Written questions by Rosindell.

What steps his Department has taken to improve the availability of GLP-1 drugs to help tackle obesity.

Obesity medicines can be effective for some patients living with obesity when prescribed alongside diet, physical activity, and behavioural support. Exactly what is most appropriate for an individual is down to health care professionals to advise, in discussion with patients, and considering relevant clinical guidance.The National Institute for Health and Care Excellence (NICE) has recommended liraglutide (Saxenda) and semaglutide (Wegovy) as clinically and cost-effective drugs for weight management in adults in the National Health Service in England. NICE guidance includes eligibility criteria and, for some products like Saxenda and Wegovy, a restriction that these treatments should be used within specialist weight management services. NHS organisations are continuing to look at the best way to manage access to these treatments.We are expecting NICE to issue guidance on tirzepatide (Mounjaro) before the end of the year. This could see it being prescribed by general practitioners rather than restricted to specialist services. To manage this, NHS England has proposed a phased rollout to make tirzepatide available in a way that is effective, affordable, and sustainable. Under NHS England’s plan, almost 250,000 people with the greatest clinical need could receive this medicine in the first three years of implementation.Integrated care boards are responsible for arranging the provision of health services within their area in line with local priorities, considering population need and relevant guidance. This includes the commissioning of NHS specialist weight management services. The licensed treatments for weight loss such as Wegovy (semaglutide) and Mounjaro (tirzepatide) are in good supply.

What steps he his taking to use (a) data and (b) AI to improve NHS efficiency.

Data and technology is a key enabling workstream in our 10-Year Health Plan. The NHS is already using and promoting several national tools and datasets to help systems and providers identify and implement efficiency opportunities. The NHS Spend Comparison Service allows NHS procurement teams to identify savings opportunities. Model Hospital is a data-driven improvement tool that provides benchmarked insights across the quality of care, productivity, and organisational culture to identify opportunities for improvement. Model Hospital includes a section on the top ten medicines to support trust progress towards meeting national and trust-level uptake and savings targets by using less costly or biosimilar versions of these drugs.The Federated Data Platform, being rolled-out to trusts and integrated care systems, will allow them to be much more effective in how they handle data to improve outcomes. It brings together information about staff, waiting times, equipment, and medicines, to allow for better planning of how the NHS uses its resources, including supply main management. This was piloted in trusts across England and showed that better use of data could help discharge patients quicker and make better use of operating theatres.My Rt Hon. Friend, the Secretary of State for Health and Social Care has also recently announced the intention for there to be a single patient record, including primary care and hospital data, so professionals have the data to make better informed decisions, and deliver more preventative and more efficient health and care.Through the AI in Health and Care Award, the Department has helped accelerate the testing and evaluation of artificial intelligence (AI) technologies to develop an evidence base to support the commissioning of technologies that are clinically and cost effective. So far, £113 million has been provided to 86 AI technologies, which are live in 99 hospitals across 40% of NHS acute trusts in England, as well as hundreds of Primary Care Networks across the United Kingdom.AI technologies have huge potential in improving efficiency across the NHS by supporting clinicians with faster and more accurate diagnosis, enhancing clinical decision-making about treatment plans, and reducing the administrative burden faced by healthcare staff. The Department and NHS England are developing guidance for the responsible use of these tools and how they can be rolled out to make the day-to-day operations of the NHS more efficient.

What steps he has taken to work with relevant organisations to increase blood donations in (a) England and (b) Romford constituency.

NHS Blood and Transplant (NHSBT) is responsible for blood donation in England.Throughout the year, NHSBT produces advertising campaigns to attract new donors, such as the new gift of blood winter stocks campaign for 2024. As part of this work, NHSBT partners with organisations to utilise their expertise and national resources to increase blood donations. Notable examples of these partnerships include Disney, Dalgety Teas, Fulham Football Club, the Civil Service, National Health Service trusts, and integrated care boards.In addition, NHSBT awards funds to community groups through its Community Grants Programme to promote blood donation. This funds community, and faith and belief organisations to drive awareness, understanding, and behaviour change. During the latest funding round, NHSBT awarded funds to 23 organisations to promote blood donation.NHSBT’s physical and digital marketing, and collaboration and partnership, activity takes place across England, including in the Romford constituency.

What the average waiting time for an NHS dental practice is in Romford constituency.

Patients in England are not registered with an NHS dental practice and there is no single waiting list, although many NHS dental practices do tend to see patients regularly and may operate local waiting list arrangements. 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 Romford constituency, this is NHS Northeast London ICB.

What assessment he has made of the potential merits of vorasdenib for treatment of low-grade gliomas.

It is critical that medicines used in the United Kingdom are safe and effective and as such, medicines cannot be marketed in the UK without a marketing authorisation. These are granted by the Medicines and Healthcare products Regulatory Agency (MHRA) which assesses all medicines with regard to their quality, safety, and efficacy. Vorasidenib, sold under the brand name Voranigo, has not been licensed by the MHRA as a treatment for low-grade gliomas. It is the responsibility of the company to apply to the MHRA for the relevant marketing authorisation. Should an application for it be received, the MHRA will consider this accordingly.In England, newly licensed medicines are also appraised by the National Institute for Health and Care Excellence (NICE) to determine whether they represent a clinically and cost-effective use of National Health Service resources. If the manufacturer of vorasidenib seeks a licence from the MHRA for the treatment of low-grade gliomas, then the NICE will consider it through the Technology Appraisal programme.

Whether the MHRA is considering the approval of vorasidenib for the treatment of low grade gliomas.

It is critical that medicines used in the United Kingdom are safe and effective and as such, medicines cannot be marketed in the UK without a marketing authorisation. These are granted by the Medicines and Healthcare products Regulatory Agency (MHRA) which assesses all medicines with regard to their quality, safety, and efficacy. Vorasidenib, sold under the brand name Voranigo, has not been licensed by the MHRA as a treatment for low-grade gliomas. It is the responsibility of the company to apply to the MHRA for the relevant marketing authorisation. Should an application for it be received, the MHRA will consider this accordingly.In England, newly licensed medicines are also appraised by the National Institute for Health and Care Excellence (NICE) to determine whether they represent a clinically and cost-effective use of National Health Service resources. If the manufacturer of vorasidenib seeks a licence from the MHRA for the treatment of low-grade gliomas, then the NICE will consider it through the Technology Appraisal programme.

What funding he is providing for people with brain tumours in financial year 2024/25.

As part of the November 2021 Budget and Spending review, the Department allocated £14 billion to NHS England from 2022/23 to 2024/25 specifically for the National Health Service in England to recover elective and cancer care, including for brain tumours. This comprised of £8 billion of resource funding and £5.9 billion of capital funding, as described in the November 2021 Budget and Spending Review.As set out in the recent October Budget, we are providing an additional £1.8 billion to directly support elective recovery and activity in 2024/25, which includes cancer care. This funding is being provided to reduce waiting times and support the NHS to deliver 40,000 additional appointments each week.To support delivery of the operational priorities for cancer, including early diagnosis, NHS England is providing over £250 million in cancer service development funding to Cancer Alliances.Further to this, in September 2024, the National Institute for Health and Care Research (NIHR) announced new research funding opportunities for brain cancer research, spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients, and a new funding call to generate high quality evidence in brain tumour care, support, and rehabilitation.Lord Darzi’s report has set out the scale of the challenges we face in fixing the NHS in England, and the need to improve cancer waiting time performance and cancer survival. The report will inform the Government’s 10-Year Health Plan to reform the NHS in England, including further detail on how we will improve outcomes for cancer.

What steps his Department is taking to improve dementia (a) diagnosis, (b) research and (c) treatment.

NHS England is committed to improving diagnosis rates and recovering them to the national ambition for two thirds of people with dementia to have a formal diagnosis.NHS England publishes a monthly report detailing the number of people with a recorded dementia diagnosis nationally and in each locality. They also measure the of quality of care such as the proportion of patients who have had a care plan review in the previous 12 months.To reduce variation in diagnosis rates, the Office for Health Improvement and Disparities’ Dementia Intelligence Network has developed a tool for local systems, which includes an assessment of population characteristics such as rurality and socio-economic deprivation. This enables systems to investigate local variation in diagnosis and take informed action to enhance their diagnosis rates. The tool has been released and is available via the NHS Futures Collaboration platform.The United Kingdom has established a rich ecosystem for dementia research, including through the UK Dementia Research Institute and related initiatives such as the Dementia Trials Accelerator which is supported by the Government’s Dame Barbara Windsor Dementia Goals programme, with £120 million of Fovernment funding committed to it. This aims to speed up the development of new treatments for dementia and neurodegenerative conditions by accelerating innovations in biomarkers, clinical trials and implementation.The £49.9 million National Institute for Health and Care Research Dementia Trials Network will deliver a coordinated network of early phase dementia trial sites to test for potential treatments.To prepare for the new generation of dementia treatments, NHS England is working closely with regulators to ensure that arrangements are in place to support the adoption of any new licensed and National Institute for Health and Care Excellence recommended treatments as soon as possible.

How much funding his Department has provided for the early detection of breast cancer in the 2024-25 financial year.

Improving early diagnosis of cancer, including breast cancer, is a priority for the Government. There are a number of National Health Service initiatives and funding streams across the NHS in England that support the early detection of breast cancer, and many organisations across the health service are involved. As a consequence, NHS England does not hold all the information on the initiatives and funding streams in 2024/25 as they are split across many budgets. Integrated care boards, supported by Cancer Alliances, provide funding for symptomatic pathways.The NHS Breast Screening Programme is funded via a portion of the overall £1.8 billion funding across public health services, including NHS screening and vaccination, child health information services, wider health and justice and armed forces.

Whether he plans to take steps with NHS England to expand access to indication-specific pricing agreements.

As part of the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth, NHS England committed to undertake two consultations on amendments to the NHS Commercial Framework for New Medicines. The first of these was launched on 31 July 2024 and ran for eight weeks. The proposed amendments would make the framework more explicit about the circumstances in which NHS England will consider indication specific pricing mechanisms. They would also align the framework with the Competition and Markets Authority statement on combination medicines.NHS England and the Department engaged with key stakeholders throughout the consultation period, and NHS England intends to publish an updated NHS Commercial Framework for New Medicines by the end of 2024.

What steps his Department is taking to (a) encourage screening for and (b) increase the rate of early diagnosis of prostate cancer.

Screening for prostate cancer is currently not recommended by the UK National Screening Committees (UK NSC). This is because of the inaccuracy of the current best test Prostate Specific Antigen (PSA). A PSA-based screening programme could harm men as some of them would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments which can also have harmful side effects.The Department has invested £16 million in the TRANSFORM trial which seeks to find ways to diagnose prostate cancer as early as possible. This trial will compare the most promising tests to look for prostate cancer in men that do not have symptoms and aim to address disparities in early detection rates across different groups.We are also working with NHS England to support the National Health Service to meet the Faster Diagnosis Standard for cancer to be diagnosed or ruled out within 28 days from an urgent suspected cancer referral. This includes introducing best practice timed pathways for prostate cancer to streamline diagnostic pathways and speed up diagnoses.

If he will make an assessment of the potential merits of bringing forward legislative proposals to mandate that fact-of-death is reported to the Office for National Statistics in England within eight days.

There is a legal responsibility to register a death within a five-day time period, from when a medical examiner submits the medical certificate of cause of death (MCCD) to the registrar. The Office for National Statistics compiles their mortality data from the data taken at registration, which is informed in part by the MCCD. The five-day requirement complements the guidance to medical practitioners that certifying the death should be completed in a timely and efficient manner. However, there are valid cases where, for example, the identification of the cause of death, including where this is ascertained through a coronial investigation, and therefore the registration must take longer, which would be incompatible with a more prescriptive legal timeline.

What steps he is taking to help increase the recruitment of NHS dentists.

We will tackle the immediate dentistry crisis 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 the retention of National Health Service dentists.We acknowledge that there are areas of the country that are experiencing recruitment and retention issues, and we are taking steps to address the workforce challenges across the country. Integrated care boards have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most, for three years.

What assessment he has made of the adequacy of dental provision in Romford constituency.

The data for the NHS North East London Integrated Care Board, which includes the Romford constituency, shows that 46% of adults were seen by a National Health Service dentist in the previous 24 months, compared to 40% in England. Additionally, 57% of children were seen by an NHS dentist in the previous 12 months, compared to 56% in England. These statistics were published by the NHS Business Services Authority on 22 August 2024, and are available at the following link:https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324

How much funding his Department has provided for the early detection of bowel cancer in the 2024-25 financial year.

We will get the National Health Service catching cancer, including bowel cancer, on time, diagnosing it earlier, and treating it faster so more patients survive this horrible set of diseases.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.The NHS bowel screening budget in FY24/25 is £293 million. Furthermore, in 2024/25, we will continue to extend the NHS Bowel Cancer Screening Programme to additional cohorts, specifically 50 to 52 year olds.

What steps he is taking to support research on (a) the causes of and (b) treatments for metastatic lung cancer.

Research is crucial in tackling cancer, which is why the Department invests over £1.5 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group, reflecting its high priority.The NIHR also invests in research infrastructure to support the delivery of research. This includes research into a novel cancer vaccine for lung cancer patients that primes the immune system to recognise and fight cancer cells.The NIHR welcomes funding applications for research into any aspect of human health, including lung cancer. 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. The NIHR welcomes further high-quality proposals to understand the causes of and to inform approaches to treating metastatic lung cancer.

What steps his Department is taking to support research on (a) the causes of and (b) treatments for atrial septal defect.

The Government, through the National Institute for Health and Care Research (NIHR), is committed to funding high quality, timely research that leads to improved outcomes for patients and the public, and which makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including people with conditions related to congenital heart disease.The Department is proud to invest £1.5 billion per year on health research through the NIHR. Over the past five financial years, from 2019/20 to 2023/24, the NIHR has invested an estimated £1.8 million on congenital heart disease, including atrial septal defect, via its research programmes. Recent examples of congenital heart disease projects funded in this way include a three-year study to assess how the use of artificial intelligence technology can detect heart conditions in babies before birth, and a five-year study to improve how the quality of congenital heart services is measured and reported in England, with further information on both studies available, respectively, at the following two links:https://fundingawards.nihr.ac.uk/award/NIHR301448https://fundingawards.nihr.ac.uk/award/PR-R20-0318-23001The Department, via NIHR, also funds infrastructure that provides clinical expertise, specialist facilities, the workforce, and support services to support research across a range of clinical areas, including congenital heart disease. The NIHR welcomes high quality funding applications for research into any aspect of human health, including congenital heart disease.

If he will take steps to provide funding for medical research into alternatives to antidepressant medication.

The Department funds research through the National Institute for Health and Care Research (NIHR). The NIHR funds an extensive portfolio of mental health research, including a number of investments focused on alternatives to antidepressant medication. For example, the NIHR Oxford Health Biomedical Research Centre has a dedicated research theme on depression therapeutics and human neurocognitive models of antidepressant action. Additionally, the NIHR invested £1.1 million in a randomised controlled trial to examine if it is feasible, safe, and effective to use psilocybin to treat people with treatment-resistant depression, which was supported by the NIHR King’s Clinical Research Facility and the NIHR Maudsley Biomedical Research Centre. The study was completed in February 2024 and the full results will be published following peer review. The NIHR welcomes funding applications for research into any aspect of human health, including alternatives to antidepressant medication.

What steps his Department is taking to treat people who have (a) post-acute withdrawal syndrome and (b) post-SSRI sexual dysfunction after taking anti-depressant medication.

The Medicines and Healthcare products Regulatory Agency (MHRA) approved product information outlines the details of possible adverse reactions associated with each medicine. Whilst post-acute withdrawal syndrome is not currently recognised as being associated with antidepressant use, the product information for the most commonly prescribed antidepressants contain advice about the risk of withdrawal reactions associated with antidepressant use, and advises users not to stop these types of medication abruptly.The product information for some antidepressants contains advice that they can be associated with sexual dysfunction where symptoms continue despite stopping the antidepressant. An expert working group of the Commission on Human Medicines has been established to review how the risk of sexual dysfunction, where symptoms may continue, is communicated to patients. Separately, a review of the communication of the risk of withdrawal reactions in the product information will be taken forward in the MHRA’s project, to improve the information supplied with known dependency-forming medicines. Patients can visit either their general practice, or a sexual health clinic, for support with erectile dysfunction.

What steps his Department is taking to help treat people who have had adverse reactions to antidepressant medication including to (a) selective serotonin reuptake inhibitors and (b) serotonin and norepinephrine reuptake inhibitors.

The Medicines and Healthcare products Regulatory Agency approved Patient Information Leaflets outline the details of possible adverse reactions associated with selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, and highlight when the advice of a healthcare professional should be sought for specific serious adverse reactions.People who are concerned about adverse reactions to antidepressants should speak to a healthcare professional. Suspected adverse reactions to medicines, including antidepressant medication, can be reported through the Yellow Card Scheme, which is the system for recording adverse reactions suspected to be associated with medicines and medical devices in the United Kingdom.