Written questions by Snowden.

If he will publish the cost-benefit modelling for the prescription of (a) donanemab and (b) lecanemab for patients with early-stage Alzheimer’s disease.

The National Institute for Health and Care Excellence has published the company’s evidence submission, which includes the company’s evidence on costs and benefits, and the external assessment group report, which assesses the company’s evidence submission as part of the papers that were considered by the independent Appraisal Committee. Information that is commercially confidential has been redacted.The economic models themselves cannot be published because they contain commercially confidential information. The papers for lecanemab are available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ta11220/documentsIn addition, the papers for donanemab are available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ta11221/documents.

Whether he has made an assessment of the capacity of care settings to cope with extreme heat in (a) Fylde constituency and (b) Lancashire.

The Care Quality Commission (CQC) is the independent regulator with oversight of quality and safety in health and care settings. Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014 compels providers to assess the risks to the health and safety of service users receiving the care or treatment and to do all that is reasonably practicable to mitigate any such risks. This includes having an appropriate assessment of environmental risks, such as extreme heat events.The CQC would expect providers to follow national guidance on extreme heat safety and to follow any relevant heat alerts when these are issued.

If he will make an assessment of the adequacy of communications in issuing heat alerts.

The UK Health Security Agency (UKHSA) operates a Weather Health Alerting (WHA) system in partnership with the Met Office, as part of its Adverse Weather and Health Plan (AWHP) for the health and social care sector. The UKHSA publishes annual reports which contain an assessment of the AWHP’s performance, including communication. The UKHSA collaborates with academic partners to assess how communications are received, and how guidance is utilised. The WHA system has approximately 35,000 subscribers. The UKHSA undertakes communication activity with the Met Office to ensure that the health system and the public are aware of periods of hot weather, the health risks of heat, and what action they should take. The UKHSA issues proactive communications for the first Heat Health Alert of any summer, and whenever an amber or red alert is issued.

What steps he is taking to help tackle (a) stigma and (b) discrimination against people with Down syndrome.

The Government is committed to championing the rights of disabled people, including people with Down syndrome. We are taking action to break down barriers to opportunity for people with Down syndrome and to raise awareness and understanding of their needs through the implementation of the Down Syndrome Act 2022. The act requires my Rt Hon. Friend, the Secretary of State for Health and Social Care to give statutory guidance to the relevant authorities regarding the appropriate actions they should be taking to support the needs of people with Down syndrome.We are taking forward the development of the draft statutory guidance as a priority and expect to publish it for public consultation this autumn. The draft guidance will set out the existing protection from discrimination for disabled people under the Equality Act, which applies to people with Down syndrome.Under the Health and Care Act 2022, from 1 July 2022, Care Quality Commission registered providers are required to ensure their staff receive specific training on learning disability and autism appropriate to their role. This will help to ensure that staff have the right knowledge and skills to provide safe and informed care. We have published a Code of Practice to guide providers on how to meet this requirement.

What recent steps his Department has taken to improve early diagnosis and support for children born with Down syndrome in (a) Fylde constituency and (b) Lancashire.

Pregnant people will be offered a screening test for Down syndrome between 10 and 14 weeks of pregnancy. If the screening test shows that the chance of the baby having Down syndrome is higher than one in 150, this is called a higher-chance result. People who receive a higher-chance result can decide to:not have any further testing;have a second screening test called a non-invasive prenatal testing, which is a blood test that can give a more accurate screening result, and can help people to decide whether to have a diagnostic test or not; andhave a diagnostic test, such as amniocentesis or chorionic villus sampling straight away, which tells people for certain whether or not their baby has Down syndrome, but in rare cases can cause a miscarriage.We are taking action to improve access to services for people with Down syndrome and to raise awareness and understanding of their needs through implementation of the Down Syndrome Act 2022. The act requires my Rt Hon. Friend, the Secretary of State for Health and Social Care to give statutory guidance to the relevant authorities regarding the appropriate actions they should be taking to support the needs of people with Down syndrome.We are taking forward the development of the statutory guidance as a priority and expect to publish it for public consultation this autumn. The guidance will help to clarify the help and services people with Down syndrome can expect to receive. The draft guidance will set out the process for diagnosing Down syndrome, and the support that health services should provide to a parent carrying a baby with Down syndrome.The draft guidance will also raise awareness of the needs of children with Down syndrome in relation to health, social care, and education, and will set out practical steps that organisations should take to meet these needs.

What support his Department is providing to people with Alzheimer's disease in (a) Fylde constituency and (b) Lancashire.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.A review of the currently commissioned dementia post diagnostic support service for Lancashire and South Cumbria took place in 2023/24. The outcome of the review was a newly designed service specification, ensuring a consistent service model for all individuals who receive a diagnosis of dementia and who are currently living with dementia, and their carers, from point of diagnosis to end of life.Under this new service, individuals will be systematically referred upon diagnosis into a post diagnostic support service and will then be contacted by a named dementia navigator who will be the contact for the individual throughout their journey with dementia.Additionally, the Government’s 10-Year Health Plan will address the challenges diagnosed by Lord Darzi and will set the vision for what good joined-up care looks like for people with a combination of complex health and care needs. It will set out how we support and enable health and social care services to work together better to provide that joined-up care.

What recent assessment his Department has made of trends in the level of demand for adult ADHD assessments in (a) Fylde constituency and (b) Lancashire.

Lord Darzi’s independent review of the National Health Service, published September 2024, highlighted that demand for assessments for attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that there are severe delays for accessing ADHD assessments.For the first time, NHS England published management information on ADHD waits at a national level on 29 May 2025 as part of its ADHD data improvement plan, which has also released technical guidance to integrated care boards (ICBs) to improve the recording of ADHD data, with a view to improving the quality of ADHD waits data and publishing more localised data in future. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.NHS England has established an ADHD taskforce which is bringing together those with lived experience with experts from the NHS, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim report was published on 20 June, with the final report expected in the summer.

What steps his Department is taking to improve access to effective (a) treatment and (b) support for people experiencing chronic insomnia in (i) Fylde and (ii) Lancashire.

It is for the NHS Lancashire and South Cumbria Integrated Care Board to decide what treatments and support for insomnia are offered to its local population, including people living in Fylde. NHS Talking Therapies for anxiety and depression offers low-intensity therapy, including cognitive behavioural therapy (CBT), which may include interventions around sleep hygiene. Individuals who are experiencing symptoms of anxiety and/or depression can be referred by their general practitioner, or can self-refer to NHS Talking Therapies via the following link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/ Individuals can also access helpful resources on sleep problems on the Every Mind Matters website, at the following link: https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/ In addition, the National Institute for Health and Care Excellence’s Prioritisation Board has agreed to prioritise digital technologies that deliver CBT interventions for insomnia and insomnia symptoms as a topic for the development of HealthTech guidance.

What steps he has taken to reduce average diagnosis times for endometriosis; and what plans he has to meet the Women’s Health Strategy targets.

It is unacceptable that women can wait up to 10 years for an endometriosis diagnosis and the Government is committed to improving the diagnosis, treatment, and ongoing care for gynaecological conditions, including endometriosis.Tackling waiting lists is a key part of our Health Mission. We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, having now delivered over three million more appointments.In November 2024, the National Institute for Health and Care Excellence updated its guideline on the diagnosis and management of endometriosis to make firmer recommendations on referral and investigations, which will help women receive a diagnosis and effective treatment faster. This includes updated recommendations that for women with symptoms of endometriosis, initial pharmacological treatment should take place in primary care, and that this can take place in parallel with additional investigations and referral to secondary care if needed. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng73The Government’s focus is on turning the commitments in the Women's Health Strategy into tangible action, such as providing emergency hormonal contraception free of charge at pharmacies on the National Health Service from October 2025, taking urgent action to tackle gynaecology waiting lists through the Elective Reform Plan, and setting out how we will eliminate cervical cancer by 2040 through the new cervical cancer plan.

If he will extend access to cardiovascular screening to people under 40 with a family history of heart disease.

The NHS Health Check is a core component of England’s cardiovascular disease (CVD) prevention programme, which assesses the risk factors for CVD in people aged 40 to 74 years old, provides advice on how to reduce the risk of developing CVD, and refers people to behaviour support programmes, clinical assessment, and treatment where appropriate.As part of ongoing reviews to ensure the programme remains evidence based, we are assessing the evidence for expanding eligibility to people under 40 years of age. This work will inform the ongoing policy for the NHS Health Check programme.

What support his Department offers to local NHS charities.

The Department does not provide support to local National Health Service charities.

Whether he plans to build more community diagnostic centres.

The Elective Reform Plan, published on 6 January 2025, sets out that we will deliver additional community diagnostic centre (CDC) capacity in 2025/26 by expanding several existing CDCs and building up to five new ones, as well as increasing the number of CDCs offering services 12 hours a day, seven days a week.NHS England is working with local National Health Service systems to identify the most appropriate locations for additional investment, including new CDCs. New CDCs should be positioned in a location that addresses local need and health inequalities. Details of future sites will be set out in due course.£1.65 billion of capital funding has been made available in 2025/26 for secondary and emergency care, which includes £0.6 billion for investment in diagnostics. This will enable the NHS to expand existing CDCs and build new CDCs as part of our Elective Reform Plan. It will also enable the completion of 2024/25 schemes.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective and urgent care capacity, including the £1.65 billion investment already announced. Further details and allocations will be set out in due course.

Pursuant to the Answer of 12 June 2025 to Question 56537 on Long Covid, whether his Department is taking steps to help ensure equitable access to long COVID (a) diagnosis and (b) treatment services in (i) rural and (ii) coastal Lancashire.

Since April 2024, the commissioning of long COVID services has been the responsibility of local integrated care boards, following the closure of the national long COVID programme. For the Fylde constituency, and Lancashire more widely, this is the Lancashire and South Cumbria Integrated Care Board.From 1 May 2025, the long COVID services in Lancashire and South Cumbria will no longer be commissioned as stand-alone services. These services have now closed to new referrals, and the way in which patients with long COVID access support will change.Anyone currently accessing the long COVID service in Lancashire and South Cumbria will be contacted directly by their provider to let them know what will happen next and how they can continue to be supported.People with long COVID symptoms should see their general practitoner, who will be able to refer them to alternative existing services depending on their clinical needs.Examples of alternative services, dependent on individual patient need, include:talking therapies;pain management services;respiratory/pulmonary rehabilitation services; andcommunity therapies, such as occupational therapy and physiotherapy.Referrals can also be made to:other specialties, including cardiology, rheumatology, gastroenterology, neurology;local wellbeing and support organisations; andlocal social prescribing services.

Pursuant to the Answer of 30 May 2025 to Question 55130 on Farmers: Mental Health Services, will the national network of Young Futures hubs include rural-focused outreach to help tackle the challenges faced by young people growing up in farming families.

National Health Service metrics and evaluation frameworks set up to measure effectiveness in mental health services do not specifically assess interventions in farming communities. NHS England currently publishes access and waiting time metrics in line with national standards for NHS Talking Therapies, children and young people with an eating disorder and Early Intervention in Psychosis. In addition, since July 2023, NHS England has included waiting times metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication to increase transparency and drive improvements in the quality of data and help services to target the longest waits. We have confirmed our commitment to recruit an additional 8,500 additional mental health staff by the end of the Parliament. We continue to work with NHS England to consider options to deliver this commitment alongside a refreshed workforce plan, to deliver the transformed health service we will build over the next decade. There are a wide range of factors that will affect this future growth of the NHS mental health workforce, and we will provide an update in due course. With regard to the roll out Young Futures hubs in communities in England, these will be designed with local areas, leveraging local understanding of services in each area. Young Futures Hubs will develop from existing buildings and provision, identified by local areas. This will make best use of existing local assets and the successes of existing provision, partnerships and support.

Pursuant to the Answer of 12 June 2025 to Question 55130 on Farmers: Mental Health Services, what (a) metrics and (b) evaluation frameworks are being used to assess the effectiveness of current mental health interventions in farming communities.

National Health Service metrics and evaluation frameworks set up to measure effectiveness in mental health services do not specifically assess interventions in farming communities. NHS England currently publishes access and waiting time metrics in line with national standards for NHS Talking Therapies, children and young people with an eating disorder and Early Intervention in Psychosis. In addition, since July 2023, NHS England has included waiting times metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication to increase transparency and drive improvements in the quality of data and help services to target the longest waits. We have confirmed our commitment to recruit an additional 8,500 additional mental health staff by the end of the Parliament. We continue to work with NHS England to consider options to deliver this commitment alongside a refreshed workforce plan, to deliver the transformed health service we will build over the next decade. There are a wide range of factors that will affect this future growth of the NHS mental health workforce, and we will provide an update in due course. With regard to the roll out Young Futures hubs in communities in England, these will be designed with local areas, leveraging local understanding of services in each area. Young Futures Hubs will develop from existing buildings and provision, identified by local areas. This will make best use of existing local assets and the successes of existing provision, partnerships and support.

Pursuant to the Answer of 12 June 2025 to Question 56537 on Long Covid, how many long COVID clinics are operational in (a) Fylde constituency and (b) Lancashire; and he plans to open further clinics in 2025.

Since April 2024, the commissioning of long COVID services has been the responsibility of local integrated care boards, following the closure of the national long COVID programme. For the Fylde constituency and Lancashire more widely, this is the Lancashire and South Cumbria Integrated Care Board (ICB).From 1 May 2025, the long COVID services in Lancashire and South Cumbria will no longer be commissioned as stand-alone services. These services have now closed to new referrals, and the way in which patients with long COVID access support will change.This decision was taken by the ICB on 26 March 2025 due to a significant drop in referrals, and a change to the national funding from 1 April 2025.The average number of referrals per month over the last 12 months across Lancashire and South Cumbria was 47. This is in comparison to an average of 72 referrals per month in 2023, 146 per month in 2022 and 172 per month in 2021.Anyone currently accessing the long COVID service in Lancashire and South Cumbria will be contacted directly by their provider to let them know what will happen next and how they can continue to be supported.People with long COVID symptoms should see their general practitioner, who will be able to refer them to alternative existing services depending on their clinical needs.

Pursuant to the Answer to Question 55130 on Farmers: Mental Health Services, what steps he is taking to help ensure that rural agricultural communities have equitable access to the 8,500 new mental health support workers.

National Health Service metrics and evaluation frameworks set up to measure effectiveness in mental health services do not specifically assess interventions in farming communities. NHS England currently publishes access and waiting time metrics in line with national standards for NHS Talking Therapies, children and young people with an eating disorder and Early Intervention in Psychosis. In addition, since July 2023, NHS England has included waiting times metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication to increase transparency and drive improvements in the quality of data and help services to target the longest waits. We have confirmed our commitment to recruit an additional 8,500 additional mental health staff by the end of the Parliament. We continue to work with NHS England to consider options to deliver this commitment alongside a refreshed workforce plan, to deliver the transformed health service we will build over the next decade. There are a wide range of factors that will affect this future growth of the NHS mental health workforce, and we will provide an update in due course. With regard to the roll out Young Futures hubs in communities in England, these will be designed with local areas, leveraging local understanding of services in each area. Young Futures Hubs will develop from existing buildings and provision, identified by local areas. This will make best use of existing local assets and the successes of existing provision, partnerships and support.

What plans his Department has to ensure that local authorities meet statutory duties on carer assessments under the Care Act 2014.

Local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers.To ensure local authorities are delivering adult social care to an acceptable standard, the Care Quality Commission (CQC) is assessing how local authorities in England are delivering their duties under Part 1 of the Care Act 2014, including their duties relating to unpaid carers. This means that the CQC is looking at how all 153 local authorities with adult social care responsibilities are conducting carers needs assessments and supporting unpaid carers in their area. To date, the CQC has published over 40 formal assessments, with ratings of Outstanding, Good, and Requires Improvement.

How many and what proportion of eligible families are receiving support through the Healthy Start scheme in (a) Fylde and (b) Lancashire.

The NHS Business Services Authority (NHSBSA) operates the Healthy Start scheme on behalf of the Department. Monthly figures for the number of people on the digital Healthy Start scheme are published on the NHS Healthy Start website, at the following link:https://www.healthystart.nhs.uk/healthcare-professionals/The NHSBSA does not hold data on the number of families receiving Healthy Start and does not currently hold the data on the number of people eligible for Healthy Start. The following table shows the number of people on the digital scheme as of 23 May 2025 in Fylde:Local authorityNumber of people on the digital schemeFylde304 In addition, the following table shows the number of people on the digital scheme in the local authorities within Lancashire:Local authorities within LancashireNumber of people on the digital schemeBurnley1014Chorley489Fylde304Hyndburn870Lancaster774Pendle782Preston1109Ribble Valley98Rossendale410South Ribble409West Lancashire610Wyre510

What assessment he has made of the potential impact of the covid-19 pandemic on the (a) management and (b) outcomes of people with diabetes in (i) Fylde constituency and (ii) Lancashire.

Annual diabetes reviews are associated with reduced emergency admissions, amputations, retinopathy, and mortality. Following a significant decrease in routine care delivery that was associated with the pandemic, the proportion of people with type 1 diabetes receiving all eight care processes in England had recovered back to 43.3%, and 62.3% for type 2 diabetes, in 2023/24, compared to 27% and 37%, respectively, in 2020/21. Information has been provided at the national level as it is not available at the constituency level.NHS England is supporting integrated care boards (ICBs), including Lancashire and South Cumbria ICB, to improve treatment and care for their populations and reduce variation by supporting systems’ awareness of national data and insights, through benchmarking and by promoting good practice. NHS England has provided £3 million of funding to systems to provide clinical leadership to ensure that clinical diabetes metrics, such as care processes and treatment targets, are reviewed at an ICB level, so that unwarranted variation can be identified. A resource hub of materials has been set up on Future NHS, which includes examples of innovation and best practice for the improvement of care process delivery, and for the achievement of treatment targets.