Written questions by Onwurah.

What assessment has he made of the potential merits of proposals in the ABPI report published in March 2026.

The Department has considered the Association of the British Pharmaceutical Industry’s (ABPI) March 2026 report, Globally competitive United Kingdom wide data-enabled clinical trials: the time is now, and its proposals on improving clinical trial set‑up and recruitment through use of healthcare data. The report raises issues that align with the Government’s ongoing work to improve the UK’s clinical research environment, including delivery of faster trial set‑up and development of the Health Data Research Service (HDRS).The HDRS will be a UK-wide service to bring new treatments and cures to patients by safely enabling the use of patient data to super-charge research, and is currently being set up. It will be for the HDRS leadership team to decide whether to take forward the recommendations of the ABPI report.The Department continues to work with industry and research system partners through the UK Clinical Research Delivery Programme to consider how such proposals could support these objectives, while ensuring high standards of data protection and public trust.As set out in our 10-Year Health Plan, we will integrate the Be Part of Research registry tool with the NHS App to allow people to find and sign up to research relevant to them.

What proportion of General Practices are signed up to the Clinical Practice Research Datalink (CPRD); and what steps his Department is taking to help address (a) technical and (b) contractual barriers preventing further practices from joining.

The Clinical Practice Research Datalink (CPRD) receives data from Optum, Vision, and TPP SystmOne practices, which represent the three largest clinical system providers to general practices (GPs). 32% of practices across all four nations currently participate in CPRD. As of 22 April, there are 7,660 practices in total, 2,428 of which currently have requested to contribute data to CPRD. The following table shows the number of practices in each nation:NationNumber of contributing practicesTotal number of practicesEngland2,1486,112Wales38368Scotland216874Northern Ireland26306 CPRD is mandated to operate on a cost-recovery basis and holds contracts with all three of the main data providers. CPRD’s current data licence and service fees are only able to support a maximum of 35% population coverage across the United Kingdom. The focus is therefore on a representative practice and patient sample rather than 100% coverage.For Northern Ireland, Scotland, and Wales, previous IT system limitations restricting participation are currently being lifted which will allow for further participation across the three devolved nations.CPRD currently has 402 TPP practices signed up in England. However, due to technical issues, CPRD is unable to use TPP patient data and continues to work with the supplier to find a solution.If a patient registers for a type 1 opt-out with their GP, or registers for the National Data Opt-out, then CPRD will not receive any new data for that patient.The number of type 1 opt-outs are not recorded centrally, as it is not possible to specify how many people who registered for a National Data Opt-out did so to opt-out of the sharing of their data via the CPRD, as the opt-out covers a range of research. Information on the numbers of National Data Opt-outs is published at the following link:https://digital.nhs.uk/dashboards/national-data-opt-out-open-data

What proportion of patients in England have exercised their right to opt out of sharing their data for research purposes via the Clinical Practice Research Datalink (CPRD).

The Clinical Practice Research Datalink (CPRD) receives data from Optum, Vision, and TPP SystmOne practices, which represent the three largest clinical system providers to general practices (GPs). 32% of practices across all four nations currently participate in CPRD. As of 22 April, there are 7,660 practices in total, 2,428 of which currently have requested to contribute data to CPRD. The following table shows the number of practices in each nation:NationNumber of contributing practicesTotal number of practicesEngland2,1486,112Wales38368Scotland216874Northern Ireland26306 CPRD is mandated to operate on a cost-recovery basis and holds contracts with all three of the main data providers. CPRD’s current data licence and service fees are only able to support a maximum of 35% population coverage across the United Kingdom. The focus is therefore on a representative practice and patient sample rather than 100% coverage.For Northern Ireland, Scotland, and Wales, previous IT system limitations restricting participation are currently being lifted which will allow for further participation across the three devolved nations.CPRD currently has 402 TPP practices signed up in England. However, due to technical issues, CPRD is unable to use TPP patient data and continues to work with the supplier to find a solution.If a patient registers for a type 1 opt-out with their GP, or registers for the National Data Opt-out, then CPRD will not receive any new data for that patient.The number of type 1 opt-outs are not recorded centrally, as it is not possible to specify how many people who registered for a National Data Opt-out did so to opt-out of the sharing of their data via the CPRD, as the opt-out covers a range of research. Information on the numbers of National Data Opt-outs is published at the following link:https://digital.nhs.uk/dashboards/national-data-opt-out-open-data

What steps his Department is taking to help ensure the NHS is not dependent on single suppliers of medical products.

Central procurement processes through NHS Supply Chain include a range of measures to prevent the dependency on single suppliers of medical products.When designing strategies, at category and sourcing strategy stages, NHS Supply Chain completes a category risk analysis which highlights sole source or supplier dominance risk and is analysed before being accepted or rejected.Unless there is a requirement for a unique product, NHS Supply Chain tries to avoid sole sourcing. Occasionally, a tender will only produce one response for a product, so market constraints may result in sole source. In this case NHS Supply Chain will review the market and seek new entrants where possible and relevant.Where the procurement of a product from a sole source is unavoidable, NHS Supply Chain will conduct enhanced due diligence on sole source suppliers which could include:- business continuity management assurances;- tailored selection criteria; and- contingency planning in the event that the sole supplier is unable to supply.

Whether he plans to bring forward a strategy for dental health research.

The Department invests over £1.6 billion each year on research through the National Institute for Health and Care Research (NIHR).Whilst there are currently no plans to develop a dental health research strategy, the NIHR continues to welcome funding applications for research into any aspect of human health and care, including dental research. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.The Department, through the NIHR, funds clinical academic training for doctors and dentists through the Integrated Academic Training Programme. This includes Academic Clinical Fellowships (ACFs) at the pre-doctoral level and Clinical Lectureships (CLs) at the post-doctoral level. Over the last five years, 91 ACFs and 24 CLs were recruited in dentistry.The Department also funds the NIHR Oral Health Research Incubator, which is a researcher-led initiative aimed at building dental research capacity at the national level.Ongoing research at Newcastle University is investigating the roles and skill utilisation of professionals in dental practice.In addition, investments in NIHR infrastructure support the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research that is funded by the NIHR’s research programmes, other public funders of research, charities, and the life sciences industry. For example, through the NIHR University College London Hospitals Biomedical Research Centre’s Oral and Dental Medicine research theme.

Pursuant to the Answer of 6 November 2025 to Question 83750 on Health Services: Innovation, what mechanisms are in place to monitor and evaluate the successful adoption and diffusion of health innovations across the NHS; which bodies are responsible for measuring this impact at (a) national and (b) regional levels; and how these findings inform future commissioning and policy decisions.

No organisations hold a statutory responsibility specifically to monitor or evaluate the rates of the successful adoption and spread of health innovation in the National Health Service. However, the NHS Business Services Authority, on behalf of the Office for Life Sciences, publishes the Innovation Scorecard every six months. This is of significant use to the NHS and has been published since January 2013.The Innovation Scorecard reports on the use of medicines and medicine groupings in the NHS in England, which have been positively appraised by the National Institute for Health and Care Excellence (NICE). It reveals what NICE-recommended treatments are available at a local level within trusts and integrated care boards, as well as at national and NHS England region levels. Data limitations mean it cannot be used for performance management, but it does allow the NHS to identify variation, which, through discussion, can be explained, challenged, or acted upon.Several organisations organise additional detailed evaluations for specific groups of health innovations. For example, the Health Innovation Network (HIN) oversees numerous national programmes which monitor the uptake and spread of selected health innovations. This helps them, and NHS England, determine how best to improve the uptake of these innovations.Regionally, HINs also undertake monitoring and evaluation for selected innovations that they support. Integrated care boards and providers may also choose to conduct their own evaluations, using local data to understand whether innovations deliver expected improvements in outcomes or efficiency.

Pursuant to the Answer of 13 November 2025 to Question 85147, what proportion of health research and development has been spent on dentistry in each of the past three years; and how the decision to allocate each sum to dentistry was arrived at.

I refer the Hon. Member to the answer I gave on 6 November 2025 to Question 85147 in which I noted that between 2022/23 and 2024/25 the National Institute for Health and Care Research (NIHR), the Department’s research delivery arm, directly spent £18.2 million on research projects and programmes on dentistry research.Programme funding allocated to a particular topic area is not calculated as a proportion of total NIHR spend. This is because, in addition to directly investing in research projects and programmes, the NIHR also provides investment for cross-cutting research delivery within the National Health Service and wider health and care system, including research facilities and workforce, known as NIHR infrastructure.The NIHR funds research in response to receiving high-quality applications through regular funding opportunities. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

How much the Department has spent on dental research in each of the last three years.

The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR).  Between the 2022/23 and 2024/25 financial years, the NIHR directly spent £18.2 million on research projects and programmes on dentistry research. The following table shows the spend on dentistry research, to the nearest £100,000, from 2022/23 to 2024/25 and in total over that period:Financial yearSpend2022/2023£5.1 million2023/2024£7.1 million2024/2025£6.1 millionTotal£18.2 million The Department, through the NIHR, also funds clinical academic training for doctors and dentists through the Integrated Academic Training Programme. This includes Academic Clinical Fellowships (ACFs) at the pre-doctoral level and Clinical Lectureships (CLs) at the post-doctoral level. From 2022 to 2024, 53 ACFs and 15 CLs were recruited in dentistry, with an estimated total value of over £14 million across the duration of the awards.In addition, investments in NIHR infrastructure, not included in the figures above, support the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research that is funded by the NIHR’s research programmes, other public funders of research, charities, and the life sciences industry. This has supported the delivery of over 50 studies and the recruitment of over 12,000 participants in research under the specialty area of oral and dental health in the last three financial years.The NIHR welcomes funding applications for research into any aspect of human health and care, including dental research. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

What comparative assessment he has made of the effectiveness of the adult oral health survey (a) before and (b) after the decision to no longer include the examination of patients in the survey.

There has been no comparative assessment of the effectiveness of the adult oral health survey (AOHS) before and after the changes in data collection. This decision occurred for the 2021 survey only, to adapt to restrictions during the COVID-19 pandemic, where face to face examinations were not feasible. The most recent 2023 AOHS survey has reintroduced a clinical examination of participants.An online and paper survey without an oral examination was undertaken in 2021 due to the COVID-19 pandemic. The results from this survey, published in January 2024, are therefore not comparable to the rest of the survey series. The most recent AOHS, provisionally scheduled to be published on 9 December, is a comprehensive survey that will include results of an oral examination of consenting participants. The survey is similar in content to the one that was conducted in 2009 and published at the time by NHS Digital.

Who is responsible for the (a) national and (b) regional (i) adoption and (ii) spread of health innovation within the NHS; and what role the Health Innovation Network and Integrated Care Systems play in this process.

Under the NHS Act 2006, NHS England has a statutory duty to promote innovation in the provision of health services. The Health and Care Act 2022 extends this duty to each integrated care board (ICB), requiring them to promote innovation as part of their planning and commissioning responsibilities. Nationally, NHS England supports the adoption and spread of innovation through programmes such as the NHS Innovation Service, Clinical Entrepreneurs Programme, and the NHS Innovation Accelerator. NHS England also works alongside the Department and the Office for Life Sciences (OLS) to develop national policy and coordinate action to strengthen the health innovation ecosystem. Innovation is a central theme of both the 10-Year Health Plan and the Life Sciences Sector Plan. The latter sets out specific actions and assigns senior responsible officers across NHS England, the Department, OLS, the Medicines and Healthcare products Regulatory Agency, and the National Institute for Health and Care Excellence, reflecting the shared national responsibility for supporting innovation. Regionally, Health Innovation Networks (HINs), commissioned by NHS England and OLS, support the adoption and spread of innovations across England through, but not limited to, building capacity to serve integrated care system (ICS) needs, supporting ICSs with the roll-out of national innovation programmes, real-world evaluation, and supporting local-to-national adoption. Each HIN serves its local population but also works as part of a network to share learning and support the spread of innovation across England. Ultimately, ICBs and National Health Service providers are the commissioners of services. They decide whether to procure new products, services, or technologies based on local priorities, evidence of benefit, affordability, and alignment with system plans.

How the Ambitions framework aligns with the NHS 10 Year Health Plan in the context of (a) the shift to neighbourhood health services, (b) integrated care and (c) preventative models of care.

The Ambitions Framework aligns with the 10-Year Health Plan in several ways, including both the foundations on which the framework is built, and the associated six ambitions. For example, the shift to neighbourhood health services aligns to education and training, community partnerships, population-based needs assessment, continuity partnership, and compassionate and resilient communities referenced in the Ambitions Framework.Ambition 1, that each person is seen as an individual, specifically references integrated care as a key building block, with alignment also clear with regards to shared records, personalised care and support planning, access to social care, inclusion of specialist level care, and ensuring an overall system approach. Finally, preventative models of care for palliative care and end of life care are not curative, but improve quality of life, preventing avoidable escalations of need, including emergency care.Therefore, alignment between the 10-Year Health Plan and the Ambitions Framework can be seen in the specific reference to rehabilitative palliative care and further complemented through 24/7 access, using new technology and improved use of existing and new data. Importantly, the Ambitions Framework was first published in 2015 and is due to be refreshed in 2026, providing further opportunity to align where appropriate.

With reference to Action 10 on page 22 of the Life Sciences Sector Plan, published on 16 July 2025, what steps his Department is taking to ensure that musculoskeletal conditions are included in plans to increase investment in health research and development focused on primary and secondary prevention and multiple long-term conditions.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health including a variety of musculoskeletal (MSK) conditions such as arthritis, including osteo, rheumatoid, psoriatic, juvenile arthritis, osteoporosis, and joint and back pain. This includes research on primary and secondary prevention of MSK and the interaction and co-concurrence of MSK with other long-term conditions. Current investments across the NIHR include:- the UK Musculoskeletal Translational Research Collaboration, which works across all sectors of the health and care system to collate expertise, resources, and to develop novel innovations to benefit those experiencing MSK related conditions, with further information available at the following link: https://www.nihr.ac.uk/about-us/what-we-do/infrastructure/translational-research-collaborations/musculosceletal;- the Oxford Biomedical Research Centre, which is evaluating new devices and surgical interventions, using large datasets to find new ways to identify and treat MSK conditions and testing new drug delivery systems to help treat MSK conditions, with further information available at the following link: https://oxfordbrc.nihr.ac.uk/research-themes/musculoskeletal/; and- a major research grant exploring whether long-term conditions such as arthritis can be predicted by a person’s level of inflammation. Predicting these conditions will enable better intervention, prevention, and treatment, with further information available at the following link: https://fundingawards.nihr.ac.uk/award/NIHR205461.

What steps he is taking to improve care for people with arthritis.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making.As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. Launched in December 2024, with 17 ICBs selected in the first cohort, including the Hampshire and Isle of Wight ICB, GIRFT teams have deployed their proven Further Faster model to work with ICB leaders to reduce MSK community waiting times, including for those with arthritis, and improve data, metrics, and referral pathways to wider support services. The GIRFT programme is continuing to develop the approach to better enable integrated care systems to commission the delivery of high-quality MSK services in the community, which will benefit patients now and into the future.Our recently published 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these will help deliver improvements to arthritis care in all parts of the country.More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their long-term conditions, including arthritis, closer to home.

What steps his Department is taking to tackle health inequalities in the North East.

This government is working to stamp out this country’s stark health inequalities. The North East has had the lowest healthy life expectancy for over ten years, which is unacceptable.The Government has put tackling these inequalities at the heart of the 10 Year Plan. We will create a fairer Britain where everyone can access quality care, regardless of background, income or postcode.We are taking unprecedented action by diverting billions of pounds to working class communities that need it most – prioritising investment in towns with the greatest health needs.

What steps he is taking to ensure that the 10 Year Health Plan supports people with (a) arthritis and (b) other long-term conditions.

The three shifts outlined in the 10-Year Health Plan will support people with long-term conditions, including those with arthritis, to better manage their condition and access services closer to home. For example, it will empower them to access their medical history and allow them to book and manage their appointments and medication.In addition, by 2028/29, neighbourhood health teams will be organised around the needs of their patients. The plan will create joined-up working across hospitals and into community settings with multi-disciplinary teams who can provide wrap-around support services.By 2030, one million patients with long-term conditions will be offered Personal Health Budgets, which will enable them to use National Health Service resources and determine the care that best suits their needs.Patients will be able to self-refer to services where clinically appropriate through the My Specialist section on the NHS App. This will accelerate their access to treatment and support. The NHS App will provide access to advice, guidance, self-care support, and appointment management. Patients will be able to manage their care in one place, giving them direct access to and preference over the services they need.As part of the NHS App, My Medicines will enable patients to manage their prescriptions, and My Health will enable patients to monitor their symptoms and bring all their data into one place.

What assessment he has made of the potential (a) financial and (b) clinical impact of the Zimmer Biomet NexGen Legacy Posterior Stabilized (LPS) knee replacement system on the NHS.

The Medicines and Healthcare products Regulatory Agency (MHRA) issued a field safety notice (FSN) in December 2022 about some devices in the NexGen family of knee implants. The FSN was issued following notification by the National Joint Registry (NJR) Implant Scrutiny Committee in 2021.The NexGen Stemmed Option Tibial Component was removed from the market because of that notice, although only use in combination with LPS Flex or LPS Flex GSF femoral components demonstrated higher revision rates, and only patients receiving the combination of devices were recommended to be reviewed.As is standard with joint replacement FSNs, the NJR supplied hospitals with a list of all the patients who had this combination implant and were still alive and had not already had a revision procedure. This represented 9,125 cases from 102 hospitals. This all happened within 48 hours of the FSN being issued. For context, 11,965 of these were implanted if patients who had died or been revised were included.In terms of the clinical impact, the NJR had first been asked to investigate use of high flex NexGen knees by a surgeon in 2014. Although the data did not meet the outlier threshold at that time, NJR did inform the MHRA because there appeared to be a particular mechanism of failure with these devices, namely tibial loosening. The MHRA followed its standard process of discussing the concerns with the manufacturer and the matter was closed since the data did not demonstrate a case to answer. NJR reported this again in 2021, by which time the data was more robust and the signal was stronger.At the time for an implant to be rated 10A, which is a measure of implant success, according to the National Institute for Health and Care Excellence (NICE), a failure rate of 10% at 10 years was used. This has recently been changed to a failure rate of 5% at 10 years.The failure rate of this implant combination at 10 years is 7%, which is still under the 10% threshold advocated by NICE. It is important that these patients remain under clinical and radiological review.NJR has made no assessment of the financial impact of the NexGen family of knee implants.

Whether he has had recent discussions with relevant stakeholders on strategies for reducing child obesity in the North East.

As part of our Health Mission, the Government is committed to ensuring that people live well for longer. This includes tackling the determinants that underpin stark health inequalities to halve the gap in healthy life expectancy between the richest and poorest regions and to create the healthiest generation of children ever.The 10-Year Health Plan for England outlines a range of actions to address childhood obesity. We will fulfil our commitments to restrict junk food advertising targeted at children, ban the sale of high-caffeine energy drinks to under 16 year olds, and use our revised National Planning Policy Framework to give local councils stronger powers to block new fast-food outlets near schools. We will work with the Department for Education to update school food standards. To support the families most in need, we are expanding free school meals to all children with a parent in receipt of universal credit. The Strengthening the Soft Drinks Industry Levy consultation sets out proposals to further drive reformulation, including ending the exemption for milk-based drinks and reducing the minimum sugar thresholds. By the end of this Parliament, we will introduce mandatory healthy food sales reporting for all large companies in the food sector.These are national-level policies and my Rt Hon. Friend, the Secretary of State for Health and Social Care has had discussions with relevant stakeholders on the Government’s approach of moving towards the prevention of ill health, including tackling obesity within its 10-Year Health Plan.Specifically, in the North East, North East local authorities received a total of £256 million in Public Health Grant funding for 2025/26. Directors of Public Health oversee the use of the Public Health Grant, working in partnership with a range of stakeholders to maximise the health gain associated with local resources, including addressing levels of childhood obesity in the North East. This includes commissioning the National Child Measurement Programme. Additionally, Directors of Public Health from each local authority are working in partnership with the North East and North Cumbria Integrated Care Board to support action to address childhood obesity through a North East and North Cumbria Healthy Weight and Treating Obesity Strategy.

If his Department will publish further details on plans to expand the provision of (a) palliative and (b) end of life care in community settings as outlined in the 10-Year Plan for Health.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life.Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs, including the Staffordshire and Stoke-on-Trent ICB, which covers the Stafford constituency, are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.As set out in the Government’s recently published 10-Year Health Plan, we are determined to shift more care out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services, including hospices, will have a big role to play in that shift, and were highlighted in the plan as being an integral part of neighbourhood teams.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative and end of life care services to ensure that, in future, services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

What steps his Department is taking to ensure that the 10-Year Plan for Health delivers equitable access to (a) palliative and (b) end of life care across all communities.

Integrated care boards (ICBs) are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.One of the three shifts that the 10-Year Health Plan will deliver is the shift of healthcare from the hospital into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care, in line with the 10-Year Health Plan.

If he will make an assessment of the potential merits of introducing regulatory standards for the marketing of consumer DNA testing kits.

The Medicines and Healthcare products Regulatory Agency is aware that there are a number of DNA test kits on the market. The majority claim to provide information on ancestry, and in general these would not be regarded as medical devices.However, those that make medical claims in relation to predisposition of medical conditions would be regarded as in vitro diagnostic medical devices and would require the relevant CE mark or a UK Conformity Assessed marking.