Beccy Cooper

The Department, in collaboration with NHS England, will outline details of the funding allocation for surgical hubs at the earliest opportunity. This will include the number of hubs to be established, and their specialty focus. Each hub will be developed based on the needs of patients and the current waiting list pressures in the areas that they cover.

No formal assessment has been made on the impact of surgical hubs on waiting times for trauma and orthopaedic treatment.

Surgical hubs enable trusts to increase resilience for elective procedures and minimise cancellations during periods of high pressure. This can reduce uncertainty for patients around last-minute cancellations, maximise the use of available capacity, and helps to reduce waiting times. In the Budget, we committed additional funding to set up new surgical hubs to help with our commitment to get the waiting lists down.

It is important that National Health Service staff are able to work in a supportive and compassionate environment that prioritises their health and wellbeing. NHS England has a wide-ranging package of mental health and wellbeing support for all staff, including nurses, which includes access to counselling services, a self-check wellbeing tool, free access to a range of wellbeing apps, and a health and wellbeing guardian role to provide board level scrutiny within NHS organisations. NHS England is also leading work with partner organisations to strengthen occupational health and wellbeing services for NHS staff.

Selling tobacco to someone underage, whether in person or online, is a serious criminal offence which carries a fine of up to £2,500 on conviction in a magistrates’ court. It is the responsibility of all retailers including those online to ensure their customers are over the age of sale. The Tobacco and Vapes Bill, introduced to Parliament on 5 November 2024, is the biggest public health intervention in a generation, and takes significant action to strengthen enforcement to ensure that current and new sales regulations are successfully implemented.

The Bill introduces a new £200 fixed penalty notice in England and Wales, which will enable Trading Standards Officers to act ‘on the spot’ to clamp down on rogue retailers selling tobacco, vapes or nicotine products to people underage, whether in-person or online. The Bill also provides powers in England, Wales, and Northern Ireland to introduce a licensing scheme for the retail sale of these products. Once the scheme is introduced, it will be a criminal offence to sell these products, either in person or online, without a licence. Licensing offences will carry significant financial penalties, and those who commit sales offences could face licence revocation, enabling Trading Standards to further clamp down on rogue retailers. The details of the licensing scheme including licence conditions will be subject to consultation ahead of introduction.

Alongside the Bill, the Government is exploring how we can further tackle online underage sales. The Department for Science, Innovation and Technology is creating a framework of standards and governance, namely the UK digital identity and attributes trust framework, underpinned by legislation, to enable the widespread use of trusted digital identity services. This framework provides a potential opportunity for companies providing age verification services to be certified, to prove they are delivering age assurance solutions that meet Government standards.

On 5 November 2024, the Government introduced the Tobacco and Vapes Bill, which stands to be the most significant public health intervention in a generation. It will create the first smoke-free generation, as children turning 15 years old this year or younger can never legally be sold tobacco, whilst those who currently legally smoke are able to continue doing so. The bill sits alongside wider support across the health service to assist smokers in quitting for good.

We remain committed to helping existing smokers to quit with effective support, which is three times as effective as making an unassisted quit attempt. The National Institute for Health and Care Excellence recommends nicotine replacement therapy for young people aged 12 years old and over, and if prescribed, that behavioural support is also provided. Local authority funding has been boosted with an additional £70 million in 2024/25 to build capacity and demand for local stop smoking support.

We are committed to training the staff we need to ensure that patients are cared for by the right professional, when and where they need it. The Long Term Workforce Plan, which included assessments of nursing demand and supply, will be reviewed following the recommendations of 10-Year Health Plan.

The Healthy Start scheme is kept under review. There have been no discussions with my Rt Hon. Friend, Secretary of State for Work and Pensions on introducing auto-enrolment for Healthy Start.

The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old, from very low-income households. It can be used to buy, or put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old. Healthy Start now supports over 355,000 beneficiaries. This figure is higher than the previous paper voucher scheme.

The NHS Business Services Authority operates the Healthy Start scheme on behalf of the Department. All applicants to the Healthy Start scheme, where they meet the eligibility criteria, must accept the terms and conditions of the prepaid card at the point of application. As the prepaid card is a financial product and cannot be issued without the applicant accepting these terms, the NHS Business Services Authority is not able to automatically provide eligible families with a prepaid card. However, we remain open to all viable routes to improve uptake.

Children currently consume twice the recommended level of sugar. There is strong evidence that high sugar intakes increase the risk of tooth decay and weight gain. Being overweight increases the risk of heart disease, stroke, type 2 diabetes, and some cancers.

We face a childhood obesity crisis, and the Government is committed to tackling this and raising the healthiest generation of children. The Government has already taken action to ensure the implementation of restrictions on the advertising of high sugar food and drink, which will incentivise industry to reformulate and reduce sugar levels in their products.

The Soft Drinks Industry Levy has nearly halved the level of sugar in drinks in scope, and the voluntary sugar reduction programme has also reduced sugar in many products.

Working together as a mission led Government, and through our shift to prevention, we are reviewing the balance of mandatory and voluntary measures that will be required to deliver further reductions in sugar levels in everyday food and drink products.

In the United Kingdom, most people’s diet is not in line with the Government’s dietary recommendations as encapsulated in the Eatwell Guide. Most people consume too many calories, too much salt, sugar, and saturated fat, and not enough fibre, fruit, and vegetables. This increases the risk of gaining weight and suffering from type 2 diabetes, heart attacks, stroke, and some cancers at an earlier age.

Whilst the Government has not made a specific assessment of the impact of improving access to healthy food for people who cannot work due to long term illness, published modelling data suggests that if population intakes were in line with the Eatwell Guide it would improve life expectancy by approximately eight years for the average 40 year old.

The Eatwell Guide shows the proportions in which different types of foods and drinks should be consumed to achieve a healthy, balanced diet. It is communicated through the NHS.UK website and Government social marketing campaigns such as Better Health, Healthier Families, and Start for Life.

Poor diet and obesity are major drivers of physical and mental ill health. No assessment has been made to date to specifically assess the impact of improving access to healthy food on National Health Service waiting lists, however shifting the focus from treatment to prevention is one of the three shifts for the Government’s mission for an NHS fit for the future, and is a cornerstone of supporting people to live healthier lives.

NHS England has no plans to update the guidance. The Department undertook a national consultation in 2017 on the prescribing of gluten-free (GF) foods in primary care. The rationale for this was the increased availability of these products in supermarkets and other food outlets at a time when the annual cost to the National Health Service of prescribing such items was £15.7 million. The first of these proposed changes to prescribing arrangements resulted in the Government’s decision to restrict NHS prescribing of such foods to only bread and mixes.

NHS England’s guidance, Prescribing Gluten-Free Foods in Primary Care, was developed to communicate to local commissioners, now integrated care boards (ICBs), the changes in legislation. Wording is included in the guidance which states that commissioners may further restrict the prescribing of GF foods by selecting bread or mixes only, or may choose to end the prescribing of GF foods altogether if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and provided they have regard to reducing health inequalities. In NHS England’s guidance, there are no limits on the amount of bread or mixes that can be prescribed. This guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/11/prescribing-gluten-free-foods-primary-care-guidance-for-ccgs.pdf

Decisions about the commissioning and funding of local health services are the responsibility of local ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practice. The guidance does not remove the clinical discretion of prescribers in accordance with their professional duties.

No assessment has been made of the potential impact of outdoor physical advertising for less healthy food and drink products on levels of child obesity. However, the Government welcomes recent action at a local level to ban junk food marketing across public transport networks and public spaces that are controlled locally.

Supporting people to stay healthier for longer is at the heart of the Government’s Health Mission. This includes taking bold action to tackle the childhood obesity crisis and create the healthiest generation of children ever.

The Government has committed to implementing the advertising restrictions set out in the Communications Act 2003 on less healthy food and drink products without further delay. The regulations introduce a 9:00pm watershed for the advertisement of less healthy food or drink products on television, and a total restriction of paid-for advertising of these products online, which will come into force United Kingdom-wide on 1 October 2025.

Evidence shows that these restrictions will have a direct impact on childhood obesity by reducing children’s exposure to advertising of less healthy products. We estimate that these restrictions will remove up to 7.2 billion calories from children’s diets per year in the UK, and reduce the number of children living with obesity by 20,000.

Annual reviews, including reviews of medication, play a key role in the ongoing management of people with respiratory diseases, such as asthma and chronic obstructive pulmonary disorder (COPD). They are recommended by the National Institute for Health and Care Excellence (NICE), playing a core part in its guidance for the diagnosis and management of asthma and COPD. Further information on the NICE’s guidance for the diagnosis and management asthma and COPD is available respectively at the following two links:

https://www.nice.org.uk/guidance/ng80

https://www.nice.org.uk/guidance/ng115

The majority of patients with COPD and asthma are managed by general practitioners and members of the primary care team, with onward referrals to secondary care where required, and so the provision of annual reviews is incentivised in primary care through the Quality and Outcomes Framework. There are specific indicators for annual reviews for both COPD and asthma within this framework, specifically sections COPD010 and AST007. The Quality and outcomes framework guidance for 2024/25 is available at the following link:

https://www.england.nhs.uk/publication/quality-and-outcomes-framework-guidance-for-2024-25/

The NICE is currently reviewing its guideline for the diagnosis, monitoring, and management of chronic asthma, and an updated version is due to be published in November 2024. Based on the draft that has been published for consultation, we anticipate annual reviews will remain a recommended core component of the ongoing management of people with asthma.

We are committed to creating the healthiest generation of children ever. To achieve this, we must ensure that families have the support they need to give their babies and children the best start and the building blocks for a healthy life.

The child health workforce, including health visitors and school nurses, is central to how we support families to give their child the best start in life. Their contact with parents, carers and children of all ages provides vital advice and support and helps ensure that health, development, and safeguarding needs are identified early.

We are committed to training the staff we need to ensure patients, their carers and their families are cared for by the right professional, when and where they need it. We will want to assure ourselves, and the National Health Service, that the current plan will deliver the reform needed. We will need to do this in light of the 10 Year Plan.

There are 10 community diagnostic centres (CDC) currently providing ultrasound liver elastography, otherwise known as a fibroscan. NHS England has plans to understand the diagnostic pathways for liver disease and how CDCs can further support this.

The pathway for assessing liver disease should start with blood tests taken in primary care, with FIB-4 liver tests available at National Health Service trusts.

Infant formula legislation sets robust nutritional and compositional standards to ensure that all infant formula meets the nutritional needs of babies for healthy growth and development, irrespective of brand or price. The legislation also restricts the marketing and promotion of infant formula so as not to discourage breastfeeding. This is in line with our international commitments to support the World Health Organisation International Code of Marketing of Breastmilk Substitutes to promote breastfeeding.

The Department has published guidance on infant and follow-on formula and food for special medical purposes, including specialist infant formulas, which advises businesses on the implementation of the regulations. Loyalty and reward card schemes vary between retailers, and it is for businesses to ensure that their activities are in compliance with the regulations on a case by case basis.

The Competition and Markets Authority (CMA) is undertaking a market study into competition in the infant formula sector in the United Kingdom. It is gathering evidence on: consumer behaviour, the drivers of choice, and the information and advice available to consumers to support their decisions; the role of the regulatory framework and its enforcement in influencing market outcomes; and the supply-side features of the market such as barriers to entry and expansion. The CMA’s market study is expected to publish an interim report in October 2024. We look forward to the CMA’s interim report into this issue and we will carefully consider any findings and recommendations for the regulatory framework for infant formula.

NHS England is assessing the role of screening for non-alcoholic fatty liver disease in children as part of the initial 30 Complication from Excess Weight clinics. Children and young people are assessed within these clinics for a range of physical and mental health problems associated with excess weight with the intention to provide early interventions. The efficacy of this approach is currently being evaluated by the National Institute for Health and Care Research.

My Rt. Hon. Friend, the Secretary of State for Health and Social Care, chairs a cross-government Health Mission Board to oversee and drive delivery of the health mission to ‘build a health and social care system fit for the future'.

Lord Darzi’s full report has laid bare the true extent of the challenges facing our health service, giving us the frank assessment necessary to face these problems honestly and properly and do the hard work required to fix them. Lord Darzi’s findings will inform our 10-year plan to radically reform the National Health Service and build a health service that is fit for the future.

The plan will consider the change needed to meet the three health mission goals; a fairer system where everyone lives well for longer, an NHS that is there when people need it, and fewer lives lost to the biggest killers. This is a long-term challenge and will take time to deliver, and so the plan will consider both what immediate actions are needed to get the NHS back on its feet and bring waiting lists down, as well as the longer-term changes needed to make the health service fit for the future.

Alongside the 10-year health plan we are also taking action to address immediate challenges in the health service, such as hiring a thousand more general practitioners and ending junior doctor strikes. We have also committed to cut NHS waiting times with 40,000 more appointments every week, double the number of cancer scanners, develop a new Dentistry Rescue Plan, hire 8,500 additional mental health staff, and ensure the return of the family doctor.

There are currently no plans for a review into the adequacy of adult liver services across the National Health Service. The commissioning of services for liver disease is generally the responsibility of integrated care systems (ICS). ICS are responsible for decisions on commissioning health services and reviewing those services to ensure they best meet the needs of their local population.

NHS England has a Hepatobiliary and Pancreas Clinical Reference Group (CRG) which provides clinical advice to NHS England in support of the commissioning of specialised services. By working in partnership with key stakeholders, the CRG helps drive improvements in the quality, equity, experience, efficiency, and outcomes of specialised services. The CRG is currently reviewing its service specification in relation to liver and pancreatic care, which is scheduled for completion before the end of the current financial year.

We are working to improve access to digital services, outcomes, and experience for the widest range of people, based on their preferences. Patients unable to use digital channels can continue to access services via telephone and through traditional face to face services.

Citizens can access a range of information on different health conditions on the National Health Service’s website, which is all clinically verified. Centrally built services, such as the NHS App and NHS website are designed to meet international accessibility standards. We are modernising the mobile patient experience within the NHS App, ensuring information is clearly structured and easy to find and understand.

NHS organisations and publicly funded social care providers in England are required to meet the Accessible Information Standard, in order to meet the communication needs of patients and carers with a disability, impairment, or sensory loss, including patients with sight or hearing loss.

We know that the National Health Service has been facing chronic workforce shortages for a number of years and, while there has been growth in the mental health workforce over recent years, more is needed.

That is why, as part of our mission to build an NHS that is fit for the future and is there when people need it, we will recruit an additional 8,500 mental health workers to reduce waiting times and provide faster treatment. We recognise that bringing in the staff needed will take time. We are working to develop a plan to deliver this expansion of the mental health workforce, including where they should be deployed to achieve maximum effect.

Supporting people to stay healthier for longer is at the heart of this government’s Health Mission. We face a childhood obesity crisis and this government will take action to tackle it head on, easing the strain on the National Health Service and creating the healthiest generation of children ever.

The Health Mission has an overall objective to reduce the amount of time spent in ill-health, tackle health inequalities and drive economic growth. This brings together all government departments with an influence over the social determinants of health, to drive forward action in these areas.

We are committed to implementing the Advertising Regulations of less healthy food to children, empowering councils to block the development of new fast-food shops outside schools and banning the sale of high-caffeine energy drinks to children under 16 years old.

Further action on obesity under the Government’s Health Mission will be set out in due course.

As set out in the King's Speech, the Government will bring forward the necessary secondary legislation to ban junk food advertising to children and to stop the sale of high-caffeine energy drinks to under 16-year-olds. We face an obesity crisis, and we will take action to tackle it head on, easing the strain on our National Health Service and creating the healthiest generation of children ever.

There is no universally agreed definition of ultra-processed foods (UPF), although NOVA is the most widely used classification system. NOVA categorises foods by how processed they are, rather than their nutritional composition.

In July 2023, the UK Scientific Advisory Committee on Nutrition (SACN) published a position statement on processed foods and health, and concluded that observed associations between UPF and health are concerning, but it is unclear whether these foods are inherently unhealthy due to processing or due to their nutritional content. Given the SACN’s concerns, they added the topic of processed foods and health to their watching brief and will consider it at their next horizon scan meeting in October 2024.

Government dietary advice, based on recommendations from the SACN, and as depicted within the Eatwell Guide, already shows that many foods that would be classified as ultra-processed are not part of a healthy, balanced diet as they are high in calories, saturated fat, salt, or sugar (HFSS). The Government’s advice on healthy eating, including the Eatwell Guide’s principles, are communicated through the NHS.UK website and the Government’s social marketing campaigns such as Better Health, Healthier Families, and Start for Life.

As UPFs tend to be HFSS, they are also likely to be the focus of policies to reduce consumption of HFSS foods, including the regulations being brought forward to ban junk food advertising to children and stopping the sale of high-caffeine energy drinks to 16-year-olds.

The National Child Measurement Programme (NCMP) collects data on children aged four to five years old, who would be in reception, and 10 to 11 years old, who would be in year 6. It provides detailed data on childhood obesity by age, sex, deprivation, and ethnicity, as well as geographic analyses.

NCMP data for 2022/23 shows that, for children living in the most deprived areas, obesity prevalence was twice as high compared with those living in the least deprived areas in both reception and year 6.

For children in reception, the data for 2022/23 shows a gap of 6.6% for obesity prevalence between the most and least deprived areas. This is the smallest disparity gap seen since 2014/15, and has been driven by a greater drop in obesity prevalence in the most deprived areas, which is at its lowest level since 2015/16. For children in year 6, the gap in obesity prevalence between the most and least deprived areas in 2022/23 has reduced to 17.1%, but is still much larger than that seen in pre-pandemic years.

A growing number of children living with obesity are developing health conditions, including high blood pressure, high cholesterol, non-alcoholic fatty liver disease, bone and joint problems, tooth decay, and type 2 diabetes.

Further health outcomes associated with obesity occur in adulthood. Approximately 80% of adolescents living with obesity will continue to live with excess weight as adults, so it is important to create an environment which helps children maintain a healthy weight.

Where a child lives therefore influences their weight status and health outcomes. There are large and persistent disparities between the most and least deprived communities of England.

One of the Government’s five missions is to build a National Health Service that is fit for the future. The Health Mission has an overall objective to reduce the amount of time spent in ill-health, tackle health inequalities, and drive economic growth.

As part of this, we’ll be taking ambitious steps to improve the nation’s health, so that we see improvement across a range of public health indicators, including obesity. Further details will be set out in due course.