Department of Health and Social Care

The Department has no current roles which focus exclusively on diversity, equity, and inclusion (DEI). The roles to support the Department's legal and policy obligations under this remit are integrated into its wider human resources and policy functions. Therefore, the Department has not made such an estimate.

The Department and the National Health Service in England are moving to a system of “data access as default” for secondary uses of NHS data, which is being supported by the implementation of Secure Data Environments (SDEs). This means that NHS data is increasingly accessed through secure platforms rather than shared with researchers.

Across the NHS Research SDE Network, which is a consortium of national and regional NHS-led SDEs, access to data is usually subject to a fee on a cost-recovery basis. Some SDEs are also exploring options of royalty or revenue sharing, profit sharing, intellectual property ownership sharing, and equity sharing. These approaches are supported by the Value Sharing Framework for NHS data partnerships, which sets out principles for NHS organisations to ensure fair value returns, including sharing in the value created by their data. Details of these are not collected centrally.

Each platform within the NHS Research SDE Network publishes a data use register that summarises the projects in progress, including those conducted by the commercial organisations referenced. Local data partnerships between NHS trusts and private companies outside the SDE network would not be collected on the same registers, and some details may be commercially sensitive.

Using the available data, we are unable to identify the number of people currently waiting for osseointegration transfemoral surgery in England.

Regardless of why patients are waiting for treatment, the Government has committed to reducing waiting times and ensuring that we 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 have already made progress, delivering on our commitment to provide an additional two million appointments and publishing our Elective Reform Plan, which details how we will go further to reduce waiting times, increase productivity, and improve patient experience.

It is unacceptable that there are such stark inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity.

Actions to tackle maternal health inequalities at the Slough and East Berkshire maternity services include, but are not limited to:

- a Rapid Communication Aid, developed to assist in identifying patient needs in 30 languages;

- free midwife-led antenatal education classes in Urdu, focusing on birth preparation for over 24 weeks gestation;

- a culturally competent genetics service being established, to support informed decision-making for close relative couples;

- equity training for staff on mandatory update day; and

- the implementation of the MAMAs phone line, a triage service staffed by midwives with interpretation services.

The Royal Berkshire NHS Foundation Trust has also focused on addressing inequalities through measures such as improving access to perinatal mental health services and antenatal and preconception information, and by promoting an increase in folic acid uptake.

Progress has also been made nationally in recent years. As part of NHS England's three-year plan, all local areas have now published Equity and Equality action plans to tackle inequalities for women and babies from ethnic minorities and for those living in the most deprived areas. However, we recognise that more is required. We are working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

Skills England and the Department for Education are reviewing the growth and skills offer, including whether employers will fund level seven apprenticeships outside of the levy. Ministers, officials, NHS England, and a range of stakeholders across the sector have been feeding into this review and will continue to work closely with Skills England to ensure that the National Health Service has access to the skilled workforce that patients need, as we rebuild the NHS and make sure that it is there for all of us when we need it.

As announced following the review of the New Hospital Programme, Watford General Hospital will be delivered in Wave 2. Enabling works, including the Outline Business Case for the Watford General Hospital scheme, will be taken forward by West Hertfordshire Teaching Hospitals NHS Trust from 2028/29, or sooner if possible.

Data from August 2024 by ASH suggests that 1.2% of children aged between 11 and 18 years old currently use nicotine pouches. A copy of the report in which this data is contained is attached.

There is currently limited research and evidence into the harms of nicotine pouches, including implications for oral health. However, they are never recommended for children. Nicotine, the active ingredient in pouches, is a highly addicted drug, and we have a duty to protect children and young people from future harm and addiction. Advice on the health impacts of nicotine can be found on the Talk to Frank website.

That is why, through the Tobacco and Vapes Bill, we are banning the advertisement and sponsorship of these products, introducing age of sale restrictions to 18 years old for nicotine pouches, banning free samples, and providing powers to restrict packaging, flavours, and point of sale displays.

We will continue to monitor the use of these products and will update public health guidance and messaging accordingly.

Data from August 2024 by ASH suggests that 1.2% of children aged between 11 and 18 years old currently use nicotine pouches. A copy of the report in which this data is contained is attached.

There is currently limited research and evidence into the harms of nicotine pouches, including implications for oral health. However, they are never recommended for children. Nicotine, the active ingredient in pouches, is a highly addicted drug, and we have a duty to protect children and young people from future harm and addiction. Advice on the health impacts of nicotine can be found on the Talk to Frank website.

That is why, through the Tobacco and Vapes Bill, we are banning the advertisement and sponsorship of these products, introducing age of sale restrictions to 18 years old for nicotine pouches, banning free samples, and providing powers to restrict packaging, flavours, and point of sale displays.

We will continue to monitor the use of these products and will update public health guidance and messaging accordingly.

The safety of children and young people is an overriding priority for the Government, and that is why we introduced an indefinite ban on the sale and supply of puberty supressing hormones from the European Economic Area and private providers in the United Kingdom.

We will monitor the impact of the ban and will not hesitate to go further if the evidence shows the indefinite ban is being circumnavigated.

Following the publication of the Cass Review Final Report, NHS England assumed responsibility for progressing the data linkage study, which will help us learn from the experiences and outcomes of young adults who accessed previous models of National Health Service gender services care.

This work is being undertaken with oversight from the NHS England National Research Oversight Board and is progressing as intended.

NHS England commissions gender services for children and young people in line with its interim service specification for children and young people with gender incongruence. These services do not make referrals for surgical interventions.

Children and young people are cared for holistically by specialist multi-disciplinary teams based in specialist children's hospitals. The multi-disciplinary team should include expertise in child and adolescent mental health, including family therapy, cognitive behavioural therapy, and neurodevelopmental conditions.

The Government is committed to delivering a National Health Service fit through the future through our 10-Year Health Plan. The first step in the process was Lord Darzi’s independent review of the NHS in England, which highlighted the undercapitalisation across the NHS. We are committed to reversing this trend and are due to publish an updated Capital Strategy in Autumn 2025.

The updated strategy will include clear funding assumptions for the NHS estate, accounting for the Government’s 10-Year National Infrastructure Strategy and the outcome of the 10-Year Health Plan.

The Government is committed to reforming services in the National Health Service to ensure every school has access to specialist mental health professionals, providing early support for young people.

NHS England recognises the value of music therapy in supporting children's mental health. The Department for Education's ongoing Curriculum and Assessment Review aims to broaden the curriculum, ensuring subjects like music, arts, sport, and drama are not overlooked.

The Government will be launching a new National Music Education Network, helping parents, teachers and children find information on courses, classes and more.

The Department publishes data on the income identified from chargeable overseas visitors in England in its Annual Report and Accounts. The consolidated NHS provider accounts published cash payments received in-year by the National Health Service from overseas visitors.

NHS 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. The Department does not hold information in the format requested regarding real terms data for written off debt.

The following table shows aggregate income identified and cash payments received between 2019-2024:

Source: The Department of Health and Social Care Annual Report and Accounts and Consolidated NHS provider accounts.

The Department publishes data on the income identified from chargeable overseas visitors in England in its Annual Report and Accounts. The consolidated NHS provider accounts published cash payments received in-year by the National Health Service from overseas visitors.

NHS 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. The Department does not hold information in the format requested regarding real terms data for written off debt.

The following table shows aggregate income identified and cash payments received between 2019-2024:

Source: The Department of Health and Social Care Annual Report and Accounts and Consolidated NHS provider accounts.

The Department regularly engages with specialist clinicians, the British Nuclear Medicine Society, and the UK Radiopharmacy Group to assist in the management of supply issues with medical radioisotopes, including those used for treating cancer patients.

To support implementation of the National Institute for Health and Care Excellence’s guidance, NHS England has been engaging with health system partners to coordinate resources and implementation efforts, to make sure that patients are on the appropriate treatment regimen and are using their inhaler at the right time, with the right technique.

The over-prescribing of reliever inhalers amongst people with asthma has seen a steady fall over the past few years. The percentage of patients on the Quality and Outcomes Framework asthma register who received six or more Short Acting Beta-2 Agonist reliever inhaler prescriptions over the previous 12 months fell from 19.8% in April 2022 to 15.9% in February 2025.

The National Institute for Health and Care Excellence (NICE) is currently developing guidance for the National Health Service on whether cerliponase alfa, also known as Brineura, can be recommended for routine NHS funding, considering real-world evidence collected during a period of managed access. NICE and NHS England are actively engaging with the company, BioMarin, as well as other stakeholders in the development of the guidance to secure continued access for NHS to Brineura at a cost-effective price. These discussions are complex and given the nature of this evaluation and the potential impact on patients and their families, it is essential that they take the necessary care to reach the best possible outcome. All parties are also committed to providing updates to stakeholders, notwithstanding the necessity that discussions are undertaken in a confidential setting.

The National Institute for Health and Care Excellence (NICE) is currently developing guidance for the National Health Service on whether cerliponase alfa, also known as Brineura, can be recommended for routine NHS funding, considering real-world evidence collected during a period of managed access. NICE and NHS England are actively engaging with the company, BioMarin, as well as other stakeholders in the development of the guidance to secure continued access for NHS to Brineura at a cost-effective price. These discussions are complex and given the nature of this evaluation and the potential impact on patients and their families, it is essential that they take the necessary care to reach the best possible outcome. All parties are also committed to providing updates to stakeholders, notwithstanding the necessity that discussions are undertaken in a confidential setting.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England. NHS Resolution does not record ethnicity data and therefore this information is not held in the format requested as it is not required for claims management purposes. NHS Resolution’s new case management system will collect the NHS number for claimants where possible, which will allow it to work with others to identify ethnicity and other protected characteristics in its data.

NHS Resolution has provided the attached information which shows: total payments for clinical negligence claims between 2019/20 and 2023/24 where the specialty is Obstetrics, broken down by year and patient age range at the time of the incident; the number of clinical negligence claims where payments have been made between 2019/20 and 2023/24 where the specialty is obstetrics, broken down by year and patient age range at the time of the incident, including interim and final payments; total payments for clinical negligence claims between 2019/20 and 2023/24 where the specialty is Obstetrics, and the injury 'Fatality' is present at any level, broken down by year; and the number of clinical negligence claims where payments have been made between 2019/20 and 2023/24 where the specialty is obstetrics and the injury 'Fatality' is present at any level, broken down by year.

NHS Resolution is unable to break down fatality by the requested mother/child split as it often receives claims from both the mother and child for the same incident. NHS Resolution’s coding of claims will only allow it to record fatality and does not distinguish who has died in those instances.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England. NHS Resolution does not record ethnicity data and therefore this information is not held in the format requested as it is not required for claims management purposes. NHS Resolution’s new case management system will collect the NHS number for claimants where possible, which will allow it to work with others to identify ethnicity and other protected characteristics in its data.

NHS Resolution has provided the attached information which shows: total payments for clinical negligence claims between 2019/20 and 2023/24 where the specialty is Obstetrics, broken down by year and patient age range at the time of the incident; the number of clinical negligence claims where payments have been made between 2019/20 and 2023/24 where the specialty is obstetrics, broken down by year and patient age range at the time of the incident, including interim and final payments; total payments for clinical negligence claims between 2019/20 and 2023/24 where the specialty is Obstetrics, and the injury 'Fatality' is present at any level, broken down by year; and the number of clinical negligence claims where payments have been made between 2019/20 and 2023/24 where the specialty is obstetrics and the injury 'Fatality' is present at any level, broken down by year.

NHS Resolution is unable to break down fatality by the requested mother/child split as it often receives claims from both the mother and child for the same incident. NHS Resolution’s coding of claims will only allow it to record fatality and does not distinguish who has died in those instances.

The NHS Business Services Authority (NHSBSA) is only able to provide information on prescriptions for cannabis-based medicines that have been prescribed and submitted to the NHSBSA. Data on National Health Service prescriptions for unlicensed cannabis-based medicines is withheld in accordance with the UK General Data Protection Regulation, due to the number of prescriptions attributed to fewer than five patients, and the enhanced risk of the release of patient identifiable information. Patient information is not routinely collected for private prescriptions.

The following table shows the number of identifiable patients that were prescribed NHS prescriptions for licensed cannabis-based medicines, for instance epidyolex, nabilone, and sativex, in the community in England in the 12 months, from February 2024 to January 2025, the latest available data:

Source: NHSBSA.

We remain committed to transforming the way we deliver healthcare for parents and children and supporting the best start in life; digitisation of records is a key enabler of this.

The Department is working closely with officials in NHS England to ensure that plans for digitising the red book align with wider, ambitious plans for digitisation of patient records across the National Health Service. This will mean we deliver the benefits of a seamless experience for families as they access and manage their own health records and those of their children through the NHS App. Further information will be available in due course on the measures we are taking to deliver digital records for children.

The eRedbook product was commissioned by NHS England (London) for several years. A comprehensive evaluation was not undertaken, although registration volumes were reported. This has informed our ambition of a digital service to help parents and professionals access information and services to give children the best start in life. The NHS App will be central to delivering this ambition.

We are committed to listening to the concerns of resident doctors, and to enhancing and improving their working lives.

We are undertaking a range of work to tackle the issues that resident doctors are facing, including improving working conditions and reforming the current system of rotations and placements, working in partnership with the British Medical Association and other partners, as agreed as part of the pay deal last year.

NHS England’s Enhancing Resident Doctors Working Lives programme continues to implement a number of measures to support resident doctors, encouraging them to stay in training and the National Health Service. This includes measures such as less than full time training options, to allow trainees to continue to work in the service and progress with their training on a reduced working pattern, where this benefits their personal circumstances.

It is critical that medicines used in the United Kingdom are safe and effective and as such, medicines cannot be marketed in the UK without a marketing authorisation. These are granted by the Medicines and Healthcare products Regulatory Agency (MHRA) which assesses all medicines with regard to their quality, safety, and efficacy. Pemivibart, sold under the brand name Pemgarda, for use in the prophylaxis of COVID-19 does not yet have a marketing authorisation. It is the responsibility of the company to apply to the MHRA for the relevant marketing authorisation. Should an application for it be received, the MHRA will consider this accordingly.

In England, the National Institute for Health and Care Excellence (NICE) considers all newly licenced medicines, those that have received a marketing authorisation, to determine whether they represent a clinically and cost-effective use of National Health Service resources. If the manufacturer of Pemgarda seeks a licence from the MHRA, then the NICE may consider it through its technology appraisal programme.

The National Institute for Health and Care Excellence (NICE) develops authoritative, evidence-based guidance for the National Health Service on best practice, based on an assessment of clinical and cost effectiveness. The NICE’s guideline on the diagnosis and management of cystic fibrosis recommends pancreatic enzyme replacement therapy as a treatment option for exocrine pancreatic insufficiency in patients with cystic fibrosis. The guideline is available at the following link:

https://www.nice.org.uk/guidance/ng78

Too many people have been left in limbo waiting for National Health Service treatment. The waiting list in the South West region stands at 642,756, with 63% of those having waited less than 18 weeks, compared with the 18-week standard of 92%, and with a median waiting time of 12.8 weeks from referral to treatment.

The Department and NHS England are supporting a range of efforts, nationally and in the South West region, to reduce the time patients are waiting from being referred for specialist care, and to return to the 18-week constitutional standard. We have delivered an additional 2.5 million operations, scans, and appointments across elective services nationally since July 2024. We will support further progress in the South West region and across the United Kingdom, with approximately £1.5 billion of capital funding in 2025/26 for new surgical hubs and diagnostic scanners across England.

The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the 18-week standard, including reforms to outpatient care to ensure care is delivered in the right clinical setting and unnecessary appointments are reduced. In addition, the plan commits to diagnostic transformation, including investment in new and expanded community diagnostic centres and the rollout of straight to test pathways. Significant transformation across high priority specialities with waiting list challenges will also bring down waiting times for patients who have been referred for specialist treatment.

The Department has made no assessment. Mounjaro is not licensed as a treatment option for Cushing’s syndrome. The National Institute for Health and Care Excellence (NICE) would consider an evaluation of Mounjaro for Cushing’s syndrome if the company, Eli Lilly, were to apply to the Medicines and Healthcare products Regulatory Agency for a marketing authorisation, or licence, for use in the treatment of Cushing’s syndrome.

Clinicians can prescribe medicines outside of their licensed indication, known as “off-label” use, where there is sufficient evidence and/or experience of using the medicine to show its safety, quality, and efficacy, provided there is no suitable alternative licensed medicine, and subject to funding by the National Health Service locally.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines supplied in the United Kingdom. Our activity spans the whole of a medicine’s lifecycle. Diethylstilboestrol (DES) is an oestrogenic hormone formerly used in the treatment of threatened miscarriage. The Government took action regarding DES in the early 1970s. In 1971, it was recognised that DES could cause a distinct type of cancer in the daughters of women who took DES in early pregnancy. Shortly afterwards, its use was contraindicated in pregnancy, pre-menopausal women, children and young adults and the Committee on Safety of Medicines wrote to all doctors in May 1973 to advise against the use of DES in pregnancy and pre-menopausal women.

DES may still be prescribed in the UK for certain types of cancer, including cancer of the prostate and metastatic post-menopausal cancer of the breast. The product information for DES clearly describes the risk of harms related to its use in pregnancy and for this reason its use is contra-indicated in pregnant women; it is not suitable for pre-menopausal women, and should not be prescribed to children or young people due to its carcinogenic potential. The use of DES is now only justified in the management of malignant disease.

The MHRA continuously assesses the benefit risk balance of all medicines at the time of initial licensing and throughout their use in clinical practice, carefully evaluating any emerging evidence on their benefits and risks.

A small increased risk of breast cancer in women who received DES whilst pregnant was first identified in the 1980s and confirmed in further studies in the 1990s, when longer follow up of women who had taken DES was available. No increased risk of other cancers has been established, including endometrial cancer or ovarian cancer.

Since 1992 the National Cancer Institute at the US National Institutes of Health has been conducting the DES Follow-up Study of more than 21,000 mothers, daughters, and sons, exposed in the womb during the mother’s pregnancy, to better understand the long-term health effects of exposure to DES. The findings of this follow up have been published in the scientific literature.

Daughters of individuals exposed to DES are at increased risk of clear cell cancer of the cervix and vagina. The current advice from the UK Health Security Agency is that routine cervical screening is appropriate for those who believed they were exposed to DES in utero; the advice is available at the following link:

https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individuals

Participation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.

The Government is committed to prioritising women’s health as we reform the National Health Service. We recognise that Premenstrual Dysphoric Disorder (PMDD) is a serious condition which can be both distressing and disabling for those that experience PMDD symptoms.

The Department and the NHS have created a women’s health area on the NHS website, which brings together over 100 health topics including periods, gynaecological conditions, fertility, pregnancy, heart health and cancers, and is designed to be a first port of call for women seeking health information. The page on premenstrual syndrome contains information and advice on PMDD.

Women’s health hubs have a key role in shifting care out of hospitals and improving care for women’s health conditions. As of December 2024, 39 out of 42 integrated care boards (ICBs) reported to NHS England that they had at least one operational women’s health hub. We continue to engage with and encourage ICBs to use the learning from the women’s health hubs pilots to improve local delivery of services to women.

Psychological support is also available to women experiencing premenstrual dysphoric disorder through local NHS Talking Therapies services, which provide evidence-based treatments, such as cognitive behavioural therapy, for common mental health conditions including depression and anxiety. People can self-refer to NHS Talking Therapies services or be referred by their general practitioner.

The Department understands the impact that Duchenne muscular dystrophy has on those living with it and their families, and the urgent need for new treatment options. The National Institute for Health and Care Excellence (NICE) recently published guidance that recommends the medicine vamorolone for treating Duchenne muscular dystrophy in people 4 years old and over. The National Health Service is required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

The Department has not had any discussions with ITF Pharma UK about resources or guidance available to NHS trusts participating in the early access programme for givinostat. Departmental officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as early access programmes, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:

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

The Department understands the impact that Duchenne muscular dystrophy has on those living with it and their families, and the urgent need for new treatment options. The National Institute for Health and Care Excellence (NICE) recently published guidance that recommends the medicine vamorolone for treating Duchenne muscular dystrophy in people 4 years old and over. The National Health Service is required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.

The Department has not had any discussions with ITF Pharma UK about resources or guidance available to NHS trusts participating in the early access programme for givinostat. Departmental officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as early access programmes, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:

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

NHS England is currently undertaking a review of adult gender services, chaired by Dr David Levy. The review will examine the model of care and operating procedures of each service, and will carefully consider experiences, feedback, and outcomes from clinicians and patients, with the aim of producing an updated service specification. The review will report its findings at the earliest opportunity.

NHS England commissions gender services for children and young people in line with its interim service specification for children and young people with gender incongruence.

Children and young people are cared for holistically by specialist multi-disciplinary teams based in specialist children's hospitals. The multi-disciplinary teams include expertise in child and adolescent mental health, including family therapy, cognitive behavioural therapy, and neurodevelopmental conditions.

Each child or young person will have a tailored individual care plan to meet their needs. Depending on individual need, the gender service for children and young people will provide psychosocial and clinical interventions, including support for the family.

The Blackpool Teaching Hospitals NHS Foundation Trust entered the national Maternity Safety Support Programme (MSSP) in September 2022, following a Care Quality Commission inspection earlier that month which rated Blackpool Victoria Hospital’s maternity services in the Fylde constituency as ‘requires improvement’ overall. The programme provides intensive support to the trust to assist in the improvement of their maternity services, including a dedicated Maternity Improvement Advisor and support to implement a tailored improvement plan. A full diagnostic assessment has identified key areas of focus with an associated improvement plan and agreed exit criteria.

The Local Maternity and Neonatal System arm of the Lancashire and South Cumbria Integrated Care Board receives reports from the MSSP, so it can support the service with focused improvement work.

A MSSP assurance visit on 27 January 2025 concluded that significant improvements had been made across a number of areas, with evidence of data demonstrating sustained improvement. The next review meeting for the service is to take place on 28 May 2025.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.

We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.

Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.

We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.

Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

Local National Health Service procuring authorities are responsible for assessing the timeliness and quality of the medical equipment delivered for their patients, procured under contracts they hold with suppliers.

The Department works closely with partners across the health system and medical technology landscape, including individual suppliers, trade associations, patient groups, and devolved administrations, to provide challenges and to ensure that stakeholder input is at the right level and at the right time. However, local NHS bodies are responsible for the provision of medical equipment to care facilities.

Local National Health Service procuring authorities are responsible for assessing the timeliness and quality of the medical equipment delivered for their patients, procured under contracts they hold with suppliers.

The Department works closely with partners across the health system and medical technology landscape, including individual suppliers, trade associations, patient groups, and devolved administrations, to provide challenges and to ensure that stakeholder input is at the right level and at the right time. However, local NHS bodies are responsible for the provision of medical equipment to care facilities.

The Government values midwives and is committed to supporting them as a profession and in their everyday working lives.

Local employers across the National Health Service have their own arrangements in place for supporting staff, including occupational health provision, employee support programmes, and a focus on healthy working environments. This, alongside strong leadership and a supportive culture, is central to improving staff engagement and morale and contributes to improved working conditions for staff.

To support local employers, NHS England has introduced targeted midwifery support, including the introduction of Perinatal Midwifery Advocates, who support trusts to offer additional capacity for wellbeing support and restorative clinical supervision, the national Preceptorship Framework, which provides early career support to help midwives transition from education to employment, the midwifery mentorship scheme, strengthened advice and support on pensions, and flexible retirement options.

The Department does not have plans to intervene in locally led arrangements for the provision of ear wax removal services. Integrated care boards are responsible for commissioning ear wax removal services in local areas in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

The Department does not hold information on the number of unfilled vacancies or the costs of using locum or bank staff to fill vacancies at Torbay Hospital. NHS England published vacancy rates by trust as of June 2024, with further information available at the following link:

https://digital.nhs.uk/supplementary-information/2024/total-vacancy-rates-by-org-since-201718

The Torbay and South Devon NHS Foundation Trust, of which the hospital is a part, has reported to NHS England a position of a zero full time equivalent vacancy rate across the trust.

The Department does not hold information on the number of National Health Service staff who have been dismissed for clinical negligence.

NHS England publishes monthly statistics detailing information on NHS staff recorded within the Electronic Staff Record, the human resource system for the NHS. Each quarter, these statistics include data on ‘reasons for leaving’, where these have been recorded upon a member of staff leaving or moving employment. The published data is available as part of the data each March, June, September, and December, at the following link:

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

Data on dismissals is available in four categories, namely those due to ‘capability’, ‘conduct’, ‘some other substantial reason’, and ‘statutory reason’. There is no way to report those specifically for clinical negligence.

Any interpretation of data should be made with the understanding that not all assignments that finish in the NHS result in a ‘reason for leaving’ being recorded. Therefore, the data presented can be viewed as a minimum number of leavers in any giving category. From analysis of the records of staff who leave NHS employment entirely, it is estimated that approximately one third of leavers do not have a reason recorded.