Written questions by Snowden.

What assessment his Department has made of the potential impact of weight loss drugs on (a) public health outcomes, (b) obesity rates and (c) associated health conditions.

Obesity is estimated to cost the NHS £11.4 billion per year and wider society around £74.3 billion.The National Institute for Health and Care Excellence (NICE) is the independent body responsible for assessing the clinical and cost-effectiveness of new medicines and health technologies for the National Health Service in England. NICE uses a structured process, including the assessment of clinical and economic evidence and the use of quality-adjusted life years (QALYs), to determine if a new treatment offers good value for money. NICE takes into account all health-related costs and benefits, which may include public health outcomes and impacts on associated health conditions. These assessments allow NICE to make evidence-based recommendations on whether a medication should be routinely funded by the NHS. The newest obesity medicines, semaglutide (Wegovy®) and tirzepatide (Mounjaro®) have been assessed and recommended by the NICE as clinically and cost-effective treatment options on the NHS for obesity. They can provide an effective tool, when prescribed alongside diet, physical activity and behavioural support, to support some people living with obesity to lose weight. Clinical trials of Mounjaro® have found an average weight loss of approximately 20%. Weight loss is associated with significant improvements in both the management of existing conditions and the risk of developing weight related health conditions. Generally, greater weight loss is associated with more health benefits so obesity medicines could have a potential impact on a number of obesity associated health conditions such as diabetes, cardiovascular disease, obstructive sleep apnoea and non-alcoholic fatty liver disease, as well as on obesity rates.

What steps his Department is taking to ensure the successful rollout of the new chickenpox vaccination programme in areas with historically low vaccine uptake.

The Department of Health and Social Care continues to work with the UK Health Security Agency (UKHSA) and NHS England to promote vaccine uptake by providing diverse delivery methods to make getting vaccinated easier, increasing outreach efforts to under-served groups, and raising awareness of the dangers of vaccine-preventable diseases.The launch of the chickenpox vaccination programme in January 2026 will see a press campaign with UKHSA and NHS England working together to inform and educate the public on the benefits of vaccination. This will continue throughout the year with key bursts of activity on all childhood immunisations.The Department will also launch a national childhood vaccination paid marketing campaign in February 2026 to encourage uptake of all childhood vaccinations for those age 0-5 years and will include high impact advertising across video on demand, online video, radio, out of home posters and social media. This will be supported by partnerships across a range of sectors including retailers, nursery providers and charities. Activity will be upweighted to key low uptake communities and geographical areas across the country.Ahead of launch, NHS England is hosting vaccine confidence sessions for health care workers to help them have vaccination conversations and address any questions or concerns with parents and carers. Communication toolkits and assets are also being issued to primary care teams across all regions to support the launch of the chickenpox programme, which will include material for parents and carers.

What assessment he has made of the adequacy of the readiness of NHS services in (a) Fylde and (b) Lancashire to deliver the chickenpox vaccine from January 2026.

On 29 August, the Government announced plans to introduce chickenpox vaccination into the routine childhood immunisation schedule from 1 January 2026, using the MMRV vaccine which protects against measles, mumps, rubella and chickenpox (varicella).The MMRV vaccine will be offered at GP practices as part of routine infant vaccination appointments.Any vaccination programme change carefully considers factors including National Health Service delivery and impact on other vaccination programmes.The Department, NHS England and the UK Health Security Agency work closely together to inform and educate the public and health professionals and ensure system readiness to maintain the high standards of the UK’s world-leading vaccination programmes, including in Fylde and Lancashire.

If he will take steps to fund specific communications campaigns in (a) Lancashire and the (b) North West to (i) raise awareness of the chickenpox vaccine and (ii) address misinformation.

On 29 August 2025, the Government announced plans to introduce chickenpox vaccination into the routine childhood immunisation schedule from 1 January 2026, using the MMRV vaccine which protects against measles, mumps, rubella and chickenpox (varicella).The launch of the chickenpox vaccination programme in January 2026 will see a press campaign with the UK Health Security Agency and NHS England working together to inform and educate through the use of low and no cost communications. This will continue throughout the year with key bursts of activity on all childhood vaccines. The last national childhood vaccination campaign was elevated in the North West area, with outdoor advertising up weighted in funding and exposure in the North West’s lowest uptake areas.The Department of Health and Social Care will also launch a national childhood vaccination paid marketing campaign in February 2026 to encourage uptake of all childhood vaccinations for those age 0-5 years and will include high impact advertising across video on demand, online video, radio, out of home posters and social media. This will be supported by partnerships across a range of sectors including retailers, nursery providers and charities. Activity will be upweighted to key low uptake communities and geographical areas across the country.Ahead of the launch, NHS England is hosting vaccine confidence sessions for health care workers to help them have vaccine conversations and address questions or concerns with parents and carers.Communications toolkits and assets will be issued to primary care teams across all regions to support the launch of the MMRV programme, which includes material for parents and carers on the new vaccination programme.

What steps his Department is taking to help ensure that people prescribed weight loss medication also adopt lifestyle changes.

Weight loss medications (semaglutide, tirzepatide and liraglutide) are licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) and recommended by the National Institute for Health and Care Excellence (NICE) as clinically and cost-effective treatment options on the NHS for obesity. Both the license and NICE guidance for these medicines specify that they should be prescribed alongside a reduced calorie diet and physical activity. NICE guidance also states that healthcare professionals should arrange information, support, and counselling on additional diet, physical activity, and behavioural strategies when these medicines are prescribed.Integrated care boards (ICBs) are responsible for commissioning health services within their area in line with local population need and taking account of relevant guidance. This includes services to support lifestyle changes alongside the prescription of these medicines. NHS England have however also made a central wraparound service available which ICBs can use to support primary care prescription of these medicines. This central service focuses on nutrition, physical activity and psychological support.Private prescribers do not have to follow NHS or NICE guidance. However, they are expected to take account of appropriate professional guidance. This includes guidance from the General Medical Council which encourages the prescription of medicines in accordance with the terms of their license unless the prescriber concludes that they should go outside of the licence for medical reasons.

What plans he has to support partnerships between (a) local pharmacies and (b) drug and alcohol support charities to deliver harm reduction services in (i) Fylde and (ii) Lancashire.

Many community pharmacies provide locally commissioned services aimed at reducing harm from the misuse of alcohol and drugs. This includes supervised consumption of opioid substitution treatment medicines like methadone, needle and syringe programmes, and naloxone provision. Pharmacies also provide free healthcare advice, public health interventions, and signposting to relevant organisations and services.Local substance misuse services and community pharmacies should work together to help provide an effective service to people who use drugs and alcohol. This includes encouraging person-centred and trauma-informed treatment with shared decision-making. In 2024, the Department published guidance for community pharmacies delivering substance misuse services. This outlined good practice for delivering safe and effective care and advice on joint working between services and commissioners and community pharmacies. This guidance is available at the following link:https://www.gov.uk/government/publications/community-pharmacy-delivering-substance-misuse-services/community-pharmacy-delivering-substance-misuse-services#multidisciplinary-team-and-joint-working The Department is aware of the challenges in the ability of some community pharmacies to provide substance misuse services and has been supporting drug and alcohol treatment services to identify local solutions, including increased payment and some alternative models of provision of these services.In addition to the Public Health Grant, in 2025/26, the Department is providing Lancashire with £10,424,106 to help improve drug and alcohol treatment and recovery systems. All funding is provided at the Lancashire level, and it is for Lancashire County Council to determine how to meet needs in Fylde. This funding can be used to support local community pharmacies and drug and alcohol support charities to deliver harm reduction services.

What regulations are in place to ensure the accuracy of health claims made in the marketing of protein supplements.

Legislation on Nutrition and Health Claims sets out the legal framework for businesses wanting to make nutrition and/or health claims on their products. A health claim is any claim that states, suggests or implies that health benefits can result from consuming a given food. These require health claims to be authorised on the basis they are supported by evidence and only health claims that are on the Great Britain Nutrition and Health Claims (GB NHC) Register of approved health claims can be used. The Register is available at the following link: https://www.gov.uk/government/publications/great-britain-nutrition-and-health-claims-nhc-register.Protein supplements are also regulated under Food Supplements (England) Regulations 2003, along with equivalent legislation for Scotland, Wales and Northern Ireland as well as all other applicable food law. The labelling requirements set out in the regulations state that labelling needs to be clear and easy for consumers to understand.

What steps he is taking to (a) inform and (b) educate parents about the new chickenpox vaccine, and to tackle vaccine hesitancy.

On 29 August 2025, the Government announced plans to introduce chickenpox vaccination into the routine childhood immunisation schedule from 1 January 2026, using the MMRV vaccine which protects against measles, mumps, rubella and chickenpox (varicella).The launch of the chicken pox vaccination programme in January 2026 will see a press campaign with the UK Health Security Agency and NHS England working together to inform and educate through the use of low and no cost communications. This will continue throughout the year with key bursts of activity on all childhood vaccines.The Department will also launch a national childhood vaccination paid marketing campaign in February 2026 to encourage uptake of all childhood vaccinations for those aged 0-5 years and will include high impact advertising across video on demand, online video, radio, out of home posters and social media. This will be supported by partnerships across a range of sectors including retailers, nursery providers and charities. Activity will be upweighted to key low uptake communities and geographical areas across the country.Ahead of the launch, NHS England is hosting vaccine confidence sessions for health care workers to help them have vaccine conversations and address questions or concerns with parents and carers.Communications toolkits and assets will be issued to primary care teams across all regions to support the launch of the MMRV programme, which includes material for parents and carers on the new vaccination programme.

What steps he plans to take to improve access to information for (a) healthcare professionals and (b) patients on the risks and benefits of weight loss drugs.

The Medicines and Healthcare products Regulatory Agency (MHRA) works hard to ensure that patients and healthcare professionals are provided with accurate and up to date information which allows them to make informed decisions about weight loss treatments.Information about the benefits and efficacy of weight loss medicines such as GLP-1 receptor agonists are made available within the Public Assessment Reports (PARs) for each product on the Products section of the MHRA website. Information on how a medicine works, how to use it, as well as all known side effects, are made publicly available through the product information. These documents are issued at the time of licensing and are updated as any new side effects are identified. This includes the Summary of Product Characteristics, which is intended for healthcare professionals, and the Patient Information Leaflet, which is provided to patients with the medicine. These documents are also published on the Products section of the MHRA website, which is available at the following link: https://products.mhra.gov.uk/.In addition, members of the public and healthcare professionals can access anonymised data on suspected side effects reported to the Yellow Card scheme via the interactive Drug Analysis Profiles (iDAP) platform. This ensures full transparency and enables anyone to view the types and numbers of suspected adverse reactions reported for a particular medicine.In addition to this, if new information becomes available about a risk of treatment, we communicate this to healthcare professionals and patients using a Drug Safety Update (DSU), which can be found on GOV.UK and are also flagged to key stakeholders or patient groups. These communicate what the risk is, how it can be minimised, and what healthcare professionals and patients should do if a patient suffers the side- effect. DSUs and other safety communications are also published in a monthly newsletter, the MHRA Safety Roundup, to which readers can subscribe to receive e-mail alerts when a new MHRA Safety Roundup is published. Users can use the search function to find Safety Roundup’s relevant to weight loss medications, which is available at the following link: https://www.gov.uk/drug-device-alerts?alert_type%5B%5D=mhra-safety-round-up.Due to the public interest and increasing use of GLP-1 receptor agonists in particular, in order to improve access to key information about these medicines, we have published public guidance online designed to raise awareness among patients about key safety considerations, including how to safely acquire and use GLP-1s, pregnancy, breastfeeding, and when to seek medical advice. This is a live document, which we update as necessary when there is safety information that we would like to highlight or if there is an area of public interest for which we can provide guidance.The guidance is available at the following link: https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know.Reach of our safety messages has been strengthened by MHRA’s Head of Enforcement, Andy Morning, who has spoken publicly about how to gain safe access to GLP-1s across a number of media platforms including radio interviews and television appearances, to raise awareness of the risks associated with unlawful supply of weight loss medicines.The MHRA works closely with other organisations such as the General Pharmaceutical Council, who regulate pharmacies, pharmacists and pharmacy technicians in Great Britain, the National Institute for Health and Care Excellence (NICE), who produce guidance for the NHS and wider health and care system, and the Advertising Standards Authority (ASA), who regulate advertising, to collaborate on communicating with the public and sharing links to guidance and information within those communications.

What recent assessment he has made of waiting times for NHS treatment of plantar fasciitis.

No recent assessment has been made specifically on plantar fasciitis waiting times. However, as set out in the Plan for Change, we have committed to return to the National Health Service constitutional standard that 92% of patients, including those waiting for fibromatosis care, wait no longer than 18 weeks from referral to treatment by March 2029. We provided additional investment in the Autumn Budget that has enabled us to fulfil our pledge to deliver over two million more elective care appointments early. More than double that number, 4.9 million more appointments, have now been delivered.The majority of treatment for plantar fasciitis is done within primary care settings, with only a small fraction of patients requiring treatment at hospitals. Data presenting a more detailed breakdown, specific to plantar fasciitis wait times, is not held by the Department.

Whether his Department has issued guidance to (a) schools and (b) colleges on the use of protein supplements by students engaged in sports programmes.

No specific guidance on the use of protein supplements has been issued to schools and colleges. However, the School Food Standards (SFS) are mandated to ensure that schools provide pupils with healthy food and drink options, enabling children to get the energy and nutrients they need across the school day. Protein supplements are not included under the SFS and so should not be provided by schools. Compliance with the SFS is mandatory for all maintained schools, academies and free schools, including sixth form colleges attached to secondary schools. Schools are encouraged to have a whole school approach to healthy eating, including local policies for food and drinks that can be brought onto the school site from home. School governing boards are responsible for setting their school food policies and ensuring compliance with the SFS. The National Diet and Nutrition Survey 2019 to 2023 reported that population level protein intakes exceed recommendations across all age and sex groups. As such, protein supplementation is largely unnecessary for the majority of the population, including children engaging in sports activities at school or college.

Whether his Department holds data on instances where the cost of drugs sourced from American pharmaceutical companies has significantly increased in the last five years; and what steps he is taking to mitigate the impact of such increases on NHS budgets.

NHS England do not record or hold data related to the medicines purchased by the NHS categorised by base of the parent company of the supplier.

Whether he has made a comparative assessment of the cost to the NHS of procuring pharmaceutical drugs from suppliers based in the (a) USA, (b) UK and (c) EU.

NHS England has not made a comparative assessment of the cost to the NHS in England from procuring pharmaceutical drugs from suppliers based in other domains, including the EU and the USA, compared to from the UK.

What discussions he has had with the Secretary of State for Education on the ability of universities to deliver healthcare and medical training courses in the context of declining revenues.

The Department for Health and Social Care works closely with the Department for Education (DfE) on a wide range of matters, including healthcare education and training funding. Matters relating to the income of universities are the responsibility of DfE.Latest figures from the Universities and Colleges Admissions Service (UCAS) for 2025 show that acceptances to undergraduate nursing and midwifery courses at English providers have increased by 2% when compared to the same point last year, and by 5% compared to pre-pandemic numbers in 2019. These are not final numbers. The UCAS Clearing cycle closes in October.

What steps he is taking to help improve access to (a) podiatry and (b) physiotherapy services for patients with plantar fasciitis.

Integrated care boards (ICBs) are responsible for commissioning services to meet the needs of their local populations, which includes the provision of physiotherapy and podiatry services for the management of plantar fasciitis.NHS England does not hold condition-specific data that would allow identification of access issues for patients with plantar fasciitis. However, aggregate data on community health services, including physiotherapy and podiatry, is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/It is important to note that this data set does not include services delivered by acute providers. For information on waiting times for specific conditions, individual providers would need to be approached directly, although such data is unlikely to be routinely collected or reported at that level of detail.The Getting It Right First Time Musculoskeletal (MSK) Community Delivery Programme is funded by the Joint Department for Work and Pensions and Department of Health and Social Care Work and Health Directorate with a key objective being the reduction of waiting times for community MSK services. The programme is using a six-point plan, a handbook with case studies, and regular meetings with senior ICB officials to support 17 systems in the reduction of their waiting times. This programme is currently being evaluated with the aim of sharing lessons across the National Health Service.

What estimate his Department has made of the potential savings to the public purse following the introduction of the chickenpox vaccine programme.

The chickenpox vaccination programme is considered cost-effective and is expected to relieve pressures on health services that currently result from treating cases of chickenpox, saving the NHS an estimated £15 million a year in costs.The vaccination programme forms part of the Government’s wider ambition to raise the healthiest generation of children ever as part of our Plan for Change, boosting the nation’s health and ensuring the future sustainability of the NHS as we shift the focus of healthcare from treatment to prevention.

What estimate he has made of the number of NHS facilities using outdated radiator systems; and what plans he has to replace them with more efficient alternatives.

The Department has not made a specific assessment of the number of National Health Service facilities using outdated radiator systems. However, we continue to support efforts to modernise the secondary care estate and to address maintenance issues, including through investment in trust heating and energy systems. The Government’s recently published 10 Year Infrastructure Strategy set out ten-year maintenance budgets for the public estate, confirming £6 billion per year for maintenance and repair of the NHS estate up to 2034/35. In 2025/26, this includes a £750 million Estates Safety Fund which will deliver vital safety improvements, enhance patient and staff environments, and reduce disruptions to NHS clinical services, as well as over £4 billion in operational capital to be allocated to local needs. In addition, the Department for Energy Security and Net Zero has invested over £1 billion on NHS decarbonisation energy projects through the Public Sector Decarbonisation Scheme since 2019.

What steps he is taking with international regulatory bodies to harmonise the regulation of weight loss drugs.

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care and regulates medicine, medical devices and blood components for transfusion in the UK. The MHRA is responsible for ensuring medicines meet appropriate standards of safety, quality, and efficacy.Weight loss medicines, like all medicines, are regulated nationally, but global harmonisation happens through bodies like the International Committee for Harmonisation (ICH), which the MHRA is a full member of.The ICH guidelines include common standards for safety, efficacy, and quality. In addition, the World Health Organisation provides international norms.Differences remain in how countries balance risks and benefits, meaning access and approval of weight loss medications can still vary worldwide. This is so that each approval matches the pathway of care in their country.To support our post-marketing signal monitoring processes, the MHRA contributes to the International Post-Market Surveillance (IPMS) teleconference between the regulatory authorities in the US, Canada, Australia, New Zealand, Switzerland and Singapore. Each authority provides topics to discuss, and share information, which has on occasion included safety topics relating to weight loss medications.

What steps he has taken to ensure post-market surveillance of NHS-provided weight loss drugs to monitor their long-term effects in patients.

The newest obesity medicines, liraglutide, under various brand names, semaglutide, under the brand name Wegovy, and tirzepatide, under the brand name Mounjaro, have only been licensed and recommended for use for the treatment of obesity over the last few years. We recognise the need to collect long-term data on both the effectiveness and side effects of these medicines. The Medicines and Healthcare products Regulatory Agency (MHRA) continually monitors the safety of medicines during their use, including weight loss medications. The MHRA has robust safety monitoring and surveillance systems in place for all healthcare products.For example, although semaglutide and some other GLP-1 treatments have been used in the treatment of diabetes for some-time, semaglutide, when used for weight management, as well as newer medicines like tirzepatide are subject to more intense monitoring by the MHRA as part of its Black Triangle scheme.The MHRA also strongly encourages patients and healthcare professionals to continue reporting suspected side effects to GLP-1 medicines through its Yellow Card Scheme, which collects reports of suspected adverse effects for all healthcare products. In addition, NHS England is working with the National Institute for Health and Care Excellence, the MHRA, and academic partners to collect real world evidence on the use of tirzepatide in National Health Services. This includes monitoring prescribing patterns, patient outcomes, and long-term safety signals through existing national datasets and local system level services.These measures ensure that the benefits and risks of using medicines for weight management are kept under ongoing review, and that appropriate action can be taken if safety concerns arise.

How the Medicines and Healthcare products Regulatory Agency plans to improve the (a) monitoring and (b) reporting of adverse effects related to weight loss drugs; and what systems are in place to ensure that (i) patients and (ii) healthcare providers can report those effects.

The Yellow Card scheme collects reports of suspected adverse effects for all healthcare products including weight loss drugs. Reporting is open to all healthcare professionals and members of the public through a variety of methods including online, via the Yellow Card app, phone, email and paper forms. To make reporting as quick and easy as possible, there is also direct integration of Yellow Card reporting functionality available within some clinical IT systems. This includes covering over 93% of GP practices across England.To improve the quality of information captured on a Yellow Card report for weight loss medicines, we have recently introduced a number of additional questions to support ongoing monitoring of the safety of these products and rapid identification of potential safety issues.Reporting to the scheme is voluntary and therefore requires sustained efforts to promote and raise awareness of the scheme. To promote the reporting of side effects, a call to report side effects is included in all communications for weight loss medicines. For example, the Medicine and Healthcare products Regulatory Agency (MHRA) guidance on GLP-1 medicines contains several links to the Yellow Card Scheme, as do the Drug Safety Updates for healthcare professionals that the MHRA have published relating to these medicines. Reporting has also been encouraged on press releases issued on the illegal sales of GLP-1s and posts on the MHRA social media platforms (X, Instagram and Facebook).Alongside data collected through the Yellow Card scheme, the MHRA also monitors for adverse events through a variety of other data sources including scientific literature, epidemiological studies, regulatory reports from other countries, and periodic safety data submitted by pharmaceutical companies. All safety concerns are evaluated by our multidisciplinary teams and expert advisory groups, and where necessary, regulatory action is taken.