Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he will take where NHS trusts tell patients with Functional Neurological Disorder that their services are not set up to treat the condition, in the context of NHS England's August 2025 Specialised Neurology Service Specification requiring FND to be provided as a core activity at every specialised neurology centre.
Answered by Sharon Hodgson
Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their local populations and for ensuring that providers deliver services in line with national service specifications. NHS England oversees this process and has mechanisms in place to assure compliance with these standards.
Where services are not meeting required standards, NHS England oversees system performance through established accountability arrangements, including routine oversight and engagement with ICBs across a range of domains such as access, quality and outcomes. Where concerns about service provision or variation are identified, NHS England works with ICBs and providers to support improvement, including through planning guidance, performance discussions, and system oversight processes.
NHS trusts are accountable to their boards, and to their local systems, for the quality and safety of the services they provide and are expected to act where gaps in provision or access are identified.
The Government recognises that access to appropriate psychological therapies and multidisciplinary support for people with functional neurological disorder (FND), including non‑epileptic seizures, can vary between areas. The majority of services for people with neurological conditions, including FND, are commissioned locally by ICBs.
The National Institute for Health and Care Excellence provides guidance to support clinicians in recognising and managing FND, and promotes a coordinated, multidisciplinary approach to care, including access to psychological therapies where clinically appropriate.
NHS England’s specialised neurology service specification requires all specialised neurology centres to ensure access to appropriate treatment services for FND, delivered through integrated pathways involving neurological, mental health and community services.
There is no single nationally mandated clinician responsible for reviewing and managing medication for patients with FND and non-epileptic seizures. Decisions about prescribing and reviewing medicines are made by the clinician responsible for that aspect of the patient’s care, which may be a general practitioner, neurologist or other specialist, depending on the patient’s needs and where care is being delivered.
In practice, medication management is typically undertaken through shared care arrangements, with clinicians working together to ensure patients receive safe, appropriate and person‑centred treatment based on clinical judgement.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether psychological therapy services are fully commissioned across all areas of England to accept referrals for patients with Functional Neurological Disorder and non-epileptic seizures; and what steps he is taking to help tackle gaps where patients are being turned away.
Answered by Sharon Hodgson
Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their local populations and for ensuring that providers deliver services in line with national service specifications. NHS England oversees this process and has mechanisms in place to assure compliance with these standards.
Where services are not meeting required standards, NHS England oversees system performance through established accountability arrangements, including routine oversight and engagement with ICBs across a range of domains such as access, quality and outcomes. Where concerns about service provision or variation are identified, NHS England works with ICBs and providers to support improvement, including through planning guidance, performance discussions, and system oversight processes.
NHS trusts are accountable to their boards, and to their local systems, for the quality and safety of the services they provide and are expected to act where gaps in provision or access are identified.
The Government recognises that access to appropriate psychological therapies and multidisciplinary support for people with functional neurological disorder (FND), including non‑epileptic seizures, can vary between areas. The majority of services for people with neurological conditions, including FND, are commissioned locally by ICBs.
The National Institute for Health and Care Excellence provides guidance to support clinicians in recognising and managing FND, and promotes a coordinated, multidisciplinary approach to care, including access to psychological therapies where clinically appropriate.
NHS England’s specialised neurology service specification requires all specialised neurology centres to ensure access to appropriate treatment services for FND, delivered through integrated pathways involving neurological, mental health and community services.
There is no single nationally mandated clinician responsible for reviewing and managing medication for patients with FND and non-epileptic seizures. Decisions about prescribing and reviewing medicines are made by the clinician responsible for that aspect of the patient’s care, which may be a general practitioner, neurologist or other specialist, depending on the patient’s needs and where care is being delivered.
In practice, medication management is typically undertaken through shared care arrangements, with clinicians working together to ensure patients receive safe, appropriate and person‑centred treatment based on clinical judgement.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what guidance exists on which clinician - GP or neurologist - is responsible for reviewing and managing medication for patients with Functional Neurological Disorder and non-epileptic seizures.
Answered by Sharon Hodgson
Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their local populations and for ensuring that providers deliver services in line with national service specifications. NHS England oversees this process and has mechanisms in place to assure compliance with these standards.
Where services are not meeting required standards, NHS England oversees system performance through established accountability arrangements, including routine oversight and engagement with ICBs across a range of domains such as access, quality and outcomes. Where concerns about service provision or variation are identified, NHS England works with ICBs and providers to support improvement, including through planning guidance, performance discussions, and system oversight processes.
NHS trusts are accountable to their boards, and to their local systems, for the quality and safety of the services they provide and are expected to act where gaps in provision or access are identified.
The Government recognises that access to appropriate psychological therapies and multidisciplinary support for people with functional neurological disorder (FND), including non‑epileptic seizures, can vary between areas. The majority of services for people with neurological conditions, including FND, are commissioned locally by ICBs.
The National Institute for Health and Care Excellence provides guidance to support clinicians in recognising and managing FND, and promotes a coordinated, multidisciplinary approach to care, including access to psychological therapies where clinically appropriate.
NHS England’s specialised neurology service specification requires all specialised neurology centres to ensure access to appropriate treatment services for FND, delivered through integrated pathways involving neurological, mental health and community services.
There is no single nationally mandated clinician responsible for reviewing and managing medication for patients with FND and non-epileptic seizures. Decisions about prescribing and reviewing medicines are made by the clinician responsible for that aspect of the patient’s care, which may be a general practitioner, neurologist or other specialist, depending on the patient’s needs and where care is being delivered.
In practice, medication management is typically undertaken through shared care arrangements, with clinicians working together to ensure patients receive safe, appropriate and person‑centred treatment based on clinical judgement.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what support his Department plans to offer hospital trusts that are in Strand 4 of the NHS acute trust league table.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The NHS Oversight Framework 2025/26 sets out how NHS England will support trusts to improve, based on an assessment of their performance. This is available at the following link:
https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/
NHS England works through regional teams to monitor National Health Service trust performance, identify issues, and deliver improvement in the most challenged areas. Improvement metrics and trajectories are agreed and proactively monitored.
NHS England may also apply interventions and require NHS trusts to take broad actions or address specific concerns related to known issues. This may involve use of NHS England’s enforcement powers, particularly to secure improvement or where improvement is deemed insufficient.
Trusts rated low for both performance and capability will receive support from the National Provider Improvement Programme (NPIP), which will replace the Recovery Support Programme. NPIP will determine whether the most challenged have the necessary conditions in place to deliver sustainable improvement and will ensure support is in place as needed. This will be in addition to any targeted improvement support for specific issues such as urgent and emergency care, outpatients, mental health, finance, or maternity.
Additionally, newly appointed very senior managers (VSMs) to NHS trusts in segment 5 will be eligible for ‘challenged organisation recruitment premiums’, to attract talented VSMs to join challenged organisations and help turn them around.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, who the designated board-level executive leads are for Down Syndrome in each ICB in England.
Answered by Stephen Kinnock - Secretary of State for Wales
It is the responsibility of integrated care boards (ICBs) to make information public about executive leads for Down syndrome in England. In accordance with statutory guidance published by NHS England on 9 May 2023, ICBs should be open and transparent about who holds these roles and should make this information publicly available. We are giving systems greater control and flexibility, and it is for individual ICBs to decide how to publicise these details.
The statutory guidance sets out NHS England’s expectations about fulfilling executive lead functions and outlines the responsibilities of these roles in more detail, and is available at the following link:
https://www.england.nhs.uk/publication/executive-lead-roles-within-integrated-care-boards/
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 31 July 2024 to Question 1642 on Dental Services, if he will make it his policy to implement the plans to reform dental services set out in the document published by his Department on 7 February 2024 entitled Faster, simpler and fairer: our plan to recover and reform NHS dentistry.
Answered by Stephen Kinnock - Secretary of State for Wales
We are currently reviewing the Dental Recovery Plan, and what elements of it can be taken forward effectively and within National Health Service budgets. It is also clear that the plan did not go far enough, and so we are also working on our Dental Rescue Plan, and prioritising initiatives that will see the biggest impact on access to NHS dental care.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to reform the provision of dental care.
Answered by Stephen Kinnock - Secretary of State for Wales
The Government plans to tackle the challenges patients face when trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments, and to recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of the (a) availability of pain services and (b) Arthritis and Musculoskeletal Alliance’s core offer for pain services.
Answered by Gillian Keegan
No specific assessment has been made. The majority of routine treatment and support for people with chronic pain is provided by local primary, community and secondary care services and commissioned via clinical commissioning groups. For patients with severe and complex pain, NHS England commissions specialised care. Upon referral to specialist centres, patients can access a range of health professionals, including consultant specialists, clinical nurse specialists, psychologists and physiotherapists and receive specialised treatment.
The core offer for pain services produced by the Arthritis and Musculoskeletal Alliance is informing guidance on the provision of high-quality services for people living with long-term pain conditions currently being produced by NHS England.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure adequate support is provided to people who live with severe chronic pain.
Answered by Gillian Keegan
The majority of routine treatment and support for people with chronic pain is provided by local primary, community and secondary care services and commissioned via clinical commissioning groups. For patients with severe and complex pain, NHS England commissions specialised care. Upon referral to specialist centres, patients can access a range of health professionals, including consultant specialists, clinical nurse specialists, psychologists and physiotherapists and receive specialised treatment.
The National Institute for Health and Care Excellence published guidance on chronic pain in April 2021, which includes recommendations on how chronic pain can be managed through pharmacological and non-pharmacological approaches, such as exercise programmes, acupuncture and psychological therapy.
NHS England has established a task and finish group to produce guidance on the provision of services for people living with long-term pain conditions by September 2022. The guidance is aimed at integrated care systems, to provide core principles which can be used to inform the development of local models of care for complex pain.
Asked by: Graham Stuart (Conservative - Beverley and Holderness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to ensure that people with chronic pain have access to non-pharmacological interventions as outlined in the NICE guideline on chronic pain.
Answered by Gillian Keegan
The National Institute for Health and Care Excellence (NICE) published its guideline on chronic pain in April 2021 which includes recommendations on how chronic pain can be managed through pharmacological and non-pharmacological approaches, such as exercise programmes, acupuncture, and psychological therapy.
While NICE’s guideline describes best practice and should be taken fully into account in the care and treatment of individual patients, it is not mandatory and does not override a medical practitioner’s clinical judgement.