Written questions by Snowden.

If his Department will make an assessment of the potential merits of introducing a (a) national standard and (b) mutual recognition framework for First Aid training across NHS trusts.

Due to the number of professional clinicians working across the National Health Service, first aid training is not a requirement for NHS staff and is only relevant in settings where clinicians do not work.The mutual recognition agreement, signed by 262 NHS organisations across England, covers all Core Skills Training Framework Subjects, including cardiopulmonary resuscitation. Additionally, the Statutory and Mandatory e-learning programme includes four resuscitation sessions which are freely available to all health and social care staff.

What estimate his Department has made of the annual cost to the NHS of staff being required to undertake duplicate First Aid training when working across multiple NHS trusts.

Due to the number of professional clinicians working across the National Health Service, first aid training is not a requirement for NHS staff and is only relevant in settings where clinicians do not work.

What information his Department holds on the (a) demography and (b) regional locations of new diagnoses of (i) HIV, (ii) hepatitis B and (iii) hepatitis C.

The UK Health Security Agency undertakes monitoring and surveillance of HIV and hepatitis B and C viral infections, including new diagnoses. This includes regional and demographic information that is published through a series of surveillance reports.A regional breakdown of new HIV diagnoses can be accessed in the HIV diagnoses, AIDS, deaths and people in care: country and region tables, United Kingdom, 2015 to 2024 table, a copy of which is attached. In addition, demographic data is available in the HIV diagnoses, AIDS, deaths and people in care: key population HIV tables, England, 2015 to 2024 table, a copy of which is also attached.Acute hepatitis B surveillance reports can be accessed at the following link:https://www.gov.uk/government/publications/acute-hepatitis-b-england-enhanced-surveillance-reportsHepatitis C laboratory reports are published annually at the following link:https://www.gov.uk/government/publications/hepatitis-c-england-and-wales-2024/laboratory-reports-of-hepatitis-c-infections-in-england-and-wales-april-to-june-2024The Department’s Fingertips tool also provides publicly accessible geographical information on hepatitis B and C and HIV, and is available at the following link:https://fingertips.phe.org.uk/search/hepatitis

Whether he will review the current appeals process for NHS prescription penalty charges to ensure that reasonable discretion is applied in cases of (a) genuine mistake and (b) hardship.

There are no plans to review the appeals process. The Real Time Exemption Checking Service in England (RTEC) helps pharmacy teams confirm whether a patient holds a valid exemption from National Health Service prescription charges quickly while in the pharmacy. The RTEC provides assurance to patients and pharmacy teams that exemptions are being claimed correctly.It is also a patient’s responsibility to be aware of their entitlement and to ensure they take appropriate steps to legitimately enable them to claim exemption from charges. Further information on this is available on the NHS.UK website and the NHS Business Services Authority (NHS BSA) website, which are available, respectively, at the following two links:https://www.nhs.uk/nhs-services/prescriptions/check-if-you-can-get-free-prescriptions/https://www.nhsbsa.nhs.uk/nhs-help-health-costsPatients can also use the NHS BSA eligibility checker, which is available at the following link:https://www.nhsbsa.nhs.uk/dont-get-caught-out-penalty-charges/check-you-tickWhere a patient is unsure if they are entitled to exemption from NHS prescription charges, they should pay the applicable charges and request an FP57 receipt and refund form at the point at which they pay the prescription charge. They can then claim a refund from the pharmacy within three months of paying the prescription charge once they have evidence of exemption.

What assessment he has made of the potential impact of the NHS emergency department opt-out testing programme on early diagnosis rates for (a) HIV, (b) hepatitis B and (c) hepatitis C.

A public health evaluation of the emergency department blood-borne virus opt-out testing programme for the first 34 sites taking part showed that there were 3,667 new diagnoses of hepatitis B, 831 of hepatitis C, and 719 of HIV between April 2022 and December 2024.Approximately 50% of all people diagnosed with hepatitis B and hepatitis C were newly diagnosed through the programme, compared to 8.3% for HIV. The vast majority, or 73.4%, of people newly diagnosed had no record of a previous bloodborne virus test, which indicates that the testing programme has been successful in accessing a population with different demographics and risk factors to testing offered in other settings and supporting the earlier diagnosis of these individuals.The public health evaluation of the emergency department opt-out testing programme is available at the following link:https://www.gov.uk/government/publications/bloodborne-viruses-opt-out-testing-in-emergency-departments/public-health-evaluation-of-bbv-opt-out-testing-in-eds-in-england-33-month-final-report-2025

If he will make an assessment of the extent of regional disparities in the treatment of musculoskeletal conditions.

Just under 18 million people, or over 30%, of all ages in England were estimated to be affected by a musculoskeletal (MSK) condition in 2023, and improving their health and work outcomes will help deliver this Government's missions to build a National Health Service fit for the future and kickstart economic growth. Data shows there are regional disparities in the prevalence of MSK conditions. In England in 2024, those in the most deprived Index of Multiple Deprivation decile were most likely to report a long term MSK problem, at 19.9%, compared to the least deprived decile, at 16.5%. To tackle this, we are delivering the ‘Getting It Right First Time’ MSK Community Delivery Programme which is working to reduce MSK community waiting times, improve data and metrics and referral pathways to wider support services, which will benefit patients now and into the future.

What recent assessment he has made of the adequacy of current NHS staffing levels in (a) hospitals and (b) general practice.

National Health Service hospitals and healthcare providers, such as general practices, are responsible for ensuring that there are sufficient staff to provide safe care for their patients.Providers already have a duty through Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to regularly review the number of staff and range of skills needed to safely meet the needs of people using their services.We will publish a 10 Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible and more fulfilled.The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients.

What steps his Department is taking to help reduce health inequalities experienced by deaf people.

It is for individual National Health Service organisations, including NHS trusts and integrated care boards, to comply with the Equality Act 2010. Under the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision to ensure that services are as accessible to disabled people, including deaf people, as they are for everybody else. This includes responsibility for ensuring that there is adequate provision of British Sign Language (BSL) interpreters to support deaf patients.Health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. The Reasonable Adjustment Digital Flag was developed in the National Repository, a digital system within the NHS where key patient information is stored to enable health and care workers to record, share and view details of reasonable adjustments, across the NHS and social care, wherever the person is seen or treated.Following the launch of the Reasonable Adjustment Digital Flag Information Standard, published in September 2023, the flag went live in the National Care Record Service and is being rolled out across England.Since 2016, all NHS organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the approach to supporting the information and communication support needs of people with a disability, impairment or sensory loss.NHS England published a revised AIS on 30 June 2025. NHS England is working to support implementation of the AIS with awareness raising, communication and engagement, and a review of the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.

If he will take steps with the Chancellor of the Exchequer to remove VAT on defibrillators.

Tax policy is a matter for HM Treasury. The Government provides VAT reliefs to aid the purchase of automated external defibrillators through VAT refunds on purchases made by local authorities, including parish councils, and VAT reliefs for purchases made through voluntary contributions where a defibrillator is donated to eligible charities or the National Health Service.

What data his Department holds on the prevalence of cleft palate syndrome in the UK; and what steps his Department is taking to raise awareness among (a) healthcare professionals and (b) the general public.

The Cleft Registry and Audit Network (CRANE) is a national register and clinical audit funded by NHS England to evaluate and report on the delivery of cleft services to children born with a cleft lip and/or palate in England, Wales, Northern Ireland, and Scotland. The 2024 Annual Report states that cleft lip and/or palate is a common condition, affecting one in 660 births and between 2021 and 2023, as 2,609 children were registered on CRANE, which is approximately 870 per year.As part of their development activities, CRANE has previously linked with national educational data in England and found that attainment gaps exist between those with a cleft and the general population.The Department, through the National Institute for Health and Care Research (NIHR), is currently funding a £2 million study to improve outcomes for individuals with cleft lip and/or palate by addressing variation in unmet needs.This study aims to understand, and subsequently develop a tool to help address, the clinical, psychosocial, educational, and patient-reported needs of young adults with cleft lip and/or palate when they move from child to adult health services. The NIHR continues to welcome funding applications for research into any aspect of human health, including cleft palate.

What information his Department holds on the long-term (a) health, (b) educational and (c) social outcomes of individuals born with cleft palate syndrome; and what steps his Department is taking to monitor these outcomes.

The Cleft Registry and Audit Network (CRANE) is a national register and clinical audit funded by NHS England to evaluate and report on the delivery of cleft services to children born with a cleft lip and/or palate in England, Wales, Northern Ireland, and Scotland. The 2024 Annual Report states that cleft lip and/or palate is a common condition, affecting one in 660 births and between 2021 and 2023, as 2,609 children were registered on CRANE, which is approximately 870 per year.As part of their development activities, CRANE has previously linked with national educational data in England and found that attainment gaps exist between those with a cleft and the general population.The Department, through the National Institute for Health and Care Research (NIHR), is currently funding a £2 million study to improve outcomes for individuals with cleft lip and/or palate by addressing variation in unmet needs.This study aims to understand, and subsequently develop a tool to help address, the clinical, psychosocial, educational, and patient-reported needs of young adults with cleft lip and/or palate when they move from child to adult health services. The NIHR continues to welcome funding applications for research into any aspect of human health, including cleft palate.

How many patients in England are receiving treatment with the Optune Tumour Treating Fields device; and at which NHS Trusts such treatment is available.

The National Institute for Health and Care Excellence (NICE) considered the use of tumour treating fields (TTF) in its guideline on brain tumours, reference code NG99, published in 2018 and recommended that the treatment should not be offered by the National Health Service for the management of newly diagnosed glioblastoma or recurrent high-grade glioma, based on an assessment of the evidence available at the time.Decisions on whether guidelines should be updated in light of new evidence are taken by the NICE prioritisation board, chaired by NICE’s Chief Medical Officer, in line with its published prioritisation framework. NICE’s prioritisation board considered TTF for glioblastoma in July 2024, where they agreed the topic should not be prioritised but reconsidered when relevant key trials have completed.At the meeting on 15 September 2025, the topic was reconsidered. The prioritisation board noted that some trials are ongoing, including a key trial that is likely to be published in 2026, and consequently agreed that the topic should still not be prioritised at this time, but revisited once those trials have been published.

What plans his Department has to request that NICE begin an appraisal of the Optune Tumour Treating Fields device for the treatment of glioblastoma.

The Department has no plans to request that the National Institute for Health and Care Excellence (NICE) appraise tumour treating fields (TTF), or to intervene in NICE’s established guidance prioritisation process.NICE considered the use of TTF in its guideline on brain tumours, reference NG99, published in 2018, and recommended that the treatment should not be offered for the management of newly diagnosed glioblastoma or recurrent high-grade glioma, based on an assessment of the evidence available at the time.Decisions on whether guidelines should be updated in light of new evidence are taken by the NICE prioritisation board, chaired by NICE’s Chief Medical Officer, in line with its published prioritisation framework. NICE’s prioritisation board considered TTF for glioblastoma in July 2024 where they agreed that the topic should not be prioritised but reconsidered when relevant key trials have completed.At the meeting on 15 September 2025, the topic was reconsidered. The prioritisation board noted that some trials are ongoing, including a key trial that is likely to be published in 2026, and consequently agreed that the topic should still not be prioritised at this time, but revisited once those trials have been published.

What assessment his Department has made of the potential impact of changes to the Nutrient Profile Model on the availability of healthier (a) food and (b) drink products.

As set out in our 10-Year Health Plan for England: fit for the future, we will take decisive action on the obesity crisis, easing the strain on our National Health Service and creating the healthiest generation of children ever. We announced that we would update the nutrient profiling model (NPM) 2004/05, which underpins the advertising restrictions and promotion restrictions on less healthy food and drink policies so that it reflects the latest dietary recommendations. We will consult on applying the updated NPM to these policies and will publish an impact assessment in due course.

What assessment his Department has made of the potential impact of misophonia on the (a) social and (b) occupational outcomes of people diagnosed with that condition.

We have made no such assessment, although it is recognised that misophonia can adversely affect a person’s ability to achieve life goals, communicate effectively, and enjoy social situations, and that this can have an impact on individuals’ mental health. The National Health Service continues to support further expansion of talking therapies and the transformation of community mental health services so they can adopt an open, 'no wrong door' approach to helping people based upon their presenting needs rather than requiring a particular diagnosis. This is being built upon through the 10-Year Health Plan's commitment to roll out new 24/7 neighbourhood mental health centres which will provide open door access to support without the need for a general practitioner referral or appointment.

If he will take steps to include the mutual recognition of mandatory training qualifications between NHS Trusts in the forthcoming NHS Workforce Strategy.

As set out in the 10-Year Health Plan, we are committed to reforming mandatory training by April 2026, to ease the burden on frontline staff and to allow a more flexible approach to workforce development. NHS England is already leading work to optimise, rationalise, and redesign statutory and mandatory training. This includes reducing the duplication of training when staff move organisation or rotate through their training programme. The mutual recognition agreement has already been signed by 262 National Health Service organisations across England and went live on 1 May 2025, so it is in place and is expected to continue to reduce the unnecessary burden on staff. The next stage of the reform work will see a new competency framework published that will fundamentally reform current training, further reducing the burden of unnecessary training, and focus on building the competence to improve the quality of services and safety across the NHS workforce.

What data his Department holds on the number of child (a) injuries and (b) illnesses linked to counterfeit toys in the last five years.

The Department does not collect or hold this data. The National Health Service classifies injuries and illnesses by diagnosis rather than cause. Hospital Episode Statistics do not have an International Classification of Disease code for counterfeit products.The Department acknowledges increasing concerns regarding the potential health risks to children associated with fake and counterfeit products. Children’s health remains a priority for the Government.

What assessment he has made of trends in the level of the use of temporary escalation spaces in the NHS.

The Government is determined to get the National Health Service back on its feet, so patients can be treated with dignity.  We are therefore doing everything we can as fast as we can to consign the delivery of care in temporary escalation spaces to the history books.Our Urgent and Emergency Care Plan, published in June 2025, set out the steps we are taking to ensure that patients will receive better, faster, and more appropriate emergency care this winter, backed by a total of nearly £450 million of funding. This includes a commitment to publish data on the prevalence of corridor care.NHS England publishes monthly data on accident and emergency performance. This includes information on those accident and emergency attendances that are 12 hours or longer for type 1 and 2 accident and emergency providers. A copy of the latest data publication is attached.

What steps he is taking to ensure equitable access to participation in mental health clinical trials across different (a) regions and (b) demographic groups in (i) general and (ii) Lancashire.

The Department is committed to ensuring that all patients have access to cutting-edge clinical trials and innovative, lifesaving treatments, including mental health clinical trials.The Department funds research and research infrastructure across England through the National Institute for Health and Care Research (NIHR), which supports patients and the public to participate in high-quality research, including on mental health.NIHR research infrastructure has national coverage across all National Health Service trusts in England, through 12 regions, to build research capacity and capability across all geographies and settings.The NIHR provides an online service called 'Be Part of Research' which promotes participation in health and social care research, by allowing users to search for relevant studies and register their interest. This makes it easier for people to find and take part in health and care research that is relevant to them, including mental health clinical trials.Through the NIHR’s Research Delivery Network (RDN), the NIHR funds the delivery of research in the North West, including for mental health trusts, and supports recruitment and screening for all eligible participants across Lancashire.From 2026/27, the RDN will adopt a new national funding model for NHS support costs and research delivery. This will be a consistent, nationally agreed funding distribution model across all regions of England and will reduce regional variation in health research delivery investment. This aims to reduce inequity in research delivery across all therapy and geography areas, including in underserved areas and settings.

What assessment his Department has made of the (a) adequacy of staffing levels and (b) potential impact of workforce levels on service delivery in hospices.

Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. As independent organisations, charitable hospices are free to develop and adapt their own terms and conditions of employment, including the pay scales. It is for them to determine what is affordable within the financial model they operate, and how to recoup any additional costs they face if they choose to utilise the terms and conditions of NHS staff on the Agenda for Change contract.The NHS has been facing chronic workforce shortages for years, and we have to be honest that bringing in the staff we need will take time. The Government will make sure the NHS has the staff it needs to be there for all of us when we need it, including at the end of life. We have developed a 10-Year Health Plan to deliver an NHS fit for the future, and a central part of the plan is our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.We will publish a new workforce plan to deliver the transformed health service we will build over the next decade, to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local integrated care board on behalf of NHS England, as happened in 2024/25 and 2025/26.  This amounts to approximately £80 million over the next three years.