Written questions by Johnson.

What steps he is taking to reduce perineal injury during vaginal deliveries.

Integrated care boards are rolling out the Perinatal Pelvic Health Services (PPHS) across England, to reduce the rates of perineal tears and improve outcomes for women. A national service specification was published in October 2023 that set out the expected standards of care for prevention, identification, and access to physiotherapy for pelvic health issues during pregnancy and at least one year after birth. This includes the implementation of the Obstetric Anal Sphincter Injuries (OASI) care bundle to reduce perineal injury in childbirth, which is a significant factor for pelvic health problems. This included perineal training and a new best practice framework for healthcare professionals, covering prevention and care under the OASI pathway. Further information on the service specification is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2023/10/PRN00147-Service-specification-perinatal-pelvic-health-services.pdf PPHS’ also work with maternity and physiotherapy services to provide quality information about the risk of developing pelvic health problems, key signs of pelvic floor dysfunction, and preventative measures like pelvic floor exercises.

What his planned timetable is to bring forward legislation to regulate NHS managers.

This Government recognises the importance of ensuring that the NHS has strong and effective leadership in place, and we are committed to introducing professional standards for, and regulation of NHS managers. On 26 November 2024 we published a consultation seeking views from stakeholders on options for regulating NHS managers. The consultation will close on 18 February 2025. We will carefully consider responses to the consultation and set out next steps in due course.

What assessment he has made of the adequacy of the uptake of Bacillus Calmette-Guérin vaccine among eligible infants.

Official vaccine coverage estimates for the Bacillus Calmette-Guérin (BCG) vaccine are measured for eligible children at three months and 12 months old, and are published quarterly by the UK Health Security Agency (UKHSA), and annually by NHS England. The UKHSA’s quarterly figures and NHS England’s annual figures are available, respectively, at the following two links:https://www.gov.uk/government/statistics/cover-of-vaccination-evaluated-rapidly-cover-programme-2024-to-2025-quarterly-datahttps://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2023-24The latest data captures BCG coverage at the age of three months old for children born 1 January to 31 March 2024, and at 12 months old for children born 1 April 2023 to 30 June 2023. Measured at three months, coverage in England was 77.4%, and measured at 12 months, it was 84.5%.

What assessment he has made of the adequacy of NHS preparedness for a pandemic.

Ensuring the United Kingdom is prepared for a future pandemic is a top priority for the Government, and the Department continuously reviews and updates our pandemic preparedness to reflect the latest scientific information, lessons learned from exercises, and our response to previous emergencies.The Department is working with NHS England, the UK Health Security Agency, and its partners across the health and care system to maintain a flexible and scalable set of capabilities which can be adapted to respond to any future threats, across all routes of infectious disease transmission. The Department’s approach to pandemic preparedness also takes into account the underlying resilience of the health and care system.NHS England is an active participant in this work and has made several improvements that will help resilience in a future pandemic, including on the coordination and escalation of a national healthcare response, high consequence infectious disease and infectious disease capacity, and critical care capacity, surge and transfer plans.

How many (a) foetuses, (b) infants and (c) children have been diagnosed with trisomy 21 in each of the last five years.

The National Disease Registration Service in NHS England collects and quality assures data about people with congenital anomalies and rare diseases across the whole of England. The service does not hold data in the relevant form for children.The following table shows the requested information for fetuses and infants between 2018 and 2021, the period for which complete data is available:Birth yearNumber of babies born aliveNumber of babies stillbornNumber of terminationsNumber of late miscarriagesNumber of fetusesTotal number of babies and fetuses with T21201873131803128151,57720196852883898471,560202067335839168551,5632021700241,049121,0611,785Source: NCARDRS Congenital Anomaly Official Statistics Report, 2021Notes:Born alive means a baby showing signs of life at birth as recorded by the Office for National Statistics.Stillbirths are pregnancy outcomes after 24 complete weeks’ gestation which result in the baby's death by the time of birth.Terminations are terminations of pregnancy regardless of gestation or civil registration status. Some of the babies shown in this table may have more than one condition, so may not have had a termination for the condition shown.Late miscarriages are pregnancy outcomes between 20 and just under 24 weeks’ gestation which result in the death of the baby.

What steps he is taking to improve the (a) quality and (b) quantity of medical research in the NHS.

The Department is improving the quality and quantity of clinical research in the National Health Service, and health and care research more widely, through investing in the National Institute for Health and Care Research. The recent Budget provides record levels of Government research and development investment, with funding for research through the Department increasing to over £2 billion in 2025/26.

Pursuant to the Answer of 11 November 2024 to Question 11938 on NHS: Employers' Contributions, whether he has made a estimate of the cost of changes to national insurance contributions announced in the Autumn Budget 2024 to (a) his Department, (b) NHSE, (c) general practices, (d) hospices, (e) charities delivering healthcare, (f) social care providers, (g) care homes, (h) air ambulance service providers, (i) each acute trust's direct costs, (j) each acute trusts indirect costs, (k) dental clinics providing NHS care, (l) opticians providing NHS appointments, (m) private healthcare providers providing NHS appointments or operations, (n) each mental health trust, (o) each ICB, (p) the cost of agency nursing staff, (q) the cost of locum doctors, (r) local pharmacies and (s) NHS suppliers and contractors.

We have taken necessary decisions to fix the foundations in the public finances at Autumn Budget. This has enabled a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The Government is also providing at least £600 million of new grant funding for social care in 2025/26, as part of the broader estimated real-terms uplift to core local government spending power of around 3.2%.The rise will be implemented from April 2025, and the Department will set out further details on allocation of funding for next year in due course, taking employer National Insurance contributions into account. The information requested is not available centrally, as the range of organisations and individuals being asked about have very different contractual relationships with the Department, NHS England, local integrated care boards and National Health Service providers.

With reference to paragraph 2.40 of the Autumn Budget 2024, HC 295, published on 30 October 2024, what estimate he has made of the potential impact of the increase in the rate of employer National Insurance Contributions on the New Hospitals Programme.

The Autumn Budget Statement announced by my Rt Hon. Friend, the Chancellor of the Exchequer on 30 October set out that we would continue to deliver the New Hospital Programme by placing it on a more sustainable and deliverable footing.We expect that the potential impact of Employer National Insurance Contributions to individual schemes in the New Hospital Programme will be covered through the individual Full Business Cases submitted by the trusts, where the final costs will be reviewed through the business case process.

How many adults have received the respiratory syncytial virus vaccination in each month since July 2024.

The UK Health Security Agency measures the coverage of vaccines against the respiratory syncytial virus (RSV). The RSV adult vaccination programme in England began on 1 September 2024. Only data for the catch-up cohort, those adults aged 75 to 79 years old before the programme start date, has been published. This publication covers the first full month of the programme, and is available at the following link:https://www.gov.uk/government/publications/health-protection-report-volume-18-2024/hpr-volume-18-issue-9-news-31-octoberDuring the reporting period, from 1 to 30 September 2024, the total vaccination uptake among the catch-up cohort was 22.6%. Data for the routine cohort, those adults turning 75 years old from the programme start date, will be published in an annual RSV report in due course. NHS England publishes weekly data by region on the RSV vaccines administered, which offers further insight into the progress of the vaccination programme. The weekly data on vaccines administered is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/vaccinations

With reference to paragraph 2.40 of the Autumn Budget 2024, HC 295, published on 30 October 2024, what estimate he has made of the increased cost to the NHS (a) directly and (b) indirectly of the increase in employer national insurance contributions.

We have taken tough decisions to fix the foundations in the public finances at Autumn Budget, this enabled the SR settlement of £22.6 billion increase in resource spending for the Department of Health and Social Care from 2023-24 outturn to 2025-26.The Employer National Insurance rise will be implemented April 2025, the Department of health and Social Care will set out further details on allocation of funding for next year in due course.

What estimate he has made of the cost to the NHS that would be incurred by an (a) 1% and (b) 2% rise in the rate of employers national insurance contributions.

We do not comment on speculation around hypothetical situations. Any decisions that could be taken on National Health Service budgets for future years will be announced at fiscal events, including the Spending Review.

What discussions he has had with stakeholders on access to the RSV vaccination for people over 80.

There is currently no advice on respiratory syncytial virus (RSV) vaccination for those aged over 80 years old to discuss with stakeholders. The Department accepted the advice of the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI is not a stakeholder but the independent expert committee that advises the Government on matters to do with immunisation.In June 2023, the JCVI advised an RSV immunisation programme for older adults aged 75 years old and above. The committee suggested an initial programme to potentially vaccinate a cohort aged from 75 to 80 years old, and then for those turning 75 years old in subsequent years, and this is the current policy for the programme. In the JCVI’s statement summarising the advice for the RSV programme, the committee stated that an extension to the initial programme would be considered when there is more certainty about protection in the very elderly and the real-world impact of the programme in 75 to 80 year olds.In line with JCVI advice, RSV vaccination programmes to protect older adults and newborn babies, via maternal vaccination, began on 1 September 2024 in England. The Department will consider any further JCVI advice on who should be offered an RSV immunisation as the committee continues to keep the evidence under review.