Written questions by Thomas.

What steps his Department is taking to expand dental services in rural areas.

We are aware of the challenges faced in accessing a dentist, particularly in more rural areas.The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England.ICBs are recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.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.

What steps his Department is taking to ensure that elderly people have reliable access to dental care.

The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. This includes considering the needs of elderly populations. The ICB for the Tewkesbury constituency is Gloucestershire ICB.We know that as people age, they tend to move to rural and coastal areas where the challenges in accessing NHS dentistry are exacerbated. We have introduced the Golden Hellos scheme which will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.ICBs may commission specialised dental services including domiciliary care for elderly people living in care homes. The National Institute for Health and Care Excellence (NICE) guideline on oral health in care homes sets out several recommendations for care homes to help maintain and improve oral health and ensure timely access to dental treatment for their residents. The Government expects care homes to be following NICE guidance and recommendations in this area.

If he will make an assessment of the potential implications for his policies of recent incidents involving known risk items being accessed by mental health patients with the knowledge of NHS staff.

On 4 April 2025, NHS England published its ‘Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management'. This promotes a shift towards a more holistic, person-centred approach rather than relying on risk prediction, which is unreliable because suicidal thoughts can change quickly. Instead, it recommends using a method based on understanding each person’s situation and managing their safety.The purpose of this guidance is to enable mental health practitioners to adopt best practice principles in working with people of all ages to stay safe from suicide. This guidance also has a section covering confidentiality and the law and refers to the consensus statement for information sharing and suicide prevention. The guidance is available at the following link:https://www.england.nhs.uk/long-read/staying-safe-from-suicide/Work is also underway to make training available to all mental health practitioners to incorporate the principles of this guidance into their practice. This training was recently launched and is available via an e-learning module. This complements existing local training on suicide prevention, and a number of other national e-learning products that are already available.The National Confidential Inquiry into Suicide and Safety in Mental Health has been commissioned through the NHS England Culture of Care programme to support every provider of National Health Service commissioned inpatient services to move to personalised safety planning in line with evidence.In addition to this, the Health Services Safety Investigations Body’s (HSSIB) investigation into mental health inpatient settings identified important concerns and safety recommendations that can help us to improve mental health care, protect patients and the public and create a safe working environment for staff. We are in the process of formally responding to all the recommendations for the Department made within these reports. NHS England will be publishing guidance in response to the HSSIB’s recommendations defining the therapeutic relationship and guidance on responding to the use of non-anchored ligature points.

What recent assessment he has made of the potential implications for his policies of rates of sexual assault incidents at inpatient mental health hospitals.

It is wholly unacceptable for any patient or member of staff to experience violence or harassment of any kind in National Health Service settings, and all organisations must take robust and compassionate action to prevent it. The Government is committed to supporting and challenging the system to ensure a safe environment for our staff and patients.Although no direct assessment of policy implications on rates of sexual assaults has been made, in September 2023, the Sexual Safety Charter was launched by NHS England with the aim of promoting a zero-tolerance approach towards sexual misconduct in the workplace. Every NHS trust and integrated care board (ICB) have since signed up to the Charter and are actively working to implement its ten principles to tackle unwanted, inappropriate or harmful sexual behaviour in the workplace.In October 2024, NHS England launched a new national sexual misconduct people policy framework and training to help staff right across the NHS to ensure they are taking the right steps in recognising, reporting and acting on sexual misconduct at work. The new framework outlines how those working in the health service should recognise, report and act on sexual misconduct in the workplace, against staff or patients. The framework is available at the following link:https://www.england.nhs.uk/publication/national-people-sexual-misconduct-policy-framework/NHS England is currently measuring the uptake of framework across all trusts and ICBs, including gathering key feedback about its impact and effectiveness so far. Feedback will be used to identify areas where organisations need support in implementing to achieve a sexual safety culture.Several tools and resources have been developed by NHS England for trusts and ICBs to adopt and take further actions on sexual misconduct. This includes the first-ever NHS-wide training on sexual misconduct awareness, now available to the entire workforce, including mental health staff conducting Mental Health Act Section 17 escort duties.NHS England has recently written to providers and asked them to take further steps to identify potential perpetrators of sexual misconduct and to redouble efforts to protect staff and patients.

Whether his Department plans to hold discussions with leaders of mental health services on meeting the requirements of the statutory duty of candour.

The Government is supportive of the review it inherited into the effectiveness of the statutory duty of candour for health and social care providers. Our aim is to ensure that all providers, including mental health trusts, and their leaders act upon the duty consistently and effectively to improve openness, coupled with effective enforcement by the Care Quality Commission.The review included a call for evidence, and the Government published its findings on 26 November 2024. These findings are available at the following link:https://www.gov.uk/government/publications/findings-of-the-call-for-evidence-on-the-statutory-duty-of-candour/findings-of-the-call-for-evidence-on-the-statutory-duty-of-candourThe Government also launched a public consultation on 26 November 2024, on proposals to regulate National Health Service managers. This sought views on making managers, including those in mental health providers, accountable for ensuring that the statutory duty is correctly followed in their organisation. In finalising the review on the statutory duty of candour, we are considering our proposals on candour set out in the Government’s response to the consultation, which was published on 21 July 2024, and other areas including recommendations made by the Infected Blood Inquiry. The consultation response is available at the following link:https://www.gov.uk/government/consultations/leading-the-nhs-proposals-to-regulate-nhs-managers/outcome/leading-the-nhs-proposals-to-regulate-nhs-managers-consultation-response

What recent assessment he has made of rates of sexual assault incidents perpetrated by mental health staff conducting Mental Health Act Section 17 escort duties or similar protective observations.

It is wholly unacceptable for any patient or member of staff to experience violence or harassment of any kind in National Health Service settings, and all organisations must take robust and compassionate action to prevent it. The Government is committed to supporting and challenging the system to ensure a safe environment for our staff and patients.Although no direct assessment of policy implications on rates of sexual assaults has been made, in September 2023, the Sexual Safety Charter was launched by NHS England with the aim of promoting a zero-tolerance approach towards sexual misconduct in the workplace. Every NHS trust and integrated care board (ICB) have since signed up to the Charter and are actively working to implement its ten principles to tackle unwanted, inappropriate or harmful sexual behaviour in the workplace.In October 2024, NHS England launched a new national sexual misconduct people policy framework and training to help staff right across the NHS to ensure they are taking the right steps in recognising, reporting and acting on sexual misconduct at work. The new framework outlines how those working in the health service should recognise, report and act on sexual misconduct in the workplace, against staff or patients. The framework is available at the following link:https://www.england.nhs.uk/publication/national-people-sexual-misconduct-policy-framework/NHS England is currently measuring the uptake of framework across all trusts and ICBs, including gathering key feedback about its impact and effectiveness so far. Feedback will be used to identify areas where organisations need support in implementing to achieve a sexual safety culture.Several tools and resources have been developed by NHS England for trusts and ICBs to adopt and take further actions on sexual misconduct. This includes the first-ever NHS-wide training on sexual misconduct awareness, now available to the entire workforce, including mental health staff conducting Mental Health Act Section 17 escort duties.NHS England has recently written to providers and asked them to take further steps to identify potential perpetrators of sexual misconduct and to redouble efforts to protect staff and patients.

What assessment he has made of the potential merits of increasing funding for new (a) services and (b) research to support people with (i) myalgic encephalomyelitis and (ii) chronic fatigue syndrome.

NHS England is responsible for allocating funding to integrated care boards, which in turn are responsible for commissioning specialist myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) services that meet the needs of their population, subject to local prioritisation and funding.On 22 July 2025, we published the final ME/CFS delivery plan, which is available at the following link:https://www.gov.uk/government/publications/mecfs-the-final-delivery-planWithin the plan there is an action for the Department and NHS England to explore whether a specialised service should be prescribed for very severe ME/CFS.The Government funds research through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC). We have assessed the ME/CFS research portfolio funded through NIHR and MRC and acknowledge that this is an under-funded area. The level of funding awarded is directly related to the number and quality of applications received and we have historically received a small number of applications for funding in this area. Between 2019/20 and 2023/24, the NIHR committed approximately £3.7 million to research projects and programmes on ME/CFS. In the same period, the MRC committed approximately £2.9 million to research into ME/CFS.Together with the MRC, we are actively exploring next steps for research in ME/CFS. In the final delivery plan for ME/CFS, we have outlined the research actions and additional support that we will offer to the research community to increase the volume and quality of applications. This includes a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical inventions for post-acute infection syndromes and associated conditions, including ME/CFS.

What steps his Department is taking to ensure that NHS dementia and care homes are adequately (a) staffed and (b) resourced.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.English local authorities have responsibility under the Care Act 2014 to meet social care needs and statutory guidance directs them to ensure there is sufficient workforce in adult social care. The Care Quality Commission (CQC) is the independent regulator for health and social care in England and assesses local authorities' delivery of their adult social care duties under Part 1 of the Care Act 2014. The specific Care Act functions assessed by the CQC are set out in regulations under the Health and Care Act 2022.The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 18 states that providers must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. Where the CQC finds a breach in this regulation, it can take regulatory action to ensure the safety of people drawing on care and support.The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. We want the people who work in care to be respected as professionals, and work is already underway to provide a career structure, give care professionals greater skills and legislate for the first ever Fair Pay Agreements.

What steps he is taking to ensure the consistency of the quality of care in England.

The Care Quality Commission (CQC) is the independent regulator for ensuring the quality of care in England. It assesses all health and social care service providers registered with the CQC for compliance against the statutory standards set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. It also assesses how well local authorities deliver adult social care by looking at their performance against their duties under Part 1 of the Care Act 2014. The CQC takes enforcement action against a provider for non-compliance.The 10-Year Health Plan sets out new statutory and non-statutory measures and clearer accountability to ensure transparency on quality of care. The CQC’s statutory powers will be extended to access all publicly held data relating directly or indirectly to care quality. Non-statutory measures include revitalising the National Quality Board and having it develop a new quality strategy by March 2026.

What recent assessment his Department has made of the adequacy of dementia care.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services.We will deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.The Government is committed to improving dementia care and empowering local leaders with the autonomy they need to provide the best services to their local community, including those with dementia.That is why we published the D100: Assessment Tool Pathway programme earlier this year, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for system leaders and help create communities and services where the best possible care and support is available to those with dementia. The D100: Pathway Assessment Tool is available at the following link:https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-tool

What steps his Department are taking to ensure the effectiveness of the (a) monitoring of and (b) improvements to dementia care.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity.To strengthen both local and national insight into dementia care, enable clearer benchmarking, and support the delivery of more timely, targeted, and person-centred support, NHS England continues to monitor the monthly dementia diagnosis rate and analyse trends at national, regional and integrated care board level. The commitment to recover diagnosis rates to the national ambition of 66.7% remains in place, ensuring identification and appropriate support for people living with dementia.In addition, NHS England is actively looking to improve the clinical utility and relevance of dementia data reporting. This includes, firstly, enhancing primary care reporting through ongoing refinement of indicators and coding approaches.Notably, a new measure was introduced in April 2025 capturing the number of people with dementia who have experienced delirium in the past 12 months. This will support systems and providers to better understand variation in care provision, improve risk stratification, and strengthen care planning.NHS England is also exploring improvements in the Mental Health Services Data Set (MHSDS) to ensure activity within Memory Assessment Services is more fully reflected in available data. Work is underway with the NHS England analyst team to scope options for developing more meaningful coverage and consistency in memory service reporting.

What steps he is taking to tackle shortages of care home workers in rural areas.

English local authorities have responsibility under the Care Act 2014 to meet social care needs, and statutory guidance directs them to ensure there is sufficient workforce in adult social care (ASC).The Care Quality Commission (CQC) is the independent regulator for health and social care in England. Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 states that providers must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. Where the CQC finds a breach in this regulation, it can take regulatory action to ensure the safety of the people drawing on care and support.The Government recognises the scale of reforms needed to make the ASC sector attractive, to support sustainable workforce growth, and to improve the recruitment and retention of the domestic workforce. This is why we are introducing the first ever Fair Pay Agreement to the ASC sector so that care professionals are recognised and rewarded for the important work that they do.We are also supporting the professionalisation of the ASC workforce by implementing the Care Workforce pathway as the first universal ASC career structure and providing £12 million through the Learning and Development Support Scheme this year for staff to complete training and qualifications.

What steps his Department is taking to (a) encourage and (b) promote careers in the social care system.

The Department is supporting the professionalisation of the adult social care (ASC) sector by expanding the Care Workforce Pathway (CWP), funding the Learning Development and Support Scheme, and introducing the first ever fair pay agreement for the sector.In April 2025, we published four additional role categories within the CWP, which is the first universal career structure for the sector providing guidance on career development by outlining the knowledge, skills, values, and behaviours to both encourage and promote care as a long-term career.The Learning Development and Support Scheme, launched in September 2024, is providing up to £12 million this financial year to support eligible care staff to complete training courses and qualifications. Additionally, a Fair Pay Agreement for the ASC sector will ensure that care professionals are recognised and rewarded for the important work that they do.

What steps his Department is taking to improve safeguards for people with neurological conditions in care homes.

The Government makes clear, in statutory guidance of the Care Act 2014, that local authorities must ensure services they commission are safe, effective and of high quality. The Care Quality Commission (CQC) assesses how well local authorities are meeting their Care Act duties in relation to safeguarding and have a duty to inform my Rt. Hon. friend, the Secretary of State for Health and Social Care, if it considers an authority is failing to discharge its functions.Regulated providers also have a key role in safeguarding adults. Care homes must ensure that they have appropriate systems and processes in place to prevent, and protect people from, abuse and improper treatment. They must also have, and effectively operate, systems and processes to investigate and promptly act upon any allegation or evidence of abuse.Where anyone alleges poor care, neglect or abuse, we expect those providing the service, local authorities and the CQC to take swift action.

What recent steps his Department has taken to help recognise (a) the skills of phlebotomists and (b) their contribution to the NHS.

The Government greatly values the expertise and contribution of all health professionals, including phlebotomists.A central part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the National Health Service needs to care for patients across our communities.

What recent steps he has taken to support unpaid carers.

The Government is committed to ensuring that families have the support they need. On the 7 April 2025 the Government increased the Carer's Allowance weekly earnings limit from £151 a week to £196, the equivalent of 16 hours at the National Living Wage. This represents the largest increase in the earnings limit since the Carer’s Allowance was introduced in 1976.Lord Darzi’s independent review of the National Health Service highlighted the need for a fresh approach to supporting and involving unpaid carers, to improve outcomes across the board for carers, for those they care for, and for the NHS itself. These findings will be carefully considered as part of our 10-year plan to reform and modernise the NHS, and as we continue to shape our plans to reform adult social care, including through the National Care Service.We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will start a national conversation about what care and support working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support.

Whether his Department is taking steps to (a) improve training on dementia care and (b) financially support family carers.

In September 2024, we launched the Adult Social Care Learning and Development Support Scheme, which allows employers to claim funding for training courses and qualifications on behalf of eligible staff. The scheme is backed by up to £12 million for the financial year 2025/26, and funding is available for a range of dementia-related qualifications.We know that many people wish to play a role in caring for their family and friends and we are committed to ensuring that families have the support that they need. This is why, on 7 April 2025, the Government increased the Carer's Allowance weekly earnings limit from £151 a week to £196, the equivalent of 16 hours at the National Living Wage. This represents the largest increase in the earnings limit since the Carer’s Allowance was introduced in 1976.

What recent assessment his Department has made of the potential merits of implementing a national screening programme for prostate cancer.

The Department is guided on screening policy by the UK National Screening Committee (UK NSC). The committee has commissioned a university to carry out a high quality review and to create a cost effectiveness model of the evidence for a national prostate cancer screening programme. This includes targeted approaches to high risk groups and an offer to all men defined by age.However, their previous review advised against screening because the current best test, the prostate specific antigen test, is not accurate. As a result, it can lead to some men receiving false reassurance when they do actually have prostate cancer, and others receiving unnecessary further tests when they did not have prostate cancer.Black men are twice as likely as white men to get prostate cancer. But using an inaccurate test on this group of men might not reduce health inequalities. Instead, it risks leading to greater levels of misdiagnosis in this group. We need a better test, which is why the Government has invested £16 million in the TRANSFORM trial, to look for a better test. This trial will ensure that one in ten participants are black men.Many prostate cancers are very slow growing and many men can live and die with prostate cancer, without ever showing any symptoms. Early diagnosis of prostate cancer can lead to unnecessary interventions and treatment that can have nasty and life altering side effects, for a cancer that would never have caused harm. That is why the UK NSC, when reviewing the evidence for a screening programme, must balance the benefits, including a reduction in mortality, against the harms. Only when the committee is confident that high quality evidence suggests a programme will do more good than harm will it be recommended.

What steps his Department is taking to ensure appropriate funding is allocated for (a) early diagnosis and (b) effective monitoring of invasive lobular carcinoma; and what funding is allocated for the (i) development and (ii) availability of treatments for that disease.

Improving early diagnosis of cancer, including lobular breast cancer, is a priority for the Government. There are multiple National Health Service initiatives and funding streams across the NHS in England that support the early detection of breast cancer.NHS England and other NHS organisations, nationally and locally, invest in publishing information on the signs and symptoms of many different types of cancer, including lobular breast cancer, through the Help Us Help You campaigns.The Department spends £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer being one of the largest areas of spend at £133 million in 2023/24, reflecting its high priority. The NIHR continues to welcome funding applications for research into any aspect of human health and care, including the treatment of lobular carcinoma.The Office for Life Sciences’ Cancer Healthcare Goals programme aims to accelerate the development and commercialisation of a new generation of cancer diagnostics and therapeutics. The programme, however, does not ringfence funding, or run funding programmes specific to cancer types.Following publication of the 10-Year Health Plan later this year, we will publish our National Cancer Plan. The cancer plan will include more details about how to improve outcomes for all tumour types through earlier diagnosis of cancer.

What steps his Department is taking to ensure that people with postural orthostatic tachycardia syndrome are supported financially; and whether he plans to include provisions for people with that syndrome within the 10-year health plan.

We want a society where every person, including those with a long-term condition, their families and carers receive high-quality, compassionate continuity of care.The NHS Low Income Scheme can provide help with health costs on an income-related basis. Approximately 89% of prescription items are currently dispensed free of charge and a wide range of exemptions from prescription charges in place. People with postural orthostatic tachycardia syndrome who are 60 years old or over are entitled to free prescriptions. For those that must pay for prescriptions, the cost can be capped by purchasing a pre-payment certificate.Our 10-Year Health Plan will provide a shared vision for the health and care system in 2035, drawing directly from the extensive engagement undertaken with the public, patients and staff. The plan will include how care models and pathways for health conditions will need to change or evolve to better meet patients’ needs.