Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

Question to the Department of Health and Social Care:

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

The Department does not hold the data in this format.

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

Question to the Department of Health and Social Care:

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

As set out in the 10-Year Health Plan, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals, support to work healthily and flexibly, and tackling violence, racism, and sexual harassment in the workplace.

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

https://nhsparliamentaryawards.co.uk/

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

Question to the Department of Health and Social Care:

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

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

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

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

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

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

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much has been spent on training UK medical students in each of the last five years, and how many of those publicly-funded graduates did not secure Foundation or speciality training places in the NHS.

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

The following table sets out the total costs incurred by NHS England in providing medical education in England between 2021/22 and 2025/26, split by placement costs and bursaries:

Source: NHS England

Notes:

1. The Department of Health and Social Care does not have the information requested for the last five full financial years, so the accompanying table incorporates the forecast spend for 2025/26.
2. The Department of Health and Social Care does not hold information on the costs incurred by the Department for Education or by bodies that the Department for Education sponsors, such as the Student Loans Company or the Office for Students. These areas of DfE provision will include tuition and maintenance loans as well as the Strategic Priorities grant which supports high cost STEM subjects.

The United Kingdom Foundation Programme Office has sought to allocate Foundation Programme places to all eligible applicants in each of the past five years.

The General Medical Council (GMC) publishes data on the proportion of doctors completing foundation year two who have subsequently entered the specialty training pipeline in each subsequent year. The data does not differentiate between the place of undergraduate study of doctors but given over 90% of doctors completing foundation year two are United Kingdom graduates, the data provides a good proxy for progression on to specialty training. This data is available as part of the GMC’s National Training Survey at the following link:

https://edt.gmc-uk.org/progression-reports/recruitment-from-f2

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps are being taken to ensure that NHS staff are not penalised financially for taking on extra responsibilities to maintain patient care.

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

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

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

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

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

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

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

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

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

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of NHS provision for complex mesh removal surgery; and what steps he is taking to ensure patients can access specialists with required expertise.

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

There are nine specialist mesh centres in operation across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team (MDT) to ensure patients get access to the specialist care and treatment that they need, including pain management.

The specialised services for service users with complications of mesh inserted for urinary incontinence, vaginal, or internal and external rectal prolapse specification published by NHS England sets out the requirement for an MDT approach to mesh services and suggests membership could include a psychologist. The specification also details that psychology services should be co-located or available to the mesh MDT.

The Department has commissioned, through the National Institute for Health and Care Research, a £1.56 million study to develop patient reported outcome measures (PROM) for prolapse, incontinence, and mesh complication surgery. Longer term, the PROM will be integrated into the pelvic floor registry which monitors and improves the safety of mesh patients. It records the surgical mesh implants, and related medical devices, given to patients, and the organisations and surgeons that have carried out the procedures.

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 unresolved mesh complications on the mental health of women impacted; and what support is available for those women.

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

There are nine specialist mesh centres in operation across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team (MDT) to ensure patients get access to the specialist care and treatment that they need, including pain management.

The specialised services for service users with complications of mesh inserted for urinary incontinence, vaginal, or internal and external rectal prolapse specification published by NHS England sets out the requirement for an MDT approach to mesh services and suggests membership could include a psychologist. The specification also details that psychology services should be co-located or available to the mesh MDT.

The Department has commissioned, through the National Institute for Health and Care Research, a £1.56 million study to develop patient reported outcome measures (PROM) for prolapse, incontinence, and mesh complication surgery. Longer term, the PROM will be integrated into the pelvic floor registry which monitors and improves the safety of mesh patients. It records the surgical mesh implants, and related medical devices, given to patients, and the organisations and surgeons that have carried out the procedures.

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 the (a) effectiveness and (b) timeliness of patient referrals between organisations in the NHS.

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

We’re improving referral processing by introducing a Single Point of Access model, which will provide consistent clinical triage and use digital solutions to streamline processes and reduce duplication. This will ensure patients are directed to the right care quickly.

To support general practitioners and avoid delays, we’re introducing national standards for response times and guidance to underpin clinical triage and advice quality. These will be monitored locally by integrated care boards and reviewed regularly.

The NHS App also already allows people to book and manage their secondary care referrals in 100% of acute trusts, with 89% allowing patients to manage follow up appointments too, with 100% expected in 2026.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the planned timeline is for publishing the next iteration of the taxonomy being developed as part of the ongoing reforms to Drug Tariff Part IX.

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

The final draft, version 1.2, of the Part IX Drug Tariff (Med Tech in the community) Wave 1 categorisation was developed in collaboration with an Expert Reference Group and updated in line with stakeholder feedback over four iterations. The final version was published in October 2025 and can be found on the NHS Business Services Authority Website at the following link:

https://www.nhsbsa.nhs.uk/manufacturers-and-suppliers/drug-tariff-part-ix-information

The Department is currently recruiting Independent Assessment Panels (IAPs) for Wave 1 and has agreed to ask them to review late feedback received from a company on the eye drops category. This is due to take place in February 2026 and will not require further input from industry as it has already been circulated for comment by them.

The Department has also offered to review Drug Tariff Committee feedback regarding the categorisation of medical devices that fall into waves 2 to 4.

The categorisation for waves 2 and 3 is currently being reviewed, and the Department expects to share the updated versions in early 2026 well in advance of the projected launch of waves 2 and 3 in 2027 and 2028 respectively. There are no confirmed plans for reviewing wave 4 at this time. The earliest launch would be in January 2029. All dates are subject to the outcome of the review of wave one.

The Department recognises that the categorisation is not stagnant and may need further amendments as medical devices continue to evolve and the IAPs are stood up. Companies can suggest further amendments when they apply to Part IX of the Drug Tariff or through the Drug Tariff Committee.

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 20 October to Question 77603 on Brain: Tumours, what steps he plans to take to incentivise pharmaceutical companies involved in developing vaccines for brain tumours to approach the NHS Cancer Vaccine Launch Pad for funding and support.

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 its research delivery arm, the National Institute for Health and Care Research (NIHR). In the financial year 2024/25, the NIHR’s reported spend on cancer research was over £141.6 million through its research programmes and infrastructure, reflecting cancer’s high priority.

The Government is taking measures to boost research into brain tumours. In December 2025, the NIHR announced the pioneering Brain Tumour Research Consortium to accelerate research into new brain tumour treatments. NIHR is investing an initial £13.7 million with significant further funding due to be awarded in 2026.

We also support the Rare Cancers Private Members Bill. This bill aims to incentivise research and investment into treatment by introducing measures to streamline clinical trial recruitment, allow patients to be more easily contacted by researchers, and also mandates a review of orphan drug regulations.

The NIHR continues to welcome funding applications for research into any aspect of human health and care, including brain tumours. These applications are subject to peer review and judged in open competition, with awards being 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, whether his Department plans to (a) alter and (b) mitigate the National Institute for Care and Excellence's downgrading of terminal cancer to moderately severe.

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

The National Institute for Health and Care Excellence (NICE) has not classified terminal cancer as moderately severe. The NICE is an independent body and is responsible for developing the methods and processes it uses to evaluate whether new medicines should be recommended for routine National Health Service funding.

In developing recommendations on whether medicines represent a clinically and cost effective use of NHS resources, NICE is able to apply a weighting that recognises the additional value that society places on treatments for severe conditions. The weighting that is applied is calculated for each appraisal based on information on the expected shortfall in life expectancy and quality of life of people with the condition taking into account existing treatment options. NICE has concluded for several appraisals of medicines for advanced cancer that a weighting should be applied based on the severity of the condition. The latest data for appraisals published up to September 2025, show that NICE has recommended 84.8% of treatments for advanced cancers since the severity modifier was introduced compared to 69.1% under its previous methods.

NICE is monitoring the impact of the changes made following the methods review and has committed to considering modular updates to its methods and processes in the future. NICE has also commissioned research to gather further evidence on societal preferences that will inform future methods reviews.

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 UK have received Allergan breast implants.

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

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.

Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.

NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.

This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.

This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

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 (a) trends in the level of variation in access to NICE-recommended biologic medicines for severe asthma.

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

No assessment has been made. NHS England is working with the health innovation networks and has formed the Respiratory Transformation Partnership. Focusing on improving the outcomes of people living with asthma and chronic obstructive pulmonary disease (COPD), this programme seeks to find scalable ways to decrease premature mortality and bed occupancy from respiratory diseases. Initiatives will seek to improve disease recognition, optimise delivery of National Institute for Health and Care Excellence (NICE) approved approaches at neighbourhood level, and uptake of existing and emerging biologic therapies.

The current NHS England severe asthma service specification is being revised by the Specialised Respiratory Clinical Reference Group. The current service specification is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2017/04/specialised-respiratory-services-adult-severe-asthma.pdf

The revised specification will support the management of patients who require further investigation and treatments including biological medicines. The specification will also be updated to reference the most recent clinical guidelines such as the British Thoracic Society, NICE, and the Scottish Intercollegiate Guidelines Network asthma guideline covering diagnosing, monitoring, and managing asthma in adults, young people, and children, and which is expected to improve outcomes for people with asthma and identify early those who require further investigation and treatments including biologic medicines. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng245

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 1 December 2025 to Question 93580 on Eating Disorders: Mental Health Services, which external stakeholders his Department is engaging with in the development of the modern service framework for mental health.

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

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.

Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

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 1 December 2025 to Question 93580 on Eating Disorders: Mental Health Services, when the Government expects to publish the modern service framework for mental health.

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

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.

Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent engagement his Department has had with the devolved Administrations in relation to the recommendations of The Hughes Report, published on 7 February 2024; and whether any Ministerial-level discussions are planned with the governments of Scotland, Wales and Northern Ireland.

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

While health is predominantly devolved, the Department holds some reserved functions and working together across the United Kingdom on health and social care is ingrained in the values of our National Health Service and social care sector.

The Patient Safety Commissioner’s report covered England-only, however, any response by the Government to the recommendations of the Hughes Report in England will likely have implications for the devolved administrations and their constituents. Engagement between officials across the UK occurs regularly and during an Inter-Ministerial Group meeting on 11 December 2025, the Hughes report was discussed and ministers across the four nations agreed to meet in January 2026 for further engagement.

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 that the introduction of digital and AI tools in mental health care enhances rather than replaces the work of qualified counsellors and psychotherapists, in line with guidance from professional bodies such as the National Counselling and Psychotherapy Society.

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

To deliver the shift from analogue to digital that is set out in the 10-Year Health Plan, we will create a digital front door for mental health care through the NHS App to boost access to early support and empower people to take steps to manage their symptoms.

Digital and artificial intelligence (AI) tools in mental health care can enhance and complement the work of qualified counsellors and psychotherapists, not replace human-delivered care. These tools can help with routine tasks like managing appointments, answering basic queries, updating clinical notes, and booking sessions. This means that clinicians can spend more time providing care to patients and patients have an improved experience across the care pathway, for example through reduced waiting times. Any new tools are introduced within a comprehensive regulatory framework in the National Health Service, underpinned by rigorous standards for safety, effectiveness, ethics, and data protection.

Publicly available AI applications that are not deployed by the NHS, such as ChatGPT and Character.AI, are not regulated as medical technologies and may offer incorrect or harmful information. Users are strongly advised to be careful when using these technologies.

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 patient experience of the NHS App.

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

The NHS App is at the forefront of a major digital transformation and will revolutionise access to healthcare by putting patients at the centre of a modern, personalised, and data-driven service. One of the key aims is to empower individuals with greater choice, transparency, and control over their care.

The NHS App is co-designed with patients from a wide range of background and needs, with 14,000 users involved in user research in 2025 alongside 42,000 survey completions. Our research teams also have a rule of always doing rounds of research with often excluded or disadvantaged groups. This is often facilitated by partners like the Royal National Institute of Blind People and Mencap who help us to involve the appropriate people.

The NHS App is already helping people manage their health more easily, whether that’s viewing records, booking appointments, ordering prescriptions, or accessing test results. In the past year alone, the app has sent over 181 million messages, supported over 32 million vaccination invites, and offered more than 16 million vaccination appointments, many in local pharmacies. These numbers show how the app is not just supporting care but actively shifting it closer to home.

By 2030, patients will be able to manage their care remotely, contribute to their health records, and navigate the system with confidence, driving better outcomes and a more integrated, responsive National Health Service.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many (a) breast implants and (b) PIP breast implants have ruptured and had to be removed in the last 10 years; and how many of those ruptured implants were not listed on the breast and cosmetic implant registry when implanted.

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

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.

Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.

NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.

This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.

This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

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 adequacy of healthcare provision in prisons; and what steps he is taking to ensure that prisoners have timely access to appropriate medical treatment.

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

NHS England commissions prison health care services into every prison in England. Every prison has onsite health care services including, primary care, mental health, dentistry, and substance misuse teams. This includes the care and management of those with long term conditions such as diabetes. All prisons offer a range of appointments to meet the needs of patients, and this includes routine appointments and urgent appointments.

NHS England commissions health care in prison that is the equivalence of community health care. The National Service Specification for primary care defines what this means for patients who require support. Access to health provision is available to every person in prison at any stage of their sentence, and this begins at the point of entry. NHS England also commissions health needs assessments across prisons to determine the needs and requirements of the prison population.

NHS England is reviewing the National Primary Care Service Specification to ensure it continues to meet the needs of the prison population.

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 adequacy of healthcare provision in prisons for inmates with diabetes; and what steps he is taking to ensure that diabetic prisoners have timely access to appropriate medical treatment.

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

NHS England commissions prison health care services into every prison in England. Every prison has onsite health care services including, primary care, mental health, dentistry, and substance misuse teams. This includes the care and management of those with long term conditions such as diabetes. All prisons offer a range of appointments to meet the needs of patients, and this includes routine appointments and urgent appointments.

NHS England commissions health care in prison that is the equivalence of community health care. The National Service Specification for primary care defines what this means for patients who require support. Access to health provision is available to every person in prison at any stage of their sentence, and this begins at the point of entry. NHS England also commissions health needs assessments across prisons to determine the needs and requirements of the prison population.

NHS England is reviewing the National Primary Care Service Specification to ensure it continues to meet the needs of the prison population.

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 for the potential implications for his policies of the BSL Advisory Board report on Health and Social Care, published on 27 November 2025.

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

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

We welcome the British Sign Language Advisory Board’s report titled Locked out: Exclusion of deaf and deafblind BSL users from health and social care in the UK. We will carefully consider its recommendations, including how, in the context of our work on the 10-Year Health Plan and reform of adult social care, we can improve the experiences of Deaf people when accessing health and care services and experience of Deaf people.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has reviewed the rate of uptake of biologic medicines for severe asthma relative to the eligible population.

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

The Department has not conducted any such review, but this information is available via the NHS England Innovation Scorecard, which is published bi-annually.

Across all disease areas, though the 10-Year Health Plan and the Life Sciences Sector Plan, the Government has commitment to reducing friction in the system to optimise access and uptake of new medicines so the most clinically and cost-effective can reach patients faster. These actions will speed up market access for new medicines and reduce local unwarranted variation in medicine use.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many and what proportion of departmental staff in each grade were rated in the top performance category in the last year.

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

Senior civil servants (SCS) and delegated grades follow different performance management frameworks. SCS’ operate within the framework for SCS performance management prescribed by Cabinet Office. For delegated performance there is a flexible framework that requires departments to reflect a number of core elements in their approach, including differentiating performance, addressing under and poor performance, and addressing diversity and inclusion. The following table shows the top ratings within the different performance management frameworks by grade and proportion, as of April 2025:

Notes:

1. the numbers rated in the top performance category are rounded to the nearest five; and
2. the proportion is calculated based on employees who received a performance rating.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the average number of working days lost to sickness absence per full-time equivalent member of staff was in (a) the Department and (b) its executive agencies in the last year; and how many formal performance warnings were issued to staff whose absence exceeded departmental triggers.

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

The average number of working days lost per full-time equivalent member of staff in the Department in the period between October 2024 and September 2025, the most recent period for which records are available, was 5.12.

The average number of working days lost per full-time equivalent member of staff in the executive agencies over the same period was 8.22 in the UK Health Security Agency (UKHSA) and 5.71 in the Medicines and Healthcare products Regulatory Agency (MHRA).

There were no formal performance warnings issued against civil servants in the Department or the UKHSA between 1 December 2024 and 30 November 2025 where the civil servant was also issued a formal attendance warning for exceeding sickness trigger points.

There were four formal performance warnings issues to staff in the MHRA whose absence exceeded departmental triggers.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the total cost was of (a) settlement agreements and (b) special severance payments made to departing departmental staff in the last year.

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

During the period 1 December 2024 to 30 November 2025, the total cost of settlement agreements to the Department was £15,000. Under HM Treasury’s rules, payments made under settlement agreements are classed as Special Severance Payments.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many and what proportion of departmental staff were promoted (a) in-grade and (b) to a higher grade in the last year broken down by (i) performance marking in the previous year and (ii) grade.

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

As of 28 November 2025, the Department had 112 employees, or 3%, on a temporary promotion to a higher grade from their substantive grade. The following table shows the percentage of employees on temporary promotion, broken down by grade:

We have only recently started to capture performance markings on the system and so cannot provide a breakdown for last year. Due to the way our data is held, we are not able to provide a breakdown of the number or proportion of staff who were promoted to a higher grade whilst on temporary promotion.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many people have been employed by (a) the National Institute for Health and Care Excellence and (b) the Medicines and Healthcare products Regulatory Agency in each year since 2005.

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

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the annual budget was for the (a) National Institute for Health and Care Excellence and (b) Medicines and Healthcare products Regulatory Agency in each year since 2005.

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

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the annual budget was for the (a) Care Quality Commission, (b) UK Health Security Agency and (c) the Food Standards Agency in each year since 2005.

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

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many people have been employed by (a) the Care Quality Commission, (b) the UK Health Security Agency and (c) the Food Standards Agency in each year since 2005.

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

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

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 number of medical graduates who have been unable to secure training scheme posts in the last three years.

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

Upon entering the National Health Service after graduation, medical students enter a two-year period of foundation programme placements. The United Kingdom Foundation Programme Office has successfully allocated foundation programme places to all eligible applicants in each of the past three years. These total 10,634 applicants for the 2025 programme, 9,702 for the 2024 programme, and 8,655 in 2023.

Upon successful completion of the foundation programme most doctors choose to apply for speciality training programmes. Competition for speciality training posts has grown in recent years, in part due to the introduction of health and care visas in 2020, as well as the decision to remove the Resident Labour Market Test for doctors in 2020 which has meant that more international medical graduates are applying for speciality training places, increasing the number of candidates for roles.

The table below presents the number of specialist training program applicants and the number of available posts in England by round. The difference between these two numbers is not exactly the number of candidates unable to secure a position as some applicants may not meet the thresholds set for recruitment to specialty training and some may be offered a specialty training post but for a range of reasons do not take up that position.

Source: NHS England Medical Specialty Programme Applications Data.

Round one of the medical specialty application process includes applications to first year specialty training and core training programmes, often referred to as ST1 and CT1 respectively, and some ‘higher’ medical specialty training programmes, usually at year three, often referred to as ST3. Round two is for entry to most ‘higher’ medical specialty training programmes, ST3 or ST4. There will be a limited number of doctors who apply in a year to both rounds one and two.

The 10-Year Health Plan set out that 1,000 more specialty training places would be created over the next three years.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would have put in place emergency legislation in the new year which would prioritise UK and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the NHS for a significant period of time for specialty training. This would have applied for current applicants for training posts starting in 2026, and every year after that.

The British Medical Association has rejected the Government's offer and the Government will consider its next steps.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many individual applicants applied for specialty training places across all 65 medical specialties; and how many training places were available in 2025.

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

The Department holds data based on the application process for medical specialty training which allows the identification of unique applicants. This data is part of management information systems summarising information supplied in medical specialty training cycles. Applicants may have chosen to only apply to one specialty programme or may have made multiple applications within the year.

The following table shows the number of unique applicants in rounds one and two of medical specialty training for 2025 and the associated training places available across the United Kingdom:

Source: NHS England Medical Specialty Programme Applications Data.

Round one of the medical specialty application process includes applications to first year specialty training and core training programmes, often referred to as ST1 and CT1 respectively, and some ‘higher’ medical specialty training programmes, usually at year three, often referred to as ST3. Round two is for entry to most ‘higher’ medical specialty training programmes, ST3 or ST4. There will be a limited number of doctors who apply in a year to both rounds one and two.

Information on the number of applications and posts available for individual medical specialty training programmes is published annually by NHS England and can be found at the following link:

https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios

The 10-Year Health Plan set out that 1,000 more specialty training places would be created over the next three years.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would have put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would have applied for current applicants for training posts starting in 2026, and every year after that.

The British Medical Association has rejected the Government's offer and the Government will consider its next steps.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, who is the Chief Risk Officer for national security risks relating to the work of their Department.

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

Each risk in the National Risk Register has a designated Risk Owner, working within the lead Government department which is responsible for designated risk areas.

The Department’s roles and accountabilities in relation to overall risk, and responsibility for managing emergencies, are outlined on the GOV.UK website, at the following link:

https://www.gov.uk/government/organisations/department-of-health-and-social-care/about/our-governance

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what are the findings of the department’s business case on new private finance in the NHS.

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

As set out in the 10 Year Infrastructure Strategy (the Strategy) and the 10-Year Health Plan, in addition to significant capital investment, the Government would explore the feasibility of using new Public Private Partnership (PPP) models for taxpayer-funded projects in very limited circumstances, where they could represent value for money. This included the potential use of PPPs to deliver Neighbourhood Health Centres (NHCs).

A business case was developed by the Department and supported by National Infrastructure and Service Transformation Authority (NISTA). The business case was considered by ministers and has resulted in the announcement in the Budget published on 26 November 2025.

The Budget builds on the Strategy and the 10-Year Health Plan by confirming that the NHS Neighbourhood Rebuild Programme will deliver new NHCs through upgrading and repurposing existing buildings and building new facilities through a combination of public sector investment and a new model of PPPs.

This new PPP model is being developed by NISTA, and is supported by the Department, and will ensure private sector expertise is harnessed to deliver these assets on time and on budget.

The new model will build on lessons from the past and other models currently in use, and will draw on lessons learnt, including the National Audit Office’s 2025 report on private finance.

To ensure the NHC PPPs are managed transparently and are fiscally sustainable, these partnerships will be budgeted for as if they are on a balance sheet.

Delivering new NHCs through a combination of public investment and PPPs will also allow, for the first time, for evidence to be built and compared between different delivery models.

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 merits of funding neighbourhood health centres through alternative, non-private finance means.

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

At the Autumn Budget, we announced our commitment to deliver 250 Neighbourhood Health Centres (NHCs) through the NHS Neighbourhood Rebuild Programme. This will deliver NHCs through a mixture of refurbishments, to expand and improve sites over the next three years, and new-build sites opening in the medium term.

The first 120 NHCs are due to be operational by 2030, delivered through public private partnerships (PPPs) and public capital. 50 NHCs will be completed through the repurposing of the existing estate with public sector funding, and 70 through new builds by 2030. 80% of the new builds will be PPPs, with a further 20% coming from public sector investment.

The Spending Review has seen the Government provide £426 million over four years through the Utilisation and Modernisation Fund, upgrading general practice estates and supporting delivery of 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will publish his Department’s business case on new private finance in the NHS.

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

The Department has no plans to publish the Neighbourhood Health Centre (NHC) Public Private Partnership (PPP) Feasibility Programme Business Case. Publication is not standard practice for business cases outside of the Government’s Major Projects Portfolio. This was a strategic outline business case, the purpose of which was to scope and identify the preferred way forward for a new potential PPP model in line with the HM Treasury five case model.

The Department and the National Infrastructure and Service Transformation Authority (NISTA) will continue to work with the market to further develop the new PPP model for NHCs, with further engagement next year. The final design and development of this new PPP model for NHCs will be led by NISTA and will be co-designed by the Department.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will publish details of his Department new private finance model for building neighbourhood health centres and the business case completed for it.

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

The Department and the National Infrastructure and Service Transformation Authority (NISTA) will continue to work with the market to further develop the new Public Private Partnership (PPP) model for neighbourhood health centres (NHCs) with further engagement next year. The final design and development of this new PPP model for NHCs will be led by NISTA and co-designed by the Department.

The Department has no plans to publish the NHC PPP Feasibility Programme Business Case. Publication is not standard practice for business cases outside of the Government Major Projects Portfolio.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of pressures facing the NHS from a surge in flu cases and staff shortages this winter, in the context of maintaining safe patient care standards.

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

The Government is clear that patients should expect and receive the highest standard of care throughout the year, including during the busy winter period.

We started earlier and have done more than ever to prepare for winter this year. We continue to monitor the impact of winter pressures on the National Health Service over the winter months, providing additional support to services across the country as needed.

Flu is a recurring pressure that the NHS faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.

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

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 8 December (HL12316), in the most recent period for which figures are available, (1) what proportion of, and (2) how many, invoices for contracts carried out for the NHS in England are not paid and must subsequently be resubmitted.

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

This information is not held centrally as NHS England do not collect supplier payment information on behalf of National Health Service trusts.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many invoices submitted to the NHS for services provided by Mildmay Hospital remain unpaid.

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

This information is not held centrally as NHS England do not collect supplier payment information on behalf of National Health Service trusts.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of reports that a third of UK citizens have used AI chatbots for emotional support or social interaction and the implications for safeguarding and mental health policy frameworks.

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

No such assessment has been made. We recognise that people are facing unacceptably long waiting times to access mental health support. This is why we are transforming the current mental health system so people can access the right support, at the right time, in the right place.

Building on the 10-Year Health Plan, the NHS Medium Term Planning Framework, published on 24 October 2025, sets targets for integrated care boards in 2026/27 to improve quality and access to mental health services. This includes expanding NHS Talking Therapies and expanding coverage of mental health support teams in schools and colleges.

This builds on the significant progress we’ve made since July 2024 to hire almost 7,000 extra mental health workers. And by spring next year, over 900,000 children and young people will have access to a Mental Health Support team in schools and colleagues.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what discussions they have had with the General Medical Council about whether patients who ask for a doctor of a preferred sex will be told the biological sex or declared gender of that medical professional.

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

The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties.

The Government has had discussions with the GMC on this issue. The GMC’s Good Medical Practice states that professionals must act with honesty and integrity and ensure their conduct justifies patient’s trust in them and the public’s trust in the profession. They must also recognise a patient’s right to choose whether to accept their advice. It is up to individual healthcare providers, rather than the GMC, to consider patient requests for care based on sex.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what discussions they have had with the General Medical Council (GMC) about whether doctors are included on GMC registers by gender or biological sex.

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

The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties.

The GMC maintains the official register of registered medical practitioners. Under the Form and Content of the Register Regulations, the GMC records a doctor's gender rather than sex.

The Government has had some discussions with the GMC about this topic. In light of the Supreme Court ruling in the case of For Women Scotland v. The Scottish Ministers regarding the meaning of “sex” in the Equality Act 2010, the GMC is in the process of reviewing its policy position regarding the recording of a doctor’s gender or biological sex on its registers.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the total number of senior managers at NHS England who have left since 1 March and received a payment in lieu of notice, and what is the total amount of these payments; and how many senior managers received a payment in lieu of annual leave, and what is the total amount of those payments.

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

Five executive senior managers at NHS England have left since 1 March 2025 and received a payment in lieu of notice. These payments total £553,252.15. 12 executive senior managers at NHS England have left since 1 March 2025 and received a payment in lieu of annual leave. These payments total £124,015.62.

Abolish tuition fees for nurse training, reinstate the NHS nursing bursary, and forgive existing student loan debt for nurses working in the NHS.

We call on the Government to amend the law to ensure there are at least one non-wholemeal flour option without folic acid fortification, and to exempt organic flour from mandatory folic acid fortification requirement from December 2026.

We ask the Government to undertake a review of the suitability of using BMI in NHS care and school health assessments, with a view to ensuring that NHS and educational health practices are fit for the 21st century and align with modern, evidence-based tools that truly support wellbeing.

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

Question to the Department for Work and Pensions:

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

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

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

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

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

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

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

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

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

Question to the Department for Education:

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

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

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

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

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

Question to the Department for Education:

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

Answered by Georgia Gould - Minister of State (Education)

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

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

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

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

Question to the Department for Education:

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

Answered by Georgia Gould - Minister of State (Education)

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

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

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

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

Found: Public Health Strategic Advisor, National Institute for Health and Care Research, Department of Health and Social Care

Found: >Public Health Strategic Advisor National Institute for Health and Care Research Department of Health and Social Care

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

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

Found: 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 Department of Health and Social Care is seeking views in this consultation on proposals to further

Found: for Health and Social Care Parliamentary Under-Secretary of State Date Department of Health and Social Care

Found: still working our way through the policy and legal analysis of the recommendations but note that DHSC

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