Written questions by Thomas.

What steps he will take in the forthcoming National Cancer Plan to improve diagnosis times for myeloma.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers, as early and quickly as possible, and to treat it faster, to improve outcomes.To tackle the late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. We will get the NHS diagnosing blood cancers earlier and treating them faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, and research and innovation. It will seek to improve every aspect of cancer care to better the experience and outcomes for people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. This will benefit all cancer patients, including leukaemia and myeloma patients.

What steps he will take in the forthcoming National Cancer Plan to improve diagnosis and treatment for penile cancer.

Reducing the number of lives lost to cancer, including penile cancer, is a key aim of the National Cancer Plan. The plan will be published early this year. It will include further details on how we will improve outcomes for patients with cancer, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates. This will benefit all cancer patients, including penile cancer patients.The Government supports Scott Arthur’s Private Members Bill on rare cancers which will make it easier for clinical trials into rare cancers, including penile cancer patients, to take place in England by ensuring the patient population can be easily contacted by researchers. This will ensure that the National Health Service will remain at the forefront of medical innovation and is able to provide patients with the newest, most effective treatment options, and ultimately boost survival rates.

What recent assessment his Department has made of the potential merits of issuing guidance to Independent Care Boards on the commissioning of providers for audiology care as an alternative to hospital services.

In line with the direction of travel set by 10-Year Health Plan, we expect integrated care boards (ICBs) to commission services to meet the reasonable needs of their populations rather than being prescriptive and adopting a one size fit all model for England. This is intended to allow services to be tailored in accordance with the local area needs. This means that National Health Service audiology services are locally commissioned.We have also published for the first time an overview of the core community health services, Standardising Community Health Services, which includes audiology, that ICBs should consider when planning for their local populations to support improved commissioning and delivery of community health services.

Pursuant to the Answer of 1 December 2025 to Question 93580 on Eating Disorders: Mental Health Services, when the Government expects to publish the modern service framework for mental health.

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

Pursuant to the Answer of 1 December 2025 to Question 93580 on Eating Disorders: Mental Health Services, which external stakeholders his Department is engaging with in the development of the modern service framework for mental health.

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

What steps he is taking to help improve recruitment and training of specialists in Ehlers-Danlos syndromes.

We recognise that doctors can find it challenging to diagnose Ehlers-Danlos syndrome (EDS) because of the wide range and variability of symptoms, and that the most common type, hypermobile EDS, currently has no specific genetic test.Resources such as the Royal College of General Practitioners’ EDS Toolkit, now maintained by Ehlers-Danlos Support UK, are helping general practitioners (GPs) to better recognise, respond to, and manage EDS and hypermobility spectrum disorders (HSD) in primary care. For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service for EDS.A primary goal of the national diagnostic service is to educate referring doctors about the diagnosis, investigation, and management of patients with complex and atypical forms of EDS. While the service focuses on rare types and accepts referrals from secondary and tertiary care, its development of guidelines and educational initiatives also benefit GPs who are on the front line of patient care.Through the 10-Year Health Plan, we are introducing neighbourhood health centres, and deploying multidisciplinary teams to provide holistic support to people with EDS. Patients will benefit from enhanced NHS App functionality, including My Medicines and My Health, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions like EDS, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs to have a personalised care plan by 2027.The Government will publish the 10 Year Workforce Plan in spring 2026. It will set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. By setting out how we will train and provide the staff, technology, and infrastructure the NHS needs, the 10 Year Workforce Plan will ensure that services are more accessible, proactive, and tailored for all patients, including those with EDS.

What steps he is taking to help ensure that people with Ehlers-Danlos syndromes are quickly and accurately diagnosed.

We recognise that doctors can find it challenging to diagnose Ehlers-Danlos syndrome (EDS) because of the wide range and variability of symptoms, and that the most common type, hypermobile EDS, currently has no specific genetic test.Resources such as the Royal College of General Practitioners’ EDS Toolkit, now maintained by Ehlers-Danlos Support UK, are helping general practitioners (GPs) to better recognise, respond to, and manage EDS and hypermobility spectrum disorders (HSD) in primary care. For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service for EDS.A primary goal of the national diagnostic service is to educate referring doctors about the diagnosis, investigation, and management of patients with complex and atypical forms of EDS. While the service focuses on rare types and accepts referrals from secondary and tertiary care, its development of guidelines and educational initiatives also benefit GPs who are on the front line of patient care.Through the 10-Year Health Plan, we are introducing neighbourhood health centres, and deploying multidisciplinary teams to provide holistic support to people with EDS. Patients will benefit from enhanced NHS App functionality, including My Medicines and My Health, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions like EDS, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs to have a personalised care plan by 2027.The Government will publish the 10 Year Workforce Plan in spring 2026. It will set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. By setting out how we will train and provide the staff, technology, and infrastructure the NHS needs, the 10 Year Workforce Plan will ensure that services are more accessible, proactive, and tailored for all patients, including those with EDS.

What steps he is taking to help improve treatment and specialist care of those with Ehlers-Danlos syndromes.

We recognise that doctors can find it challenging to diagnose Ehlers-Danlos syndrome (EDS) because of the wide range and variability of symptoms, and that the most common type, hypermobile EDS, currently has no specific genetic test.Resources such as the Royal College of General Practitioners’ EDS Toolkit, now maintained by Ehlers-Danlos Support UK, are helping general practitioners (GPs) to better recognise, respond to, and manage EDS and hypermobility spectrum disorders (HSD) in primary care. For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service for EDS.A primary goal of the national diagnostic service is to educate referring doctors about the diagnosis, investigation, and management of patients with complex and atypical forms of EDS. While the service focuses on rare types and accepts referrals from secondary and tertiary care, its development of guidelines and educational initiatives also benefit GPs who are on the front line of patient care.Through the 10-Year Health Plan, we are introducing neighbourhood health centres, and deploying multidisciplinary teams to provide holistic support to people with EDS. Patients will benefit from enhanced NHS App functionality, including My Medicines and My Health, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions like EDS, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs to have a personalised care plan by 2027.The Government will publish the 10 Year Workforce Plan in spring 2026. It will set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. By setting out how we will train and provide the staff, technology, and infrastructure the NHS needs, the 10 Year Workforce Plan will ensure that services are more accessible, proactive, and tailored for all patients, including those with EDS.

If he will take steps to include provisions relating to the treatment and care of people with eating disorders in the forthcoming modern service framework for mental health.

The exact scope of the modern service framework for people with severe mental illness is currently under development with external stakeholders, but we expect that it will include care and treatment for people with eating disorders.

Whether he is taking steps to ensure accountability for the equitable provision of palliative care.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence. The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.We will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Additionally, through the National Institute for Health and Care Research, the Department is investing £3 million in a new Policy Research Unit in Palliative and End of Life Care. This unit launched in January 2024 and is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.On ICB accountability, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.

If he will make it his policy to extend the eligibility criteria for the covid-19 vaccine to include people with asthma.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness (hospitalisations and deaths) arising from COVID-19. Population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed.On 13 November 2024, JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government accepted the JCVI’s advice that in autumn 2025, a COVID-19 vaccination should be offered to the following groups:adults aged 75 years and over;residents in care homes for older adults;individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).The Government has no plans to change eligibility for autumn 2025. It has accepted the JCVI advice for this campaign in full. As for all vaccines, the JCVI keeps the evidence under regular review.

What steps his Department is taking to help increase capacity in phlebotomy services.

Blood tests are among the most commonly requested diagnostic investigations across primary and secondary care, and they are readily available across all 27 National Health Service pathology networks. Phlebotomy – the procedure to collect blood samples – is widely available across general practice, community health services, and secondary care phlebotomy clinics, supporting equitable access to blood testing. Where phlebotomy services are provided by general practice, they are commissioned locally by integrated care boards (ICBs). ICBs are responsible for commissioning phlebotomy services based on local population need and are funded for these services as part of their annual funding allocations. In January 2025, we published the Elective Reform Plan, which sets out the productivity and reform efforts needed to return to the 18-week constitutional standard by the end of this parliament. The Plan commits to transform and expand diagnostic services and speed up waiting times for tests, a crucial part of reducing overall waiting times. Community Diagnostic Centres (CDCs), including those in Gloucestershire and Herefordshire, are supporting one of the governments key strategic shifts – moving care from the hospital to the community. CDCs offer local populations a wide range of diagnostic tests, including phlebotomy, closer to home and greater choice on where and how they are undertaken.We are continuing to invest in expanding diagnostic capacity in the NHS. As set out in the Elective Reform Plan, we plan to build up to five more CDCs in 2025/26, alongside increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week. This is backed by part of the £600 million of capital investment for diagnostic services announced at the October 2024 Spending Review.

What steps he is taking to ensure equality of access to tofersen by people diagnosed with SOD1 motor neurone disease across England.

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. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by the superoxide dismutase – 1 (SOD1) gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE has not yet been able to start the evaluation of tofersen as it is unable to issue guidance on the use of the technology without receiving an evidence submission about the technology’s clinical and cost-effectiveness from the marketing authorisation holder. Therefore, NICE is ready to review tofersen via its HST programme, as soon as Biogen indicates that it is ready to start the NICE evaluation.I am aware that the marketing authorisation holder has established early access programmes (EAPs) through which some patients are currently accessing tofersen. Participation in company-led schemes is decided at an individual NHS trust level and under these programmes, the cost of the drug is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the administration costs and must provide clinical resources to deliver the EAP. No assessment has been made of regional variation in access to tofersen through the programme.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes, providing advice on potential financial, resourcing, and clinical risks. ICSs should use the guidance to help determine whether to implement any of these schemes, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What information his Department holds on the number of children and young adults with (a) PANS and (b) PANDAS.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

What recent assessment his Department has made of the adequacy of the provision of (a) treatment and (b) care for children and young adults with (i) PANS and (ii) PANDAS.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will make an assessment of the adequacy of the the availability of training programmes on (a) PANS and (b) PANDAS for NHS staff.

Information on the number of children and young adults with paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is not collected at present as there are no internationally agreed criteria to identify these conditions. The PANS PANDAS Steering Group is currently working on a consensus for case identification to support a national survey. Due to the emerging nature of the evidence base there is currently a lack of consensus on what good clinical practice and training on PANS and PANDAS may look like, and no assessments have therefore been made.

If he will hold discussions with the National Institute for Health and Care Excellence on the development of guidelines for PANS and PANDAS.

Decisions on topics for new or updated guidance from the National Institute for Health and Care Excellence (NICE) are considered through an established NICE prioritisation process with decisions overseen by a prioritisation board, chaired by NICE’s Chief Medical Officer.NICE’s prioritisation board considered the development of guidance on paediatric acute-onset neuropsychiatric syndrome and paediatric autoimmune neuropsychiatric disorder associated with streptococcus in November 2024 and concluded that there is insufficient evidence in this area to develop useful guidance.

What recent assessment his Department has made of the geographic differences in the cost of abiraterone for high-risk prostate cancer patients in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.

What steps his Department is taking to ensure that veterans who leave the armed forces can access NHS dental care.

We are working to improve access to National Health Service dentistry, which will also benefit our valued members of the Armed Forces community, including our respected veterans who have spent their careers defending our country.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists. The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament. Veterans will be able to benefit from the improved access these changes bring.We are also supporting more than 1,500 children in British military families overseas through our supervised toothbrushing programme. Free NHS dental care is available to people who meet the following criteria:under 18 years old, or under 19 years old and in full-time education;pregnant or have had a baby in the previous 12 months;being treated in an NHS hospital and the treatment is carried out by the hospital dentist, although patients may have to pay for any dentures or bridges;receiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits; and/orreceiving War Pension Scheme payments, or Armed Forces Compensation Scheme payments and the treatment is for your accepted disability.

What steps his Department is taking to reduce geographical cost differences for (a) abiraterone and (b) similar drugs in England.

The procurement of abiraterone for secondary care is currently part of NHS England’s generic wave tender structure. NHS England tenders two regions out of six at a time to encourage competition and to ensure supply chain resilience, awarding the top two compliant suppliers onto the framework each time. Prices may vary between regions, but within NHS England’s terms and conditions there is a price review mechanism whereby any price changes can be matched/applied in other regions. Also, within the tender there is a price limiter criterion which is applied so that only bids that are in line with market norms will be compliant.