Shockat Adam

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.

In 2025/26 alone, this government plans to spend over £8 billion on early years entitlements and we have increased the early years pupil premium by over 45%. On top of this, we are providing further supplementary funding of £75 million for the Early Years Expansion Grant.

To set early years funding rates, we uplift the national average rate from the previous year taking into account cost pressures facing the sector, including forecasts of average earnings and inflation, and the National Living Wage. We use the early years national funding formulae (EYNFF) to distribute the early years entitlements budget to local authorities. The EYNFF includes a base rate for each child, which is the same minimum funding for every child no matter where they live or whether they have additional needs. This rate is based on the core costs of childcare provision and has been informed by the cost of childcare review.

To make sure we can account for the differences in costs across the country, such as on staffing and premises costs, we also apply an area cost adjustment for each area. This approach only increases funding, it never reduces the base rate or additional needs funding.

The average hourly funding rate provided for 3 and 4-year-olds since 2018 is as follows:

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.

In 2025/26 alone, this government plans to spend over £8 billion on early years entitlements and we have increased the early years pupil premium by over 45%. On top of this, we are providing further supplementary funding of £75 million for the Early Years Expansion Grant.

To set early years funding rates, we uplift the national average rate from the previous year taking into account cost pressures facing the sector, including forecasts of average earnings and inflation, and the National Living Wage. We use the early years national funding formulae (EYNFF) to distribute the early years entitlements budget to local authorities. The EYNFF includes a base rate for each child, which is the same minimum funding for every child no matter where they live or whether they have additional needs. This rate is based on the core costs of childcare provision and has been informed by the cost of childcare review.

To make sure we can account for the differences in costs across the country, such as on staffing and premises costs, we also apply an area cost adjustment for each area. This approach only increases funding, it never reduces the base rate or additional needs funding.

The average hourly funding rate provided for 3 and 4-year-olds since 2018 is as follows:

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

In July 2024, this government established the independent Curriculum and Assessment Review, covering ages 5 to 18, chaired by Professor Becky Francis CBE.

The Review seeks to deliver a rich, broad, inclusive and innovative curriculum that readies young people for life and work. This includes creative subjects such as art, music and drama, as well as skills for life and work.

On 18 March, the Review published a well-evidenced, clear interim report, which sets out its interim findings and confirms the key areas for further work.

The final report with recommendations will be published this autumn, along with the government’s response. The Review’s recommendations will inform changes to the current system.

The Durham Commission report published in 2019 set out a number of recommendations, and some were taken forward by the previous government, Arts Council England and others.

This includes the ‘Creativity Collaboratives’ programme established by Arts Council England in 2021 to test innovative practices in teaching for creativity.

I refer the hon. Member for Leicester South to the answer of 13 May 2025 to Question 49523.

Schools are free to decide which events to commemorate and what activities to put in place to support pupils’ understanding of significant events and particular months or days dedicated to specific historical events, such as the International Day of Reflection and Commemoration of the 1995 Genocide in Srebrenica.

Schools also have the opportunity to mark such events though the curriculum, and to teach about the Srebrenica Genocide, for example, through subjects such as history and citizenship.

Within schools, statutory relationships, sex and health education (RSHE) supports children and young people to make informed decisions in relation to their mental wellbeing and online behaviour. The RSHE statutory guidance is clear that children and young people should be taught about the risks related to gambling including the accumulation of debt, how advertising and information is targeted at them and how to be a discerning consumer of information online.

These subjects support children and young people to develop self-control and their ability to self-regulate, as well as providing strategies for doing so.

Young people attending further education (FE) colleges, take part in regular tutor sessions that are devoted to their personal development. This includes financial education and the informed use of money where the dangers of gambling can be discussed. The department continues to work closely with the FE sector to promote and support providers to develop and implement a whole college approach to mental health and wellbeing. This includes establishing Mental Health Support Teams in schools and colleges to provide early intervention for students experiencing mild to moderate mental health issues.

As outlined in the 10-Year Health Plan and the Life Sciences Sector Plan, we want patients to have fast and safe access to the most innovative technology, wherever they live in the country. Improving the adoption and procurement of medical technology will help the National Health Service secure the best outcomes for patients, including patients with sight threatening conditions, whilst also delivering greater value-for-money for the NHS.

The Department invests over £1.6 billion each year on research, including on eye care, through its research delivery arm, the National Institute for Health and Care Research.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for evaluating new medicines, medical devices, and other technologies to determine their clinical and cost-effectiveness before recommending them for NHS use.

Where a NICE technology appraisal recommends a medicine or treatment, the NHS is legally required to fund them. Where NICE guidance is not available on a particular medical technology, we would expect commissioners to take funding decisions on the basis of the available evidence of the clinical benefits.

As outlined in the 10-Year Health Plan and the Life Sciences Sector Plan, we want patients to have fast and safe access to the most innovative technology, wherever they live in the country. Improving the adoption and procurement of medical technology will help the National Health Service secure the best outcomes for patients, including patients with sight threatening conditions, whilst also delivering greater value-for-money for the NHS.

The Department invests over £1.6 billion each year on research, including on eye care, through its research delivery arm, the National Institute for Health and Care Research.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for evaluating new medicines, medical devices, and other technologies to determine their clinical and cost-effectiveness before recommending them for NHS use.

Where a NICE technology appraisal recommends a medicine or treatment, the NHS is legally required to fund them. Where NICE guidance is not available on a particular medical technology, we would expect commissioners to take funding decisions on the basis of the available evidence of the clinical benefits.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

We recognise the vital contribution the optometry sector plays in the early detection of sight threatening conditions. The 10-Year Health Plan will support more eye care services being delivered in the community.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

The expansion of and funding for Advice and Guidance and referral triage more broadly for 2026/27 are currently under consideration, and a decision will be confirmed later this year.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

The 10-Year Health Plan supports more locally developed and integrated neighbourhood care rather than a top-down, one-size-fits-all solution. Integrated care boards will want to take different approaches to commissioning primary and secondary eye care services, depending on the skills and resources available to them.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

NHS.net, formally NHSmail, provides licences for optometry practices in England, specifically for General Ophthalmic Services contractors with 10 or fewer sites. Eligible practices can receive one shared mailbox and up to three individual NHS.net accounts per site, enabling the secure communication of patient data. NHS.net also provides secure communication to other commissioned partners delivering healthcare across pharmacy, dentistry, social care, and other neighbourhood community providers.

High street optometrists play a vital role in the early detection of a range of eye conditions. Integrated care boards are responsible for commissioning primary and secondary eye care services and can commission additional diagnostic services from high street optometrists based on providers and priorities in their areas, for example additional testing to support effective referrals to secondary care.

NHS England’s digital accelerators pilots have provided the evidence to demonstrate the value of the digital integration of primary and secondary care through a refined single point of access model. The digitally enabled single point of access uses IT connectivity between primary and secondary eye care services to improve the referral and triage of patients, with patient data and images being assessed by clinicians to determine if patients need an appointment in secondary care. This was found to reduce unnecessary hospital appointments, the time from referral to treatment, and supports more patients being managed in the community. The learning from the pilots has been shared with integrated care boards.

Integrated care boards (ICBs) are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests, whether provided by the NHS or privately, play a vital role in the early detection of sight threatening eye conditions.

ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

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

We recognise the importance of making better use of the optometry sector and the capabilities to support eyecare capacity in the community, in order to reduce pressures on hospital services whilst also providing care closer to home. In line with our 10-Year Health Plan, we are working to develop neighbourhood health services so that more care takes place in the community, including optometry.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary care, such as eye and optometry services, to meet the populations’ needs.

NHS England is working with eyecare providers to consider how eyecare services should be commissioned to ensure future sustainability. This includes looking at how more patients can be triaged and managed in the community, freeing up capacity for those that need face to face specialist care.

Integrated care boards (ICBs) are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests, whether provided by the NHS or privately, play a vital role in the early detection of sight threatening eye conditions.

ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

NHS England has been supporting the integrated care boards (ICBs) with the roll out of the special schools’ sight testing service. NHS England hosted a series of webinars to talk ICBs through the nationally developed service specifications. Each ICB received a comprehensive information pack outlining the level of interest expressed by both educational settings and service providers.

NHS England has established reporting on ICB progress in commissioning services, and all have indicated that they are either actively commissioning services, preparing for procurement activities, or planning engagement with local schools. Whilst services are being commissioned, the proof of concept contractors continue to provide services across 83 special schools.

The National Institute for Health and Care Excellence (NICE) has been monitoring the impact of the severity modifier since it was implemented in 2022. Data up to March 2025 shows that the proportion of positive cancer recommendations is higher (85%) than with the end-of-life modifier it replaced (75%) and the proportion of positive recommendations for advanced cancer treatments is also higher (81% compared to 69%).

Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed, including treatments for advanced breast cancer (such as Truqap and Korserdu), which are now available to eligible National Health Service patients.

The severity modifier is therefore working as intended and there are currently no plans to adjust or change it in the near future. However, NICE has commissioned research on people’s attitudes to how the severity modifier should be applied that will inform future reviews of NICE’s methods.

The Government announced in the 10 Year Infrastructure Strategy document on 19 June 2025, as well as in the 10-Year Health plan published on 3 July 2025, that it will explore the feasibility of using new Public Private Partnerships (PPPs) to deliver certain types of primary and community health infrastructure, including neighbourhood health centres. The business case is being co-developed by the Department of Health and Social Care and the National Infrastructure and Service Transformation Authority. The decision on whether to proceed with the use of PPPs for neighbourhood health centres will be made by HM Treasury and relevant ministers by the 2025 Autumn Budget.