Written questions by Sabine.

What discussions he has had with Integrated Care Boards on policies on liothyronine, including requiring Exceptional/Individual Funding Requests and applying bans on new patients; and if he will issue guidance to prevent restrictions where NHS England guidance supports its use in some patients.

The Department has not held any discussions with integrated care boards regarding their policies on liothyronine. NHS England regional teams have distributed the Items that should not be prescribed in primary care policy guidance to local healthcare systems. These systems are responsible for ensuring that prescribing practices follow the guidance provided.

What steps he is taking to ensure that Integrated Care Boards follow NHS England guidance on liothyronine.

The Department has not held any discussions with integrated care boards regarding their policies on liothyronine. NHS England regional teams have distributed the Items that should not be prescribed in primary care policy guidance to local healthcare systems. These systems are responsible for ensuring that prescribing practices follow the guidance provided.

What steps he is taking to extend fracture liaison services.

Fracture Liaison Services are commissioned by integrated care boards, which are well-placed to make decisions according to local need.Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.Officials continue to work closely with NHS England to explore a range of options to provide better quality and access to these important preventative services.

What steps he is taking to ensure that NHSE informs ICBs, practitioners and Regional Pharmacists about amendments to the liothyronine (T3) section in the guidance document entitled Items which should not routinely be prescribed in primary care.

Regional chief pharmacists have been informed of the changes made to the liothyronine section, including Armour Thyroid and liothyronine combination products, of the ‘items that should not be prescribed in primary care’ policy guidance via email. They have been asked to cascade this information through their integrated care board’s regional networks.

What plans he has to make weight loss medications available to people living with obesity who are unable to afford them privately and who fall below the weight threshold required for NHS prescription as a result of using the medication.

Our 10-Year Health Plan highlights the risk that these medicines will be accessed by those who can pay over those with the highest clinical need. The plan makes a commitment to expand access on the National Health Service through innovative industry partnerships, delivering weight loss services and treatments to patients. Continuing to make these medicines more widely available on the NHS will help reduce inequalities in access.NHS access is being prioritised for those with the highest clinical need first. NHS England has worked with clinical experts, integrated care boards, patient and public representatives, healthcare professionals, charities, and royal colleges on its prioritisation approach, which is set out in its interim commissioning guidance and available at the following link:https://www.england.nhs.uk/publication/interim-commissioning-guidance-implementation-of-the-nice-technology-appraisal-ta1026-and-the-nice-funding-variation-for-tirzepatide-mounjaro-for-the-management-of-obesity/We do not currently have plans to make these medicines available to those who have fallen below the weight threshold required for NHS prescription as a result of using the medication privately. For patients prescribed these medicines by the NHS, they will continue to receive these medicines for as long as clinically appropriate. For those not currently eligible for weight loss medications, there are a variety of weight management services provided by the NHS and local government. These range from multi-component behavioural programmes to specialist services for those living with severe obesity and associated co-morbidities.

Whether he has made an assessment of the potential merits of compensating (a) people and (b) families of people with Foetal Valproate Syndrome.

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

What assessment he has made of the potential implications for his policies of the report by the Patient Safety Commissioner entitled The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh, published on 7 February 2024.

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

What recent steps he has taken with the British Dental Association to make changes to the dental contract.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability.Ministers meet regularly with external stakeholders on a variety of topics, including, but not limited to, dentistry. Details of ministerial meetings are published quarterly in arrears on the GOV.UK website.We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for National Health Service dental patients.

When he last met with the British Dental Association.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability.Ministers meet regularly with external stakeholders on a variety of topics, including, but not limited to, dentistry. Details of ministerial meetings are published quarterly in arrears on the GOV.UK website.We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for National Health Service dental patients.

What his Department's timeline is for publishing its plan for Fracture Liaison Services.

Fracture Liaison Services are commissioned by integrated care boards, which are well-placed to make decisions according to local need.Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.

What progress he has made on creating a treatment pathway for children with Fetal Alcohol Spectrum Disorder in the NHS.

It is the responsibility of the integrated care boards in England to make appropriate provision to meet the health and care needs of their local population, including treatment pathways and support for foetal alcohol spectrum disorder (FASD), in line with relevant National Institute for Health and Care Excellence guidelines. The Department asked the National Institute for Health and Care Excellence to produce a quality standard in England for FASD to help providers and commissioners improve both diagnosis and support for people affected by FASD. This includes guidance on individualised management plans, which help to coordinate care across a range of healthcare professionals, as well as education and social services, to improve outcomes. The quality standard also covers support during pregnancy to improve awareness and prevent the disorder. The quality standard was published in March 2022, and is available at the following link:https://www.nice.org.uk/guidance/qs204

Whether she has made an assessment of the effectiveness of in-community support for children with Fetal Alcohol Spectrum Disorder.

It is the responsibility of the integrated care boards in England to make appropriate provision to meet the health and care needs of their local population, including treatment pathways and support for foetal alcohol spectrum disorder (FASD), in line with relevant National Institute for Health and Care Excellence guidelines. The Department asked the National Institute for Health and Care Excellence to produce a quality standard in England for FASD to help providers and commissioners improve both diagnosis and support for people affected by FASD. This includes guidance on individualised management plans, which help to coordinate care across a range of healthcare professionals, as well as education and social services, to improve outcomes. The quality standard also covers support during pregnancy to improve awareness and prevent the disorder. The quality standard was published in March 2022, and is available at the following link:https://www.nice.org.uk/guidance/qs204

Whether his Department plans to review prescription charges for long-term medication.

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate.There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with chronic illnesses may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. People who need to pay and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in ten monthly direct debit instalments.The list of specified medical conditions that provide exemption from prescription charges is available at the following link:https://www.nhsbsa.nhs.uk/check-if-you-have-nhs-exemption/medical-exemption-certificatesThe exemption covers all the patient’s prescriptions, not just those for the qualifying condition.

What the criteria is for medication for long-term illnesses to be exempt from prescription charges.

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate.There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with chronic illnesses may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. People who need to pay and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in ten monthly direct debit instalments.The list of specified medical conditions that provide exemption from prescription charges is available at the following link:https://www.nhsbsa.nhs.uk/check-if-you-have-nhs-exemption/medical-exemption-certificatesThe exemption covers all the patient’s prescriptions, not just those for the qualifying condition.

What the age range will be of people considered by the Children and Young People with Cancer Taskforce.

The Department is committed to improving outcomes and patient experience for children, teenagers, and young adults with cancer, from birth to 24 years of age. That is why we have relaunched the Children and Young People Cancer Taskforce, which will identify tangible ways to drive improvements for cancer patients across this age range. The taskforce’s membership, which is currently being finalised, will reflect the diversity of needs across these patient groups.We recognise that cancer in teenagers and young people is different to cancer in adults and children, and so age-appropriate care is necessary, particularly regarding treatment, diagnosis, and wider support, as per the NHS England service specifications. Department officials are working with chairs of the taskforce to develop the Terms of Reference ahead of the first meeting, currently planned for March. The taskforce will consider the most appropriate dissemination routes or publication channels for taskforce materials in due course.

What plans he has to improve (a) awareness of and (b) access to formula milk for infants.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life and that includes helping families to access support to feed their baby.Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Competition and Markets Authority is undertaking a market study on infant and follow on formula and is due to publish its final report, with recommendations later this month. We welcome this report and will carefully consider its findings and recommendations including any on increasing awareness of, and access to, infant formula.

What support is available for mothers experiencing poor mental health post-partum related to breastfeeding.

Whilst the relationship with breastfeeding and postnatal depression is complex, a successful breastfeeding experience may protect against mental health issues such as postnatal depression.Through the Family Hubs and Start for Life programme, the Department is providing £18.5 million in 2025/26 to 75 local authorities in England with high levels of deprivation to improve infant feeding services and provide practical support with breastfeeding. Local authorities are using this investment to put in place a range of specialist support and advice to help parents to meet their infant feeding goals no matter how they choose to feed their baby.We are also helping the early years workforce to better understand the links between breastfeeding and perinatal mental health. In August 2023, a free e-learning package was launched which has already been taken up by hundreds of staff.

What data his Department holds on the proportion of mothers who (a) breastfeed, (b) use formula and (c) use both for infants in the first six weeks of life.

The Department collects, holds, and publishes numbers and rates of babies fully breastfed, partially breastfed, and not at all breastfed, at six to eight weeks of age. It can be assumed that babies partially breastfed and not at all breastfed are receiving formula milk for at least part of their diet. The data is provided to the Department by local authorities.The Department publishes the data quarterly and annually, for England, by region, and by upper tier local authority. The latest annual data is for the financial year 2023/24, and the latest quarterly data is for the second quarter of the 2024/25 financial year.In the financial year 2023/24, 52.7% of babies were breastfed or partially breastfed in England. This proportion has been improving since the financial year 2020/21 when it was 47.6%.In addition, the Department publishes data on the numbers and rates of babies receiving breastmilk as their first feed. This is published annually for England, by region, and by upper tier local authority. This data is collected by NHS England in the Maternity Services Data Set.The latest data is for the financial year 2023/24 when 71.9% of babies received breastmilk as their first feed. The proportion of babies whose first feed was breast milk has remained at approximately 72% each year between 2019 and 2024.

What assessment he has made of the potential impact of the transition between children social care and adult social care on patients.

The Department works closely with the Department for Education and other partners to understand the difficulties young disabled people and their families can face when they transition into adult social care, and to identify opportunities to better support young people at this crucial stage of their life.

What steps he is taking to increase the uptake of smear tests.

To support improving access and uptake of the NHS Cervical Screening Programme, the National Health Service has a series of initiatives underway, including:developing a digital-first approach to cervical screening invitations and reminders;introducing revised invitation correspondence, and a subsequent reminder letter, that is sent at 24.5 years old to specifically highlight the need to attend cervical screening, even if they have had the human papillomavirus (HPV) vaccination, and raise awareness of HPV vaccine catch-up offers, for those up to 25 years old;using the new IT system, the Cervical Screening Management System, to enable an opt-in process for transgender and non-binary people’s screening invitations, to ensure that no-one eligible misses the opportunity to be invited and participate;expanding the of the range of accessible public information materials across all screening programmes, and continuing to highlight the importance of screening within our regular equalities-focused communications and engagement;developing an agile cervical screening workforce that can respond to fluctuations in demand through workforce planning, accounting for potential future changes to screening offers, directed by the UK National Screening Committee;identifying low-cost or no-cost opportunities to communicate the NHS’s aim to eliminate cervical cancer by 2040, highlighting the value of cervical screening and the HPV vaccination as fundamental to achieving this goal; andThe UK National Screening Committee’s consideration of whether the introduction of self-sampling for non-attenders to the cervical screening programme may increase uptake.