Written questions by Bloore.

What assessment he has made of the potential impact of the affordability of prescriptions on people with long-term conditions.

Approximately 89% of prescription items are dispensed free of charge in the community in England. There are a wide range of exemptions from prescription charges already in place, for which those with long-term conditions may be eligible, to support the affordability of prescriptions. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three month and 12-month certificates available, and PPCs can be paid for in 10 direct debit instalments.

What steps he is taking to improve health outcomes for survivors of acquired brain injuries.

The Government wants a society where every person, including those with a long-term condition such as an acquired brain injury (ABI), receives high-quality, compassionate continuity of care, with their families and carers supported.We will change the National Health Service so that it becomes not just a sickness service, but able to prevent ill health in the first place. This will help us be better prepared for the change in nature of disease and allow our services to focus more on the management of chronic, long-term conditions, like ABI, including rehabilitation where appropriate.The National Institute for Health and Care Excellence is currently developing guidance ‘Rehabilitation for chronic neurological disorders including acquired brain injury’, which is expected to be published on 16 July 2025. More information is available at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ng10181I met the original proponent of the ABI strategy, my Hon. Friend, Sir Chris Bryant MP, on 27 November 2024 to discuss ABI and we had a very fruitful discussion about what might be achievable in the both the short term and the longer term. Sir Chris remains a huge advocate for those that have suffered an ABI and I fully agree with him that the Government should, and importantly will, do more, including showcasing those areas that have effectively integrated post-hospital care and support, including rehabilitation, to other areas where patients are not getting the care and support they deserve.A decision on next steps on ABI at the national level will be taken in due course.Meanwhile, we have committed to develop a 10-year plan to deliver an NHS fit for the future. We will be carefully considering input from the public, patients, health staff, and our stakeholders as we develop the plan over the coming months. The engagement process has been launched and I would encourage stakeholders to engage with that process to allow us to fully understand what is not working as well as it should and what the potential solutions are, including on ABI. More information is available at the following link:https://change.nhs.uk/en-GB/

What his Department's timetable is for the commencement of dentist contract renegotiations.

To rebuild dentistry in the long term and increase access to National Health Service dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.There are no perfect payment systems and careful consideration needs to be given to any potential changes to the complex dental system so that we deliver a system better for patients and the profession. We continue to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.

What assessment he has made of the potential implications for his policies of Getting It Right First Time's guidance entitled Heavy Menstrual Bleeding, published in October 2021; and whether he plans to implement their recommendations.

The Getting It Right First Time’s (GIRFT) 2021 report into maternity and gynaecology identified a key barrier in treating heavy menstrual bleeding as the commissioning arrangements for contraceptive and sexual health services. The report recommended the lifting of restrictions on providing long-acting reversible contraception (LARC) for non-contraceptive purposes, such as treatment for heavy menstrual bleeding.The commissioning of LARC is a decision for individual integrated care boards, who can decide whether to offer LARC through general practices or sexual health services, or both, based on an assessment of population need.Additionally, £25 million has been invested by the Department to support the development of at least one pilot women’s health hub in every integrated care system, and work is ongoing with NHS England to provide this. Women’s health hubs bring together healthcare professionals and existing services to address fragmentation in reproductive health care and remove the barriers women face accessing treatment. Providing care and treatment for heavy menstrual bleeding is a core service of the hubs, and this includes treatment with LARCs.

If he will publish a cancer strategy which includes measures on tackling (a) pancreatic and (b) other less survivable cancers.

The Health Mission sets the objective of building a National Health Service fit for the future. As part of that work, and in response to Lord Darzi’s report, we have launched an extensive programme of engagement to develop a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts, from hospital to community, from analogue to digital, and from sickness to prevention.In addition, following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients, including those with pancreatic and other less survivable cancers.We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be, and will provide updates on this in due course.NHS England is delivering a range of interventions that are expected to improve early diagnosis and treatment for patients with suspected and diagnosed pancreatic cancer. This includes providing a route into pancreatic cancer surveillance for patients at inherited high-risk, to identify lesions before they develop into cancer, and diagnose cancers sooner.In March 2024, NHS England published guidance for providers and systems to implement a timed Hepato-Pancreato-Biliary cancer pathway with the aim of ensuring that patients with some suspected tumour types, including suspected pancreatic cancer, receive a diagnosis or have cancer ruled out within 28 days of urgent referral.

With reference to the recommendations of the report by the Getting It Right First Time programme entitled Maternity and Gynaecology, published in September 2021, what steps his Department is taking to provide primary care practitioners with (a) training and (b) other resources to deliver long-acting reversible contraception as part of treatment options for women with heavy menstrual bleeding.

The 2021 Getting It Right First Time national report for maternity and gynaecology recommended that clinical commissioning groups, now integrated care boards (ICBs), commission contraceptive and sexual health services to provide intrauterine devices, which are a form of long-acting reversible contraception (LARC) for heavy menstrual bleeding, in relevant cases. ICBs may commission sexual health services or general practices (GPs) to offer LARC as a locally enhanced service to their local population. It is for ICBs to decide on commissioning arrangements for their area, based on an assessment of local need.The Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. A core service offered by hubs is treatment for heavy menstrual bleeding and provision of LARC. By providing an enhanced and more specialist service through hubs in the community, they enable women to be more effectively diagnosed and treated promptly in the community. The hubs also provide a centre for the training and support to GPs to help with upskilling, and reduce variation in the care that women can expect to receive.Other training and guidance are available for primary care practitioners. For example, the Royal College of General Practitioners has developed a Women’s Health Library, drawing together educational resources and guidelines on women’s health, so primary healthcare professionals have the most up-to-date information for their patients. The Faculty of Sexual and Reproductive Healthcare also offers a range of contraception qualifications that healthcare professionals can undertake.

What assessment his Department has made of the potential impact of increasing access to long-acting reversible contraception for heavy menstrual bleeding in primary care on (a) waiting times and (b) demand for secondary care gynaecology services.

The National Institute for Health and Care Excellence’s guideline on heavy menstrual bleeding recommends an intrauterine system or hormonal coil, which is a form of long-acting reversible contraception (LARC), as a first line treatment. In the women’s health strategy call for evidence, held in 2021, we heard about the challenges women faced accessing LARCs for the management of menstrual problems.A cost benefit analysis on women’s health hubs conducted by the Department estimated that if 50% of LARC procedures for gynaecology were provided in women’s health hubs, it would produce a net saving of £1.8 million, and reduce pressures on secondary care gynaecology services. The cost benefit analysis is available at the following link:https://www.gov.uk/government/publications/womens-health-hubs-information-and-guidance/womens-health-hubs-cost-benefit-analysis#cost-benefit-analysis-assumptionsThe Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. Pilot women’s health hubs provide intermediate and streamlined care in the community, which reduces pressures on services such as secondary care referrals and general practice appointments. A core service offered by hubs is treatment for heavy menstrual bleeding, and the fitting or removal of a LARC. Cutting waiting lists, including for gynaecology, is a key part of our Health Mission and a top priority for the Government.

What discussions his Department has had with NHS England on (a) renewing the national maternity safety ambitions beyond 2025 and (b) amending those ambitions to include reducing inequalities.

The Government is committed to ensuring that all women and babies received safe, personalised, equitable, and compassionate care. I am urgently considering, with my officials and NHS England, the immediate action needed across maternity and neonatal services to improve outcomes and address the stark inequalities that persist for women and babies, including what targets are needed.This includes consideration of what comes beyond the national maternity safety ambition, ensuring that we take an evidence-based approach, and that any targets set are women and baby-centred and focused on tackling inequalities.

How many Primary Care Networks have used the Additional Roles Reimbursement Scheme to fund enhanced practice nurse roles to deliver specialist dementia nursing support in primary care.

NHS England does not hold this information centrally. The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.The Additional Role Reimbursement Scheme aims to grow and diversify the general practice workforce. The scheme provides funding for additional roles in primary care networks, to help create bespoke multi-disciplinary teams.

What estimate he has made of the number of specialist dementia nurses working in Acute Trusts.

NHS England does not hold this information centrally. The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.

How many integrated care boards had strategies in place to meet the needs of local populations affected by dementia (a) as of 28 October 2024, (b) in 2023 and (c) in 2022.

NHS England is committed to improving diagnosis rates and recovering them to the national ambition for two thirds of people with dementia to have a formal diagnosis. This commitment is included in the operational planning guidance for 2024/25, giving clear direction for integrated care boards (ICBs) to prioritise dementia.Local authorities are required to provide or arrange services that meet the social care needs of the local population, including carers, under the Care Act 2014. It is the responsibility of ICBs to work with the third sector in their geographical area to offer services that meet the needs of their population. NHS England would expect ICBs to take account of the National Institute for Health and Care Excellence’s guidelines when commissioning services for their local population.

Whether he plans to introduce a National Brain Tumour Strategy.

Ministers regularly meet with a wide range of cancer partners, including brain cancer charities and patient groups. Ministers also regularly meet with teams from the National Health Service, including clinical specialists where this is appropriate. These meetings are valuable opportunities to discuss raising awareness, screening, treatments, innovation, and the care experiences of people living with cancer.The Department, NHS England, and the National Institute for Health Care and Research (NIHR) are taking several steps to help improve outcomes for brain tumour patients. NHS England is committed to ensuring that all cancer patients are offered Holistic Needs Assessment and Personalised Care and Support Planning, ensuring care is focused on what matters most to each person. As well as this, all patients, including those with secondary cancers, will have access to the right expertise and support, including a Clinical Nurse Specialist or other support worker.Further to this, in September 2024, the NIHR announced new research funding opportunities for brain cancer research, spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients, and a new funding call to generate high quality evidence in brain tumour care, support, and rehabilitation. We will get the NHS diagnosing cancer, including brain tumours, on time, diagnosing it earlier, and treating it faster, so more patients survive this horrible set of diseases, and we will improve patients’ experience across the system.

Whether his Department plans to update the NHS website to include up-to-date information on menstrual health conditions using (a) plain and (b) accessible English.

The Department worked with NHS England to introduce a new women’s health area on the National Health Service’s website in 2023. This brings together over 100 health topics including periods, gynaecological conditions, fertility, pregnancy, heart health, and cancers, and is designed to be a first port of call for women seeking health information. Further information is available at the following link:https://www.nhs.uk/womens-health/As part of this work, a number of pages were updated, including pages on heavy periods and endometriosis, and a new page on adenomyosis was created. One of the key goals of the NHS website is to provide users with clear and accurate health information. There are no current plans to further update the NHS website on menstrual conditions, subject to the standard review of all editorial content at least every three years.The NHS has also used its YouTube channel to provide up-to-date information on endometriosis and heavy menstrual bleeding, with further information on both topics available, respectively, at the following two links:https://www.youtube.com/watch?v=ABi1ncHorBYhttps://www.youtube.com/watch?v=1Pgm30RYVIs&list=PLnhASgDToTkvLigKt1XBE-iwZVJxd7Lto

What steps he is taking to improve (a) diagnosis, (b) treatment and (c) ongoing care for (i) endometriosis, (ii) polycystic ovary syndrome and (iii) other menstrual health conditions in (A) Redditch and (B) England; and what steps he is taking to align these efforts with the Women's Health Strategy for England.

The Government is committed to prioritising women’s health and improving the diagnosis, treatment, and ongoing care for gynaecological conditions. We are considering how to take forward the Women’s Health Strategy for England.National Institute for Health and Care Excellence (NICE) guidelines support healthcare professionals to diagnose and treat conditions. The NICE has published Women’s and reproductive health guidelines, which are available at the following link:https://www.nice.org.uk/hub/indevelopment/gid-hub10001In April 2024, the NICE published updated recommendations on the treatment of endometriosis when fertility is a priority. The NICE is also updating the guidance on the diagnosis of endometriosis, and is planning the development of a guideline on the assessment and management of polycystic ovary syndrome. The NICE has also published a guideline on heavy menstrual bleeding assessment and management. Women's health is also embedded into the Royal College of General Practitioners curriculum for trainee general practitioners (GPs).Women’s health hubs also play a key role in improving care for gynaecological conditions. The Department has invested £25 million over 2023/24 and 2024/25 to support the establishment of at least one pilot women’s health hub in every integrated care system. NHS England has asked the integrated care boards (ICBs) to report regularly on their progress implementing the funding. The Herefordshire and Worcestershire ICB has reported to NHS England that it is using the funding to set up two pilot hubs, one within Herefordshire and one within Worcestershire. To date, the pathway redesign as part of the women’s health hubs has been priority for Herefordshire and Worcestershire, with initial focus on menopause. Following implementation of a menopause pilot, focus will be on the remaining core services, specifically menstrual health.Healthcare services in Herefordshire and Worcestershire offer advice, care, and treatment for menstrual conditions, including endometriosis and polycystic ovary syndrome. The integrated care system is focused on women’s health and hosts a monthly Gynaecology Forum which incorporates clinical and operational discussion on all elements of women’s health. The Worcestershire Acute Hospitals NHS Trust qualifies as a Specialist Endometriosis Centre, with clinics and operations offered in Kidderminster, Redditch, and Worcester. GP referral pathways, specialist endometriosis and pain clinics, and multi-disciplinary meetings provide diagnosis and treatment of all stages of endometriosis. The Worcestershire Acute Hospitals NHS Trust also employs a dedicated Endometriosis Specialist Nurse and hosts an Endometriosis Support Group for patients.

What steps his Department is taking to help improve the (a) information and (b) resources on menstrual health conditions provided to primary healthcare professionals to help (i) diagnosis and (ii) referrals to specialist treatment.

A range of information and resources are available to help primary care professionals to diagnose and treat menstrual health conditions, and where needed refer to secondary care.The National Institute for Health and Care Excellence (NICE) has published Women’s and reproductive health guidelines, which cover a range of menstrual health conditions including heavy menstrual bleeding, endometriosis, and menopause. The NICE has also published several clinical knowledge summaries focused on menstrual health conditions. The guidelines and clinical knowledge summaries are available, respectively, at the following two links:https://www.nice.org.uk/hub/indevelopment/gid-hub10001https://cks.nice.org.uk/specialities/womens-health/The Royal College of General Practitioners has developed a Women’s Health Library, drawing together educational resources and guidelines on women’s health so primary healthcare professionals have the most up-to-date information for their patients.NHS England has developed a shared decision tool to help women and general practitioners (GPs) make decisions about the best treatments for heavy menstrual bleeding, which is available at the following link:https://www.england.nhs.uk/publication/decision-support-tool-making-a-decision-about-managing-heavy-periods/NHS England is developing a set of responses to common questions asked by GPs to help manage menstrual health and other common women’s health conditions, which will soon be available.The Department has invested £25 million over 2023/24 and 2024/25 to support the establishment of at least one pilot women’s health hub in every integrated care system. These provide more specialist care for women in the community, and many of them also act as a point of training and support for their local GP community.

Whether his Department plans to implement the policies in the policy paper entitled Women’s Health Strategy for England, published on 20 July 2022.

This government is committed to prioritising women’s health as we build an NHS fit for the future, and women’s equality will be at the heart of our missions. We are considering how to take forward the Women’s Health Strategy for England, and work continues to improve health outcomes for women. For example, the Department is continuing to work with NHS England to support the establishment of at least one pilot women’s health hub in every integrated care system, following a £25 million investment. As of September 2024, 36 of the 42 ICBs reported to NHS England that their pilot women’s health hub was open. Additionally, on 9th October, during Baby Loss Awareness Week, the Department launched an extension to the Baby Loss Certificate Service, meaning the service is now available for all historic losses, with no backdate, as well as future losses.