the National Institute for Health and Care Excellence indicates that advocacy can provide several benefits, including helping to uphold individuals’ rights, supporting vulnerable individuals, involvement in decision-making, and promoting continuity of care.

There are several different types of patient advocacy services, and it is for local commissioning bodies to plan and commission advocacy services, in line with relevant legislation.

Specifically on complaints advocacy services, whilst National Health Service organisations must have their own complaints procedures, they are not required to provide complaints advocacy services. The legal duty to provide this service rests with local authorities, who are required by the Health and Social Care Act 2012 to make arrangements for the provision of independent advocacy services in their area. Each year the Government provides approximately £15 million of grant funding to local authorities towards this service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the article published in Cell on 2 December, The effect of shingles vaccination at different stages of the dementia disease course, which suggests a causal relationship between shingles vaccination and a lower risk of developing dementia and further advancement of dementia following diagnosis; and in the light of that, what plans they have to request that the Joint Committee on Vaccination and Immunisation reconsider the current availability of the shingles vaccination on the NHS.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Following a request from the Department, the Joint Committee on Vaccination and Immunisation (JCVI) briefly discussed the emerging evidence on the link between shingles vaccination and dementia in its June 2025 meeting.

It was noted that results were consistent across different vaccines and different observational studies and had some potential biological plausibility. However, based on currently available data, this possible benefit was not quantifiable due to the high chance of bias in many of these observational studies.

For these reasons, no change to the current JCVI recommendation on shingles vaccination could be advised at this time. The JCVI continues to monitor emerging evidence relating to all immunisation programmes, including on the potential link between shingles vaccination and dementia, keeping its advice under review.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what discussions his Department has had with Surrey County Council on future arrangements for gathering local patient views on (a) health and (b) social care services in Surrey Heath constituency.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Local patient views will continue to be gathered through a variety of means, including local Healthwatch organisations, patient participation groups, and through national and local surveys.

As set out in the 10-Year Health Plan for England: fit for the future, we are proposing to abolish local Healthwatch arrangements to place responsibility for obtaining feedback from local communities with integrated care boards for health, and local authorities for social care.

Implementing the abolition of local Healthwatch arrangements will require amendments to primary legislation. The timing of this is subject to the will of Parliament and will happen when parliamentary time allows.

As part of her review of patient safety, Dr Dash heard from more than 100 individuals or organisations with an interest in patient safety. The Department has also conducted several engagement events with local Healthwatch organisations and their representatives. This engagement is vital to communicate plans and to answer questions. This engagement will continue as the policy is further developed.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that communications from NHS trusts to deaf and deafblind patients are accessible.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Integrated care boards are responsible for commissioning services to meet the health needs of their local population, which includes responsibility for ensuring that there is adequate provision of British Sign Language interpreters to support deaf patients in the community.

Nationally, all National Health Service organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the approach to supporting the information and communication support needs of people with a disability, impairment, or sensory loss. This includes support for deaf and deafblind patients.

NHS England published a revised AIS on 30 June 2025. NHS England is working to support implementation of the AIS with awareness raising, communication, and engagement, and a review of the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of making patient records owned by the patient.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Health records are not owned by patients, as the providers of care who create and maintain the records are the data controllers, although all patients have the right to access their records under the Data Protection Act 2018. Patients also have the legal right to ask for factual inaccuracies to be amended.

The general practice (GP) record can be viewed online on the NHS App, or by logging onto the National Health Service website. Individuals can alternatively contact their practice to view their record. To view a hospital record, individuals can ask the trust where they are a patient.

As part of the 10-Year Health Plan, we are developing a single patient record which will give patients greater control over their records, and act as a patient passport to seamless care. It will provide a single, secure, and authoritative account of their data by bringing together all of a patient’s medical information from different records in one place, for example GP and hospital data, and patients will be able to view the record securely on the NHS App and add their own data, for example from a wearable device.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what was the total annual NHS expenditure on GnRH analogue puberty blockers for under-18s in each financial year since 2010.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Gonadotropin-releasing hormone (GnRH) agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These can include precocious puberty, some forms of cancer, and endometriosis. They have also been used outside of their licenced indication to treat gender dysphoria.

There is no central registry that provides the total number of children in England who have been prescribed GnRH agonists through the National Health Service since 2010.

The following table shows the number of identifiable patients and total net ingredient cost for NHS prescriptions of GnRH agonists for all purposes for children aged 17 years old and under that were prescribed and dispensed in community pharmacies or general practices in England in each year from 2015/2016 to September 2025:

Source: ePACT2, which sources data from the NHS Business Services Authority’s Information Services Data Warehouse.

Note: the net ingredient cost is the basic price of a product excluding VAT. It does not take account of discounts, rebates, dispensing costs, fees, and allowances paid to pharmacists and appliance contractors for the service they provide to the NHS, or prescription charge income received, where the single charge or Prescription Prepayment Certificate fee is paid, or foregone where prescriptions are dispensed free of charge.

The NHS Business Services Authority does not hold patient data prior to April 2015. This data excludes dispensing in secondary care and other settings, and private prescriptions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether any NHS Trusts (a) employ specialist staff or (b) operate dedicated services to address genetic disorders associated with consanguinity.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service in England supports patients with a variety of conditions related to genetics. NHS England is piloting and evaluating new models of care to improve the equity of access to genetic services for the small proportion of couples at increased genetic risk due to close relative marriage. NHS England is funding additional capacity in several professions, including midwifery, genomics associates, and neonatal nurses, in nine pilot sites through the Genetic Risk Equity Project. 3.8 whole time equivalent (WTE) midwives and one WTE neonatal nurse were in post in 2024/25 to deliver the Genetic Risk Equity Project.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many NHS staff there are whose responsibilities include addressing genetic disorders associated with consanguinity.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service in England supports patients with a variety of conditions related to genetics. NHS England is piloting and evaluating new models of care to improve the equity of access to genetic services for the small proportion of couples at increased genetic risk due to close relative marriage. NHS England is funding additional capacity in several professions, including midwifery, genomics associates, and neonatal nurses, in nine pilot sites through the Genetic Risk Equity Project. 3.8 whole time equivalent (WTE) midwives and one WTE neonatal nurse were in post in 2024/25 to deliver the Genetic Risk Equity Project.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many patients aged under 18 have been prescribed GnRH analogue puberty blockers through the NHS in each year since 2010.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

Gonadotropin-releasing hormone (GnRH) agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These can include precocious puberty, some forms of cancer, and endometriosis. They have also been used outside of their licenced indication to treat gender dysphoria.

There is no central registry that provides the total number of children in England who have been prescribed GnRH agonists through the National Health Service since 2010.

The following table shows the number of identifiable patients and total net ingredient cost for NHS prescriptions of GnRH agonists for all purposes for children aged 17 years old and under that were prescribed and dispensed in community pharmacies or general practices in England in each year from 2015/2016 to September 2025:

Source: ePACT2, which sources data from the NHS Business Services Authority’s Information Services Data Warehouse.

Note: the net ingredient cost is the basic price of a product excluding VAT. It does not take account of discounts, rebates, dispensing costs, fees, and allowances paid to pharmacists and appliance contractors for the service they provide to the NHS, or prescription charge income received, where the single charge or Prescription Prepayment Certificate fee is paid, or foregone where prescriptions are dispensed free of charge.

The NHS Business Services Authority does not hold patient data prior to April 2015. This data excludes dispensing in secondary care and other settings, and private prescriptions.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of inpatient mental health capacity in Greater Manchester; and what discussions he has had with Pennine Care NHS Trust on that issue.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

No such specific assessment has been made. The Greater Manchester Integrated Care Partnership is responsible for commissioning National Health Service mental health inpatient beds to meet the needs of the local population across Greater Manchester. Neither ministers nor departmental officials have held discussions with the Pennine Care NHS Trust on that issue.

Nationally, our ambition is to avoid unnecessary admissions to mental health inpatient services and provide care close to home, including alternatives to admission. The 10-Year Health Plan sets out our plans to transform mental health services to improve access and treatment, and to promote good mental health and wellbeing for the nation. This includes piloting neighbourhood mental health centres, which will bring together a range of community mental health services under one roof, including crisis services and short-stay beds.

In addition, all integrated care boards (ICBs) were asked to publish a three-year plan to localise and realign mental health, learning disability, and autism inpatient care. The Greater Manchester ICB shared their plan at their public board on 20 November 2024. The plan commits to making the best use of resource and reducing reliance on inpatient care, so that more people can access care and support for their mental health, as and when they need it.

We will move care closer to home by reducing out of area placements for mental health patients by March 2027, as outlined in the medium-term planning framework. We will also use new integrated health organisations to break down barriers between services and ensure more integrated, holistic care, addressing both physical and mental health care needs, with more freedom to determine how best to meet the needs of their local populations.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what materials will be provided by the Government for the (a) the Premier League and (b) Samaritans in the Together Against Suicide Partnership.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

As part of England's first ever Men's Health Strategy, the Government announced a groundbreaking partnership with the Premier League to tackle male suicide and improve health literacy. We will work with the Premier League to co-create materials that promote signposting to existing mental health and suicide prevention support. The partnership will also champion NHS England’s new Staying Safe from Suicide guidance, embedding its principles across club staff and driving adoption of the associated e-learning among mental health practitioners within club networks, ensuring best practice reaches those supporting players and fans. Further information on the Staying Safe from Suicide guidance and the associated e-learning is available, respectively, at the following two links:

https://www.england.nhs.uk/long-read/staying-safe-from-suicide/#

https://www.minded.org.uk/Component/Details/849008

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to improve the discharge process for patients in Surrey who are medically fit to leave hospital.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Urgent and Emergency Care plan for 2025/26 identifies reducing delays in hospital discharge as a key priority. Further information on the Urgent and Emergency Care plan for 2025/26 is available at the following link:

https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/

Hospitals are expected to eliminate discharge delays of more than 48 hours caused by in-hospital issues, to work with local authorities to tackle the longest delays, starting with those over 21 days, and to profile discharges by pathway to support local planning. In addition to this, we published a new policy framework on 30 January 2025 for the £9 billion Better Care Fund policy framework 2025 to 2026, which requires the National Health Service and local authorities to jointly agree local goals for reducing discharge delays. Further information on the Better Care Fund policy framework 2025 to 2026 is available at the following link:

https://www.gov.uk/government/publications/better-care-fund-policy-framework-2025-to-2026

We are working with trusts, integrated care systems, and local authorities to share and embed best practice and to help them to use performance data more effectively to address their discharge delays. The Local Government Association has published a range of guidance documents and high impact change models to support improvements to hospital flow and discharge processes, which can be found at the following link:

https://www.local.gov.uk/our-support/partners-care-and-health/better-care-fund-support-programme-2025-26

Officials held a call on 18 July 2025 with the Epsom and St. Helier Trust regarding the trust’s discharge challenges and proposed actions to improve the situation.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how his Department is supporting schools in West Dorset constituency to provide mental health support for children on the child and adolescent mental health services waiting list.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

For children and young people in distress or struggling with their mental health, fast access to early, high-quality support is critical, including in West Dorset.

That is why the 10-Year Health Plan sets out how we will work with schools and colleges to better identify and meet children's mental health needs by continuing to roll out mental health support teams in schools and colleges, to reach full national coverage by 2029.

The 10-Year Health Plan will build on the work that has already begun to bring down waiting lists. This includes providing mental health support for almost one million more young people in school this year and an extra £688 million in Government funding this year to transform mental health services, specifically to hire more staff, deliver more early interventions, and get waiting lists down.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to improve access to child and adolescent mental health services in schools in West Dorset constituency.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

For children and young people in distress or struggling with their mental health, fast access to early, high-quality support is critical, including in West Dorset.

That is why the 10-Year Health Plan sets out how we will work with schools and colleges to better identify and meet children's mental health needs by continuing to roll out mental health support teams in schools and colleges, to reach full national coverage by 2029.

The 10-Year Health Plan will build on the work that has already begun to bring down waiting lists. This includes providing mental health support for almost one million more young people in school this year and an extra £688 million in Government funding this year to transform mental health services, specifically to hire more staff, deliver more early interventions, and get waiting lists down.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to integrate child and adolescent mental health service provision into schools nationally.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

For children and young people in distress or struggling with their mental health, fast access to early, high-quality support is critical, including in West Dorset.

That is why the 10-Year Health Plan sets out how we will work with schools and colleges to better identify and meet children's mental health needs by continuing to roll out mental health support teams in schools and colleges, to reach full national coverage by 2029.

The 10-Year Health Plan will build on the work that has already begun to bring down waiting lists. This includes providing mental health support for almost one million more young people in school this year and an extra £688 million in Government funding this year to transform mental health services, specifically to hire more staff, deliver more early interventions, and get waiting lists down.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the independent investigation of the activities of the orthopaedic surgeon at Addenbrooke's Hospital by Verita, published on 29 October, and whether it informed the duty of candour and assistance proposed in the Public Office (Accountability) Bill.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 19 November 2025, the Parliamentary Under-Secretary of State for Health Innovation and Safety met with a number of families to discuss how they have been impacted by surgeries carried out by Kuldeep Stohr, and also considered the report by Verita, published on 29 October 2025, into the missed opportunities by the Cambridge University Hospitals NHS Foundation Trust (CUH). The report made for difficult reading and highlighted multiple missed opportunities in clinical oversight, leadership, and governance to address concerns that were previously raised about Ms Stohr’s clinical practice.

The trust board has accepted the findings and recommendations of the Verita investigation in full and is committed to delivering systemic and transparent change. The Government is assured that NHS England, the Care Quality Commission, the integrated care board, and Healthwatch will provide independent assurance that the trust is fully implementing all recommendations, ensuring accountability, transparency, and measurable improvements in patient safety. The trust is also establishing a new Patient Advisory Board and Young Patients’ Advisory Board to ensure that the CUH’s response delivers meaningful and patient-centred improvement.

The Public Office (Accountability) Bill was published on 16 September 2025. The duty of candour and assistance in the bill was not informed by the Verita report. The bill responds to long-standing demands for openness and transparency from families affected by major institutional failures such as those seen in Hillsborough as well as the Horizon and Infected Blood scandals.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure capital investment in NHS estate and infrastructure supports improvements in climate resilience.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

We recognise the importance of increasing the climate resilience of the National Health Service estate and infrastructure. NHS trusts are responsible for maintaining their estate, including adapting premises to reduce the risks associated with climate change, as set out in the NHS Standard Contract.

The Department is supporting the improvement of NHS sites by investing £30 billion over the next five years in day-to-day maintenance and repair, with £5 billion allocated specifically to address the most critical building issues. NHS trusts will be able to direct some of this funding towards improving the climate resilience of their estate where this is locally appropriate. Additionally, the Department is making sure all new hospitals are fit for the future. The Department’s New Hospital Programme requires schemes to achieve a minimum rating of BREEAM ‘Excellent’ for new builds, and ‘Very Good’ for refurbishments. All NHS investments in new buildings and upgrades to existing facilities that are subject to HM Treasury business case approval process must align with the NHS Net Zero Building Standard, which includes a focus on overheating risks.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the unit cost per day is for NHS (a) elective, (b) non-elective, (c) high dependency and (d) standard ward beds.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The following table shows the bed day cost for elective and non-elective admissions, for 2024/25:

Source: National Cost Collection Patient Level Cost dataset for admitted patient care. Point of delivery, cost and length of stay data submitted to the dataset by National Health Service providers in the latest financial year, 2024/25.

NHS England does not hold the data to calculate the bed day cost for high dependency and standard ward beds.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will review the November 2025 decrease to the Agenda for Change mileage payments for community staff.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

As set out in NHS Terms and Conditions of Service (TCS) Handbook, which is ratified by the NHS Staff Council, mileage reimbursement rates are reviewed twice a year in April and November.

The outcome of the November 2025 review resulted in a reduction of reimbursement rates due to sustained decreases in fuel prices for the 12-month period ending in October 2025. Reimbursement rates will drop to 56 pence per mile up to 3,500 miles claimed before dropping to 21 pence per mile thereafter. The revised rates will apply to mileage incurred from 1 January 2026.

These changes apply to all staff directly employed under Agenda for Change terms and conditions and Resident Doctors. There are no specific rates for community staff.

The NHS Staff Council, which is responsible for maintaining the NHS TCS, is currently negotiating a new mechanism that will determine a fair reimbursement rate for miles incurred by these staff. Further updates on their work will be made in due course.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of rising demand for ambulance services on Category 2 performance in the east of England.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The East of England Ambulance Service NHS Trust (EEAST) has experienced sustained growth in demand in recent years. In the current financial year-to-date, to November 2025, the service has responded to over 640,000 incidents. This represents the highest year-to-date total to November since records began in 2018/19, and an increase of more than 40,000 incidents compared to the same period last year.

Despite increased demand, Category 2 performance has improved. In the current financial year to date, to November 2025, the mean Category 2 response time has been 34 minutes 56 seconds.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he plans to provide additional funding to (i) James Paget Hospital and (ii) Northgate Hospital to help support (a) local residents and (b) its seasonal tourist population.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Integrated care boards (ICBs) are responsible for commissioning and funding the care delivered by healthcare providers, including the James Paget University Hospitals NHS Foundation Trust and the Norfolk and Suffolk NHS Foundation Trust. The amount of funding received by each provider is based on the NHS Payment Scheme, which is a set of rules, prices, and guidance that determine how the providers of National Health Service funded healthcare are paid for the services they deliver.

NHS England is responsible for determining the allocation of financial resources to ICBs. The process of setting funding allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time according to factors such as demography, morbidity, deprivation, and the unavoidable cost of providing services in different areas.

NHS England produces a technical guide to allocation formulae, with the 2025/26 edition available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2025/02/PRN01601-technical-guide-to-allocation-formulae-and-convergence-for-2025-to-2026-revenue-allocations.pdf

The edition covering 2026/27 to 2028/29 allocations will be published in due course.

The NHS also has an operational pressures escalation levels (OPEL) framework which provides a standardised approach to support an effective, integrated, and coordinated response to acute trust operational pressures. This includes actions locally, regionally, and nationally that support the depressurising of services and ensure patient safety. Further information about the OPEL framework is published by NHS England, and is available at the following link:

https://www.england.nhs.uk/long-read/integrated-opel-framework-2024-to-2026/#escalation-and-actions-in-response-to-operational-risks-and-pressures

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that patients in Great Yarmouth receive equal access to NHS services.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

As part of the 10-Year Health Plan we are focusing the role of integrated care boards (ICBs) on strategic commissioning to improve population health. NHS England has published the Strategic Commissioning Framework which supports the development of care models that are better matched to local needs, improved access to appropriate services, and a stronger focus on population health and reducing inequalities.

As outlined in our 10-Year Health Plan, neighbourhood health plans will be created, including for the Norfolk and Waveney ICB, which covers Great Yarmouth.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has direct oversight of financial efficiencies at the James Paget Trust.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The East of England Regional Team has detailed and regular engagement with the James Paget University Hospitals NHS Foundation Trust to discuss both their financial position and, more specifically, the delivery of their financial efficiencies. The monthly financial position and progress in delivering efficiencies is a key aspect of the monthly System Financial Review meetings with the trust’s Chief Finance Officer, alongside the integrated care board and other trusts within the local system.

As of October 2025, the James Paget University Hospitals Trust is on track to deliver against its agreed efficiency target.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the level of ambulance handover delays at James Paget Hospital in each of the past three years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England publishes monthly data on ambulance handovers, including at the James Paget University Hospitals NHS Foundation Trust over the past three years. This information is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/ambulance-management-information

In addition, weekly handover data split by day is also published as part of national winter reporting. This information is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/uec-sitrep

We are working closely with the trust and system partners to deliver ongoing, evidence-based improvement to ambulance handovers. Key actions include the Release and Respond Programme since December 2024, which targets long delays and supports rapid handovers, new protocols for managing hospital capacity and safe patient flow, enhanced discharge planning and long length-of-stay reviews, Same Day Emergency Care investment enabling same-day assessment and treatment, and enhanced geriatrician support for early assessment and frailty management.

These initiatives are already delivering positive results with the average handover time reducing by 27 minutes in November 2025 compared to November 2024. Furthermore, current four-hour performance for November stands at 73.4%, up 10.3% from last November.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of staff parking charges on recruitment and morale at James Paget Hospital.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

No assessment has been made of the impact of staff parking charges on recruitment and morale at James Paget Hospital.

The health and wellbeing of National Health Service staff is a top priority, and all 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 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.

All NHS hospitals in England are expected to follow the published NHS Car Parking Guidance. The guidance makes clear that where hospital car parking charges exist, they should be reasonable for the area.

In addition, free hospital car parking is already in place for ‘in-need’ groups, and this includes NHS staff working overnight.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much (i) James Paget University Hospitals NHS Foundation Trust and (ii) Norfolk and Waveney Community Health and Care NHS Trust spent on external consultants in each of the last three financial years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The following table shows the amount spent by James Paget University Hospitals NHS Foundation Trust and Norfolk and Waveney Community Health and Care NHS Trust for the last three financial years:

The information is published in their annual report and accounts on their websites, where further detail is available.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many staff left his Department in each of the last five years by grade.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Information on the number of civil servants leaving each Government department and organisation for the years 2021 to 2025 is published annually through the ‘Civil Service data browser’ as part of Civil Service Statistics 2025, an accredited official statistics publication. This information is available through the Civil Service data browser for 2021 through 2025 at the following link:

https://civil-service-statistics.jdac.service.cabinetoffice.gov.uk/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will take steps to ensure that the Levy review does not reduce access to (a) hormonal therapy and (b) surgery for trans and non-binary 18-25 year olds.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England is currently carrying out a review of adult gender services. The review, chaired by Dr David Levy, has examined the model of care and operating procedures of each service, and has carefully considered experiences, feedback and outcomes from clinicians and patients. The review has been conducted in line with the publicly available terms of reference and key lines of enquiry. The Government will carefully consider the findings of the review.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support NHS staff employed in Band 2 roles with pay and conditions.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

On 22 May, the Department accepted the headline pay recommendations made by the independent NHS Pay Review Body. This means Agenda for Change (AfC) staff in England, including Band 2 staff, have received a 3.6% uplift, giving them an above forecast inflation pay rise for the second year in a row. The process for the 2026/27 pay round is already underway, with the Department publishing its evidence to the Pay Review Bodies on 30 October.

We have also agreed to provide the NHS Staff Council with a funded mandate to negotiate changes to the AfC pay structure. We will work in partnership with the NHS Staff Council to implement these changes for 2026/27.

We continue to work in partnership with stakeholders, including trade unions and employers, to implement a suite of non-pay measures to improve working conditions for National Health Service staff, such as tackling violence against NHS staff and improving the application of the Job Evaluation Scheme.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he plans to support the continued (a) development and (b) implementation of NHS England’s elective toolkit for aortic dissection in the context of the planned abolition of NHS England.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department will continue to support the implementation of NHS England’s acute aortic dissection toolkit which was published in 2022 by NHS England.

In collaboration with the ‘Earnest’ trial, NHS England will undertake a stocktake of implementation progress, the findings of which will be shared with regional commissioning teams and clinical networks to support further action as required.

NHS England’s national team is also working with the vascular and cardiac professional societies to develop a type B, elective aortic dissection toolkit, which is anticipated for publication in 2026.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to Answer of 3 December 2025 to Question 94075 on Health Services: Foreign Nationals, when he last reviewed the operation of the NHS cost-recovery regime with NHS England: and what milestones have been set to measure improvements in the effectiveness of that regime.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department and NHS England publish data annually on the income identified, recovered, and written off from chargeable overseas visitors in England in the Department’s Annual Report and Accounts and in NHS England’s Consolidated NHS provider accounts. The information for the last three years is available at the following links:

https://assets.publishing.service.gov.uk/media/692dc4e8345e31ab14ecf846/consolidated-nhs-provider-accounts-ara-2024-to-2025.pdf

https://assets.publishing.service.gov.uk/media/693a97ef6a12691d48491de0/dhsc-annual-report-and-accounts-2024-2025-print-ready.pdf

https://assets.publishing.service.gov.uk/media/6745b836e7cf64050b8098c4/consolidated-nhs-provider-accounts_annual-report-and-accounts-2023-to-2024_print-ready.pdf

https://assets.publishing.service.gov.uk/media/676150ef26a2d1ff18253415/dhsc-annual-report-and-accounts-2023-2024-web-accessible.pdf

https://assets.publishing.service.gov.uk/media/65b2a4fc5f8ce2000d3ae544/consolidated-provider-accounts-2022-to-2023-print.pdf

https://assets.publishing.service.gov.uk/media/65b236c81702b10013cb1289/DHSC-Annual-report-and-accounts-2022-2023-web-accessible.pdf

National Health Service charges can be recovered up to six years from the date of invoice, and therefore the amount recovered in a year does not necessarily mean it was identified in the same financial year.

No formal review of the system of cost recovery has taken place. However, we continue to work with NHS England to ensure that the system works as effectively and fairly as possible.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much income was (a) invoiced, (b) collected, and( c) written off under the NHS cost-recovery regime in each of the last three financial years.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department and NHS England publish data annually on the income identified, recovered, and written off from chargeable overseas visitors in England in the Department’s Annual Report and Accounts and in NHS England’s Consolidated NHS provider accounts. The information for the last three years is available at the following links:

https://assets.publishing.service.gov.uk/media/692dc4e8345e31ab14ecf846/consolidated-nhs-provider-accounts-ara-2024-to-2025.pdf

https://assets.publishing.service.gov.uk/media/693a97ef6a12691d48491de0/dhsc-annual-report-and-accounts-2024-2025-print-ready.pdf

https://assets.publishing.service.gov.uk/media/6745b836e7cf64050b8098c4/consolidated-nhs-provider-accounts_annual-report-and-accounts-2023-to-2024_print-ready.pdf

https://assets.publishing.service.gov.uk/media/676150ef26a2d1ff18253415/dhsc-annual-report-and-accounts-2023-2024-web-accessible.pdf

https://assets.publishing.service.gov.uk/media/65b2a4fc5f8ce2000d3ae544/consolidated-provider-accounts-2022-to-2023-print.pdf

https://assets.publishing.service.gov.uk/media/65b236c81702b10013cb1289/DHSC-Annual-report-and-accounts-2022-2023-web-accessible.pdf

National Health Service charges can be recovered up to six years from the date of invoice, and therefore the amount recovered in a year does not necessarily mean it was identified in the same financial year.

No formal review of the system of cost recovery has taken place. However, we continue to work with NHS England to ensure that the system works as effectively and fairly as possible.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential merits of an Accident and Emergency Appreciation Week.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Government highly values hardworking National Health Service staff who go above and beyond to provide rapid and critical care. Local NHS trusts have in place their own approaches to recognising and rewarding staff, supported by advice and guidance set out in the Staff Recognition Framework, which is available at the following link:

https://www.england.nhs.uk/long-read/staff-recognition-framework/

Members of Parliament can also acknowledge the work of NHS staff in their constituency through the NHS Parliamentary Awards, with further information available at the following link:

https://nhsparliamentaryawards.co.uk/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure equitable access to funding for IVF surrogacy for people post cancer treatment.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Funding decisions for fertility services, including cases where a surrogate may be involved, are made by integrated care boards (ICBs), which are responsible for commissioning services based on the clinical needs of their populations. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines to support fair and consistent access across England.

NICE is currently reviewing the fertility guidelines and will consider whether its current recommendations for access to National Health Service funded treatment are still appropriate. A consultation on revised guidelines was published on 10 September and closed on 21 October 2025. The outcome of this review will support ICBs in making commissioning decisions that promote equitable access to fertility services, including for those whose fertility has been affected by medical treatment such as cancer.

Work continues between the Department and NHS England to analyse the current understanding and provision of NHS funded fertility services and address longstanding variation in access.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to review the NHS Pension Annual Allowance rules to prevent excessive charges for staff covering rota gaps.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The annual allowance limits the amount that an individual can save in their pension pot before they have to pay tax. It aims to ensure that the incentives for pension saving, which are costly to the taxpayer, are appropriately targeted across society. Tax policy, including the level of the annual allowance, is a matter for my Rt. Hon. Friend, the Chancellor of the Exchequer.

From 6 April 2023, the previous administration introduced reforms to the annual allowance, increasing both the standard and tapered annual allowances, allowing National Health Service staff to save more into their pensions each year before facing a tax charge.

Where NHS staff have pension savings that exceed the annual allowance, for example due to unexpected circumstances such as taking on extra hours or additional responsibilities within the NHS, they can carry forward any unused annual allowance from the previous three tax years. This will increase their current year’s allowance, reducing or potentially avoiding any annual allowance tax charge that is due.

Additionally, the NHS Pension Scheme offers a Scheme Pays facility which allows impacted members to pay charges using the value of their pension. This spreads the cost of paying a tax charge over the lifetime of the pension rather than requiring an immediate outlay. For most members, the growth in their pension benefits at retirement, even net of a charge, would still represent an excellent return on their pension contributions.

Information for trusts is available on NHS Employers website, which is available at the following link:

https://www.nhsemployers.org/publications/annual-allowance.

Information for members is available on the NHS Pensions website, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/annual-allowance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how his Department is supporting senior NHS staff in West Dorset constituency who face large Annual Allowance charges due to extra hours worked during staffing shortages.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The annual allowance limits the amount that an individual can save in their pension pot before they have to pay tax. It aims to ensure that the incentives for pension saving, which are costly to the taxpayer, are appropriately targeted across society. Tax policy, including the level of the annual allowance, is a matter for my Rt. Hon. Friend, the Chancellor of the Exchequer.

From 6 April 2023, the previous administration introduced reforms to the annual allowance, increasing both the standard and tapered annual allowances, allowing National Health Service staff to save more into their pensions each year before facing a tax charge.

Where NHS staff have pension savings that exceed the annual allowance, for example due to unexpected circumstances such as taking on extra hours or additional responsibilities within the NHS, they can carry forward any unused annual allowance from the previous three tax years. This will increase their current year’s allowance, reducing or potentially avoiding any annual allowance tax charge that is due.

Additionally, the NHS Pension Scheme offers a Scheme Pays facility which allows impacted members to pay charges using the value of their pension. This spreads the cost of paying a tax charge over the lifetime of the pension rather than requiring an immediate outlay. For most members, the growth in their pension benefits at retirement, even net of a charge, would still represent an excellent return on their pension contributions.

Information for trusts is available on NHS Employers website, which is available at the following link:

https://www.nhsemployers.org/publications/annual-allowance.

Information for members is available on the NHS Pensions website, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/annual-allowance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what measures are being considered to prevent NHS staff nationally from being deterred from covering rota gaps due to Annual Allowance charges.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The annual allowance limits the amount that an individual can save in their pension pot before they have to pay tax. It aims to ensure that the incentives for pension saving, which are costly to the taxpayer, are appropriately targeted across society. Tax policy, including the level of the annual allowance, is a matter for my Rt. Hon. Friend, the Chancellor of the Exchequer.

From 6 April 2023, the previous administration introduced reforms to the annual allowance, increasing both the standard and tapered annual allowances, allowing National Health Service staff to save more into their pensions each year before facing a tax charge.

Where NHS staff have pension savings that exceed the annual allowance, for example due to unexpected circumstances such as taking on extra hours or additional responsibilities within the NHS, they can carry forward any unused annual allowance from the previous three tax years. This will increase their current year’s allowance, reducing or potentially avoiding any annual allowance tax charge that is due.

Additionally, the NHS Pension Scheme offers a Scheme Pays facility which allows impacted members to pay charges using the value of their pension. This spreads the cost of paying a tax charge over the lifetime of the pension rather than requiring an immediate outlay. For most members, the growth in their pension benefits at retirement, even net of a charge, would still represent an excellent return on their pension contributions.

Information for trusts is available on NHS Employers website, which is available at the following link:

https://www.nhsemployers.org/publications/annual-allowance.

Information for members is available on the NHS Pensions website, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/annual-allowance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance his Department has provided to NHS trusts in West Dorset constituency on managing staff concerns over Annual Allowance charges.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The annual allowance limits the amount that an individual can save in their pension pot before they have to pay tax. It aims to ensure that the incentives for pension saving, which are costly to the taxpayer, are appropriately targeted across society. Tax policy, including the level of the annual allowance, is a matter for my Rt. Hon. Friend, the Chancellor of the Exchequer.

From 6 April 2023, the previous administration introduced reforms to the annual allowance, increasing both the standard and tapered annual allowances, allowing National Health Service staff to save more into their pensions each year before facing a tax charge.

Where NHS staff have pension savings that exceed the annual allowance, for example due to unexpected circumstances such as taking on extra hours or additional responsibilities within the NHS, they can carry forward any unused annual allowance from the previous three tax years. This will increase their current year’s allowance, reducing or potentially avoiding any annual allowance tax charge that is due.

Additionally, the NHS Pension Scheme offers a Scheme Pays facility which allows impacted members to pay charges using the value of their pension. This spreads the cost of paying a tax charge over the lifetime of the pension rather than requiring an immediate outlay. For most members, the growth in their pension benefits at retirement, even net of a charge, would still represent an excellent return on their pension contributions.

Information for trusts is available on NHS Employers website, which is available at the following link:

https://www.nhsemployers.org/publications/annual-allowance.

Information for members is available on the NHS Pensions website, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/annual-allowance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will review the rules on NHS Pension Annual Allowance charges to reduce the risk of staff being financially penalised for working additional hours.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The annual allowance limits the amount that an individual can save in their pension pot before they have to pay tax. It aims to ensure that the incentives for pension saving, which are costly to the taxpayer, are appropriately targeted across society. Tax policy, including the level of the annual allowance, is a matter for my Rt. Hon. Friend, the Chancellor of the Exchequer.

From 6 April 2023, the previous administration introduced reforms to the annual allowance, increasing both the standard and tapered annual allowances, allowing National Health Service staff to save more into their pensions each year before facing a tax charge.

Where NHS staff have pension savings that exceed the annual allowance, for example due to unexpected circumstances such as taking on extra hours or additional responsibilities within the NHS, they can carry forward any unused annual allowance from the previous three tax years. This will increase their current year’s allowance, reducing or potentially avoiding any annual allowance tax charge that is due.

Additionally, the NHS Pension Scheme offers a Scheme Pays facility which allows impacted members to pay charges using the value of their pension. This spreads the cost of paying a tax charge over the lifetime of the pension rather than requiring an immediate outlay. For most members, the growth in their pension benefits at retirement, even net of a charge, would still represent an excellent return on their pension contributions.

Information for trusts is available on NHS Employers website, which is available at the following link:

https://www.nhsemployers.org/publications/annual-allowance.

Information for members is available on the NHS Pensions website, which is available at the following link:

https://www.nhsbsa.nhs.uk/member-hub/annual-allowance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the average ambulance response time for Category 2 calls was in rural parts of the East Midlands in each of the last 12 months; and how this compares with response times in urban areas in the region.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

We acknowledge that ambulance performance has not consistently met expectations in recent years, and we are taking serious steps to improve performance across the country, including rural and semi-urban areas. That is why we published our Urgent and Emergency Care Plan for 2025/26, backed by almost £450 million of capital investment, which commits to reducing ambulance response times for Category 2 incidents to 30 minutes on average this year.

The NHS Constitutional standards for ambulance response time metrics are measured with an average figure as well as a 90th centile standard which means that trusts are held to account for the response times they provide to all patients, improving the performance management of the ‘long tail’ of delayed ambulance responses that we know can particularly affect rural and semi-urban areas. In the East Midlands, the latest NHS England figures show a 22-minute improvement in the Category 2 90th centile response time compared with last year.

We have already seen improvements in ambulance response times for the East Midlands Ambulance Service NHS Foundation Trust (EMAS). The latest National Health Service performance figures for EMAS show that Category 2 incidents were responded to in 46 minutes and 55 seconds on average, over 11 minutes faster than the same period last year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of ambulance response times in rural areas of the East Midlands; and what steps are being taken to improve response times in those communities.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

We acknowledge that ambulance performance has not consistently met expectations in recent years, and we are taking serious steps to improve performance across the country, including rural and semi-urban areas. That is why we published our Urgent and Emergency Care Plan for 2025/26, backed by almost £450 million of capital investment, which commits to reducing ambulance response times for Category 2 incidents to 30 minutes on average this year.

The NHS Constitutional standards for ambulance response time metrics are measured with an average figure as well as a 90th centile standard which means that trusts are held to account for the response times they provide to all patients, improving the performance management of the ‘long tail’ of delayed ambulance responses that we know can particularly affect rural and semi-urban areas. In the East Midlands, the latest NHS England figures show a 22-minute improvement in the Category 2 90th centile response time compared with last year.

We have already seen improvements in ambulance response times for the East Midlands Ambulance Service NHS Foundation Trust (EMAS). The latest National Health Service performance figures for EMAS show that Category 2 incidents were responded to in 46 minutes and 55 seconds on average, over 11 minutes faster than the same period last year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has been made of trends in complaints and compensation payments for unacceptable standards of maternity care since 2015.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

As assessment has not been made of the trends in complaints for unacceptable standards of maternity care. The rising costs of clinical negligence claims against the National Health Service in England is, however, of great concern to the Government.

A report published by the National Audit office (NAO) on 17 October 2025 stated that "over the last 20 years the cost of settling claims involving infants and children has increased significantly. Between 2006/07 and 2024/25, the total cost for obstetrics claims involving cerebral palsy or brain damage increased by over £1 billion in real terms, with average compensation for claims settled with damages growing by 305% (from £2.8 million to £11.2 million)”. The report can be viewed at the following link:

https://www.nao.org.uk/reports/costs-of-clinical-negligence/#downloads

As announced in the 10-Year Health Plan for England, David Lock KC is providing expert policy advice on the rising legal costs of clinical negligence and how we can improve patients’ experience of claims, which will inform future policy making in this area. No decisions on policy have been taken at this point, and the Government will provide an update on the work done and next steps in due course.

Baroness Amos is leading a rapid, independent investigation into NHS Maternity and Neonatal services to help us understand the systemic issues behind why so many women, babies, and families experience unacceptable care. The investigation will look into the maternity and neonatal system nationally, bringing together the findings of past reviews into one clear national set of recommendations. This will also include local investigations of maternity and neonatal services in selected trusts.

On 9 December, Baroness Amos published reflections on what she has heard so far as part of the National Maternity and Neonatal Investigation, following engagement with women and families. Baroness Amos’ reflections and initial findings can be found at the following link:

https://www.matneoinv.org.uk/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of cancelled annual leave days as a result of strike action in the NHS since July 2024.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

The Department has made no estimate of the number of cancelled annual leave days as a result of strike action in the National Health Service. Information is not held centrally on the level of cancellation of annual leave of NHS staff, including for the reason of cover of staff who are undertaking industrial action.

Our priority is to keep patients as safe as possible during any industrial action. The NHS makes every effort through rigorous contingency planning to minimise the disruption of industrial action and its impact on patients and the public. Assessments are made by local Trusts about levels of resourcing available, and they can escalate concerns via regions and nationally, where appropriate.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of the (a) quality and (b) availability of cancer services for patients in Telford.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Cancer services are provided from the Lingen Davies Centre at The Royal Shrewsbury Hospital, which comprises of an outpatient area, a chemotherapy day centre and radiotherapy facilities.

Linear accelerators at the Shrewsbury and Telford Hospital NHS Trust, deliver around 1600 radiotherapy treatments, alongside 1700 systemic anti-cancer therapy (chemotherapy) treatments, each month for the population of Shropshire, Telford and the Wrekin. NHS England also commission cancer surgery for patients in the integrated care board.

Many rare cancers have dedicated pathways in place to ensure all patients can access the services required. These pathways are all agreed with the West Midlands Cancer Alliance.

The National Cancer Patient Experience Survey (CPES) allows cancer patients to give feedback on the care that they have received. This feedback is used to understand where care is working well and how National Health Service cancer services across England can be improved. Results from the survey are used by providers to improve the experience of cancer patients at a national, regional, and local level.

The CPES 2024 results for the Shrewsbury and Telford Hospital NHS Trust, were published in July 2025 and are available at the following link:

https://www.ncpes.co.uk/wp-content/uploads/2025/07/CPES-2024-Trust-The-Shrewsbury-and-Telford-Hospital-NHS-Trust-RXW.pdf

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to address regional and rural-urban disparities in ambulance response times, with reference to the performance of East Midlands Ambulance Service.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

We acknowledge that ambulance performance has not consistently met expectations in recent years, and we are taking serious steps to improve performance across the country, including rural and semi-urban areas. That is why we published our Urgent and Emergency Care Plan for 2025/26, backed by almost £450 million of capital investment, which commits to reducing ambulance response times for Category 2 incidents to 30 minutes on average this year.

The NHS Constitutional standards for ambulance response time metrics are measured with an average figure as well as a 90th centile standard which means that trusts are held to account for the response times they provide to all patients, improving the performance management of the ‘long tail’ of delayed ambulance responses that we know can particularly affect rural and semi-urban areas. In the East Midlands, the latest NHS England figures show a 22-minute improvement in the Category 2 90th centile response time compared with last year.

We have already seen improvements in ambulance response times for the East Midlands Ambulance Service NHS Foundation Trust (EMAS). The latest National Health Service performance figures for EMAS show that Category 2 incidents were responded to in 46 minutes and 55 seconds on average, over 11 minutes faster than the same period last year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure greater deaf awareness among frontline NHS staff.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Since 2016, all National Health Service organisations and publicly funded social care providers have been expected to meet the Accessible Information Standard (AIS), which details the approach to supporting the information and communication support needs of people with a disability, impairment, or sensory loss. This includes support for deaf people and ensuring that British Sign Language (BSL) interpreters are provided when needed.

On 30 June 2025, NHS England published a revised AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision.

NHS England revised the AIS e-learning for health module to match the latest version of the standard to support effective implementation. This training module includes specific reference to the needs of deaf people and BSL interpreting.

NHS England is working to support implementation of the AIS with awareness raising, communication and engagement. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.

Found: But this year has been quite extraordinary with the amount of funding that we have received from DHSC

Found: If you take the elective waiting list, that is predominantly a DHSC responsibility.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what steps they are taking in response to the findings of PwC’s Youth Employment Index regarding the role of long-term sickness in driving youth economic inactivity.

Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)

Long-term sickness continues to be the most common reason for economic inactivity in the working age population. Good work is generally good for health and wellbeing, so we want everyone to get work and get on in work, whoever they are and wherever they live. Backed by £240 million investment, the Get Britain Working White Paper launched in November 2024 is driving forward approaches to tackling economic inactivity.

Young disabled people and young people with health conditions are a diverse group so access to the right work and health support, in the right place, at the right time, is key. We therefore have a range of specialist initiatives to support individuals to stay in work and get back into work, including those that join up employment and health systems. Existing measures include support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants, as well as joining up health and employment support around the individual through Employment Advisors in NHS Talking Therapies, Individual Placement and Support in Primary Care and WorkWell.

Additionally, the Youth Guarantee and Pathways to Work will guarantee specialist support for young people with long-term health conditions and disabled young people. We have announced an £820 million funding package for the Youth Guarantee to overhaul support and give a generation of young people a brighter future.

We set out our plan for the “Pathways to Work Guarantee” in our Pathways to Work Green Paper and we are building towards our guaranteed offer of personalised work, health and skills support for disabled people and those with health conditions on out of work benefits. The guarantee is backed by £1 billion a year of new, additional funding by the end of the decade. We anticipate the guarantee, once fully rolled out, will include: a support conversation to identify next steps, one-to-one caseworker support, periodic engagement, and an offer of specialist long-term work health and skills support.

In recognition of employers’ vital role in addressing health-related economic activity, we appointed Sir Charlie Mayfield to lead the independent Keep Britain Working Review. The Report was published on 5 November. In partnership with DBT and DHSC, we are immediately launching Vanguards to test new employer-led approaches to support individuals to stay in work and develop a Healthy Workplace Standard, putting Sir Charlie’s key recommendations into action from day one.  Additionally, the JWHD has developed a digital information service for employers, continues to oversee the Disability Confident Scheme, and continues to increase access to Occupational Health.

The NHS 10 Year Health Plan, published in July, stated our intention to break down barriers to opportunity by delivering the holistic support that people need to access and thrive in employment by ensuring a better health service for everyone, regardless of condition or service area. It outlines how the neighbourhood health service will join up support from across the work, health and skills systems to help address the multiple complex challenges that often stop people finding and staying in work.

Additionally, Alan Milburn will author an independent report to tackle the persistently high numbers of young people out of work, education and training. The report will examine why increasing numbers of young people are falling out of work or education before their careers have begun, with a particular focus on the impact of mental health conditions and disability. It will make recommendations for policy response to help young people with health conditions access work, training or education, ensuring they are supported to thrive and are not sidelined. It will complement the Timms Review by focusing specifically on the links between youth mental health, economic inactivity and the benefit system.

Question to the Department for Education:

To ask the Secretary of State for Education, what guidance her Department provides to local authorities on reviewing care plans where new diagnoses of (a) special educational needs, (b) disabilities or (c) neurodevelopmental conditions are identified after a child has entered foster care.

Answered by Josh MacAlister - Parliamentary Under-Secretary (Department for Education)

The department has published a comprehensive suite of guidance to ensure that children in care have their needs identified and supported, as part of a dynamic and continuous cycle of care planning. This includes:

• The Children Act 1989 guidance, Volume 2.
• Promoting the health and wellbeing of looked-after children (joint Department for Education and Department of Health and Social Care guidance).
• Promoting the educational outcomes of looked-after children.
• The Special Educational Needs and Disability Code of Practice.

As part of this, each child must have a care plan, bringing together information from assessment across the dimensions of their developmental needs, incorporating a health plan and a personal education plan. Reviews must occur within 20 days of entering care, again within three months, and at least every six months thereafter, and can be brought forward if circumstances change significantly, including to account for significant health, medical events, or diagnoses.

Question to the Department for Education:

To ask the Secretary of State for Education, what steps she plans to take to improve a) universal, b) targeted and c) specialist speech, language and communication support.

Answered by Georgia Gould - Minister of State (Education)

Speech and Language Therapists (SaLTs) play a critical role in early intervention for children and young people. By breaking down communication barriers, they unlock learning, inclusion, and opportunity for every child.

The department is working closely with the Department of Health and Social Care and NHS England to improve access to community health services, including speech and language therapy, for children and young people with special educational needs and disabilities. This includes extending the Early Language and Support for Every Child programme, trialling new ways of working to better identify and support children with speech, language and communication needs in early years settings and primary schools.

We are also continuing to grow the pipeline. In addition to the undergraduate degree route, speech and language therapists can also train via a degree apprenticeship. This route is now in its fourth year of delivery and offers an alternative pathway to the traditional degree route into a successful career as a speech and language therapist.

Further plans to bolster this critical workforce will be set out in the forthcoming Schools White Paper.

Question to the Department for Education:

To ask the Secretary of State for Education, if she will make it mandatory for all schools to hold spare AAIs, and ensure relevant staff are trained in their use.

Answered by Georgia Gould - Minister of State (Education)

The Human Medicines (Amendment) Regulations 2017 have allowed all schools to buy adrenaline auto-injectors (AAI devices) without a prescription for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working.

The Department of Health and Social Care has published non-statutory guidance to accompany this legislative change, which is available at: https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schools.

The department is working with DHSC and NHS England to consider how we might extend the availability of adrenaline auto-injectors in schools.

Found: The results are used by the Department of Health and Social Care for performance assessment, improvement

Found: DHSC (2024)27 used topic modelling in combination with officials reviewing a sample of representative

Found: MP who was the first ever Children’s Social Care Adviser earlier this year at the Department of Health and Social Care

Found: urgent medical treatment in the UK following agreement about such treatment with the Department of Health and Social Care

Found: The MHRA is an executive agency of the Department of Health and Social Care.  

Found: The MHRA is an executive agency of the Department of Health and Social Care.  

Found: The MHRA is an executive agency of the Department of Health and Social Care.  

Found: The MHRA is an executive agency of the Department of Health and Social Care.   

Found: Figure 6: Circular economy-based system loops, taken from the Design for Life Roadmap, DHSC The