Written questions by Mohamed.

What steps he is taking to ensure continuity of ADHD care for people on the right to choose waiting list in England when they move to Scotland to take up a place at University.

Healthcare is a devolved matter and the Right to Choose applies only to National Health Services commissioned in England. When a person moves from England to Scotland, their healthcare, including access to attention deficit hyperactivity disorder assessment and treatment, becomes the responsibility of NHS Scotland, which operates under its own clinical pathways, eligibility criteria, and commissioning arrangements.

What assessment his Department has made of the (a) potential implications for his policies of trends in the level of profits generated by private care homes in the last three years and (b) potential impact of this has on the funding and sustainability of social care.

Provider profits are a necessary component of any healthy industry and play an important role in attracting investment to the sector. The Department monitors financial health using the Earnings Before Interest, Tax, Depreciation, Amortisation, Rent and Management (EBITDARM) margin, a recognised accountancy measurement for businesses with assets and incomes such as care homes. Latest published data is from the Care Quality Commission’s Market Oversight scheme last year and suggests that non-specialist care homes had an EBITDARM margin of 26.9% as of March 2024.We have provided the Market Sustainability and Improvement Fund (MSIF) to local authorities since 2023/24, with one of the three target areas local authorities can spend their allocations on being to improve fee rates to providers. MSIF is designed to support increased adult social care capacity and improve market sustainability.Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people.  This includes a duty to work closely with local provider to promote best practice and achieve a sustainable balance of quality, effectiveness, and value for money.

What steps his Department is taking with (a) UK Research and Innovation and (b) the National Institute for Health and Care Research to prioritise further research into early diagnosis of (i) pancreatic cancer and (ii) other less survivable cancers.

The Department of Health and Social Care invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). Government responsibility for funding cancer research is shared between UK Research and Innovation, funded by the Department for Science, Innovation and Technology and including the Medical Research Council, and the NIHR. Research funders work closely to drive the maximum collective research impact on policy, practice, and individual lives.NIHR investments are pivotal to informing efforts to improve cancer prevention, treatment, and outcomes. An example of this is the NIHR investing £2.4 million into the miONCO-Dx trial, which seeks to develop a blood test designed to detect 12 different cancers, that could transform how cancer is diagnosed in the National Health Service.The NIHR continues to welcome funding applications for research into any aspect of human health and care, including all cancers. These 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. Welcoming applications on all cancers to all NIHR programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.The forthcoming National Cancer Plan will include further details on how the NHS will improve diagnosis and outcomes for cancer patients in England.

What discussions his Department has had with the Royal College of Physicians on the administrative error in the 2023 Membership of the Royal Colleges of Physicians of the UK part two examinations.

We recognise that this will be a concerning time for those doctors affected. We have asked the UK Statutory Education Bodies, which is NHS England in the case of England, to work with the Royal College of Physicians and the General Medical Council to ensure this issue is rectified as a matter of urgency.

What steps he is taking to ensure Deprivation of Liberty Safeguard applications are processed within 21 days.

Processing Deprivation of Liberty Safeguard (DoLS) applications is the responsibility of local authorities. There is considerable variation in how local authorities process and complete their DoLS applications with some areas successfully processing applications within 21 days. It is the responsibility of local authorities to make sure their systems for managing DoLS are informed by best practice.

What steps he is taking to increase the supply of Pancreatic Enzyme Replacement Therapy.

The Department continues to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Suppliers have managed to secure additional pharmaceutical ingredient resulting in expected increased volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the gap in the market and provided advice to clinicians on prescribing and ordering these imports.In December 2024, the Department issued further management advice to healthcare professionals. This includes actions for clinicians to consider these unlicensed imports when licensed stock is unavailable and for integrated care boards to ensure local mitigation plans are put in place and implemented.

Whether he has had discussions with medical suppliers on the availability of Pancreatic Enzyme Replacement Therapy.

The Department continues to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Suppliers have managed to secure additional pharmaceutical ingredient resulting in expected increased volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the gap in the market and provided advice to clinicians on prescribing and ordering these imports.In December 2024, the Department issued further management advice to healthcare professionals. This includes actions for clinicians to consider these unlicensed imports when licensed stock is unavailable and for integrated care boards to ensure local mitigation plans are put in place and implemented.

What steps his Department is taking with Action for Pulmonary Fibrosis to help improve health outcomes for people with pulmonary fibrosis.

NHS England is responsible for the commissioning of services for interstitial lung disease and funds the cost of anti-fibrotic treatments to treat this disease. Access to these treatments has recently been expanded to patients with non-idiopathic pulmonary fibrosis, following the publication of the National Institute for Health and Care Excellence’s Technology Appraisal, Nintedanib for treating progressive fibrosing interstitial lung diseases, in November 2021.In order to increase awareness of pulmonary fibrosis, NHS England has established 13 Respiratory Clinical Networks across the country. These have been vital in providing clinical leadership for respiratory services and supporting services in primary care, including restoring spirometry, which is one of the tests used to diagnose pulmonary fibrosis.Pulmonary rehabilitation plays an important role in the management of patients with pulmonary fibrosis and should be made available to all patients who would benefit from this intervention.

What steps he is taking to reduce speech and language therapy workforce shortages.

We want to remove the barriers to training as a speech and language therapist (SLT), which is why eligible SLT students can get a non-repayable grant of £5,000 a year through the NHS Learning Support Fund. Further financial support is also available for childcare, dual accommodation costs, and travel. This is in addition to the student support package available from Student Finance England, which includes loans for tuition fees and living costs.We will also publish a refreshed Long Term Workforce Plan which will deliver the transformed health service we will build over the next decade to ensure that the National Health Service has the right people, including those who work in speech and language therapy, in the right places, with the right skills to deliver the care patients need when they need it.

What steps he is taking to improve diagnosis times for people with pulmonary fibrosis.

NHS England is responsible for the commissioning of services for interstitial lung disease and funds the cost of anti-fibrotic treatments to treat this disease. Access to these treatments has recently been expanded to patients with non-idiopathic pulmonary fibrosis, following the publication of the National Institute for Health and Care Excellence’s Technology Appraisal, Nintedanib for treating progressive fibrosing interstitial lung diseases, in November 2021.In order to increase awareness of pulmonary fibrosis, NHS England has established 13 Respiratory Clinical Networks across the country. These have been vital in providing clinical leadership for respiratory services and supporting services in primary care, including restoring spirometry, which is one of the tests used to diagnose pulmonary fibrosis.Pulmonary rehabilitation plays an important role in the management of patients with pulmonary fibrosis and should be made available to all patients who would benefit from this intervention.

What steps his Department is taking with NHS England and the Department for Education to reduce speech and language therapy waiting lists.

Community health services, including speech and language therapy, are locally commissioned to enable systems to best meet the needs of their communities.We recognise the impact that long waits to access speech and language therapy can have on the individual, as well as their families and carers, and we are working closely with NHS England and the Department of Education to improve timely access to community health services and on actions to reduce long waits. We continue to improve access to Speech and Language Therapy by including the Early Language and Support for Every Child (ELSEC) pathfinder project within the Department for Education’s existing Change Programme, in partnership with NHS England.The ELSEC programme provides training and support to education settings, through a new workforce model that employs pre-qualification speech and language Therapy Support Assistants, and focuses on early intervention, to increase their ability to support children’s speech, language, and communication development.

What steps he is taking to increase access to pulmonary fibrosis treatment in England.

NHS England is responsible for the commissioning of services for interstitial lung disease and funds the cost of anti-fibrotic treatments to treat this disease. Access to these treatments has recently been expanded to patients with non-idiopathic pulmonary fibrosis, following the publication of the National Institute for Health and Care Excellence’s Technology Appraisal, Nintedanib for treating progressive fibrosing interstitial lung diseases, in November 2021.In order to increase awareness of pulmonary fibrosis, NHS England has established 13 Respiratory Clinical Networks across the country. These have been vital in providing clinical leadership for respiratory services and supporting services in primary care, including restoring spirometry, which is one of the tests used to diagnose pulmonary fibrosis.Pulmonary rehabilitation plays an important role in the management of patients with pulmonary fibrosis and should be made available to all patients who would benefit from this intervention.

What his planned timetable is for publishing the Maternity and Neonatal Estates Review.

NHS England will publish the findings of the National Health Service maternity and neonatal estates survey, which examined compliance against the current standards for estates, including the requirements of neonatal parental accommodation. The Government’s response to the House of Lords Pre-term Birth Inquiry committed to publishing the survey in early 2025, and the ambition remains to publish it as soon as possible.

If he will make an assessment of the potential merits of including Band 2 NHS workers in pay progression policies.

As part of the 2023 Agenda for Change pay deal between the Government, employers, and trade unions, there was a mutual agreement to uplift the value of the bottom pay point of band two to the same value as the top pay point, and this position was ratified by the NHS Staff Council.Any further changes to the pay structure will be for the NHS Staff Council to ratify or agree to, as part of any future negotiations.

When NHS England next plans to update its publication entitled Health Building Note 09-03: Neonatal units, first published in March 2013.

Guidance related to the National Health Service Estate is reviewed, prioritised and updated to reflect changing legislative, regulatory, technological and policy requirements. As part of the three-year delivery plan and subsequent for maternity and neonatal service survey, NHS England plans to start the update of this Health Building Note in 2025/26. Usually, guidance notes take between 18 and 24 months to update and so NHS England plans to publish this in 2027/28.

Pursuant to the Answer of 2 December 2024 to Question 15960 on Neonatal Inequalities, if he will make an assessment of the potential merits of (a) monitoring and (b) reporting on (i) pre-term births and (ii) neonatal brain injuries by (A) ethnicity and (B) deprivation.

The Government is committed to ensuring that all women and babies received safe, personalised, equitable, and compassionate care. I am urgently considering the immediate action needed across maternity and neonatal services to improve outcomes and address the stark inequalities that persist for women and babies across ethnicity and deprivation.The Department’s officials work closely with NHS England and maternity and neonatal sector partners to monitor inequalities in perinatal outcomes by ethnicity and deprivation, including through the published Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK reports. The Office of National Statistics’ report on preterm birth by ethnicity and the recent Imperial College London Brain Injury Surveillance Reports include breakdowns by ethnicity and deprivation. There are no current plans to make a further specific assessment of the merits of monitoring and reporting on pre-term births and neonatal brain injuries by ethnicity and deprivation.

What steps he plans to take to help improve (a) access to GP appointments and (b) rates of early-stage cancer diagnosis in areas of socio-economic deprivation in Yorkshire.

We know that patients are struggling to access general practices (GPs), and that these struggles can be particularly acute for patients living in deprived areas. We will support equitable access to GP services, and we have already committed to recruiting over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme, as part of an initiative to address GP access. In order to ensure that all patients have multiple routes of access, we have committed to introducing a modern booking system, to end the 8:00am scramble. The chances of surviving cancer are higher if diagnosed at an early stage. Therefore, early diagnosis is a key priority for the Government. We will improve cancer survival rates and hit all National Health Service cancer waiting time targets, so no patient waits longer than they should, including in Yorkshire.

If he will have discussions with social care providers on the potential impact of Autumn Budget 2024 on the social care sector.

The Department holds regular meetings with adult social care stakeholders, including service providers and representative bodies, to discuss key issues and developments such as the impact of the Budget on the sector. The Government will make available up to £3.5 billion of additional funding for social care authorities in 2025/26. We will set out further details at the Local Government Finance Settlement.

What steps he plans to take ensure there is sufficient provision of (a) rehabilitation and (b) prehabilitation for cancer patients across all cancer alliances.

National Health Service trusts and cancer alliances are responsible for ensuring that plans are in place to meet the needs of patients in their localities. Therefore, the Department does not have additional plans to ensure there is provision of rehabilitation and prehabilitation for cancer patients across all cancer alliance areas.A range of resources are available to the NHS workforce to support prehabilitation, rehabilitation, and physical activity. For example, NHS England provides the PRosPer Cancer Prehabilitation and Rehabilitation learning programme, which aims to support allied health professionals and the wider healthcare workforce in developing their skills in providing personalised care, prehabilitation, and rehabilitation in the cancer pathway. This programme forms part of the Personalised Care Institute’s library of personalised care training for all healthcare professions.

What his planned timetable is for when cancer sites will have recurrence data collection mandated to align with the collection of breast cancer recurrence data.

The National Disease Registration Service (NDRS), part of NHS England, collects patient data on cancer as well as congenital anomalies and rare diseases. The NDRS has been collecting recurrence data for non-primary cancers via data submissions as part of the Cancer Outcomes and Services Dataset since 2013. Recurrence data can also be obtained from the Cancer Waiting Times treatment dataset for diagnosed cancer patients.The Diagnostic Imaging Data Set (DID) is a central collection of detailed information about diagnostic imaging tests carried out on National Health Service patients, published by NHS England. Development of DIDS version 2.0 has commenced with the gathering of requirements from various stakeholders including NHS England, NHS Data Model and Dictionary, providers, and system suppliers. One of the requirements under consideration is the addition of an alert to identify if the imaging showed a suspected or confirmed cancer, recurrence, or progression. Such an alert could improve recording of the progression to metastatic status or the recurrence of cancer. Development of DIDS version 2.0 provides a window of opportunity to both reduce the burden of data collection, while improving the value of the dataset in assessing clinical outcomes.