Lord Hunt of Kings Heath

In academic year 2020-21, Research England allocated £66.4 million to Mathematical Sciences. This financial year the Engineering and Physical Sciences Research Council, part of UK Research and Innovation (UKRI), is forecasting a spend of £50.975 million on Mathematical Sciences research in English universities. Plans for funding for future years will be dependent on the outcome of the recently announced Spending Review.

In academic year 2020-21, Research England allocated £66.4 million to Mathematical Sciences. This financial year the Engineering and Physical Sciences Research Council, part of UK Research and Innovation (UKRI), is forecasting a spend of £50.975 million on Mathematical Sciences research in English universities. Plans for funding for future years will be dependent on the outcome of the recently announced Spending Review.

Universities are independent, autonomous organisations and are therefore responsible for their decisions relating to research priorities and which activities to support.

The Government is committed to ensuring fair pay and we are clear that all workers should be treated with dignity and decency. We have announced that in April 2020 the National Living Wage (NLW) will increase by 6.2 per cent to £8.72 for those aged 25 and over. This increase will mean that a full-time worker will see their pay increase by £930 over the year.

The Government considers the expert and independent advice of the Low Pay Commission (LPC) when setting the rates. The LPC draws on a wide range of analysis to make its recommendations – this includes independent research, stakeholder evidence and a consideration of impacts on businesses.

Workers who believe that they have been underpaid the minimum wage or treated unfairly at work may wish to contact the Advisory, Conciliation and Arbitration service (Acas) for impartial information and advice.

The Associated Board of the Royal Schools of Music is a registered charity (charity number 292182). The Charity Commission for England and Wales expects charities to have and adhere to a robust conflict of interests policy.

The Charity Commission is aware of, and assessing, concerns raised about the Associated Board of the Royal Schools of Music.

For the 2021/22 financial year, the government contributed over £1.6 billion to the Teachers’ Pension Scheme. For the 2020/21 financial year, the Government contributed over £1.7 billion.

The government does not make any explicit contribution on behalf of any sector but does contribute to the overall cost of pension payments where these exceed the total contributions received in any year.

Independent schools are allowed to participate in the scheme, on a voluntary basis, to help facilitate the movement of staff between the state and private sectors. This benefits all sectors by enhancing opportunities for sharing best practice.

The government has not undertaken any such analysis of the potential advantages of ending arrangements by which private schools are permitted to participate in the Teachers’ Pension Scheme.

For the 2021/22 financial year, the government contributed over £1.6 billion to the Teachers’ Pension Scheme. For the 2020/21 financial year, the Government contributed over £1.7 billion.

The government does not make any explicit contribution on behalf of any sector but does contribute to the overall cost of pension payments where these exceed the total contributions received in any year.

Independent schools are allowed to participate in the scheme, on a voluntary basis, to help facilitate the movement of staff between the state and private sectors. This benefits all sectors by enhancing opportunities for sharing best practice.

The government has not undertaken any such analysis of the potential advantages of ending arrangements by which private schools are permitted to participate in the Teachers’ Pension Scheme.

For the 2021/22 financial year, the government contributed over £1.6 billion to the Teachers’ Pension Scheme. For the 2020/21 financial year, the Government contributed over £1.7 billion.

The government does not make any explicit contribution on behalf of any sector but does contribute to the overall cost of pension payments where these exceed the total contributions received in any year.

Independent schools are allowed to participate in the scheme, on a voluntary basis, to help facilitate the movement of staff between the state and private sectors. This benefits all sectors by enhancing opportunities for sharing best practice.

The government has not undertaken any such analysis of the potential advantages of ending arrangements by which private schools are permitted to participate in the Teachers’ Pension Scheme.

For the 2021/22 financial year, the government contributed over £1.6 billion to the Teachers’ Pension Scheme. For the 2020/21 financial year, the Government contributed over £1.7 billion.

The government does not make any explicit contribution on behalf of any sector but does contribute to the overall cost of pension payments where these exceed the total contributions received in any year.

Independent schools are allowed to participate in the scheme, on a voluntary basis, to help facilitate the movement of staff between the state and private sectors. This benefits all sectors by enhancing opportunities for sharing best practice.

The government has not undertaken any such analysis of the potential advantages of ending arrangements by which private schools are permitted to participate in the Teachers’ Pension Scheme.

The General Teaching Council for England (GTCE) was in place from 2000 to 2012 and was funded through registration fees. The department’s data retention policy is 6+1 years. As such, we no longer have access to data relating to the period 2000 to 2012.

The ‘Transparency and Freedom of Information releases’ contains information about the GTCE’s Annual Report and Financial Statements from 2005 to 2012. This can be accessed at: https://www.gov.uk/search/transparency-and-freedom-of-information-releases?organisations%5B%5D=general-teaching-council-for-england&parent=general-teaching-council-for-england.

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’s Treasury’s (HMT) announcement on 30 March 2023 of the Government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise. That is why the Government has committed to providing funding for the 2024/25 financial year for centrally funded employers, like maintained schools and academies, to help address the impacts involved.

The Department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’s Treasury’s (HMT) announcement on 30 March 2023 of the government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise.

The department appreciates that the independent schools that choose to participate in the TPS will therefore be faced with an increase in employee-related costs. Mindful of this and their need to plan, the department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

817 employers providing private education for school age children are currently participating in the TPS.

A total of 333 employers providing private education for school age children have stopped participating in the TPS in the last five years. This comprises 96 in 2019, 110 in 2020, 82 in 2021, 38 in 2022 and 7 in 2023. Additionally in the last five years, a further 90 such employers have taken the option of a phased withdrawal meaning they will continue participating for existing teaching staff only. This comprises 14 in 2021 (when the phased withdrawal policy was introduced), 62 in 2022 and 14 in 2023 (the latter including two establishments with future withdrawal dates).

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’s Treasury’s (HMT) announcement on 30 March 2023 of the government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise.

The department appreciates that the independent schools that choose to participate in the TPS will therefore be faced with an increase in employee-related costs. Mindful of this and their need to plan, the department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

817 employers providing private education for school age children are currently participating in the TPS.

A total of 333 employers providing private education for school age children have stopped participating in the TPS in the last five years. This comprises 96 in 2019, 110 in 2020, 82 in 2021, 38 in 2022 and 7 in 2023. Additionally in the last five years, a further 90 such employers have taken the option of a phased withdrawal meaning they will continue participating for existing teaching staff only. This comprises 14 in 2021 (when the phased withdrawal policy was introduced), 62 in 2022 and 14 in 2023 (the latter including two establishments with future withdrawal dates).

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’s Treasury’s (HMT) announcement on 30 March 2023 of the government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise.

The department appreciates that the independent schools that choose to participate in the TPS will therefore be faced with an increase in employee-related costs. Mindful of this and their need to plan, the department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

817 employers providing private education for school age children are currently participating in the TPS.

A total of 333 employers providing private education for school age children have stopped participating in the TPS in the last five years. This comprises 96 in 2019, 110 in 2020, 82 in 2021, 38 in 2022 and 7 in 2023. Additionally in the last five years, a further 90 such employers have taken the option of a phased withdrawal meaning they will continue participating for existing teaching staff only. This comprises 14 in 2021 (when the phased withdrawal policy was introduced), 62 in 2022 and 14 in 2023 (the latter including two establishments with future withdrawal dates).

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’ Treasury’s (HMT) announcement on 30 March 2023 of the government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise. That is why HMT has committed to continue discussions with the department on the impact for TPS employers in the higher education sector.

The Department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

Work on finalising the 2020 valuation of the Teachers’ Pension Scheme (TPS) is still ongoing and the department expects to be able to publish the outcome in late summer.

There are several policy decisions and scheme-based assumptions still to be determined that could affect the final outcome, which means it is not possible at this stage to accurately assess the likely impact on scheme employers. Following His Majesty’s Treasury’s (HMT) announcement on 30 March 2023 of the government’s response to the consultation on the methodology for determining the discount rate to be applied in the valuation of public service schemes, it is expected that the contribution rate for the TPS will need to rise. That is why the government has committed to providing funding for the 2024/25 financial year for centrally funded employers, including those in the further education sector, to help address the impacts involved.

The department is working with HMT and the actuary for the TPS, the Government Actuary’s Department, to progress the TPS valuation as quickly as possible. Regular updates will continue to be provided to the groups representing employers and members.

While the department is now collecting daily attendance data from 78% of schools, data is not held specifically on the effect of days such as World Book Day or other non-uniform days on school attendance.

The government does not determine whether schools have non-uniform days. Many pupils enjoy such events, and they can help to support worthy causes.

Safe and well-maintained school buildings that support a high-quality education are a priority for the department. That is why we have committed £1.8 billion in the 2022/23 financial year to improve school buildings across England, as part of over £13 billion allocated since 2015.

In addition, the School Rebuilding Programme will carry out major rebuilding and refurbishment projects at 500 schools across England, with buildings prioritised based on their condition. There are now 400 projects in the programme. The most recent set of 239 schools were announced in December 2022. All new buildings in the programme are designed to the department’s standards, including being net zero carbon in operation.

This financial year, eligible schools have also received an allocation from an additional £447 million in capital funding for improvements to buildings and facilities, prioritising works to improve energy efficiency.

The department has carried out the Condition Data Collection (CDC) to understand the condition of the school estate in England and how it is changing over time. This directly informs investment in the condition of school buildings. Individual CDC reports are shared with every school and the academy trusts and local authorities responsible for those schools, to help inform their investment plans alongside their own more detailed condition surveys and safety checks. CDC2 is currently underway to ensure the department maintains an up-to-date understanding of the condition of school buildings.

The department is committed to supporting working families and parents back into employment, by improving the cost, choice, and availability of childcare. We are currently exploring a wide range of options to achieve this ambition.

The consultation on Childcare: Regulatory Changes, closed on 16 September 2022, and the department will respond in due course. We consulted on:

• Moving to the Scottish staff-to-child ratios for two-year-olds, from a ratio of 1:4 to 1:5.
• Amending early years foundation stage framework wording on childminder ratios, so it is clear that childminders have flexibility within their ratios in circumstances where they are caring for sibling children, or their own child.
• Seeking views on further options for reforming ratios in future, working with the sector and parents to shape the future regulatory framework.

The department’s priority continues to be to provide safe, high-quality, and affordable early years provision for our youngest children.

Officials have discussed with local authorities and Dioceses in Education Investment Areas (EIAs) the strategic needs of their areas and how area-based commissioning of trusts might take place. That exercise is leading to the development of statements that the department expects to publish later this year.

In addition, regulations came into force on 1 September enabling the Secretary of State for Education to intervene in schools judged as Requires Improvement by Ofsted which were also judged below Good at their previous inspection, where they are not making the necessary improvements. The department plans to write to schools in EIAs informing them that they are eligible for intervention and inviting them to make representations.

Officials have discussed with local authorities and Dioceses in Education Investment Areas (EIAs) the strategic needs of their areas and how area-based commissioning of trusts might take place. That exercise is leading to the development of statements that the department expects to publish later this year.

In addition, regulations came into force on 1 September enabling the Secretary of State for Education to intervene in schools judged as Requires Improvement by Ofsted which were also judged below Good at their previous inspection, where they are not making the necessary improvements. The department plans to write to schools in EIAs informing them that they are eligible for intervention and inviting them to make representations.

The department has received 29 registrations of interest from local authorities interested in establishing a multi-academy trust through a test-and-learn exercise. The department is withholding the release of the names of the local authorities who submitted a registration of interest, as it has previously applied a Freedom of Information Act exemption to this information: Section 35(1)(a) relating to the formulation and development of government policy.

The department undertook a public interest test as required by the Act and concluded that not disclosing the information outweighed the public interest in disclosure.

The department will publish the names of the successful applications for the test-and-learn in due course.

Details of what Regional Directors consider when making decisions about trust growth are set out in 'Building strong academy trusts: Guidance for academy trusts and prospective converters' published in May 2021. Before approving a decision about growth, Regional Directors will consider the evidence about the educational and financial capacity of the academy trust. In doing so, they will consider the particular circumstances and maturity of the academy trust.

In addition, 'Implementing school system reform in 2022/23', published in May 2022, sets out that Regional Directors will adopt an area-based approach to commissioning. This will focus on quality first, identifying those trusts which are best placed to take on underperforming schools in these areas. Area-based commissioning will commence initially in education investment areas, prior to being rolled out across the country in due course.

The department has been clear that we will continue to fund some BTECs and other qualifications in future, where there is a clear need for skills and knowledge that A levels and T Levels cannot provide, and where they meet new quality standards. These will continue to play an important role for 16 to 19 year olds and adults. This includes for students taking qualifications such as BTECs as their full programme of study, where there is no A level or T Level, and those taking mixed programmes of A levels and other qualifications. We expect to fund small academic qualifications that should typically be taken alongside A levels in priority subject areas such as science, technology, engineering and mathematics (STEM) and in areas where an A level is not available, such as health and social care. We will set out the full approval criteria in due course.

The health T Level will help raise awareness amongst young people of the occupational choices within the healthcare sector and provide an opportunity for employers to strengthen their engagement with local schools and colleges. In addition, the health T Level will provide a pipeline of young talent who may move into Trainee Nursing Associate and Assistant Health Practitioner roles, later progressing to the registered occupations.

In November last year the department announced an extra year before our reforms are implemented, including the removal of overlapping qualifications. This extra year will allow the department to continue to support the growth of T Levels and gives more notice to providers, awarding organisations, employers, students and parents so that they can prepare for the changes.

The department’s guidance for completing the school census specifies that in this context, gender should be specified as either 'M' (male) or 'F' (female) (which may be different from the individual’s legal sex). This should be self-declared and recorded according to the wishes of the parent and/or pupil. The school census does not collect the ‘sex’ of pupils.

The department believes that this guidance is consistent, but the changing use of language in this area, and the evolving needs of the school population, have led to the department reviewing its data standards. The department intends to publish a new standard making a distinction between ‘sex’ and ‘gender’ in the coming months. School census guidance will need to be updated to conform to the new data standard.

The department’s guidance for completing the school census specifies that in this context, gender should be specified as either 'M' (male) or 'F' (female) (which may be different from the individual’s legal sex). This should be self-declared and recorded according to the wishes of the parent and/or pupil. The school census does not collect the ‘sex’ of pupils.

The department believes that this guidance is consistent, but the changing use of language in this area, and the evolving needs of the school population, have led to the department reviewing its data standards. The department intends to publish a new standard making a distinction between ‘sex’ and ‘gender’ in the coming months. School census guidance will need to be updated to conform to the new data standard.

In her letter of 6 November 2018, Her Majesty’s Chief Inspector (HMCI) recommended a review of the monitoring arrangements in place at the time and that new ones should be put in their place. Such a review was carried out by departmental officials, working alongside officials in Ofsted and at the Independent Schools Inspectorate (ISI). Following this review, new directions were issued to HMCI on 4 November 2019.

The new arrangements outlined above were aimed at giving greater flexibility to Ofsted and ISI to develop a joint programme of work to exchange and develop their mutual knowledge and understanding of inspecting independent schools.

It is worth noting that the School Inspection Service, which previously undertook inspections of some independent schools, has now closed and that there is now only one independent inspectorate, ISI. As such, and given the new directions issued on 4 November 2019, HMCI should no longer have regard to the matters in the February 2015 directions, which were the subject of the 6 November 2018 letter.

Children’s Homes (England) Regulations 2015 and accompanying statutory guidance, ‘Guide to the Children’s Homes Regulations including the quality standards’, include provisions around behaviour and restraint. Responsibility for the welfare of children while transported, including from one location to another, from a secure children’s home is noted in the protection of children quality standard, Regulation 12. The registered person and local authority overall have a responsibility to ensure that children are kept safe, and their welfare promoted.

All incidents of restraint when a young person is cared for by a children’s home must be recorded and made available to Ofsted during an inspection. If transportation is arranged by the local authority who has responsibility for the child, then the care of the child would fall to them. Where local authorities have contract arrangements with transport services, restraint should only be used in very limited circumstances, in accordance with government guidance on the use of restraint, and must always be necessary and proportionate.

During all inspections of children’s homes, inspectors assess all incidents of restraint. Where a provider has restrained a child in a way that does not comply with the regulations, Ofsted will take action. This can include suspension of a service if they believe that children are at risk due to the inappropriate use of restraint or restrictive practices.

Data is not collected by the Department for Education on the use of restraint. This is collected by Ofsted.

Legislation is in place to ensure that the use of restraint in respect of looked-after children is used in very limited circumstances and must be necessary and proportionate. Under the Children’s Homes (England) Regulations (2015), all incidents of restraint when a young person is cared for by a children’s home must be recorded.

Regulation 20(1) states that the only purposes for which restraint can be used in a children's home are to prevent injury to any person (including the child who is being restrained) or to prevent serious damage to the property of any person. In addition, restraint may be used on a child in a secure children's home for the purpose of preventing a child from absconding from the home. Regulation 20(2) states that restraint in relation to a child must be necessary and proportionate.

Similar regulations apply to children in foster care. Regulation 13(2)(b) of the Fostering Services (England) Regulations 2011 states that fostering service providers must take all reasonable steps to ensure that no child placed with a foster parent is subject to any measure of control, restraint or discipline which is excessive or unreasonable.

Ofsted regularly inspect all children’s homes in England to ensure they are complying with their legal duties, which include detailing incidents of restraint. Ofsted also inspects local authorities’ fostering services and independent fostering agencies to ensure they are meeting their duties and responsibilities. The department does not collect data on the use of handcuffs for children in the care system.

Legislation is in place to ensure that the use of restraint in respect of looked-after children is used in very limited circumstances and must be necessary and proportionate. Under the Children’s Homes (England) Regulations (2015), all incidents of restraint when a young person is cared for by a children’s home must be recorded.

Regulation 20(1) states that the only purposes for which restraint can be used in a children's home are to prevent injury to any person (including the child who is being restrained) or to prevent serious damage to the property of any person. In addition, restraint may be used on a child in a secure children's home for the purpose of preventing a child from absconding from the home. Regulation 20(2) states that restraint in relation to a child must be necessary and proportionate.

Similar regulations apply to children in foster care. Regulation 13(2)(b) of the Fostering Services (England) Regulations 2011 states that fostering service providers must take all reasonable steps to ensure that no child placed with a foster parent is subject to any measure of control, restraint or discipline which is excessive or unreasonable.

Ofsted regularly inspect all children’s homes in England to ensure they are complying with their legal duties, which include detailing incidents of restraint. Ofsted also inspects local authorities’ fostering services and independent fostering agencies to ensure they are meeting their duties and responsibilities. The department does not collect data on the use of handcuffs for children in the care system.

Legislation is in place to ensure that the use of restraint in respect of looked-after children is used in very limited circumstances and must be necessary and proportionate. Under the Children’s Homes (England) Regulations (2015), all incidents of restraint when a young person is cared for by a children’s home must be recorded.

Regulation 20(1) states that the only purposes for which restraint can be used in a children's home are to prevent injury to any person (including the child who is being restrained) or to prevent serious damage to the property of any person. In addition, restraint may be used on a child in a secure children's home for the purpose of preventing a child from absconding from the home. Regulation 20(2) states that restraint in relation to a child must be necessary and proportionate.

Similar regulations apply to children in foster care. Regulation 13(2)(b) of the Fostering Services (England) Regulations 2011 states that fostering service providers must take all reasonable steps to ensure that no child placed with a foster parent is subject to any measure of control, restraint or discipline which is excessive or unreasonable.

Ofsted regularly inspect all children’s homes in England to ensure they are complying with their legal duties, which include detailing incidents of restraint. Ofsted also inspects local authorities’ fostering services and independent fostering agencies to ensure they are meeting their duties and responsibilities. The department does not collect data on the use of handcuffs for children in the care system.

The department does not comment on resources from subject associations or other providers. The statutory Relationships, Sex and Health Education (RSHE) guidance sets out clear advice on choosing resources: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education. Schools should assess each resource they intend to use, to ensure that it is appropriate for the age and maturity of pupils, and sensitive to their needs.

The RSHE guidance and training resources have been designed to equip all schools to provide comprehensive teaching in these areas in an age-appropriate way. The guidance and materials should give schools the confidence to construct a curriculum that meets the needs of their pupils and reflects a diversity of views and backgrounds, whilst fostering all pupils’ respect for others, understanding of healthy relationships, and ability to look after their own wellbeing.

The department expects schools to consult with parents and to make reasonable decisions about the content of their curriculum.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

In April 2020, the government invested £100 million into laptops and 4G wireless routers for disadvantaged students to enable them to engage in remote learning. This was also made available for children with a social worker and care leavers, to improve digital access to support and services. The department has so far delivered over 220,000 laptops and tablets, and over 50,000 routers to local authorities to distribute to vulnerable children and young people in their local areas.

Of these devices, 148,000 have been provided specifically to children with a social worker and care leavers and the guidance issued to local authorities identified care leavers as a priority group. Responsibility for identifying which young people require devices lies with local authorities. The guidance is available here: https://www.gov.uk/guidance/laptops-tablets-and-4g-wireless-routers-provided-during-coronavirus-covid-19.

These devices are an important injection of support from the government for care leavers who are at greater risk of isolation and, alongside many excellent local initiatives, have helped to improve digital access for this cohort.

All local authorities have a duty to consult on and publish a local offer for their care leavers. This includes care leavers’ statutory entitlements, as well as any discretionary support and services that the local authority chooses to provide. Some local authorities have included supplying mobile phones, data packages or other forms of digital access for their care leavers during the COVID-19 outbreak, and may consider making this part of their local offer going forward.

Mark Riddell, the government’s National Adviser for care leavers, and departmental officials from the Care Leavers Policy Team are actively engaged with the organisations campaigning for better digital access for care leavers.

We want to support all young people to be happy, healthy, and safe. We also want to equip them for adult life and to make a positive contribution to society. That is why we are making Relationships Education compulsory for primary school-aged pupils, Relationships and Sex Education (RSE) compulsory for secondary school-aged pupils, and Health Education compulsory for pupils in all state-funded schools from September 2020.

In light of the circumstances caused by the COVID-19 outbreak, and following engagement with the sector, the department is reassuring schools that although the subjects will still be compulsory from 1 September 2020, schools have flexibility over how they discharge their duty within the first year of compulsory teaching.

The safety of children is our top priority. We expect all schools to ensure that the materials and teaching resources they use are appropriate, and to ensure that they comply with their statutory duty to safeguard children’s welfare. The statutory guidance sets out clear advice on choosing resources. Schools should assess each resource they intend to use to ensure that it is appropriate for the age and maturity of pupils, and sensitive to their needs, where relevant.

The department does not recommend specific resources but has suggested resources for schools to consider as set out in Annex B of the statutory guidance. We encourage schools to use resources that have been quality assured by reputable organisations, such as the NSPCC on safeguarding issues. The department will be providing further advice to schools on choosing appropriate resources and is developing teacher training modules for these subjects, which the department has quality assured and recommends.

Schools must consult with parents on the school’s RSE policy. Schools should also ensure that, when they engage parents, they provide examples of the resources they plan to use, for example the books or materials they will use in lessons. The statutory guidance can be accessed via the following link: https://www.gov.uk/government/publications/relationships-education-relationships-and-sex-education-rse-and-health-education.

In covering the content of the new subjects, the guidance also sets out schools’ duty to comply with relevant requirements of the Equality Act 2010 including the Public Sector Equality Duty. Schools should also be aware of their duties regarding impartiality and balanced treatment of political issues in the classroom to ensure content is handled in an appropriate way.

At the heart of these subjects there is a focus on keeping children safe, and schools can play an important role in preventative education. Keeping Children Safe in Education (KCSIE) sets out that all schools and colleges should ensure children are taught about safeguarding, including how to stay safe online, as part of providing a broad and balanced curriculum. The guidance can be accessed via the following link: https://www.gov.uk/government/publications/keeping-children-safe-in-education--2.

Ofqual conducted a public consultation from 15-29 April, seeking views on aspects of the proposed assessment arrangements for GCSEs, AS and A levels, including standardisation of centre assessment grades. Ofqual received over 12,500 responses to their consultation, and on 22 May they published their decisions.

Ofqual have decided not to include the trajectory of exam centres’ results in the statistical standardisation process. This is due to potential unfairness caused by the unreliability of any trajectory predictions and the disadvantage that this might cause students in those centres with stable results.

Whilst this is a matter for Ofqual as the independent regulator of qualifications, I am satisfied that Ofqual’s approach is the best solution given these extraordinary circumstances.

We are working with Public Health England to update the School Food Standards in relation to sugar and fibre.

On 7 May and 6 November 2019, we brought together an advisory group comprising of key stakeholders in the food, nutrition and health sectors. These stakeholders hold a wide breadth of knowledge and expertise in relation to school food. This was to discuss the proposed updates to the standards; we are considering those views and the next steps.

We will release more information on our plans for the update shortly.

Birmingham City University, of which The Royal Birmingham Conservatoire is a part, is registered with the Office for Students (OfS) in the approved (fee cap) category of the OfS’s register. It is funded by government, via the OfS, in a way that is consistent with the approach the OfS takes to other such providers, including those in London. While the Secretary of State for Education issues strategic guidance to the OfS, including its funding priorities, the OfS is ultimately responsible for funding decisions. The OfS is planning to review its funding method, including for specialist providers, and will consult on those changes in due course.

We do not have any plans to review the remit of the OfS in relation to their funding powers.

Birmingham City University, of which The Royal Birmingham Conservatoire is a part, is registered with the Office for Students (OfS) in the approved (fee cap) category of the OfS’s register. It is funded by government, via the OfS, in a way that is consistent with the approach the OfS takes to other such providers, including those in London. While the Secretary of State for Education issues strategic guidance to the OfS, including its funding priorities, the OfS is ultimately responsible for funding decisions. The OfS is planning to review its funding method, including for specialist providers, and will consult on those changes in due course.

We do not have any plans to review the remit of the OfS in relation to their funding powers.

Securing further improvement in the quality of the children’s social care system is a priority. We welcome the contribution both of these reports make to these efforts. Whilst local authorities are responsible for the deployment of child and family social workers, the government is continuing to invest in practice improvement. This includes our £84 million investment in the Strengthening Families, Protecting Children programme; and securing better research and evidence about practice and the social work workforce such as through the What Works for Children’s Social Care. Our large-scale longitudinal study of child and family social workers will provide significant insights into the experience of child and family social workers and will help both the government and employers identify priorities for action.

Securing further improvement in the quality of the children’s social care system is a priority. We welcome the contribution both of these reports make to these efforts. Whilst local authorities are responsible for the deployment of child and family social workers, the government is continuing to invest in practice improvement. This includes our £84 million investment in the Strengthening Families, Protecting Children programme; and securing better research and evidence about practice and the social work workforce such as through the What Works for Children’s Social Care. Our large-scale longitudinal study of child and family social workers will provide significant insights into the experience of child and family social workers and will help both the government and employers identify priorities for action.

Integrated care boards (ICBs) in England should have procurement policies in place that provide assurances to their respective Boards that procurement processes are conducted in a fair and open process which is compliant with relevant legislation such as:

- National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013;

- Public Contracts Regulations 2015;

- Health and Social Care Act 2012;

- Equality Act 2010; and

- Managing Public Money 2023.

All three ICBs have undertaken “lessons learnt” reviews following the judgement of the Court.

NHS Gloucestershire ICB’s Lessons Learnt report was approved by its Audit Committee on 8 September 2022. All recommendations from this report have been implemented by the ICB’s Board. The report has not been published externally but is used by NHS Gloucestershire ICB to train and educate its staff.

Integrated care boards (ICBs) in England should have procurement policies in place that provide assurances to their respective Boards that procurement processes are conducted in a fair and open process which is compliant with relevant legislation such as:

- National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013;

- Public Contracts Regulations 2015;

- Health and Social Care Act 2012;

- Equality Act 2010; and

- Managing Public Money 2023.

All three ICBs have undertaken “lessons learnt” reviews following the judgement of the Court.

NHS Gloucestershire ICB’s Lessons Learnt report was approved by its Audit Committee on 8 September 2022. All recommendations from this report have been implemented by the ICB’s Board. The report has not been published externally but is used by NHS Gloucestershire ICB to train and educate its staff.

Integrated care boards (ICBs) in England should have procurement policies in place that provide assurances to their respective Boards that procurement processes are conducted in a fair and open process which is compliant with relevant legislation such as:

- National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013;

- Public Contracts Regulations 2015;

- Health and Social Care Act 2012;

- Equality Act 2010; and

- Managing Public Money 2023.

All three ICBs have undertaken “lessons learnt” reviews following the judgement of the Court.

NHS Gloucestershire ICB’s Lessons Learnt report was approved by its Audit Committee on 8 September 2022. All recommendations from this report have been implemented by the ICB’s Board. The report has not been published externally but is used by NHS Gloucestershire ICB to train and educate its staff.

Integrated care boards (ICBs) in England should have procurement policies in place that provide assurances to their respective Boards that procurement processes are conducted in a fair and open process which is compliant with relevant legislation such as:

- National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013;

- Public Contracts Regulations 2015;

- Health and Social Care Act 2012;

- Equality Act 2010; and

- Managing Public Money 2023.

All three ICBs have undertaken “lessons learnt” reviews following the judgement of the Court.

NHS Gloucestershire ICB’s Lessons Learnt report was approved by its Audit Committee on 8 September 2022. All recommendations from this report have been implemented by the ICB’s Board. The report has not been published externally but is used by NHS Gloucestershire ICB to train and educate its staff.

NHS England is currently scoping a national programme of work on attention deficit hyperactivity disorder and a senior official will be asked to lead the work on NHS England’s behalf.

The Department is taking actions to help develop or extend fellowships to support brain tumour researchers. For example, in July 2023, the National Institute for Health and Care Research (NIHR) jointly funded with the Tessa Jowell Brain Cancer Mission (TJBCM), the first two TJBCM Neuro-Oncology Fellowships, a new Fellowship Programme to support high quality training in neuro-oncology clinical practice and research to ensure clinicians are equipped with the relevant research skills needed to lead neuro-oncology trials that change practice.

Other capacity-building initiatives underway include, the designation of 28 TJBCM adult Centres of Excellence within the National Health Service, creating a world-class network of brain tumour treatment and research centres to provide the best care and share best practice; the Tessa Jowell Academy Programme, a free national learning and networking digital platform for National Health Service brain tumour professionals to share excellence in research, treatment and care, and the TJBCM Brain Tumour Research Novel Therapeutics Accelerator programme, to review and provide guidance on the translation and development of novel treatments, guided by a multidisciplinary international group of experts.

The current Gloucestershire Integrated Care Board guidance on the prescribing of liothyronine was agreed by the former Gloucestershire Clinical Commissioning Group in April 2023. Any patients new to Gloucestershire will have their current clinical status reviewed within the existing local clinical pathway. This process will involve an initial ‘advice and guidance’ specialist review which, based on individual patient circumstances, will inform a decision on whether a more detailed specialist clinical review is indicated or not.

The intention is that ongoing treatment of a patient’s condition will normally continue whilst the clinical review process is completed. The outcome of this process is that local specialists, general practitioners, and patients can have a high level of confidence in the quality and standards of care provided to patients indicated for liothyronine on the National Health Service in Gloucestershire.

NHS England publishes details of data sharing agreements through a data uses register available on the NHS England website in an online-only format. Current and previous agreements with UK Biobank can be viewed by searching for them as a data controller.

Accredited counsellors and psychotherapists constitute a significant proportion of the NHS Talking Therapies workforce. A collaborative campaign to encourage accredited counsellors and psychotherapists to apply to work in NHS Talking Therapies services has been developed by NHS England with several of the counselling and psychotherapy professional bodies. These professionals are a vital part of our mental health workforce and are fully integrated within it, delivering psychological therapies for depression recommended by the National Institute for Health and Care Excellence.

The Department is working closely with the Tessa Jowell Brain Cancer Mission (TJBCM) in hosting customised workshops for researchers, and training for clinicians. These actions will grow capacity for brain cancer research, attracting new researchers, developing the community, and supporting researchers to submit high-quality research funding proposals.

The TJBCM recently announced two appointments to the inaugural Tessa Jowell Fellowship programme. These 12-month fellowships will support high quality training in neuro-oncology clinical practice and research, to ensure clinicians are equipped with the relevant research skills needed to lead neuro-oncology trials that change practice.

Additionally, the TJBCM have designated 28 adult Tessa Jowell Centres of Excellence within the National Health Service, which has created a world-class network of brain tumour treatment and research centres to provide the best care and share best practice.

Contracting decisions are made by commissioners, who must have the flexibility to commission partnerships, individuals, and private and third sector organisations to deliver general practitioner services within the National Health Service to meet the specific needs of their populations.

We are investing at least £2.3 billion extra funding a year in expanding and transforming mental health services in England by March 2024. This funding will help hubs to hire counsellors, youth workers and other local experts.

The drop-in centres offer mental health support and advice to local young people who will not need a referral by a doctor or school. Services provided include group work, counselling, psychological therapies, specialist advice and signposting to information and other services.

The NHS England Workforce, Training and Education directorate has developed a pilot programme to train graduates to become fully accredited psychotherapeutic counsellors who are qualified to work in NHS Talking Therapies services, providing therapies for depression recommended by the National Institute for Health and Care Excellence (NICE). This is a fully funded education pathway where trainees are salaried and their full tuition fees funded by the National Health Service. Counsellors and psychotherapists are also contributing to other pathways across the range of severity and types of mental health problems, where they have the required qualifications to deliver the relevant NICE recommended treatments.

Ministerial meetings with external organisations are routinely published on GOV.UK on a quarterly basis in an online-only format. A review of this data shows that there were five meetings between Departmental ministers and representatives from Babylon Health within the period 2013-2023.

The Department of Health and Social Care does not have any current plans to commission an independent review of Babylon Health.

In 2018, NHS Hammersmith and Fulham Clinical Commissioning Group and NHS England commissioned Ipsos Mori to undertake an independent evaluation of the Babylon GP at Hand practice. The final report was published in May 2019 and is publicly available.

The 2022/23 payments made by the National Health Service to general practice is published by NHS Digital. Over £11 million was paid to Babylon GP Practice, including Primary Care Network and COVID-19 payments (minus deductions) in 2022/23.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

Following discussion at the National Data Advisory Group in March, the Department raised with NHS England the possibility of changing the name of the interim Advisory Group for Data. There are no plans to direct NHS England to change the name.

The Department’s aim is to ensure Ministers receive the right insights to support their decisions, and ensure Ministers understand performance in the sector. The Private Office Data Science unit is a small, flexible team of analysts and data scientists from the Department’s analytical community that support the direct needs of the Secretary of State for Health and Social Care (Steve Barclay MP). The unit follows the same standards and governance as all analysts under the Director of Analysis, working directly with the rest of the analytical community to deliver data and analysis to support decision making. They are supported by expert data and analysis, from others in health and care system, working closely with our agencies and partners, with the unit as a conduit for these insights. As this is a flexible Private Office function, it does not have a pre-specified work programme.

The ‘Delivery plan for recovering access to primary care’, published by NHS England in May 2023, set out actions on how bureaucracy and workload can be cut by improving the interface between primary and secondary care, cutting unnecessary burdens on general practitioners through the Bureaucracy Busting Concordat, which was published in August 2022, and streamlining the Investment and Impact Fund from 36 to five indicators from 2023/24. Copies of both the delivery plan and the Concordat are attached.

Spending on general practice rose by nearly a fifth in real terms between 2017 and the most recent data in 2021. More specifically, spending grew from £11.3 billion in 2016/17 to £13.5 billion in 2021/22, representing a 19% increase in real terms.

General Practice (GP) partnerships, individually and through Primary Care Networks, deliver high quality care to patients all over the country. The Government continues to support the partnership model which has underpinned general practice since before the establishment of the National Health Service, and has many advantages. While partnerships holding a GP contract will continue to be in the majority, it is important that sustainable alternative models are available to mitigate difficulties in recruitment and retention.

The partnership model is not the only model currently delivering general practice. GP practices can and do choose to organise themselves in different ways to support scale and resilience, many of which cite evidence of good outcomes in terms of staff engagement and patient experience.

NHS England has committed to a review of the Additional Roles Reimbursement Scheme by the end of 2023. This work will cover the performance of the scheme to date and inform the Government’s approach to any future support for additional clinical roles in general practice.

In addition, the Department has funded, via the National Institute for Health and Care Research, a project to look at the impact of non-general practitioner staff in practices on patient care.

In response to feedback from the profession, work is being undertaken to review the current incentive schemes in primary care, with the aim of making them more focussed and streamlined to give clinicians the flexibility to provide care that is aligned with patient needs. We will consult the profession, patients, and the broader system on primary care incentives this year to inform future reform.

The NHS Long Term Workforce Plan commits to implementing the actions from the NHS People Plan, including ensuring staff can work flexibly. However, as independent contractors, it is for general practitioner practices to decide staffing levels and distribution of work across their teams.

The Advisory Group for Data (AGD) is convened by NHS England and builds on the previous work by the Independent Group Advising on the Release of Data (IGARD). Currently operating in interim form, it includes the members of IGARD, alongside a representative of the Caldicott Guardian of NHS England, the Data Protection Officer, and senior staff supporting on Data and Analytics.

It provides NHS England with access to expert advice and assurance on internal and external access to data in relation to the exercise of NHS England’s functions transferred to it from NHS Digital, including on specific requests for the dissemination of information in accordance with the statutory guidance issued by my Rt hon. Friend, the Secretary of State for Health and Social Care. Its minutes are published on the NHS England website.

The National Data Advisory Group (NDAG) is convened by the Department to provide strategic policy advice on data and data sharing, including the implementation of Data Saves Lives, the data strategy. It does not advise on specific data sharing requests and has a different membership to the ADG. NDAG includes, among others, the National Data Guardian for Health and Social Care, the Chair of the Academy of Medical Royal Colleges and the Chief Executive of the Patient’s Association.

No specific assessment has been made of the number of continence care specialists within the National Health Service workforce. NHS England publishes Hospital and Community Health Service workforce statistics for England, including by NHS trust. The published data is not though able to identify staff specialising in continence care.

The modelling and staff training plans presented in the NHS Long Term Workforce Plan look at the NHS as a whole at a high level to inform Government decisions on the workforce the NHS will need to meet the changing needs of the population over the next 15 years. This is designed to identify the right supply of staff across all clinical pathways and specialisms rather than workforce plans for specific services.

NHS England's Excellence in Continence Care guidance published in July 2018 brings together evidence-based resources and research for guidance for integrated care boards (ICBs), National Health Service providers, health and social care staff. It indicates that personalised care including personal health budgets can be arranged locally by ICBs to help people manage and pay for their continence care needs. A copy of the guidance is attached.

There are no plans at this stage to conduct a new National Audit of Continence Care.

NHS England will report on the National Bladder and Bowel Health Project setting out progress of development of Incontinence care pathways to its Excellence in Continence Care Board in October 2023. This will be published shortly afterwards setting out next steps for improving incontinence care pathways and will be shared with stakeholders for their consideration and input.

NHS England's Excellence in Continence Care guidance published in July 2018 brings together evidence-based resources and research for guidance for integrated care boards (ICBs), National Health Service providers, health and social care staff. It indicates that personalised care including personal health budgets can be arranged locally by ICBs to help people manage and pay for their continence care needs. A copy of the guidance is attached.

There are no plans at this stage to conduct a new National Audit of Continence Care.

NHS England will report on the National Bladder and Bowel Health Project setting out progress of development of Incontinence care pathways to its Excellence in Continence Care Board in October 2023. This will be published shortly afterwards setting out next steps for improving incontinence care pathways and will be shared with stakeholders for their consideration and input.

NHS England's Excellence in Continence Care guidance published in July 2018 brings together evidence-based resources and research for guidance for integrated care boards (ICBs), National Health Service providers, health and social care staff. It indicates that personalised care including personal health budgets can be arranged locally by ICBs to help people manage and pay for their continence care needs. A copy of the guidance is attached.

There are no plans at this stage to conduct a new National Audit of Continence Care.

NHS England will report on the National Bladder and Bowel Health Project setting out progress of development of Incontinence care pathways to its Excellence in Continence Care Board in October 2023. This will be published shortly afterwards setting out next steps for improving incontinence care pathways and will be shared with stakeholders for their consideration and input.

NHS England's Excellence in Continence Care guidance published in July 2018 brings together evidence-based resources and research for guidance for integrated care boards (ICBs), National Health Service providers, health and social care staff. It indicates that personalised care including personal health budgets can be arranged locally by ICBs to help people manage and pay for their continence care needs. A copy of the guidance is attached.

There are no plans at this stage to conduct a new National Audit of Continence Care.

NHS England will report on the National Bladder and Bowel Health Project setting out progress of development of Incontinence care pathways to its Excellence in Continence Care Board in October 2023. This will be published shortly afterwards setting out next steps for improving incontinence care pathways and will be shared with stakeholders for their consideration and input.

The Minister of State for Health and Secondary Care (Will Quince MP) is aware of this campaign and has exchanged correspondence with Young Lives vs Cancer on this matter.

The Government recognises that the cost of travel should not be a barrier to treatment. There are schemes, such as the Healthcare Travel Costs Scheme, in place to provide financial assistance for travel to a hospital or other National Health Service premises for specialist NHS treatment or diagnostics tests when referred by a doctor or other primary healthcare professional.

NHS England is responsible for determining allocations of individual resources to integrated care boards (ICBs), which are responsible for commissioning palliative and end of life care in response to the needs of their local population.

NHS England has no plans to publish the contribution made by each ICB to hospices or other end of life services, nor the proportion of total funding raised by hospices each contribution represents. ICB annual reports and accounts are published by each individual ICB and are available to the public via their websites.

There are no plans for the Government to fund individual hospices directly.

As stated in the Health and Care Act 2022, integrated care boards (ICBs) are responsible for commissioning palliative and end of life care services, which may include services delivered by independent charitable hospices, in response to the needs of their local population. NHS England has actively increased its support to local commissioners to improve the accessibility, quality and sustainability of palliative and end of life care services for all. This has included the publication of statutory guidance and service specifications.

The exception to funding hospices via ICBs is the Children’s Hospice Grant, which has provided funding direct to hospices since 2007. In June 2023, NHS England confirmed that it would be renewing the grant for 2024/25, once again allocating £25 million grant funding for children’s hospices. NHS England will confirm details of the allocation mechanism in due course.

The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services, other than primary care, and may be used in relation to hospices. The Contract (in full-length and shorter-form versions) has now been updated for 2023/24. As such, NHS England has no plans to introduce a model NHS hospice contract for integrated care boards.

Brain tumour research remains a challenging scientific area, with a relatively small research community. We are working closely with the Tessa Jowell Brain Cancer Mission (TJBCM) in hosting customised workshops for researchers, and training for clinicians. These actions will grow the capacity for brain cancer research, attracting new researchers, developing the community, and supporting researchers to submit high-quality research funding proposals.

The TJBCM recently announced two appointments to the inaugural Tessa Jowell Fellowship programme. These 12-month fellowships will support high quality training in neuro-oncology clinical practice and research, to ensure clinicians are equipped with the relevant research skills needed to lead neuro-oncology trials that change practice.

Additionally, the TJBCM have designated 28 adult Tessa Jowell Centres of Excellence within the National Health Service, which has created a world-class network of brain tumour treatment and research centres to provide the best care and share best practice.

The early access to medicines scheme (EAMS) aims to give patients with life threatening or seriously debilitating conditions access to medicines that do not yet have a marketing authorisation when there is a clear unmet medical need.

Under the scheme, the Medicines and Healthcare products Regulatory Agency (MHRA) will give a scientific opinion on the benefit/risk balance of the medicine, based on the data available when the EAMS submission was made and the EAMS criteria. The MHRA will make an evaluation of products, including drugs such as for brain tumour treatments, once an application is received.

If we do receive an application, it is only made public where an EAMS Scientific Opinion (SO) is awarded. All EAMS SOs are published on the EAMS webpage. All drugs that have previously held an EAMS SO are also published on the EAMS webpage.

The Medicines and Healthcare products Regulatory Agency (MHRA) is aware that customers who have submitted initial applications and amendments to our Clinical Investigations and Trials team have experienced extended timeframes in some cases, and understands how this unpredictability may be reducing the number of cancer drugs that can transition from a Phase 1 study to MHRA approval. To help improve the predictability of decision making in applications for clinical trials, the MHRA have implemented several actions.

The MHRA are looking at novel ways to develop staff capability and expertise. New assessor capacity is being supplemented with an additional fixed-term resource of appropriately experienced and qualified specialists to support the training and supervision of new staff and to help reduce the current backlog. The MHRA has also established links with the Association of the British Pharmaceutical Industry and the BioIndustry Association on clinical trials, to reduce the backlog of delayed applications, which may include applications for cancer drugs. Additionally, they have already reallocated work, and are evaluating queued applications for complexity, to improve the speed of assessment, and are changing processes to take a joined-up risk-proportionate approach.

The MHRA is committed to reducing these backlogs so that it makes regulatory decisions in accordance with statutory timeframes for all new fully compliant clinical trial applications received from 1 September 2023. This will enable more cancer drugs to progress from Phase 1 studies to MHRA approval where appropriate.

Following the United Kingdom’s departure from the European Union, the Medicines and Healthcare products Regulatory Agency has not had recent discussions with European health ministers regarding collaboration to capture data from clinical trials for less common cancers, such as brain tumours.

The class of medicines known as benzodiazepines include a number of active substances and have been extensively studied. Benzodiazepines are indicated for short-term (two to four weeks) use. All medicines are associated with some risks and these medicines are no exception.

Safety concerns that are established to be associated with a medicine are outlined in the product information available for each medicine, this includes possible side effects. The product information for benzodiazepines do not currently include a risk of Alzheimer's disease or lung cancer. However, there is a warning that patients with severe liver impairment may develop encephalopathy (damage or disease which affects the brain). In addition, the drug withdrawal reactions may include seizure and this may be more common in patients with pre-existing seizure disorders or who are taking other medicines which lower the seizure threshold such as antidepressants.

Local authorities (LAs) in England are responsible for commissioning drug treatment services, including specialist services for prescribed drug dependency. The Government’s 10-year drug strategy is underpinned by record new investment, including £532 million for LAs to invest in drug treatment and recovery services in addition to the public health grant. LAs’ individual financial allocations and assessment of local need will determine if specialist services for prescribed drug dependency are a viable intervention, and it is for LAs to make the assessment to resource this from their drug treatment funding.

The Office for Health Improvement and Disparities provide oversight of local delivery at a national level and continue to monitor implementation against the aims of the drug strategy.

The data requested is not held centrally.

The framework for action sets out five actions for integrated care boards (ICBs) to consider to further reduce inappropriate prescribing of high-strength painkillers and other addiction-causing medicines, like opioids and benzodiazepines.

ICBs should take a population health management approach using data on primary care prescribing and health inequalities to monitor implementation of the actions. This includes looking at data on access to services, patient experience feedback and outcomes for communities within the integrated care system that often experience health inequalities.

There are several data resources used to give insights to ICBs and foster improvement at the local level, with data being available on an Opioid Prescribing Comparators dashboard. This dashboard can be used to review up-to-date data, highlight variation, and support local work to reduce harm from the prescribing of dependence and withdrawal forming medicines, as well as equip users with the tools for ongoing monitoring. The dashboard will be continually reviewed and updated with more metrics and views. More data is also available on duration of treatment of opioids, benzodiazepines, and z-drugs, as well as the number of patients prescribed a dependence forming medicine who have received a structured medication review.

The information requested is not collected centrally.

Andrew Bennett is NHS England’s national clinical director for musculoskeletal conditions. His portfolio includes osteoporosis and fracture prevention.

General Practice Extraction Service data for pandemic planning and research has been used by Cohorting as a Service to identify patients in clinically at-risk groups to receive COVID-19 and influenza vaccinations. There are no plans to use this data within Cohorting as a Service for other purposes.

The safety of medicines on the United Kingdom market are continuously monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). There are currently no plans to conduct any further reviews into the harms associated with benzodiazepines, Z-drugs and antidepressants, however, any new data would be carefully considered. Details about the possible risks and side effects are outlined in the product information available for each medicine.

Benzodiazepines and Z-drugs are authorised for short term use, two to four weeks, and should not be used long term due to the risk of dependence and subsequent withdrawal reactions. Healthcare professionals have been reminded of these risks by the MHRA, the Department and professional bodies which have highlighted the extensive warnings about the risks of dependence, the need to limit prescribing and advice about gradual withdrawal.

The safety of medicines on the United Kingdom market are continuously monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). There are currently no plans to conduct any further reviews into the harms associated with benzodiazepines, Z-drugs and antidepressants, however, any new data would be carefully considered. Details about the possible risks and side effects are outlined in the product information available for each medicine.

Benzodiazepines and Z-drugs are authorised for short term use, two to four weeks, and should not be used long term due to the risk of dependence and subsequent withdrawal reactions. Healthcare professionals have been reminded of these risks by the MHRA, the Department and professional bodies which have highlighted the extensive warnings about the risks of dependence, the need to limit prescribing and advice about gradual withdrawal.

Legislative competence for alcohol pricing policy is devolved. A formal assessment has not been carried out, however we are following developments on alcohol policies in other nations closely to see what works.

Following BUPA’s notice to NHS England of closures, regional teams and integrated care boards across England are working together to ensure that patients continue to have access to National Health Service dental care. This includes an assessment to identify potential gaps in NHS dental service provision and to consider what actions may be required.

The Northeast and North Cumbria Integrated Care Board (ICB) is proactively issuing regular communications updates to patients and local stakeholders regarding the pressures facing National Health Service dentistry locally, whilst seeking to build resilience through local initiatives that seek to improve access to unscheduled urgent dental care for those in greatest clinical need.

Since taking on NHS Primary Care regulatory dental commissioning responsibility from NHS England on 1 April 2023, the Northeast and North Cumbria ICB have agreed to the establishment of a Local Dental Crisis Task and Finish Group to explore further ways in which the ICB could seek to address NHS dental access and workforce pressures in addition to the

NHS Long term workforce strategy, and also committed to an independent oral health review of the North East & North Cumbria area with a view to the findings becoming available by October 2023.

The steps outlined above will help to inform the ICB's future commissioning of NHS dental services. There are no plans to require ICBs to submit proposals on their commissioning of NHS dental services.

In July 2022, we announced a package of dental system improvements which outlined the steps we are taking to meet oral health need and increase access to dental care across all regions in England. We know more needs to be done and we continue to work with the sector and NHS England to consider further changes which will be announced shortly.

The Northeast and North Cumbria Integrated Care Board (ICB) is proactively issuing regular communications updates to patients and local stakeholders regarding the pressures facing National Health Service dentistry locally, whilst seeking to build resilience through local initiatives that seek to improve access to unscheduled urgent dental care for those in greatest clinical need.

Since taking on NHS Primary Care regulatory dental commissioning responsibility from NHS England on 1 April 2023, the Northeast and North Cumbria ICB have agreed to the establishment of a Local Dental Crisis Task and Finish Group to explore further ways in which the ICB could seek to address NHS dental access and workforce pressures in addition to the

NHS Long term workforce strategy, and also committed to an independent oral health review of the North East & North Cumbria area with a view to the findings becoming available by October 2023.

The steps outlined above will help to inform the ICB's future commissioning of NHS dental services. There are no plans to require ICBs to submit proposals on their commissioning of NHS dental services.

In July 2022, we announced a package of dental system improvements which outlined the steps we are taking to meet oral health need and increase access to dental care across all regions in England. We know more needs to be done and we continue to work with the sector and NHS England to consider further changes which will be announced shortly.

The Northeast and North Cumbria Integrated Care Board (ICB) is proactively issuing regular communications updates to patients and local stakeholders regarding the pressures facing National Health Service dentistry locally, whilst seeking to build resilience through local initiatives that seek to improve access to unscheduled urgent dental care for those in greatest clinical need.

Since taking on NHS Primary Care regulatory dental commissioning responsibility from NHS England on 1 April 2023, the Northeast and North Cumbria ICB have agreed to the establishment of a Local Dental Crisis Task and Finish Group to explore further ways in which the ICB could seek to address NHS dental access and workforce pressures in addition to the

NHS Long term workforce strategy, and also committed to an independent oral health review of the North East & North Cumbria area with a view to the findings becoming available by October 2023.

The steps outlined above will help to inform the ICB's future commissioning of NHS dental services. There are no plans to require ICBs to submit proposals on their commissioning of NHS dental services.

In July 2022, we announced a package of dental system improvements which outlined the steps we are taking to meet oral health need and increase access to dental care across all regions in England. We know more needs to be done and we continue to work with the sector and NHS England to consider further changes which will be announced shortly.

The Northeast and North Cumbria Integrated Care Board (ICB) is proactively issuing regular communications updates to patients and local stakeholders regarding the pressures facing National Health Service dentistry locally, whilst seeking to build resilience through local initiatives that seek to improve access to unscheduled urgent dental care for those in greatest clinical need.

Since taking on NHS Primary Care regulatory dental commissioning responsibility from NHS England on 1 April 2023, the Northeast and North Cumbria ICB have agreed to the establishment of a Local Dental Crisis Task and Finish Group to explore further ways in which the ICB could seek to address NHS dental access and workforce pressures in addition to the

NHS Long term workforce strategy, and also committed to an independent oral health review of the North East & North Cumbria area with a view to the findings becoming available by October 2023.

The steps outlined above will help to inform the ICB's future commissioning of NHS dental services. There are no plans to require ICBs to submit proposals on their commissioning of NHS dental services.

In July 2022, we announced a package of dental system improvements which outlined the steps we are taking to meet oral health need and increase access to dental care across all regions in England. We know more needs to be done and we continue to work with the sector and NHS England to consider further changes which will be announced shortly.

For the value-based procurement projects for absorbent continence products the proposed product category is disposable continence containment products. The scope is any patients/users who are receiving continence care from the NHS, at home, in care homes or residential homes and acute wards. Once the pilot site has been identified it is estimated to be six to eight weeks for completion. The methodology looks at baseline data of current impact of care pathway delivered in practice, review of information, clinical changes based on baseline, a review of impact of changes and a sign of savings before scaling across a trust. The assessment criteria will be confirmed with the pilot site.

The Rothwell scale is an industry standard to measure the working absorbency of disposable continence products, enabling transparency and comparability of products fluid management. Subjective quality metrics like ease of use and comfort, will be user dependent. Objective elements that contribute to subjective elements such as comfort are included. For example, specifications include elasticated flexible sides, guard channels to reduce leakage, super absorbent polymers to remove fluid from skin contact. When a trust selects a supplier, the trust will evaluate potential suppliers on the framework, evaluating the subjective, qualitative features of ease of use, comfort, comparative reduction in leakages, quality of life and health outcomes.

All National screening programmes are introduced based on recommendations made by the UK National Screening Committee (UK NSC). The UK NSC assesses and evaluates the evidence to offer screening when it will offer more good than harm. Screening age ranges are selected based on the range where the evidence supports that balance.

The National Health Service breast screening programme invites eligible women to be screened every three years from the age of 50 up to their 71st birthday.

The NHS bowel screening programme invited men and women every two years from ages 60 to 74 years old. The programme is expanding to make it available to everyone aged 50 to 59 years old. This is happening gradually over four years and started in April 2021.

The NHS cervical screening programme invites people with a cervix between the ages of 25 and 49 for screening every three years, whilst people aged 50 to 64 receive an invitation every five years.

The NHS abdominal aortic aneurysm screening programme offers men a screening the year they turn 65.

The NHS diabetic eye screening programme is offered to anyone with diabetes who is 12 years old or over. Those eligible are invited for an annual screening.

The NHS targeted lung cancer screening programme that has been recently announced will invite people aged 55 to 74 identified as being at high risk of lung cancer for screening.

For antenatal screening programmes, pregnant women are invited early for screening once the pregnancy has been confirmed. This includes the NHS foetal anomaly screening programme and NHS infectious diseases in pregnancy.

Screening for newborns is also offered early at a time when conditions can be detected and where early treatment can improve the baby’s health and prevent severe disability or even death. Newborn screening programmes include the NHS newborn blood spot screening programme, the NHS newborn hearing screening programme, the NHS newborn and infant physical examination screening programme and the NHS sickle cell and thalassaemia screening programme.

NHS England advises that it has sought views on the draft terms of reference for its Advisory Group for Data from the Department, The National Data Guardian, The Independent Group Advising (NHS Digital) on Release of Data prior to the legal merger, and subsequently the interim data advisory group established until terms of reference are finalised and approved and NHS England's Cyber Security and Risk Committee. The draft terms of reference are currently being updated to take into account feedback and once they have been approved by the Board or a sub-committee of the Board, NHS England advises it will publish them in line with the Statutory Guidance.

The statutory guidance on NHS England’s protection of patient data states that the data advisory group should, among other functions, be able to provide NHS England with advice as requested on "streamlining and continuously improving internal and external data access processes, using a clearly understood risk management framework, precedent approaches and standards that requests must meet". Once the terms of reference for the new group are approved and the group is in place NHS England will work, with the new group's advice, to agree an appropriate risk management framework including considering the form that might take, how it might be summarised or articulated, and what information about it should be published. Interim arrangements are in place while this new group is being established and advice is sought based on the published Data Access Request Service (DARS) Standards and Precedents in relation to applications for access to data. These arrangements and the advice provided by the group are reflected in the minutes of each meeting of the interim group.

NHS England advises that it has sought views on the draft terms of reference for its Advisory Group for Data from the Department, The National Data Guardian, The Independent Group Advising (NHS Digital) on Release of Data prior to the legal merger, and subsequently the interim data advisory group established until terms of reference are finalised and approved and NHS England's Cyber Security and Risk Committee. The draft terms of reference are currently being updated to take into account feedback and once they have been approved by the Board or a sub-committee of the Board, NHS England advises it will publish them in line with the Statutory Guidance.

The statutory guidance on NHS England’s protection of patient data states that the data advisory group should, among other functions, be able to provide NHS England with advice as requested on "streamlining and continuously improving internal and external data access processes, using a clearly understood risk management framework, precedent approaches and standards that requests must meet". Once the terms of reference for the new group are approved and the group is in place NHS England will work, with the new group's advice, to agree an appropriate risk management framework including considering the form that might take, how it might be summarised or articulated, and what information about it should be published. Interim arrangements are in place while this new group is being established and advice is sought based on the published Data Access Request Service (DARS) Standards and Precedents in relation to applications for access to data. These arrangements and the advice provided by the group are reflected in the minutes of each meeting of the interim group.

The National Health Service body mass index (BMI) calculator was temporarily removed from the NHS.UK website on 29 March 2023 due to the requirement to update the disclaimer and to remove the physical activity and calorie information which was no longer in line with latest health guidance. The BMI calculator, without the physical activity and calorie information, was made available again on 30 May 2023.

A new version of the BMI calculator is being developed to reflect the latest health guidance. A first release is expected to be available by November 2023.

Information about physical activity and guidance about eating a healthy, balanced diet continues to be available on the NHS.UK website.

The National Health Service body mass index (BMI) calculator was temporarily removed from the NHS.UK website on 29 March 2023 due to the requirement to update the disclaimer and to remove the physical activity and calorie information which was no longer in line with latest health guidance. The BMI calculator, without the physical activity and calorie information, was made available again on 30 May 2023.

A new version of the BMI calculator is being developed to reflect the latest health guidance. A first release is expected to be available by November 2023.

Information about physical activity and guidance about eating a healthy, balanced diet continues to be available on the NHS.UK website.

The National Health Service body mass index (BMI) calculator was temporarily removed from the NHS.UK website on 29 March 2023 due to the requirement to update the disclaimer and to remove the physical activity and calorie information which was no longer in line with latest health guidance. The BMI calculator, without the physical activity and calorie information, was made available again on 30 May 2023.

A new version of the BMI calculator is being developed to reflect the latest health guidance. A first release is expected to be available by November 2023.

Information about physical activity and guidance about eating a healthy, balanced diet continues to be available on the NHS.UK website.

NHS England defines bed equivalents as beds freed up through steps taken to avoid an admission to a general and acute bed in hospital, or to support a patient to leave a general and acute bed when they are medically fit to do so. This could include for example capacity within virtual wards or hospital at home schemes.

Following publication of the 2021 evidence-based review, the Department is taking forward a programme of work to modernise the NHS Health Check and deliver recommendations from the review. So far this has included, investing nearly £17 million for the development of an innovative digital NHS Health Check to bolster current local authority delivery of the programme. The digital health check, will be rolled out from Spring 2024, which will give users choice about where and when to have a check and enable increased overall uptake and improved efficiency of the programme. We are also improving uptake by supporting local authorities with the recovery of the programme following the COVID-19 pandemic by launching a training hub, showcasing innovative local delivery models and facilitating communities of practice, with activity reaching over 91% of pre-pandemic levels at the end of December 2022.

Following publication of the 2021 evidence-based review, the Department is taking forward a programme of work to modernise the NHS Health Check and deliver recommendations from the review. So far this has included, investing nearly £17 million for the development of an innovative digital NHS Health Check to bolster current local authority delivery of the programme. The digital health check, will be rolled out from Spring 2024, which will give users choice about where and when to have a check and enable increased overall uptake and improved efficiency of the programme. We are also improving uptake by supporting local authorities with the recovery of the programme following the COVID-19 pandemic by launching a training hub, showcasing innovative local delivery models and facilitating communities of practice, with activity reaching over 91% of pre-pandemic levels at the end of December 2022.

NHS Supply Chain has a value based procurement programme with a standard approach and principles in place to build a consistent interpretation of the concept of value based procurement. There are 30 projects across the organisation’s categories which are in scope for NHS Supply Chain’s pipeline for value-based procurement. NHS Supply Chain continues to work closely with NHS England on a joint evaluation approach.

NHS Supply Chain is running two value-based procurement projects specifically in the continence category area, which encompasses absorbent continence products. The relevant NHS organisations and suppliers are involved in the development of these projects to ensure that the outcomes fit the NHS’s requirements. These projects are following the standard approach and principles as outlined on NHS Supply Chain’s website.

The Department’s Medical Technology Directorate is working closely with NHS Supply Chain and NHS England to implement a consistent methodology for value-based procurement to be adopted at a national and local level. The directorate will continue to engage with both industry and patients in the development of this and other policies.

As of February 2023, 877,000 patients on atrial fibrillation registers from their general practice who were eligible for anticoagulation received treatment. The percentage of patients treated with anticoagulation increased by 7% between April 2022 and February 2023, equivalent to over 130,000 additional patients.

A list of ‘purposes’ and how many users there are for each individual purpose is attached, due to the size of the data. Notes have been included indicating those purposes that are for administrative use and those that have been deprecated since the previous answer and so no longer exist.

As part of the Value Based Procurement (VBP) programme, NHS Supply Chain (NHSSC) has developed a toolkit and two VBP models. The toolkit and models are designed for internal use by NHSSC’s procurement teams and Category Management Service Providers and are not available for publication as they are commercially sensitive.

Recognising the public interest in openness, transparency and accountability in public procurement, NHSSC is supporting awareness of VBP across the National Health Service and the supplier community. NHSSC has a dedicated VBP website that is updated as the programme evolves. This website contains the 2021 ‘Value Based Procurement Project Report and Findings’ that has an overview of the VBP toolkit.

The Health and Care Act 2022 (Consequential and Related Amendments and Transitional Provisions) Regulations 2022 SI/634 has made consequential amendments to regulation 2 of the NHS Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, replacing references to Clinical Commissioning Groups with integrated care boards (ICBs). ICBs are now the statutory bodies responsible for patient rights.

The disposable continence framework in place at NHS Supply Chain runs until August 2025. All suppliers and products on the NHS Supply Chain framework must meet industry standards and a quality specification to be awarded onto the framework. Products are categorised using the Rothwell scale which measures the level of absorbency.

NHS Supply Chain are currently in the process of working on two separate value-based procurement projects, both of which aim to concentrate on the key fundamental areas outlined in the question.

In addition, the Government's new Medical Technology Strategy, published in February 2023, identified incontinence products as one area of focus. The Department will work with clinicians to review, assess and categorise similar products to lay the foundations for value-based procurement. This assessment of products will be shared with NHS Supply Chain and other organisations involved in the purchase of incontinence products.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes it uses in the development of its guidance, including the discount rate, taking into account its responsibilities under Managing Public Money.

NICE concluded a comprehensive review of its methods and processes in 2022, including consideration of the discount rate. Following public consultation, NICE concluded that it was appropriate to maintain the existing rate of 3.5% due to policy and fiscal implications and interdependencies beyond the scope of the review. The Department and HM Treasury were engaged throughout the review.

NICE is introducing a new modular approach for further methods updates, where it will work with its system partners on the methodological priorities for the healthcare system.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes it uses in the development of its guidance, including the discount rate, taking into account its responsibilities under Managing Public Money.

NICE concluded a comprehensive review of its methods and processes in 2022, including consideration of the discount rate. Following public consultation, NICE concluded that it was appropriate to maintain the existing rate of 3.5% due to policy and fiscal implications and interdependencies beyond the scope of the review. The Department and HM Treasury were engaged throughout the review.

NICE is introducing a new modular approach for further methods updates, where it will work with its system partners on the methodological priorities for the healthcare system.

Funding decisions for health services in England are made by integrated care boards and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.

The Women’s Health Strategy was published on 20 July 2022 and contained a number of important changes and future ambitions to improve the variations in access to National Health Service funded fertility services. Among the initial priorities, we will work with NHS England to eliminate unfair financial burdens faced by female same-sex couples when accessing NHS funded services and to remove non-clinical access criteria.

In preparation for the new NICE fertility guideline due to be published in 2024, which sets the standard for clinical care, we expect local NHS commissioners to be improving their offer to fertility patients in anticipation of implementing the new guideline.

Funding decisions for health services in England are made by integrated care boards and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.

The Women’s Health Strategy was published on 20 July 2022 and contained a number of important changes and future ambitions to improve the variations in access to National Health Service funded fertility services. Among the initial priorities, we will work with NHS England to eliminate unfair financial burdens faced by female same-sex couples when accessing NHS funded services and to remove non-clinical access criteria.

In preparation for the new NICE fertility guideline due to be published in 2024, which sets the standard for clinical care, we expect local NHS commissioners to be improving their offer to fertility patients in anticipation of implementing the new guideline.

The Government has stated its intention to expand water fluoridation across the North-East of England, subject to consultation, to reach an additional 1.6 million people. It plans to hold the public consultation on the proposed expansion in the North-East in 2023. Following the consultation, we will provide an update on the proposals for water fluoridation.

The Government has no powers to prosecute unregulated overseas prescribers, but arrangements are in place to safeguard patients as follows.

The UK currently recognises prescriptions from countries on an approved list. A prescription from a country not on the list would not be recognised. We will only recognise prescriptions issued by prescribers of equivalent professional status to those eligible to prescribe in the UK.

We would expect all registered pharmacies and pharmacists to meet the regulatory standards set by the General Pharmaceutical Council or the Pharmaceutical Society of Northern Ireland when considering dispensing any lawfully valid prescription. Any registered pharmacy or pharmacist failing to meet the relevant regulatory standards may be subject to action by the regulator.

The requested information is not held centrally. The Care Quality Commission does not have a regulated activity of prescribing or dispensing.

The General Pharmaceutical Council (GPhC) regulates pharmacists, pharmacy technicians and pharmacies in England, Scotland and Wales. The Pharmaceutical Society of Northern Ireland regulates pharmacists and pharmacies in Northern Ireland.

All pharmacies in Great Britain, including those providing internet services, must be registered with the GPhC. The Department does not hold information on the number of independent online providers offering GPhC regulated dispensing services.

Medicines and medical devices are not ordinary consumer goods and their supply is tightly controlled in the United Kingdom. All service providers must adhere to high standards when prescribing and supplying medications to patients, particularly if the patient’s journey is not face to face.

The regulation of providers delivering general practitioner consultations over the internet and providers prescribing medications in response to online forms is the responsibility of Care Quality Commission. General Pharmaceutical Council sets standards for professional practice for all registered pharmacies, including non-NHS distance selling pharmacies. The Medicines and Healthcare products Regulatory Agency is responsible for regulating all medicines and medical devices in the UK.

To ensure remote supply of medicines to patients is safe, regulators have issued guidance for online providers on how to comply with the legislation and meet expected standards of services and provided guidance for patients about the importance of checking that services they access are statutory regulated. The regulators are working together to address various concerns about remote practice.

The decision about data collection required to support these regulatory activities is at the discretion of the regulatory bodies.

The requested information is not held centrally. The Care Quality Commission does not have a regulated activity of prescribing or dispensing.

The General Pharmaceutical Council (GPhC) regulates pharmacists, pharmacy technicians and pharmacies in England, Scotland and Wales. The Pharmaceutical Society of Northern Ireland regulates pharmacists and pharmacies in Northern Ireland.

All pharmacies in Great Britain, including those providing internet services, must be registered with the GPhC. The Department does not hold information on the number of independent online providers offering GPhC regulated dispensing services.

Medicines and medical devices are not ordinary consumer goods and their supply is tightly controlled in the United Kingdom. All service providers must adhere to high standards when prescribing and supplying medications to patients, particularly if the patient’s journey is not face to face.

The regulation of providers delivering general practitioner consultations over the internet and providers prescribing medications in response to online forms is the responsibility of Care Quality Commission. General Pharmaceutical Council sets standards for professional practice for all registered pharmacies, including non-NHS distance selling pharmacies. The Medicines and Healthcare products Regulatory Agency is responsible for regulating all medicines and medical devices in the UK.

To ensure remote supply of medicines to patients is safe, regulators have issued guidance for online providers on how to comply with the legislation and meet expected standards of services and provided guidance for patients about the importance of checking that services they access are statutory regulated. The regulators are working together to address various concerns about remote practice.

The decision about data collection required to support these regulatory activities is at the discretion of the regulatory bodies.

We do not have data that shows how many patients are unable to leave hospital due to a lack of capacity in domiciliary or residential care. For some patients, there is data on the number for whom the primary reason is that they are awaiting availability of resource for assessment and start of care at home (pathway 1) and the number awaiting availability of a bed in a residential or nursing home that is likely to be permanent (pathway 3). Pathway 1 includes domiciliary care but will also include other types of care at home provided by the National Health Service or local authority.

The following table shows the number of patients with a Length of Stay (LOS) of seven days or over on pathway 1 or pathway 3 for the week ending 14 May 2023.

As of March 2023, NHS England had delivered an additional 7,820 beds or bed equivalents. Of these, 4,805 were general and acute beds and community beds, 628 were virtual ward beds and 2,387 were bed equivalents from patient flow initiatives. The additional general and acute beds delivered are beds in National Health Service hospitals.

NHS England does not hold the number of outsourced beds. Systems may commission private providers for the provision of step down intermediate care capacity outside of hospital either on a spot purchase or block purchase basis.

As of March 2023, NHS England had delivered an additional 7,820 beds or bed equivalents. Of these, 4,805 were general and acute beds and community beds, 628 were virtual ward beds and 2,387 were bed equivalents from patient flow initiatives. The additional general and acute beds delivered are beds in National Health Service hospitals.

NHS England does not hold the number of outsourced beds. Systems may commission private providers for the provision of step down intermediate care capacity outside of hospital either on a spot purchase or block purchase basis.

As of March 2023, NHS England had delivered an additional 7,820 beds or bed equivalents. Of these, 4,805 were general and acute beds and community beds, 628 were virtual ward beds and 2,387 were bed equivalents from patient flow initiatives. The additional general and acute beds delivered are beds in National Health Service hospitals.

NHS England does not hold the number of outsourced beds. Systems may commission private providers for the provision of step down intermediate care capacity outside of hospital either on a spot purchase or block purchase basis.

As part of the Value Based Procurement (VBP) programme, NHS Supply Chain has developed a toolkit and two VBP models. One model can be applied to the renewal of existing frameworks or contracts for product ranges, and the other is for the procurement of innovation. The toolkit and models are designed for internal use by NHS Supply Chain’s procurement teams and Category Management Service Providers and are not available for publication.

However, to support awareness of VBP across the National Health Service and the supplier community, NHS Supply Chain has a dedicated VBP website that is updated as the programme evolves. This website contains the 2021 ‘Value Based Procurement Project Report and Findings’ that has an overview of the VBP toolkit. A copy is attached.

The Governments of the United Kingdom provide financial support to unpaid carers through Carer’s Allowance, the Carer Element in Universal Credit and through other benefits. As adult social care is a devolved matter, Devolved Administrations are responsible for delivery of services and support to carers in Scotland, Wales and Northern Ireland. In England, Under the Care Act 2014, local authorities are required to undertake a Carer’s Assessment for any unpaid carers who appears to have a need for support and to meet their eligible needs on request from the carer. We have earmarked £327 million in the Better Care Fund for 2023/24 to provide short breaks and respite services, as well as additional advice and support for carers.

The UK Health Security Agency (UKHSA) position on incinerators is that modern, well run and regulated municipal waste incinerators (MWIs) are not a significant risk to public health. This view is based on detailed assessments of the effects of air pollutants on health and on the fact that these incinerators make only a very small contribution to local concentrations of air pollutants.

Public Health England funded a study by the Small Area Health Statistics Unit at Imperial College London which found no link between exposure to emissions from, or living close to, MWIs and infant deaths or reduced foetal growth. The study also found no evidence of increased risk of congenital anomalies from exposure to MWI chimney emissions, but a small potential increase in risk of congenital anomalies for children born within ten kilometres of MWIs. A causal association between the increased risk of congenital anomalies for children born close to MWIs has not been established.

UKHSA has not received or commissioned any assessments on disposing of plastic waste by incineration. UKHSA’s position is that well run and regulated modern MWIs are not a significant risk to public health when incinerating the general municipal waste mix which includes plastic.

When consulted, UKHSA provides an expert and independent opinion to the regulator (Environment Agency) on the potential impacts on human health of emissions including nitrogen oxides arising from existing or proposed regulated facilities, such as MWIs. Emissions from existing regulated facilities are closely monitored and regulated by the Environment Agency.

The UK Health Security Agency (UKHSA) position on incinerators is that modern, well run and regulated municipal waste incinerators (MWIs) are not a significant risk to public health. This view is based on detailed assessments of the effects of air pollutants on health and on the fact that these incinerators make only a very small contribution to local concentrations of air pollutants.

Public Health England funded a study by the Small Area Health Statistics Unit at Imperial College London which found no link between exposure to emissions from, or living close to, MWIs and infant deaths or reduced foetal growth. The study also found no evidence of increased risk of congenital anomalies from exposure to MWI chimney emissions, but a small potential increase in risk of congenital anomalies for children born within ten kilometres of MWIs. A causal association between the increased risk of congenital anomalies for children born close to MWIs has not been established.

UKHSA has not received or commissioned any assessments on disposing of plastic waste by incineration. UKHSA’s position is that well run and regulated modern MWIs are not a significant risk to public health when incinerating the general municipal waste mix which includes plastic.

When consulted, UKHSA provides an expert and independent opinion to the regulator (Environment Agency) on the potential impacts on human health of emissions including nitrogen oxides arising from existing or proposed regulated facilities, such as MWIs. Emissions from existing regulated facilities are closely monitored and regulated by the Environment Agency.

The UK Health Security Agency (UKHSA) position on incinerators is that modern, well run and regulated municipal waste incinerators (MWIs) are not a significant risk to public health. This view is based on detailed assessments of the effects of air pollutants on health and on the fact that these incinerators make only a very small contribution to local concentrations of air pollutants.

Public Health England funded a study by the Small Area Health Statistics Unit at Imperial College London which found no link between exposure to emissions from, or living close to, MWIs and infant deaths or reduced foetal growth. The study also found no evidence of increased risk of congenital anomalies from exposure to MWI chimney emissions, but a small potential increase in risk of congenital anomalies for children born within ten kilometres of MWIs. A causal association between the increased risk of congenital anomalies for children born close to MWIs has not been established.

UKHSA has not received or commissioned any assessments on disposing of plastic waste by incineration. UKHSA’s position is that well run and regulated modern MWIs are not a significant risk to public health when incinerating the general municipal waste mix which includes plastic.

When consulted, UKHSA provides an expert and independent opinion to the regulator (Environment Agency) on the potential impacts on human health of emissions including nitrogen oxides arising from existing or proposed regulated facilities, such as MWIs. Emissions from existing regulated facilities are closely monitored and regulated by the Environment Agency.

There are no current plans to present data by local authority. It would be technically possible to do so, but the number of babies in each local authority would be too small, especially when stratified by anomaly group, and would likely lead to much of the data being supressed for reasons of information governance.

Value-based procurement (VBP) is a procurement approach that delivers a reduction in the whole life costs of healthcare where value can be created from financial, efficiency, patient, and environmental benefits.

In May 2019, NHS Supply Chain launched a project to consider the potential benefits and practical application of VBP. This involved a series of pilot projects to test the concept of VBP in practice, with a view to producing a scalable model for potential wider deployment.

An internal toolkit for the use of Category Tower Service Providers was produced as an output of the VBP project. It is designed to be flexibly applied to the varying product ranges procured through NHS Supply Chain. Central to the guide has been the creation of two models: one can be applied to the renewal of existing frameworks/contracts for product ranges, the other for the procurement of innovation. Activity will be delivered across a wide range of categories including cardiology, orthopaedics, sterile intervention equipment and ward-based consumables.

The Government's new Medical Technology Strategy, published in February 2023, commits to developing an environment that supports the understanding and delivery of value for money and affordability across the whole patient pathway, using high quality data to ensure that prices are both reasonable for the health system and sustainable for suppliers. The application and adoption of VBP in the National Health Service is a key priority under the strategy to realise the potential of medical technology to improve patient outcomes and support the NHS workforce. The Department’s Medical Technology Directorate is working closely with NHS Supply Chain and NHS England to build on the work already undertaken to ensure that a consistent methodology is now developed and adopted at both a national and local level.

The information requested is not held centrally.

Cohorting as a Service uses SNOMED CT Codes from general practitioner (GP) practice extracts, with data being collected using the General Practice Extraction service. This collection is supported by the British Medical Association, Royal College of General Practitioners and National Data Guardian, and collects a specific set of patient data from GP practices in England on a fortnightly basis.

The data includes personally identifiable information such as National Health Service number and date of birth because the information is required for delivering direct care. The NHS England vaccination programme uses the information to identify and contact patients who fall within clinically ‘at-risk’ groups within an age group.

The Secretary of State or NHS England issue Directions for information collection, then approval for collection is obtained, confirming that the Information Standard, Collection or Extraction has been through assessment and is demonstrated to meet the quality assurance criteria set by the Data Alliance Partnership Board.

Information relating to representations made on this matter by different Departments and agencies is not held centrally. In 2021, the Government implemented temporary tariff suspensions on a set of goods, including urine drainage bags, to support the healthcare response to the COVID-19 pandemic. The Government has extended the majority of these suspensions until 31 December 2023. We have recently received stakeholder feedback on tariffs on urine drainage bags and are considering the evidence provided alongside wider United Kingdom Government analysis.

The Department invited a range of stakeholders including industry bodies, patient organisations and civil society organisations to workshops which took place from January 2023 until March 2023. These workshops were a listening exercise that aimed to illicit a diverse range of perspectives. The insights taken from these workshops will be used to inform the preparations for negotiation of a successor to the 2019 voluntary scheme for branded medicines and pricing access.

The Government is working to better understand the impacts of the operation of the current voluntary scheme for branded medicines pricing and access (VPAS) on the United Kingdom life sciences industry. We are in direct conversations with pharmaceutical companies, including in the recent pre-negotiation workshops, as well as with the Department for Science, Innovation and Technology, and the Department for Business and Trade about the business environment for life sciences.

The Government is open to ideas about how a successor to VPAS should operate from 2024 onwards. We are working with industry to agree a mutually beneficial successor that supports better patient outcomes; ensures the sustainability of National Health Service spend on branded medicines; and enables a strong UK life sciences industry.

The multi-year vision for the Future of UK Clinical Research Delivery: 2021 to 2022 implementation plan was published on 23 March 2021 and sets out our ambition to create a patient-centred, pro-innovation and digitally enabled clinical research environment including phase 1 trials. A copy is attached. Implementing the vision will unleash the true potential of our clinical research environment to improve health, capitalise on our renowned research expertise, and make the United Kingdom one of the best places in the world to design and deliver research.

National Institute for Health and Care Research (NIHR) infrastructure spans early translational experimental medicine, through clinical and onto applied health and care research. NIHR has recently invested over £969 million to strengthen the infrastructure supporting Phase 1 trial capacity over the next five years. This includes funding for the NIHR Biomedical Research Centres, the NIHR Clinical Research Facilities, and Experimental Cancer Medicine Centres.

On 1 April 2023, Healthcare Safety Investigation Branch (HSIB) national investigation programme was expected to transition into the Health Services Safety Investigations Body (HSSIB), a new body established under the Health and Care Act 2022.

We have been working on transitional arrangements to set up both bodies by April. However, there have been some delays to this, including appointments to the Board of the new organisation which will not be completed by April 2023. Whilst we could legally establish HSSIB by commencing the relevant provisions in the Health and Care Act 2022, we believe the delay will allow us to ensure a smooth transition of the investigation programme from HSIB to HSSIB.

NHS England is not releasing technical details, including specifications or code from the Foundry system, as it would go beyond details provided to bidders as part of the commercial process to procure its replacement, the Federated Data Platform and Associated Services.

The information requested is not held centrally by the Department or NHS England.

The Government has no plans to set up a public inquiry into the Gender Identity Development Service for Children and supports the ongoing Independent Review of Gender Identity Services for Children and Young People currently being carried out by Dr Hilary Cass, also known as the Cass Review. The review is expected to set out findings and make recommendations in relation to pathways of care, clinical models and management, and the use of, and research into the long-time effects of, hormone treatment. The Cass Review published an interim report in March 2022 and is due to conclude by the end of 2023.

Cohorting uses the same underlying technology platform as NHS England’s Secure Data Environment service. Cohorting is carried out in other national programmes such as screening, which do not use the Cohorting as a Service system. There are forms of cohorting for other purposes such as population health and research; the Cohorting as a Service system is not currently intended to be used for these.

There are no plans to direct NHS England to publish the agenda and minutes of its Data, Digital and Technology committee and other board committees. NHS England should consider how best to ensure transparency in its governance arrangements.

The clinical data used in the Cohorting as a Service system covers between 15 and 20 million people in the flu and COVID-19 cohorts. The system is built and maintained by NHS England employees and one main contractor, with less than fifteen people in the team having access to the relevant clinical cohorting data. This data is only accessed by exception, for example to investigate or resolve problems. The remainder of the team use test data for building the service and do not have access to the clinical data.

The system accesses the following data fields:

- NHS Number;

- surname and forename;

- date of birth/age;

- address and postcode;

- ethnicity;

- sex;

- the associated SNOMED5 CT codes and dates for medical conditions and drug treatment(s) relevant to the cohort criteria.

The Future of UK Clinical Research Delivery 2022-2025 implementation plan summarises the progress made in 2021-22 towards delivering the vision and the actions that are being taken by the various delivery partners (the National Institute for Health and Care Research (NIHR), NHS England, the Medicines and Healthcare products Regulatory Agency, Health Research Authority and Devolved Administrations) between 2022 and 2025 to make progress to achieve our vision in full by 2031. This plan is being delivered under the UK Recovery, Resilience and Growth Programme.

To support the growth of phase 1 trial capacity the NIHR has confirmed an investment of £969 million over the next five years in its early translational research infrastructure, which includes the NIHR Biomedical Research Centres, NIHR Clinical Research Facilities and NIHR/Cancer Research UK Experimental Cancer Medicine Centres.

NHS England does not hold a dataset that nationally monitors readmissions for this cohort but has plans to collect data in the near future which will allow review of, and feedback on, this metric.

Membership, attendance, and a summary of the business considered by the Data, Digital and Technology Committee will be published in the NHS England annual report. This is the process followed for all NHS England Board Committees, and NHS England do not intend to publish agenda and minutes of Committee meetings.

The membership of the Committee includes the NHS England Chair, at least two NHS England Non-Executive Directors, external subject matter expert members, the National Director of Transformation, Chief Operating Officer, Chief Strategy Officer, Chief Information Officer and the Head of the combined Digital Policy Unit within NHS England and the Department.

I believe the answer given is compatible with NHS England’s Data Promise 4.

Specifications will be placed in the Library of the House when they are available.

Whilst no independent assessment has been carried out on the removal of patients from the waiting list at East Sussex Healthcare NHS Trust, this has been investigated by NHS England and identified as an error in reporting.

The correct percentage of the waiting list that was flagged for removal through error identification is 14%.

At a local level, there is a requirement to follow three stages in waiting list validation: technical, administrative and clinical. Patients who are initially flagged for removal then undergo a manual validation stage whereby trust staff validate that the identified patients should be removed before actioning this themselves. This is supported by local governance arrangements and clinical oversight, to ensure that patients are removed safely and appropriately. All patients removed from waiting lists following validation are notified of this stage in their care pathway. Therefore, it is not expected that any patients would need be ‘readded’ due to the processes in place.

No such assessment has been made. Access to National Health Service mental health services is based on clinical need, including for patients with Huntington’s disease and organic brain disorders.

The NHS Long Term Plan commits an additional £2.3 billion a year for the expansion and transformation of mental health services in England by 2023/24 so that an additional two million people, including those with Huntington’s disease and organic brain disorders, can get the NHS-funded mental health support that they need.

No such assessment has been made. Access to National Health Service mental health services is based on clinical need, including for patients with Huntington’s disease and organic brain disorders.

The NHS Long Term Plan commits an additional £2.3 billion a year for the expansion and transformation of mental health services in England by 2023/24 so that an additional two million people, including those with Huntington’s disease and organic brain disorders, can get the NHS-funded mental health support that they need.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative evidence-based guidance for the National Health Service on best practice. Topics for guideline development are identified and prioritised through a topic selection process that considers the evidence base, variation in practice and burden of disease.

Following the Westminster Hall debate on Huntington’s Disease on 9 November 2022, the Department is preparing an evidence-based paper on a potential guideline on Huntington’s Disease for consideration through the NICE topic selection process.

The Independent Advisory Group on the Release of Data (IGARD) was asked to provide feedback on Draft guidance on NHS England’s protection of patient data, which was published on 23 January 2023 in an online-only format. We expect to continue receiving feedback from members of IGARD and other stakeholders on this draft and identify issues to address before the guidance is finalised, which we intend to do by the end of February 2023.

IGARD has also been actively involved in developing draft Terms of Reference (ToR) for the new data advisory group to be established in line with the draft statutory guidance. The ToR will continue to be developed and will be finalised to reflect the statutory guidance once finalised.

No specific assessments have been made of the costs of reviewing patients currently prescribed liothyronine in secondary care.

The Department has no plans for a review. The current Gloucestershire Integrated Care Board guidance on the prescribing of liothyronine, agreed by the former Gloucestershire Clinical Commissioning Group in April 2022, is under a local review to be completed within the next four months and will consider the position on new patients already on liothyronine moving into Gloucestershire.

The NHS Accelerated Access Collaborative (AAC) made a Phase 4 Artificial Intelligence (AI) Award to Healthy.io under Round 1 of the AI Award programme. As part of the award process, the AAC commissioned an independent service evaluation and a randomised controlled trial, supported by Leicester Clinical Trials Unit. The results of these will be published as part of the Award process by September 2024. All 20 Primary Care Networks in Oxfordshire are taking part in the Healthy.io AI Award programme pilot and 2760 patients have been asked if they would like to take part.

The Department does not hold a copy of the contract between Buckinghamshire Oxfordshire and Berkshire West Integrated Care Board and Healthy.io. Our understanding is that this contract was for a pilot project and has not been continued. During the pilot, 38 general practices in Oxfordshire signed up to Healthy.io and submitted 6473 patients, of which 6053 were eligible.

No assessments have been made.

The Independent Group Advising on the Release of Data (IGARD) were asked to provide feedback on the latest draft of the guidance on a quick turnaround, as the transfer of NHS Digital’s functions to NHS England was conducted at pace because we are keen to see the benefits of creating a single statutory body responsible for data and digital technology for the National Health Service delivered quickly.

This was not intended to be a hard deadline for receiving comments, or the end of the process, as the guidance has not been finalised. We have been reviewing the feedback from IGARD and other stakeholders. The Department would welcome any further feedback that those who were members of IGARD, and others, wish to provide, as we finalise the guidance and then keep it under review.

My officials have discussed the concerns raised by IGARD with NHS England officials.

Life Sciences pharmaceutical manufacturing was responsible for approximately £20.1 billion worth of exports in 2021. This figure is based on a US dollar figure of $27.7 billion, using the 2021 OECD average conversion rate.

The official statistics from the Office for Life Sciences show that employment in core biopharmaceutical manufacturing employment declined between 2009 and 2019 but increased by 5% between 2019 and 2021. The Life Sciences Vision sets out an ambition to create a globally competitive environment for Life Science manufacturing investments. To help meet these ambitions, the Government launched the £60 million Life Sciences Innovative Manufacturing Fund in March 2022 to incentivise globally mobile manufacturing investments in the United Kingdom.

Maria Caulfield MP is the minister responsible for NHS Wheelchair Services. As Minister for Mental Health and Women’s Health Strategy, disabilities including autism are part of her portfolio. The minister has held this role since 27 October 2022.

Integrated care boards (ICBs) are responsible for the development, provision and commissioning of local wheelchair services. NHS England has committed to develop a framework for ICBs to support them in commissioning effective, efficient and personalised wheelchair services. The framework will include the updated Wheelchair Charter.

Regarding the processes established within individual ICBs to audit Wheelchair Service standards of service, the Government does not hold this information centrally.

Integrated care boards (ICBs) are responsible for the development, provision and commissioning of local wheelchair services. NHS England has committed to develop a framework for ICBs to support them in commissioning effective, efficient and personalised wheelchair services. The framework will include the updated Wheelchair Charter.

Regarding the processes established within individual ICBs to audit Wheelchair Service standards of service, the Government does not hold this information centrally.

The Government remains firmly committed to the statutory and voluntary schemes for branded medicines and to working with the pharmaceutical industry to deliver on the ambitions set out in the Life Sciences Vision to create an environment that facilitates innovation for the development of medicines in the United Kingdom.

The Department is consulting on a proposed update to the statutory scheme payment percentage for 2023. The proposed increase to the payment percentage of 27.5% will ensure continued broad commercial equivalence between the Statutory Scheme and the Voluntary Scheme for Branded Medicines Pricing and Access. We published an impact assessment of this policy titled Autumn 2022 update to the Statutory Scheme controlling the costs of branded health service medicines. A copy of the impact assessment is attached.

Existing reporting tools, such as NHS Digital’s Innovation Scorecard, monitor the use of innovative medicines and medicinal products. To further analyse the extent of regional variation in the uptake of National Institute for Health and Care Excellence (NICE) approved medicines, the Office for Life Sciences (OLS) is working with NHS England and jointly engaging with stakeholders across the health system to understand the drivers of variation and the barriers to equitable uptake.

No specific assessment has been made of variation in access to innovative medicines by socioeconomic status, nor of the impact of inequitable access to innovative medicines on the economy.

The Strategic Metrics Group, with representatives across Government, the National Health Service, NICE and industry are working to deliver on commitments set out in the Life Sciences Vision. This will improve the NHS use of proven and cost-effective innovations, including new medicines, through strengthened innovation metrics and a focus on identifying and addressing unwarranted variation in uptake.

The Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department, regulates medicines, medical devices and blood components for transfusion in the United Kingdom. MHRA employs over 1380 staff and for 2021/22, its total resources were £167 million, funded mostly by income from fees and charges for both statutory and non-statutory sales of products and services. The fees that MHRA charges for its services reflect the cost of providing that service and these are set in legislation, following public consultation and Parliamentary scrutiny.

MHRA and the National Institute for Health and Care Excellence (NICE) work closely together to ensure that there is a joined-up, and timely approach to supporting access for National Health Service patients to new medicines. NICE aims wherever possible to publish final guidance on new medicines within 90 days of MHRA granting a marketing authorisation.

The National Institute for Health and Care Research (NIHR) Clinical Research Network (CRN) supports study sites to deliver research across England. In 2021/22 there were 6,383 studies on the NIHR CRN portfolio which has seen year-on-year growth in study numbers, recruiting more than one million participants. Overall, this suggests there are greater opportunities for people to participate in clinical trials that could benefit patient outcomes. The Department, in partnership with NHS England, is taking action to recover the United Kingdom’s (UK’s) capacity to deliver clinical research through the Research Reset programme to ensure new studies can open and be delivered within planned timescales, while addressing the backlog caused by the pandemic to ensure the UK remains an attractive global destination for new research.

Data published by the Association of the British Pharmaceutical Industry highlights a decline in the number of commercial contract clinical trials initiated in the United Kingdom (UK), primarily in 2020 and 2021. This was the result of the pandemic when many studies were paused to focus on nationally prioritised COVID-19 studies. There has, however, been a year-on-year growth in the number of studies overall and by December 2021, the number of studies on the National Institute for Health and Care Research Clinical Research Network portfolio was higher than ever before. Increased workload pressure on the National Health Service (NHS) research & development workforce, in the context of the recovery of wider NHS services and changes to care pathways, means the UK has seen a growing backlog of studies waiting to start or taking longer to complete. The Department, in partnership with NHS England, is taking action to recover the UK’s capacity to deliver commercial research through the Research Reset programme to ensure new studies can open and be delivered within planned timescales, while addressing the backlog to ensure the UK remains an attractive global destination for new research.

We have no current plans to ask the National Institute for Health and Care Excellence (NICE) to develop any such recommendation. NICE is responsible for developing its guidelines independently in consultation with a wide range of stakeholders based on a broad remit referred to it by either the Department or NHS England.

No assessment has been made. Decisions about prescribing are made with the healthcare professional concerned, who has clinical responsibility for that particular aspect of a patient’s care. Prescribers must ensure that the medicines considered appropriate for their patients can be safely prescribed and take account of the appropriate national guidance on clinical effectiveness and the local commissioning decisions of their respective integrated care boards (ICBs). NHS England formally oversees ICBs and has a legal duty to annually assess the performance of each ICB and publish their findings.

Ministers and officials at the Department meet with senior National Health Service leaders on a regular basis to discuss NHS performance, including accident and emergency and ambulance services. As announced at the Autumn Statement, plans for the recovery of urgent and emergency care services will be published in early 2023.

The ‘2023/24 priorities and operational planning guidance’, published on 23 December 2022, sets out the action and funding agreed with NHS England to begin recovering National Health Service core services and productivity, including additional capacity for Urgent and Emergency Care. A copy of the guidance is attached.

There will be £1 billion of funding through system allocations to increase capacity based on agreed system plans. It is anticipated that capacity will be focused on increasing General & Acute capacity, intermediate and step-down care and community beds with an expectation of an increase in the utilisation of virtual wards. £600 million will be distributed in 2023/24 and £1 billion in 2024/25 through the Better Care Fund to get people out of hospital on time into care settings, freeing up NHS beds for those that need them. In addition, a £400 million ring-fenced local authority grant for adult social care will support discharge among other goals. There will also be an increase in allocations for systems that host ambulance services to increase ambulance capacity.

Local National Health Service trusts are responsible for managing its own staffing levels and for recruiting the number of health professionals required to meet local service need as part of their workforce planning. The NHS published plans for increasing capacity in urgent and emergency care over winter. The plans looked to reduce hospital occupancy through increasing capacity by the equivalent of at least 7,000 general and acute beds, through a mix of new physical beds, virtual wards and improvements elsewhere in the pathway. This intervention was developed with integrated care boards responsible for developing plans to achieve this increase in bed capacity based on realistic assumptions, including how many staff can be recruited and at what speed.

To help address staff shortages Health Education England (HEE) National Allied Health Professionals (AHP) Workforce Supply Project delivered valuable recruitment initiatives including improved return to practice pathways, pre-registration apprenticeships and more jobs for new graduates helping to improve staffing shortages. A HEE national programme started in 2022/23 to support NHS trusts with AHP international recruitment.

Furthermore, all-eligible nursing, midwifery and allied health profession degree students have received a non-repayable training grant of a minimum of £5,000 per academic year. To support future workforce planning the Department have commissioned NHS England to develop a long term plan for the NHS workforce for the next 15 years. The plan will help ensure that we have the right numbers of staff, with the right skills to transform and deliver high quality services fit for the future.

The additional £200 million announced on 9 January is specifically for short term care, to allow local areas to purchase bedded step-down capacity and associated clinical and therapeutic support for those patients who do not meet the criteria to remain in hospital. It will be for integrated care boards to determine how best to address need in line with the guidance set out by NHS England.

We are making available £500 million to support safe and timely discharges from hospital and can be used to boost workforce capacity. We committed a further £200 million to fund short term National Health Service step-down care packages and wrap-around primary and community health services to support patient’s recovery.

We are making available £500 million to support safe and timely discharges from hospital. We committed a further £200 million to fund short term National Health Service step-down care packages and wrap-around primary and community health services to support patients' recovery. The Government has also provided an extra £50 million in capital funding to expand ambulance hubs and hospital discharge lounges, designed to accommodate patients waiting for short term delays to transfers of care.

The winter plan set out a commitment to increase general and acute bed capacity by the equivalent of at least 7,000 beds, through a mix of new physical beds and innovative virtual wards. NHS England report that additional capacity has continued to be put in place across the winter period and that the Nation Health Service is on track to deliver the total additional beds by the end of March this year.

A copy of a spreadsheet which lists how many users there are for each individual purpose is attached.

It is expected that all existing dashboards within Foundry will be interoperable. Over the coming months, an assessment will be undertaken to determine which dashboards will be migrated to the new Federated Data Platform and which will be decommissioned. The format of the specifications for these dashboards will be developed as part of the planned transition activities of the programme.

There are 4 steps to register access to the NHS National Data Platform (Foundry).

1. Register for an Okta account - Okta is a cloud-based identity management service.

2. Submit a Foundry Access Request Form – used to record contact details, purpose of the request, required products/tools, and information governance compliance.

3. Download and register two factor authentication - to ensure that only the applicant can use the account. It will also ensure the security of the data within the Foundry platform.

4. Launch the Foundry platform

A copy is attached of the Foundry System Access Form.

The number of hospital beds provided is an operational matter for National Health Service commissioners and providers. NHS trusts will make decisions on their bed stock based on the demand within the local population and other factors such as the increase in the proportion of elective care day cases over time, which reduces the number of hospital beds required for overnight stays. Accounting for the impact of the pandemic, the number of NHS general and acute hospital beds has remained relatively stable from 2015/16, at around 102,000 beds.

The NHS is working hard to deliver their winter plan, increasing hospital bed capacity by the equivalent of 7,000 beds. In addition, under the Delivery plan for recovering urgent and emergency care services published on 30 January sets a further 5,000 new beds will be established in 2023/24, alongside expanded use of virtual wards so that up to 50,000 patients a month can benefit from them. This is backed by a £1 billion dedicated fund.

Medicines frequently go in and out of stock. The latest up to date information about medicine supply issues being managed by the Department is available in an online only format, on the Specialist Pharmacy Services website, which also hosts comprehensive management advice for NHS healthcare professionals.

Prescribers must ensure that the medicines considered appropriate for their patients can be safely prescribed and take account of the appropriate national guidance on clinical effectiveness and the local commissioning decisions of their respective integrated care boards.

The National Institute for Health and Care and Excellence recommends that natural thyroid or armour thyroid extract should not be offered for the management of primary hypothyroidism due to insufficient evidence that it offers greater benefits than levothyroxine.

In the event of a medicine proving ineffective, a general practitioner or other responsible clinician should work with the patient to determine the most appropriate course of action or further treatment. Prescribers should ensure that the medicines considered appropriate for the patients can be safely prescribed and take account of appropriate national guidance on clinical effectiveness and the local commissioning decisions of the local integrated care board. Arrangements for monitoring the effects of the medicines should be agreed with the patient on prescribing.

There are no current plans to have discussions with NHS England. NHS Devon Integrated Care Board has policies in place to support patients with hypothyroidism and follows national guidance which states that there is no convincing evidence to support routine use of thyroid extracts, armour thyroid, in managing hypothyroidism.

The National Institute for Care and Excellence (NICE) recommends that natural thyroid extract should not be offered for the management of primary hypothyroidism as there is not enough evidence that it offers benefits over levothyroxine. Natural thyroid extract does not have a United Kingdom marketing authorisation.

The Minderoo Precision Brain Tumour Programme has recruited over 100 patients for whole genome sequencing in its first year and has returned results within three weeks of surgery on average. This has led to funding for a United Kingdom precision platform trial in brain cancer, which is anticipated to be available to patients at specific centres in 2023. The deployment dates and locations of these centres will be determined by a separate selection process.

The Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). The NIHR’s research expenditure for all cancers in 2020/21 was £73.5 million and 7.3% was spent on brain tumour research. Information on expenditure in 2021/22 will be available in 2023.

In May 2018, the Government announced £40 million over five years for brain cancer research through the Tessa Jowell Brain Cancer Mission via the National Institute for Health and Care Research (NIHR). While the NIHR requested funding applications on brain tumour research, this a difficult area with a relatively small research community. The NIHR will provide funding for research training elements of the Tessa Jowell Fellowships to train specialist brain tumour oncologists.

Where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This is being delivered through the National Health Service comprehensive model of personalised care, empowering patients to manage their care and and maximise the potential of digital and community-based support. All patients will have access to the appropriate expertise and support, including a Clinical Nurse Specialist or other support worker. After treatment, patients move to a follow-up pathway to suit their needs, which ensures rapid access to clinical support is available should they have concerns regarding their health.

NHS England is reviewing and updating all service specifications, which describe the relevant specialists involved in clinical multidisciplinary teams to optimise patient care.

In 2018, Cambridge University Hospitals NHS Foundation Trust was allocated £100 million of Wave 4 Sustainability and Transformation Partnership funding for Cambridge Children’s Hospital. The Department and NHS England are working with the Trust regarding plans for the scheme, including delivery timescales.

A copy of the letter sent by the National Data Guardian to National Health Service integrated care systems and Senior Information Risk Owners on 7 November is attached. This letter was published by the National Data Guardian on 23 November 2022.

Any patient can opt out from the sharing of their data for secondary use purposes in line with the National Data Opt-Out policy. This can be done at any time through the NHS App, online, by phone, email or post. Implementation of the National Data Opt-Out policy has been mandatory for health and adult social care organisations since 31 July 2022.

The procurement process for the Federated Data Platform has not yet commenced. Once operational, data will be treated in accordance with the provisions set out in the Data Protection Act 2018 and UK General Data Protection Regulation. Opted out data will be separated from non-opted out data prior to the commencement of secondary use.

NHS Digital has not judged that individual level pseudonymised data is not personal data. NHS Digital processes this data on the basis that it is personal data, in line with the definition within the UK General Data Protection Regulations and the Data Protection Act 2018.

Shared Care Records and the Federated Data Platform will operate separately. Shared Care Records will ensure that authorised health and care professionals providing direct care to patients have safe, secure and ready access to the person-based records and care plans required to provide high quality, individual and integrated care.

There must be a clear, legal basis to use data held in Shared Care Records for purposes other than direct care, which includes explicit patient consent. Approval may be given under the Health Service (Control of Patient Information) Regulations 2002, subject to advice from the Confidentiality Advisory Group of the Health Research Authority, which protects and promotes the interests of patients and the public while facilitating appropriate use of confidential patient information for purposes beyond direct patient care.

Following our previous response, NHS Resolution has reviewed the 30 cases taken to trial. It has subsequently identified that one claim was incorrectly classified as having been taken to trial. NHS Resolution has confirmed that of the 29 clinical negligence claims taken to trial in 2021/22, nine were heard in the higher courts, including the High Court and 20 in the county courts.

There are no plans to do so. NHS England determines policy and strategy for integrated care boards (ICBs), with the Director of Personalised Care and Community Services having responsibility for wheelchair services. ICBs are responsible for commissioning and ensuring healthcare needs of local communities are met and providers are required to ensure statutory responsibilities are met for the delivery of safe, effective, efficient, high quality services.

The Minister of State for Social Care (Helen Whately MP) has Ministerial responsibility for disabilities.

From 2015, the former clinical commissioning groups were required to report total expenditure to include assessment, service and equipment provision, repair and maintenance. The following table shows annual reported expenditure on National Health Service wheelchair and postural seating services in England in each year from 2015/16 to 2021/22. Data is not available for 2020/21 as wheelchair services were suspended during the COVID-19 pandemic and data collection was paused from Quarter 4 2019/20. This also affects the total reported expenditure in 2019/20.

The Minister of State for Social Care (Helen Whately MP) has Ministerial responsibility for disabilities.

From 2015, the former clinical commissioning groups were required to report total expenditure to include assessment, service and equipment provision, repair and maintenance. The following table shows annual reported expenditure on National Health Service wheelchair and postural seating services in England in each year from 2015/16 to 2021/22. Data is not available for 2020/21 as wheelchair services were suspended during the COVID-19 pandemic and data collection was paused from Quarter 4 2019/20. This also affects the total reported expenditure in 2019/20.

NHS England has assessed the report by Frontier Economics and has compared the findings to existing policy and data requirements for wheelchair provision for integrated care boards (ICBs). ICBs are responsible for commissioning and providing wheelchair services for local populations, supported by NHS England. NHS England has established a national wheelchair dataset which reviews waiting times during care pathways to enable targeted action if improvements are required. It has also developed a wheelchair currency model for providers, commissioners and systems to understand complexities in patient populations and support commissioning using the currencies as an evidence base. The model also supports benchmarking across localities and nationally.

NHS England’s service specification for wheelchair services enables ICBs to review and improve local wheelchair services and the introduction of personal wheelchair budgets and legal rights offers a framework to commission personalised and integrated wheelchair services. ICBs are responsible for providing information on local provision of wheelchair services and providers have a responsibility to ensure that users can provide feedback and or raise concerns.

NHS England has assessed the report by Frontier Economics and has compared the findings to existing policy and data requirements for wheelchair provision for integrated care boards (ICBs). ICBs are responsible for commissioning and providing wheelchair services for local populations, supported by NHS England. NHS England has established a national wheelchair dataset which reviews waiting times during care pathways to enable targeted action if improvements are required. It has also developed a wheelchair currency model for providers, commissioners and systems to understand complexities in patient populations and support commissioning using the currencies as an evidence base. The model also supports benchmarking across localities and nationally.

NHS England’s service specification for wheelchair services enables ICBs to review and improve local wheelchair services and the introduction of personal wheelchair budgets and legal rights offers a framework to commission personalised and integrated wheelchair services. ICBs are responsible for providing information on local provision of wheelchair services and providers have a responsibility to ensure that users can provide feedback and or raise concerns.

NHS England has assessed the report by Frontier Economics and has compared the findings to existing policy and data requirements for wheelchair provision for integrated care boards (ICBs). ICBs are responsible for commissioning and providing wheelchair services for local populations, supported by NHS England. NHS England has established a national wheelchair dataset which reviews waiting times during care pathways to enable targeted action if improvements are required. It has also developed a wheelchair currency model for providers, commissioners and systems to understand complexities in patient populations and support commissioning using the currencies as an evidence base. The model also supports benchmarking across localities and nationally.

NHS England’s service specification for wheelchair services enables ICBs to review and improve local wheelchair services and the introduction of personal wheelchair budgets and legal rights offers a framework to commission personalised and integrated wheelchair services. ICBs are responsible for providing information on local provision of wheelchair services and providers have a responsibility to ensure that users can provide feedback and or raise concerns.

NHS England has assessed the report by Frontier Economics and has compared the findings to existing policy and data requirements for wheelchair provision for integrated care boards (ICBs). ICBs are responsible for commissioning and providing wheelchair services for local populations, supported by NHS England. NHS England has established a national wheelchair dataset which reviews waiting times during care pathways to enable targeted action if improvements are required. It has also developed a wheelchair currency model for providers, commissioners and systems to understand complexities in patient populations and support commissioning using the currencies as an evidence base. The model also supports benchmarking across localities and nationally.

NHS England’s service specification for wheelchair services enables ICBs to review and improve local wheelchair services and the introduction of personal wheelchair budgets and legal rights offers a framework to commission personalised and integrated wheelchair services. ICBs are responsible for providing information on local provision of wheelchair services and providers have a responsibility to ensure that users can provide feedback and or raise concerns.

The UK Health Security Agency is the permanent standing capacity to prepare for, prevent and respond to threats to health. The Centre for Pandemic Preparedness within the UKHSA, will work with the Department and NHS England to ensure the United Kingdom is protected against future health threats.

The UKHSA has specialist staff, including laboratory-based staff in specialities such as epidemiology, genomics, microbiology, toxicology and other areas. A workforce model, including a register of reserves, is under development with other measures to ensure sufficient expertise is available to deploy on an emergency basis.

While no specific assessment has been made, we welcome research on the early detection of dementia and neurodegeneration which may enable targeted treatments for those most at risk.

In November 2021, the National Institute for Health and Care Research issued a £9 million invitation for research proposals on digital approaches to the early detection and diagnosis of dementia. In addition, in 2021/22 we made £17 million available to clinical commissioning groups to address dementia waiting lists and increase the number of diagnoses.

The following table shows the number of cases notified through NHS Resolution’s clinical negligence indemnity schemes in each year since 2017/18, by funding arrangement. This excludes cases under the Existing Liabilities Scheme for General Practice, which addresses inherited liabilities.

The National Health Service winter resilience plans will increase capacity for winter 2022/23, with the equivalent of at least 7,000 general and acute beds, including the use of innovative virtual wards to treat patients safely at home.

To prepare for future pandemics, updated planning scenarios have been developed that reflect the impact of a broader range of pathogens with pandemic potential. These scenarios are being used to inform the requirements for robust, flexible and deployable capabilities which can be adapted to outbreaks of different scales and characteristics.

The UK Health Security Agency (UKHSA) became fully operational on 1 October 2021 and includes the new Centre for Pandemic Preparedness. Working with the Department and NHS England, the UKHSA will ensure that measures are in place to protect against all future health threats, including pandemics, through the enhanced capabilities deployed to address COVID-19 and other infectious disease outbreaks.

As of September 2022, the Department holds 9.4 billion items of personal protective equipment (PPE), which could be used in response to a further wave of COVID-19. The Department has committed to providing PPE for free until the end of March 2023 and holds sufficient stocks to meet projected demand across all categories.

We are unable to provide the information requested on the suppliers for current stocks. When a product is quality assured and joins the supply chain, its source is not recorded.

The Department signed contracts with approximately 30 United Kingdom-based companies for 3.9 billion units of personal protective equipment (PPE), which have been successfully delivered. UK manufacturers remain on NHS Supply Chain’s framework agreements to provide PPE to the National Health Service. NHS Supply Chain and the Department continue to work with UK PPE manufacturers to ensure resilience in supplies.

The following table shows the number of clinical negligence claims settled in 2021/22, whether damages were paid and the status of the proceedings of these claims.

Source: NHS Resolution

Notes:

1. The percentage figures in the table may not add to exactly 100% due to rounding.
2. NHS Resolution has identified that the text accompanying figure 8 of the Annual Reports and Accounts refers to the percentage of clinical negligence claims that have resolved without damages in 2021/22 as 48.5%. The correct figure is 48.2%. NHS Resolution is arranging for an update to the amendments section of its annual report and accounts.

The Federated Data Platform will be procured by NHS England via an open competition, in line with the Public Contracts Regulations 2015. The competition is open to all suppliers and will abide by all the core principles of the Regulations, including transparency, non-discrimination, equal treatment and proportionality. It is anticipated that the procurement will launch in September 2022. A preferred supplier will not be selected until the competition has completed.

A copy of the ‘purposes’ and the associated work areas or ‘capabilities’ contained in NHS England’s COVID-19 Data Store National Data Platform is attached, due to the size of the data.

We are unable to provide the information requested on average staff turnover as it is not held in the format requested and could only be obtained at disproportionate cost.

The number of scientific advisors has remained stable. There are six new posts currently advertised to recruit permanent civil servants as scientific advisors, to replace contractors in these roles. In addition, organisational learning is being recorded to ensure continuity, including a new management information system and appropriate handover periods as staff are replaced.

The appraisal of sacituzumab govitecan is not included in this statistic as the National Institute for Health and Care Excellence (NICE) has not yet issued its final guidance. The appraisal of tucatinib is not recorded by the timeliness metric for 2021/22 as NICE’s final guidance was issued in the 2022/23 business year.

NICE issued final guidance within 90 days of licensing for 100% of published appraisals of new active substances where timelines were within NICE’s control. Topics outside of this timeframe were impacted by external factors such as where a company requested a delay to NICE’s evaluation.

The Department participated in the National Institute for Health and Care Excellence’s (NICE) recent review of its methods and processes for health technology evaluations. Patient-reported outcome measures are embedded throughout NICE’s process and methods for reviewing medicines and medical devices.

The Medicines and Healthcare products Regulatory Agency (MHRA) will develop processes for patient engagement and involvement and has committed to publish information on how this is achieved. The MHRA intends to embed these processes by December 2022.

The Immunisation and Vaccination Management Capability includes non-COVID-19 vaccinations, such as influenza and is compliant with the UK General Data Protection Regulation (UK GDPR), specifically in the category of “provision of health and social care” and “public interest in the area of public health”. The Capability does not process patient-identifiable data.

National Health Service trusts using the Trust Care Co-ordination Solution remain the controllers of patient data and appoint processors such as Palantir to undertake processing tasks at its direction or on its behalf. The Solution directly supports patient care delivered by NHS trusts under the UK GDPR as the processing of “public task/official authority”

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

The National Institute for Health and Care Excellence (NICE) commits to publishing draft recommendations on new medicines approximately at the time of licensing, with final guidance within three months of licensing wherever possible. In 2021/22, guidance was issued within three months of a licence for 100% of new medicines where NICE proceeded to appraisal and 98 technology appraisals were published, meeting the target in its business plan.

The Department holds regular accountability meetings with NICE to discuss a range of issues, including the delivery of its commitments. NICE is prioritising the flexibility and capacity of its technology appraisal programme through a more proportionate approach to assessments. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to the increasing numbers of topics referred for appraisal.

The UK Health Security Agency regularly engages with the diagnostics industry in the United Kingdom and others on the Coronavirus Test Device Approvals (CTDA) process. We will review the CTDA process due by the end of the year and consider its efficiency and transparency.

The Department and the National Institute for Health and Care Excellence (NICE) have discussed the decision to reschedule the committee meeting for the appraisal of Trodelvy to June 2022. This was due to the large number of other items, including other cancer treatments, on the agenda for the meeting in May and ensuring all topics were given the appropriate time and diligence. The consultation for this appraisal received a high number of responses and NICE wishes to ensure sufficient time for the committee to consider this feedback. NICE expects to issue final guidance on Trodelvy in August 2022.

The Coronavirus Test Device Approvals (CTDA) process is designed to evaluate mature COVID-19 testing technologies and the scope of the policy is kept under review. The UK Health Security Agency (UKHSA) has consulted with industry and the public on the expansion of the CTDA process and is currently analysing the responses received. The UKHSA is considering its regulatory role in relation to testing for other infectious diseases and we have committed to reviewing the CTDA process by the end of 2022.

Current delays in the Coronavirus Test Device Approval (CTDA) process have been due to further information being sought from applicants during the validation process. However, to ensure applications meet the required standards, expert support has been provided by officials, with 60% of approvals being processed in the last three months.

The number of scientific advisors has also been increased to meet demand. Online guidance for applicants has also been updated to provide greater clarity for acceptance criteria for the range of viral loads within positive samples. Officials continue to work with applicants to provide support during the process and minimise any potential delays.

The Department’s online only impact assessment included a cost analysis and calculations on the implementation of the Coronavirus Test Device Approvals process. It is intended that this regulation should be cost neutral for taxpayers and as such, the Government recovers the costs from applicants, while ensuring fees are as low as possible. However, through engagement in a public consultation and with industry, we recognised concerns on ensuring smaller businesses can access the market. Therefore a discounted rate of 55% is offered, in line with taxation benefits for research and development spending offered to small to medium-sized enterprises. We have committed to review the policy at the end of 2022.

While there was no specific early engagement programme, the National Institute for Health and Care Excellence’s (NICE) recent review of its methods and processes for health technology evaluation was overseen by a steering group and working group. The organisations which participated in these groups are as follows:

Centre for Health Technology Evaluation, NICE;

Centre for Guidelines, NICE;

Centre for Health Economics, University of York;

NHS England and NHS Improvement;

The Office for Life Sciences;

The Department of Health and Social Care;

NICE appraisal committee;

British In Vitro Diagnostics Association;

The Association of the British Pharmaceuticals Industry;

The Psoriasis and Psoriatic Arthritis Alliance;

The British Medical Journal Technology Assessment Group;

The Ethical Medicines Industry Group;

The BioIndustry Association;

Genetic Alliance;

ReCor Medical UK, Association of British HealthTech Industries;

School of Health and Related Research, the University of Sheffield;

Alzheimer's Research UK.