Chloe Smith

The Government is taking steps through NHS England to improve outcomes for cancer patients, including those cancers mentioned by the Less Survivable Cancer Taskforce, namely lung, liver, brain, oesophageal, pancreatic and stomach. Diagnostic checks are a key part of cancer pathways and the 150 community diagnostic centres (CDCs) opened by the Government will give earlier diagnostic tests, benefitting millions of patients including those who are referred with suspected less survivable cancers. National Health Service systems have been asked to prioritise CDC capacity towards their most challenged cancer pathways, where this is clinically appropriate, and these centres have delivered over six million additional tests for all elective activity since July 2021. The CDC programme is on track to meet its target to open up to 160 CDCs by March 2025, with many due to open ahead of schedule.

In November 2022, the NHS also announced an expansion of direct access to diagnostic scans across all general practices, to help cut waiting times and speeding up cancer diagnosis, or all-clear for patients. The NHS is now looking to widen the clinical pathways for which this is offered.

Making improvements across different cancer types is critical to helping achieve the NHS Long Term Plan ambition of diagnosing 75% of patients at an early stage by 2028 and reducing inequalities in cancer survival. NHS England has commissioned new cancer clinical audits covering six cancer types, some of which are less survivable: pancreatic cancer, ovarian cancer, non-Hodgkin lymphoma, kidney cancer and primary and metastatic breast cancer. All six audits will cover care delivered in England and Wales.

Cancer is being diagnosed at earlier stages, more often, with survival rates improving across almost all types of cancer with the National Health Service seeing and treating record numbers of cancer patients over the last two years.

The planned Major Conditions Strategy will look at the early diagnosis and treatment of cancer. The strategy will look at a wide range of interventions and enablers to improve outcomes and experience for a range of cancer patients, including those less survivable cancers. We have already acted upon some of the areas that the 2020 Less Survivable Cancer Taskforce report requested, for example the introduction of targeted lung health checks, trials for cytosponge, and the roll out of non-specific symptom pathways. The report is available at the following link:

https://lesssurvivablecancers.org.uk/our-asks/

We are establishing a governance structure to work with the Office for Students and key stakeholders to develop a methodology for allocating dental undergraduate student expansion, focussing on areas that have dental workforce challenges and aligning the methodology principles to that being developed for medical expansion.

NHS England provided guidance for integrated care boards (ICBs) that requires dental allocations to be ringfenced in 2023/24, with any unused resources re-directed to improve National Health Service dental access in the first instance and not spent on other services. In November 2023, NHS England confirmed that where ICBs had not spent all of their allocation on improving access to dentistry, they would be able to retain any underspend and use this to balance their bottom line and any other pressures. ICBs will decide how to use any forecast underspend in line with this guidance. We are currently considering arrangements for 2024/25.

There are no current estimates of how much dental ringfence NHS dental funding has been used to support costs associated with strike action. NHS England has issued additional funding to systems of £800 million so far in this financial year to directly cover the costs of strikes.

In the Primary Care Recovery Plan, we committed to reviewing the National Planning Policy Framework (NPPF) and planning guidance to ensure primary care infrastructure can be supported through the planning system where new development creates a need for it.

We continue to work closely with the Department for Levelling Up, Housing & Communities to ensure these commitments are met through its cross-government engagement. This will take place as part of the latest NPPF refresh as well as through negotiations on the future Infrastructure Levy, as the Levelling Up and Regeneration Bill has received Royal Assent.

Integrated care boards will play a key future role in partnering with Local Planning Authorities to ensure their local Infrastructure Delivery Strategies accurately capture the vision for healthcare in the area.

NHS England is responsible for commissioning primary care dentistry to meet the needs of the local population. Many of the dentistry commissioning functions undertaken by NHS England will transfer to integrated care boards (ICBs) from April 2023. ICBs will be responsible for meeting the needs of their local populations of all ages, working with patient groups. NHS England has made available to commissioners an Assurance Framework to provide assurances on commissioning.

In circumstances where a person or parents are unable to access an urgent dental appointment for their child directly through a National Health Service dental practice, they are advised to contact NHS 111 for assistance.

In September 2022, we announced ‘Our plan for patients’ which sets out how we will meet oral health needs and increase access to National Health Service dental services for patients of all ages, whilst making the NHS dental contract more attractive to dental practices. These changes have been implemented, including through regulations that came into effect on 25 November 2022. NHS England is holding further discussions with the British Dental Association and other stakeholders for plans for additional reforms of the NHS Dental System coming shortly.

In circumstances where a guardian or parents are unable to access an urgent dental appointment for their child directly through a NHS dental practice, they are advised to contact NHS 111 for assistance.

Information on the number of children who have seen a dentist or hygienist in Norwich in the last six or 12 months is not available.

Dental Statistics, published by NHS Digital, provides information on NHS dental activity in England and is available from the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2021-22-annual-report

The table below shows that the proportion of children in Norfolk County Council who have seen an NHS dentist in the last 12 months (to June 2022) is almost 10% lower than the national average. Published data is not available for Norwich.

NHS England commissions community dental services to offer dental care to vulnerable patients, including those with special educational needs and disabilities, who cannot be treated in a general NHS dental practice or may be in locations that cannot access NHS dental services.

In September 2022, we announced ‘Our plan for patients’ which sets out how we will meet oral health needs and increase access to National Health Service dental services for patients of all ages, whilst making the NHS dental contract more attractive to dental practices. These changes have been implemented, including through regulations that came into effect on 25 November 2022. NHS England is holding further discussions with the British Dental Association and other stakeholders for plans for additional reforms of the NHS Dental System coming shortly.

In circumstances where a guardian or parents are unable to access an urgent dental appointment for their child directly through a NHS dental practice, they are advised to contact NHS 111 for assistance.

Information on the number of children who have seen a dentist or hygienist in Norwich in the last six or 12 months is not available.

Dental Statistics, published by NHS Digital, provides information on NHS dental activity in England and is available from the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2021-22-annual-report

The table below shows that the proportion of children in Norfolk County Council who have seen an NHS dentist in the last 12 months (to June 2022) is almost 10% lower than the national average. Published data is not available for Norwich.

NHS England commissions community dental services to offer dental care to vulnerable patients, including those with special educational needs and disabilities, who cannot be treated in a general NHS dental practice or may be in locations that cannot access NHS dental services.

In September 2022, we announced ‘Our plan for patients’ which sets out how we will meet oral health needs and increase access to National Health Service dental services for patients of all ages, whilst making the NHS dental contract more attractive to dental practices. These changes have been implemented, including through regulations that came into effect on 25 November 2022. NHS England is holding further discussions with the British Dental Association and other stakeholders for plans for additional reforms of the NHS Dental System coming shortly.

In circumstances where a guardian or parents are unable to access an urgent dental appointment for their child directly through a NHS dental practice, they are advised to contact NHS 111 for assistance.

Information on the number of children who have seen a dentist or hygienist in Norwich in the last six or 12 months is not available.

Dental Statistics, published by NHS Digital, provides information on NHS dental activity in England and is available from the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2021-22-annual-report

The table below shows that the proportion of children in Norfolk County Council who have seen an NHS dentist in the last 12 months (to June 2022) is almost 10% lower than the national average. Published data is not available for Norwich.

NHS England commissions community dental services to offer dental care to vulnerable patients, including those with special educational needs and disabilities, who cannot be treated in a general NHS dental practice or may be in locations that cannot access NHS dental services.

In September 2022, we announced ‘Our plan for patients’ which sets out how we will meet oral health needs and increase access to National Health Service dental services for patients of all ages, whilst making the NHS dental contract more attractive to dental practices. These changes have been implemented, including through regulations that came into effect on 25 November 2022. NHS England is holding further discussions with the British Dental Association and other stakeholders for plans for additional reforms of the NHS Dental System coming shortly.

In circumstances where a guardian or parents are unable to access an urgent dental appointment for their child directly through a NHS dental practice, they are advised to contact NHS 111 for assistance.

Information on the number of children who have seen a dentist or hygienist in Norwich in the last six or 12 months is not available.

Dental Statistics, published by NHS Digital, provides information on NHS dental activity in England and is available from the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2021-22-annual-report

The table below shows that the proportion of children in Norfolk County Council who have seen an NHS dentist in the last 12 months (to June 2022) is almost 10% lower than the national average. Published data is not available for Norwich.

NHS England commissions community dental services to offer dental care to vulnerable patients, including those with special educational needs and disabilities, who cannot be treated in a general NHS dental practice or may be in locations that cannot access NHS dental services.

The minimum income guarantee (MIG) rates are reviewed annually, with a review of the rates for the next financial year currently ongoing. Following the last review, the MIG was increased in line with inflation from 6 April 2022. The rates for 23-24 will be published in a Local Authority Circular.

There has been no specific discussion with Cabinet colleagues on the impact of the MIG on the living standards and quality of life of disabled people, and no specific assessment has been made of the impact of the level of the MIG on disabled people and local authority budgets.

The minimum income guarantee (MIG) rates are reviewed annually, with a review of the rates for the next financial year currently ongoing. Following the last review, the MIG was increased in line with inflation from 6 April 2022. The rates for 23-24 will be published in a Local Authority Circular.

There has been no specific discussion with Cabinet colleagues on the impact of the MIG on the living standards and quality of life of disabled people, and no specific assessment has been made of the impact of the level of the MIG on disabled people and local authority budgets.

The minimum income guarantee (MIG) rates are reviewed annually, with a review of the rates for the next financial year currently ongoing. Following the last review, the MIG was increased in line with inflation from 6 April 2022. The rates for 23-24 will be published in a Local Authority Circular.

There has been no specific discussion with Cabinet colleagues on the impact of the MIG on the living standards and quality of life of disabled people, and no specific assessment has been made of the impact of the level of the MIG on disabled people and local authority budgets.

The minimum income guarantee (MIG) rates are reviewed annually, with a review of the rates for the next financial year currently ongoing. Following the last review, the MIG was increased in line with inflation from 6 April 2022. The rates for 23-24 will be published in a Local Authority Circular.

There has been no specific discussion with Cabinet colleagues on the impact of the MIG on the living standards and quality of life of disabled people, and no specific assessment has been made of the impact of the level of the MIG on disabled people and local authority budgets.

On 25 November 2022 we introduced a contractual responsibility for National Health Service dentists to keep their NHS.UK profiles up to date so that patients can find a dentist more easily. Practices are required to update their NHS.UK profiles at least once every 90 days, including information on whether they are accepting new patients.

Commissioners will have access to a report showing which practices are non-compliant, with monitoring due to come into effect from end of March 2023.

The Government is providing £500 million to reduce delays in discharges from hospital to social care, which will be distributed to local authorities and integrated care boards (ICBs). The allocations were published on 16 November 2022 and are available at the following link:

https://www.gov.uk/government/publications/adult-social-care-discharge-fund-local-authority-and-integrated-care-board-icb-allocations

We are working with the National Health Service, the Care Quality Commission and local partners to ensure high quality patient outcomes at the Norfolk and Suffolk NHS Foundation Trust. The local system has been assessing how mental health delivery might operate in future and how services should be configured, with options for improving service delivery.

I will be hosting a meeting with Norfolk and Suffolk MPs and National Health Service system partners on 12th December to discuss the improvement work that they have been taking to improve services at the Trust.

NHS England has allocated an additional £150 million for the ambulance service in 2022/23, with £20 million to upgrade the ambulance fleet in each year to 2024/25, including in Norfolk.

The National Health Service will increase capacity by the equivalent of at least 7,000 general and acute beds to improve patient flow through hospital and reduce waiting times transferring ambulance patients to accident and emergency departments. This is in addition to a £500 million Adult Social Care Discharge Fund to support the National Discharge Taskforce to reduce delayed discharges to care settings, increase bed capacity and improve patient flow through hospital. NHS England is also providing targeted support to some hospitals facing the greatest delays in the handover of ambulance patients into the care of hospitals, to identify short and longer-term interventions to reduce delays.

NHS England has allocated an additional £150 million for the ambulance service in 2022/23, with £20 million to upgrade the ambulance fleet in each year to 2024/25, including in Norfolk.

The National Health Service will increase capacity by the equivalent of at least 7,000 general and acute beds to improve patient flow through hospital and reduce waiting times transferring ambulance patients to accident and emergency departments. This is in addition to a £500 million Adult Social Care Discharge Fund to support the National Discharge Taskforce to reduce delayed discharges to care settings, increase bed capacity and improve patient flow through hospital. NHS England is also providing targeted support to some hospitals facing the greatest delays in the handover of ambulance patients into the care of hospitals, to identify short and longer-term interventions to reduce delays.

We expect this data to published with monthly general practice appointment data on 24 November 2022.

On 22 September 2022, we announced ‘Our plan for patients’, which contains measures to assist people make an informed choice on their general practitioner (GP) practice, book an appointment more easily, benefit from more care options and increase the diversity of general practice teams. This aims to increase the availability of appointment types, such as face-to-face, in England, including in Norfolk.

NHS England’s guidance states that GP practices must provide face-to-face appointments and remote consultations and should respect preferences for face-to-face care unless there are good clinical reasons to the contrary.  While remote consultations can provide additional choice, flexibility and convenience for patients, this is not suitable for all patients or in all circumstances.

In July 2022, we announced improvements to the National Health Service dental system, including a requirement for dentists to update information at NHS.UK at least every 90 days. Compliance will be monitored on the number of dentists updating this availability quarterly through NHS dental contracts.

NHS England asked dental practices to return to full delivery of contracted activity from July 2022, including in Norwich North. In September, we announced ‘Our plan for patients’, which outlines how we will meet oral health needs and increase access to dental care, including in Norwich North.

The plan includes improvements to ensure dentists are renumerated fairly for more complex work, allowing greater flexibility to reallocate resources and to utilise dentists with greater capacity to deliver National Health Service treatment, whilst enabling full use of the dental team. The plan also includes streamlining processes for overseas dentists and holding the local NHS to account for dentistry provision. In addition, Health Education England is also reforming dental education to improve the recruitment and retention of dental professionals.

NHS England asked dental practices to return to full delivery of contracted activity from July 2022, including in Norwich North. In September, we announced ‘Our plan for patients’, which outlines how we will meet oral health needs and increase access to dental care, including in Norwich North.

The plan includes improvements to ensure dentists are renumerated fairly for more complex work, allowing greater flexibility to reallocate resources and to utilise dentists with greater capacity to deliver National Health Service treatment, whilst enabling full use of the dental team. The plan also includes streamlining processes for overseas dentists and holding the local NHS to account for dentistry provision. In addition, Health Education England is also reforming dental education to improve the recruitment and retention of dental professionals.

The information requested is not held centrally.

£400 million in resilience money has been invested in the National Health Service for winter 2015/16. Of this £400 million North Norfolk, South Norfolk, West Norfolk and Norwich clinical commissioning groups (CCGs) received £4.8 million of resilience money in their baseline, however it is not possible to give a specific figure for Norfolk and Norwich University Hospitals Trust. Learning from previous years, we have put this money into the CCG baseline for 2015/16 so that the National Health Service can plan effectively at local level for the long-term and take earlier action to tackle the symptoms of seasonal pressures.

As part of the best practice guidance from the Safer, Faster, Better report (April 2015), all System Resilience Groups are implementing eight high impact interventions. These focus on short term priorities needed to improve flow through the system and reduce pressure on emergency departments.

NHS England has advised that it is considering extending the current interim commissioning policy for Sofosbuvir plus ledipasvir (Harvoni) and another direct acting antiviral combination therapy for selected patients with cirrhosis associated with Hepatitis C.

NHS England has completed the evidence review and finalised its draft proposals. In doing so, it has engaged with clinical and patient stakeholders from the national lead Clinical Reference Group. NHS England has advised that the aim is that interim commissioning policies will be in place by the first half of 2015.

The Government’s commitment to parity of esteem has been made explicit in legislation, as well as the NHS Constitution.

We have extended the legal right to choice in mental health so people with mental health problems will have the same choice for their care as they do for their physical health.

We estimate that funding for mental health has increased by approximately £302 million in 2014-15, total mental health spending rose from £11.362 billion in 2013-14 with £11.664 billion planned in 2014-15.

The Department and NHS England continue to work together to ensure that there are consistent messages to commissioners and providers about the importance of delivering parity of esteem for mental health service users.

Monitor and NHS England are responsible for setting the national tariff arrangements and are working together to develop a national payment system for mental health which promotes improving outcomes and recovery.

Currently, prices for mental health services are agreed locally. However, mental health clusters have been developed as the currencies underpinning payment for mental health services.

Local commissioners and mental health providers are encouraged to use the clusters as the basis for reaching financial settlements and we know that some health economies are already using clusters as the basis for payment for mental health services.

Public Health England has also made a commitment to addressing parity of esteem which includes working to promote good mental health and preventing mental health problems.

In our new five-year plan for mental health, Achieving Better Access to Mental Health Services by 2020, we identified £40 million additional spending this year and freed up a further £80 million for 2015-16. This will, for the first time ever, enable the setting of access and waiting time standards in mental health services and includes new targets to make sure that, by 2016, at least 50% of young people referred for early intervention in psychosis services will start treatment within two weeks.

There has been sustained investment in mental health over the course of this parliament. We have invested £400 million in Improving Access to Psychological Therapy (IAPT) for adults and £54 million over the four year period from 2011-2015 in the children and young people’s IAPT programme to transform child and adolescent mental health services.

We will also be investing £30m a year over the next five years in England to improve services for young people with mental health problems. This will place particular emphasis on eating disorders.

We have invested £2 million in nine street triage pilots where police and mental health professionals work together to support people in mental health crisis access safe, appropriate care and we have committed £25 million in 2014-15 to commission 10 trial sites delivering on a new standard service specification for liaison and diversion services in England.