Written questions by Snowden.

If his Department will make an assessment of the potential impact of the introduction of digital ID on levels of registration for the organ donors' register.

NHS Blood and Transplant (NHSBT) is the organ donation organisation for the UK responsible for the NHS Organ Donor Register (ODR), which is available at the following link:https://www.organdonation.nhs.uk/register-your-decision/For the purposes of this response, Digital ID has been assumed to refer to the potential introduction of a citizen ID as recently announced by the UK Government.Presently, NHSBT has made no formal assessment on the potential impact of the introduction of Digital ID on levels of ODR registration. The appropriateness of this will be monitored going forward.

What steps he is taking to increase the availability of histotripsy treatment on the NHS.

Histotripsy is a non-invasive ultrasound treatment that destroys tumours without the need for surgery or radiation. It was one of eight transformative technologies supported through the Government’s Innovative Devices Access Pathway (IDAP) pilot. This programme aimed to streamline patient access to medical devices that address an unmet clinical need in the National Health Service.Through the IDAP, an Unmet Clinical Need Authorisation was granted by the Medicines and Healthcare products Regulatory Agency, exempting the manufacturer from certain regulatory requirements under specific conditions given the critical unmet need of liver cancer, allowing early market access. Histotripsy is now available for conditional use in the NHS for patients with liver tumours. NHS treatments will begin in October 2025 as a first in Europe, strengthening the United Kingdom’s position as a global leader in medical innovation.

With reference to his Department's press release entitled 14 NHS trusts the focus of national maternity investigation, published on 15 September, what his planned timeline is for completion of each local trust investigation; what the interim milestones will be; and if he will provide regular updates to Parliament on progress.

The independent investigation is chaired by Baroness Valerie Amos and supported by a small team of expert advisors.Local investigations will be carried out by trained investigators who will spend several days on site at each trust, supported by a small team. Our current expectation is that visits will take place between October and December 2025, though these timings are indicative only, and are subject to final confirmation, particularly in light of the pressures faced by trusts during the winter months.The investigation will produce an initial set of national recommendations by December 2025, with a final report and recommendations to be published in spring 2026. This is due to the ambition, size, and scope of the investigation.The 14 National Health Service trusts were selected by the independent investigation based on a variety of factors, including results from the Care Quality Commission’s Maternity Patient Survey and Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s Perinatal Mortality Rates, in addition to variation in case mix, trust type, geographic coverage, provision of care to individuals from diverse backgrounds, and family feedback.Three of the trusts have been included due to their inclusion in previous investigations or reviews, with these three trusts being the Shrewsbury and Telford Hospital NHS Trust, the East Kent Hospitals University NHS Foundation Trust, and the University Hospitals of Morecambe Bay NHS Foundation Trust.By taking this approach, the investigation can capture learning from a wide range of provision and experiences, ensuring the findings are relevant across the system.

With reference to his Department's press release entitled 14 NHS trusts the focus of national maternity investigation, published on 15 September 2025, if he publish the full data and methodology used to select the 14 NHS trusts under investigation.

The independent investigation is chaired by Baroness Valerie Amos and supported by a small team of expert advisors.Local investigations will be carried out by trained investigators who will spend several days on site at each trust, supported by a small team. Our current expectation is that visits will take place between October and December 2025, though these timings are indicative only, and are subject to final confirmation, particularly in light of the pressures faced by trusts during the winter months.The investigation will produce an initial set of national recommendations by December 2025, with a final report and recommendations to be published in spring 2026. This is due to the ambition, size, and scope of the investigation.The 14 National Health Service trusts were selected by the independent investigation based on a variety of factors, including results from the Care Quality Commission’s Maternity Patient Survey and Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s Perinatal Mortality Rates, in addition to variation in case mix, trust type, geographic coverage, provision of care to individuals from diverse backgrounds, and family feedback.Three of the trusts have been included due to their inclusion in previous investigations or reviews, with these three trusts being the Shrewsbury and Telford Hospital NHS Trust, the East Kent Hospitals University NHS Foundation Trust, and the University Hospitals of Morecambe Bay NHS Foundation Trust.By taking this approach, the investigation can capture learning from a wide range of provision and experiences, ensuring the findings are relevant across the system.

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

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

What steps his Department is taking to help ensure that NHS trusts move into financial surplus by 2030.

The National Health Service priorities and operational planning guidance 2025/26 made it clear that living within budget, reducing waste and increasing productivity is a priority. This year’s financial framework changes include making deficit support funding conditional on performance, implementing a financial override in the Oversight Framework, and introducing additional support for efficiency and productivity through the new Financial Performance and Improvement Programme. The 10-Year Health Plan also made several longer-term commitments to strengthen the NHS financial foundation, which are now being taken forward, including:(a) A commitment to deliver 2% annual productivity growth, which will unlock £17 billion in savings over 3 years.(b) A new approach to NHS financial management including multi-year settlements, and phasing out deficit support funding;(c) Sharper financial incentives including the use of best practice tariffs, and changing the funding model to encourage urgent and emergency care to shift to the community;(d) A fairer geographical distribution of funding, to target areas with disproportionate economic and health challenges; and(e) Reform of the capital regime, giving more power to the frontline and speeding up the capital approvals process.

What assessment he has made of the availability of continuous positive airway pressure machines for NHS patients diagnosed with sleep apnoea.

No specific assessment has been made by the Department.The provision of treatments for sleep apnoea is a commissioning matter and these decisions are the responsibility of integrated care boards, taking into account the needs of their local populations and national guidance such as the National Institute for Health and Care Excellence (NICE) guidelines on diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome.NICE has recommended continuous positive airway pressure machines (TA139) as a treatment option for adults with moderate or severe symptomatic obstructive sleep apnoea or hypopnoea syndrome, where certain clinical criteria are met.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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