Written questions by Brewer.

What assessments his Department has made of how to best support patients suffering with overlapping illnesses.

We recognise the growing prevalence and complexity of overlapping and co-existing chronic illnesses and long-term conditions, and the importance of improving diagnosis, management, and support for these patients.Through the 10-Year Health Plan, we are expanding community diagnostic services, introducing Neighbourhood Health Centres, and deploying multidisciplinary teams to provide holistic support. Patients will benefit from enhanced NHS App functionality, including My Medicines and My Health, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs having a personalised care plan by 2027.The appointment by NHS England of a National Specialty Adviser on multi-morbidity provides expert leadership to improve care for people with multiple long-term conditions, ensuring services are better coordinated, evidence-based, and focused on holistic patient needs.We also recognise that doctors can find it challenging to diagnose Ehlers-Danlos syndrome (EDS) and postural tachycardia syndrome (PoTS) because these conditions share symptoms with many other disorders.Resources such as the Royal College of General Practitioners’ Syncope Toolkit for PoTS and the EDS Toolkit, now maintained by Ehlers-Danlos Support UK, are improving clinician awareness of both conditions. The National Institute for Care Excellence provides a clinical knowledge summary on blackouts and syncope to support consistent assessment and diagnosis of PoTS. NHS England commissions a National Diagnostic Service for rare EDS subtypes.

What steps his Department taking to help improve the diagnosis of overlapping illnesses such as PoTs and EDS.

We recognise the growing prevalence and complexity of overlapping and co-existing chronic illnesses and long-term conditions, and the importance of improving diagnosis, management, and support for these patients.Through the 10-Year Health Plan, we are expanding community diagnostic services, introducing Neighbourhood Health Centres, and deploying multidisciplinary teams to provide holistic support. Patients will benefit from enhanced NHS App functionality, including My Medicines and My Health, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs having a personalised care plan by 2027.The appointment by NHS England of a National Specialty Adviser on multi-morbidity provides expert leadership to improve care for people with multiple long-term conditions, ensuring services are better coordinated, evidence-based, and focused on holistic patient needs.We also recognise that doctors can find it challenging to diagnose Ehlers-Danlos syndrome (EDS) and postural tachycardia syndrome (PoTS) because these conditions share symptoms with many other disorders.Resources such as the Royal College of General Practitioners’ Syncope Toolkit for PoTS and the EDS Toolkit, now maintained by Ehlers-Danlos Support UK, are improving clinician awareness of both conditions. The National Institute for Care Excellence provides a clinical knowledge summary on blackouts and syncope to support consistent assessment and diagnosis of PoTS. NHS England commissions a National Diagnostic Service for rare EDS subtypes.

What steps his Department is taking to reduce ambulance wait times for Category 2 calls to the national target of 18 minutes.

The Government recognises that in recent years ambulance performance has not met the high standards patients should expect.In October, NHS England published the Medium Term Planning Framework which sets out ambitious targets to improve core urgent and emergency care performance to constitutional standards, including by shortening average Category 2 response times to 18 minutes. This is being supported by practical actions, including reducing avoidable ambulance dispatches and conveyances and ambulance handover delays.The measures being taken are already improving ambulance response times, including in North East Hampshire. The latest National Health Service performance figures for the South Central Ambulance Service NHS Foundation Trust, which serves North East Hampshire, show that in October, Category 2 incidents were responded to in 31 minutes 54 seconds on average, over six minutes faster than the same period last year.

What steps his Department is taking to reduce ambulance response times in North East Hampshire constituency.

The Government recognises that in recent years ambulance performance has not met the high standards patients should expect.In October, NHS England published the Medium Term Planning Framework which sets out ambitious targets to improve core urgent and emergency care performance to constitutional standards, including by shortening average Category 2 response times to 18 minutes. This is being supported by practical actions, including reducing avoidable ambulance dispatches and conveyances and ambulance handover delays.The measures being taken are already improving ambulance response times, including in North East Hampshire. The latest National Health Service performance figures for the South Central Ambulance Service NHS Foundation Trust, which serves North East Hampshire, show that in October, Category 2 incidents were responded to in 31 minutes 54 seconds on average, over six minutes faster than the same period last year.

Whether he has made an assessment of the potential impact of GP fees for (a) letters requested to support applications relating to (i) mental health, (ii) housing, (iii) education and (iv) welfare and (b) other non-NHS letters on patients; and whether he plans to issue guidance to GP practices on fee structures for such documentation in cases involving (A) financial hardship and (B) vulnerable people.

There are some medical evidence letters, certificates, and/or reports that general practices (GPs) may charge for, and others that they must not charge patients for. The legislation that sets this out is the General Medical Services and Personal Medical Services Regulations, which form the basis of the GP Contract with the National Health Service. There is no statutory limit to the level of such fees as this is outside of core NHS work.The Professional Fees Committee of the British Medical Association suggests guideline fees for such services to help doctors set their own professional fees.We recognise that there are concerns about some fees GPs charge for letters and the consistency of those charges, as well as the additional burden these requests can place on GPs. Where GPs charge for that evidence, these charges should be clear, fair, and consistent. Where possible and appropriate we would encourage people to use alternative evidence.We are continuing to work across the Government to cut red tape and improve ways of working, including work to improve the patient experience, such as removing the need to request unnecessary medical evidence where possible.

Pursuant to the Answer of 17 October 2025 to Question 80524 on Nurses: Training, whether training courses in learning disability nursing will be available in North East Hampshire constituency.

Undergraduate training places for learning disability nursing are not centrally commissioned by the Government. Instead, they are determined by university education providers, who decide the number of learners they admit based on learner demand and provider capacity. The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.

What steps he is taking to reduce waiting times to those seeking psychological therapy to support their employment efforts.

It is unacceptable that some people are not receiving the mental health care they need. We are determined to change that. We have already taken significant steps to improve National Health Service mental health services, including hiring almost 7,000 extra mental health workers since July 2024, and thanks to an increase in NHS Talking Therapies, more adults with anxiety and depression are getting back into work.We are continuing to roll out employment advisors in our talking therapies services to support people with common mental health conditions to seek and retain employment. These advisors help people who are in work but are struggling or facing difficulties in the workplace, for instance being off work sick or looking for work, so we can provide the right support at the right time.We continue to meet the waiting time standard in place for NHS Talking Therapies services. The latest data from June 2025 shows 89.1% of people completing treatment waited less than six weeks for their first appointment against a target of 75%. And 98.6% of people completing treatment waited less than 18 weeks, against a target of 95%.

What steps his Department is taking with (a) NHS England and (b) integrated care boards to ensure that NHS dental provision is effectively delivered under the Armed Forces Covenant Duty; and whether he has considered increasing levels of (i) guidance and (ii) oversight in this area to help prevent disadvantage for service families following relocation.

We recognise that Armed Forces families may move more frequently than the civilian population in support of our service personnel. Data on dental access does not suggest that Armed Forces families are being disadvantaged when compared to the civilian population. We are taking steps to improve access to dentistry and members of the armed forces community will also benefit from the improved access these changes bring about, in the same way as the civilian population.NHS England is working proactively with the Ministry of Defence and the Armed Forces Families Federations to provide guidance to integrated care boards in relation to local dental access for families relocating to the area and guidance for families. Signposting for Armed Forces Personnel on dentistry access for their families has been improved through the ‘Discover My Benefits website’, and A “Myth Busting” paper has been prepared by the Armed Forces Families Federation. This includes a link to the Single Point of Contact for NHS England dedicated to Armed Forces access issues.Free NHS dental care is available to people receiving War Pension Scheme payments, or Armed Forces Compensation Scheme payments, and the treatment is for your accepted disability. We are also supporting more than 1,500 children in British military families overseas through our supervised toothbrushing programme.

What steps he is taking to reduce waiting times for people seeking psychological therapy to support employment.

The Government is committed to delivering expansions of NHS Talking Therapies and individual placement and support schemes to address the root causes of mental health issues and provide support for people to contribute to the economy by remaining in or returning to work. We will also make it easier for people to self-refer to talking therapies services through the NHS App. We are continuing to roll out employment advisors in our NHS Talking Therapies services to support people with common mental health conditions in seeking and retaining employment. Our advisors help people who are in work but struggling or facing difficulties in the workplace, are off work sick, or are looking for work, so we can provide the right support at the right time. Confidential support is available to people at any stage of their career. This could include school- or college-leavers looking for their first job to people looking at changing their lifestyle or work-life balance as they get closer to retirement. We are also expanding individual placement and support schemes embedded in community mental health services to improve employment outcomes for people with severe mental illness. These schemes offer intensive, individually tailored support to get people into work, with ongoing support for the employer and employee to help ensure the person keeps their job.

What legislative steps his Department is taking to ensure that GP practices assess shared care requests on a case-by-case basis; and whether he plans to introduce legislation to improve consistency and equity in shared care arrangements for patients with mental health diagnoses.

There are currently no plans to introduce legislation for shared care arrangements.Shared care arrangements between a general practitioner (GP) and a specialist are voluntary agreements and are not a part of the GP Contract. GPs do not receive additional funding for taking part in shared care agreements and are able to refuse participation if they think they do not have capacity, or it is not clinically appropriate.The General Medical Council’s guidance helps GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care arrangement, a GP will need to consider a number of factors to determine whether it is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes being satisfied that any prescriptions or referrals for treatment are clinically appropriate.These processes apply to all shared care requests, including those involving patients with a mental health diagnosis.

What steps he is taking to protect NHS (a) staff and (b) volunteers from (i) verbal abuse, (ii) threats, (iii) unauthorised sharing of personal information and (iv) other forms of abuse; whether he plans to extend zero tolerance policies to cover digital harassment; and what steps his Department is taking to provide (A) guidance and (B) support to NHS providers for affected (1) staff and (2) volunteers.

Everyone working or volunteering in the National Health Service has a fundamental right to be safe and work in an environment free from all forms of harassment, bullying and violence, including digital harassment.Individual employers are responsible for the health and safety of their staff and volunteers and put in place many measures to do this including appropriate security, training, and emotional support for those affected by violence. Additionally, NHS England have developed an NHS Civility and Respect programme which provides national guidance, training and resources to help organisations build positive workplace cultures, tackle bullying and harassment, and ensure staff and volunteers feel safe and supported in all work environments.

What steps his Department is taking to (a) assess the needs of and (b) provide appropriate support for parents of twins.

There is a wide network of universal services and tailored information that parents of twins are able to access.When babies are delivered safely, parents will likely have them beside them on the postnatal ward, where they will be supported to care for and feed their newborn. In the case that infants are born very early, they may need to spend some time in special (neonatal) care, which is not uncommon in the case of twin births.The National Health Service website, Your newborn twins, provides expectant parents of twins advice on how to prepare for twins being born early, taking twins home and getting twins into a routine. This is available at the following link:https://www.nhs.uk/baby/newborn-twins-and-multiples/your-newborn-twins/Additionally, health visiting services are offered to all families, including five health and development reviews, information, support and intervention at key stages for parents and children. Where additional needs are identified, the health visiting service can either provide additional support directly or refer to NHS or local services as required.The Family Hubs and Start for Life programme is also supporting parents and carers of children of all ages, with a strong focus on conception to age two. Family hubs provide a wide range of universal services that could help parents of twins, such as support with infant feeding, perinatal mental health, and parent-infant relationships. We know that some local areas are offering more targeted support for parents of twins and multiples through their family hub networks.

What steps he is taking to (a) reduce wait times and (b) increase capacity for paediatric blood tests.

We inherited a broken National Health Service, and reducing elective waiting lists is a key part of getting it back on its feet and building an NHS that is fit for the future. To that end we have committed to achieving the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment by March 2029. Cutting waiting times for diagnostic tests such as blood tests is a crucial step in reducing the elective waiting list. Blood tests are among the most commonly requested diagnostic investigations across primary and secondary care, and they are readily available across all 27 NHS pathology networks. Phlebotomy, the procedure to collect blood samples, is widely available across general practice, community health services, and secondary care phlebotomy clinics, supporting equitable access to blood testing. The NHS is taking steps to reduce wait times for blood tests. These include establishing more straight to test pathways, whereby a patient is referred straight to a diagnostic test without the need for an additional outpatient appointment first, as well as investing in digital pathology and automation of histopathology services to reduce the time patients wait for blood test results to be processed. Alongside this, we are continuing to invest in expanding diagnostic capacity in the NHS. As set out in the Elective reform Plan, we plan to build up to five more community diagnostic centres (CDCs) in 2025/26, alongside increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week. This is backed by part of the £600 million of capital for diagnostic services announced at the October Spending Review. CDCs offer local populations, including children, a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken. This reduces the need for hospital visits, reduces pressure on hospitals, and speeds up diagnosis. CDCs are expected to offer their services to children and young people where it is safe and appropriate to do so. Phlebotomy is a core service provided by all standard and large model CDCs.

What assessment his Department has made of the adequacy of the (a) support available to ambulance staff who attend traumatic callouts and (b) suicide prevention training requirements for ambulance service managers in North East Hampshire constituency.

The mental health of all National Health Service staff is a high priority, including ambulance staff as responders to emergency incidents. Ambulance trusts and the Association of Ambulance Trust Chief Executives have worked closely with NHS England to ensure there is a good range of health and wellbeing support for staff. This includes an ambulance sector specific suicide prevention pathway to provide immediate support 24/7 for staff experiencing suicidal ideation.Significant work is also underway to strengthen the quality and consistency of suicide training across the health system. NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management to support the Government’s work to reduce suicide and improve mental health services. This is available at the following link:https://www.england.nhs.uk/publication/staying-safe-from-suicide/

What steps her Department is taking to help encourage the take-up of disability nursing courses.

We are working closely with key partners, including higher education providers and employers, to promote learning disability nursing roles and attract people into the profession through various routes including apprenticeships.We want to remove the barriers to training in clinical roles, which is why in addition to the support available from the Student Loans Company, eligible students studying for a nursing degree receive supplementary non-repayable funding via the Learning Support Fund. This comprises a training grant of £5,000 per academic year and a £1,000 per academic year grant for priority subjects such as learning disability nursing, with further support depending on individual circumstances.We will publish a refreshed 10-year workforce plan later this year to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need.

What steps his Department is taking to help (a) reduce paediatric surgical waiting times and (b) ensure timely access to treatment for children requiring surgery.

Our Elective Reform Plan, published in January 2025, sets out how the National Health Service will reform elective care services and meet the 18-week referral to treatment standard for all patients, including children and young people, by March 2029.  As a First Step to achieving this, we have exceeded our pledge to deliver an extra 2 million operations, scans and appointments in our first year of government, delivering 5.2 million more appointments.We have made it easier to track elective waiting times for children and young people through the publication of new demographic data as part of monthly inequalities statistical releases. This was a commitment in the Elective Reform Plan and is a big step forward in improving the transparency of waiting times and will provide accountability for children’s elective waiting lists.The Plan also sets out several commitments specifically in relation to children and young people, including that integrated care boards and providers should ensure interventions are in place to reduce disparities for groups who face additional waiting list challenges; and primary and secondary care clinicians are to improve e-RS functionality (a national digital platform for referring patients into elective care), by including data to enable better prioritisation of children and young people.Finally, the clinically-led Getting It Right First Time children and young people programme will continue to work with providers to ensure they are implementing best practice to improve children’s outcomes and waiting times across all medical and surgical specialities.

With reference to the Home Office's document entitled Statement of changes in immigration rules, published on 1 July 2025, what steps her Department is taking to help ensure that vacancies in social care settings can be filled.

Although overseas recruitment for adult social care ended as of 22 July 2025, for a transition period until 2028, in-country switching for those already in the country and working legally for their employers will be permitted. This means, for example, that care providers will continue to be able to recruit those who want to switch from student or graduate visas, who we know have provided a vital role in workforce capacity in recent years. This approach will be kept under review. International workers who are already sponsored to work legally in the sector by the end of the transition period will be able to continue to extend their stay, change sponsors and when qualified, apply to settle. These arrangements include those who need to switch employers following a sponsor licence revocation. The Department is providing up to £12.5 million this financial year to 15 regional partnerships to help support workers affected by licence revocation into alternative, ethical employment.More broadly, we recognise the scale of reform needed to make adult social care attractive as a career and are determined to ensure those who work in care are respected as professionals. That is why we are introducing new Fair Pay Agreements for adult social care workers, with legislation currently going through Parliament, implementing the first universal career structure for adult social care. We are also providing £12 million this year for staff to complete training and qualifications. These changes will help attract staff to the sector, providing proper recognition and opportunities for them to build their careers.

What assessment he has made of the potential impact of the revised covid-19 autumn 2025 vaccination eligibility criteria on vulnerable patients with underlying health conditions.

The Government’s policy on groups eligible for vaccination programmes is based on the advice of the independent expert body, the Joint Committee on Vaccination and Immunisation (JCVI). Over time, the risk from COVID-19 has reduced across the United Kingdom population, through exposure to the virus, changes in the virus and vaccination.The JCVI carefully considered the latest evidence on the risk of illness, serious disease in specific groups, as well as cost-effectiveness analysis, to provide the Government with advice on the autumn 2025 programme. The evidence indicates that whilst the risk from COVID-19 is now much lower for most people, adults aged 75 years old and over, residents in care homes for older adults, and those who are immunosuppressed are those at highest risk of serious COVID-19 disease. A more targeted vaccination programme, aimed at individuals, with a higher risk of developing serious disease, and where vaccination was considered potentially cost-effective, was advised for autumn 2025.Whilst current COVID-19 vaccines provide good protection against hospitalisation and/or death for those at highest risk, they provide very limited protection against acquiring COVID-19 infection or mild illness, meaning any potential public health benefit of reducing transmission is much less evident.Long term health consequences following COVID-19 infection, including post-COVID syndromes, such as long COVID, have been discussed at meetings of the JCVI. It remains uncertain whether getting extra COVID-19 vaccine doses has any effect on the chances of developing long COVID, how it progresses, or how it affects people.The JCVI has proactively published an updated list of Research Recommendations, encouraging future investigations on the exploration of data and evidence on the benefit of vaccination amongst post-COVID syndromes, and those with underlying medical conditions who are not currently eligible.The JCVI keeps all vaccination programmes under review. Accordingly, the Government will consider any additional advice from the JCVI in due course. Further information on the details of the modelling and analysis considered are within the 2025 and spring 2026 advice, on the GOV.UK website.Information is collected on hospital bed occupancy and on the reason for hospital admissions. It is, however, not possible to determine which admissions associated with COVID-19 were for individuals who were eligible for vaccination in autumn 2024 but no longer eligible in autumn 2025.

What steps he is taking to ensure that parents receive (a) up to date and (b) relevant advice for feeding infants.

The Department undertakes a range of activities to ensure that parents receive up-to-date and relevant advice on infant feeding. We are investing £18.5 million in 2025/26 for infant feeding support across 75 local authorities in England through the Family Hubs and Start for Life programme. We have also extended the National Breastfeeding Helpline so that more families across the United Kingdom can access evidence-based information and support 24 hours a day, every day of the year.The Best Start in Life and NHS websites both provide trusted information on breastfeeding, formula feeding and introducing solid food, and are regularly updated in line with guidance from the Scientific Advisory Committee on Nutrition and the National Institute for Health and Care Excellence. Recent updates include advice on the use of shop-bought baby food.Voluntary industry guidelines for commercial baby food and drink aimed at babies and young children aged up to 36 months old have also been published. The guidelines encourage manufacturers to reduce levels of sugar and salt in, and improve the labelling and marketing of, these products. This will make it easier for parents and carers to make healthier and more informed choices.To ensure information reaches families at the right time, targeted advertising campaigns are run primarily on social media to engage parents whose babies are approaching weaning age, providing them with timely and relevant advice. In addition, most families receive infant feeding information and support from midwives and health visitors, who deliver targeted interventions as appropriate and support families in accessing specialist services where needed.

What steps he is taking to ensure that the NHS provides adequate support to (a) digitally excluded and (b) vulnerable people in (i) North East Hampshire constituency and (ii) other rural areas.

We are working to improve access to digital services, outcomes, and experience for the widest range of people, based on their preferences. Digital health tools should be part of a wider offering that includes face-to-face support with appropriate help for people who struggle to access digital services. NHS England has successfully run a number of programmes to support patients, carers, and health service staff with their digital skills. These include: the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online; the Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation and means to access health information and services online; and the NHS App ‘Spoken Word’ Pilot project, designed to test the efficacy of promoting National Health Service digital health products and services in languages other than English.NHS England has published a framework for NHS action offering support to vulnerable people and those digitally excluded in rural areas and is developing further resources and practical actions including one-to-one support to improve digital literacy and access to NHS tools. All programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion.We know that some patients may struggle or prefer not to use digital options. That is why we have also committed to work with digital transformation teams in integrated care boards and with groups at risk of digital exclusion to ensure digital solutions are inclusive. We will also continue to provide high quality, non-digital options for those who want and need them.