Written questions by Ribeiro-Addy.

What steps his Department is taking to improve coordination between NHS hospitals within the same region to offer patients earlier appointments at alternative sites.

As set out in the Plan for Change, we have committed to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment (RTT) by March 2029.Planning Guidance for 2025/26 sets a target that 65% of patients wait for 18 weeks or less by March 2026, with every trust expected to deliver a minimum 5 percentage point improvement on current performance over that period.It is for Integrated Care Boards (ICBs) to determine how best to manage their system capacity to meet this target. Mutal aid is a route some systems are using for those waiting longest. This can mean that some patients receive treatment at a different hospital to the one they originally selected (with the patient’s agreement).NHS England regional and national teams work with providers and ICBs with particularly significant waits, and this can include identifying alternative capacity outside of individual systems.Patients have a right to choose their provider when they are referred to consultant-led care as an outpatient, informed by waiting times information. Patients also have a right to request their ICB find an alternative provider if they are waiting over 18 weeks for consultant-led care.

If he will make an assessment of the potential impact of the Government’s immigration policies on trends in the level of recruitment of internationally educated nurses into (a) the NHS and (b) social care roles; and whether he has prepared contingency plans for a reduction in the level of recruitment.

The immediate changes to the skills thresholds outlined in the Immigration White Paper relate to roles below Regulated Qualifications Framework (RQF) level 6. Nurses meet the new skill threshold of RQF level 6 and in turn remain eligible for the Health and Care Worker visa. The Government is committed to developing homegrown talent and giving opportunities to more people across the country to join our National Health Service. The 10 Year Workforce Plan will outline strategies for improving retention, productivity, training, and reducing attrition, thereby enhancing conditions for all staff while gradually reducing reliance on international recruitment, without diminishing the value of their contributions. We acknowledge that the adult social care sector faces significant challenges in the recruitment and retention of the nursing workforce and we recognise the need for a strong emphasis on retaining nurses within adult social care, by supporting and valuing the workforce. The Department continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool, and intelligence from key sector partners.

Pursuant to the Answer of 2 July 2025 to Question 63048 on Blood: Donors, if he will publish the combined ethnic and gender breakdown of the 173,574 donors deferred due to Haemoglobin as a proportion of (a) total deferrals and (b) total deferrals per ethnic group.

NHS Blood and Transplant is responsible for collecting blood donations across England, in order to fulfil hospital requests to meet patient need. From 1 June 2024 to 31 May 2025, a total of 173,574 donors were deferred due to low haemoglobin. The table attached shows the combined ethnic and gender breakdown of these deferrals as a proportion of total deferrals, and the total deferrals per ethnic group.

Pursuant to the Answer of 2 July 2025 to Question 63048 on Blood: Donors, if he will publish the ethnic and gender breakdown of the 4,493 donors deferred due to travel as a proportion of (a) total deferrals and (b) total deferrals per ethnic group.

NHS Blood and Transplant is responsible for collecting blood donations across England, in order to fulfil hospital requests to meet patient need. From 1 June 2024 to 31 May 2025, a total of 4,493 donors deferred due to travel. The table attached shows the ethnic and gender breakdown of these deferrals as a proportion of total deferrals and the total deferrals per ethnic group.

Pursuant to the Answer of 2 July 2025 to Question 63048 on Blood: Donors, if she will provide the ethnic breakdown of the 173,574 donors deferred due to Haemoglobin as a proportion of (a) total deferrals and (b) total deferrals per ethnic group.

NHS Blood and Transplant (NHSBT) is responsible for collecting blood donations across England, in order to fulfil hospital requests to meet patient need. From 1 June 2024 to 31 May 2025, a total of 173,574 donors were deferred due to low haemoglobin. The following table shows the ethnic breakdown of these deferrals as a proportion of total deferrals, and the total deferrals per ethnic group:EthnicityTotal deferralsLow haemoglobin deferralsPercentage of total deferralsPercentage of total deferrals per ethnicityAny other Asian background3,4481,7370.6%50.4%Any other Black/African/Caribbean background7244600.2%63.5%Any other ethnic group1,4096680.2%47.4%Any other mixed/multiple ethnic background2,1141,1910.4%56.3%Any other White background17,3439,5583.3%55.1%Arab1,0054290.1%42.7%Asian Bangladeshi8174440.2%54.3%Asian Indian7,1764,3671.5%60.9%Asian Pakistani2,1261,0730.4%50.5%Black- African6,5624,1951.4%63.9%Black- Caribbean3,6632,4720.8%67.5%Chinese1,7099210.3%53.9%English/Welsh/Scottish/Northern Irish/British231,879139,70148.0%60.2%Mixed White and Asian2,0711,0800.4%52.1%Mixed White and Black African8425000.2%59.4%Mixed White and Black Caribbean2,0931,3190.5%63.0%Not disclosed1,5168690.3%57.3%Unknown8804300.1%48.9%White Irish3,6342,1600.7%59.4%Total291,011173,57459.6%59.6%Source: data is taken from NHSBT’s centrally held administrative systems, extracted 27 June 2025Note: ‘Any other ethnic group’ includes Gypsy or Irish Traveller and Roma to comply with small number suppression.

Whether he has made an assessment of the potential merits of routinely publishing data on (a) blood donations and (b) donation deferrals.

NHS Blood and Transplant (NHSBT) is responsible for blood donation in England.NHSBT does not routinely publish data on blood donation or donation deferrals, however it agrees that there is merit in publishing this data routinely and is considering doing so on an annual basis.

Pursuant to the Answer of 2 July 2025 to Question 63048 on Blood: Donors, whether he will provide a breakdown of the top 10 countries travelled to by the 4,493 donors deferred due to travel.

NHS Blood and Transplant (NHSBT) is responsible for blood donation in England. NHSBT has confirmed that they do not hold the requested data.

Pursuant to the Answer of 2 July 2025 to Question 63048 on Blood: Donors, what the ethnic breakdown is of the 4,493 donors deferred due to travel; and what this is as a proportion of (a) total deferrals and (b) total deferrals per ethnic group.

NHS Blood and Transplant (NHSBT) is responsible for collecting blood donations across England, in order to fulfil hospital requests to meet patient need.From 1 June 2024 to 31 May 2025, a total of 4,493 donors deferred due to travel. The following table shows the ethnic breakdown of these deferrals as a proportion of (a) total deferrals and (b) total deferrals per ethnic group:EthnicityTotal DeferralsDeferrals due to Travel% of Total Deferrals% Total Deferrals by EthnicityAny other Asian background3,448630.0%1.8%Any other Black/African/Caribbean background724210.0%2.9%Any other ethnic group*1,409440.0%3.1%Any other Mixed / Multiple ethnic background2,114380.0%1.8%Any other White background17,3432730.1%1.6%Arab1,005200.0%2.0%Asian Bangladeshi817110.0%1.3%Asian Indian7,1761570.1%2.2%Asian Pakistani2,1262320.1%10.9%Black- African6,5622650.1%4.0%Black- Caribbean3,663660.0%1.8%Chinese1,709340.0%2.0%English/Welsh/Scottish/Northern Irish/British231,8793,1071.1%1.3%Mixed White and Asian2,071390.0%1.9%Mixed White and Black African842150.0%1.8%Mixed White and Black Caribbean2,093230.0%1.1%Not Disclosed1,516200.0%1.3%Unknown880190.0%2.2%White Irish3,634460.0%1.3%Grand Total291,0114,4931.5%1.5%Source: NHSBT’s centrally held administrative systems, extracted 27 June 2025.Note: *Any other ethnic group includes Gypsy or Irish Traveller and Roma to comply with small number suppression.

What assessment his Department has made of the potential impact of immigration salary thresholds on the number of overseas NHS staff on band three Agenda for Change pay.

From 9 April 2025, the minimum salary for Health and Care Worker Visa holders increased to £25,000 per year. This applies to new Certificates of Sponsorship assigned on or after that date. Entry level National Health Service Agenda for Change band 3 roles do not meet the new minimum salary threshold for a Health and Care Worker visa.NHS Agenda for Change pay band 3 staff currently on the Health and Care Worker visa are not required to meet the new minimum salary threshold until the point at which they need to renew their visa. At this point, we expect the majority of staff to have accrued two or more years experience, and therefore be at the top of pay band 3, which is above the new minimum salary threshold.Whilst we hugely value our international workforce and the skills and experience they bring, we are also committed to growing homegrown talent and giving opportunities to more people across the country to join our NHS. The 10 Year Workforce Plan will outline strategies for improving retention, productivity, training, and reducing attrition, thereby enhancing conditions for all staff while gradually reducing reliance on international recruitment, without diminishing the value of their contributions.

What steps his Department is taking to review severity modifiers used by the National Institute for Health and Care Excellence to assess treatments for incurable secondary breast cancer.

The National Institute for Health and Care Excellence (NICE) is responsible for the methods and processes that it uses in the development of its recommendations. The severity modifier was introduced in January 2022 as part of a number of changes intended to make NICE’s methods fairer, faster, and more consistent.NICE carried out a review of the implementation of the severity modifier in September 2024 and found that it is operating as intended. Since the introduction of the severity modifier in December 2022, the proportion of positive cancer recommendations is higher, at 84.8%, than with the end-of-life modifier it replaced, at 75%, and the proportion of positive recommendations for advanced cancer treatments is also higher, at 81.1% compared to 69%.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews.

What steps his Department is taking to ensure that experienced non-medical aesthetic practitioners are included in (a) consultations and (b) policy development on the regulation of cosmetic procedures.

In exploring options for the regulation of cosmetic procedures, the Department has engaged with a broad range of stakeholders, including representatives from the British Beauty Council and the Beauty Industry Group. The Department will continue to engage with a broad range of stakeholders in addressing concerns about the safety of the cosmetics sector, and will notify them of any upcoming consultations on this area to which they can contribute.

What discussions his Department has had with representative bodies of non-medical aesthetic practitioners on regulatory proposals for that sector.

In exploring options for the regulation of cosmetic procedures, the Department has engaged with a broad range of stakeholders, including representatives from the British Beauty Council and the Beauty Industry Group. The Department will continue to engage with a broad range of stakeholders in addressing concerns about the safety of the cosmetics sector, and will notify them of any upcoming consultations on this area to which they can contribute.

What assessment his Department has made of the potential impact of the National Institute for Health and Care Excellence's changes to drug appraisal methods on access to new treatments for people with secondary breast cancer.

The National Institute for Health and Care Excellence (NICE) is responsible for the methods and processes that it uses in the development of its recommendations. The severity modifier was introduced in January 2022 as part of a number of changes intended to make NICE’s methods fairer, faster, and more consistent.NICE carried out a review of the implementation of the severity modifier in September 2024 and found that it is operating as intended. Since the introduction of the severity modifier in December 2022, the proportion of positive cancer recommendations is higher, at 84.8%, than with the end-of-life modifier it replaced, at 75%, and the proportion of positive recommendations for advanced cancer treatments is also higher, at 81.1% compared to 69%.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews.

What steps he is taking to ensure that patients with incurable secondary breast cancer are able to access new life-extending treatments.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources.To enable rapid access for NHS patients to new and effective life-extending treatments, NICE aims, wherever possible, to issue recommendations on new medicines close to the point of licensing.NHS England is legally required to fund the use of NICE approved cancer medicines from the date of positive draft guidance, and the Cancer Drugs Fund provides £340 million of ringfenced funding to support patient access to the most promising new cancer medicines while further evidence is collected on their use to address clinical uncertainty.NICE has recommended 24 out of the 25 breast cancer treatments it has assessed since April 2018.

How many sickle cell patients (a) with and (b) without the Ro subtype were unable to receive a matching transfusion due to low supplies in the last 12 months.

NHS Blood and Transplant is responsible for collection of blood donations and supply of blood and blood products to hospitals to meet patient need in England.Data is not held centrally on the purpose for which each blood product is requested and supplied.

How many and what proportion of blood donors with Ro blood type have had their donations deferred in the last 12 months; and what was the reason for those deferrals.

Between 1 June 2024 and 31 May 2025, the number of Ro blood type donor attendances was 59,655. Of those, 9,978, or 16.7%, were deferred. The following table show the number of Ro donor deferrals, the percentage of Ro donor attendances, and the percentage of total Ro deferrals, broken down by the reason for deferral:ReasonNumber of Ro donor deferralsPercentage of Ro donor attendancesPercentage of total Ro deferralsAdministrative2840.5%2.8%Blood Pressure530.1%0.5%Clinical890.1%0.9%Haemoglobin6,80611.4%68.2%Infection / contact5090.9%5.1%Medical1,3932.3%14.0%Other400.1%0.4%Skin piercing2390.4%2.4%Surgery1130.2%1.1%Travel1830.3%1.8%Vaccination460.1%0.5%No suitable vein2230.4%2.2%Total9,97816.7%100%Note: this data refers to whole blood donors only and does not include plasma or platelet donors.The codes that are given above are used to group together a range of more specific reasons for deferral, particularly the “medical” deferral code. It is not possible to provide a more detailed breakdown of this code without accessing individual donor records.

How many and what proportion of blood donors have had their appointment deferred due to (a) low haemoglobin, (b) recent travel, (c) activities that increase risk of HIV infection, (d) anaemia, (e) hepatitis exposure, (f) hypertension, (g) medications, (h) pregnancy, (i) recent vaccination, (j) no viable vein and (k) any other reason for deferral by (i) ethnicity, (ii) gender, (iii) age and (iv) other identity markers in the last 12 months.

NHS Blood and Transplant (NHSBT) is responsible for collecting blood donations across England, in order to fulfil hospital requests to meet patient need.From 1 June 2024 to 31 May 2025, a total of 1,734,2851 appointments were attended. Of those, a total of 291,011, or 16.8%, were deferred.Codes are used to group together various reasons for deferral, particularly the “medical” deferral code. It is not possible to break down the reason for the deferrals further without accessing individual donor records. Anaemia is not distinguished from low haemoglobin during a session as a donor may be deferred when their haemoglobin is too low to donate, but is within “normal range” for other purposes. The following table shows the number and percentage of appointment deferrals, the deferral reason, and the percentage of attendances:Deferral reasonNumber deferredPercentage of attendances (%)Percentage of total deferrals (%)Administrative8,3920.52.9Blood Pressure1,9000.10.7Clinical8,9560.53.1Haemoglobin173,5741059.6Infection/Contact16,87615.8Medical53,7463.118.5Other1,7610.10.6Skin Piercing7,8770.52.7Surgery3,8470.21.3Travel4,4930.21.5Vaccination1,3690.10.5No Suitable Vein8,2200.52.8Total291,01116.8100.0Source: NHSBT’s centrally held administrative systems, extracted 27 June 2025Notes:administrative deferrals are non-clinical deferrals, for instance a donor who is unable to donate as insufficient time has elapsed between their previous donation and their current attendance; andthe data counts the unique number of appointments attended, not unique donors, and so a donor attending more than once in the period will be counted each time they attend. This data refers to whole blood donors only and does not include data on platelet and plasma donations. Tables showing further breakdowns by ethnicity, gender, age, and main blood group are attached, due to the size of the data.

What steps he plans to take through (a) dietary guidelines, (b) public health policy and (c) food strategies to (i) promote and (ii) help improve public access to (A) whole and (B) minimally processed foods.

The Government is promoting access to healthy food through dietary guidelines which are presented to the public through the Government’s Eatwell Guide. The terms ‘whole’ and ‘minimally processed’ are not used because they are difficult to define and could be interpreted as including foods that we are advised to eat less often and/or in small amounts, such as butter. The Eatwell Guide already advises that people should eat more fruit and vegetables, and more wholegrain or higher-fibre foods, as well as less processed meat, and less food and drink that is high in sugar, calories, saturated fat, and salt.The Eatwell Guide principles are communicated through a variety of channels, including the NHS.UK website and Government social marketing campaigns. For example, the Better Health Healthier Families website and the Healthy Steps email programme, which aims to help families with primary aged children in England to eat well and move more.Policies to promote and improve public access to whole and minimally processed foods include:- the Healthy Start scheme, which supported over 361,000 people in April 2025;- the Nursery Milk Scheme, which provides a reimbursement to childcare providers in England and Wales for a daily 1/3 pint portion of milk to children and babies; and- the School Fruit and Vegetable Scheme, which provides approximately 2.2 million children in Key Stage 1 with a portion of fresh fruit or vegetables per day at school.The Government has announced a new cross-Government Food Strategy. The Food Strategy aims to provide more easily accessible and affordable, safe, nutritious, healthy food to tackle diet-related ill health, helping to give children the best start in life and helping adults live longer, healthier lives.

Pursuant to the Answer of 5 March 2025 to Question 33072 on Stem Cell: Donors, if he will make it his policy to help develop a (a) sustainable and (b) resilient supply of stem cells from UK based donors; and whether he will commission an independent review of the (i) supply and (ii) use of hematopoietic stem cell transplantation.

Between 2022 and 2025, the Department’s Stem Cell Programme has provided £2.4 million of funding to Anthony Nolan and NHS Blood and Transplant for a three-year targeted stem cell donor recruitment campaign. The approach has focused on increasing the sustainability and resilience of the United Kingdom’s stem cell supply by recruiting donors most likely to donate, those being male donors aged 16 to 30 years old, and addressing health inequalities, with targeted campaigns to recruit donors from ethnic minorities. Funding to both organisations has been extended by one year, to 2025/26.The Department recognises the need to ensure stem cell supply and use for transplantation is optimised. However, there are no imminent plans to undertake an independent review.

What assessment he has made of the potential impact of the White Paper entitled Restoring Control over the Immigration System, published on 13 May 2025, on levels of retention of internationally-educated nursing staff in the NHS.

We hugely value our health and social care workers from overseas who work tirelessly to provide the best possible care and enhance our health and care workforce with their valuable skills, experience and expertise. We are committed to providing high-quality support to internationally educated nursing staff to help their integration into the National Health Service workforce and to creating a compassionate and inclusive work culture that has a focus on staff health and wellbeing.No assessment has been made of the potential impact of the White Paper, Restoring Control over the Immigration System, on levels of retention of internationally educated nursing staff in the NHS. This government remains committed to developing homegrown talent and giving opportunities to more people across the country to join our NHS. The Immigration White Paper set out reforms to legal migration, so that we can restore order, control and fairness to the system, bring down net migration and promote economic growth. The changes set out include a complete overhaul of the relationship between the immigration system, training and the labour market to support sustainable growth as well as a sustainable immigration system.The report by the Royal College of Nursing, Unreciprocated Care: why internationally educated nursing staff are leaving the UK, touches on some important issues, including on support and retention of internationally educated nursing staff. The Department will reflect further on the report and its recommendations, as we strive to continuously improve on the measures we already have in place, set out below, to support internationally recruited healthcare staff.On specific measures, the NHS Equality, Diversity and Inclusion Plan includes a High Impact Action that addresses the importance of ensuring that internationally recruited healthcare staff feel welcomed and valued at the start of their career.Successful induction processes and ongoing pastoral and professional support is of the utmost importance to retain newly recruited international staff so that they receive clear communication, guidance and support around their conditions of employment. The NHS Pastoral Care Quality Award scheme was set up to recognise a commitment to supporting internationally educated nurses and midwives at every stage of recruitment and beyond. As well as helping to standardise the quality and delivery of pastoral care, this award is an opportunity for trusts to have their work recognised and to demonstrate their commitment to supporting internationally educated nurses and midwives.NHS Employers has also published the International Retention Toolkit which outlines the actions employers can take to ensure internationally recruited staff will want to stay, thrive and build lasting careers in the NHS. The toolkit is available at the following link:https://www.nhsemployers.org/publications/international-retention-toolkit