Written questions by Snowden.

Whether his Department plans to expand the Further Faster 20 programme.

The Further Faster 20 (FF20) initiative was announced in September 2024, run by the Getting It Right First Time (GIRFT) team in NHS England to deploy expert advice to National Health Service trusts in areas with the highest levels of economic inactivity to get patients treated faster. Data from October 2024 to August 2025 shows waiting lists across these areas have been reduced by over 66,000.Whilst there are currently no formal plans to expand the FF20 programme, key learnings have been taken from the FF20 work to date which are available to all trusts. This includes vital work on clinic template standardisation. An operational guide developed by GIRFT from FF20 trust engagement demonstrates to trusts across the country how they can unlock additional outpatient capacity and activity across relevant specialities. Work is ongoing to support trusts to adopt approaches outlined in this guidance.GIRFT is a national programme designed to improve the treatment and care of patients across more than 40 surgical and medical specialties, including diagnostics, day case surgery, outpatient services and clinical coding. GIRFT has already expanded its on-the-ground support to NHS trusts through the GIRFT Further Faster Urgent and Emergency Care (UEC) programme to support 20 acute providers in England strengthen UEC pathways ahead of the winter period.

What estimate he has made of the level of uptake of (a) flu, (b) RSV and (c) whooping cough vaccinations among pregnant women in Fylde constituency in the last 12 months.

The UK Health Security Agency (UKHSA) routinely monitors and reviews vaccination coverage of all routine immunisation programmes in England. UKHSA does not collect or publish data at constituency level and is therefore unable to provide these data. UKHSA publishes data for uptake of influenza, respiratory syncytial virus (RSV) and pertussis vaccinations for England at national and NHS commissioning region level. For pertussis and influenza, data are published by integrated care board level for Lancashire and South Cumbria.Flu vaccine uptake for pregnant women in Lancashire and South Cumbria integrated care board was 31.4% during the 2024 to 2025 flu season.RSV vaccine uptake for pregnant women is published for England at a national and NHS commissioning region level only. Uptake for women in the North-West region was 53.2%. The latest assessment for women delivering in May 2025 is available at the following link:https://www.gov.uk/government/publications/rsv-maternal-vaccination-coverage-in-englandPertussis vaccine uptake for pregnant women is published for England at a national and NHS commissioning region level only. Uptake for women in the North-West region was 66.2% and in Lancashire and South Cumbria integrated care board was 62.1%.The latest assessment for women delivering in June 2025 is available at the following link:https://www.gov.uk/government/publications/pertussis-immunisation-in-pregnancy-vaccine-coverage-estimates-in-england-october-2013-to-march-2014/prenatal-pertussis-vaccination-coverage-in-england-from-april-to-june-2025

What assessment his Department has made of trends in the level of gender disparities in the (a) diagnosis and (b) treatment of chronic urinary tract infections.

The National Institute for Health and Care Excellence’s guidance on prevalence suggests urinary tract infections are more common in women than in men, with men estimated to account for around 20% of all occurrences. Further information on factors related to incidence including those specific to gender is available at the following link:https://cks.nice.org.uk/topics/urinary-tract-infection-lower-men/background-information/prevalence/

What steps his Department is taking to help ensure that all pregnant women are routinely offered the whooping cough vaccine between 20 and 32 weeks of pregnancy.

The Department is working with NHS England and the UK Health Security Agency to encourage high uptake of all immunisations, including in underserved communities and in groups with historically lower vaccination rates.Significant efforts have been made to raise awareness of the importance of vaccination to protect babies against whooping cough, also known as pertussis. These include targeted campaigns using social media, digital screen graphics, and community outreach. The National Health Service actively promotes vaccination for pregnant women to protect their newborns, and efforts are underway to enhance the recording and monitoring of vaccinations, ensuring accurate data collection to assess the programme’s effectiveness.Recent data shows maternal pertussis vaccination coverage from April 2025 to June 2025 was 71.2%, which was 11.6 percentage points higher than the period from April 2024 to June 2024.However, there is more to do to stabilise and improve uptake, and that is why we have set out actions to improve uptake in our 10-Year Health Plan for England. Putting our plans into action, we have recently launched a campaign to promote awareness and confidence in vaccination, including for pregnant women, which will run throughout the year. To improve accessibility, community pharmacies in areas of high deprivation and low uptake are now also commissioned to offer some vaccinations, making it more convenient for individuals to get vaccinated.

What steps his Department is taking to help raise awareness among (a) general practitioners and (b) the public on the (i) signs and (ii) symptoms of aplastic anaemia.

The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community, which includes increasing awareness of rare diseases among healthcare professionals. With over 7,000 rare diseases, it is not possible for healthcare professionals to receive comprehensive training on every condition. It is therefore important that they are aware of rare diseases more broadly and are alert to considering them. The 2025 England Rare Diseases Action Plan updates on progress to increase awareness of rare diseases among healthcare professionals. This includes launching new resources on the innovative digital educational resource GeNotes and developing a range of training and educational resources on rare diseases to include rare diseases in UK health professional education and training frameworks.

What requirements are in place for (a) airlines, (b) rail services, (c) buses and (d) other public transport operators to carry adrenaline auto-injectors.

There are not any requirements for airlines, rail services, buses or public transport operators to carry adrenaline auto-injectors (AAIs). Guidance published in June 2023 by the Medicines and Healthcare products Regulatory Agency states that prescribers should prescribe two AAIs to make sure patients always have the second dose, and that those who are prescribed AAIs should always carry two AAIs at all times. There are a number of implications that would need to be given careful consideration if AAIs were to be located in public places or placed on airlines, rail services, buses and other public transport operators. For example, we would need to consider the impacts on supplies of AAIs for patients who are prescribed them.

Whether he has had recent discussions with medical researchers on the development of histotripsy treatments.

Histotripsy is a non-invasive ultrasound treatment that destroys tumours without the need for surgery or radiation. HistoSonics developed the Edison System to deliver histotripsy, and this was one of eight transformative technologies supported through the Government’s Innovative Devices Access Pathway pilot. This programme aimed to streamline patient access to medical devices that address an unmet clinical need in the National Health Service.In August 2024, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, met with clinicians and researchers at Leeds Teaching Hospitals NHS Trust to discuss their pioneering work in histotripsy research and trials, including the world’s first kidney tumour procedure and the HOPE4LIVER and CAIN studies.In June 2025, the Parliamentary Under-Secretary of State for Health and Social Care (Baroness Merron) met with clinicians and researchers at Cambridge University Hospitals to announce the conditional use of histotripsy in the NHS for patients with liver tumours. NHS treatments will begin in October 2025 as a first in Europe, strengthening the United Kingdom’s position as a global leader in medical innovation. The Government continues to work closely with clinical and research experts to accelerate evidence generation of this transformative technology.

If he will make an assessment of the effectiveness of histotripsy treatment in the NHS.

Early clinical evidence shows that histotripsy, a non-invasive focused ultrasound treatment, can safely and precisely destroy liver tumours without the need for surgery or radiation. Histotripsy remains under evaluation, and the Government continues to monitor real-world outcomes, including its effectiveness in the National Health Service. The Government is working with clinical and research experts to accelerate United Kingdom-based evidence generation to support wider NHS adoption of histotripsy.HistoSonics developed the Edison System to delivery histotripsy, and this was selected as one of eight transformative technologies supported through the Government’s Innovative Devices Access Pathway (IDAP) pilot, which streamlines patient access to medical devices addressing unmet clinical needs in the NHS.Through the IDAP, the Medicines and Healthcare products Regulatory Agency (MHRA) granted HistoSonics an Unmet Clinical Need Authorisation (UCNA), exempting the manufacturer from certain regulatory requirements under strict conditions, allowing early market access. This authorisation is reserved for technologies that address a critical unmet clinical need and demonstrate sufficient data for safety and early effectiveness, with evidence that the manufacturer is working towards full regulatory approval. The UCNA requires ongoing reporting to the MHRA to monitor safety and performance.

What steps his Department is taking to raise public awareness on (a) the signs of anaphylaxis and (b) the appropriate use of EpiPens.

Since October 2017, the Human Medicines (Amendment) Regulations 2017 has allowed all schools to buy adrenaline auto-injectors (AAIs) without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. The Department has published non-statutory guidance to accompany this legislative change, which is available at the following link:https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schoolsThis guidance advises schools on the recognition and management of an allergic reaction and anaphylaxis, and outlines when and how an AAI should be administered for pupils. The guidance makes clear that any AAIs held by a school should be considered as a spare device and not a replacement for a pupil’s own AAI. It also states that children at risk of anaphylaxis should have their own prescribed AAIs at school for use in an emergency, and that they should carry two devices at all times.There are many implications that would need to be given careful consideration if AAIs were to be located in public places such as shopping centres, sports venues, or transport hubs. For example, we would need to consider the impacts on the supplies of AAIs for patients who are currently prescribed them.In June 2023, the Medicines and Healthcare products Regulatory Agency (MHRA), with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and to provide advice on the use of AAIs. The MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs.Ambulance staff are trained in how to treat a range of conditions, including anaphylaxis. Treatment options may include a dose of adrenalin via a syringe or use of AAIs. The Community First Responder (CFR) programme enables volunteers trained by the ambulance service to attend certain types of emergency calls in the area where they live or work. CFRs have had first aid training but are not medically trained. CFRs are trained in the administration of a patient’s own AAI, which would ensure the correct medication and dose for that patient. In general, CFRs do not carry medication.

What assessment his Department has made of the adequacy of the availability of EpiPens in (a) schools, (b) shopping centres, (c) sports venues, (d) transport hubs and (e) other public places.

Since October 2017, the Human Medicines (Amendment) Regulations 2017 has allowed all schools to buy adrenaline auto-injectors (AAIs) without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. The Department has published non-statutory guidance to accompany this legislative change, which is available at the following link:https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schoolsThis guidance advises schools on the recognition and management of an allergic reaction and anaphylaxis, and outlines when and how an AAI should be administered for pupils. The guidance makes clear that any AAIs held by a school should be considered as a spare device and not a replacement for a pupil’s own AAI. It also states that children at risk of anaphylaxis should have their own prescribed AAIs at school for use in an emergency, and that they should carry two devices at all times.There are many implications that would need to be given careful consideration if AAIs were to be located in public places such as shopping centres, sports venues, or transport hubs. For example, we would need to consider the impacts on the supplies of AAIs for patients who are currently prescribed them.In June 2023, the Medicines and Healthcare products Regulatory Agency (MHRA), with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and to provide advice on the use of AAIs. The MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs.Ambulance staff are trained in how to treat a range of conditions, including anaphylaxis. Treatment options may include a dose of adrenalin via a syringe or use of AAIs. The Community First Responder (CFR) programme enables volunteers trained by the ambulance service to attend certain types of emergency calls in the area where they live or work. CFRs have had first aid training but are not medically trained. CFRs are trained in the administration of a patient’s own AAI, which would ensure the correct medication and dose for that patient. In general, CFRs do not carry medication.

What assessment his Department has been of the (a) long-term health outcomes and (b) quality of life of patients who have undergone treatment for aplastic anaemia.

No such assessment has been made. The majority of the treatment pathway for aplastic anaemia is an integrated care board commissioning responsibility and data is not held centrally. Hematopoietic stem cell transplant (HSCT) is a curative treatment option for aplastic anaemia. NHS England does not directly collect data on long-term outcomes and quality of life for patients with aplastic anaemia who have received a stem cell transplant. Instead, the British Society of Blood and Marrow Transplantation and Cellular Therapy collects data on transplants performed by United Kingdom transplant centres, and reports this back to the NHS England Blood and Marrow Transplantation Clinical Reference Group (CRG). This includes individual centre annual summary reports. These reports are reviewed by the CRG and insights from the analysis are shared with local commissioners so that they can address any issues with providers. However, HSCT is performed for a number of conditions and the CRG does not routinely review long-term outcomes for individual conditions at a granular level.

What assessment his Department has made of the adequacy of NHS treatment protocols for chronic urinary tract infections.

No specific assessment has been made by the Department. The National Health Service treats patients with recurrent urinary tract infections (UTIs) and chronic UTIs using the same care pathway until it becomes evident that symptoms are not resolving. The National Institute for Health and Care Excellence has published guidance for the NHS on the management of recurrent UTIs, which can be found at the following link:https://www.nice.org.uk/guidance/ng112

Whether first responders are (a) trained and (b) equipped to administer EpiPens in emergency situations; and what guidance is in place on their use.

Since October 2017, the Human Medicines (Amendment) Regulations 2017 has allowed all schools to buy adrenaline auto-injectors (AAIs) without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. The Department has published non-statutory guidance to accompany this legislative change, which is available at the following link:https://www.gov.uk/government/publications/using-emergency-adrenaline-auto-injectors-in-schoolsThis guidance advises schools on the recognition and management of an allergic reaction and anaphylaxis, and outlines when and how an AAI should be administered for pupils. The guidance makes clear that any AAIs held by a school should be considered as a spare device and not a replacement for a pupil’s own AAI. It also states that children at risk of anaphylaxis should have their own prescribed AAIs at school for use in an emergency, and that they should carry two devices at all times.There are many implications that would need to be given careful consideration if AAIs were to be located in public places such as shopping centres, sports venues, or transport hubs. For example, we would need to consider the impacts on the supplies of AAIs for patients who are currently prescribed them.In June 2023, the Medicines and Healthcare products Regulatory Agency (MHRA), with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and to provide advice on the use of AAIs. The MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs.Ambulance staff are trained in how to treat a range of conditions, including anaphylaxis. Treatment options may include a dose of adrenalin via a syringe or use of AAIs. The Community First Responder (CFR) programme enables volunteers trained by the ambulance service to attend certain types of emergency calls in the area where they live or work. CFRs have had first aid training but are not medically trained. CFRs are trained in the administration of a patient’s own AAI, which would ensure the correct medication and dose for that patient. In general, CFRs do not carry medication.

How much funding his Department has allocated to research on aplastic anaemia in each of the last five years.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health and care including aplastic anaemia.Applications to the NIHR 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. Topics for new research can be proposed to the NIHR at the following link:https://www.nihr.ac.uk/get-involved/suggest-a-research-topicThe NIHR has not allocated funding to research on aplastic anaemia in the last five years, neither directly nor through its research programmes or career development awards, because no applications were received that were deemed fundable by the NIHR.The NIHR also works closely with other Government funders, including UK Research and Innovation, which is funded by the Department for Science, Innovation and Technology and includes the Medical Research Council, to fund research into a range of conditions, including aplastic anaemia.

What assessment he has made of the link between untreated Urinary Tract infections and (a) mental confusion and (b) aggression in patients with neurological injuries.

Through the National Institute for Health and Care Research (NIHR), the Department has funded and supported multiple studies investigating urinary tract infections (UTIs), with some funded studies studying the link between UTIs and cognitive outcomes. For example, NIHR has funded the ‘IntraVESical Preparations for REcurrent Urinary Tract Infection Prevention’ (VESPER) study. This study aims to determine whether in-bladder treatments are more effective and cost-efficient than second-line oral antibiotics in reducing recurrent UTIs in women who have not responded to first-line preventative antibiotics. It will connect clinical outcomes with quality-adjusted life year (QALY)-based evaluations that take cognitive changes into account.NIHR infrastructure is also conducting relevant research that is investigating UTIs and considering cognitive outcomes. The NIHR Southampton Biomedical Research Centre, is leading the ‘DIagnoSing Care hOme UTI’ (DISCO UTI) study which is investigating new ways to accurately diagnose and treat UTIs in care homes, as UTIs can cause symptoms like confusion, resulting in difficulties when diagnosing UTIs in care home residents.

What steps his Department is taking to ensure safe staffing levels at The Harbour mental health facility in Blackpool.

As of July 2025, the Lancashire and South Cumbria NHS Foundation Trust’s in-patient settings achieved a fill rate of above 90% for planned rostered hours, as clinically required. Fill rates are a key metric for monitoring whether enough staff are available to meet patient needs.The trust is also required to report care hours per patient day monthly. The most recent figures for the trust and Harbour hospital were 12.9, and 16 respectively. This is above the national average of 9, and the highest out of all mental health trusts in the North West region.Nationally, the Government has also committed to recruiting an additional 8,500 mental health workers by the end of this Parliament, to ease pressure on busy mental health services. We are more than halfway towards our target.

What support is available for NHS mental health staff who are injured at work or absent due to work-related stress.

The health and wellbeing of National Health Service staff is a top priority, including those who work in mental health settings. It is important that employers across the NHS take a preventative and proactive approach to supporting their staff and keeping them healthy. At a national level, NHS staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health and wellbeing support, including for trauma and addiction. The 10-Year Health Plan aims to significantly reduce sickness absence rates. We will introduce a new set of staff standards for modern employment which will ensure employers support staff to work healthily and flexibly. We will also roll out Staff Treatment hubs, starting in 2027, to ensure staff have access to high quality support for mental health and back conditions.

What recent assessment his Department has made of the potential impact of staffing shortages on patient and staff safety in psychiatric wards in Lancashire and South Cumbria NHS Foundation Trust.

As of July 2025, the Lancashire and South Cumbria NHS Foundation Trust’s in-patient settings achieved a fill rate of above 90% for planned rostered hours, as clinically required. Fill rates are a key metric for monitoring whether enough staff are available to meet patient needs.The trust is also required to report care hours per patient day monthly. The most recent figures for the trust and Harbour hospital were 12.9, and 16 respectively. This is above the national average of 9, and the highest out of all mental health trusts in the North West region.Nationally, the Government has also committed to recruiting an additional 8,500 mental health workers by the end of this Parliament, to ease pressure on busy mental health services. We are more than halfway towards our target.

What recent discussions his Department has had with the Nursing and Midwifery Council on the balance of academic and practical training in nurse education programmes.

No recent discussions have taken place. Higher education institutions and practice placement providers develop the content of programmes and determine the balance of academic and practical learning in line with the outcome standards set by the Nursing and Midwifery Council (NMC).Nursing students are required to complete 2,300 hours of practice learning as part of their pre-registration programme, 600 of which can be completed through simulated training. The NMC is currently conducting a review of nursing and midwifery practice learning requirements.

What steps his Department is taking to ensure childcare policy supports the recruitment and retention of student nurses as part of the NHS Long Term Workforce Plan, updated on 22 April 2024.

The Department for Education provides the primary funding support package for English domiciled students in higher education through the student loans system. Eligible students can also apply for the Childcare Grant and Parents’ Learning Allowance.The Department of Health and Social Care provides eligible healthcare students, including student nurses, with supplementary, non-repayable support via the NHS Learning Support Fund (LSF). This includes a £5,000 training grant for all students eligible for the LSF and a further £2,000 per academic year for those students with childcare responsibility. These funding arrangements are reviewed annually ahead of the start of each academic year.We will publish a 10 Year Workforce Plan (10YWP) to create a workforce ready to deliver a transformed service. This 10YWP 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.