Written questions by Stephenson.

With reference to the policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, how clinical negligence cases involving mistakes by surgical robots will be handled.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England.The bulk of NHSR’s workload is handling negligence claims on behalf of the members of their indemnity schemes. One of the indemnity schemes is the Clinical Negligence Scheme for Trusts (CNST). CNST handles all clinical negligence claims against member NHS bodies where the incident in question took place on or after 1 April 1995.The scheme covers all clinical negligence claims arising from the diagnosis, care, or treatment of patients by the Member, rather than specifying particular procedures.In every claim pursued, NHSR assesses whether their member has been negligent in treating the patient. This will include an assessment of whether any technology employed to assist the treatment has been used appropriately.It is important to note that surgical robots are not in anyway autonomous and are used as a surgical instrument by a qualified surgeon. This Government is setting a target of 500,000 robotic surgical operations by 2035 where the evidence supports it, in terms of faster recovery and reduced complications for patients.

With reference to page 15 of the policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, whether he has had discussions with the Secretary of State for Work and Pensions on the potential merits of co-locating Job Centre services within Neighbourhood Health Centres.

Our aim is to have a Neighbourhood Health Centre in each community that provides easier, more convenient access to a full range of health and care services on people’s doorsteps, bringing together National Health Service, local authority, and voluntary sector services in one building to help create a holistic offer that meets the needs of local populations.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While we will be clear on the outcomes we expect, and we will give significant licence to tailor the approach to local need, for example to consider the merits of co-locating Job Centre services within Neighbourhood Health Centres. While the focus on personalised, coordinated care will be consistent, this will mean services will look different in rural communities, coastal towns, and deprived inner cities.The rollout of Neighbourhood Health Centres will be progressive over this Parliament, with early sites focused on the areas of greatest need.Furthermore, the Government is committed to supporting more individuals into employment. On 9 October, the Department for Work Pensions confirmed Connect to Work funding of over £1 billion across England and Wales over the next five years, which will support 300,000 disabled people and people with health conditions and/or other complex barriers to employment to find and remain in work.There is a range of existing Department for Work Pensions employment support depending on individual needs, including local level provision for disabled people and disadvantaged groups. This includes employment advisors in Talking Therapies, increased Work Coach Support in Job Centres, and Access to Work grants, among others.

If he will make an estimate of the number of GPs per head of population in Bedfordshire by 2035, in the context of the 10 Year Health Plan.

Each general practice (GP) is required to provide services to meet the reasonable needs of their patients. There is no NHS England recommendation for how many patients a GP should have assigned, or the ratio of GPs or other practice staff to patients. The demands each patient places on their GP are different and can be affected by many different factors, including rurality and patient demographics. It is necessary to consider the workforce for each practice as a whole, not only GPs but also the range of health professionals available who are able to respond to the needs of their patients.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade to treat patients on time again.

If he will make an estimate of the number of face-to-face GP appointments in 2025/26.

This Government has committed to guarantee a face-to-face appointment for all those who want one. The National Health Service is clear that general practices must provide face-to-face appointments, alongside remote consultations, and patients’ input into consultation type should be sought and their preferences for face-to-face care respected unless there are good clinical reasons to the contrary. Since appointment types, whether face-to-face or remote, in any given year, including 2025/26, are determined based on patient preferences and clinical need, it is not possible to produce a reliable estimate for the number of face-to-face appointments for 2025/26.

With reference to the 10-Year Health Plan, what safeguards will be put in place to prevent hostile actors from accessing genomic data held by the NHS.

All organisations that have access to National Health Service patient data and systems must use the Data Security and Protection Toolkit (DSPT) to provide assurance on an annual basis that they are practising good data security and that personal information is handled correctly. In September 2025, we introduced the Cyber Assessment Framework (CAF) to aligned DSPTs in order to raise DSPT requirements for genomics organisations as suggested by the Department. The CAF is the National Cyber Security Centre’s framework and focuses on outcomes and principles to guide good decision-making, and the CAF-aligned DSPT return is supported by an independent audit to the mandated framework.National cyber teams are tackling the changing cyber risk head-on through their ambitious Cyber Improvement Programme, expanding protection and services to better protect the health and care system, backed up with over £338 million of investment since 2017.Patients who are offered whole genome sequencing through the NHS can consent to having their genomic data stored in the National Genomic Research Library (NGRL) which is run by Genomics England. Data stored in the NGRL is de-identified and access to it is carefully controlled, including through an independent Access Review Committee, which ensures that only approved individuals from approved institutions have access to the data. Approved researchers can only access the data within a Secure Research Environment for health research purposes and are not allowed to extract data from the library.

With reference to page 36 of the NHS 10 Year Health Plan, published on 3 July 2025, how the cost of operating Neighbourhood Health Centres will be shared amongst (a) local government, (b) the voluntary sector and (c) the NHS.

As set out on page 36 of the 10-Year Health Plan, neighbourhood health centres will provide easier, more convenient access to a full range of health and care services on people’s doorsteps, joining up National Health Service, local authority, and voluntary services as a one-stop shop.Rollout of the neighbourhood health centres will be progressive over this Parliament, with early sites focused on areas of greatest need.We are developing a National Framework for Neighbourhood Health Plans and Model Neighbourhood to provide greater clarity and consistency for systems in developing and scaling neighbourhood health.This will provide a shared reference point to help shape and inform locally led approaches to neighbourhood health, which may include cost sharing amongst the systems and organisations involved in operating neighbourhood health centres.

Whether he plans to allow patients to access NHS dental care through the NHS App.

The Government currently has no plans to enable patients to access NHS dental care through the NHS App. However, NHS England routinely seeks opportunities to expand the functionality of the NHS App, and progress on including dental bookings in the functionality will depend on digital readiness and wider service commissioning provisions.

If he will make an estimate of the cost to (a) the NHS and (b) the public purse of the resident doctor strikes in 2025.

The five-day resident doctor strike in July 2025 had an estimated cost to the National Health Service of approximately £240 million and this was a starting estimate for the planned November strike. The costs were lower than in July 2024 as a result of lower turnout. We continue to update estimates as new data becomes available, in line with receiving business as usual financial data from NHS systems. The NHS has tried and tested plans in place to minimise disruption and will work with partners to ensure safe care for patients continues to be available and emergency services continue to operate.

With reference to page 34 of his Department's policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what the outcome will be if a patient and care team do not agree on the contents of a care plan.

Our 10-Year Health Plan will ensure that people with complex needs are supported to be active participants in their own care. As part of this, 95% of people with complex needs or long-term conditions will have an agreed personalised care plan by 2027. We recognise that care plans should be developed collaboratively between patients and care teams. Reaching agreement is essential, as a lack of consensus can lead to delays in care and reduced patient engagement.Patients have the right to autonomy over decisions about their own care, and both clinical and personal aspects should be approached as shared decisions. Where disagreements arise, particularly those relating to funding, can be escalated to the integrated care board for resolution.Work is currently underway to determine how care plans will be delivered, including escalation routes if agreement can’t be made.

What the maximum distance a patient should be from a (a) neighbourhood health centre and (b) GP surgery is under the 10 Year Health Plan.

There is no centrally stipulated limit on the distance a patient should be from a general practice surgery or a neighbourhood health centre (NHC). Integrated care boards are required to commission services that meet the reasonable needs of the population they serve.The Government has committed to deliver a NHC in every community across the country over the course of the 10-Year Health Plan. The Department is currently determining how best to trial NHCs, including identifying potential site locations.

With reference to p.81 of the 10 Year Health Plan, published on 3 July 2025, what steps he is taking to ensure the accuracy of triage using AI on the NHS App for each patient.

We are currently developing our plans in response to the 10-Year Health Plan commitments to support artificial intelligence (AI) assisted triage. We will do so following stringent clinical safety standards as outlined in the NHS Service Standard, as well as rigorous evaluations of health outcomes and operational impact.When developed, AI triage within the NHS App will use artificial intelligence to assess symptoms and guide patients to the most appropriate care, whether it's self-care, booking an appointment, or seeking other help.The NHS operates within a comprehensive regulatory framework for AI, underpinned by rigorous standards established by bodies including the Medicines and Healthcare products Regulatory Agency, National Institute for Health and Care Excellence, Health Research Authority, and Care Quality Commission. These agencies ensure that AI technologies are deployed safely and effectively within healthcare settings. Additionally, continuous monitoring after deployment is essential to ensure long-term safety of AI solutions, so we are working closely with regulators to identify new measures for mitigating risk and providing assurance. We are also leading on shaping a regulatory landscape that ensures AI technologies are safe, transparent and work for everyone.

With reference to page 34 of his Department's policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what the outcome will be if a patient needs to spend more than their Personal Health Budget on care.

Personal health budget holders should have regular contact with their local integrated care board (ICB) so that if their situation changes, including in relation to costs, their personalised care and support plan can be reviewed. A personal health budget review can also be requested at any time by an individual or their local ICB if circumstances have changed.

How many languages the NHS app will be available in by 2035.

The 10-Year Health Plan recently committed to offering services in the NHS App in multiple languages to reach people who have difficulty with English where it is not their first language. Scoping has started to understand how to deliver this in a safe and cost-effective way, so that translations are reliable, consistent across patient journeys, accessible by those that they are intended for, and are making good use of public funds. The NHS App is currently available in English and Welsh.

With reference to page 12 of the policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what incentives will be provided for healthier choices.

The Department will shortly launch a market engagement process with business to inform the creation of the newly announced NHS Points digital scheme. This will include inviting views and evidence as to what types of incentives could be provided in return for healthier choices. The Department will consider what types of incentives are evidenced to have the greatest impact on driving positive behaviour change.

With reference to page 14 of the policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, if he has made an assessment of the potential impact of the Employment Rights Bill on his plans for the NHS workforce.

The Employment Rights Bill is the first stage of Make Work Pay, which is a core part of the mission to grow the economy, raise living standards across the country and create opportunities for all. The approach is designed to help more people to stay in work, support workers’ productivity and improve living standards. Once implemented, the Bill will represent the biggest upgrade in employment rights for a generation. The measures contained in the Bill support the 10-Year Health Plan’s ambition to make the National Health Service the country’s best employer.

Which areas he plans to designate as integrated health organisations in 2026; and what criteria he will use to identify those areas.

As outlined in the 10-Year Health Plan, National Health Service foundation trusts that have shown an ability to meet core standards, improve population health, form partnerships with others, and remain financially sustainable over time will be eligible for designation as integrated health organisations (IHOs).We expect to designate a small number of IHOs in 2026 following a rigorous authorisation process. The process and criteria for assessment are currently in development.

If he will make an estimate of the percentage of NHS services provided by private healthcare providers (a) on 6 September 2025 and (b) at the end of the 10 Year Health Plan period.

The 10-Year Health Plan builds on the Elective Reform Plan and the Independent Sector Partnership Agreement, published in January 2025. It reinforces the commitment to use available capacity in the independent sector to treat National Health Service patients, driving choice and empowerment for more patients, and further commits enter discussions to expand NHS provision in the most disadvantaged areas to tackle health inequalities.The overall proportion of health spending on independent sector providers has not increased significantly over recent years. In 2013/14, 6.1% or £6.5 billion of total health spending was spent on purchase of healthcare from independent sector providers. In 2023/24, this was 6.8% or £12.4 billion. No estimate has been made of the percentage of NHS services provided by independent sector providers or private companies on 6 September 2025. In the recently published data for NHS elective care activity, covering activity in June 2025, independent sector providers delivered 8% of activity.No forecasting has been undertaken of the expected volumes of activity undertaken by independent sector providers or private companies at the end of the 10-Year Health Plan period.

If he will make an assessment of the potential impact of doctors’ strikes on the measures in his 10 Year Health Plan.

Whilst the Department has not made a specific assessment, there is data which demonstrates the number of appointments rescheduled because of strike action. This is available at the following link:https://www.england.nhs.uk/2025/08/nhs-publishes-strike-impact-data-following-a-record-june-for-treatments/Any resident doctor strike action will undeniably have a damaging effect on patient safety, hospital care, and some of the measures in the 10-Year Health Plan. Strikes are in nobody’s interest and ongoing action puts additional pressure on the National Health Service and staff who continue to work hard to keep services running and provide much needed care to the public.

With reference to page 12 of policy paper entitled 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what assessment he has made of the potential impact of reducing the headcount of Integrated Care Boards on their capacity.

NHS England has asked integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and reduce duplication of responsibilities within the health and care structure. All ICBs shared their delivery plan in accordance with the guidance set out in Sir Jim Mackey's letter of 1 April 2025 and the Model ICB framework.NHS England is working closely with ICBs to ensure the changes do not compromise quality of care. The Government expects ICBs to continue to deliver on all of their statutory responsibility relating to commission of health services and protect frontline medical staff from cuts.

If he will make an estimate of the size of the maintenance backlog in the NHS at the end of the 10 Year Health Plan.

Alongside the 10-Year Health Plan detailing our ambition to deliver a National Health Service fit for the future, the Government recently published a 10 Year Infrastructure Strategy setting out 10-year maintenance budgets for the public estate, with £6 billion per year for maintenance and repair of the NHS estate up to 2034-35.Investment will be targeted to address critical infrastructure risk and eradicate reinforced autoclaved aerated concrete (RAAC), starting to reverse the underinvestment of the previous 15 years.