Written questions by Dixon.

What consideration his Department has given to reviewing NHS optical voucher values for children with complex visual needs, particularly those with conditions such as Albanism.

Awaiting answer.

What assessment his Department has made of the potential merits of implementing a proportionate regulatory framework for day care services for older and disabled adults, including dementia day care services.

The Care Quality Commission (CQC) is the independent regulator for health and social care in England. The CQC monitors, inspects, and regulates adult social care services to make sure they meet fundamental standards of quality and safety. Where concerns on quality or safety are identified, the CQC uses its regulatory and enforcement powers available and will take action to ensure the safety of people drawing on care and support.Day care services are operated by local authorities, the National Health Service, or voluntary/private organisations. These services operate in the premises in which social, recreational, and care services may be provided to people who need them, due to old age, illness, or disability. Currently, day care services for older and disabled adults, including dementia day care, in which no personal care is provided, are not regulated by the CQC. For day care services to be brought into scope of the CQC’s regulatory remit would require a change in legislation.These regulations are not currently under review. Any amendments to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 would be subject to the usual Parliamentary process which would include a public consultation, and thus an opportunity to consider the merits of further regulation of social care providers.

What steps his Department is taking to ensure General Practice nursing and administrative staff are offered a pay increase as a result of the funding increase for GP contracts for 2025/26.

The Government looks to the independent pay review bodies for a pay recommendation for National Health Service staff, including both contractor and salaried general practitioners (GPs). They consider a range of evidence from organisations including the Government, the NHS, and trade unions to reach their recommendations.The independent review body on Doctors’ and Dentists’ Remuneration (DDRB) have recommended an uplift of 4% to the pay ranges for salaried GPs, and to GP contractor pay. As with last year, we accepted the DDRB’s pay recommendation. We have provided an increase to core funding for practices to allow this 4% pay uplift, on top of the provisional 2.8% uplift already provided, to be passed on to salaried and contractor GPs. The additional funding will also allow for pay uplifts for other salaried GP staff, including nursing and administrative staff. Information on the funding increase was communicated to practices on 31 July 2025. Further information can be found at the following link:https://www.england.nhs.uk/long-read/implementing-the-2025-26-gp-contract/The Government has written to the British Medical Association’s General Practitioners Committee England to set out its expectations regarding the extra funding being used to fund uplifts for all staff and a letter to ICBs was published on 31 July, and is available at the following link:https://www.england.nhs.uk/long-read/financial-implications-and-actions-for-integrated-care-boards-icbs-following-the-mid-year-updates-to-the-2025-26-gp-contract/We expect GP contractors to implement pay rises to other practice staff in line with the uplift in funding they have received. As self-employed contractors to the NHS, it is up to GPs how they distribute pay and benefits to their staff.

Whether his Department has made an assessment of the potential merits of funding the full cost of specialist palliative care delivered by hospices.

Integrated care boards (ICBs) are responsible for commissioning core and specialist palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable ICBs to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care.Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. We will consider contracting and commissioning arrangements as part of our MSF. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission core and specialist care more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.Hospices provide both core and specialist palliative care. Whilst acknowledging that not everyone will need specialist palliative care, we must ensure is that there is equitable and timely access to these services, whether they are provided by hospices or the National Health Service.

What funding he plans to make available to Integrated Care Boards to meet demand for ADHD and Autism assessments.

NHS England is responsible for determining allocations of financial resources to integrated care boards (ICBs). Funding for attention deficit hyperactivity disorder (ADHD) and autism assessments are included within NHS England’s financial allocations to ICBs. The process of setting allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time.ICB allocations for 2026/27 to 2028/29 were published on 17 November 2025, and are available at the following link:https://www.england.nhs.uk/publication/allocation-of-resources-2026-27-to-2027-28/Through the Medium-Term Planning Framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experiences, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

For what reason the shingles vaccine is offered by the NHS to people who turned 65 on or after 1 September 2023 but not those who were born between 1955 and 1958 unless they have a severely weakened immune system.

From September 2023, the routine shingles vaccination programme changed from the one-dose Zostavax vaccine to the two-dose Shingrix vaccine, to better protect individuals from the effects of shingles, provide better clinical outcomes, and reduce pressures on the health system. The programme was also expanded, and as a result, almost one million more people became eligible for the shingles vaccination.The expansion to individuals aged 60 years old is being rolled out in phases to maximise cost-effectiveness and population benefit, ensure consistent messaging to maximise coverage, and take account of National Health Service capacity, all while being consistent with the approach taken by all four nations in the United Kingdom. During the first phase, which commenced in September 2023, those who reach the ages of 65 or 70 years old will be called in for vaccination on or after their 65th or 70th birthday. During the second phase, from September 2028, individuals will be called in for vaccination on or after their 60th or 65th birthday. From 1 September 2033 onwards, vaccination will be routinely offered to those turning 60 years of age on or after their 60th birthday.At this point in the year, the majority of individuals born in 1955 will have turned 70 years old and therefore will now be eligible for their vaccination. Those who have not yet turned 70 years old but were already 65 years old or over before 1 September 2023 will become eligible when they turn 70 years old.As of September 2025, all severely immunosuppressed individuals aged 18 years old and over became eligible for shingles vaccination. This is because individuals who are severely immunosuppressed are most at risk of serious illness and complications from shingles, and so it is particularly important that they are protected against this disease.This is a relatively newly expanded programme, and anyone unsure if they are eligible for the shingles vaccination should check online, on the NHS.UK website, or should speak to their general practitioner.

What plans he has to strengthen statutory guidance related to the legal duty to commission palliative care services included in the Health and Care Act 2022.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services, available within the ICB catchment. There are no current plans to update the statutory guidance.The ICBs are expected to follow the statutory guidance in exercising their functions and must pay due regard to it in the planning, commissioning, and delivery of palliative care and end of life care services.Additionally, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.

How much and what proportion of funding for the NHS was spent on (a) legal costs and (b) compensation related to employment tribunals in each of the last five financial years, broken down by NHS Trust.

Neither the Department nor NHS England hold information which breaks down the proportion of National Health Service funding that was spent on legal costs and compensation relating to employment tribunals.

(a) which stakeholders he has consulted and (b) what data sources he has used to develop the basis of the adult social care resource formula.

It is important that the Adult Social Care Relative Needs Formula accurately reflects the relative need for services to ensure funding is allocated to the places that need it most and to enable all local authorities to focus on improving adult social care outcomes.The Department commissioned independent academics at the Adult Social Care Research Unit to develop an update to the current Adult Social Care Relative Needs Formula. This update reflects a more up to date assessment of relative adult social care need in England and is being consulted on as part of the Ministry of Housing, Communities and Local Government’s Local Government Funding Reform consultation. The Adult Social Care Research Unit’s research report is available at the following link:https://ascru.nihr.ac.uk/wp-content/uploads/2025/05/2025_06_16_Revision-of-ASC-RNF-2024.pdf

What steps his Department is taking to ensure the assessment framework used for commissioning the adult social care resource formula focuses on outcomes.

It is important that the Adult Social Care Relative Needs Formula accurately reflects the relative need for services to ensure funding is allocated to the places that need it most and to enable all local authorities to focus on improving adult social care outcomes.The Department commissioned independent academics at the Adult Social Care Research Unit to develop an update to the current Adult Social Care Relative Needs Formula. This update reflects a more up to date assessment of relative adult social care need in England and is being consulted on as part of the Ministry of Housing, Communities and Local Government’s Local Government Funding Reform consultation. The Adult Social Care Research Unit’s research report is available at the following link:https://ascru.nihr.ac.uk/wp-content/uploads/2025/05/2025_06_16_Revision-of-ASC-RNF-2024.pdf

What estimate he has made of the number of mental health staff that will be placed in schools; and what assessment he has made of the level of qualification that will be required by those staff members; and how those staff members will be funded.

We are working closely with local commissioners to deliver mental health support teams in schools in England so they cover 100% of pupils by 2029/30. NHSE have estimated that around 2,400 Education Mental Health Practitioners (EMHP) are placed throughout the 600 current operational Mental Health Support Teams. Actual numbers will vary slightly at a local level, according to need. The average coverage of schools per team can change from year to year and an extensive independent evaluation is due to publish in 2026 that will inform future roll-out.EMHP undertake a year-long training course to qualify. They can train for a postgraduate or graduate diploma, depending on whether they already have a degree qualification.Annual National Health Service day-to-day spending will increase by £29 billion in real terms, via a £53 billion cash uplift, by 2028/29, compared to 2023/24. This will take the NHS resource budget to £226 billion by 2028/29, the equivalent to a 3% average annual real terms growth rate over the Spending Review period.In the Spending Review announcement, we have confirmed that we will fulfil the Government’s commitments to recruit an additional 8,500 mental health staff by the end of the Parliament.

Pursuant to Answer of 3rd April 2025 on Question 44192 on Events Industry: First Aid, when his Department plans to publish the updated Event Healthcare Standard; and whether he is taking steps to consult with (a) stakeholders, (b) healthcare providers and (c) event organisers during its development.

Following the Manchester Arena Inquiry Volume Two report recommendations the government committed to develop an Event Healthcare Standard. This guidance will support the Care Quality Commission’s regulation of the provision of treatment of disease, disorder, or injury rather than first aid.The Event Healthcare Standard will be written by an authorship group, made up of clinicians and experts from within the healthcare sector, sports and events industries. The authorship group is also overseen by a review panel of experts and stakeholders also made-up healthcare providers, sports and events industries. We aim to publish the standard in the middle of 2026.The Government will continue to engage with stakeholders within the health, sports and events sector as work on the standard progresses.

If he will make an assessment of whether local authorities are able to meet their statutory duties to unpaid carers under the Care Act 2014.

The Care Quality Commission (CQC) is assessing how well 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 local authorities are supporting unpaid carers in their area. All 153 local authorities in England are being assessed, with ratings and reports available on the CQC’s website. The assessments identify local authorities’ strengths and areas for improvement, facilitating the sharing of good practice and helping us to target support where it is most needed. The Government recognises the challenges facing the adult social care system. That is why the Government is launching 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 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.

Pursuant to the Answer of 14 October 2024 on Enzyme Replacement Therapy: Drugs, what progress his Department has made in tackling shortages of (a) ADHD medication, (b) Creon and (c) other medications used in the management of (i) enzyme deficiency disorders and (ii) cystic fibrosis.

The Department has continued to work hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.We are continuing to work to resolve medicine supply issues, where they remain, for some strengths of methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term.In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinions for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.The Department is also continuing to engage with suppliers of Creon and other pancreatic enzyme replacement therapies (PERT) to boost production to mitigate the supply issue. The supplier of Creon expects to receive increased quantities for 2025. Suppliers of alternative PERT and specialist importers of unlicensed medicines continue to supply increased volumes to assist in covering the gap in the market. In December, the Department issued further management advice to healthcare professionals. This directs clinicians to unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure local mitigation plans are implemented. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice, including advice on preserving the available stock of alternative PERT for certain patient cohorts.

What steps his Department is taking to increase the supply of GLP-1 receptor agonist medications for diabetic patients in Shipley constituency.

There are ongoing global supply issues with some medications used to treat diabetes, and we continue to work closely with industry partners to improve the situation. Supplies of Rybelsus, which is an oral semaglutide available in tablet form, have been boosted to support demand from new patients with type 2 diabetes, as well as those unable to obtain their existing treatment. The Medicines and Healthcare products Regulatory Agency’s regulatory approval of Mounjaro, an injectable medicine for adults with type 2 diabetes, has brought an additional treatment option to the United Kingdom’s market. We have provided advice for healthcare professionals on how to manage patients requiring these medicines whilst there are shortages, and are keeping this under review as the situation evolves. The Department has also added some of these products to the list of medicines that cannot be exported from, or hoarded in, the UK. The guidance is clear that medications licensed to treat type 2 diabetes should not be prescribed for weight loss, except where specifically licenced for this use. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance. The Department monitors and manages medicine supply at a national level, so that stocks remain available to meet regional and local demand. Information on stock levels within individual pharmacies is not held centrally.

What steps her Department is taking to ensure the McCloud remedy is implemented for affected NHS workers by April 2025.

The NHS Business Services Authority (NHSBSA) is implementing the McCloud remedy for impacted members of the NHS Pension Scheme. Remedy implementation is a complex and large-scale undertaking. The core element of the remedy will provide members with a choice of benefits at retirement for the period the discrimination identified by the McCloud judgment was effective. Approximately 350,000 retired members will be offered this choice retrospectively.The Department expects that the majority of impacted retired members will not receive their choice until after April 2025.Whilst the majority of impacted retired members are likely to already be in receipt of their most beneficial set of benefits, the Department is working with the NHSBSA to accelerate the provision of this choice, particularly for members for whom there would be an immediate financial impact. The NHSBSA will communicate revised timelines with members once these are confirmed.

If he will review the tapered annual allowance threshold for NHS pensions.

Tax policy is a matter for my Rt Hon. Friend, the Chancellor of the Exchequer. The tapered annual allowance threshold applies universally and restricts the amount of tax-free pension saving available to the wealthiest in society.

What steps his Department is taking to help reduce waiting times for ADHD assessments.

The Department is currently considering next steps to improve access to attention deficit hyperactivity disorder (ADHD) assessments. It is the responsibility of integrated care boards to make appropriate provision to meet the health and care needs of their local population, including ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD and to help provide a joined-up approach in response to concerns around rising demand.Alongside the work of the taskforce, NHS England will continue to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services to ensure best practice is captured and shared across the system.

If he will make an assessment of the potential merits of instructing NICE to review it's infant head circumference measurement guidelines, in the context of improving the diagnosis and treatment of (a) hydrocephalus and (b) other long term related complications.

The National Institute for Health and Care Excellence (NICE) develops its guidance independently and keeps its published guidelines under active surveillance so that it is able to update its recommendations in light of any significant new evidence. Decisions on updates to existing guidance are made by NICE’s Prioritisation Board in line with NICE’s published common prioritisation framework.NICE’s guideline on “suspected neurological conditions: recognition and referral” includes recommendations on head circumference measurement. We understand that NICE is currently reviewing its recommendations to consider if any update to its recommendation is warranted.

What steps his department is taking to tackle shortages in (a) ADHD medication, (b) Creon and (c) medications used in the management of enzyme deficiency disorders and cystic fybrosis.

The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules and guanfacine prolonged-release tablets are now available.We are continuing to work to resolve medicine supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the UK from October 2024 onwards.In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance which includes offering rapid response to primary care teams seeking urgent advice/opinion for the management of patients including those known to be at a higher risk of adverse impact because of these shortages.The Department has also been working with suppliers to address current supply issues with Creon which is used by patients with conditions such as cystic fibrosis and certain cancers including pancreatic cancer. The supply issues with Creon are impacting countries throughout Europe and have been caused by limited availability of raw ingredients and manufacturing capacity constraints to produce volumes needed to meet demand. These issues have resulted in knock-on supply disruptions of alternative pancreatic enzyme replacement therapy (PERT) medications. The Department is continuing to work with all suppliers of PERT to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets and increase production.The supplier of Creon has advised that they expect to have regular supplies released each month going forward and are working to increase the quantities released. Serious Shortage Protocols are in place for Creon 10,000 and 25,000 capsules which pharmacists can use to restrict supply to one month at a time to ensure more patients have access to it whilst stock is limited.We have issued comprehensive guidance to healthcare professionals about these supply issues, which provides advice on how to manage patients whilst there is disruption to supply. This guidance is being kept under review and updates will be made, as necessary.