Sharon Hodgson

The government is committed to delivering an ambitious strategy to reduce child poverty by tackling the root causes and giving every child the best start in life. To support this, a new Ministerial taskforce has been set up to develop a Child Poverty Strategy. The taskforce will consider a range of policies, assessing what will have the greatest impact in driving down rates of child poverty. As with all policies, the government keeps the approach to free school meals under review.

The Department is committed to improving outcomes and patient experience for children, teenagers, and young adults with cancer, from birth to 24 years of age. That is why we have relaunched the Children and Young People Cancer Taskforce, which will identify tangible ways to drive improvements for cancer patients across this age range. The taskforce’s membership, which is currently being finalised, will reflect the diversity of needs across these patient groups.

We recognise that cancer in teenagers and young people is different to cancer in adults and children, and so age-appropriate care is necessary, particularly regarding treatment, diagnosis, and wider support, as per the NHS England service specifications. Department officials are working with chairs of the taskforce to develop the Terms of Reference ahead of the first meeting, currently planned for March. The taskforce will consider the most appropriate dissemination routes or publication channels for taskforce materials in due course.

There are nine specialist mesh centres across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse gets the right support. Each mesh centre is led by a multi-disciplinary team to ensure patients get access to the specialist care and treatment that they need, including pain management and psychological support.

According to information held by NHS England, since going live in July 2021, there have been 281 surgical mesh removal operations at the University College London Hospital. Monthly data is not available due to very low patient numbers per month.

The Department does not hold information on how much each mesh centre received in specialised commissioning funding and on the number of removals that have taken place each month since the service began.

There are nine specialist mesh centres across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team to ensure patients get access to the specialist care and treatment that they need, including pain management and psychological support.

There are nine specialist mesh centres across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team to ensure patients get access to the specialist care and treatment that they need, including pain management and psychological support. NHS England publishes data on referral to treatment waiting times. This is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/

The Department does not hold information on the average waiting times specifically for mesh centres. Tackling waiting lists is a key part of our Health Mission and we are taking steps to return to the 18-week standard. The Elective Reform Plan sets out how the National Health Service will reform elective care services and meet the 18-week referral to treatment standard by March 2029.

The National Disease Registration Service within NHS England, as the national cancer registry, collects diagnosis and treatment data on cancer patients in England.

Using the data behind the Accredited Official Statistics on Cancer Registrations combined with Cancer Waiting Times data, there were 15,739 patients alive with metastatic breast cancer on 1 January 2023, which is the most recent estimation point available.

This estimate includes patients diagnosed with metastatic, or stage four, breast cancer, as well as breast cancer patients who were diagnosed at stages one, two, or three and who have had a referral for metastatic treatment or palliative care.

The Department continues to advise patients to follow National Health Service guidance on sun protection. This advice is available publicly on the NHS.UK website, which is available at the following link:

https://www.nhs.uk/live-well/seasonal-health/sunscreen-and-sun-safety/

It includes guidance on the extra care that should be taken for babies and children.

We have committed to develop a 10-year plan to deliver a National Health Service fit for the future. The engagement process has been launched, and as we work to develop and finalise the plan, I would encourage those concerned about excessive exposure to ultraviolet radiation to engage with that process so we can identify what the potential solutions are. Further information is available at the following link:

https://change.nhs.uk/en-GB/

The Department continues to advise patients to follow National Health Service guidance on reducing the risk of skin cancer. This advice is available publicly on the National Health Service website, at the following link:

https://www.nhs.uk/conditions/melanoma-skin-cancer/

The Department is not taking any additional steps, currently or within the last three years, to specifically fund skin cancer awareness campaigns.

NHS England run Help Us Help You campaigns to increase knowledge of cancer symptoms and address the barriers to acting on them, to encourage people to come forward as soon as possible to see their general practitioner. The campaigns focus on a range of symptoms as well as encouraging body awareness to help people spot symptoms across a wide range of cancers at an earlier point.

The National Disease Registration Service (NDRS) in NHS England, as the national cancer registry, collects diagnosis and treatment data on cancer patients in England. The NDRS does not hold data on the number of people who developed secondary breast cancer after completing the 10-year recommended hormone therapy. Further information on the NDRS is available at the following link:

https://digital.nhs.uk/ndrs

Research is crucial in tackling cancer, which is why the Department invests over £1.5 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24. Cancer is a major area of NIHR spend, reflecting its high priority. The NIHR has commissioned three current studies relevant to this issue, specifically:

• Improving outcomeS for Women diagnosed with early breast cancer through adhErence to adjuvant Endocrine Therapy (SWEET);
• Medication brand changes in hormone therapy for breast cancer. A community pharmacy intervention development to improve patients’ adherence and quality of life. ENABLE; and
• POSNOC - POsitive Sentinel NOde: adjuvant therapy alone versus adjuvant therapy plus Clearance or axillary radiotherapy: A randomised controlled trial of axillary treatment in women with early stage breast cancer who have metastases in one or two sentinel nodes.

The NIHR's Biomedical Research Centres (BRCs) are networks of experts that work collaboratively between the National Health Service and internationally renowned universities. They facilitate early-stage experimental medicine research and support the translation of scientific discoveries. The BRCs are currently supporting a further two relevant studies:

• Supporting Women With Adherence To Hormone Therapy Following Breast Cancer; and
• Unirad: Randomized, Double-blind, Multicentre Phase Iii Trial Evaluating The Safety And Benefit Of Adding Everolimus To Adjuvant Hormone Therapy In Women With Poor Prognosis, Er+ And Her2- Primary Breast Cancer Who Remain Free Of Disease After At Least 1 Year Of Adjuvant Hormone Therapy.

The NIHR continues to encourage and welcome funding applications for research into any aspect of human health, including cancer. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

The Department accepted the Independent Medicines and Medical Devices Safety Review’s recommendation to undertake a selective retrospective audit of a defined cohort of women who have undergone mesh procedures. NHS Digital, now NHS England, has audited all pelvic floor surgeries completed between 2006 and 2011 to generate a historical baseline of outcomes by procedure type, and to support further research and analysis. This audit was conducted using initial procedures, and re-operations and follow up procedures recorded within Hospital Episode Statistics data. The results are currently undergoing peer review and will be published by NHS England at the earliest opportunity.

The Department accepted the Independent Medicines and Medical Devices Safety Review’s recommendation to undertake a selective retrospective audit of a defined cohort of women who have undergone mesh procedures. NHS Digital, now NHS England, has audited all pelvic floor surgeries completed between 2006 and 2011 to generate a historical baseline of outcomes by procedure type, and to support further research and analysis. This audit was conducted using initial procedures, and re-operations and follow up procedures recorded within Hospital Episode Statistics data.

The results are currently undergoing peer review and will be published by NHS England at the earliest opportunity. NHS England expects to be able to notify users of a date for the publication via their publications calendar. Subject to peer review, the publication is expected to include information around data quality.

No recent estimate has been made. Data is only available up to 2020 from the National Disease Registration Service. The data for the year 2020 highlights that 24.4% of bowel cancer patients were diagnosed through emergency presentation.

It is a priority for the Government to support the National Health Service to diagnose cancer, including bowel cancer, as early and as quickly as possible, and to treat it faster, to improve outcomes. The Department is committing to this by improving waiting times for cancer diagnosis and treatment, starting by delivering an extra 40,000 operations, scans, and appointments each week, to support faster diagnosis and access to treatment.

The NHS Bowel Cancer Screening programme currently invites people aged 56 to 74 years old for screening every two years. However, this age cohort is increasing to those aged 50 to 74 years old by 2025, which may reduce the number of late diagnoses.

Furthermore, NHS England runs Help Us Help You campaigns to increase knowledge of cancer symptom and address barriers to acting on them, to encourage people to come forward as soon as possible to see their general practitioner. This campaign urged people to take up the offer of bowel screening when invited.

The National Institute for Health and Care Excellence has guidance on the recognition, assessment, and management of coeliac disease, which is available at the following link:

https://www.nice.org.uk/guidance/ng20

The guidance outlines a number of symptoms which are suggestive of coeliac disease and suggests that any person with these symptoms should be offered serological testing for coeliac disease. The guidance also states that first-degree relatives of people with coeliac disease should also be offered serological testing.

No formal assessment has been made of the impact of diagnostic delays on the long-term health of patients with undiagnosed coeliac disease, but the Government does recognise that patients, including those with coeliac disease. have been let down for too long whilst they wait for the care they need.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.

We have made a commitment that 92% of patients should wait no longer than 18 weeks from Referral to Treatment within our first term. This includes those waiting for treatment for coeliac disease. As a first step to achieving this, following the Budget, we will deliver an additional 2 million operations, scans, and appointments across all specialities during our first year in Government, which is equivalent to 40,000 per week.

The Royal College of General Practitioners has an e-learning module on the diagnosis and management of coeliac disease and its immunological comorbidities, which is designed to raise awareness and understanding of the symptoms of coeliac disease amongst general practitioners and primary care professionals, and support early diagnosis. The e-learning module highlights that untreated coeliac disease can have important consequences, including small bowel lymphoma and osteoporosis.

The National Health Service website is also a key awareness tool and contains useful information for the public about coeliac disease, its symptoms, and how it is diagnosed and treated.

https://www.nhs.uk/conditions/coeliac-disease/

The National Institute for Health and Care Excellence has guidance on the recognition, assessment, and management of coeliac disease, which is available at the following link:

https://www.nice.org.uk/guidance/ng20

The guidance outlines a number of symptoms which are suggestive of coeliac disease and suggests that any person with these symptoms should be offered serological testing for coeliac disease. The guidance also states that first-degree relatives of people with coeliac disease should also be offered serological testing.

No formal assessment has been made of the impact of diagnostic delays on the long-term health of patients with undiagnosed coeliac disease, but the Government does recognise that patients, including those with coeliac disease. have been let down for too long whilst they wait for the care they need.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.

We have made a commitment that 92% of patients should wait no longer than 18 weeks from Referral to Treatment within our first term. This includes those waiting for treatment for coeliac disease. As a first step to achieving this, following the Budget, we will deliver an additional 2 million operations, scans, and appointments across all specialities during our first year in Government, which is equivalent to 40,000 per week.

The Royal College of General Practitioners has an e-learning module on the diagnosis and management of coeliac disease and its immunological comorbidities, which is designed to raise awareness and understanding of the symptoms of coeliac disease amongst general practitioners and primary care professionals, and support early diagnosis. The e-learning module highlights that untreated coeliac disease can have important consequences, including small bowel lymphoma and osteoporosis.

The National Health Service website is also a key awareness tool and contains useful information for the public about coeliac disease, its symptoms, and how it is diagnosed and treated.

https://www.nhs.uk/conditions/coeliac-disease/

The National Institute for Health and Care Excellence has guidance on the recognition, assessment, and management of coeliac disease, which is available at the following link:

https://www.nice.org.uk/guidance/ng20

The guidance outlines a number of symptoms which are suggestive of coeliac disease and suggests that any person with these symptoms should be offered serological testing for coeliac disease. The guidance also states that first-degree relatives of people with coeliac disease should also be offered serological testing.

No formal assessment has been made of the impact of diagnostic delays on the long-term health of patients with undiagnosed coeliac disease, but the Government does recognise that patients, including those with coeliac disease. have been let down for too long whilst they wait for the care they need.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.

We have made a commitment that 92% of patients should wait no longer than 18 weeks from Referral to Treatment within our first term. This includes those waiting for treatment for coeliac disease. As a first step to achieving this, following the Budget, we will deliver an additional 2 million operations, scans, and appointments across all specialities during our first year in Government, which is equivalent to 40,000 per week.

The Royal College of General Practitioners has an e-learning module on the diagnosis and management of coeliac disease and its immunological comorbidities, which is designed to raise awareness and understanding of the symptoms of coeliac disease amongst general practitioners and primary care professionals, and support early diagnosis. The e-learning module highlights that untreated coeliac disease can have important consequences, including small bowel lymphoma and osteoporosis.

The National Health Service website is also a key awareness tool and contains useful information for the public about coeliac disease, its symptoms, and how it is diagnosed and treated.

https://www.nhs.uk/conditions/coeliac-disease/

We welcome the House of Lords’ Preterm Birth Committee’s report focused on reducing risks and improving lives. We thank all the individuals and organisations that gave evidence to the Inquiry, and the committee members for their detailed examination of the issues and evidence in drawing their conclusions. We will respond to the report and the recommendations in the new year.

The National Maternity Safety Ambition will end in 2025. We are currently looking carefully at what comes beyond this ambition, to ensure that an evidence-based approach is taken, and that all targets are woman- and baby-centred.

The Family Hubs and Start for Life programme is central to the Government’s commitments to give every baby the best start in life, and to deliver the healthiest generation ever.

The Prime Minister’s Plan for Change outlined that we will give children the best start in life by strengthening and joining up family services to improve support through pregnancy and early childhood. There will be investment to continue to build up the Family Hub and Start for Life programme. The Autumn Budget announcement has already confirmed £69 million to continue delivery of a network of Family Hubs in 2025/26.

We are aware that local authorities such as Sunderland are undertaking financial planning for 2025/26, and have communicated with those for whom programme funding information is critical for operational business purposes.

The Government recognises the significant impact of delays in post-mortems on bereaved families. Specialised perinatal pathology services provide medical investigations, including post-mortem examinations following the death of a foetus or baby. These services are delivered by 18 National Health Service hospital trusts in England.

Perinatal pathology services are currently experiencing significant staff shortages. There are 26.15 whole time equivalent consultant vacancies, which is a 46% vacancy rate across the service. The lack of consultant staff is impacting the service’s ability to produce post-mortem reports in line with national standards, as set out in NHS England’s service specification B, which is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2013/06/e12-perinatal-path.pdf

In response to the impact that the staffing challenges are having have on the service, NHS England has established a Perinatal Pathology Transformation Programme which is implementing interventions to increase perinatal pathology service capacity over time and improve the post-mortem reporting time. The programme reports to a national Steering Group which has clinical, commissioning, and key stakeholder representation, including service users and patient and public voice representation, through the baby loss charity Sands. The Royal College of Pathologists is also included in the membership of the Steering Group.

Additionally, we welcome and are carefully considering the findings of the Justice Committee’s recent follow-up Inquiry into the Coroner Service, including on coronial pathology provision.

We are committed to getting the National Health Service diagnosing cancer earlier and treating it faster so that more patients survive. This includes children, teenagers and young adults (CTYA).

NHS England has published service specifications that set out the service standards required of all providers of CTYA cancer services. The requirements include ensuring that every patient has access to specialist care and reducing physical, emotional, and psychological morbidity arising from treatment for childhood cancer. The specifications are available at the following link:

https://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b05/

Children’s cancer care is managed by principal treatment centres (PTCs) who ensure quality care. Each PTC has a multi-disciplinary team which meets at least weekly and includes a specific focus on the psychosocial needs of patient. The multi-disciplinary team ensures that each service user is assessed for psychological needs and can access any psychosocial support that is required.

The Department is also taking steps to improving waiting times for cancer diagnosis and treatment across all cancer patient groups in England. We will start by supporting the NHS to deliver an extra 40,000 scans, appointments and operations each week to ensure that patients are seen as quickly as possible.

The National Institute for Health and Care Excellence has set out guidance for general practitioners on the symptoms of cancer in CTYA, recommending referral within 48 hours for those presenting with potential cancer symptoms. To support timely investigation after referral, we are working with the NHS to maximise the pace of the roll-out of additional diagnostic capacity, including via the roll out of community diagnostic centres.

We are committed to getting the National Health Service diagnosing cancer earlier and treating it faster so that more patients survive. This includes children, teenagers and young adults (CTYA).

NHS England has published service specifications that set out the service standards required of all providers of CTYA cancer services. The requirements include ensuring that every patient has access to specialist care and reducing physical, emotional, and psychological morbidity arising from treatment for childhood cancer. The specifications are available at the following link:

https://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b05/

Children’s cancer care is managed by principal treatment centres (PTCs) who ensure quality care. Each PTC has a multi-disciplinary team which meets at least weekly and includes a specific focus on the psychosocial needs of patient. The multi-disciplinary team ensures that each service user is assessed for psychological needs and can access any psychosocial support that is required.

The Department is also taking steps to improving waiting times for cancer diagnosis and treatment across all cancer patient groups in England. We will start by supporting the NHS to deliver an extra 40,000 scans, appointments and operations each week to ensure that patients are seen as quickly as possible.

The National Institute for Health and Care Excellence has set out guidance for general practitioners on the symptoms of cancer in CTYA, recommending referral within 48 hours for those presenting with potential cancer symptoms. To support timely investigation after referral, we are working with the NHS to maximise the pace of the roll-out of additional diagnostic capacity, including via the roll out of community diagnostic centres.

The 2021 National Institute for Health and Care Excellence’s (NICE) guidelines on the diagnosis and management of myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), provides recommendations on principles of care for people with severe ME/CFS, including hospital care, and adapting a multidisciplinary approach with access to a range of health and social care professionals based on needs.

The NICE’s guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account in designing services to meet the needs of their local population, and to work towards their implementation over time.

No specific assessment has been made of the adequacy of the safety of National Health Service care for patients with severe and very severe ME/CFS, but there are steps that the Government is taking to improve care for patients with ME/CFS, including those with severe and very severe ME/CFS.

The Department has funded the £3.2 million DecodeME study with the Medical Research Council to understand the causes and consequences of, and find treatments for, ME/CFS. This study aims to understand if there is a genetic component to the condition and, in doing so, increase our understanding of ME/CFS to support the development of diagnostic tests and targeted treatments.

The public consultation on the interim delivery plan for ME/CFS was run in 2023. It has been a priority since July 2024 to publish the response to the 2023 consultation on the ME/CFS interim delivery plan. Departmental officials are in the process of finalising a report summarising the responses, for publication. The consultation responses, alongside continued stakeholder engagement, will inform the development of the final delivery plan, which we aim to publish in the winter of 2024/25. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease, including those with severe and very severe ME/CFS.

The 2021 National Institute for Health and Care Excellence’s (NICE) guidelines on the diagnosis and management of myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), provides recommendations on principles of care for people with severe ME/CFS, including hospital care, and adapting a multidisciplinary approach with access to a range of health and social care professionals based on needs.

The NICE’s guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account in designing services to meet the needs of their local population, and to work towards their implementation over time.

No specific assessment has been made of the adequacy of the safety of National Health Service care for patients with severe and very severe ME/CFS, but there are steps that the Government is taking to improve care for patients with ME/CFS, including those with severe and very severe ME/CFS.

The Department has funded the £3.2 million DecodeME study with the Medical Research Council to understand the causes and consequences of, and find treatments for, ME/CFS. This study aims to understand if there is a genetic component to the condition and, in doing so, increase our understanding of ME/CFS to support the development of diagnostic tests and targeted treatments.

The public consultation on the interim delivery plan for ME/CFS was run in 2023. It has been a priority since July 2024 to publish the response to the 2023 consultation on the ME/CFS interim delivery plan. Departmental officials are in the process of finalising a report summarising the responses, for publication. The consultation responses, alongside continued stakeholder engagement, will inform the development of the final delivery plan, which we aim to publish in the winter of 2024/25. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease, including those with severe and very severe ME/CFS.