Written questions by Ballinger.

What assessment she has made of potential shortfalls in funding for service delivery by hospice providers.

Palliative care services are included in the list of services that an integrated care board (ICB) must commission. To support ICBs in meeting this duty, NHS England has published statutory guidance and service specifications. The statutory guidance makes clear that ICBs must work to ensure there is sufficient provision of care services to meet the needs of their local populations, which may include hospice services available within the ICB’s catchment area.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative care and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We recognise the significant challenges facing the hospice sector, which is why we are providing £125 million in capital funding for adult and children’s hospices, to ensure they have the best physical environment for care and to free up other funding for patient care. We are also providing approximately £80 million in revenue funding for children and young people’s hospices over the next three financial years, giving them the stability they need to plan ahead.NHS England continues to work closely with ICBs to support more strategic, data-driven commissioning of palliative care and end of life care services, including those delivered by hospices. In February, NHS England wrote to all ICBs requesting an update on the financial stability of hospices in their footprint as a matter of urgency, and the steps being taken to mitigate risks.We are also considering these as we develop the Palliative Care and End of Life Care Modern Service Framework, which will support strategic commissioning, and help address challenges in access, quality, and sustainability across the sector.

Which organisations will replace Healthwatch Dudley; and how health and social care will be monitored in Dudley borough.

As set out in the Review of patient safety across the health and care landscape report published in July 2025, and in the 10-Year Health Plan for England: fit for the future, the statutory functions of local Healthwatch bodies will be transferred to integrated care boards (ICBs) for health, and to local authorities (LAs) for social care.Both ICBs and LAs will be required to demonstrate how they have gathered patient and user feedback, including and how this has fed into their strategic planning.To further ensure that the patient voice is at the heart of planning considerations, as part of their regulatory role, the Care Quality Commission will assess whether every commissioner and provider is listening to the views of local people.

Whether he plans to expand protected research time for NHS clinicians contributing to research.

The Government’s 10-Year Health Plan for England: fit for the future highlights the opportunities for improved care and innovation that comes from research and life sciences in the National Health Service. The upcoming 10 Year Workforce Plan is considering all aspects of the NHS workforce, including the research workforce. The 10-Year Health Plan is available at the following link: https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future The Department, through the National Institute of Health and Care Research, funds protected time for research and research training as part of career development awards, allowing award holders to develop and utilise research skills alongside clinical practice. This includes Academic Clinical Fellowships and Clinical Lectureships, which are clinical academic training posts, primarily for doctors and dentists, that are undertaken alongside specialty training. The Senior Clinical and Practitioner Research Award provides funding for professionals to have protected time for research within their current practice roles. It is available to all professions, with priority given to those typically underrepresented in research. The Department is working with key stakeholders and the devolved administrations to develop a UK Research Workforce Strategy, to be published in the coming months. The strategy sets out a 10-year vision to embed research and innovation into core practice within the NHS, social care, and public health system, aligned with the 10-Year Health Plan, Life Sciences Sector Plan, and Office for the Strategic Co-ordination of Health Research reports. The ambition is to address barriers and build research capacity across all professions, settings, and geographies to lead and deliver high-quality research, as well as to routinely implement research findings to drive improved patient outcomes along with enhanced efficiency and productivity across the health, social care, and public health system.

If he will make an assessment of the potential merits of introducing (a) national guidance and (b) regulations on setting a minimum age for body piercings.

There are no plans to set a national minimum age for body piercings. The Department has produced model byelaws for cosmetic piercing under the Local Government Act 2003 and Local Government (miscellaneous provisions) Act 1982. The purpose of the model byelaws is to recognise and set nationally accepted standards that reduce the spread of infectious diseases and protect public health. Further, the Tattooing and body piercing guidance toolkit, a copy of which is attached, provides local authorities and businesses with information on good standards of practice. These national models and standards help local authorities create clear and consistent byelaws, which is beneficial for both local businesses and the public.

How the (a) commissioning and (b) funding model for gambling harm treatment services is structured across England; and whether he plans to issue a Letter of Comfort to Providers.

At present, NHS England provides ringfenced funding to the integrated care boards for the commissioning of eight regional gambling harms services in England. The majority of other gambling harms treatment services in England, largely provided by the voluntary, community, and social enterprise sector, are commissioned by GambleAware until 31 March 2026.The new statutory levy on gambling operators came into effect in April 2025. Under the levy, NHS England, and appropriate bodies in Scotland and Wales, are the commissioners for gambling-related harm treatment and support services. They will receive 50% of available levy funding to improve and expand treatment services across Great Britain.From 1 April 2026, NHS England will be taking on responsibility for the commissioning of the full gambling harms treatment pathway in England, from referral and triage through to aftercare. All services will be funded by the new levy, which will be ringfenced for services to reduce gambling harms. NHS England is currently working at pace to confirm future commissioning arrangements and aims to provide all stakeholders with an update in the autumn.

Whether funding for gambling harm treatment services will be structured through (a) block funding, (b) activity-based models or (c) outcome-based models; what his Department's timetable is for (i) implementing its funding model and (ii) providing payments to providers; and whether his Department plans to provide (A) upfront or (B) staged payments for those providers.

The new statutory levy on gambling operators came into effect in April 2025. Under the levy, NHS England, and appropriate bodies in Scotland and Wales, are the commissioners for gambling-related harm treatment and support services. They will receive 50% of available levy funding to improve and expand treatment services across Great Britain.From 1 April 2026, NHS England will take on responsibility for the commissioning of the full gambling harms treatment pathway in England, from referral and triage through to aftercare. NHS England continues to work at pace on the design of the future commissioning approach, however, no decisions have yet been taken. The aim is to provide all stakeholders with a further update in the coming months. All contracting arrangements and their associated funding models will subsequently be confirmed by the appropriate commissioners.

Whether the contracting process to enable established providers to apply for or maintain commissioned status for the commissioning of gambling harm treatment services will be through (a) open tendering, (b) direct awards, (c) partnership agreements and (d) a spot-purchasing framework; and whether that process will (i) be the same or (ii) vary across England.

The new statutory levy on gambling operators came into effect in April 2025. Under the levy, NHS England, and appropriate bodies in Scotland and Wales, are the commissioners for gambling-related harm treatment and support services. They will receive 50% of available levy funding to improve and expand treatment services across Great Britain.From 1 April 2026, NHS England will take on responsibility for the commissioning of the full gambling harms treatment pathway in England, from referral and triage through to aftercare. NHS England continues to work at pace on the design of the future commissioning approach, however, no decisions have yet been taken. The aim is to provide all stakeholders with a further update in the coming months. All contracting arrangements and their associated funding models will subsequently be confirmed by the appropriate commissioners.

Whether the Office for Health Improvement and Disparities will be responsible for commissioning gambling harm treatment services in relation to the portion of the Gambling Levy allocated for treatment; and what role his Department expects that NHS England will have in the commissioning of gambling harm treatment services in the long term.

Under the new statutory levy on gambling operators which came into effect in April, NHS England and appropriate bodies in Scotland and Wales are the commissioners for gambling-related harm treatment and support services. They will receive 50% of available levy funding to improve and expand treatment services across Great Britain.NHS England continues to lead work on the future design of treatment and support services in England, working closely with the other levy commissioners to ensure a co-ordinated approach to addressing gambling-related harms.The Department of Health and Social Care will continue to work closely with NHS England and the Department for Culture, Media and Sport to fully consider the implications of the NHS England transformation announcement on the future statutory levy commissioning structure.

What assessment he has made of the potential implications for his policies of the implementation by some NHS Integrated Care Boards of minimum waiting times for elective treatment; and what assessment he has made of the potential impact of this on (a) patient choice (b) the ability to meet NHS constitutional access standards.

There is no formal policy supporting minimum waits in the National Health Service. However, the NHS Standard Contract technical guidance for 2025/26 states that commissioners may choose to include minimum waiting times in Activity Planning Assumptions to ensure the delivery of targets within agreed financial allocations. The full guidance is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/04/08a-nhssc-2526-contract-technical-guidance-final.pdfPatients continue to have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient.We will work closely with all systems to ensure they deliver the expected level of improvement in waiting times set out in 2025/26 Planning Guidance, which is the first step in delivering on our commitment that by March 2029, 92% of patients wait no longer than the constitutional standard of 18 weeks from referral to consultant-led treatment.

What assessment his Department has made of the UK’s capacity to attract investment in dementia clinical trials, in the context of the availability of disease-modifying treatments in other countries that have not yet been approved for use by the NHS.

No particular assessment has been made.The Department is committed to turbocharging medical research and delivering better patient care, to make the United Kingdom a world-leading destination for clinical research. We are working to fast-track clinical trials to drive global investment into life sciences, improve health outcomes and accelerate the development of medicines and therapies of the future, including treatments for dementia.The Department delivers dementia research via the National Institute for Health and Care Research (NIHR). Government funders are investing in dementia research across all areas, from causes, diagnosis and prevention to treatment, care and support, including for carers.The NIHR is investing nearly £50 million to the UK Dementia Trials Network, which will deliver a coordinated network of early phase dementia trial sites. This will be complemented by the £20 million Dementia Clinical Trials Accelerator, designed to position the UK as the destination of choice for late phase clinical trials in dementia and neurodegenerative diseases.

Whether he has made an assessment of the potential impact of (a) seed oils, (b) added gluten and (c) processed food standards on public health.

Government advice on a healthy, balanced diet is encapsulated in the United Kingdom’s Eatwell Guide. This is underpinned by the robust independent risk assessments and recommendations of the Scientific Advisory Committee on Nutrition (SACN).SACN has not undertaken a specific assessment of seed oils. However, SACN’s 2019 report on ‘Saturated fats and health’ concluded that reducing saturated fats reduces the risk of heart disease and lowers cholesterol. SACN recommended that saturated fat intake is reduced and saturated fats are substituted with unsaturated fats. Vegetable oils, including seed oils, are higher in unsaturated fats and lower in saturated fat than alternatives such as butter, ghee and palm oil. The topic of individual fatty acids, including omega-3 and omega-6 polyunsaturated fatty acids, of which seed oils may be a source, is on SACN’s watching brief.SACN has not undertaken a specific assessment of the impact of added gluten on health outcomes. However, gluten-containing carbohydrate foods were considered as part of SACN’s report on ‘Carbohydrates and health’ published in 2015. SACN recommended that approximately 50% of total dietary energy should be derived from carbohydrates. Government dietary advice, as depicted in the Eatwell Guide, is that we should choose wholegrain or higher fibre versions of starchy carbohydrates wherever possible. Management of clinical conditions for which gluten has a role is under the remit of the National Institute for Health and Care Excellence.There are no food standards on processed foods. However, the evidence on processed foods and health has been assessed by SACN in position statements published in 2023 and 2025. SACN has concluded that the observed associations between higher consumption of (ultra) processed foods and adverse health outcomes are concerning. SACN has recommended that on balance, most people are likely to benefit from reducing their consumption of processed foods high in energy, saturated fat, salt and free sugars and low in fibre. This is based on the nutrient content of many ultra-processed foods and concerns raised in relation to health. SACN will continue to keep the topic under review.

Whether his Department is taking steps to ensure that (a) hospitals offer (i) gluten and (i) dairy free food that is not high in added sugars and (b) people with restricted diets have access to (A) healthy and (B) fresh food when in hospital.

NHS England has published their Food and Drink Standards, which set out the expectations for National Health Service trusts regarding the food they provide to patients and staff. Emphasis is placed on providing healthy, nutritious food options. The standards include requirements that hospital food has:healthy, balanced meal options, providing animal and plant-based protein, starchy carbohydrates, fat, fibre, and micronutrients, including iron and calcium, and both milk and non-milk products;adequate and varied provision;culturally appropriate options, taking account of local needs; andprovision for a range of dietary requirements, for instance vegetarian and vegan, and allergies, for instance gluten and nut-free options.

If he will introduce legislation to (a) protect and (b) guide the ambulance service on a statutory footing.

National Health Service ambulance services have already been placed on a statutory footing through existing legislation.NHS England will publish further guidance to support integrated care boards in their commissioning of ambulance services in 2025/26, and will provide a new ambulance commissioning specification for 2026/27.

Whether his Department is taking steps to stop the provision of (a) clinical and (b) therapy services by (i) unregulated and (ii) unregistered individuals.

The Government has no plans to stop the provision of clinical or therapy services by either unregulated and/or unregistered individuals.

What steps he is taking to tackle (a) supply chains issues and (b) shortages of ADHD medication in the West Midlands.

The resilience of the United Kingdom’s supply chains is a key priority, and we are committed to helping build long term supply chain resilience for medicines. The Department works in partnership with industry, the National Health Service, and the wider health system to help ensure the continuity of the supply of medical products, including for attention deficit hyperactivity disorder (ADHD) medicines. These issues are often global in nature. We monitor and manage medicine supply issues at a national level, so that stocks remain available to meet regional and local demand, and therefore there are no specific measures for the West Midlands.As a result of intensive work, some issues with ADHD medicines have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.However, whilst the supply of methylphenidate prolonged-release tablets has improved, issues still persist. We are continuing to work to resolve these remaining issues by engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support the continued growth in demand for the short and long-term. The Department is also working with new suppliers of methylphenidate prolonged-release tablets to improve supply and resiliency for the UK market.We are supporting an ADHD taskforce that NHS England has established to examine ADHD service provision. The taskforce will bring together expertise from across a broad range of sectors, including the NHS, education, and justice, to help provide a joined-up approach in response to concerns around rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.The Department has worked with NHS specialists to develop advice on prescribing alternative ADHD medications. We expect that ADHD service providers should follow this guidance and offer rapid responses for urgent advice, especially for high-risk patients. To aid decision-making at the point of the prescribing and dispensing of ADHD medicines, we continue to update a list of available ADHD products on the Specialist Pharmacy Service website.

What steps his Department is taking to ensure that NHS staff training is (a) effective, (b) time efficient and (c) value for money.

Statutory and mandatory training is wide ranging and completed by all National Health Service staff. NHS England is leading work to reform statutory and mandatory training through a programme to optimise, rationalise, and redesign training. The aim is for the redesigned mandatory training to improve outcomes and staff experience, and take less time whilst being more relevant, higher quality, better value, and more portable.

What steps he is taking to address the shortages in Pancreatic enzyme replacement medication.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Increased volumes of PERT are expected for 2025, and specialist importers have sourced unlicensed stock to assist in covering the gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This includes actions for clinicians to consider unlicensed imports when licensed stock is unavailable and for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice.

What steps his Department is taking to ensure equal access to diagnosis of prostate cancer.

NHS England is taking steps to raise awareness of the symptoms of prostate cancer, where there are opportunities to do so. To address disparities and find ways to better detect prostate cancer, we have invested £16 million in the TRANSFORM trial, aimed at helping to find a way of catching prostate cancer in men, even if they are not displaying any symptoms. This research will ensure that one in ten participants are black men to address identified inequalities.

Whether his Department has made an assessment of the potential merits of introducing a mandatory and formal way for recording if and when patients have had an assessment for section 117 aftercare.

Section 117 of the Mental Health Act 1983 requires local social services authorities and National Health Service commissioners to provide or arrange for the provision of aftercare to adults or children detained in hospital for treatment under section 3, 37, 45A, or transferred under section 47 or 48 of the Act who then leave hospital. No assessment of patients is required to determine whether they are eligible for s117 aftercare although professionals would of course be expected to work with a patient to understand their individual needs.There are no plans at present to introduce any such mandatory training or require mandatory recording of the number of people eligible for section 117 who local social services authorities and NHS commissioners have responsibility for.

Whether he has made an assessment of the potential merits of mandatory training for (a) psychiatrists, (b) psychiatric nurses and (c) social workers on legal obligations under section 117 of the Mental Health Act 1983.

Section 117 of the Mental Health Act 1983 requires local social services authorities and National Health Service commissioners to provide or arrange for the provision of aftercare to adults or children detained in hospital for treatment under section 3, 37, 45A, or transferred under section 47 or 48 of the Act who then leave hospital. No assessment of patients is required to determine whether they are eligible for s117 aftercare although professionals would of course be expected to work with a patient to understand their individual needs.There are no plans at present to introduce any such mandatory training or require mandatory recording of the number of people eligible for section 117 who local social services authorities and NHS commissioners have responsibility for.