Written questions by Ribeiro-Addy.

What estimate he has made of the number of patients unable to secure appointments with their GP due to (a) digital exclusion and (b) lack of telephone access.

General practices (GPs) and other National Health Service organisations are encouraged to support patients to use online routes where this would be convenient for them, and there is work to improve the usability of digital tools so that they are accessible to larger numbers of patients. However, a choice of access routes should remain available. As outlined in the GP Contract, digital services should be provided in addition to other channels for accessing GPs, such as in person visits, rather than as a replacement. Practice receptions should also remain open to ensure that those without access to a telephone or online services are not disadvantaged.

If he will make an assessment of the potential merits of reviewing the minimum iron level required to donate blood.

NHS Blood and Transplant (NHSBT) tests for haemoglobin levels rather than iron levels ahead of blood donation. If the test shows that the haemoglobin is low, the donor is deferred and information is provided on how they can increase haemoglobin levels through altering their diet, and book an appointment with their general practitioner if levels are particularly low. On average, 7% to 11% of donors are deferred because of low haemoglobin levels, but this rises to 12% of black heritage donors and to 25% of female black heritage donors. These deferrals impact on donor retention, as donors deferred for low haemoglobin are less likely to return.Currently there are no plans to review minimum haemoglobin levels to donate blood. Donors whose haemoglobin levels are below safe levels to donate are deferred in accordance with the Blood Safety and Quality Regulations 2005 and the guidance issued by the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) which states ‘taking a donation from a person with a haemoglobin concentration below the recommended value may make them anaemic’.Increasing diversity in the donor base is a priority for NHSBT, so they can provide matched blood for more patients, including those with rare blood types commonly found in black, Asian, and minority ethnic women. NHSBT provides grants to community and faith groups to encourage donation, including in black, Asian, and minority ethnic communicates. The Department provided seed funding for NHSBT to increase its collection capacity, particularly in diverse areas where higher proportions of the population have rare blood types, including Brixton and Brighton.

What assessment he has made of the impact of blood donation rules on iron levels on the number of Black, Asian and Minority Ethnic women unable to donate blood.

NHS Blood and Transplant (NHSBT) tests for haemoglobin levels rather than iron levels ahead of blood donation. If the test shows that the haemoglobin is low, the donor is deferred and information is provided on how they can increase haemoglobin levels through altering their diet, and book an appointment with their general practitioner if levels are particularly low. On average, 7% to 11% of donors are deferred because of low haemoglobin levels, but this rises to 12% of black heritage donors and to 25% of female black heritage donors. These deferrals impact on donor retention, as donors deferred for low haemoglobin are less likely to return.Currently there are no plans to review minimum haemoglobin levels to donate blood. Donors whose haemoglobin levels are below safe levels to donate are deferred in accordance with the Blood Safety and Quality Regulations 2005 and the guidance issued by the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) which states ‘taking a donation from a person with a haemoglobin concentration below the recommended value may make them anaemic’.Increasing diversity in the donor base is a priority for NHSBT, so they can provide matched blood for more patients, including those with rare blood types commonly found in black, Asian, and minority ethnic women. NHSBT provides grants to community and faith groups to encourage donation, including in black, Asian, and minority ethnic communicates. The Department provided seed funding for NHSBT to increase its collection capacity, particularly in diverse areas where higher proportions of the population have rare blood types, including Brixton and Brighton.

What assessment he has made of the potential impact of blood donation rules on (a) iron levels in and (b) the adequacy of the supply of rare blood types commonly found in Black, Asian and Minority Ethnic women.

NHS Blood and Transplant (NHSBT) tests for haemoglobin levels rather than iron levels ahead of blood donation. If the test shows that the haemoglobin is low, the donor is deferred and information is provided on how they can increase haemoglobin levels through altering their diet, and book an appointment with their general practitioner if levels are particularly low. On average, 7% to 11% of donors are deferred because of low haemoglobin levels, but this rises to 12% of black heritage donors and to 25% of female black heritage donors. These deferrals impact on donor retention, as donors deferred for low haemoglobin are less likely to return.Currently there are no plans to review minimum haemoglobin levels to donate blood. Donors whose haemoglobin levels are below safe levels to donate are deferred in accordance with the Blood Safety and Quality Regulations 2005 and the guidance issued by the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) which states ‘taking a donation from a person with a haemoglobin concentration below the recommended value may make them anaemic’.Increasing diversity in the donor base is a priority for NHSBT, so they can provide matched blood for more patients, including those with rare blood types commonly found in black, Asian, and minority ethnic women. NHSBT provides grants to community and faith groups to encourage donation, including in black, Asian, and minority ethnic communicates. The Department provided seed funding for NHSBT to increase its collection capacity, particularly in diverse areas where higher proportions of the population have rare blood types, including Brixton and Brighton.

Whether the Maternity Disparities Taskforce is still active; how many meetings of that taskforce have taken place since it was established; and if he will publish the (a) dates and (b) durations of those meetings.

The Maternity Disparities Taskforce is not currently active, having met six times on: 8 March 2022, 16 May 2022, 18 July 2022, 18 April 2023, 5 September 2023 and 31 January 2024. The duration of these meetings were approximately an hour and a half.It is a priority for the Government to make sure all women and babies receive the high-quality care they deserve, regardless of their background or ethnicity.  The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health, Baroness Merron, is considering the immediate action needed to tackle inequalities for women and babies and racism in maternity services; including what targets are needed.

What steps he is taking to support Start for Life services in Lambeth; and if he will extend the funding of such services beyond 1 April 2025.

The Family Hubs and Start for Life programme is central to delivering the Government’s commitments to give every baby the best start in life, and to deliver the healthiest generation of children ever. Lambeth is one of 75 local authorities the Government is funding to ensure parents and carers can access Start for Life services, from conception to the age of two years old.We work closely with Lambeth to support programme implementation across all funded strands, and they have opened six Family Hub sites with Start for Life services at their heart since 2023. We also signpost policy toolkits, provide guidance, and facilitate the sharing of good practice between local authorities.The Autumn Budget announcement included £69 million to continue delivery of a network of Family Hubs in 2025/26. The Department will confirm Start for Life funding in due course.

If he will make an assessment of the potential implications for (a) his policies and (b) the forthcoming UK National Screening Committee review on prostate cancer guidelines of the findings of the report by Prostate Cancer UK entitled Lifetime risk of being diagnosed with, or dying from, prostate cancer by major ethnic group in England 2008–2010, published in July 2015, on the risk of prostate cancer for Black men.

The UK National Screening Committee (UK NSC) is carrying out an evidence review for prostate cancer screening, and this includes different potential ways of screening the whole population from 40 years of age onwards, and targeted screening programmes aimed at groups of men identified as being at higher than average risk, such as those with a family history, carriers of the BRCA2 gene mutation, and based on ethnicity.The UK NSC is aware of Prostate Cancer UK’s report, and this will be considered as part of its evidence review process, with further information available at the following link:https://www.gov.uk/government/publications/uk-nsc-evidence-review-process/uk-nsc-evidence-review-process

With reference to Prostate Cancer UK's study entitled Using real world data to bridge the evidence gap left by prostate cancer screening trials, published in October 2024, what assessment he has made of the potential implications for his policies of the finding relating to the reduction in potential harm following prostate-specific antigen testing.

The UK National Screening Committee (UK NSC) does not currently recommend screening for prostate cancer. This is because of the inaccuracy of the current best test for the condition, the prostate specific antigen test.A UK NSC evidence review for prostate cancer screening is already underway. We welcome the study by Prostate Cancer UK, and will make sure it is fed into the UK NSC’s review of prostate screening.

Whether he is issuing guidance to GPs encouraging them to discuss a PSA test with men at the highest risk of developing prostate cancer.

The UK National Screening Committee is carrying out an evidence review of prostate cancer screening which includes looking at the evidence for targeted screening of specific high-risk groups. This will determine whether a Prostate Specific Antigen (PSA) test-based screening programme for high-risk groups could provide more good than harm.Based on the current evidence, the guidance to general practices is not to proactively offer a PSA to men without symptoms as the high level of inaccuracy could lead to unnecessary tests that carry risks of life-changing harm, such as urinary and faecal incontinence, sexual dysfunction, as well as a smaller but serious risk of sepsis. Additionally, some prostate cancers may not produce elevated PSA levels, leading to false-negative results that provide deceptive reassurance.

How many students were enrolled on (a) pre-registration undergraduate and (b) postgraduate midwifery courses in each year of study in each of the last five years.

In order to bring together questions on the education and training of midwives and the flow of staff into the National Health Service midwifery workforce, a number of strands of the available data are presented below.Data published by the Office for Students, in the Higher Education Students Early Statistics Survey (HESES), collates figures submitted by individual higher education providers to give an indication of the number of students starting in each academic year. The HESES’ data includes figures on undergraduate and postgraduate midwifery courses in England. The latest published data is for those starting courses in 2023. The following table shows the number of undergraduate and postgraduate starters on midwifery courses in England for 2019 to 2023:20192020202120222023Undergraduate starters2,9303,4603,5653,3053,255Postgraduate starters55100135190195Source: The Office for Students’ HESES data for 2023.The following table shows the number of qualifiers from undergraduate midwifery courses in England, with a qualifier being defined by the Higher Education Statistics Agency (HESA) as a student who gained a qualification during the academic year in question, for the academic years 2020/21 to 2022/23: 2020/212021/222022/23Undergraduate midwifery qualifiers1,8952,3802,705Source: HESA’s qualifier data 2023Note: Data is currently only available up to the academic year 2022/23.Additionally, there are midwives training through an apprenticeship route. The following table shows the number of starts on midwifery apprenticeships, including apprenticeships within NHS and non-NHS organisations, in each of the last five years:Year2019/202020/212021/222022/232023/24Starts2639224272Source: Department for Education Apprenticeships and traineeships statistics, October 2024.Note: Data on the provisional starts for the year 2023/24 is only available between August 2023 to July 2024.The Department does not hold data which would allow the identification of the route which joiners to the NHS registered midwifery workforce have taken to become active in the service, or what these flows will be in future years. Data published by NHS England does show the total annual number of staff who join active service across NHS trusts and other core organisations. Joiners are not the same as those recruited to the NHS, as they will include staff returning after breaks in activity. Joiners will also include experienced midwives joining from non-NHS providers. Within this data we can see the number who are joiners at Agenda for Change pay band five, which is where newly qualified or less experience staff would be placed. Data also contains the nationality of staff joining active service, and whilst self-reported nationality is not the same as place of training or previous residence, it does provide a guide to scale. The following table shows the annual number of midwives joining active service in the NHS in England, as well as those joining at band five, and those joining who reported non-United Kingdom nationalities, for each of the last five years up until June:Year endingJune 2020June 2021June 2022June 2023June 2024Annual midwives joining active service3,2421,8453,3203,8834,278Joining at band five1,6854211,7662,1722,479Joining any grade with a non-UK nationality243155247593616Source: NHS England, NHS Workforce Statistics.

How many people graduated from pre-registration undergraduate midwifery courses as newly-qualified midwives in each of the last five years.

In order to bring together questions on the education and training of midwives and the flow of staff into the National Health Service midwifery workforce, a number of strands of the available data are presented below.Data published by the Office for Students, in the Higher Education Students Early Statistics Survey (HESES), collates figures submitted by individual higher education providers to give an indication of the number of students starting in each academic year. The HESES’ data includes figures on undergraduate and postgraduate midwifery courses in England. The latest published data is for those starting courses in 2023. The following table shows the number of undergraduate and postgraduate starters on midwifery courses in England for 2019 to 2023:20192020202120222023Undergraduate starters2,9303,4603,5653,3053,255Postgraduate starters55100135190195Source: The Office for Students’ HESES data for 2023.The following table shows the number of qualifiers from undergraduate midwifery courses in England, with a qualifier being defined by the Higher Education Statistics Agency (HESA) as a student who gained a qualification during the academic year in question, for the academic years 2020/21 to 2022/23: 2020/212021/222022/23Undergraduate midwifery qualifiers1,8952,3802,705Source: HESA’s qualifier data 2023Note: Data is currently only available up to the academic year 2022/23.Additionally, there are midwives training through an apprenticeship route. The following table shows the number of starts on midwifery apprenticeships, including apprenticeships within NHS and non-NHS organisations, in each of the last five years:Year2019/202020/212021/222022/232023/24Starts2639224272Source: Department for Education Apprenticeships and traineeships statistics, October 2024.Note: Data on the provisional starts for the year 2023/24 is only available between August 2023 to July 2024.The Department does not hold data which would allow the identification of the route which joiners to the NHS registered midwifery workforce have taken to become active in the service, or what these flows will be in future years. Data published by NHS England does show the total annual number of staff who join active service across NHS trusts and other core organisations. Joiners are not the same as those recruited to the NHS, as they will include staff returning after breaks in activity. Joiners will also include experienced midwives joining from non-NHS providers. Within this data we can see the number who are joiners at Agenda for Change pay band five, which is where newly qualified or less experience staff would be placed. Data also contains the nationality of staff joining active service, and whilst self-reported nationality is not the same as place of training or previous residence, it does provide a guide to scale. The following table shows the annual number of midwives joining active service in the NHS in England, as well as those joining at band five, and those joining who reported non-United Kingdom nationalities, for each of the last five years up until June:Year endingJune 2020June 2021June 2022June 2023June 2024Annual midwives joining active service3,2421,8453,3203,8834,278Joining at band five1,6854211,7662,1722,479Joining any grade with a non-UK nationality243155247593616Source: NHS England, NHS Workforce Statistics.

How many people have entered the NHS midwifery workforce through (a) pre-registration undergraduate courses, (b) apprenticeships, (c) postgraduate conversion from nursing, (d) return to midwifery programmes, (e) international recruitment and (f) other routes according to the most recent data available to his Department; and what assessment his Department has made of the contribution of each route to growing that workforce over the (i) last and (ii) next five years.

In order to bring together questions on the education and training of midwives and the flow of staff into the National Health Service midwifery workforce, a number of strands of the available data are presented below.Data published by the Office for Students, in the Higher Education Students Early Statistics Survey (HESES), collates figures submitted by individual higher education providers to give an indication of the number of students starting in each academic year. The HESES’ data includes figures on undergraduate and postgraduate midwifery courses in England. The latest published data is for those starting courses in 2023. The following table shows the number of undergraduate and postgraduate starters on midwifery courses in England for 2019 to 2023:20192020202120222023Undergraduate starters2,9303,4603,5653,3053,255Postgraduate starters55100135190195Source: The Office for Students’ HESES data for 2023.The following table shows the number of qualifiers from undergraduate midwifery courses in England, with a qualifier being defined by the Higher Education Statistics Agency (HESA) as a student who gained a qualification during the academic year in question, for the academic years 2020/21 to 2022/23: 2020/212021/222022/23Undergraduate midwifery qualifiers1,8952,3802,705Source: HESA’s qualifier data 2023Note: Data is currently only available up to the academic year 2022/23.Additionally, there are midwives training through an apprenticeship route. The following table shows the number of starts on midwifery apprenticeships, including apprenticeships within NHS and non-NHS organisations, in each of the last five years:Year2019/202020/212021/222022/232023/24Starts2639224272Source: Department for Education Apprenticeships and traineeships statistics, October 2024.Note: Data on the provisional starts for the year 2023/24 is only available between August 2023 to July 2024.The Department does not hold data which would allow the identification of the route which joiners to the NHS registered midwifery workforce have taken to become active in the service, or what these flows will be in future years. Data published by NHS England does show the total annual number of staff who join active service across NHS trusts and other core organisations. Joiners are not the same as those recruited to the NHS, as they will include staff returning after breaks in activity. Joiners will also include experienced midwives joining from non-NHS providers. Within this data we can see the number who are joiners at Agenda for Change pay band five, which is where newly qualified or less experience staff would be placed. Data also contains the nationality of staff joining active service, and whilst self-reported nationality is not the same as place of training or previous residence, it does provide a guide to scale. The following table shows the annual number of midwives joining active service in the NHS in England, as well as those joining at band five, and those joining who reported non-United Kingdom nationalities, for each of the last five years up until June:Year endingJune 2020June 2021June 2022June 2023June 2024Annual midwives joining active service3,2421,8453,3203,8834,278Joining at band five1,6854211,7662,1722,479Joining any grade with a non-UK nationality243155247593616Source: NHS England, NHS Workforce Statistics.

If he will make an assessment of the adequacy of the availability of flexible working arrangements for NHS midwives.

All employees covered by the NHS Terms and Conditions of Service Handbook have the right to request flexible working from day one, without the need to provide a justification.NHS England is committed to promoting and supporting flexible working opportunities in midwifery, and across the wider National Health Service workforce. They have brought together midwifery leaders from across the system to support the implementation of flexible working across maternity services. There are no plans to assess the adequacy of flexible working arrangements specifically for maternity staff at this time.

How many and what proportion of people who joined the NHS as a midwife were newly-qualified as midwives in each of last five years.

In order to bring together questions on the education and training of midwives and the flow of staff into the National Health Service midwifery workforce, a number of strands of the available data are presented below.Data published by the Office for Students, in the Higher Education Students Early Statistics Survey (HESES), collates figures submitted by individual higher education providers to give an indication of the number of students starting in each academic year. The HESES’ data includes figures on undergraduate and postgraduate midwifery courses in England. The latest published data is for those starting courses in 2023. The following table shows the number of undergraduate and postgraduate starters on midwifery courses in England for 2019 to 2023:20192020202120222023Undergraduate starters2,9303,4603,5653,3053,255Postgraduate starters55100135190195Source: The Office for Students’ HESES data for 2023.The following table shows the number of qualifiers from undergraduate midwifery courses in England, with a qualifier being defined by the Higher Education Statistics Agency (HESA) as a student who gained a qualification during the academic year in question, for the academic years 2020/21 to 2022/23: 2020/212021/222022/23Undergraduate midwifery qualifiers1,8952,3802,705Source: HESA’s qualifier data 2023Note: Data is currently only available up to the academic year 2022/23.Additionally, there are midwives training through an apprenticeship route. The following table shows the number of starts on midwifery apprenticeships, including apprenticeships within NHS and non-NHS organisations, in each of the last five years:Year2019/202020/212021/222022/232023/24Starts2639224272Source: Department for Education Apprenticeships and traineeships statistics, October 2024.Note: Data on the provisional starts for the year 2023/24 is only available between August 2023 to July 2024.The Department does not hold data which would allow the identification of the route which joiners to the NHS registered midwifery workforce have taken to become active in the service, or what these flows will be in future years. Data published by NHS England does show the total annual number of staff who join active service across NHS trusts and other core organisations. Joiners are not the same as those recruited to the NHS, as they will include staff returning after breaks in activity. Joiners will also include experienced midwives joining from non-NHS providers. Within this data we can see the number who are joiners at Agenda for Change pay band five, which is where newly qualified or less experience staff would be placed. Data also contains the nationality of staff joining active service, and whilst self-reported nationality is not the same as place of training or previous residence, it does provide a guide to scale. The following table shows the annual number of midwives joining active service in the NHS in England, as well as those joining at band five, and those joining who reported non-United Kingdom nationalities, for each of the last five years up until June:Year endingJune 2020June 2021June 2022June 2023June 2024Annual midwives joining active service3,2421,8453,3203,8834,278Joining at band five1,6854211,7662,1722,479Joining any grade with a non-UK nationality243155247593616Source: NHS England, NHS Workforce Statistics.

With reference to the Levelling Up the United Kingdom White Paper, published in February 2022, whether he is taking steps to implement the Community Eatwell pilot.

The prevention of ill health is a clear mission for the Government, and the cornerstone of this is supporting people to live healthier lives. The Government is committed to creating the healthiest generation of children ever, as set out in our Child Health Action Plan. The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or can be put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old.The Government also encourages everyone to have a healthy balanced diet in line with the United Kingdom’s Eatwell Guide. Further action on diet and obesity under the Government’s Health Mission will be set out in due course.

What steps he is taking to increase the (a) access to and (b) affordability of (i) fruit and (ii) vegetables for families living on low incomes in Lambeth.

The Government is committed to creating the healthiest generation of children ever, as set out in our Child Health Action Plan. The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or can be put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old.The NHS Business Services Authority (NHS BSA) delivers the scheme on behalf of the Department. The NHS BSA is committed to increasing uptake of the Healthy Start scheme to ensure as many children as possible have a healthy start in life.The NHS BSA promotes the Healthy Start scheme through its digital channels and has created free tools to help stakeholders promote the scheme locally. The NHS BSA has also reached out to stakeholders to see how it can support them in promoting the scheme.The Government is committed to a prosperous horticulture sector and values the vital work of the industry in maintaining a secure supply of fruit and vegetables.

Whether he plans to update the 2021 NICE guideline for long covid.

We have no plans to instruct the National Institute for Health and Care Excellence (NICE) to review its guideline on managing the long-term effects of COVID-19. The 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 the NICE’s Prioritisation Board, in line with NICE’s published common prioritisation framework. The NICE does not currently have plans to update its guideline on managing the long-term effects of COVID-19.

What recent assessment he has made of the potential impact of Long Covid on the health and social care workforce.

The most recent data from the Office for National Statistics estimated that for the 4-week period ending 5 March 2023, 4.41% of healthcare workers and 5.33% of social care workers had self-reported long COVID symptoms of any duration.

Whether he has made an assessment of the potential merits of supporting the wider roll-out of air filtration systems within NHS services.

No such assessment has been made. National Health Service organisations and primary care providers regularly review all their estates locally to ensure they meet the required standards for ventilation and infection, as well as the required prevention and control measures, and will invest in improvements where required. Guidance is provided to the NHS on air quality in its facilities in the Health Technical Memorandum 03-01: Specialised ventilation for healthcare premises, and the NHS Estates Technical Bulletin (NETB 2023/01A): application of HEPA filter devices for air cleaning in healthcare spaces: guidance and standards, with further information available at the following link:https://www.england.nhs.uk/publication/specialised-ventilation-for-healthcare-buildings/Guidance to the NHS on air quality in its facilities is also provided in the NHS Estates Technical Bulletin (NETB 2023/01B): application of ultraviolet (UVC) devices for air cleaning in occupied healthcare spaces: guidance and standards, with further information available at the following link:https://www.england.nhs.uk/long-read/application-of-ultraviolet-uvc-devices-for-air-cleaning-in-occupied-healthcare-spaces-guidance-and-standards/NHS guidance is reviewed and updated in response to changes in clinical practice, technology, and risk assessments.

What steps he is taking to improve access to community-based mental health support for low-income children and families.

There are currently approximately 65 locally funded early support hubs in England offering early access mental health interventions to thousands of children and young people aged 11 to 25 years old, including those from low-income families.The Department is running a £8 million Shared Outcomes Fund project throughout 2024/25 to boost and evaluate the impact of 24 of these existing early support hubs, including two in London.In addition, we will roll out Young Futures hubs in every community. This national network is expected to bring local services together, deliver support for teenagers at risk of being drawn into crime or facing mental health challenges and, where appropriate, deliver universal youth provision. They will provide open access mental health support for children and young people in every community.We will be working closely with colleagues across the Government to design Young Futures hubs, as well as engaging widely with young people and stakeholders to shape their service offer.