Asked by: Stuart Andrew (Conservative - Daventry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of changes to Indicative Action Plans and the introduction of minimum waiting times on patients with ongoing care needs, including those at risk of serious complications such as irreversible sight loss.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set indicative activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.
The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.
The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.
Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.
While IAPs and AMPs are implemented to ensure this financial balance, all providers are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.
Asked by: Stuart Andrew (Conservative - Daventry)
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 Integrated Care Boards do not (a) implement minimum waiting times and (b) make reductions to Indicative Action Plans in ways that could risk patient harm.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set indicative activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.
The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.
The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.
Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.
While IAPs and AMPs are implemented to ensure this financial balance, all providers are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.
Asked by: Stuart Andrew (Conservative - Daventry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether (a) his Department and (b) NHS England has issued guidance to Integrated Care Boards on the use of minimum waiting times for elective care.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set indicative activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.
The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.
The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.
Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.
While IAPs and AMPs are implemented to ensure this financial balance, all providers are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has for financial support for patients required to travel very long distances to access (a) stem cell transplants, (b) CAR-T immunotherapy and (c) other specialist treatments; what recent assessment he has made of the financial impact on such patients of claiming reimbursement of substantial travel costs retrospectively under the Healthcare Travel Costs Scheme; and if he will make it his policy to amend that scheme to allow payment in advance to patients having to undertake expensive journeys to and from treatment centres.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
No such assessment has been made, and there are no current plans to amend the Healthcare Travel Costs Scheme (HTCS).
It is already the case that where required and appropriate, advance payments may be made to patients on low incomes to allow them to attend their appointments. Further information can be found on the HTCS webpage, at the following link:
https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/
Asked by: Pippa Heylings (Liberal Democrat - South Cambridgeshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether NHS England holds data on the number of (i) current and (ii) previously looked-after children on waiting lists for (a) mental health services and (b) neurodevelopmental assessments.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England holds data on the number of current looked-after children accessing or waiting for contact with secondary mental health services. We can identify individuals waiting for neurodevelopmental, autism, or mental health assessment via the indicated primary reason for referral or type of team they were referred to.
NHS England does not hold specific data on the number of previously looked after children. If an individual is no longer a looked-after child, this would not be held within the dataset.
Asked by: Shaun Davies (Labour - Telford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the gender breakdown is of maternity services staff for each NHS trust.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
NHS England publishes Hospital and Community Health Services workforce statistics for England which include information on the gender of staff. The data is drawn from the Electronic Staff Record, the human resources system for the National Health Service. Further information is available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics
The attached table presents data drawn from the underlying Electronic Staff Record information which is used by NHS England to produce the monthly NHS Workforce Statistics as the publication routinely presents data on the gender of staff by their staffing group but does not present this information broken down by individual organisation or the care setting or specialism staff are working in.
Staff working in maternity services have been defined as doctors working in the specialty area of obstetrics and gynaecology, midwives, nurses working either maternity or neonatal nursing settings, and patient facing support staff working in either maternity services or neonatal nursing settings.
Asked by: James Naish (Labour - Rushcliffe)
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 changes to safe staffing levels in mental health services on patient safety; whether the Department has revised its definition of safe staffing levels in response to workforce shortages; and what steps he is taking to ensure that staffing standards are maintained at levels that protect both patient safety and staff wellbeing.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
No assessment has been made. NHS England is currently updating guidance on how trusts should set their staffing levels, via the Developing Workforce Safeguards and Safe Staffing in Mental Health Services 2018 framework, to reflect current evidence and operations. Staffing any service and any shift should be built around the needs of patients which should be the aim of all National Health Service providers.
Guidance on safe staffing levels also specifies that every NHS organisation should have a strategic workforce plan which is discussed and agreed at the trust board level and should also have escalation processes to cover staffing shortages or changes.
Asked by: Liz Jarvis (Liberal Democrat - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what his expected timetable is for the implementation of measures to expand access to talking therapies, assertive outreach, and digital access to mental health support through the NHS App under the 10-Year Health Plan.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
To deliver the shift from analogue to digital that is set out in the 10-Year Health Plan, we will create a digital front door for mental health care through the NHS App to boost access to early support and to empower people to take steps to manage their symptoms.
This has already started, with mental health appointment management now available in eight National Health Service trusts, with a further 18 trusts now funded to come online soon. Underserved groups will be able to find and access Talking Therapies through targeted messaging from next year as well.
We have also been making improvements to the self-referral pathways between NHS 111 online and NHS Talking Therapies, meaning that the 20,000 people with mental health queries who go to NHS 111 online are now better served. This is in addition to supporting people in crisis through the 111 online symptom checker that advises on what to do next.
We are also planning to move all direct-to-patient communication services to NHS Notify and use NHS App-based ‘push’ notifications as the preferred method of contact so that patients can access referral and appointment details, and share and update information with ease.
More widely, we support the adoption of digital technology across the NHS Talking Therapies pathway. NHS England and the National Institute for Health and Care Excellence (NICE) provide assurance around Digitally Enabled Therapies with a strong evidence base, and 7% of NHS Talking Therapies treatments are delivered via these tools. More recently, NICE has provided assurance around Digital Front Doors into NHS Talking Therapies services and we are seeing rapid adoption of these tools, which use artificial intelligence and can improve the quality and accuracy of the assessment.
The NHS 10-Year Health Plan committed to improving assertive outreach care and treatment to ensure 100% national coverage in the next decade. Following the 2025/26 Planning Guidance, systems have reviewed their provision and developed local action plans to strengthen care and treatment. This has been supported by national guidance on intensive and assertive community mental health treatment which helps local areas assess and enhance their services. Recognising all the hard work and improvements systems have already made, we will continue working with regions and integrated care boards to ensure this remains a local priority.
Asked by: Sharon Hodgson (Labour - Washington and Gateshead South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress his Department has made on developing national guidance for Auditory Verbal therapy for deaf children since March 2025; and whether he plans to establish a timeline for publishing that guidance.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the provision and commissioning of services to meet the needs of their local populations, including services for non-hearing children. NHS England supports ICBs to make informed decisions about the provision of audiology services so that they can provide consistent, high quality, and integrated care.
Auditory verbal therapy (AVT) is one type of therapy to support children with hearing loss, and it is important that local commissioners have the discretion to decide how best to meet the needs of their local population, informed by the best available evidence and guidance.
Based on consideration of the current evidence on AVT for deaf children, NHS England has no plans to develop such national guidance. In November 2025, NHS England appointed two national specialty advisers for hearing and associated conditions who are considering care pathway improvements for hearing services. The national speciality advisors are committed to meeting with the charity Auditory Verbal UK (AVUK) to discuss AVT, with a meeting scheduled.
The National Institute for Health and Care Excellence’s prioritisation board considered childhood hearing loss as a potential guideline topic in August 2024, but concluded that there is limited evidence available in this area and that the 2015 NHS England Action Plan on Hearing Loss and guidance issued in 2019 addresses care for this population, and it is understood that AVUK are in the process of developing the evidence base for the intervention. The NHS England Action Plan on Hearing Loss is available at the following link:
https://www.england.nhs.uk/wp-content/uploads/2015/03/act-plan-hearing-loss-upd.pdf
Asked by: Dan Carden (Labour - Liverpool Walton)
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 improve (a) diagnosis, (b) treatment and (c) ongoing care for patients with endometriosis.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to prioritising women’s health, including endometriosis diagnosis, treatment, and ongoing care. It is unacceptable that women can wait so long for an endometriosis diagnosis, and we have already taken action to address this.
The National Institute for Health and Care Excellence (NICE) updated their guideline on endometriosis in November 2024 to make firmer recommendations on referral and investigations, and this will help women receive a diagnosis and effective treatment faster.
Research has led to new treatments being made available, including the NICE approval of two pills to treat endometriosis this year, namely Relugolix and Linzagolix. Both are estimated to help approximately 1,000 women with severe endometriosis for whom other treatment options haven’t been effective.
Through the National Institute for Health and Care Research (NIHR), the Department has commissioned several studies focused on endometriosis diagnosis, treatment, and patient experience. At present, the NIHR is funding five active research awards into endometriosis totalling an investment of approximately £5.5 million. A further £2.3 million award on the effectiveness of pain management for endometriosis is due to commence in March 2026.
We are expanding the number of dedicated and protected surgical hubs, of which gynaecology procedures are a key offering.
As announced in September, we will establish an “online hospital”, NHS Online, which will give people on certain pathways the choice of getting the specialist care they need from their home. Menstrual problems that may be a sign of several conditions, including endometriosis, will be among the conditions available for referral to NHS Online from 2027.
NHS England is also updating the service specification for severe endometriosis which is due to be published in due course. This will improve the standards of care for women with severe endometriosis by ensuring specialist endometriosis services have access to the most up-to-date evidence and advice.