Written questions by Snowden.

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, 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.

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 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 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.

What steps his Department is taking to support the mental health needs of unpaid carers.

The Government is committed to ensuring that families have the support that they need. We want to ensure that people who care for family and friends are better able to look after their own physical and mental health and wellbeing.We have invested in expanding and transforming National Health Service mental health services with a focus on improving mental health support for individuals and carers.Carers experiencing common mental health conditions, including depression and anxiety, can self-refer to NHS Talking Therapies services or can be referred by their general practitioner. In addition, carers experiencing a mental health crisis can speak to a trained NHS professional at any time through the mental health option on NHS 111. This service gives people the chance to be listened to by a trained member of staff who can help direct them to the right place.We are also recruiting 8,500 more mental health workers, expanding mental health support teams to cover 100% of pupils by 2029/30, introducing community-based Young Futures hubs, and modernising the Mental Health Act.Further, we have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will start a national conversation about what care and support working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers, who provide vital care and support.

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.

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.

What steps his Department is taking to improve access to respite care for unpaid carers.

The Government is committed to ensuring that families have the support they need. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers.The Better Care Fund includes funding that can be used for carer support, including short breaks and respite services. Local areas determine how the money is best used to support carers, depending on local need and with reference to their statutory responsibilities.

What data his Department holds on disparities in diabetes outcomes in different regions of (a) England and (b) Wales.

NHS England, through the National Diabetes Audit (NDA), collects and publishes comprehensive data on diabetes care and outcomes across England. The NDA is a national clinical audit that measures the effectiveness of diabetes healthcare against National Institute for Health and Care Excellence (NICE) clinical guidelines and quality standards. It is a key resource for identifying and addressing regional disparities in diabetes services.The most recent NDA annual report, for 2023/24, was published 12 December 2024 and is available at the following link:https://digital.nhs.uk/data-and-information/clinical-audits-and-registries/national-diabetes-audit/dashboardsData can be viewed at national, regional, integrated care board, primary care network and practice level. An example of data that can be viewed at regional level is the proportion of people receiving all eight NICE-recommended care processes. In 2023/24, 47.2% of people with type 1 diabetes in England received all eight processes. The same year, 62.4% of people with type 2 diabetes in England received all eight care processes. Regional performance varies for both type 1 and type 2 diabetes. For instance, the highest achieving regional area saw completion of type 2 eight care processes at 72.2% and the lowest 58.5%. A further example is diabetes prevalence and variation between the least and most deprived quintiles. The audit reports a general practitioner-recorded prevalence of type 2 diabetes of approximately 3.5 million adults in England, with data showing that 23.6% of this cohort are in the most deprived quintile, compared to 15% in the least deprived quintile.The NDA collects and publishes some data from Wales, which is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit/complications-and-mortality-2009-2023

What steps he is taking to retain workers in the health system.

The Government is committed to making the National Health Service the best place to work, to ensure the retention of our hardworking and dedicated staff. We will publish a refreshed workforce plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.NHS England is leading work nationally through its retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

What steps he is taking to support people with motor neurone disease in Fylde constituency.

Integrated care boards (ICBs) are responsible for commissioning most services for people with long-term conditions, including motor neurone disease (MND) services. ICBs are allocated funding by NHS England to meet local need and priorities, and improve outcomes. The NHS Lancashire and South Cumbria ICB oversees healthcare services in the region, including in the Fylde area. NHS England continues to set national standards, service specifications, and clinical access policies, which ICBs are expected to apply.At the national level, there are several initiatives supporting service improvement and better care for patients with MND, including those patients in the Fylde constituency. These initiatives include the Getting It Right First Time Programme for Neurology and the RightCare Progressive Neurological Conditions Toolkit. NHS England has also established a Neurology Transformation Programme, a multi-year, clinically led programme, which has developed a new model of integrated care to support ICBs to deliver the right service, at the right time for all neurology patients, including those with MND.NHS England commissions the specialised elements of MND care that patients may receive from 27 specialised neurology centres across England. Within these specialised centres, neurological multidisciplinary teams ensure that patients can access a range of health professionals and specialised treatment and support, according to their needs.Government responsibility for delivering MND research is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation, and Technology, with research delivered via UK Research and Innovation. Government funders are continuing to invest into MND research, for example: investing £12.5 million to support the best discovery science in MND at the UK Dementia Research Institute; £6 million of Government funding for the Motor Neurone Disease Translational Accelerator, which is seeking to speed up the development of treatments for MND; and £8 million investment into EXPERTS-ALS, which screens for drugs that have the potential to be successful in clinical trials for people with MND.

What steps his Department is taking to help tackle health inequalities impacting children in poverty in Fylde constituency.

The United Kingdom faces significant health inequalities, with healthy life expectancy varying widely across and between communities. Through our Health Mission, we are focused on addressing the wider determinants of health to improve healthy life expectancy for all and to halve the gap in healthy life expectancy between different regions of England.The Department is working closely with the Child Poverty Taskforce to develop and deliver an ambitious strategy to reduce child poverty, tackle the root causes, and give every child, including those in Fylde constituency, the best start in life. This will help fulfil our ambition to raise the healthiest generation of children ever. An important part of this will be alleviating the negative experience of living in poverty through supporting families and enhancing public services.The Office for Health Improvement and Disparities’ North West Regional Team is working to provide system leadership for population health and for reducing health inequalities across the North West, including the Fylde constituency.