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.

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

We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD, and to help provide a joined-up approach in response to concerns around rising demand.

Alongside the work of the taskforce, NHS England will continue to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services to ensure best practice is captured and shared across the system.

This data is published annually by NHS England in the NHS Payments to General Practice Report and will be available in due course.

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

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

NHS staff have been overworked for years, with staff being burnt out and demoralised.

We are committed to training the staff we need, including anaesthetists, to ensure patients are cared for by the right professional, when and where they need it.

We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

There is no quick fix, but through the NHS Long Term Workforce Plan we will build a health service fit for the future.

NHS staff have been overworked for years, with staff being burnt out and demoralised.

We are committed to training the staff we need, including anaesthetists, to ensure patients are cared for by the right professional, when and where they need it.

We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

There is no quick fix, but through the NHS Long Term Workforce Plan we will build a health service fit for the future.

The Government is considering Sir Brian Langstaff’s recommendations, including recommendation 9 that relates to the use of alternatives to plasma-derived medicines. We will provide an update to Parliament on the progress we are making by the end of the year, as the Inquiry recommends.

In April 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) reviewed the latest scientific evidence available on the safety of donor plasma from the United Kingdom and was able to lift the ban on its use for immunoglobulin-based medicines; the ban had been in place since the mid-1990s due to concerns about over the potential spread of variant Creutzfeldt-Jakob (vCJD) disease. This was followed by a review of and lifting of the ban on albumins, also derived from UK donor plasma.

Both immunoglobulin and albumin are critical medicines for the National Health Service, with approximately 17,000 patients in England relying on immunoglobulins each year but these products are in short supply globally. Following the MHRA view that UK plasma is safe, the Department set up the Plasma for Medicines programme to increase our self-sufficiency and to protect vulnerable patients from the risk of global supply shocks. The first UK donor plasma was shipped for manufacture into medicines in August 2024 and these will be available to NHS patients from January 2025.

The Health Mission sets the objective of building a National Health Service fit for the future. As part of that work, and in response to Lord Darzi’s report, we have launched an extensive programme of engagement to develop a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts, from hospitals to the community, from analogue to digital, and from sickness to prevention.

In addition, following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including those with blood cancer.

We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be, and will provide updates on this, including on publication dates, at the earliest opportunity.

In 2022, there were an estimated 99,000 people living with HIV in England, and 108,500 in the United Kingdom. Of those, 5% were unaware of their HIV status.

This data is from 2022, and was published by the UK Health Security Agency on the GOV.UK website, in an online only format. Estimates for 2023 will be released on 28 November 2024.

In 2022, there were an estimated 99,000 people living with HIV in England, and 108,500 in the United Kingdom, both diagnosed and undiagnosed. Of those, 94% were receiving treatment.

This data is from 2022, and was published by the UK Health Security Agency on the GOV.UK website, in an online only format. Estimates for 2023 will be released on 28 November 2024.

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and to better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.

Now that the budget for Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements.

The following table shows the detentions under the Mental Health Act 1983, by legal status and across all providers, each year from 2021/22 to 2023/24:

Source: the Emergency Care Data Set and the Mental Health Data Set.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget 2024, which enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The employer National Insurance rise will be implemented in April 2025, and the Department will set out further details on the allocation of funding for next year in due course.

The usual process of declarations of interest and agreement of appropriate mitigations for non-executive board member (NEBM) appointments was carried out, overseen by the Permanent Secretary. He is content that the process has been carried out, that appropriate declarations have been made, and that appropriate mitigations for any conflicts arising have been put in place. NEBMs are contracted to work for two to three days a month and therefore it is not unusual for them to hold multiple other positions and interests. Their declarations of interest are published each year in the Register of Interests in the Department’s Annual Report and Accounts, and will also be published on GOV.UK website as per the new guidance on NEBM declarations of interest, that will be published soon. These declarations will be published at the earliest opportunity.

Tackling waiting lists is a key part of our Health Mission. We have committed to getting back to the NHS Constitutional standard that at least 92% of patients wait no longer than 18 weeks from Referral to Treatment within our first term. As a first step to achieving this, we will deliver 2 million additional appointments, scans, and operations, or the equivalent to 40,000 per week.

Whilst no formal assessment has been made of the specific potential impact of anaesthetic workforce shortages on the National Health Service’s ability to tackle the backlog, the Government will ensure the NHS has the right people, in the right places, with the right skills, to deliver the care patients need.

The National Institute for Health and Care Excellence’s guideline on heavy menstrual bleeding recommends an intrauterine system or hormonal coil, which is a form of long-acting reversible contraception (LARC), as a first line treatment. In the women’s health strategy call for evidence, held in 2021, we heard about the challenges women faced accessing LARCs for the management of menstrual problems.

A cost benefit analysis on women’s health hubs conducted by the Department estimated that if 50% of LARC procedures for gynaecology were provided in women’s health hubs, it would produce a net saving of £1.8 million, and reduce pressures on secondary care gynaecology services. The cost benefit analysis is available at the following link:

https://www.gov.uk/government/publications/womens-health-hubs-information-and-guidance/womens-health-hubs-cost-benefit-analysis#cost-benefit-analysis-assumptions

The Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. Pilot women’s health hubs provide intermediate and streamlined care in the community, which reduces pressures on services such as secondary care referrals and general practice appointments. A core service offered by hubs is treatment for heavy menstrual bleeding, and the fitting or removal of a LARC. Cutting waiting lists, including for gynaecology, is a key part of our Health Mission and a top priority for the Government.

The 2021 Getting It Right First Time national report for maternity and gynaecology recommended that clinical commissioning groups, now integrated care boards (ICBs), commission contraceptive and sexual health services to provide intrauterine devices, which are a form of long-acting reversible contraception (LARC) for heavy menstrual bleeding, in relevant cases. ICBs may commission sexual health services or general practices (GPs) to offer LARC as a locally enhanced service to their local population. It is for ICBs to decide on commissioning arrangements for their area, based on an assessment of local need.

The Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. A core service offered by hubs is treatment for heavy menstrual bleeding and provision of LARC. By providing an enhanced and more specialist service through hubs in the community, they enable women to be more effectively diagnosed and treated promptly in the community. The hubs also provide a centre for the training and support to GPs to help with upskilling, and reduce variation in the care that women can expect to receive.

Other training and guidance are available for primary care practitioners. For example, the Royal College of General Practitioners has developed a Women’s Health Library, drawing together educational resources and guidelines on women’s health, so primary healthcare professionals have the most up-to-date information for their patients. The Faculty of Sexual and Reproductive Healthcare also offers a range of contraception qualifications that healthcare professionals can undertake.

Obesity medicines can be effective for some patients living with obesity when prescribed alongside diet, physical activity, and behavioural support. Exactly what is most appropriate for an individual is down to health care professionals to advise, in discussion with patients, and considering relevant clinical guidance.

The National Institute for Health and Care Excellence (NICE) has recommended liraglutide (Saxenda) and semaglutide (Wegovy) as clinically and cost-effective drugs for weight management in adults in the National Health Service in England. NICE guidance includes eligibility criteria and, for some products like Saxenda and Wegovy, a restriction that these treatments should be used within specialist weight management services. NHS organisations are continuing to look at the best way to manage access to these treatments.

We are expecting NICE to issue guidance on tirzepatide (Mounjaro) before the end of the year. This could see it being prescribed by general practitioners rather than restricted to specialist services. To manage this, NHS England has proposed a phased rollout to make tirzepatide available in a way that is effective, affordable, and sustainable. Under NHS England’s plan, almost 250,000 people with the greatest clinical need could receive this medicine in the first three years of implementation.

Integrated care boards are responsible for arranging the provision of health services within their area in line with local priorities, considering population need and relevant guidance. This includes the commissioning of NHS specialist weight management services. The licensed treatments for weight loss such as Wegovy (semaglutide) and Mounjaro (tirzepatide) are in good supply.

The Department does not hold or collect the information requested.

The National Health Service is able to send out reminder letters to patients in 24 languages, which are available at the following link:

https://digital.nhs.uk/services/e-referral-service/language-options-for-e-rs-reminder-letters

The NHS is also able to provide information about data choices in 11 languages, which are available at the following link:

https://www.nhs.uk/your-nhs-data-matters/different-languages-and-formats/

The Department does not hold this information centrally.

The information requested on the cost to the public purse for the training and integration of National Health Service staff recruited from abroad is not collected centrally.

The Department does not hold this information centrally.

Approximately £1.5 billion of additional capital funding has been allocated in the budget for 2025/26, to support National Health Service performance across secondary and emergency care, and to begin to deliver against the Government's three strategic shifts, which include moving care from the hospital to the community.

This investment will deliver new surgical hubs and diagnostic scanners. This creates new capacity for over 30,000 additional procedures, and over 1.25 million diagnostic tests, as they come online. The investments made at the October Budget also add new beds across the NHS estate.

Collectively, these investments will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community via the expansion of community based diagnostic capacity. More details will follow at the earliest opportunity.

The NHS is prioritising the roll-out of additional diagnostic capacity, and is currently delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs), with capacity prioritised for cancer diagnostics. In August 2024, NHS England published an updated list of 168 CDC sites currently delivering activity. A total of 170 CDCs have been approved and will be delivering activity by March 2025.

The Nursing and Midwifery Council (NMC) is the independent regulator of nurses and midwives in the United Kingdom, and nursing associates in England. The Government has no current plans to amend the Nursing and Midwifery Order 2001, to abolish the requirement for NMC registrants to pay a registration fee.

The UK's model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government. All registered health and social care professions in the UK pay an annual registration fee to their regulatory body. Being funded by registrant fees enables the NMC to maintain its independence, allowing it to take action if it identifies risks to patient safety or the public’s confidence in the profession.

The Department does not hold data on the number of men who live in areas without universally accessible and fully National Health Service funded vasectomy services.

NHS vasectomy services in England are commissioned locally by integrated care boards. In most parts of the country, vasectomy is available free of charge from the NHS.

The Government is committed to tackling the workforce crisis across the National Health Service. This will be achieved through better workforce planning, which will address the recruitment and retention challenges facing the NHS.

NHS England continues to lead on a range of initiatives to boost retention, with a strong focus on improving organisational culture, supporting staff wellbeing, and promoting flexible working opportunities. It is continually reviewing the effectiveness of these, and their impact on the workforce.

No specific estimate of the future numbers of doctors and anaesthetists preparing to leave the profession has been made. The General Medical Council publishes annual information on the total number of doctors leaving their register of licenced professionals. This shows that in 2022, 11,319 doctors left the licenced register, the equivalent to 4% of the register. No information is available for anaesthetists specifically.

The Getting It Right First Time’s (GIRFT) 2021 report into maternity and gynaecology identified a key barrier in treating heavy menstrual bleeding as the commissioning arrangements for contraceptive and sexual health services. The report recommended the lifting of restrictions on providing long-acting reversible contraception (LARC) for non-contraceptive purposes, such as treatment for heavy menstrual bleeding.

The commissioning of LARC is a decision for individual integrated care boards, who can decide whether to offer LARC through general practices or sexual health services, or both, based on an assessment of population need.

Additionally, £25 million has been invested by the Department to support the development of at least one pilot women’s health hub in every integrated care system, and work is ongoing with NHS England to provide this. Women’s health hubs bring together healthcare professionals and existing services to address fragmentation in reproductive health care and remove the barriers women face accessing treatment. Providing care and treatment for heavy menstrual bleeding is a core service of the hubs, and this includes treatment with LARCs.

To repair the public finances and help raise the revenue required to increase funding for public services, the Government has taken the difficult decision to increase employer National Insurance. On the impact on charities in particular, our tax regime for charities, including exemption from paying business rates, is among the most generous of anywhere in the world, with tax reliefs for charities and their donors worth just over £6 billion for the tax year to April 2024.

We are committed to moving towards a neighbourhood health service, with more care delivered in local communities to spot problems earlier. Women’s health hubs are an example of this approach and can play a key role in delivering the Government’s commitments on tackling long National Health Service waiting lists, as well as shifting care into the community. The Department has invested £25 million to support the establishment of at least one pilot women’s health hub in every integrated care system.

We know that more needs to be done, and we will prioritise women’s health as we build an NHS fit for the future.

There has been no specific estimate made regarding the number of newborn babies losing their sight in one eye due to insufficient staffing levels. As per the National Health Service newborn and infant physical examination (NIPE) screening programme, the vision of newborn babies must be assessed within 72 hours of birth, and at the six-to-eight-week checkup. Further information on the NIPE is available at the following link:

https://www.gov.uk/government/collections/nhs-newborn-and-infant-physical-examination-nipe-screening-programme

We recognise the concerns around workforce shortages. Whilst change will not happen overnight, we are committed to training thousands more midwives to better support women and babies throughout pregnancy and beyond.

The responsibility for staffing levels should remain with clinical and other leaders at a local level, responding to local needs, supported by national and professional bodies’ guidelines, and regulated by the Care Quality Commission.

I refer the Hon. Member to the answer I gave to the Hon. Member for Westmorland and Lonsdale on 24 October 2024 to Question 10063.

The Department has not made a formal assessment of the policy implications following this clinical trial. The adoption of new treatments into the National Health Service in England is generally the result of National Institute for Health and Care Excellence guidance and commissioner decisions.

The recommended treatment plan for muscle-invasive bladder cancer depends on how far the cancer has spread. All hospitals use multidisciplinary teams to treat bladder cancer. These are teams of specialists that work together to make decisions about the best way to proceed with treatment.

Data and technology is a key enabling workstream in our 10-Year Health Plan. The NHS is already using and promoting several national tools and datasets to help systems and providers identify and implement efficiency opportunities. The NHS Spend Comparison Service allows NHS procurement teams to identify savings opportunities. Model Hospital is a data-driven improvement tool that provides benchmarked insights across the quality of care, productivity, and organisational culture to identify opportunities for improvement. Model Hospital includes a section on the top ten medicines to support trust progress towards meeting national and trust-level uptake and savings targets by using less costly or biosimilar versions of these drugs.

The Federated Data Platform, being rolled-out to trusts and integrated care systems, will allow them to be much more effective in how they handle data to improve outcomes. It brings together information about staff, waiting times, equipment, and medicines, to allow for better planning of how the NHS uses its resources, including supply main management. This was piloted in trusts across England and showed that better use of data could help discharge patients quicker and make better use of operating theatres.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has also recently announced the intention for there to be a single patient record, including primary care and hospital data, so professionals have the data to make better informed decisions, and deliver more preventative and more efficient health and care.

Through the AI in Health and Care Award, the Department has helped accelerate the testing and evaluation of artificial intelligence (AI) technologies to develop an evidence base to support the commissioning of technologies that are clinically and cost effective. So far, £113 million has been provided to 86 AI technologies, which are live in 99 hospitals across 40% of NHS acute trusts in England, as well as hundreds of Primary Care Networks across the United Kingdom.

AI technologies have huge potential in improving efficiency across the NHS by supporting clinicians with faster and more accurate diagnosis, enhancing clinical decision-making about treatment plans, and reducing the administrative burden faced by healthcare staff. The Department and NHS England are developing guidance for the responsible use of these tools and how they can be rolled out to make the day-to-day operations of the NHS more efficient.

The Government is committed to prioritising women’s health as we build a National Health Service fit for the future, and women’s equality will be at the heart of our missions. Women should not have to suffer in silence and any woman concerned about menopause symptoms should seek advice from their general practitioner or other healthcare professional, who can advise about treatment options, including hormone replacement therapy (HRT).

There are over 70 HRT products, and the vast majority are in good supply. There have been issues with the supply of a limited number of HRT products, primarily due to very sharp increases in demand, but the supply position for the majority has improved considerably over the last year.

More than 500,000 people benefitted from accessing cheaper HRT prescriptions during its first year of operation. The HRT Prescription Prepayment Certificate (PPC) can represent significant savings for patients who are prescribed one of the listed HRT medications. For example, a patient who pays the prescription charge could save nearly £220 per year with an HRT PPC, if they were prescribed two listed HRT items per month.

It is unacceptable that patients are waiting too long to get the care they need, including the nearly 600,000 on gynaecology waiting lists.

We are looking into this issue to understand what is driving demand for gynaecology and what steps we could take to return to the 18-week standard. Women’s health hubs play a key role in shifting care from hospitals to the community. There are a range of efforts underway to address challenges identified, including support to trusts where performance is of concern, ongoing efforts to transform outpatient pathways, and the use of surgical hubs which provide high volume low complexity surgery, including for gynaecology.

Tackling waiting lists is a key part of our Health Mission. We will deliver an extra 40,000 operations, scans, and appointments per week, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks. The Government will prioritise women’s health as we build a 10-Year Health Plan to reform the National Health Service and make it fit for the future, modernising care so that it takes place efficiently and closer to home, prioritising patient experience, and ensuring that regardless of what treatment you are waiting for, you will be seen, diagnosed, and treated in a timely way.

Prior to 2020/21, the mechanism used to collect and record accident and emergency activity was not sufficiently granular to identify the requested conditions. However, NHS England can provide a count of attendances with a relevant primary diagnosis from 2020/21 onwards. The following table shows the number of attendances, broken down by the relevant diagnosis, from 2020/21 to 2023/24:

Source: the data is from The Emergency Care Data Set, which is available at the following link:
https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/emergency-care-data-set-ecds

NHS England is working closely with the Independent Healthcare Providers Network and the wider sector to ensure we have appropriate mechanisms to track and monitor the independent sector’s impact on the long-term National Health Service capacity landscape. From October 2024, NHS England will be reporting independent sector activity data based on the Secondary Uses Service data submissions, to which a large number of independent sector provider sites currently report. This will therefore enable us to more fully capture the sector’s activity.

NHS England continues to explore opportunities for the independent sector to support the NHS in the areas of greatest need, including in diagnostics and the most challenged specialties, while ensuring that NHS care remains free at the point of use. NHS England meets regularly with all independent sector providers to encourage this collaborative working.

Tackling waiting lists is a key part of our Health Mission and a top priority for the Government, including waits for joint replacement surgery. We have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment by the end of this Parliament. As a first step, we will deliver an additional 2 million operations, scans, and appointments during our first year in Government, which is the equivalent to 40,000 per week.

We are also supporting dedicated and protected surgical hubs to help reduce elective surgery wait times, including for joint replacement, by focusing on high volume low complexity surgeries, as recommended by the Royal College of Surgeons of England, transforming the way the National Health Service provides elective care.

As of November 2024, there are currently 110 operational surgical hubs across England. There are currently two operational surgical hubs within the Hampshire and the Isle of Wight Integrated Care System offering trauma and orthopaedics services, including joint replacement, those being the Lymington Hospital Elective Hub, and the Winchester Country Hospital Elective Hub. Patients in the Gosport constituency can be referred to the two surgical hubs for trauma and orthopaedics services.

The Department and NHS England will set out details on the allocation of further funding at the earliest opportunity, including how many new surgical hubs will be established.

The Department of Health and Social Care works closely with the Department for Education on a wide range of matters to ensure the education system is supporting healthcare students, while delivering value for money for taxpayers. Student funding arrangements are reviewed annually ahead of the start of each academic year. The Government currently has no plans to introduce a student loan forgiveness model for nursing degree graduates.

National Health Service organisations in London will have their own plans in place to manage their recruitment and retention needs, based on local workforce planning.

A clear plan for retention is an essential component of an overall supply plan for the NHS. We need to retain the experienced and skilled staff that we already have, and ensure that the NHS is an attractive place to work so that we can bring in the new trainees and recruits that we need. Nationally, the NHS retention programme is working with NHS organisations to improve culture and leadership across the NHS, addressing issues that matter to staff, such as the need for good occupational health and wellbeing support and the promotion of opportunities to work flexibly.

We have launched a 10-Year Health Plan to reform the NHS. A central and core part of the 10-Year Health Plan will be our workforce, and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients when and where they need it.

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

The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. For the Dartford constituency, this is the NHS Kent and Medway ICB.

It currently costs approximately £200,000 per week, the equivalent to £850,000 for November 2024, to store personal protective equipment unsuitable for National Health Service use. The figure is dynamic because the stock is reducing.

A programme of work is underway to reduce our excess stock. This work will significantly reduce the cost of our storage network, and is due to be complete by January 2025, through sales, donations, recycling, and energy from waste.