Cat Smith

The Government is committed to doing more to ensure that everyone, including older people, girls and women and those with disabilities, all have access to and benefit from quality sport and physical activity opportunities. Sport and physical activity is central to achieving our health and opportunity manifesto missions, with the biggest gains coming from supporting those who are inactive to move more.

The Government provides the majority of support for grassroots sport through Sport England - which annually invests over £250 million in Exchequer and Lottery funding. Sport England’s work focuses on increasing participation in sport and to boost diversity at a grassroots level to give more and better opportunities to all.

Sport England provides long term investment to the Lawn Tennis Association, the National Governing Body for tennis in Britain, which receives up to £10.2 million for five years to invest in community tennis and padel initiatives that will benefit everyone, including disabled people, women and girls and older people.

Sport England also works to ensure that each of their programmes impact directly on disabled people and those with a long-term health condition, with initiatives like the 'We are Undefeatable' campaign and partnerships with disability organisations.

Decisions with regards to future departmental budgets will be made as part of the upcoming spending review process.

The Government is committed to doing more to ensure that everyone, including older people, girls and women and those with disabilities, all have access to and benefit from quality sport and physical activity opportunities. Sport and physical activity is central to achieving our health and opportunity manifesto missions, with the biggest gains coming from supporting those who are inactive to move more.

The Government provides the majority of support for grassroots sport through Sport England - which annually invests over £250 million in Exchequer and Lottery funding. Sport England’s work focuses on increasing participation in sport and to boost diversity at a grassroots level to give more and better opportunities to all.

Sport England provides long term investment to the Lawn Tennis Association, the National Governing Body for tennis in Britain, which receives up to £10.2 million for five years to invest in community tennis and padel initiatives that will benefit everyone, including disabled people, women and girls and older people.

Sport England also works to ensure that each of their programmes impact directly on disabled people and those with a long-term health condition, with initiatives like the 'We are Undefeatable' campaign and partnerships with disability organisations.

Decisions with regards to future departmental budgets will be made as part of the upcoming spending review process.

The Government supports investment in drug and alcohol treatment and recovery services, to ensure that those people with a substance use need get appropriate help and support. In addition to the Public Health Grant, the Department has allocated local authorities a further £267 million in 2024/25 to improve the quality and capacity of drug and alcohol treatment and recovery. This is alongside £105 million made available by the Department of Health and Social Care, the Department for Work and Pensions, and the Ministry of Housing, Communities and Local Government to improve employment and housing support.

My Rt. Hon. friend, the Chancellor of the Exchequer announced updates to the fiscal framework, and earlier this year launched the Spending Review which has now settled the 2025/26 departmental budgets. She has also made it clear that the Government will conclude a multi-year Spending Review in spring 2025. In future, we anticipate that Spending Reviews will be set every two years to cover a three-year period, including a one-year overlap with the previous Spending Review, helping build in greater certainty and stability over public finances.

Now that the Autumn Budget has been completed, the Department is working to be able to announce future funding allocations for drug and alcohol treatment and recovery systems. We will communicate with the sector about this as soon as we are able to, as we recognise the importance of this information in maintaining delivery and planning for 2025/26.

We will publish local authority public health grant allocations for 2025/26 in due course, with the aim of giving local authorities as much notice as possible to plan.

We will aim to confirm future multi-year allocations later in 2025, following the next phase of the Spending Review in spring.

The standard process confirming the total funding amount for major infrastructure projects involves the review and approval of a Full Business Case. All trusts in the programme have previously received indicative funding allocations to support planning, however these are commercially sensitive.

There are two New Hospital Programme schemes in Lancashire and South Cumbria, the scheme for the Lancashire Teaching Hospitals NHS Foundation Trust at Royal Preston Hospital, and the scheme for the University Hospitals of Morecambe Bay NHS Foundation Trust at Royal Lancaster Infirmary. Up to the end of the 2023/24, both trusts received £6.7 million each for their new hospital schemes.

The breakdown of how much the trusts received for their new hospital schemes is published annually as part of the Department’s Annual Reports and Accounts, with Public Dividend Capital to individual trusts included in the Financial Assistance Report under section 40 of the National Health Service Act 2006. The 2022/23 report is available at the following link:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023

Both schemes are at Pre-Consultation Business Case stage, and are at Royal Institute of British Architects Stage 1.

The standard process confirming the total funding amount for major infrastructure projects involves the review and approval of a Full Business Case. All trusts in the programme have previously received indicative funding allocations to support planning, however these are commercially sensitive.

There are two New Hospital Programme schemes in Lancashire and South Cumbria, the scheme for the Lancashire Teaching Hospitals NHS Foundation Trust at Royal Preston Hospital, and the scheme for the University Hospitals of Morecambe Bay NHS Foundation Trust at Royal Lancaster Infirmary. Up to the end of the 2023/24, both trusts received £6.7 million each for their new hospital schemes.

The breakdown of how much the trusts received for their new hospital schemes is published annually as part of the Department’s Annual Reports and Accounts, with Public Dividend Capital to individual trusts included in the Financial Assistance Report under section 40 of the National Health Service Act 2006. The 2022/23 report is available at the following link:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023

Both schemes are at Pre-Consultation Business Case stage, and are at Royal Institute of British Architects Stage 1.

The standard process confirming the total funding amount for major infrastructure projects involves the review and approval of a Full Business Case. All trusts in the programme have previously received indicative funding allocations to support planning, however these are commercially sensitive.

There are two New Hospital Programme schemes in Lancashire and South Cumbria, the scheme for the Lancashire Teaching Hospitals NHS Foundation Trust at Royal Preston Hospital, and the scheme for the University Hospitals of Morecambe Bay NHS Foundation Trust at Royal Lancaster Infirmary. Up to the end of the 2023/24, both trusts received £6.7 million each for their new hospital schemes.

The breakdown of how much the trusts received for their new hospital schemes is published annually as part of the Department’s Annual Reports and Accounts, with Public Dividend Capital to individual trusts included in the Financial Assistance Report under section 40 of the National Health Service Act 2006. The 2022/23 report is available at the following link:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023

Both schemes are at Pre-Consultation Business Case stage, and are at Royal Institute of British Architects Stage 1.

The standard process confirming the total funding amount for major infrastructure projects involves the review and approval of a Full Business Case. All trusts in the programme have previously received indicative funding allocations to support planning, however these are commercially sensitive.

There are two New Hospital Programme schemes in Lancashire and South Cumbria, the scheme for the Lancashire Teaching Hospitals NHS Foundation Trust at Royal Preston Hospital, and the scheme for the University Hospitals of Morecambe Bay NHS Foundation Trust at Royal Lancaster Infirmary. Up to the end of the 2023/24, both trusts received £6.7 million each for their new hospital schemes.

The breakdown of how much the trusts received for their new hospital schemes is published annually as part of the Department’s Annual Reports and Accounts, with Public Dividend Capital to individual trusts included in the Financial Assistance Report under section 40 of the National Health Service Act 2006. The 2022/23 report is available at the following link:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023

Both schemes are at Pre-Consultation Business Case stage, and are at Royal Institute of British Architects Stage 1.

The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, some issues, including with some Tegretol presentations, have been resolved. The Department continues to work closely with industry, the National Health Service, and others to help ensure patients continue to have access to an alternative treatment until their usual product is back in stock. This includes working with manufacturers of alternatives formulations to ensure they remain available and can support increased demand.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information is not collected on a local level.

The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.

We are continuing to work to resolve supply issues where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the UK from October 2024.

In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinion for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.

To aid ADHD service providers and prescribers further we have widely disseminated our communications, and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients.

As set out in the NHS Priorities and Operational Planning Guidance for 2024/25, NHS England is continuing to expand access to mental health services, to increase the number of people accessing mental health support. Integrated care boards are responsible for providing health and care services to meet the needs of their local populations.

We plan to recruit an additional 8,500 mental health workers across child and adult mental health services in England, to reduce delays and provide faster treatment, including in rural areas.

The Suicide prevention strategy for England: 2023 to 2028, published in September 2023, sets out an ambition to conduct and commission research and data linkage projects, including supporting the Department for Environment, Food and Rural Affairs to look at agricultural workers, to understand the unique challenges in that occupational group and respond appropriately.

In addition, through its Farming and Countryside Programme, the Department for Environment, Food and Rural Affairs is working with a range of farming charities, including the Royal Agricultural Benevolent Institution and the Yellow Wellies charity, which have highlighted mental health challenges for farming communities.

As set out in the NHS Priorities and Operational Planning Guidance for 2024/25, NHS England is continuing to expand access to mental health services, to increase the number of people accessing mental health support. Integrated care boards are responsible for providing health and care services to meet the needs of their local populations.

We plan to recruit an additional 8,500 mental health workers across child and adult mental health services in England, to reduce delays and provide faster treatment, including in rural areas.

The Suicide prevention strategy for England: 2023 to 2028, published in September 2023, sets out an ambition to conduct and commission research and data linkage projects, including supporting the Department for Environment, Food and Rural Affairs to look at agricultural workers, to understand the unique challenges in that occupational group and respond appropriately.

In addition, through its Farming and Countryside Programme, the Department for Environment, Food and Rural Affairs is working with a range of farming charities, including the Royal Agricultural Benevolent Institution and the Yellow Wellies charity, which have highlighted mental health challenges for farming communities.

The emergency banning order limiting the sale or supply of puberty blockers against private or non-United Kingdom prescriptions allows a child under 18 years old, who was already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.

This government has committed to implementing the expert recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institue of Health and Care Research – the research arm of the department – are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

Children and young people unable to access puberty blockers are strongly advised to meet with their clinician. We expect clinicians to be working with impacted patients to consider what the best care for them is going forward. Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:

https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

The emergency banning Order, restricting the sale or supply of puberty blockers, was introduced by the previous Government. The Order enables those who were already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues, before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.

The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This Government will always act in the interests of patient safety, which is why the Secretary of State signalled his intention to renew the Order and consult on a permanent ban (subject to the outcome of the ongoing judicial review).

We are committed to implementing the recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institute of Health and Care Research, the research arm of the Department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

We will continue to monitor the impacts of the Order, including on mental health. Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, has examined evidence for a large rise in suicides claimed by campaigners. His paper, which was published on 19 July 2024, concluded that the data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock clinic.

Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:

https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

Professor Appleby’s paper is available at the following link:

https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report

The emergency banning Order, restricting the sale or supply of puberty blockers, was introduced by the previous Government. The Order enables those who were already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues, before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.

The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This Government will always act in the interests of patient safety, which is why the Secretary of State signalled his intention to renew the Order and consult on a permanent ban (subject to the outcome of the ongoing judicial review).

We are committed to implementing the recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institute of Health and Care Research, the research arm of the Department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

We will continue to monitor the impacts of the Order, including on mental health. Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, has examined evidence for a large rise in suicides claimed by campaigners. His paper, which was published on 19 July 2024, concluded that the data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock clinic.

Some children and young people may be concerned by these changes. If they are already under the care of a Children and Young People’s mental health provider or the Child and Adolescent Mental Health Services, they can contact their team for advice. If they are not, their general practice team will be able to assess whether further referrals for mental health support are required. Patients can also be signposted to the advice on getting mental health support available on the NHS.UK website. Anyone in need of urgent support can contact NHS 111 and choose the mental health option, option two. Further details are available at the following link:

https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

Professor Appleby’s paper is available at the following link:

https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report

The emergency banning order limiting the sale or supply of puberty blockers against private or non-United Kingdom prescriptions allows a child under 18 years old, who was already on a course of treatment with Gonadotrophin-Releasing Hormone Analogues before 3 June 2024 from a UK based private or National Health Service provider, to continue to have them supplied. Those who were already on a course of treatment prescribed by an EEA or Switzerland registered prescriber can legally switch to a UK based prescriber to continue their treatment.

This government has committed to implementing the expert recommendations of the Cass Review to ensure that young people presenting to the NHS with gender dysphoria are receiving appropriate and high-quality care. That is why NHS England and the National Institue of Health and Care Research – the research arm of the department – are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

We recognise the value of engaging with representative groups and want to reset the relationship the department has with LGBT+ groups. My rt. Hon. Friend, the Secretary of State for Health and Social Care, will be meeting with LGBT+ stakeholders as soon as possible to hear directly about the health and care issues that are most important to them.

The expert Cass Review, which is one of the most comprehensive reviews of gender identity services for children and young people to date, states that the rationale for early puberty suppressing hormones to treat gender dysphoria is unclear and the effects on cognitive and psychosexual development are unknown. This is why NHS England and the National Institute of Health and Care Research, the research arm of the department, are working together to commission a study into the potential benefits and harms of puberty suppressing hormones as a treatment option for children and young people with gender incongruence. The study team is now in place and are finalising their application for funding which will be assessed by an independent scientific review study ahead of the commencement of wider approvals, including ethics, and set up.

The Cass Review is one of the most comprehensive reviews of gender identity services for children and young people to date worldwide.

The Cass review included an assessment of evidence from other countries and concluded that there was a lack of evidenced-based guidelines and, therefore, limitations for adopting these for National Health Service gender services. Informed by the Cass review, we are now reforming transgender care for young people in this country, based on the best possible evidence. That means a holistic approach, with puberty suppressing hormones only considered within a much broader needs assessment, and only then in the context of a clinical trial. We are committed to implementing the recommendations of the Cass Review, as that is the care model we believe to be the best approach in the interests of patient safety.

It is simply not possible for pharmacists to check whether prescriptions issued from overseas registered prescribers have been issued in a similarly safe and effective way, and we know that some overseas providers who advertise their services do not follow this approach.