Written questions by Cooper.

What steps his Department is taking to increase the number of face-to-face GP appointments in Mid Cheshire constituency.

We know that patients are finding it harder than ever to see a general practitioner (GP). Patients can’t get through the front door of the National Health Service, so they aren’t getting the timely care they need.Mid-Cheshire sits within the NHS Cheshire and Merseyside Integrated Care Board, where 62.8% of appointments were face-to-face in June 2024. Compared to August 2023, where 66.2% of appointments were face-to-face, appointments delivered face-to-face are down by 3.4%.We have pledged to guarantee a face-to-face appointment for all those who want one. We will make sure the future of GPs is sustainable by training thousands more GPs, ensuring increased capacity across the NHS to deliver this commitment and secure a future pipeline of GPs.

What steps his Department is taking to reduce waiting times for NHS treatment in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

Tackling waiting lists is a key part of our Health Mission and a top priority for the Government, as we get the National Health Service back on its feet. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.My Rt Hon. Friend, the Chancellor of the Exchequer has now announced new investment to support this. Funding has been provided to support the delivery of our commitment to an extra 40,000 NHS operations, scans, and appointments per week. A £1.5 billion capital investment has also been announced towards new surgical hubs and scanners, alongside £70 million for new radiotherapy machines. We will be supporting NHS trusts to deliver more activity through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.We are transforming diagnostics to cut long waits through the Community Diagnostic Centres (CDCs). In Cheshire there are four CDCs currently delivering much needed diagnostic activity, specifically: the Congleton War Memorial CDC; the Shopping City CDC; the Warrington and Halton CDC; and the CDC at Victoria Infirmary Northwich, located within the Mid-cheshire constituency, which has been delivering activity since October 2021.Dedicated and protected surgical hubs are transforming the way the NHS providers elective care by focusing on high volume low complexity surgeries. Across England, there are currently 110 operational surgical hubs as of September 2024. In Cheshire, a new surgical hub is due to open in April 2025, the Cheshire and Merseyside Surgical Centre, and will provide services to patients across Cheshire and Merseyside.

What (a) financial and (b) other steps his Department is taking to support the work of Air Ambulance charities.

The Department and the National Health Service continue to support the work of air ambulance charities, including through NHS ambulance trusts’ provision of key clinical staff and medical equipment, which supports the operation of air ambulances.

What recent estimate he has made of the average waiting time for mental health treatment in (a) Mid Cheshire constituency, (b) Cheshire and (c) England in each of the last five years.

The following table shows both the mean and median average waiting times, measured in days, for mental health treatment for adults in the Cheshire East local authority, for the last five years:Waiting time between referral and second contact for adults in the Cheshire East local authorityYear in which contact occurredNumber of adult referrals with a second contact in the yearMean average waiting timeMedian average waiting time2019/205,262148.8512020/215,986122.2342021/224,285156.343.52022/233,005234.3692023/245,165206.451 Similarly, the following table shows both the mean and median average waiting times, measured in days, for mental health treatment for children and young people aged under 18 years old in the Cheshire East local authority, for the last five years:Waiting time between referral and first contact for children and young people aged under 18 years old in the Cheshire East local authorityYear in which contact occurredNumber of child referrals with a first contact in the yearMean average waiting timeMedian average waiting time2019/203,244133.5282020/212,85471.1172021/222,810139.6272022/233,615197.1462023/244,145104.330 The following table shows both the mean and median average waiting times, measured in days, for mental health treatment for adults in the Cheshire East and Cheshire West, and Chester local authorities combined, for the last five years:Waiting time between referral and second contact for adults for the Cheshire East and Cheshire West, and Chester local authorities combinedYear in which contact occurredNumber of adult referrals with a second contact in the yearMean average waiting timeMedian average waiting time2019/2010,328132.9472020/2110,474115.6272021/227,645164.8482022/236,210218.1562023/2410,005157.934 In addition, the following table shows both the mean and median average waiting times, measured in days, for mental health treatment for children and young people aged under 18 years old in the Cheshire East and Cheshire West, and Chester local authorities combined, for the last five years:Waiting time between referral and first contact for children and young people aged under 18 years old for Cheshire East, and Cheshire West and Chester local authorities combinedYear in which contact occurredNumber of child referrals with a first contact in the yearMean average waiting timeMedian average waiting time2019/205,300106.0272020/214,73263.114.52021/224,510133.2262022/235,715172.9442023/247,31083.330 The following table shows both the mean and median average waiting times, measured in days, for mental health treatment for adults in England, for the last five years:Waiting time between referral and second contact for adults in EnglandYear in which contact occurredNumber of adult referrals with a second contact in the yearMean average waiting timeMedian average waiting time2019/201,137,74682.1202020/211,139,42369.7132021/221,188,52963.6152022/231,176,74868.2192023/241,289,41772.320 Finally, the following table shows both the mean and median average waiting times, measured in days, for mental health treatment for children and young people aged under 18 years old in England, for the last five years:Waiting time between referral and first contact for children and young people aged under 18 years old in EnglandYear in which contact occurredNumber of child referrals with a first contact in the yearMean average waiting timeMedian average waiting time2019/20567,23681.6132020/21568,70375.372021/22652,86965.0112022/23674,70269.7132023/24744,50675.414Source: Mental Health Services Dataset (MHSDS), NHS EnglandNotes:waiting time is measured in days;this data differs from published waiting times because rather than looking at just community mental health it looks at the full scope of data in the MHSDS, so will include neurodevelopmental referrals across all ages, and neurocognitive referrals, including a large number of dementia diagnostic referrals for adults, as well as other smaller areas of provision, such as services for gender identity and for addictions; andthe statistics including waiting times for adult services for Talking Therapies for Anxiety and Depression are reported via a separate dataset and have not been included here.

What steps he is taking to improve waiting times for cancer treatment in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

The Government is committed to improving cancer survival rates and hitting all National Health Service cancer waiting time targets within five years, so that no patient waits longer than they should.NHS England and the integrated care boards are responsible for commissioning and ensuring the healthcare needs of local communities in England are met, including for cancer patients. The Department is working with NHS England to deliver interventions to improve outcomes for those with cancer across England, including in Cheshire.The NHS will maximise the pace of the roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.

What steps he is taking to improve access to mental health services in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

NHS Cheshire and Merseyside Integrated Care Board is responsible for providing health and care services to meet the needs of the people of Mid Cheshire constituency and Cheshire, taking into account local considerations.Nationally, we recognise that many people with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure that mental health is given the same attention and focus as physical health, so that people can be confident in accessing high quality mental health support when they need it. We will recruit an additional 8,500 mental health workers to reduce delays and provide faster treatment which will also help ease pressure on hospitals. By cutting mental health waiting lists and intervening earlier with more timely mental health support, we can get this country back to good health.We will also ensure every young person has access to a mental health professional at school, and set up Young Futures hubs in every community, offering open access mental health services for young people.

What steps his Department is taking to improve the early (a) diagnosis and (b) treatment of pancreatic cancer in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

The Department is working with NHS England to deliver interventions to improve outcomes for those with pancreatic cancer across England, including Cheshire and mid-Cheshire.Early diagnosis is imperative to improving outcomes for all types of cancer, especially pancreatic due to the non-specific nature of its symptoms. As the first step to ensuring faster diagnosis and treatment, we will deliver an extra 40,000 operations, scans, and appointments each week.For pancreatic cancer specifically, NHS England is providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer. NHS England is additionally creating pathways to support faster referral routes for people with non-specific symptoms and is increasing direct access for general practitioners to diagnostic tests.NHS England is also funding a new audit into pancreatic cancer, aiming to provide regular and timely evidence to cancer service providers of where patterns of care in England may vary, to increase the consistency of access to treatments and to stimulate improvements in cancer treatment and outcomes for patients.Information on the average time to diagnose pancreatic cancer in Chester, Cheshire and England is not available in the format requested.

If he will make an estimate of what the average time was to diagnose pancreatic cancer in (a) Mid Cheshire constituency, (b) Cheshire and (c) England in each of the last five years.

The Department is working with NHS England to deliver interventions to improve outcomes for those with pancreatic cancer across England, including Cheshire and mid-Cheshire.Early diagnosis is imperative to improving outcomes for all types of cancer, especially pancreatic due to the non-specific nature of its symptoms. As the first step to ensuring faster diagnosis and treatment, we will deliver an extra 40,000 operations, scans, and appointments each week.For pancreatic cancer specifically, NHS England is providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer. NHS England is additionally creating pathways to support faster referral routes for people with non-specific symptoms and is increasing direct access for general practitioners to diagnostic tests.NHS England is also funding a new audit into pancreatic cancer, aiming to provide regular and timely evidence to cancer service providers of where patterns of care in England may vary, to increase the consistency of access to treatments and to stimulate improvements in cancer treatment and outcomes for patients.Information on the average time to diagnose pancreatic cancer in Chester, Cheshire and England is not available in the format requested.

What steps his Department is taking to help improve outcomes for patients who have been diagnosed with pancreatic cancer in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

The Department is working with NHS England to deliver interventions to improve outcomes for those with pancreatic cancer across England, including Cheshire and mid-Cheshire.Early diagnosis is imperative to improving outcomes for all types of cancer, especially pancreatic due to the non-specific nature of its symptoms. As the first step to ensuring faster diagnosis and treatment, we will deliver an extra 40,000 operations, scans, and appointments each week.For pancreatic cancer specifically, NHS England is providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer. NHS England is additionally creating pathways to support faster referral routes for people with non-specific symptoms and is increasing direct access for general practitioners to diagnostic tests.NHS England is also funding a new audit into pancreatic cancer, aiming to provide regular and timely evidence to cancer service providers of where patterns of care in England may vary, to increase the consistency of access to treatments and to stimulate improvements in cancer treatment and outcomes for patients.Information on the average time to diagnose pancreatic cancer in Chester, Cheshire and England is not available in the format requested.

What steps his Department is taking to help improve research into treatments for pancreatic cancer; and how much funding his Department has allocated to pancreatic cancer research in each of the last 14 years.

Research is crucial in tackling cancer. The Department spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer the largest area of spend at more than £121.8 million in 2022/23. NIHR spends more on cancer than any other disease group, reflecting its high priority.NIHR have committed more than £7.6 million to pancreatic directly funded cancer research, across 15 research projects, since 2010/11. The NIHR continues to welcome funding applications for research into all cancer types. Funding applications are subject to peer review and judged in open competition.The following table shows the amount of funding allocated to pancreatic cancer research in each year since 2010/11 committed by NIHR: YearTotal (£,000)2010/113,1002011/122012/132013/142014/1566.52015/162912016/1766.52017/182,0002018/192019/20149.52020/21440.72021/22544.32022/231502023/24839.5 Additionally, NIHR infrastructure funding supports the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research that is funded by the NIHR’s research programmes, other public funders of research, charities and the life sciences industry. In doing so, our investment plays a crucial role in underpinning the research funded by our partners.As part of our commitment to driving more and better research into less survivable cancers, the Government awarded £2 million to new interdisciplinary research teams tackling hard to treat cancers, via the Medical Research Council’s two-day cancer ‘sandpit’ strategic funding opportunity in 2023 focused on technological innovation for understanding cancers, including pancreatic, with the poorest survival rates.

What steps his Department is taking to reduce waiting times for children requiring an autism assessment in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

The Department is currently considering next steps to improve access to autism assessments. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessments, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people and adults referred to an autism assessment service. In 2024/25 £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.

If he will make an assessment of the potential merits of offering potential foster carers the required health assessment free of charge on the NHS.

Foster carers must undergo a full assessment and be approved by a fostering service provider before any child can be placed in their care. This includes a medical assessment. These assessments are not part of the GP contract with the National Health Service.When asked to assist with medical evidence reports, there are some letters, certificates, or reports that general practices may charge for, and other certificates that they must not charge for. This is set out in law through the General Medical Services and Personal Medical Services Regulations, which form the basis of the GP contract with the NHS.The Department for Education sets out National Minimum Standards for fostering, and costs for caring may be covered by local authorities or fostering agencies.

What recent estimate he has made of the number of people in (a) Mid Cheshire constituency, (b) Cheshire and (c) England who have unmet care needs; and what steps his Department is taking to help ensure those care needs are met.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014.We recognise that there are challenges in adult social care, with people needing to fight a complicated system or go without the care they need. Lord Darzi’s report indicated a growing gap between requests and those receiving publicly funded care, and the number of people receiving long term care decreased between 2015/16 and 2022/23. There is limited information on self-funders who arrange their own care.Long-term reform is needed in adult social care. We will work with the sector to build consensus for a National Care Service, based on consistent national standards, to support people in living independent and dignified lives.In the interim, Care Quality Commission (CQC) local authority assessments consider the performance of the delivery of the Care Act 2014 duties, including the timeliness of assessing care needs. If the CQC identifies that a local authority has failed or is failing its functions to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene. The CQC has published its first nine local authority ratings and reports.

What steps he is taking to improve patient access to primary care in (a) Mid Cheshire constituency, (b) Cheshire and (c) England.

We are committed to fixing the crisis in primary care to secure the long-term sustainability of the National Health Service and increase access to local services across the country.We are also committed to moving towards a Neighbourhood Health Service, with more care delivered in local communities to spot problems earlier. We will trial Neighbourhood Health Centres to bring together a range of services under one roof, ensuring healthcare is closer to home and that patients receive the care they deserve.We have pledged to train thousands more general practitioners (GPs) to increase capacity, and additional funding of £82 million has now been made available to include newly qualified GPs in the Additional Roles Reimbursement Scheme over 2024/25.

What recent estimate his Department has made of the number of (a) adults and (b) children in Mid Cheshire constituency who (i) are not registered with an NHS dentist and (ii) have been unable to access NHS dental treatment in each of the last five years; and what steps his Department is taking to improve access to NHS dentistry in Mid Cheshire constituency.

Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend, allowing patients the choice of where they would like to receive a course of treatment. Therefore, we cannot provide the number of people who are not registered with an NHS dentist.The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England. For the Mid Cheshire constituency, this is the NHS Cheshire and Merseyside ICB.We do not hold information on the number of adults and children unable to access NHS dental treatment, but the GP Patient Survey (GPPS) gives information on the percentage of adults who tried to get an NHS dental appointment in the last two years but were not successful in doing so. The GPPS is available at the following link:https://www.england.nhs.uk/statistics/2024/07/11/gp-patient-survey-dental-statistics-january-to-march-2024-england/The Government is committed to tackling the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and retaining NHS dentists.

What the average waiting time was for mental health treatment in (a) Mid Cheshire constituency, (b) Cheshire and (c) England in each of the last three years.

A table showing the average waiting time for mental health treatment for the Mid Cheshire constituency, Cheshire, and England for those aged over 18 years old, and another table for those aged under 18 years old, for each of the last three years, is attached.