Written questions by Snowden.

What estimate he has made of the number of vacancies for newly qualified midwives in the North West of England.

The Department does not hold information on the number of vacancies for newly qualified midwives in the Northwest of England.

If he will make an estimate of the number of appointments that were cancelled as a result of doctor strikes in Lancashire.

On 22 March 2026, the Government made a formal offer to the British Medical Association (BMA) Resident Doctors Committee (RDC) to seek to resolve their dispute. This was the product of joint negotiation with the BMA RDC officers. This offer was rejected by the committee on 25 March and the BMA RDC immediately called industrial action for 7 to 13 April 2026. In the last year, the BMA RDC have called four rounds of strike action in England.NHS England records the number of rescheduled appointments and workforce absences during strike actions, including those in Lancashire. The latest data for April is pending, but data on the from the previous three rounds in 2025 is available at the following link:https://www.england.nhs.uk/publication/preparedness-for-potential-industrial-action-in-the-nhs/Due to the dedication of National Health Service staff, the NHS delivered almost 95% of planned activity during the five days of strike action in December 2025, similar to the levels of activity during the November strikes and surpassing levels in July.

Whether he plans to introduce safeguards to ensure that patients presenting with symptoms indicative of serious conditions, including heart arrhythmias, are prioritised appropriately in GP triage systems.

General practices (GPs) are independent contractors to the National Health Service and are responsible for the safe operation of their appointment and triage arrangements, including ensuring that patients with symptoms suggestive of any serious conditions are identified and prioritised appropriately.It is for individual practices to decide how triage systems are configured and overseen within local workflows, and we are clear that GPs must be able to exercise their own clinical judgement when triaging patients, so that those with potentially serious symptoms are identified promptly and directed to the right care.

What estimate he has made of the cost to the health service of injuries related to accidents involving hire e-bikes in the last 12 months.

The information requested is not collected centrally and no such estimate has been made by the Department.

What recent discussions he has had with NHS England on improving continuity of care between secondary care and primary care following A&E attendance.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, set out clear ambitions as part of the 10-Year Health Plan around moving the National Health Service from analogue to digital, harnessing technology to allow patients to better manage their own care. The Medium Term Planning Framework reiterates this focus, including achieving full compliance with the minimum standards set out in the Digital Capabilities Framework.NHS England is supporting integrated care boards and providers to improve information sharing and coordination at discharge from urgent and emergency care, so primary care teams have timely access to relevant clinical information and can arrange appropriate follow‑up.This includes continued rollout of the NHS Federated Data Platform, which supports integrated care systems to connect data across urgent, acute, and community services, helping to improve care transitions and follow‑up after accident and emergency attendance.We are continuing to work across Government to cut red tape and improve ways of working, including work to improve the patient experience at the interface of primary and secondary care.

What assessment he has made of the adequacy of the accessibility of GP appointment systems for patients who do not have access to the internet.

We understand that not all patients have access to or want to use online services. The GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a general practice (GP).The 2026/27 GP Contract includes a new requirement for practices to enable online appointment requests throughout the duration of core opening hours, which will ease the pressure on phone lines for people who prefer to telephone.The Office for National Statistics’ Health Insight Survey from March 2026 shows that 73.7% of patients reported it was “easy” to contact their GP, up from 60.9% in July 2024.

What steps his Department is taking to protect young people in (a) Fylde and (b) Lancashire from Meningitis B.

Meningococcal disease is an uncommon but serious disease caused by meningococcal bacteria. The MenACWY vaccine offers good protection against several strains of meningococcal disease and is routinely offered to teenagers in school years 9 and 10. However, it does not protect against all strains. Other strains, such as Meningitis B (MenB), can circulate among young adults. From 2015, the MenB vaccine has been available on the National Health Service as part of routine childhood immunisations, but most students would not be vaccinated.The importance of raising awareness in parents, teenagers, and other adults about the signs and symptoms of meningitis and septicaemia remains key. There are a range of resources developed by the UK Health Security Agency (UKHSA), co-branded with the NHS, that set out these key messages and their importance, such as the teenage guide to immunisation. The guide is available at the following link:https://www.gov.uk/government/publications/immunisations-for-young-peopleThe UKHSA collaboratively produces a university vaccine communications toolkit. This is shared with the distribution lists of Universities UK and the Association of Managers of Student Services in Higher Education, and is available at the following link:https://find-public-health-resources.service.gov.uk/University%20vaccine%20communications%20toolkit/UNI24In addition, United Kingdom guidance on the public health management of meningococcal disease provides clear advice on the management of confirmed and probable cases of invasive meningococcal disease, including MenB, to minimise onward transmission and further associated cases. This guidance is available at the following link:https://www.gov.uk/government/publications/meningococcal-disease-guidance-on-public-health-management

How many members of the NHS Pension Scheme who retired since April 2021 are awaiting revised pension calculations or backdated payments as part of the McCloud remedy.

The Department recognises the importance of providing NHS Pension Scheme members certainty about when they will receive their McCloud Remediable Service Statements.The current number of members who have retired since April 2021 and are awaiting a Remediable Service Statement that will show their choice of pension benefits is 209,989.The current number of members who have received their Remediable Service Statements and have made their choice and are awaiting backdated payments is 116.An independent review of the NHS Business Service Authority’s revised plans for the delivery of the McCloud remedy for NHS Pension Scheme members is ongoing. The independent review team is expected to assess this revised delivery plan shortly. Subject to the review team's assurance, we intend to issue new deadlines for the administration of remedy statements and update the House in May 2026.In the meantime, the authority continues to provide Remediable Service Statements to affected members, prioritising those who may be most affected by the discrimination highlighted by the McCloud judgment. Additionally, members who meet specific criteria can request to receive a prioritised Remediable Service Statement. More information is available at the following link:https://www.nhsbsa.nhs.uk/public-service-pensions-remedy-mccloud/making-your-decision-about-your-nhs-pension-benefitsThe Government is committed to ensuring that affected members are not subject to financial disadvantage due to these delays. Pension arrears arising from the McCloud remedy are paid with 8% interest, and a compensation scheme is available for members who have experienced other direct financial losses.

Whether his Department plans to establish a national clinical pathway for the diagnosis and management of craniocervical instability in patients with Ehlers-Danlos syndrome.

Decisions on the development of clinical pathways, the commissioning of services, and the configuration of specialist diagnostics remain the responsibility of local integrated care boards, which are best placed to assess local population needs and ensure access to appropriate expertise and investigations.For patients with suspected craniocervical instability (CCI), the National Health Service already supports clinical assessment through neurology, neurosurgery, rheumatology, and specialist pain services, depending on presenting symptoms and co‑existing conditions such as Ehlers-Danlos syndrome (EDS). Where clinically appropriate, patients may be referred for imaging through NHS diagnostic pathways, in line with national evidence‑based guidance. Specialist review is arranged based on the judgement of the responsible NHS clinicians.Access to magnetic resonance imaging and other diagnostic imaging continues to expand through the Government’s wider programme of community diagnostic centres, which is increasing capacity across England and supporting earlier identification of complex conditions, such as CCI, as part of the 10‑Year Health Plan.For these reasons, the Department has no current plans to establish a national clinical pathway specifically CCI, including in patients with EDS.

Whether he intends to use powers in the Tobacco and Vapes Bill to prohibit the sale of vaping devices designed to operate with refill containers that, when attached, resulting in a total liquid capacity exceeding 2ml.

The Tobacco and Vapes Bill will stop vapes and nicotine products from being deliberately branded, promoted, and advertised to children and will provide the Government with new powers to restrict the packaging, device appearance, and display of vapes and other nicotine products to stop the next generation from becoming hooked on nicotine.On 8 October 2025, we launched a Call for Evidence which sought evidence on the size and shape of vapes, vape tanks, and the components of vaping products, including pods, puff-count capacity, and nicotine delivery.We are now reviewing the responses, and these will help inform decisions around our future regulatory approach once the Tobacco and Vapes Bill has been enacted.The Department for Environment, Food and Rural Affairs, as part of their upcoming Circular Economy Growth Plan, will consider evidence across a range of interventions, including but not limited to the regulation of product features to support increased recyclability.

What assessment his Department has made of the potential implications for its policies on vaping regulation of vaping devices marketed as delivering tends of thousands of puffs.

The Tobacco and Vapes Bill will stop vapes and nicotine products from being deliberately branded, promoted, and advertised to children and will provide the Government with new powers to restrict the packaging, device appearance, and display of vapes and other nicotine products to stop the next generation from becoming hooked on nicotine.On 8 October 2025, we launched a Call for Evidence which sought evidence on the size and shape of vapes, vape tanks, and the components of vaping products, including pods, puff-count capacity, and nicotine delivery.We are now reviewing the responses, and these will help inform decisions around our future regulatory approach once the Tobacco and Vapes Bill has been enacted.The Department for Environment, Food and Rural Affairs, as part of their upcoming Circular Economy Growth Plan, will consider evidence across a range of interventions, including but not limited to the regulation of product features to support increased recyclability.

What assessment his Department has made of the potential impact of location restrictions for high fat, sugar and salt products on fruit and nut (a) bars and (b) bags; and what steps he is taking to ensure that regulation does not have unintended consequences for competition.

As set out in the 10-Year Health Plan, we will take decisive action on the obesity crisis to ease the strain on our National Health Service and create the healthiest generation of children ever.Restrictions on the promotion by location of ‘less healthy’ food and drink products in stores and their equivalent places online have been in place since 2022. These restrictions apply to categories of products that impact most on childhood obesity, which were chosen following public consultation. Only fruit and nut bars and bags that are high in saturated fat, salt, or sugar are in scope of the restrictions. There are exceptions for certain coated nuts products. The products that are in and out of scope of the restrictions are set out in the Schedule to the Food (Promotion and Placement) (England) Regulations 2021 regulations and we have published guidance to support industry on complying with the restrictions.We published a detailed impact assessment on the costs to industry and the benefits of this policy on the GOV.UK website. We will continue to monitor the effectiveness of the restrictions and will publish a Post Implementation Review within five years of the restrictions taking legal effect which would consider any unintended consequences of the policy.

What safeguards are in place to ensure that patients with a stoma are (a) offered a choice of dispensing provider and (b) actively involved in decisions relating to appliance selection; and how is compliance with those safeguards is monitored across Integrated Care Systems.

There are a range of legislative and operational safeguards in place to support patient choice and facilitate co-decision between clinicians and patients regarding stoma appliances. In terms of legislation, the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 aim to ensure that pharmaceutical services are delivered in a manner that is not conflicted with inducements that may be provided.Guidance on Managing conflicts of interest in the NHS, updated in 2024, outlines that in services like stoma, where staff may be sponsored by industry, then such post holders must not promote or favour the sponsor’s specific products, and information about alternative products and suppliers should be provided. In addition, the British Healthcare Trade Association agreed a Code of Practice with its members who are involved in the dispensing of these appliances. The code aims to ensure ethical conduct and to safeguard patient interests in the dispensing process.How compliance with the safeguards is monitored is a decision for the integrated care systems. Some areas have introduced central prescribing hubs in order to avoid any undue influence from sponsored posts or the dispensing contractors. Under the prescribing hubs a patient can use any dispensing contractor, but the prescription cannot be changed by them.

What data his Department holds on variation between Integrated Care Systems in access to specialist stoma review and structured follow-up.

The Department has not specifically attempted to estimate the full costs to the National Health Service of preventable stoma management or the merits of introducing a nationally mandated annual specialist stoma review requirement within the NHS Standard Contract. However, as part of work linked to reforms of Part IX of the Drug Tariff, the Department is aware that patient experience varies, and through NHS England, is currently reviewing the provision of stoma products and stoma services.The Department does not hold data on variation between integrated care systems (ICS) in access to specialist stoma review and structured follow-up. However, through this work NHS England has been engaging ICSs to understand what impacts stoma care and to identify improvements.

What estimate his Department has made of the full cost to the NHS of preventable stoma management complications; and whether he will consider commissioning a national economic impact assessment of the potential savings associated with mandated annual specialist stoma reviews.

The Department has not specifically attempted to estimate the full costs to the National Health Service of preventable stoma management or the merits of introducing a nationally mandated annual specialist stoma review requirement within the NHS Standard Contract. However, as part of work linked to reforms of Part IX of the Drug Tariff, the Department is aware that patient experience varies, and through NHS England, is currently reviewing the provision of stoma products and stoma services.The Department does not hold data on variation between integrated care systems (ICS) in access to specialist stoma review and structured follow-up. However, through this work NHS England has been engaging ICSs to understand what impacts stoma care and to identify improvements.

What assessment his Department has made of the potential merits of introducing a nationally mandated annual specialist stoma review requirement within the NHS Standard Contract.

The Department has not specifically attempted to estimate the full costs to the National Health Service of preventable stoma management or the merits of introducing a nationally mandated annual specialist stoma review requirement within the NHS Standard Contract. However, as part of work linked to reforms of Part IX of the Drug Tariff, the Department is aware that patient experience varies, and through NHS England, is currently reviewing the provision of stoma products and stoma services.The Department does not hold data on variation between integrated care systems (ICS) in access to specialist stoma review and structured follow-up. However, through this work NHS England has been engaging ICSs to understand what impacts stoma care and to identify improvements.

What steps he is taking to help reduce the need for patients to contact GP practices at 8am in order to secure a same-day appointment.

We have pledged to end the 8:00am scramble by introducing a modern booking system. As part of this, we have introduced a new requirement for general practices to make online appointment requests available throughout the duration of core opening hours, which will help reduce pressure on phone lines for patients who prefer to call. General practices are independent businesses that hold contracts with the National Health Service to provide essential services. The contracts are clear that patients must be offered an assessment of need or signposting to a different service on the day they contact their practice. This is to ensure that we move away from a ‘first come, first served’ approach to a more equitable one that benefits all patients. NHS England published the Medium‑Term Planning Framework in October, setting a new requirement for all urgent appointments to be delivered on the same day, ensuring that patients needing urgent care are prioritised. Building on this, the 2026/27 GP Contract makes it explicit that any requests identified as clinically urgent, as determined by the general practice, must be dealt with on the same day.

How many households in (i) Fylde constituency and (ii) across Lancashire will benefit from the Disabled Facilities Grant in 2026–27.

We have recently confirmed funding of £723 million for the Disabled Facilities Grant (DFG) in England in 2026/27. The full list of allocations, including for Fylde and Lancashire, can be found at the following link:https://www.gov.uk/government/consultations/changing-the-way-government-allocates-disabled-facilities-grant-funding-to-local-authorities-in-england/outcome/changing-the-way-government-allocates-disabled-facilities-grant-funding-to-local-authorities-in-england-consultation-response#annex-a-list-of-local-authority-dfg-allocations-2026-27We do not know how many households will benefit in Fylde and Lancashire specifically, as- people apply for the grant locally and it is up to each local authority to manage their allocation whilst meeting their statutory duties. In 2024/25, the DFG supported nearly 60,000 people nationally to make adaptations to their homes, with an average grant of approximately £10,000.

What discussions he has had with representative organisations, including Mencap, on the adequacy of social care charging reforms.

Last year, the Prime Minister asked Baroness Louise Casey of Blackstock to chair an independent commission into adult social care to look at how to build a social care system that is fit for the future, including how best to make it fair and affordable Baroness Casey and her team have been engaging extensively, putting the voices of people who draw on care and their families at the centre of the conversation, as well as meeting with sector organisations. Later this year, the commission will also launch a national conversation to build public consensus on what adult social care should deliver for citizens.

What recent progress he has made on implementing the £500 million fair pay agreement for adult social care workers.

The consultation on the design of the Fair Pay Agreement process has now closed, however the Easy Read version remains open until 6 March to ensure everyone has the opportunity to contribute. We are analysing the responses and will set out our formal response in due course.We expect regulations establishing the negotiating body, bringing together employer and employee representatives, will be laid in 2026. We expect negotiations will be held in 2027. Once an agreement on how the funding should be spent has been reached, the Fair Pay Agreement will be implemented in 2028.