Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that neurodevelopmental assessments for children, including assessments for autism and ADHD, are carried out to an adequate and consistent standard across England, in line with NICE guidance, and that such assessments involve appropriate multidisciplinary input and sufficient direct observation of the child.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has recognised that, nationally, demand for assessments for autism and attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, recognising the need for early intervention and support.
It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to autism and ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.
On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for people referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and following a recent diagnosis of autism. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.
NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.
The Medium-Term Planning Framework, published 24 October, was explicit that ICBs and providers are expected to optimise existing resources to reduce long waits for ADHD and autism assessments and improve the quality of assessments by implementing existing and new guidance, as published.
My Rt Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December 2025 the launch of an independent review into the prevalence and support for mental health conditions, ADHD, and autism. This independent review will inform our new approach to mental health so people receive the right support, at the right time and in the right place. Likewise, the review will inform our approach so that people with ADHD and autistic people have the right support in place to enable them to live well in their communities.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the potential merits of expanding NHS IVF funding criteria to cover individuals whose infertility results directly from medically necessary procedures, such as hysterectomy.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No recent assessments have been undertaken by the Department.
Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.
NICE is currently reviewing the fertility guideline and will consider whether its current recommendations for access to National Health Service-funded treatment are still appropriate. The draft guidance was consulted on between 10 September and 21 October 2025, and final guidance is expected to be published in March 2026. We expect ICBs to consider and reflect the updated NICE fertility guideline in their commissioning decisions when it is published, and we are working with NHS England to support greater consistency in provision.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he plans to extend NHS eligibility for the Shingrix shingles vaccine to older adults who previously received Zostavax.
Answered by Ashley Dalton
The Joint Committee on Vaccination and Immunisation (JCVI) is an independent departmental expert committee which advises the Government on matters related to vaccination and immunisation.
In November 2024, the JCVI provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over, regardless of whether these older individuals have previously been eligible for, or have been vaccinated with, Zostavax. The Department is carefully considering this advice as it sets the policy on who should be offered shingles vaccinations.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
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 potential impact on patients with relapsed or refractory Mantle Cell Lymphoma of NICE’s draft decision not to recommend brexucabtagene autoleucel (Tecartus) for NHS use; and whether he plans to review the CAR‑T delivery tariff to ensure continued access to treatments.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is currently re-evaluating brexucabtagene autoleucel to determine whether it can be recommended for routine National Health Service funding following a period of managed access through the Cancer Drugs Fund. NICE’s draft guidance, published in December, does not recommend it as a clinically and cost-effective use of NHS resources. The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients with mantle cell lymphoma will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.
The CAR-T delivery tariff reflects the costs which the NHS incurs for delivering CAR-T therapy. The tariff was updated for the start of the 2024/25 financial year following a planned costing review involving all CAR-T providers in England. This enabled the tariff to be updated with the benefit of the significant delivery experience that can be drawn on having first routinely introduced CAR-T in the NHS in 2023. Other than considering an appropriate inflationary uplift on an annual basis, in line with usual practice, there are no plans to further review the tariff at this time. Other CAR-T therapies have been recommended for routine NHS adoption in England by NICE based on an assessment of clinical and cost effectiveness that reflects the existing CAR-T delivery tariff, most recently obecabtagene autoleucel for acute lymphoblastic leukaemia.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of mandating restaurants in England to display their food hygiene rating.
Answered by Ashley Dalton
The Food Hygiene Rating Scheme is operated by the Food Standards Agency (FSA) in partnership with local authorities across England, Wales, and Northern Ireland. Evidence from Wales and Northern Ireland demonstrates that mandatory display has improved transparency, which encourages businesses to achieve better levels of compliance with hygiene requirements.
Introducing a statutory scheme in England with mandatory display of ratings at premises and online, would require primary legislation and the securing of a suitable legislative vehicle and parliamentary time. Ministers will consider the options in due course supported by the FSA.
In the meantime, the FSA is continuing to work with its local authority partners to deliver an excellent Food Hygiene Rating Scheme.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
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 support patients with Functional Neurological Disorder (FND), and what assessment he has made of the potential merits of establishing a pathway of care and treatment from diagnosis of FND.
Answered by Ashley Dalton
In August, NHS England updated the Specialised Neurology Service Specification, which is available at the following link:
https://www.england.nhs.uk/publication/specialised-neurology-services-adults/
The updated service specification includes specific reference to functional neurological disorder (FND). It states that all specialised neurology centres must include access to treatment services for FND. Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care.
In October 2025, the National Institute for Care Excellence (NICE) published guidance on rehabilitation for chronic neurological disorders, including acquired brain injury, with the reference code NG252. This guidance includes FND within its scope.
There are also a number of other national-level initiatives supporting service improvement and better care for patients with neurological conditions, including FND, such as the Getting It Right First Time Programme for Neurology and the Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England.
There are a number of policies outlined in the 10-Year Health Plan which should have a positive impact on care for patients with FND. More tests and scans delivered in the community, better joint working between services, and greater use of technology will all support people to manage FND closer to home.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department is taking steps to (a) review and (b) update the guidance entitled Children and young people’s continuing care national framework, published on 22 January 2016.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Framework for Children and Young People’s Continuing Care, published by the then Department of Health, now the Department of Health and Social Care, in January 2016 is intended to support good practice locally, providing guidance for integrated care boards (ICBs) and local authorities on the process for assessing, deciding, and agreeing packages of care for children and young people.
There are currently no plans to review or update the Children and Young People's Continuing Care National Framework.
ICBs are responsible for the provision and commissioning of services to meet the needs of their local populations. NHS England supports ICBs to implement the National Framework for Children and Young People’s Continuing Care, and it has now started to collect Children and Young People’s Continuing Care activity data as part of the All-age Continuing Care Patient Level Dataset which launched on 1 April 2025, and which is available at the following link:
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to review workforce speciality training allocations in the NHS; and if he will take steps to increase the number of (a) training posts and (b) permanent positions for newly qualified doctors in (i) General Practice, (ii) sexual health, (iii) haematology specialties and (iv) other positions.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As set out in our 10-Year Health Plan, published on 3 July, we will work across the Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training. The Plan also sets out that over the next three years we will create 1,000 new specialty training posts with a focus on specialties where there is greatest need.
In acknowledgement of doctors’ concerns about jobs and access to training places, the Government made an offer to the British Medical Association’s Resident Doctors Committee to double the previously announced increase in specialty training places in the 10-Year Health Plan to 2,000, bringing 1,000 of these forward to next year, create an alternative training pathway, and take steps to prioritise UK medical graduates and doctors with significant NHS experience for specialty posts. The new specialty training posts will focus on specialties where there is greatest need. On top of this commitment, NHS England has already made changes to the specialty training application process this year to reduce competition and support UK graduates.
The Government has committed to training thousands more general practitioners (GPs) and has increased the number of available GP training places by an additional 250 from September 2025. This brings the total number of GP training places to 4,250 per year.
As self-employed contractors to the NHS, it is for GPs to determine how they run their operations, including staffing arrangements.
We are investing an additional £1.1 billion in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest cash increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.
Since October 2024, we have funded primary care networks with an additional £160 million to recruit recently qualified GPs through the Additional Roles Reimbursement Scheme. Over 2,500 individual GPs have now been recruited, preventing them graduating into unemployment. This was a measure to respond to feedback from the profession and to help solve an immediate issue of GP unemployment.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
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 potential impact of mandatory folic acid fortification on people with MTHFR gene variants.
Answered by Ashley Dalton
The Government’s policy to mandate the fortification of non-wholemeal wheat flour with folic acid is aimed at reducing the incidence of neural tube defects (NTDs) in pregnancy. This policy is based on robust assessment of the evidence by the UK Scientific Advisory Committee on Nutrition (SACN) and has included two public consultations.
The SACN’s assessment included consideration of individuals with a specific MTHFR gene variant that reduces their ability to process folate from their diet resulting in lower levels of folate in their blood. The two public consultations invited feedback from a wide range of stakeholders, which included individuals concerned about MTHFR gene variants.
An increased intake of folic acid will raise blood folate levels, which reduces the risk of an NTD-affected pregnancy. Therefore, mandatory folic acid fortification is likely to be beneficial to individuals with the specific MTHFR gene variant.
The Government is exploring options to evaluate the policy, which will assess health impacts across different population groups.
Asked by: Mike Martin (Liberal Democrat - Tunbridge Wells)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many newly qualified nurses have secured employment through the Graduate Guarantee scheme since its introduction; what assessment he has made of the effectiveness of the Graduate Guarantee scheme; and with reference to the forthcoming 10 Year Workforce Plan, what steps his Department is taking to align the number of nursing graduates with the availability of entry-level posts.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Supporting newly qualified nurses and midwives to move smoothly into employment is a key priority. The Graduate Guarantee, introduced in August 2025, is now being implemented across the National Health Service to ensure every newly qualified nurse and midwife is supported to secure appropriate employment. Early feedback from trusts and regions indicates that it is having a positive impact on the current recruitment cycle, with organisations recruiting ahead of turnover and creating additional entry-level posts.
We expect the recruitment cycle to be concluded by March 2026 for this cohort, and published workforce statistics will provide a transparent assessment of the current NHS workforce. The forthcoming Chief Nursing Officer professional strategy for nursing and midwifery, alongside the 10 Year Workforce Plan, will set out further details on future workforce needs.