Lord Kamall

The geography of neighbourhoods should be determined locally by integrated care boards in partnership with their strategic partners, particularly local authorities. The Government aims to establish a Neighbourhood Health Centre in every community as we shift from hospital to community. Nationwide coverage will take time, but we will start in areas with the greatest need, for instance where healthy life expectancy is lowest, including coastal towns and communities with higher deprivation levels. Wherever possible, we will maximise value for money by repurposing poorly used, existing National Health Service and public sector estates. The Department is also currently writing a business case on Public Private Partnerships for Neighbourhood Health Centres for review as part of the Autumn Budget.

The Neighbourhood Health Service will embody our new preventative principle that care should happen as locally as it can, digitally by default, in a patient’s home if possible, in a Neighbourhood Health Centre when needed, and only in a hospital if necessary. The Neighbourhood Health Service will mean millions of patients are treated and cared for closer to home by new teams of professionals. We have launched the National Neighbourhood Health Implementation Programme to support systems across the country to test new ways of working, share learning, and scale what works. This programme will inform future strategy and policy development, and outcome metrics will be rigorously monitored.

To support neighbourhood health, we will introduce two new contracts, with roll-out beginning next year, one of which will create neighbourhood providers that deliver enhanced services for groups with similar needs over a footprint of approximately 50,000 people. In many areas, existing groups of general practices will be well placed to take on these contracts.

The Professional Standards Authority for Health and Social Care (PSA) operates an accredited voluntary register scheme for professions not subject to statutory regulation.

The Government values the scheme and the PSA quality mark demonstrates a register’s commitment to high standards of care and provides assurance around professional standards and ethical behaviours.

The scheme covers voluntary registers across a range of professions, including a number relating to counselling and psychotherapy.

The NHS.UK website sets out that professionals must be on one of the PSA’s accredited registers in order to work as a counsellor in the National Health Service.

The Professional Standards Authority for Health and Social Care (PSA) operates an accredited voluntary register scheme for professions not subject to statutory regulation.

The Government values the scheme and the PSA quality mark demonstrates a register’s commitment to high standards of care and provides assurance around professional standards and ethical behaviours.

The scheme covers voluntary registers across a range of professions, including a number relating to counselling and psychotherapy.

The NHS.UK website sets out that professionals must be on one of the PSA’s accredited registers in order to work as a counsellor in the National Health Service.

The Expert Advisory Group on Allergy (EAGA), which is co-chaired by the Department, currently advises the Department, NHS England and other Government departments on the priority areas for policy change and development related to allergy care and outcomes. The EAGA will continue to support the Department and its partners to ensure that the specific needs of people with allergies are addressed through broader National Health Service reforms.

The 10-Year Health Plan will ensure a better health service for everyone, regardless of condition or geography. Its three big shifts, namely from hospital to community, from analogue to digital, and from sickness to prevention will all help deliver improvements to allergy care. With more tests delivered in the community and better joint working with multidisciplinary teams, including allergy specialists, working in local communities as part of the neighbourhood health service. The greater use of apps and wearable technology will also support people to manage their allergies closer to home.

We are committed ensuring we have the staff we need in the NHS, and we want to hear from partners to make sure we have the right people, in the right places, with the right skills. We will provide more details about what will be included in the 10-Year Workforce Plan in due course.

The Additional Roles Reimbursement Scheme aims to enhance the overall capacity of and capabilities of primary care teams to address a wide range of patient needs and broader healthcare challenges in their localities. Networks may recruit dieticians and nurses with advanced skills and knowledge in a specific area of healthcare or disease management depending upon the needs of their populations.

NHS England does not collect national data on allergy prevalence or services, nor does it issue specific guidance. In conducting health needs assessments to inform their commissioning decisions, integrated care boards will have access to a wide range of data sources, including public health data, hospital statistics, primary care data, and social care metrics.

The Expert Advisory Group on Allergy (EAGA), which is co-chaired by the Department, currently advises the Department, NHS England and other Government departments on the priority areas for policy change and development related to allergy care and outcomes. The EAGA will continue to support the Department and its partners to ensure that the specific needs of people with allergies are addressed through broader National Health Service reforms.

The 10-Year Health Plan will ensure a better health service for everyone, regardless of condition or geography. Its three big shifts, namely from hospital to community, from analogue to digital, and from sickness to prevention will all help deliver improvements to allergy care. With more tests delivered in the community and better joint working with multidisciplinary teams, including allergy specialists, working in local communities as part of the neighbourhood health service. The greater use of apps and wearable technology will also support people to manage their allergies closer to home.

We are committed ensuring we have the staff we need in the NHS, and we want to hear from partners to make sure we have the right people, in the right places, with the right skills. We will provide more details about what will be included in the 10-Year Workforce Plan in due course.

The Additional Roles Reimbursement Scheme aims to enhance the overall capacity of and capabilities of primary care teams to address a wide range of patient needs and broader healthcare challenges in their localities. Networks may recruit dieticians and nurses with advanced skills and knowledge in a specific area of healthcare or disease management depending upon the needs of their populations.

NHS England does not collect national data on allergy prevalence or services, nor does it issue specific guidance. In conducting health needs assessments to inform their commissioning decisions, integrated care boards will have access to a wide range of data sources, including public health data, hospital statistics, primary care data, and social care metrics.

The Expert Advisory Group on Allergy (EAGA), which is co-chaired by the Department, currently advises the Department, NHS England and other Government departments on the priority areas for policy change and development related to allergy care and outcomes. The EAGA will continue to support the Department and its partners to ensure that the specific needs of people with allergies are addressed through broader National Health Service reforms.

The 10-Year Health Plan will ensure a better health service for everyone, regardless of condition or geography. Its three big shifts, namely from hospital to community, from analogue to digital, and from sickness to prevention will all help deliver improvements to allergy care. With more tests delivered in the community and better joint working with multidisciplinary teams, including allergy specialists, working in local communities as part of the neighbourhood health service. The greater use of apps and wearable technology will also support people to manage their allergies closer to home.

We are committed ensuring we have the staff we need in the NHS, and we want to hear from partners to make sure we have the right people, in the right places, with the right skills. We will provide more details about what will be included in the 10-Year Workforce Plan in due course.

The Additional Roles Reimbursement Scheme aims to enhance the overall capacity of and capabilities of primary care teams to address a wide range of patient needs and broader healthcare challenges in their localities. Networks may recruit dieticians and nurses with advanced skills and knowledge in a specific area of healthcare or disease management depending upon the needs of their populations.

NHS England does not collect national data on allergy prevalence or services, nor does it issue specific guidance. In conducting health needs assessments to inform their commissioning decisions, integrated care boards will have access to a wide range of data sources, including public health data, hospital statistics, primary care data, and social care metrics.

Government responsibility for delivering dementia research is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation.

The Department of Health and Social Care is committed to ensuring that all patients, including those with dementia, have access to cutting-edge clinical trials and innovative, lifesaving treatments.

As an example, the Department, via the NIHR, is investing nearly £50 million into the Dementia Trials Network, a coordinated network of trial sites across the United Kingdom, which will offer people with dementia the opportunity to take part in early phase clinical trials irrespective of where they live. This is complemented by the £20 million Dementia Trials Accelerator, designed to position the UK as the destination of choice for late phase clinical trials in dementia and neurodegenerative diseases.

The NIHR also funds research infrastructure which supports patients and the public to participate in high-quality research, including research on dementia. For example, the aim of the University College London Hospitals’ Biomedical Research Centre’s dementia theme is to develop novel treatments through precision medicine. The theme’s focus on young onset and familial dementias provides key insights into the factors that can cause or speed up neurodegeneration, allowing a window for treatments to be administered, before functional decline occurs.

In partnership with Alzheimer’s Society, Alzheimer’s Research UK, and Alzheimer Scotland, the NIHR also delivers Join Dementia Research, an online platform which enables the involvement of people with and without a dementia diagnosis, as well as carers, to take part in a range of important research, including studies evaluating potential treatments for dementia.

The Government’s Dame Barbara Windsor Dementia Goals programme, which is expected to have nearly £150 million of Government funding allocated to it, or aligned with it, aims to speed up the development of new treatments for dementia and neurodegenerative conditions by accelerating innovations in biomarkers, clinical trials, and implementation.

We recognise the importance of a timely diagnosis and remain committed to increasing diagnosis rates and ensuring that people can access any licensed and National Institute for Health and Care Excellence-recommended treatment and/or support they need. The Government is investing in dementia research across all areas, from causes, diagnosis and prevention, to treatment, care, and support, including for carers.

The NHS Health Check, a core component of England’s cardiovascular disease (CVD) prevention programme, aims to prevent some cases of dementia in eligible people by making them aware that many of the risk factors for CVD are the same as those for dementia, and what is good for the heart is good for the brain. While there are no plans to incorporate early cognitive screening in the NHS Health Check, for those aged 65 to 74 years old, the programme signposts individuals to memory services if appropriate.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.

We recognise the importance of a timely diagnosis and remain committed to increasing diagnosis rates and ensuring that people can access any licensed and National Institute for Health and Care Excellence recommended treatment and/or support they need.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity.

Support for self-care is an essential service that all pharmacies must provide, and can include the provision of advice, information, and where appropriate, the sale of over-the counter-medicines to patients, carers, and the general public to support their self-care for minor ailments. This gives patients easy access to advice from highly trained and skilled healthcare professionals in the community and relieves pressure in other areas of the National Health Service.

Under Pharmacy First, NHS 111, general practices, and accident and emergency departments can refer patients to see a pharmacist for advice on a minor illness, which may include the sale of over-the-counter medicines. They can also refer patients to one of the Pharmacy First seven clinical pathways, as part of which pharmacies can supply prescription-only medicines to patients. Patients can also walk into a pharmacy for treatment as part of the seven clinical pathways.

The 10-Year Health Plan describes a shared vision for the health and care system in 2035, drawing directly from the extensive engagement that has been undertaken with the public, patients, and staff. The plan includes how care models and pathways will need to change or evolve to better meet their needs, and the cultural and behavioural changes we want to see.

There are no current plans to allow patients to directly nominate a distance selling pharmacy (DSP) from within the NHS App. Patients can continue to nominate a DSP through existing routes, which currently provide a more seamless patient experience.

The Department does not hold this information as the 2025 medical specialty recruitment process is still ongoing.

NHS England has a Data Sharing Agreement, project code DARS-NIC-381078-Y9C5K, with a consortium of academic organisations in the United Kingdom for the purpose of the Health Data Research UK-led, British Heart Foundation Data Science Centre’s CVD-COVID-UK programme. This agreement was put in place by NHS Digital prior to its merger with NHS England in 2023.

The agreement was subject to reviews by NHS Digital’s Independent Group Advising on Release of Data on 25 June 2020, 23 July 2020, 15 October 2020, 3 December 2020, 25 February 2021, 29 July 2021, 5 May 2022, and 24 November 2022. It was also subject to advice from the Professional Advisory Group on 24 June 2020 and 28 July 2021.

As part of the agreed process, all projects undertaken under this agreement required approval by the CVD-COVID-UK Approvals and Oversight Board. NHS Digital/NHS England had a representative on that board and through this decision-making forum, engaged in discussions with Health Data Research UK about projects that used NHS England’s data for pandemic planning and research.

For a project to proceed, approval was required from the NHS Digital/NHS England representative and from the board as a whole. Under the terms of the agreement, the CVD-COVID-UK oversight committee is required to maintain a list of projects undertaken under the agreement and must provide a quarterly report to NHS Digital/NHS England.

Subsequently, concerns have been raised by the Royal College of General Practitioners and the British Medical Association in relation to the Foresight project which was undertaken under the above agreement. NHS England has confirmed to the Royal College of General Practitioners and the British Medical Association that NHS England’s Data Protection Officer is undertaking assurance, and NHS England has met operationally with others, including Health Data Research UK, in relation to this work.

The General Practice Extraction Service Data for Pandemic Planning and Research is not being used for direct care decisions.

NHS England has a Data Sharing Agreement, project identification code DARS-NIC-381078-Y9C5K, with a consortium of academic organisations in the United Kingdom for the purpose of the Health Data Research UK-led, British Heart Foundation Data Science Centre’s CVD-COVID-UK programme.

This agreement was put in place by NHS Digital prior to its merger with NHS England in 2023, and prior to the establishment of NHS England’s Advisory Group for Data (AGD). The AGD was informed of a Senior Information Risk Owner decision to approve an amendment to the agreement on 22 February 2024.

The agreement was subject to reviews by NHS Digital’s Independent Group Advising on the Release of Data (IGARD) on 25 June 2020, 23 July 2020, 15 October 2020, 3 December 2020, 25 February 2021, 29 July 2021, 29 July 2021, 5 May 2022, and 24 November 2022. It was also subject to advice from the Professional Advisory Group on 24 June 2020 and 28 July 2021.

The agreement allowed the data controllers under that agreement to approve access to National Health Service data for individual projects, subject to approval per project by the CVD-COVID-UK oversight committee, which included a representative of NHS Digital/NHS England. Individual projects were not reviewed by IGARD or the AGD.

Under the terms of the agreement, the CVD-COVID-UK oversight committee is required to maintain a list of projects undertaken under the agreement and provide a quarterly report to NHS Digital/NHS England. The following table lists the projects and their current status from the latest report provided in April 2025:

The status of project CCU078 has been updated to reflect that NHS England paused the project on 29 May. Further detail on the projects is published on the British Heart Foundation Data Science Centre’s website.

The single patient record will give staff in any provider access to the information they need to provide care, and would end the need for patients to have to repeat their medical history when interacting with the National Health Service.

We are currently in the early stages of considering the scope, and this includes what information patients will be able to see about when and where their record is accessed. Our engagement with the public identified the importance of there being an audit trail of access.

We will mandate its use by the NHS and social care, so that everyone has the opportunity to have a single patient record.

The single patient record will give staff in any provider access to the information they need to provide care, and would end the need for patients to have to repeat their medical history when interacting with the National Health Service.

We are currently in the early stages of considering the scope, and this includes what information patients will be able to see about when and where their record is accessed. Our engagement with the public identified the importance of there being an audit trail of access.

We will mandate its use by the NHS and social care, so that everyone has the opportunity to have a single patient record.

The Department does not hold data on medical specialty training places by integrated care board, but is able to present data by National Health Service training region. The following table shows the number of trauma and orthopaedics specialist training posts available in the 2023 and 2024 entry rounds by region:

Source: NHS England, available on the NHS.UK website, in an online only format.

The table presents the number of posts offered at specialist training stage three, meaning medical professionals will already have undertaken at least two years of relevant core training or equivalent before entry to this specialty training programme.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. This is central to the vision in our 10 Year Plan. 
 
We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

The Department does not hold data on medical specialty training places by integrated care board, but is able to present data by National Health Service training region. The following table shows the number of medical oncology specialist training posts available in the 2023 and 2024 entry rounds by region:

Source: NHS England, available on the NHS.UK website, in an online only format.

The table presents the number of posts offered at specialist training stage three, meaning medical professionals will already have undertaken at least two years of relevant core training or the equivalent, before entry to this specialty training programme.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. This is central to the vision in our 10 Year Plan. 
 
We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

The Department does not hold data on medical specialty training places by integrated care board, but is able to present data by National Health Service training region. The following table shows the number of paediatric specialist training posts available in the 2023 and 2024 entry rounds by region:

Source: NHS England, available at the NHS.UK website, in an online only format.

The table presents the number of posts offered at both specialist training stage one, and at stages three or four. The latter stages mean that the medical professionals will likely have already undertaken at least three or four years of relevant training, or an equivalent, before entry to this later stage of the specialty training programme.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. This is central to the vision in our 10 Year Plan. 
 
We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

The Department does not hold data on medical specialty training places by integrated care board but is able to present data by National Health Service training region. Data is only available for the combined obstetrics and gynaecology specialist training pathway, as opposed to specifically gynaecology specialist training. The following table shows the number of obstetrics and gynaecology specialist training posts available in the 2023 and 2024 entry rounds by region:

Source: NHS England, available on the NHS.UK website, in an online only format.

The table presents the number of posts offered at both specialist training stages one and three. The latter meaning medical professionals will already have undertaken at least two years of relevant training or equivalent before entry to this later stage of the specialty training programme.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. This is central to the vision in our 10 Year Plan. 
 
We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

The NHS App supports seamless pharmacy services by allowing patients to order repeat prescriptions, nominate their preferred pharmacy, and manage their medication. A new prescription tracker feature means that nearly 1,500 pharmacies are now offering the new prescription tracking service through the NHS App, which provides updates on when prescriptions are ready to be collected. Work has also commenced on an ‘in App’ notification, which will enhance this feature further.

In relation to nominating distance selling pharmacies (DSPs), users of the NHS App are currently given the option to nominate a ‘high street’ or an ‘online-only’ pharmacy. For those wishing to nominate ‘online-only’ pharmacies, users are directed to the internet pharmacies section, to search for and contact their chosen DSP directly, as key information is required by the DSP before the nomination can be applied.

The Information Commissioner’s Office detailed guidance on anonymisation and pseudonymisation, which is a helpful and welcome resource. NHS England continues to apply the National Data Opt Out option, in line with the National Data Opt Out Policy guidance, which the Department keeps under review.

The Department and NHS England are currently conducting large-scale public engagement on health data in the National Health Service to help inform future policy on opt-out options.

No specific assessment has been made of the impact the 2025/26 Payment Scheme and Standard Contract will have on the willingness of ophthalmology service providers to build new specialist eye hospitals in England, or the ability and willingness of other independent providers of National Health Service funded care in England to build new health infrastructure. It is for independent sector providers to determine the most appropriate investment decisions for their businesses.

However, decisions around the annual Payment Scheme and updates to the Standard Contract are subject to consultation, with a legal duty to consult on the Payment Scheme and Standard Contract every year. This includes consultation with independent providers.

The consultation on the Payment Scheme proposed requiring commissioners to set a payment limit for elective services, and all services paid for on an activity basis, based on the value of planned levels of activity. Providers would not be paid for activity above this limit. Following consideration of consultation feedback, this proposal has not been implemented. As in previous years, providers will be paid prices for all activity delivered, subject to any activity management restrictions contractually applied by commissioners. A consultation on further changes to the Standard Contract closed on 28 April 2025, and NHS England is reflecting on the feedback received before publishing the final contract.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds.

As we develop what this new centre looks like we will be transparent and clear about the precise changes in organisational design. It is essential that information relating to people’s identifiable health and care is shared appropriately, lawfully, and in line with their reasonable expectations.

To support implementation of the National Institute for Health and Care Excellence’s guidance, NHS England has been engaging with health system partners to coordinate resources and implementation efforts, to make sure that patients are on the appropriate treatment regimen and are using their inhaler at the right time, with the right technique.

The over-prescribing of reliever inhalers amongst people with asthma has seen a steady fall over the past few years. The percentage of patients on the Quality and Outcomes Framework asthma register who received six or more Short Acting Beta-2 Agonist reliever inhaler prescriptions over the previous 12 months fell from 19.8% in April 2022 to 15.9% in February 2025.

The Government is committed to reforming services in the National Health Service to ensure every school has access to specialist mental health professionals, providing early support for young people.

NHS England recognises the value of music therapy in supporting children's mental health. The Department for Education's ongoing Curriculum and Assessment Review aims to broaden the curriculum, ensuring subjects like music, arts, sport, and drama are not overlooked.

The Government will be launching a new National Music Education Network, helping parents, teachers and children find information on courses, classes and more.

Data generated by apps and devices may not be used exclusively for the direct care of patients; some data may be generated by a wearable which will be used for a secondary purpose, such as research, but this must happen in accordance with the law. An individual would have to give their consent for the use of their data by a third-party app.

The NHS Federated Data Platform does not access data from the NHS App or wearables.

Following the election, the Government has outlined its ambitions through the Plan for Change, which sets out an ambitious set of milestones, across the missions, for this Parliament.

As the House would expect, the Government continually reviews its work to ensure that it is delivering the best outcomes for the people of the United Kingdom, and that its policies continue to represent the best value for the taxpayer.

Public reviews will be available on GOV.UK as they are published.

As part of its annual planning round for 2025/26, NHS England consulted on proposals for the NHS Payment Scheme (NHSPS), a set of rules, prices, and guidance that governs transactions between providers and commissioners of National Health Service funded secondary care. It is not a change to the Right to Choose.

As set out in the Elective Reform Plan, integrated care boards will be allocated the funding needed to deliver improvements to the 18-week referral-to-treatment performance standard for consultant-led care.

NHS England has conducted an assessment of the impact of the proposed NHSPS, as required by law, which is attached. This impact assessment includes consideration of the impact on patient choice.

No such assessment has been made. NHS England published Excellence in Continence Care on 23 July 2018, a copy of which is attached, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being.”

NHS England will consider the next steps for Excellence in Continence Care. The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life for people with faecal incontinence.

The number of fully qualified general practitioners (GPs) increased by 535 full-time equivalent between July 2024 and December 2024. This data includes estimates for practices that did not provide fully valid staff records. This does not include recently qualified GPs employed through the Additional Roles Reimbursement Scheme (ARRS).

Information on the number of recently qualified general practitioners for which primary care networks are claiming reimbursement via the ARRS is currently being collated and is not yet published. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices and blood components for transfusion meet applicable standards of safety, quality and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions including amending the product information.

The MHRA has received a total of 112 reports through the Yellow Card scheme for all antidepressant medications of reports of completed suicide which have been received between 1 January 2015 and 25 February 2025. The following table shows a yearly breakdown thereof:

Source: MHRA

Note: List of antidepressant medications included in the search were: escitalopram, citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline, venlafaxine, duloxetine, reboxetine, amitriptyline, clomipramine, dosulepin, dothiepin, doxepin, imipramine, lofepramine, nortryptiline, trimipramine, trazodone Isocarboxazid, tranylcypromine, moclobemide, phenelzine, agomelatine, vortioxetine, L-tryptophan, esketamine, mianserin, mirtazapine.

It is important to note that anyone can report to the MHRA’s Yellow Card scheme and the recording of these reports in the Yellow Card database does not necessarily mean that the adverse reactions have been caused by the suspect drug. Many factors must be considered in assessing causal relationships, including temporal association, the possible contribution of concomitant medication, and the underlying disease. We encourage reporters to report suspected adverse reaction reports, the reporter does not have to be sure of a causal association between the drug and the reactions; a suspicion will suffice.

The number of reports received cannot be used as a basis for determining the incidence of a reaction, as neither the total number of reactions occurring, nor the number of patients using the drug, is known. All fatal reports including those reporting completed suicide are assessed by the MHRA and cumulative information is reviewed at regular intervals. Warnings about the risk of suicidal behaviours are contained in the product information for all licensed antidepressants and these warnings are based on causality assessments of individual case reports and the totality of evidence from clinical trials and the scientific literature.

The Department is committed to maximising our potential to lead the world in clinical trials and ensuring clinical trials are more accessible, including for children and young people. The Department does not hold data on the overall percentage of children and young people with cancer that are enrolled in clinical trials nationwide, but does collect data on participation through National Institute for Health and Care Research (NIHR) funded infrastructure.

The Department funds research and research infrastructure through the NIHR. NIHR-funded infrastructure is enabling clinical trial participation for children and young people with cancer. In particular, the NIHR Clinical Research Network, now the NIHR Research Delivery Network, supported 117 cancer studies which children and young people were eligible for between 2021/22 and 2023/24, and across all these studies, 6904 total participants were recruited during this timeframe.

The NIHR provides an online service called Be Part of Research which promotes participation in health and social care research by allowing users to search for relevant studies and register their interest. This makes it easier for people to find and take part in health and care research that is relevant to them.

Through the NIHR, the Department also jointly funds the Experimental Cancer Medicine Centre Paediatric Cancer Network with Cancer Research UK and the Little Princess Trust, which brings together clinicians and translational scientists to run early phase clinical trials for children and young people with cancer.

The research participant experience is an essential part of delivering a world-class research system with participant feedback providing research delivery teams, study sponsors and the Department with actionable data to improve accessibility of health and care studies, and increase recruitment rates and retention of participants.

The Department-funded National Institute for Health and Care Research (NIHR) has operated the Participant in Research Experience Survey (PRES) since 2015/16, which aims to offer as many research participants as possible the chance to contribute their experiences of taking part in research. PRES currently operates nationally across the NIHR Research Delivery Network portfolio and is offered to all participants in eligible cancer studies including young people.

To improve data collection on research experience, NIHR is currently exploring a national roll-out of a digital PRES which will increase ease and access for participants to provide feedback on their experience. This system will also be scalable beyond the NIHR Research Delivery Network Portfolio.

To increase transparency in accessing available data on participants’ experiences of research, the PRES dashboard can be accessed by users from across the research system with the following email address domains: nhs.uk, nhs.net, nhs.scot, dh.gsi.gov.uk, ac.uk, hscni.net, nrs.org.uk, mhra.gov.uk, gov.uk, ncri.org.uk.

Local authorities are best placed to understand and plan for the needs of their population, which is why the Care Act 2014 places a duty on them to shape their care market to meet the diverse needs of all local people.

Local authorities also have a temporary duty under the Care Act 2014 to ensure continuity of care if a provider exits the market due to business failure. This is to ensure that people continue to receive the care and support they need.