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 His Majesty's Government what estimate they have made of the level of rising healthcare demand in England over the next five years.

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

Growth in healthcare demand, alongside wider financial considerations and the cost of new commitments for the National Health Service, is analysed in the round as part of the Spending Review process. The outcome of the most recent Spending Review 2025 is given in the Spending Review 2025 policy paper, on the GOV.UK website, in an online only format.

As set out in the document, this level of funding growth will support the NHS to deliver on the Government's priorities, including delivery of the Government’s Plan for Change commitment, meaning that by the end of the Parliament, 92% of patients will start consultant led treatment for nonurgent conditions within 18 weeks of referral.

At the 2025 Autumn Budget the Government protected the NHS envelope announced at the 2025 Spending Review. This will see the NHS in England receiving an over £15 billion real terms increase in annual resource budgets by the end of the period, between 2025/26 and 2028/29.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether ensuring that high-risk men get access to prostate cancer screening will be an objective of the national cancer plan.

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

Early diagnosis is a key focus of the National Cancer Plan, which will build on the shifts in care set out in the 10-Year Health Plan to diagnose cancers earlier. The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including prostate cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s survival rates.

My Rt Hon. Friend, the Secretary of State for Health and Social Care will consider the final recommendation of the UK National Screening Committee (UK NSC) on screening for prostate cancer when it is received. He will make a decision on whether to accept the recommendation, including any decisions on implementation at that point.

It is anticipated that the final recommendation will be provided in early 2026 after the conclusion of a 12-week consultation which opened on 28 November 2025. This seeks views on an evidence review and a draft recommendation to:

• offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from 45 years old to 61 years old;
• not recommend population screening;
• not recommend targeted screening of black men;
• not recommend targeted screening of men with family history; and
• collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history as soon as the trial data becomes available, and to await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of benefit and harm of screening.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the expected (1) total and (2) per capita reduction in daily calorie intake for (1) adults and (2) children in England as a result of the extension of the soft drinks industry levy announced on 25 November.

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

The changes to the Soft Drinks Industry Levy announced in the 2025 Autumn Budget are:

• reducing the lower sugar threshold to 4.5 grams per 100 millilitres, as it is currently at five grams per 100 millilitres; and
• removing previous exemptions for milk-based and milk substitute drinks.

These changes will apply from 1 January 2028. They are designed to encourage producers to reformulate their products to reduce sugar levels and avoid paying the levy, thus reducing the calories consumed from the drinks in scope.

The Department carried out a health benefit assessment to estimate the calorie reduction from these changes through reformulation and substitution to alternative drinks. Together, these changes reduce sugar and calorie intake from drinks across all age groups.

The analysis used nutrition data from the National Diet and Nutrition Survey, sales data from Worldpanel by Numerator, formerly Kantar WorldPanel, and a series of assumptions to estimate the sugar and calories removed from diets due to the changes. The approach, data sources, and assumptions are set out in detail in the published assessment.

This analysis estimates per person per day calorie reductions of 0.3 kcal in five to 10 year olds, 0.4 kcal in 11 to 18 year olds, 0.3 kcal in 19 to 64 year olds, and 0.2 kcal in those aged 65 years old and over. This is equivalent to approximately four million kcal per day in children and 13 million kcal per day in adults.

Question to the Department of Health and Social Care:

To ask His Majesty's Government on the basis of what evidence they have estimated that the extension of the soft drinks industry levy, announced on 25 November, could prevent almost 14,000 cases of adult obesity and nearly 1,000 cases of childhood obesity.

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

The changes to the Soft Drinks Industry Levy announced in the 2025 Autumn Budget are:

• reducing the lower sugar threshold to 4.5 grams per 100 millilitres, as it is currently at five grams per 100 millilitres; and
• removing previous exemptions for milk-based and milk substitute drinks.

These changes will apply from 1 January 2028. They are designed to encourage producers to reformulate their products to reduce sugar levels and avoid paying the levy, thus reducing calories consumed from the drinks in scope.

Evidence shows that energy dense diets such as those that are high in sugar can contribute to excess calorie intake, which if sustained leads to weight gain and obesity. Population-level policies therefore aim to create a healthier food environment to reduce excess calories and obesity prevalence across the entire population.

The Department carried out a health benefit assessment to estimate the calorie reduction from these changes through reformulation and substitution to alternative drinks. Together, these changes reduce sugar and calorie intake from drinks across all age groups.

The analysis used nutrition data from the National Diet and Nutrition Survey, sales data from Worldpanel by Numerator, formerly Kantar WorldPanel, and a series of assumptions to estimate the sugar and calories removed from diets due to the changes. The approach, data sources, and assumptions are set out in detail in the published assessment.

This analysis estimates per person per day calorie reductions of 0.3 kcal in five to 10 year olds, 0.4 kcal in 11 to 18 year olds, 0.3 kcal in 19 to 64 year olds, and 0.2 kcal in those aged 65 years old and over.

The BMI Prevalence Model was then used to simulate the change in obesity prevalence from the estimated change in calorie intake at a population level. This model is based on weight loss equations by Henry (2005), a sample of height and weight data from Health Survey for England, and population data from Office for National Statistics.

This modelling estimates that a calorie reduction of this scale could translate into reducing cases of adult obesity by almost 14,000 and childhood obesity by almost 1,000.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the estimated cost of strikes within the NHS in the past six months; and what new proposals are being considered to protect patient services during any further strikes.

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

The five-day resident doctor strike in July 2025 had an estimated cost to the National Health Service of approximately £240 million, and this is a starting estimate for the planned November strike. The costs were lower than in July 2024 as a result of lower turnout. We continue to update estimates as new data becomes available, in line with receiving business as usual financial data from NHS systems.

The NHS has tried and tested plans in place to minimise disruption and will work with partners to ensure that safe care for patients continues to be available and emergency services continue to operate. Data published on 23 November shows that the NHS met its ambitious goal to maintain 95% of planned care during the November round of strike action, surpassing the 93% protected during action in July, while still maintaining critical services, including maternity services and urgent cancer care.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential impact of people being held in Accident and Emergency departments due to unavailability of local NHS mental health beds on patients.

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

While no such specific assessment has been made, we know that in some local areas there is a need for more beds. This is being addressed in part through investment in new units, although this should be considered as part of a whole system transformation approach.

Investment of £75 million of capital funding this year aims to improve inpatient care and help stop mental health patients being sent far from home for treatment. Our neighbourhood mental health centres will also improve continuity of care, drive down waits, and reduce inpatient admissions. These centres provide round the clock, open-access to treatment and support for adults with severe mental health needs. We have opened the first of six 24/7 neighbourhood mental health centres in England, in Tower Hamlets, and other local areas are looking to rollout the model more widely.

We also know that pressures in accident and emergency are best addressed by clear, efficient, and adequately resourced routes to appropriate crisis care. NHS Operational and Planning Guidance for 2025/26 tasks local health systems to improve patient flow through mental health crisis pathways and reduce waits longer than 12 hours in accident and emergency departments. Systems should do this by maximising the use of crisis alternatives and through robust system oversight.

Substantial progress has been achieved in building more robust crisis care pathways across all ages ensuring that people in mental health crisis have access to timely and appropriate support. Key developments include the introduction of the NHS 111 ‘select mental health’ option, investment in alternative crisis services, roll-out of the Mental Health Response Vehicles programme, and full national coverage of 24/7 liaison mental health teams in general acute hospitals. We are also investing up to £120 million to bring the number of mental health emergency departments up to approximately 85. Mental health emergency departments provide rapid assessment and support in a therapeutic setting, helping those with mental health needs get the right care quickly and reducing reliance on emergency departments.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what evidence NICE has identified as the basis for its clinical assessment of puberty blockers for gender dysphoria; and whether NICE has undertaken (a) scoping and (b) evaluation exercises since 2015.

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

The National Institute for Health and Care Excellence (NICE) has not developed guidance on, or made a clinical assessment of, puberty blockers for gender dysphoria. In 2020, NICE developed two evidence summaries:

• Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria; and
• Gender-affirming hormones for children and adolescents with gender dysphoria.

These summaries were commissioned by NHS England and developed by NICE to an NHS England process. They helped inform the Cass review.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the Cancer Plan will specifically address the availability of products containing Melanotan II.

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

The Government is taking steps to prevent, diagnose, and treat cancers more quickly, including skin cancers. The forthcoming National Cancer Plan will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care. It will set out how we will improve outcomes for cancer patients, including by speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates. We will publish the National Cancer Plan in the new year to reduce the number of lives lost to cancer over the next 10 years.

We received over 11,000 responses to our call for evidence from individuals, professionals, and organisations, and we are reviewing the submissions from skin cancer partners. While no formal assessment has been made of the availability and levels of the use of tan-enhancing products containing Melanotan II, respondents shared concerns about tanning products and their potential links to cancer, particularly melanoma. Our expansive engagement will allow the National Cancer Plan to have patients at its heart.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicinal products and medical devices in the United Kingdom.

Although tanning is not considered to be a medical purpose, injectable products containing Melanotan I or Melanotan II have been determined as medicinal products due to their similarity to the authorised medicine Scenesse.

In relation to nasal sprays containing Melanotan I or Melanotan II, there are no equivalent authorised medicines, and in the absence of medicinal claims, they are not regarded as medicinal products.

Medicinal products must hold a relevant Marketing Authorisation to be legally sold and supplied in the United Kingdom. This also guarantees that the medicines have been tested for conformity with strict standards of quality, safety, and efficacy. The MHRA takes action when a medicinal product without appropriate authorisations is identified.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has he made of the impact of the findings by the study of 1,005 GPs entitled “General practitioners’ adoption of generative artificial intelligence in clinical practice in the UK: An updated online survey”, published in the Digital Health science journal on 25th November 2025 that stated that 35% of doctors used AI for writing documentation, 27% for differential diagnoses and 24% for treatment or referrals despite having no formal training or oversight.

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

The Department is aware of the study published in Digital Health on 25 November 2025 regarding the adoption of generative artificial intelligence (AI) by general practitioners (GPs). AI has the potential to transform health and care services by improving health outcomes, enhancing patient safety, and reducing costs. However, it is crucial to rigorously and regularly evaluate AI technologies to ensure they work safely, ethically, and effectively in different clinical settings.

The Department is currently assessing the implications of these findings through engagement with NHS England, the General Medical Council, and other stakeholders. Guidance is also being developed to ensure safe and ethical use of AI in clinical settings, which includes requirements for training and accountability, and working with regulators such as the Medicines and Healthcare products Regulatory Agency and the National Institute for health and Care Excellence to develop evaluation pathways for AI tools. This is to ensure the AI tools meet standards equivalent to other regulated medical technologies, and whether additional safeguards or standards needed to mitigate risks to patient safety and data security are explored.

We will continue to monitor emerging evidence and ensure that any integration of AI into clinical practice is underpinned by appropriate oversight, transparency, and professional responsibility.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what evidence his Department has received on the potential over-diagnosis of mental health conditions and neurodivergence.

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

The most recent evidence about the prevalence of mental health conditions and neurodiversity comes from the Adult Psychiatric Morbidity Survey 2023/24, which provides data on the prevalence of both treated and untreated mental health disorders and neurodevelopmental conditions in the English adult population.

The survey found that common mental health conditions among adults, especially young adults, have become more widespread over time. There has also been a noticeable increase in the number of adults screening positive for attention deficit hyperactivity disorder (ADHD). In contrast, the prevalence of autism in adults has remained steady over the years.

We are deeply concerned that many adults, young people, and children with mental health conditions, ADHD, and autism have been let down by services and are not receiving timely or appropriate support and treatment. That is why we have launched an independent review into the prevalence and support for mental health conditions, ADHD, and autism.

The review will examine the similarities and differences between mental health conditions, ADHD, and autism, 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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department reviews NHS England expenditure reports relating to the prescribing of puberty blockers for children; and whether (a) financial oversight and (b) risk assessments have been conducted since 2010.

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

All arms-length bodies, including NHS England, are held to high standards of financial responsibility and publish annual reports and accounts which are laid before Parliament.

Gonadotrophin releasing hormone analogues, or puberty blockers, have been prescribed to children under 16 years of age in England for licenced uses, for instance precocious puberty and endometriosis, and off label uses, such as gender dysphoria. The cost of prescribing drugs to a patient is met by the patient's integrated care board.

Regarding risks assessments conducted since 2010, in March 2024 NHS England published a suite of documentation relating to its decision to remove gonadotrophin releasing hormone analogues as a routine treatment option in the National Health Service for children under 18 years old with gender dysphoria. This documentation included a review of the published evidence, which concluded that there is very limited evidence about safety, risks, benefits, and outcomes for the use of this medication in children with gender dysphoria.

Restrictions on the sale and supply of these medicines via private and NHS prescriptions were introduced in May 2024. As part of that legislation the Government conducted a targeted consultation and sought advice on patient safety from the independent Commission on Human Medicines (CHM) and Cass Review.

The Government response to the consultation, the full report of the CHM, and the Cass review are available publicly, and respectively, at the following three links:

https://www.gov.uk/government/consultations/proposed-changes-to-the-availability-of-puberty-blockers-for-under-18s/outcome/governments-response-to-the-targeted-consultation-on-proposed-changes-to-the-availability-of-puberty-blockers

https://www.gov.uk/government/publications/chms-report-on-proposed-changes-to-the-availability-of-puberty-blockers/commission-on-human-medicines-report-on-proposed-permanent-order-to-restrict-the-sale-and-supply-of-gnrh-agonists-in-children-and-young-people-under-1

https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143633/https://cass.independent-review.uk/

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the extent to which patients and their families have been engaged in NICE's project to appraise the effectiveness of vorasidenib.

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

The National Institute for Health and Care Excellence (NICE) is the independent body that makes evidence-based recommendations for the National Health Service on whether new medicines should be routinely funded by the NHS on the basis of an assessment of clinical and cost effectiveness. NICE develops its guidance through extensive engagement with interested parties, including patient groups.

NICE is currently evaluating vorasidenib for treating astrocytoma or oligodendroglioma with IDH1 or IDH2 mutations after surgery in people 12 years old and over. As part of the appraisal process, NICE’s independent committee was provided with evidence submissions from three patient groups. The committee also heard expert personal perspectives from two patient experts.

The draft guidance was shared with all stakeholders as well as being published on the NICE website for public comment as part of the consultation which took place between 15 October and 4 November 2025. The committee reviewed the consultation comments at the committee meeting on 20 November 2025. NICE currently expects to publish final guidance in January 2026.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to change their genomic testing strategy.

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

The NHS Genomic Medicine Service’s (NHS GMS) service specification, published in July 2025, sets out future testing strategy, including focus on improved turnaround times and requirements to deliver the Genomic Population Health Service, in line with the 10-Year Health Plan. The final service specification was published in Autumn 2025 following stakeholder feedback. The new NHS GMS will be operational from April 2026 and will set out the new model up to 2036.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what estimate have they made of the effect of the agreement recently concluded between the UK and USA as part of the Economic Prosperity Deal on the cost of purchasing drugs for the NHS for each of the financial years 2025/26, 2026/27, 2027/28, and 2028/29; and whether any such costs were included in planning for the recent Budget 2025.

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

Every patient deserves access to the best possible treatment. This deal is a vital investment that builds on the strength of our National Health Service and world leading life sciences sector.

Costs will start smaller but will increase over time as the National Institute for Health and Care Excellence (NICE) approves more life improving and lifesaving medicines. Total costs over the Spending Review period are expected to be approximately £1 billion. But the final costs will clearly depend on which medicines NICE decides to approve and the actual uptake of these. This is not something that we can pre-empt at this time as it depends on which drugs come to market, and which are assessed as approved for use on the NHS accordingly.

At the Spending Review we delivered a record real terms increase for day-to-day spending for the NHS in England up to April 2029. This deal will be funded by allocations made at the Spending Review, where front line services will remain protected through the record funding secured. Future year funding will be settled at the next Spending Review.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to allow accredited artificial intelligence assistants to perform simple administrative tasks in the NHS.

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

Artificial intelligence (AI) technologies are already supporting healthcare staff with routine administrative tasks and clinical decision making. AI-powered tools, such as ambient voice technologies, help ease the administrative burden faced by staff and make systems more efficient.

One study has found that ambient voice technologies can generate time savings of up to 30 minutes per person per day when staff are supported by AI for basic administrative tasks.

AI tools that assist with other common administrative tasks have also been developed and trialled, such as tools that can automatically generate patient discharge summaries, forecast demand for accident and emergency services, and support with staff rostering based on availability and skillsets. The former two of these examples are two of the Prime Minister’s AI Exemplars, as announced in August this year.

The Department and NHS England are working to test, support, and regulate promising new technologies that can augment, not replace, our National Health Service and care staff. In April, NHS England published guidance on the use of AI-enabled ambient scribing products in health and care settings.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to publish the draft service specification for the Genomic Medicine Service, and if so, when.

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

The NHS Genomic Medicine Service’s (NHS GMS) service specification, published in July 2025, sets out future testing strategy, including focus on improved turnaround times and requirements to deliver the Genomic Population Health Service, in line with the 10-Year Health Plan. The final service specification was published in Autumn 2025 following stakeholder feedback. The new NHS GMS will be operational from April 2026 and will set out the new model up to 2036.

Question to the Department of Health and Social Care:

To ask His Majesty's Government when they will begin the consultation for the new Autism Strategy.

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

In developing the next national autism strategy, we will consider evidence and outputs from all relevant work including the recently published House of Lords Autism Act 2009 Committee’s report Time to deliver: The Autism Act 2009 and the new strategy. We will be responding to the committee’s helpful recommendations, including regarding a new national autism strategy, in the new year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to WPQ 89628 answered on 20 November 2025, whether his Department plans to set targets regarding the improvement of community care for young people with eating disorders.

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

Eating disorders have a devastating impact on young people’s lives and Lord Darzi’s investigation found that people accessing National Health Service mental health services are waiting too long, receive variable quality of care, and suffer from entrenched inequalities. This Government has already taken significant steps to stabilise and improve NHS mental health services but there is much more to do.

Although there are currently no plans to set targets regarding the improvement of community care for young people with eating disorders, more young people are being supported to access NHS mental health services. Between July and September 2025, 3,010 young people with eating disorder issues entered treatment, which is an increase of 14% compared to the same period last year. This is helped by almost 7,000 extra mental health workers being recruited since July 2024, against our target of 8,500 by the end of this Parliament.

The 10-Year Health Plan aims to shift more care to the community and reform the health system, including eating disorder services, to adopt more neighbourhood models of working where cross-sector collaboration is the norm.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, when he plans to publish the report into the cost of clinical negligence being prepared by David Lock KC.

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

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.

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. The review is ongoing, following initial advice to ministers and the recent National Audit Office’s report.

The results of David Lock’s work 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.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 7 November (HL11405), what monitoring processes are in place to ensure that the national sample handling guidance for the whole genome sequencing of solid tumours is being implemented fully.

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

The performance of the NHS Genomic Medicine Service is monitored quarterly through an assurance framework, which ensures all seven NHS Genomic Laboratory Hubs are operating to national quality standards. This identifies and minimises any potential variation and ensures consistent delivery of the criteria outlined in the National Genomic Test Directory.

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 reverse the long-term decline in the amount spent on medicines as a percentage of the NHS budget.

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

We continue to support the United Kingdom’s world leading life sciences sector through investment, innovation and reform as set out in our Life Sciences Sector Plan and 10-Year Health Plan, through which we committed to accelerating growth in net spend on innovative medicines to unlock the potential for patients.

As announced as part of our world-leading agreement with the United States, we will increase the amount which the UK pays for life-changing medicines by 25% through changes to the way that medicines are evaluated by the National Institute for Health and Care Excellence (NICE), including an increase to the NICE cost-effectiveness threshold. In this way, we are increasing the value that we place on innovations that deliver improvements to patient health, ensuring faster patient access for vital medicines for cancer, rare diseases and other conditions.

We are giving a clear signal that we want to bring innovative medicines to National Health Service patients, encouraging the life sciences industry to prioritise the UK as an early launch market, and help get the newest available treatments to those who need them.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what aggregated safety data, including adverse-event summaries, the MHRA has recorded relating to the use of puberty blockers in under-18s since 2010; and whether the Department has been informed of any safety signals during that period.

Answered by Zubir Ahmed - 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 their independent advisory committee, the Commission on Human Medicines, where appropriate to inform regulatory decisions.

Puberty blockers are also known as gonadotrophin-releasing hormone (GnRH) analogues. These medicines are licenced for conditions such as young children who enter puberty too early, also known as precocious puberty, prostate cancer, and endometriosis. The use of GnRH analogues to suppress puberty in children and young people with gender dysphoria is off-label prescribing. This means that the use of these medicines for this purpose is outside of the licensed uses, and as such the benefits and risks of the medicine for use in this specific population have not been assessed. The MHRA does not regulate off-label use.

The MHRA has received three United Kingdom suspected adverse drug reaction reports in which a GnRH analogue has been reported as being used in a child or young person for the purpose of puberty suppression in gender dysphoria. The GnRH analogues included in this search were buserelin, leuprorelin, goserelin, gonadorelin, nafarelin, and triptorelin. Please note it is not mandatory to provide information on indication when submitting an adverse drug reaction report.

It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.

The MHRA has not identified any safety signals which concern the off-label use of the GnRH analogues for the purpose of puberty suppression in gender dysphoria. However, we acknowledge that there is a clear lack of clinical evidence for the safety and efficacy of using these medicines for gender incongruence and/or dysphoria in those aged 18 years old and under. That is why NHS England and the National Institute for Health and Care Research have commissioned a carefully designed clinical trial to assess the relative benefits and harms of puberty suppressing hormones on young people’s physical, social, and emotional well-being.

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 to Question 90413 on Maternity Services: Inquiries and Question 95963 on Prostate Cancer: Screening.

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

I refer the hon. Member to the answer I gave on 11 December 2025 to Question 90413, as well as to the answer my hon. Friend, the Minister for Public Health and Prevention, gave on 10 December 2025 to Question 95963.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, when he plans to make a decision on the replacement system for the NHS Electronic Staff Record.

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

The NHS Business Services Authority signed a contract with Infosys to deliver a new enhanced workforce management system for the National Health Service on 10 October 2025. Further details on the programme can be found at the following link:

https://www.nhsbsa.nhs.uk/future-nhs-workforce-solution-transformation-programme

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps is his Department is taking to ensure brain tumour patients have timely access to whole genome sequencing.

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

Genomic testing is delivered through the NHS Genomic Medicine Service via seven regional NHS Genomic Laboratory Hubs (NHS GLHs). Testing follows the National Genomic Test Directory, which includes whole genome sequencing (WGS) for neurological tumours, including primary brain cancers. NHS England has produced national sample handling guidance for WGS of solid tumours, including brain tumours, to maintain DNA quality and improve access to WGS by standardising the collection, processing, and transport of samples. Approaches to the handling of fresh tissue have also been reviewed to speed up processes. In 2025/26, NHS England is continuing its Cancer Genomics Improvement Programme to deliver quality improvement initiatives, education, local engagement, and the establishment of Cellular Pathology Genomic Centres to streamline cancer genomics pathways and accelerate genomic testing. These approaches are addressing variability and ensuring equitable regional access to WGS for brain tumour patients. NHS England monitors performance through Patient Level Contract Monitoring data and works with NHS GLHs to address variation and drive improvements.

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 savings to the NHS from reducing the number of failed or repeated prescriptions for the same item.

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

No specific assessment has been made.

As part of providing National Health Service pharmaceutical services, pharmacy contractors are required to dispense all prescriptions reasonably promptly. If there is an issue with a prescription, such as an error on the prescription or duplicate prescriptions, pharmacy teams are expected to raise the issue with the patient and use their professional judgement on how to proceed. This may include referring back to the general practitioner (GP) if the prescription needs to be changed, for example if the product prescribed is not available and the GP needs to consider what alternative would be suitable. If a prescription is not dispensed to the patient, the pharmacy will not be paid for that prescription.

Prescribers are responsible for ensuring that suitable arrangements are in place for monitoring, follow-up, and review of any prescription-only medicines. Prescribers, pharmacies, and patients share responsibility to ensure patients are only receiving the medication they require.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has received legal advice on the PATHWAYS trial.

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

The healthcare of children, like all patients, deserves evidence-based treatments where possible. That is why we are following expert, independent advice from the Cass Review to implement a programme of research to support the National Health Service to provide the best support to children and young people with gender incongruence. The programme includes the PATHWAYS trial, a carefully designed clinical trial to assess the relative benefits and harms of puberty-suppressing hormones as a treatment option for children and young people with gender incongruence.

The Government Legal Department is the Government’s principal legal advisers. Its core purpose is to help the Government to govern well, within the rule of law. They regularly provide advice to the Department of Health and Social Care.

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 implications for his Department’s policies of the Hughes Report entitled Options Options for redress for those harmed by valproate and pelvic mesh, published on 7 February 2024.

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

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. I have met the Patient Safety Commissioner this month to work up the Department’s plans to address her recommendations, and the Government will provide an update in due course.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much each country has paid back for healthcare use by their citizens in the UK within the same year in the latest year for which figures are available.

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

NHS care is provided free at the point of use to people who are ordinarily resident in the United Kingdom, including people who were born abroad if they are not subject to immigration controls. Where the person is not ordinarily resident, the National Health Service recovers costs for healthcare provided in the UK through the immigration health surcharge (IHS), directly charging individuals for care provided and charging countries responsible for their healthcare costs through reciprocal healthcare agreements.

The UK’s reciprocal healthcare agreements with the European Union, European Free Trade Association states and Switzerland allow for the reimbursement of costs at a country level. The UK pays for healthcare costs of eligible people visiting or living in these countries under these agreements. For other countries, the UK does not fund overseas treatment and NHS costs incurred are recovered through the IHS or directly charging the individual.

The following table shows the Department’s income and expenditure on overseas healthcare from the United Kingdom’s reciprocal healthcare agreements for 2023/24, the latest year for which figures are available:

The figures in the table above relate to all reciprocal healthcare agreements where costs are exchanged between the UK and other countries. These figures are not directly comparable to the figures quoted in the Department’s accounts, which are not broken down by country and include accounting treatment and aggregation of other costs. Negative values in the table above reflect adjustments to prior year forecasts compared to actual receipts/payments received from member states.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much his Department has spent on overseas healthcare in the latest year for which figures are available, broken down by country.

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

NHS care is provided free at the point of use to people who are ordinarily resident in the United Kingdom, including people who were born abroad if they are not subject to immigration controls. Where the person is not ordinarily resident, the National Health Service recovers costs for healthcare provided in the UK through the immigration health surcharge (IHS), directly charging individuals for care provided and charging countries responsible for their healthcare costs through reciprocal healthcare agreements.

The UK’s reciprocal healthcare agreements with the European Union, European Free Trade Association states and Switzerland allow for the reimbursement of costs at a country level. The UK pays for healthcare costs of eligible people visiting or living in these countries under these agreements. For other countries, the UK does not fund overseas treatment and NHS costs incurred are recovered through the IHS or directly charging the individual.

The following table shows the Department’s income and expenditure on overseas healthcare from the United Kingdom’s reciprocal healthcare agreements for 2023/24, the latest year for which figures are available:

The figures in the table above relate to all reciprocal healthcare agreements where costs are exchanged between the UK and other countries. These figures are not directly comparable to the figures quoted in the Department’s accounts, which are not broken down by country and include accounting treatment and aggregation of other costs. Negative values in the table above reflect adjustments to prior year forecasts compared to actual receipts/payments received from member states.

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 protocols for exchanging medical records electronically between NHS organisations on patients in West Dorset constituency.

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

Ensuring information can be shared between services is essential for safe and effective care. Improving this will enable better informed clinical and care decision-making that is empowered by access to precise and comprehensive information, enhancing the quality and safety of care for patients.

NHS England has been supporting National Health Service trusts and foundation trusts in acquiring and developing the effectiveness of their electronic patient records and support is available to bring trusts to an optimum level of digital maturity which will further reduce barriers to the sharing of information needed to treat patients. Further information on electronic patient records for trusts and foundation trusts is available at the following link:

https://www.england.nhs.uk/long-read/data-and-clinical-record-sharing/

To ensure continuity of care and to reduce delays in treatment, NHS England is working with NHS Wales on improving the interoperability of services, sharing care records, technical collaboration on Fast Healthcare Interoperability Resources based messaging standards, and longer-term ambitions for a single patient record.

The Government's 10-Year Health Plan includes the objective of delivering a single patient record. We will be engaging with the devolved administrations on the single patient record, to support appropriate cross-border referrals, and appropriate information sharing to inform good decision-making, support healthcare, and minimise risk to patients.

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 implications for his policies of trends in the proportion of patients treated within 18 weeks in Mid and South Essex Integrated Care Board facilities over the past year.

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

We are clear that the extent of waits for treatment is unacceptable, and cutting waiting lists is a key priority for the Government. We have committed to returning by March 2029 to the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment (RTT).

Between July 2024 and June 2025, we delivered 5.2 million additional appointments compared to the previous year, more than double our pledge of two million. This marks a vital first step towards delivering the constitutional standard.

As an interim goal, NHS England’s Operational Planning Guidance 2025/26 has set the national ambition for 65% of patients waiting no longer than 18 weeks for treatment, with every trust expected to deliver a minimum five percentage point improvement in performance, and to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list.

To support this improvement across all trusts and systems, there is a robust performance management process in place. The new NHS Oversight Framework 2025/26 ensures that there is public accountability for performance and NHS England works with systems and providers to support improvement.

In coordination with the NHS Mid and South Essex Integrated Care Board, NHS England has heightened executive oversight and assurance processes in place with the Mid and South Essex NHS Foundation Trust to monitor and support recovery plans. An extensive targeted recovery plan focuses on orthopaedic mutual aid, optimising and expanding existing capacity, pathway reform, improvements to validation processes and demand management.

A new interim Chief Executive Officer and Chief Operating Officer have been appointed at the trust, in addition to a dedicated Executive Elective Recovery Director to drive and oversee turnaround of elective care performance.

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 support Mid and South Essex Integrated Care Board to reduce the number of pathways waiting more than 52 weeks for treatment.

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

We are clear that the extent of waits for treatment is unacceptable, and cutting waiting lists is a key priority for the Government. We have committed to returning by March 2029 to the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment (RTT).

Between July 2024 and June 2025, we delivered 5.2 million additional appointments compared to the previous year, more than double our pledge of two million. This marks a vital first step towards delivering the constitutional standard.

As an interim goal, NHS England’s Operational Planning Guidance 2025/26 has set the national ambition for 65% of patients waiting no longer than 18 weeks for treatment, with every trust expected to deliver a minimum five percentage point improvement in performance, and to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list.

To support this improvement across all trusts and systems, there is a robust performance management process in place. The new NHS Oversight Framework 2025/26 ensures that there is public accountability for performance and NHS England works with systems and providers to support improvement.

In coordination with the NHS Mid and South Essex Integrated Care Board, NHS England has heightened executive oversight and assurance processes in place with the Mid and South Essex NHS Foundation Trust to monitor and support recovery plans. An extensive targeted recovery plan focuses on orthopaedic mutual aid, optimising and expanding existing capacity, pathway reform, improvements to validation processes and demand management.

A new interim Chief Executive Officer and Chief Operating Officer have been appointed at the trust, in addition to a dedicated Executive Elective Recovery Director to drive and oversee turnaround of elective care performance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential impact of prolonged waiting times for ADHD assessment on children’s (a) wellbeing and (b) educational outcomes in (i) Surrey and (ii) the Surrey Heath constituency.

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

The Government has recognised that, nationally, demand for assessments for autism and 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. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism and ADHD services, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines.

The NICE guidance for the diagnosis of autism recommends that the length between referral and first appointment should be no more than 13 weeks. We know that this is not happening routinely across the country. In respect of ADHD, the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, however it sets out best practice on providing a diagnosis.

Through the NHS Medium-term planning framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

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 and autistic people 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, whether he will make an assessment of the adequacy of local capacity to meet increases in demand for (a) ADHD and (b) Autism assessments in (i) Surrey and (ii) Surrey Heath constituency.

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

The Government has recognised that, nationally, demand for assessments for autism and 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. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism and ADHD services, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines.

The NICE guidance for the diagnosis of autism recommends that the length between referral and first appointment should be no more than 13 weeks. We know that this is not happening routinely across the country. In respect of ADHD, the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, however it sets out best practice on providing a diagnosis.

Through the NHS Medium-term planning framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

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 and autistic people 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, whether the UK is (a) excluded from, (b) partially exempted from and (c) otherwise subject to special treatment under the United States’ Most Favoured Nation drug pricing policy.

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

Thanks to strong United Kingdom support for innovation, the UK has secured mitigations under the United States’ ‘Most Favoured Nation’ drug pricing initiative so that we will continue to ensure access to the latest treatments. This will encourage pharmaceutical companies from around the world to prioritise the UK for early launches of their new medicines, meaning British patients could be among the first globally to access breakthrough treatments.

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 vision rehabilitation in (a) Ashfield constituency and (b) the UK.

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

Under the Care Act 2014, local authorities have the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people, including those with sight loss, have a choice of appropriate services and equipment that maximise independence.

Although the Care Quality Commission (CQC) is not currently required to assess vision rehabilitation services, as regulated activities under the Health and Social Care Act 2008, sensory services, including vision rehabilitation, do form part of the CQC’s overall assessment of local authorities’ delivery of adult social care.

CQC assessments identify local authorities’ strengths and areas for development, in their delivery of their duties under part 1 of the Care Act. This facilitates the sharing of good practice and helps us to target support where it is most needed. It may be helpful to know that the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement. Reports are published on the CQC’s website, available at the following link:

https://www.cqc.org.uk/care-services/local-authority-assessment-reports

In England, we continue to fund the Disabled Facilities Grant (DFG) which is administered by local authorities. This grant helps eligible older and disabled people, including those with a vision impairment, to adapt their homes to make them safe and suitable for their needs. Practical changes include installing stairlifts, level-access showers, and ramps.

We have provided an additional £172 million over two years to uplift the DFG, which could provide approximately 15,000 extra home adaptations to give people more independence in their homes. This brings total funding for the DFG to £711 million in both 2024/25 and 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 ensuring electronic medical record systems in NHS England and NHS Wales can exchange patient information more easily.

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

Ensuring information can be shared between services is essential for safe and effective care. Improving this will enable better informed clinical and care decision-making that is empowered by access to precise and comprehensive information, enhancing the quality and safety of care for patients.

NHS England has been supporting National Health Service trusts and foundation trusts in acquiring and developing the effectiveness of their electronic patient records and support is available to bring trusts to an optimum level of digital maturity which will further reduce barriers to the sharing of information needed to treat patients. Further information on electronic patient records for trusts and foundation trusts is available at the following link:

https://www.england.nhs.uk/long-read/data-and-clinical-record-sharing/

To ensure continuity of care and to reduce delays in treatment, NHS England is working with NHS Wales on improving the interoperability of services, sharing care records, technical collaboration on Fast Healthcare Interoperability Resources based messaging standards, and longer-term ambitions for a single patient record.

The Government's 10-Year Health Plan includes the objective of delivering a single patient record. We will be engaging with the devolved administrations on the single patient record, to support appropriate cross-border referrals, and appropriate information sharing to inform good decision-making, support healthcare, and minimise risk to patients.

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 risks to patients from the electronic exchange of medical records between NHS England and NHS Wales.

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

Ensuring information can be shared between services is essential for safe and effective care. Improving this will enable better informed clinical and care decision-making that is empowered by access to precise and comprehensive information, enhancing the quality and safety of care for patients.

NHS England has been supporting National Health Service trusts and foundation trusts in acquiring and developing the effectiveness of their electronic patient records and support is available to bring trusts to an optimum level of digital maturity which will further reduce barriers to the sharing of information needed to treat patients. Further information on electronic patient records for trusts and foundation trusts is available at the following link:

https://www.england.nhs.uk/long-read/data-and-clinical-record-sharing/

To ensure continuity of care and to reduce delays in treatment, NHS England is working with NHS Wales on improving the interoperability of services, sharing care records, technical collaboration on Fast Healthcare Interoperability Resources based messaging standards, and longer-term ambitions for a single patient record.

The Government's 10-Year Health Plan includes the objective of delivering a single patient record. We will be engaging with the devolved administrations on the single patient record, to support appropriate cross-border referrals, and appropriate information sharing to inform good decision-making, support healthcare, and minimise risk to patients.

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 adequacy of waiting times for neurodevelopmental assessments for children with (a) ADHD or (b) Autism in (i) Surrey and (ii) the Surrey Heath constituency.

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

The Government has recognised that, nationally, demand for assessments for autism and 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. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including provision of autism and ADHD services, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines.

The NICE guidance for the diagnosis of autism recommends that the length between referral and first appointment should be no more than 13 weeks. We know that this is not happening routinely across the country. In respect of ADHD, the NICE guideline does not recommend a maximum waiting time for people to receive an assessment for ADHD or a diagnosis, however it sets out best practice on providing a diagnosis.

Through the NHS Medium-term planning framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

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 and autistic people 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 steps his Department is taking to (a) support the development of treatments for Huntington's disease and (b) improve the ability of the NHS to deliver new gene therapies for people living with rare diseases.

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

We recognise the significant challenges faced by those living with rare diseases such as Huntington’s Disease. The Department supports research into Huntington’s disease through the National Institute for Health and Care Research (NIHR). NIHR infrastructure supports pioneering research into Huntington's, including the positive preliminary results for a novel gene therapy reported this year. NHS England will assess the service delivery impact of any specific gene therapy for Huntingdon's disease within three years of its expected licensing decision by the Medicines and Healthcare products Regulatory Agency. The National Institute for Health and Care Excellence (NICE) will make recommendations for the National Health Service on new medicines based on clinical and cost effectiveness. NHS England is required to fund medicines recommended by NICE, within three months of the publication of final guidance. The NHS has a dedicated team to support the adoption of advanced therapy medicinal products (ATMPs) that are recommended by NICE. NHS England works with a variety of internal and external stakeholders to ensure timely patient access to ATMPs that are on NICE’s technology appraisal and highly specialised technology workplan.

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 (a) improve recognition of topical steroid withdrawal and (b) ensure that NHS clinicians are able to diagnose that condition accurately.

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

The Medicines and Healthcare products Regulatory Agency (MHRA) has reviewed topical steroid withdrawal (TSW) reactions and first communicated about these reactions in September 2021 through our Drug Safety Update (DSU), which is widely disseminated among health care professionals. This communication can be found at the following link:

www.gov.uk/drug-safety-update/topical-corticosteroids-information-on-the-risk-of-topical-steroid-withdrawal-reactions

The MHRA had continued to monitor reports of TSW reactions and undertook a further review in 2024, resulting in an additional DSU publication which can be found at the following link:

www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions

During this review advice was sought from dermatologists, the National Eczema Society, and the Commission on Human Medicines. Consequently, the MHRA took forward a number of actions including ensuring there are updated warnings in the product information that is supplied with the creams, and the inclusion of information regarding the potency of topical steroids on the packaging. The British National Formulary (BNF) has updated their topical steroids potency information in line with the outcomes of the MHRA review. BNF treatment summary for topical corticosteroids, including information on withdrawal reactions, can be found at the following link:

https://bnf.nice.org.uk/treatment-summaries/topical-corticosteroids/

Furthermore, the MHRA engaged with the British Association of Dermatologists who have released an updated statement that can be found at the following link:

https://cdn.bad.org.uk/uploads/2024/02/22095550/Topical-Steroid-Withdrawal-Joint-Statement.pdf

Following these discussions, the British Association of Dermatologists has formed a Topical Steroid Withdrawal Working Party Group in collaboration with National Eczema Society, Scratch That, Primary Care Dermatology Society, and the British Dermatological Nursing Group. A Topical Steroid Withdrawal Joint Statement from the Topical Steroid Withdrawal Working Party Group is available at the following link:

https://www.bad.org.uk/topical-steroid-withdrawal-joint-statement

The objective of the TSW Working Party Group is to develop an expert consensus guidance on supporting people with concerns about TSW, including a Patient Information Leaflet, and any revision to the above joint statement, as appropriate.

The MHRA acknowledges that more high-quality research would enhance the understanding of TSW reactions, including what causes them and how to accurately diagnose and manage them. To make good decisions about what research to fund, the National Institute of Health and Care Research (NIHR) needs a balanced picture about which questions most urgently need answering. To achieve this, they ask patients, carers, clinicians, healthcare workers, service managers, and researchers for research topics. Any member of the public can submit suggestions via the NIHR website at the following link:

https://www.nihr.ac.uk/get-involved/suggest-a-research-topic

In the meantime, the MHRA continues to monitor reports of TSW reactions via the Yellow Card Scheme, which encourages anyone to report if they suspect an adverse reaction to a medical product or products. Access to the Yellow Card reporting site can be found at the following link:

https://yellowcard.mhra.gov.uk/

In addition to Yellow Card Scheme, the MHRA receives adverse event reports from pharmaceutical companies who collect data from healthcare professionals and patients, as well as cases from published literature and other sources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department plans to increase funding for research into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

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

As set out in the final delivery plan, the Department has taken actions to strengthen research capacity and capability in relation to myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). The level of research funding is determined by the quantity and quality of proposals that are recommended for support through the competitive process through the National Institute for Health and Care Research (NIHR) funding committees.

The actions announced in the final delivery plan include a research showcase event, a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical interventions, and the announcement of new funded studies in health and care services, research infrastructure, and capacity-building.

We are determined to accelerate progress in the treatment and management of ME/CFS and will continue working with the ME/CFS community to identify and address barriers to research. The NIHR welcomes funding applications for research into any aspect of human health and care, including ME/CFS. Research funding is available, and applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has his Department made of the potential impact of ICB mergers on continuity and access in rural and semi-rural areas.

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

Across larger integrated care board (ICB) footprints there will be a renewed focus on the local level as part of our commitment to delivering care closer to home, and this includes rural and semi rural areas. As outlined in our 10-Year Health Plan, neighbourhood health plans will be created and will be brought together as part of the ICBs’ plans to improve population health locally.

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 restore the 18-week referral-to-treatment standard at Mid and South Essex Integrated Care Board; and by what timeframe.

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

We are clear that the extent of waits for treatment is unacceptable, and cutting waiting lists is a key priority for the Government. We have committed to returning by March 2029 to the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment (RTT).

Between July 2024 and June 2025, we delivered 5.2 million additional appointments compared to the previous year, more than double our pledge of two million. This marks a vital first step towards delivering the constitutional standard.

As an interim goal, NHS England’s Operational Planning Guidance 2025/26 has set the national ambition for 65% of patients waiting no longer than 18 weeks for treatment, with every trust expected to deliver a minimum five percentage point improvement in performance, and to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list.

To support this improvement across all trusts and systems, there is a robust performance management process in place. The new NHS Oversight Framework 2025/26 ensures that there is public accountability for performance and NHS England works with systems and providers to support improvement.

In coordination with the NHS Mid and South Essex Integrated Care Board, NHS England has heightened executive oversight and assurance processes in place with the Mid and South Essex NHS Foundation Trust to monitor and support recovery plans. An extensive targeted recovery plan focuses on orthopaedic mutual aid, optimising and expanding existing capacity, pathway reform, improvements to validation processes and demand management.

A new interim Chief Executive Officer and Chief Operating Officer have been appointed at the trust, in addition to a dedicated Executive Elective Recovery Director to drive and oversee turnaround of elective care performance.

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 support the Mid and South Essex Integrated Care Board to reduce its pathways waiting list.

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

We are clear that the extent of waits for treatment is unacceptable, and cutting waiting lists is a key priority for the Government. We have committed to returning by March 2029 to the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment (RTT).

Between July 2024 and June 2025, we delivered 5.2 million additional appointments compared to the previous year, more than double our pledge of two million. This marks a vital first step towards delivering the constitutional standard.

As an interim goal, NHS England’s Operational Planning Guidance 2025/26 has set the national ambition for 65% of patients waiting no longer than 18 weeks for treatment, with every trust expected to deliver a minimum five percentage point improvement in performance, and to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list.

To support this improvement across all trusts and systems, there is a robust performance management process in place. The new NHS Oversight Framework 2025/26 ensures that there is public accountability for performance and NHS England works with systems and providers to support improvement.

In coordination with the NHS Mid and South Essex Integrated Care Board, NHS England has heightened executive oversight and assurance processes in place with the Mid and South Essex NHS Foundation Trust to monitor and support recovery plans. An extensive targeted recovery plan focuses on orthopaedic mutual aid, optimising and expanding existing capacity, pathway reform, improvements to validation processes and demand management.

A new interim Chief Executive Officer and Chief Operating Officer have been appointed at the trust, in addition to a dedicated Executive Elective Recovery Director to drive and oversee turnaround of elective care performance.

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 public stigma surrounding age-related hearing loss.

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

The Government recognises the impact that age-related hearing loss can have on people’s lives, and that the challenges they face can be exacerbated by stigma surrounding the condition.

It is important that people with age-related hearing loss are actively supported and empowered to lead the lives they want for themselves and their families, and NHS England is working with partners to support people in England to age well. In 2017, NHS England published a guide for commissioners and health and social care providers to support older people with hearing loss to maintain health, wellbeing, and independence. This guide is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2017/09/hearing-loss-what-works-guide-healthy-ageing.pdf

The National Institute for Health and Care Excellence has also published guidelines, titled Hearing loss in adults: assessment and management, which aims to improve the lives of adults with hearing loss by advising healthcare staff on assessing and managing hearing loss in primary, community, and secondary care settings. This guide is also available at the following link:

https://www.nice.org.uk/guidance/ng98/resources/hearing-loss-in-adults-assessment-and-management-pdf-1837761878725

The Government recognises the pivotal role that local authorities, and adult social care specifically, play in nurturing local communities and helping people to live as independent and fulfilling lives as possible. We are progressing towards a National Care Service based on higher quality of care, greater choice and control, and better joined-up services, with over £4 billion of additional funding available for adult social care by 2028/29.

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 NHSE informs ICBs, practitioners and Regional Pharmacists about amendments to the liothyronine (T3) section in the guidance document entitled Items which should not routinely be prescribed in primary care.

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

Regional chief pharmacists have been informed of the changes made to the liothyronine section, including Armour Thyroid and liothyronine combination products, of the ‘items that should not be prescribed in primary care’ policy guidance via email. They have been asked to cascade this information through their integrated care board’s regional networks.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he plans to take to help ensure that respiratory research challenges funded by National Institute for Health and Care Research will help tackle respiratory disease in adults.

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

The Department invests over £1.6 billion each year on research through the National Institute for Health and Care Research (NIHR). In the last five financial years it has invested £152 million directly into research funding on respiratory health conditions in adults. In addition, investment through NIHR infrastructure also supports the country’s leading experts to develop and deliver high-quality early translational, clinical, and applied health research across a range of research areas. The NIHR Respiratory Translational Research Collaboration is a network of leading universities, National Health Service trusts, and research centres in the United Kingdom who carry out early translational respiratory research. It works with life sciences companies, charities, and other funders to design and deliver complex, multicentre studies that accelerate research to benefit patients. Further information is available at the following link:

https://www.nihr.ac.uk/about-us/what-we-do/infrastructure/translational-research-collaborations/respiratory

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has considered requesting the National Institute for Clinical Excellence to set national clinical guidelines for developmental language disorders.

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

Topics for new or updated National Institute for Health and Care Excellence (NICE) guidance are considered through an established prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.

The NICE Prioritisation Board considered developmental language disorder: diagnosis and management as a topic for guidance development at its meeting on 20 November 2025. They recognised that developmental language disorder is a significant condition that affects a large population. However, they agreed that there is unlikely to be sufficient evidence available at this time to be able to develop a useful and usable guideline. Therefore, the topic was not selected for guidance development at this time.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he plans to prevent NHS trusts from generating surpluses from car parking income charged to staff, patients and visitors.

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, how many women in the Bristol East constituency have been affected by faulty PIP breast implants.

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

The role of the Medicines and Healthcare products Regulatory Agency (MHRA) is to monitor all incidents that are reported to us, making sure that these incidents are investigated fully and that any necessary action is taken. The poly implant prothèse (PIP) issue was a result of the use of a non-approved silicone in the production of the breast implants and fragile shells. Not all PIP implants manufactured during the affected period used industrial-grade silicone or had more fragile shells. As a result, rupture rates vary depending on the batch received and early rupture typically occurs within the first five to 10 years. Due to the overall fraudulent activity, we do not know how many fall into this category.

We worked with the National Health Service and other health partners to ensure the issue was properly investigated. It is important to note that while PIP implants are associated with a higher risk of rupture, leading to symptoms such as tenderness or swollen lymph glands, there is no evidence linking ruptured PIP implants to serious long-term health issues. The PIP breast implants were withdrawn from the United Kingdom in 2010, and two independent reviews have identified lessons learned, the Howe Review (2012) and the Keogh Review (2013), with further information available on both, respectively, at the following two links:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/216537/dh_134043.pdf

https://www.gov.uk/government/publications/review-of-the-regulation-of-cosmetic-interventions

One of the concerning issues for women with breast implants at the time of PIP was that women didn’t know they had PIP breast implants. It is estimated that approximately 47,000 British women had PIP implants fitted. We are unable to provide the granularity for individual constituencies, although further information is available at the following link:

https://www.nhs.uk/conditions/pip-implants/

However, please note that any PIP implants still in place have now exceeded 15 years in situ, which is the upper end of the 10 to 15 year typical life expectancy of a breast implant. As with any medical device reaching the end of its expected lifespan, clinical decisions regarding removal or replacement should be made on an individual basis in discussion between the doctor and the individual involved.

The health system has enacted important changes since the publication of reviews focused on PIP implants. As a result of the Keogh Review, since 2016 the Breast and Cosmetic Implant Registry collects data on all types of breast implant and removal surgery in England and Scotland, which aims to help detect emerging safety issues and trace patients if necessary.

As part of MHRA’s regulatory reform program, we are intending to also improve the traceability of medical devices through the introduction of Unique Device Identifiers (UDI) which will help identify individual medical devices and who manufactured the device or placed it on the market.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps are his department taking to ensure the that upcoming GP Connect requirements support confidentiality and data integrity.

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

GP Connect helps clinicians to gain access to general practice (GP) patient records during interactions away from a patient’s registered practice and makes their medical information available to appropriate health and social care professionals when and where they need it, to support the patient’s direct care. From a privacy, confidentiality, and data protection perspective, GP Connect provides a method of secure information transfer and reduces the need to use less secure or less efficient methods of transferring information, such as email or telephone.

Access to GP Connect is governed by role-based access and organisational controls, and only people who need to see the GP patient record for a patient’s direct care should be able to see it. Data integrity is ensured by the GP Connect Application Programming Interface sharing an accurate, consistent, and real time complete copy of specific data held in the source GP record. All systems that allow the use of GP Connect must undergo a robust compliance process.

All organisations applying to use GP Connect must comply with the National Data Sharing Arrangement (NDSA) and end-user agreement that sets out their responsibilities and confidentiality obligations. Further information is available at the following link:

https://digital.nhs.uk/services/gp-connect/national-data-sharing-arrangement-for-gp-connect

The NDSA and its terms and conditions stipulate that any information received or accessed about a patient for direct care purposes must remain confidential.

NHS England has published a Privacy Notice and a Data Protection Impact Assessment for GP Connect, which can be found, respectively, at the following two links:

https://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-privacy-notice/impact-assessment

https://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-privacy-notice

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many reports of BIA-ALCL there have been in the UK; and which manufacturers of breast implants those reports have been associated with.

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

As has been previously shared in evidence submitted to the Women and Equalities Select Committee in July 2025, with further information in the document attached, the Medicines and Healthcare product Regulatory Agency (MHRA) closely monitors Breast Implant Associated- Anaplastic Large Cell Lymphoma (BIA-ALCL), a cancer of the immune system, not a breast cancer, and publishes the output from this monitoring on the GOV.UK webpage, at the following link:

https://www.gov.uk/guidance/breast-implants-and-anaplastic-large-cell-lymphoma-alcl

The MHRA has developed, with advice from independent expert advisory group, a follow up strategy to collect further data on adverse incidents reporting BIA-ALCL. This has informed the information that is published on the MHRA webpage relating to BIA-ALCL which includes the most up to date number of confirmed reports of BIA-ALCL made to the MHRA, and the breakdown of the number of confirmed reports of primary BIA-ALCL cases by manufacturer of breast implant.

Please note that the data on the GOV.UK webpage should be interpreted in the context of the ‘Notes and limitations to the data’ section also provided on the webpage.

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 support NHS staff working in South Holland and the Deepings constituency.

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

The health and wellbeing of all National Health Service staff is a top priority. Local employers across the NHS have arrangements in place for supporting staff, including occupational health provision, employee support programmes, and a focus on healthy working environments. At a national level NHS staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health and wellbeing support, including trauma and addiction.

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

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential merits of increasing the accessibility of Enhertu as a treatment for breast cancer.

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

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE) following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently and on the basis of the available evidence.

NICE has recommended Enhertu (trastuzumab deruxtecan) in advanced breast cancer for treating HER2-positive unresectable or metastatic breast cancer after one or more anti-HER 2 treatments and for treating HER2-positive unresectable or metastatic breast cancer after two or more anti-HER2 therapies. Enhertu is now funded for eligible patients in England in line with NICE’s recommendations.

NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.

Ministers met with the manufacturers of Enhertu, AstraZeneca, and Daiichi Sankyo in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance published in July 2024 will therefore remain unchanged. Although the deadline for a rapid review has now passed, NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Written Statement entitled Mental Health Conditions, Autism and ADHD Prevalence and Support, published on 4 December 2025, HCWS1132, what criteria will be used to appoint members to the Advisory Working Group, how individuals with lived experience will be involved in the development and scrutiny of the Review’s findings, and what steps he plans to take to ensure that any recommendations accepted by the Government are implemented uniformly across Integrated Care Boards and local authorities, with transparent reporting and measurable outcomes.

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

The Chair and vice-chairs of the independent review into the prevalence of and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism will appoint an Advisory Working Group which involves a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities, and people with lived experience to directly shape the recommendations and scrutinise the evidence. As the review is independent it is for the chairs to determine the process for engaging.

The Government has begun to address fundamental problems in National Health Service mental health services and will progress towards a new approach for mental health in 2026. As part of this we are radically enhancing transparency of mental health providers with consequences for poor performance. New league tables are driving improvement in the quality and safety of care, rewarding improvement and success. We are tackling unacceptable failures in care quality through stronger accountability and enhanced support.

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 implications for his policies of trends in the level of legal costs associated with lower value clinical negligence claims.

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

We welcome the report by the National Audit Office (NAO) entitled Costs of clinical negligence. 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. The review is ongoing, following initial advice to ministers and the recent NAO report.

The results of David Lock’s work will inform future policymaking 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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Written Statement entitled Mental Health Conditions, Autism and ADHD Prevalence and Support, published on 4 December 2025, HCWS1132, what assessment he has made of regional variation in diagnostic practice, referral thresholds and waiting times for autism and ADHD assessments; whether the Independent Review will examine the extent to which inconsistent clinical pathways drive disparities in outcomes; and what steps he plans to take to ensure that adults, young people and children in every Integrated Care Board area receive timely, consistent and clinically robust diagnostic assessment and ongoing support.

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

The Department has not made an assessment. We have commissioned an independent review into prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism. The review will look to understand the similarities and difference between mental health conditions, ADHD, and autism. It will look at prevalence, early intervention and treatment, and the current challenges facing clinical services. This will include exploring the factors that have contributed to the increase in prevalence and inequalities in access and outcomes. It will also examine the extent to which diagnosis, medicalisation, and treatment improve outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation.

The review will appoint an Advisory Working Group which involves a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities, and people with lived experience to directly shape the recommendations and scrutinise the evidence.

The chairs will provide a short report within six months setting out conclusions and recommendations for responding to the rising need, both within the Government and across the health system and wider public services.

As this is an independent review, it is therefore for the Chair and vice-chairs to explore and consider topics and themes relevant to the terms of reference. It would not be appropriate for the Department to comment or influence further on specific topics, findings, and recommendations. The Government will consider any recommendations and respond accordingly.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Written Statement entitled Mental Health Conditions, Autism and ADHD Prevalence and Support, published on 4 December 2025, HCWS1132, what assessment his Department has made of the factors contributing to the reported increase in the prevalence of mental health conditions, autism and ADHD over the past decade; what analysis he has undertaken to differentiate between changes in underlying incidence, improved public awareness, altered diagnostic practice and broader social determinants; and whether he will publish a cross-government strategy setting out how Departments intend to respond to rising prevalence and associated demand on public services.

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

The Department has not made an assessment. We have commissioned an independent review into prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism. The review will look to understand the similarities and difference between mental health conditions, ADHD, and autism. It will look at prevalence, early intervention and treatment, and the current challenges facing clinical services. This will include exploring the factors that have contributed to the increase in prevalence and inequalities in access and outcomes. It will also examine the extent to which diagnosis, medicalisation, and treatment improve outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation.

The review will appoint an Advisory Working Group which involves a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities, and people with lived experience to directly shape the recommendations and scrutinise the evidence.

The chairs will provide a short report within six months setting out conclusions and recommendations for responding to the rising need, both within the Government and across the health system and wider public services.

As this is an independent review, it is therefore for the Chair and vice-chairs to explore and consider topics and themes relevant to the terms of reference. It would not be appropriate for the Department to comment or influence further on specific topics, findings, and recommendations. The Government will consider any recommendations and respond accordingly.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Written Statement entitled Mental Health Conditions, Autism and ADHD Prevalence and Support, published on 4 December 2025, HCWS1132, what assessment his Department has made of the wider financial and operational impact on local authorities, schools, criminal justice agencies and employers arising from the increased prevalence of mental health conditions, autism and ADHD; and whether the Independent Review will produce recommendations for cross-government funding mechanisms or reforms to ensure that pressure on non-NHS services does not undermine the sustainability of local support and early-intervention provision.

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

The Department has not made an assessment. We have commissioned an independent review into prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism. The review will look to understand the similarities and difference between mental health conditions, ADHD, and autism. It will look at prevalence, early intervention and treatment, and the current challenges facing clinical services. This will include exploring the factors that have contributed to the increase in prevalence and inequalities in access and outcomes. It will also examine the extent to which diagnosis, medicalisation, and treatment improve outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation.

The review will appoint an Advisory Working Group which involves a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities, and people with lived experience to directly shape the recommendations and scrutinise the evidence.

The chairs will provide a short report within six months setting out conclusions and recommendations for responding to the rising need, both within the Government and across the health system and wider public services.

As this is an independent review, it is therefore for the Chair and vice-chairs to explore and consider topics and themes relevant to the terms of reference. It would not be appropriate for the Department to comment or influence further on specific topics, findings, and recommendations. The Government will consider any recommendations and respond accordingly.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has undertaken a review of the medical exemption criteria for prescription charges, particularly in relation to solid-organ transplant recipients.

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

No review of the medical exemption criteria for prescription charges has been undertaken.

There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which recipients of a solid-organ transplant may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.

People on low incomes can apply for help with their health costs through the NHS Low Income Scheme, which provides help based on a comparison between a person’s income and requirements.

People who need to pay and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as needed for a set cost. An annual PPC costs £114.50 and will save money if they need 12 or more items in 12 months. To help spread the cost, people can pay for an annual PPC by 10 monthly direct debits, which works out as just over £2 per week. A three-month PPC for £32.05 is also available.

To further support patients National Health Service prescription charges in England have been frozen for the second successive year, keeping the cost for a single charge at £9.90.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he plans to treat developmental language disorders in line with autism by matching levels of freely available support, training and information for parents and carers.

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

Community health services, including children’s speech and language therapy, are locally commissioned to enable systems to best meet the needs of their communities. NHS England is working with the Department for Education to identify and support children with speech, language, and communication needs by co-funding pathfinder sites to deliver the Early Language Support for Every Child programme.

The programme aims to identify and support children and young people in their early years and primary school settings with mild to moderate speech, language, and communication needs, reducing the rate of specialist referrals, and increasing workforce capacity through innovative workforce models.

On 5 April 2023, NHS England published a national framework and operational guidance to help integrated care boards (ICBs) and the National Health Service to deliver improved outcomes for people referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and following a recent diagnosis of autism. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.

The Medium-Term Planning Framework, published 24 October, was explicit that ICBs and providers are expected to optimise existing resources to reduce long waits for autism assessments and improve the quality of assessments by implementing published guidance.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress he has made on implementing the recommendations of the First Do No Harm report; and if he will publish an updated timetable for delivery of those recommendations.

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

Seven of the nine recommendations made in the First Do No Harm report have been previously accepted in full, in part, or in principle. Four of these have been successfully implemented, including appointing Professor Henrietta Hughes as the first ever Patient Safety Commissioner in England in respect of medicines and medical devices, and establishing nine specialist mesh centres, which are in operation across England.

Whilst the Government has no plans to publish a timetable, progress is ongoing in respect of the remaining recommendations. For example, the Medicines and Healthcare products Regulatory Agency has undergone an ambitious organisation-wide transformation to ensure it becomes a progressive and responsive patient-focussed regulator of medical products, for recommendation six, the Medical Devices and Outcomes Registry is now live and healthcare providers are required to contribute data, for recommendation seven, and regarding mandatory reporting of payments for the pharmaceutical and medical device industries, the Government intends to publish its response to a public consultation on this topic later this month, for recommendation eight.

Work is also ongoing across the Government to consider the recommendations in the Hughes Report, which looked into, and provided advice on, redress for those affected by sodium valproate and pelvic mesh.

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 improve access to routine tissue freezing for brain cancer patients in a) Epping Forest and b) England for even access to advanced treatments, diagnostics and research.

Answered by Ashley Dalton - Parliamentary Under-Secretary (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, what assessment his Department has made of the potential merits of implementing the recommendations in the National Audit Office’s report entitled Costs of clinical negligence, published on 17 October 2025.

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

We welcome the report by the National Audit Office (NAO) entitled Costs of clinical negligence. 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. The review is ongoing, following initial advice to ministers and the recent NAO report.

The results of David Lock’s work will inform future policymaking 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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will publish the findings of David Lock KC’s review into clinical negligence costs.

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

We welcome the report by the National Audit Office (NAO) entitled Costs of clinical negligence. 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. The review is ongoing, following initial advice to ministers and the recent NAO report.

The results of David Lock’s work will inform future policymaking 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.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will publish a list of the research programmes that are underway on the safety of breast implants.

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

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is not currently funding any specific research into the safety of breast implants but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.

The Department does not hold information related to breast implant safety research funded by other sources.

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 support visually impaired people to live independently.

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

Under the Care Act 2014, local authorities have the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people, including those with sight loss, have a choice of appropriate services and equipment that maximise independence.

Although the Care Quality Commission (CQC) is not currently required to assess vision rehabilitation services, as regulated activities under the Health and Social Care Act 2008, sensory services, including vision rehabilitation, do form part of the CQC’s overall assessment of local authorities’ delivery of adult social care.

CQC assessments identify local authorities’ strengths and areas for development, in their delivery of their duties under part 1 of the Care Act. This facilitates the sharing of good practice and helps us to target support where it is most needed. It may be helpful to know that the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement. Reports are published on the CQC’s website, available at the following link:

https://www.cqc.org.uk/care-services/local-authority-assessment-reports

In England, we continue to fund the Disabled Facilities Grant (DFG) which is administered by local authorities. This grant helps eligible older and disabled people, including those with a vision impairment, to adapt their homes to make them safe and suitable for their needs. Practical changes include installing stairlifts, level-access showers, and ramps.

We have provided an additional £172 million over two years to uplift the DFG, which could provide approximately 15,000 extra home adaptations to give people more independence in their homes. This brings total funding for the DFG to £711 million in both 2024/25 and 2025/26.

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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.

Question to the Department for Science, Innovation & Technology:

To ask the Secretary of State for Science, Innovation and Technology, what the (a) name, (b) job title, (c) annual remuneration, (d) time commitment and (e) expected end date is for each direct ministerial appointment in her Department.

Answered by Ian Murray - Minister of State (Department for Science, Innovation and Technology)

Please see a list of all the Direct Ministerial Appointments (DMAs) in DSIT to date, including job title, renumeration, time commitment and expected end date.

Live Appointments:

• Matt Clifford: the Prime Minister’s AI Opportunities Advisor. 1 day per week, Term Dates: 13/01/2024 - 13/01/2026.
• Dr Dan Mahoney: Life Sciences Investment Envoy. 15 days per year, Term Dates:18/11/2024 - 18/05/2026.
• Theo Blackwell: Local Digital Champion. 2 days per week, Term Dates: 13/01/2025 - 31/12/2025.
• Yoshua Bengio: International AI Safety Report Chair. 26 days per year, Term Dates: 29/01/2025 - 31/03/2026.
• Lord David Willetts: Regulatory Innovation Office Chair. 36 days per year, Term Dates: 07/03/2025 - 07/03/2027
• Steve Bates: Office for Life Sciences Executive Chair. Full-time, Term Dates: 29/09/2025 - 29/03/2027.
• Anne Lingford-Hughes, Peter Johnson, Hilary Evans-Newton, Nadeem Sarwar, Husseini Manji, Kathryn Abel and Naveed Sattar: OLS Healthcare Goals Chairs, 4-8 days per month, Term Dates: 30/09/2025 - 05/03/2027 (DHSC appointments with joint accountability between DHSC, DSIT and DBT)
• Simon Johnson, Tom Blomfield and Raia Hadsell: AI Ambassadors. 2 days per year, Term Dates: 21/11/2025 - 21/11/2026.
• James Wise: Sovereign AI Champion, 10 days per year. Term Dates: 21/11/2025 - 21/11/2026.
• Anne Marie Imafidon: Women in Tech Envoy. 20 days per year, Term Dates: 15/12/2025 - 15/06/2027.
• Prof. Sir Jonathan Irving Bell: Life Sciences Champions, 30 days per year, Term Dates: 01/01/2011 - 31/122025
• Sir Jon Symonds: Life Sciences Champions, 30 days per year, Term Dates: 01/01/2021- 31/12/2025.

Appointments that have now ended

• Matt Clifford: Lead Reviewer of the Artificial Intelligence Action Plan. 4-8 days per month, Term Dates: 22/07/2024 - 03/09/2024.
• Martha Lane Fox (Co-Chair), Poppy Gustafsson, Paul Willmott (Co-Chair), Jeni Tennison, Dr Anne-Marie Imafidon, Lou Cordwell, Aaron Maniam, David Eaves, Sarah Hunter, Lisa Harrington, Josie Cluer and Lord Richard Allan: Digital Centre Design Panel Members. 1 day a month, Date: 30/09/2024 - 04/01/2025.
• Ian Hogarth: AI Safety Institute Chair. 10 days per year, Term Dates: 10/02/2025 - 09/12/2025.

Appointments made before July 2024 (publicly available information)

• David Morris: UK Government Space Advisor. 2022 to 2024.
• Simon Fell: Rural Connectivity Champion. 2023 to 2024.
• Hilary Evans: Co-Chair for Dementia Mission. 2023 to 2024.
• Nadeem Sarwar: Co-Chair for the Dementia Mission. 2023 to 2024.
• Stephen McPartland: Chair of the McPartland Review. 2024.
• Alice Sullivan: Independent Reviewer of Data Collection. 2024.

Question to the Department for Science, Innovation & Technology:

To ask the Secretary of State for Science, Innovation and Technology, what discussions she has had with the Secretary of State for Health and Social Care on reducing clinical trial set-up times.

Answered by Kanishka Narayan - Parliamentary Under Secretary of State (Department for Science, Innovation and Technology)

Reducing clinical trial set-up times is a priority across government, and the Department of Health and Social Care and Department of Science, Innovation and Technology are working closely together to fulfil the Prime Minister’s target of achieving study set-up in under 150 days by March 2026.

Cross-departmental monitoring takes place via the UK Clinical Research Delivery (UKCRD) programme, a cross-sector programme that brings together delivery partners and key stakeholders, and through the joint-ministerial Life Sciences Delivery Board, which provides strategic oversight of progress on the Government’s ambitions for the Life Sciences sector, including targets to reduce set-up times for clinical trials.

Question to the Department for Education:

To ask the Secretary of State for Education, if she will establish a cross-government protocol with the Home Office and the Department of Health and Social Care setting out roles, referral routes and timescales between schools, police forces and health services when responding to allegations of child-on-child sexual abuse.

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

This government is taking the strongest action to tackle child sexual abuse and exploitation. This includes setting up a new national inquiry, with which government departments will cooperate fully, to ensure we are tackling this vile crime and supporting victims and survivors.

Working Together is the national multi-agency statutory guidance for all practitioners working with children and their families. Local safeguarding partners (local authorities, police and health) already have a statutory duty to set out in their threshold document and local protocols the process for referrals, assessments, support and services for children who need help or protection. This guidance underpins Ofsted’s Inspection of Local Authority Children’s Services framework.

We are also delivering the biggest reform to children’s social care in a generation, investing £2.4 billion in the Families First Partnership programme, introducing multi-agency child protection teams through our landmark Children's Wellbeing and Schools Bill and establishing a national Child Protection Authority.

Question to the Department for Education:

To ask the Secretary of State for Education, what steps she is taking to improve (a) universal, (b) targeted and (c) specialist speech, language and communication support for children in schools.

Answered by Georgia Gould - Minister of State (Education)

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 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.

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Found: This will be further supported with £5 million each year from the Department of Health and Social Care

Found: The MoJ are working with the Department of Health and Social Care, NHS England (NHSE), the Welsh Government

Found: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Q3 2025 Department of Health and Social Care

Found: class="govuk-table__cell">Q3 2025

Found: Transport [note 4] 963 938 0 25 94 Department for Work and Pensions 1091 1074 0 17 2 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: 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: We have advised the Department of Health and Social Care on early proposals to modernise the regulations

Found: The MoJ are working with the Department of Health and Social Care, NHS England (NHSE), the Welsh Government

Found: endometrial cancer with microsatellite stability or mismatch repair proficiency The Department of Health and Social Care

Found: Radiographers • UK Clinical Pharmacy Association • UK Oncology Nursing Society Others • Department of Health and Social Care

Found: Radiographers • UK Clinical Pharmacy Association • UK Oncology Nursing Society Others • Department of Health and Social Care

Found: SDR recommends that MOD and the Department of Health and Social Care (DHSC) work cl osely together.

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