Written questions by Jones.

What progress his Department has made on (a) improving the process for clinical trials and (b) ensuring that those trials are more accessible for teenagers and young adults.

In order to maximise our potential to be a world leader and develop a more competitive, efficient, and accessible clinical research system, the Department is committed to implementing recommendations from Lord O'Shaughnessy’s independent review of commercial clinical trials in full.Significant progress has already been made to reform the clinical research system. The Department has streamlined the costing and contracting activities for commercial sponsors by introducing the National Contract Value Review as a standardised system-wide process, supported by the Department’s research delivery arm, the National Institute for Health and Care Research (NIHR). As reported in October 2024, the proportion of NIHR portfolio studies delivering to time and target is currently greater than 80%, and overall recruitment, including recruitment into commercial contract studies on the NIHR Portfolio, continues to exceed pre-COVID-19 levels.The Department is committed to ensuring that clinical trials are people-centred and more accessible, including for teenagers and young adults. For example, the NIHR provides an online service called Be Part of Research which promotes participation in health and care research by allowing users to search for relevant studies and register their interest.

What plans his Department has to invest in the recruitment and retention of radiologists in the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board.

Information on local plans is not collected centrally by the Department. National Health Service organisations are responsible for their own recruitment, and for developing their own workforce plans based on service needs.At a national level, we are committed to training the staff the NHS needs, and we will work closely with partners in education to do this. NHS England continue to lead on a range of initiatives to boost retention of existing staff and ensure the NHS remains an attractive career choice for new recruits.

What steps his Department is taking to include policies on (a) diagnosis, (b) care and treatment and (c) research into brain tumours in the (i) NHS 10-year plan and (ii) cancer strategy.

I refer the hon. Member to the answer I gave to the hon. Member for Gordon and Buchan on 28 November 2024 to Question 15703.

What recent assessment his Department has made of the adequacy of the capacity of colonoscopy services; and whether his Department plans to increase the capacity of these services ahead of the extension of the bowel cancer screening programme to people aged 50 and above by April 2025.

NHS England is responsible for delivering the NHS Bowel Cancer Screening programme and planning for the age extension in the programme from 60 years old down to 50 years old.The age extension for bowel screening started in April 2021 with the 56-year-old cohort and, based on modelling and clinical advice, has been planned to gradually reduce to age 50 years old by 2025. This has been done to ensure that screening centres could manage any required increase in colonoscopy capacity.

What estimate his Department has made of the colonoscopy capacity required to implement the UK National Screening Committee's recommendations for bowel cancer that everyone aged 50-74 be offered Faecal Immunochemical Test screening every two years at a sensitivity level of 20μg/g.

NHS England is responsible for delivering the NHS Bowel Cancer Screening (NHS BCSP) programme, including planning for the age extension in the programme from 60 down to 50 years old, and reducing the Faecal Immunochemical Test (FIT) down from 120 micrograms per gram.The age extension for bowel screening started in April 2021 with the 56-year-old cohort and, based on modelling and clinical advice, has been planned to gradually reduce to 50 years old by 2025. This has been done to ensure that screening centres can manage any required increase in colonoscopy capacity.NHS England has advised that planning is well underway to lower the threshold of the FIT from 120 micrograms per gram to 80 micrograms per gram in the NHS BCSP in England. Further updates on how this will be implemented are expected early in the new year.

Whether his Department plans to reduce the sensitivity threshold of the Bowel Cancer Screening Programme from 120μg/g closer to the UK National Screening Committee recommendation of 20μg/g.

NHS England is responsible for delivering the NHS Bowel Cancer Screening (NHS BCSP) programme, including planning for the age extension in the programme from 60 down to 50 years old, and reducing the Faecal Immunochemical Test (FIT) down from 120 micrograms per gram.The age extension for bowel screening started in April 2021 with the 56-year-old cohort and, based on modelling and clinical advice, has been planned to gradually reduce to 50 years old by 2025. This has been done to ensure that screening centres can manage any required increase in colonoscopy capacity.NHS England has advised that planning is well underway to lower the threshold of the FIT from 120 micrograms per gram to 80 micrograms per gram in the NHS BCSP in England. Further updates on how this will be implemented are expected early in the new year.

What steps his Department is taking to (a) increase the capacity of colonoscopy services and (b) ensure patients from the bowel cancer screening programme are seen within the targeted waiting times.

The National Health Service is taking steps to improve bowel cancer outcomes for patients across England. We will improve cancer survival rates and hit all NHS cancer waiting time targets, so no patient, including those referred through the bowel cancer screening programme, waits longer than they should.We are transforming diagnostic services, which will support the NHS to increase capacity to meet the demand for diagnostic services, through investment in new capacity, including magnetic resonance imaging and computed tomography scanners. A national transformation project has been established to enable and support the timely recovery of gastrointestinal (GI) endoscopy services. Endoscopy services have also been established in several Community Diagnostic Centres throughout the country, which also contributes to the timely recovery of GI endoscopy services.Furthermore, National Institute for Health and Care Excellence guidelines encourage general practitioners to use Faecal Immunochemical Test kits for symptomatic patients to rule out the need for a colonoscopy, which increases the capacity of available colonoscopists for the bowel screening program.

What steps his Department plans to take to help improve awareness of (a) Crohn’s disease, (b) ulcerative colitis and (c) inflammatory bowel disease.

NHS England’s Getting It Right First Time Programme on gastroenterology aims to reduce variations in care, increase early diagnosis and proactive management of Crohn’s disease and colitis, and increase access to inflammatory bowel disease (IBD) specialist nurses. The National institute for Health and Care Excellence (NICE) has also produced a range of guidance on IBD, Crohn’s disease, and colitis, to support early diagnosis and effective management of these conditions. It ensures that the care provided to people with IBD is based on the best available evidence. In the last two years, the NICE has recommended four new drugs for the treatment of moderate to severe Crohn’s disease and ulcerative colitis, including Upadacitinib, Risankizumab, Mirikizumab, and Etrasimod.NHS England’s National Bladder and Bowel Health Project is delivering better care for people with IBD, with a focus on developing clinical pathways. NHS England commissions specialised colorectal services nationally to support equity of access to high-quality treatment for patients with IBD requiring complex surgery. This work is supported within NHS England by the clinical leadership of the Specialised Colorectal Services Clinical Reference Group, which is made up of experts in surgery, medicine, radiology, pathology, and nursing, alongside patient and public voice representatives. To raise awareness of IBD among general practitioners and other primary care staff, the Royal College of General Practitioners has produced an Inflammatory Bowel Disease Toolkit. The toolkit outlines when to suspect IBD, the appropriate investigative tests and diagnostic tools for IBD, how to manage a flare-up of symptoms, and how to support patients with IBD.

What steps he is taking to reduce waiting times for autism assessments in (a) Wokingham and (b) Berkshire.

It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessments, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.The Buckinghamshire, Oxfordshire and West Berkshire ICB advises that it has implemented a new assessment model within its neurodevelopmental conditions service, to enable the team to carry out additional assessments. The ICB further advises that it commissions Living Well from Autism Berkshire to provide needs-led community support, which is available for people of all ages waiting for an autism diagnosis, or who have suspected autism. The ICB is also working with the three Berkshire West local authorities, including Wokingham, as well as Children’s Services and Education to introduce a needs-led approach to autism, to ensure that children have their needs met sooner, before diagnosis.

If he will make an estimate of average waiting times for (a) assessment and (b) diagnosis of autism in (i) adults and (ii) children in (A) Wokingham, (B) Berkshire, and (C) England.

The information requested is not held centrally, but may be held by individual providers or integrated care boards (ICBs). Some relevant information is available on autism assessment waiting times for England, and for the NHS Buckinghamshire, Oxfordshire and Berkshire West ICB.In England in September 2024, the Autism Waiting Time Statistics show that there was a total of 204,876 patients with an open suspected autism referral. 126,318 of these patients were aged zero to 17 years old, and 78,638 of these patients were aged 18 years old and over. The median waiting time of all patients across England with an open suspected autism referral, where their first care contact was in the quarter, was 360 days for zero- to 17-year-olds, and 244 days for over 18-year-olds.In the NHS Buckinghamshire, Oxfordshire and Berkshire West ICB in September 2024, the Autism Waiting Time Statistics show that there was a total of 8,825 patients with an open suspected autism referral. 7,120 of these patients were aged zero- to 17-years-old, and 1,710 of these patients were aged 18-years-old and over. The median waiting time of all patients in this ICB with an open suspected autism referral, where their first care contact was in the quarter, was 783 days for zero- to 17-year-olds, and 209 days for over 18-year-olds.Since each metric is rounded to the nearest five in the published data, the number of adults and children do not add up to the total number of patients. Data on children and young people in this dataset is expected to be an underestimate, and caution should be used when interpreting these statistics since they are experimental rather than official statistics. The majority of children assessed for autism in the United Kingdom are seen in child development services, which are out of the scope of this dataset. This means the published figures will underestimate the volume of referrals or diagnoses, and the associated impact on health services. NHS England continues to conduct exploratory analysis into the Community Services Dataset with a view to including autism waiting times data from that dataset.

What account the development of the National Cancer Plan is taking of the Children and Young People’s Cancer Plan published by Young Lives vs Cancer and the Children's Cancer and Leukaemia Group in January 2023.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has been clear in his view that there should be a national cancer plan, and we are now in discussions about what form it should take, including how we will account for children and young people. We will develop and publish the 10-Year Health Plan before publishing a new national cancer plan, and will provide updates in due course.We recognise that cancer in children and young people is different to cancer in adults, and should be treated as such, particularly in regard to treatment, diagnosis, and wider support. We are committed to carefully considering this as part of our work.In spring 2024, a series of stakeholder workshops, carried out in preparation for the Children and Young People Cancer Taskforce, identified several key areas where we know further work is required to improve the care and treatment of children and young people with cancer. These include data, early detection and diagnosis, and access to clinical trials. The work carried out to date on the taskforce was incredibly valuable, and remains important to the Department's work. We are committed to progressing work in this area and we will set out more details on next steps for the taskforce in due course.Young Lives vs Cancer is a valued stakeholder with a unique perspective on this issue. We will continue to engage with them, as well as other children and young people cancer charity stakeholders as we progress this work.

What assessment he has made of the implications for his policies of the (a) differences between cancer in (i) children and young people under 25 and (ii) older adults and (b) strategic approaches to meet the needs of each population.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has been clear in his view that there should be a national cancer plan, and we are now in discussions about what form it should take, including how we will account for children and young people. We will develop and publish the 10-Year Health Plan before publishing a new national cancer plan, and will provide updates in due course.We recognise that cancer in children and young people is different to cancer in adults, and should be treated as such, particularly in regard to treatment, diagnosis, and wider support. We are committed to carefully considering this as part of our work.In spring 2024, a series of stakeholder workshops, carried out in preparation for the Children and Young People Cancer Taskforce, identified several key areas where we know further work is required to improve the care and treatment of children and young people with cancer. These include data, early detection and diagnosis, and access to clinical trials. The work carried out to date on the taskforce was incredibly valuable, and remains important to the Department's work. We are committed to progressing work in this area and we will set out more details on next steps for the taskforce in due course.Young Lives vs Cancer is a valued stakeholder with a unique perspective on this issue. We will continue to engage with them, as well as other children and young people cancer charity stakeholders as we progress this work.

What progress he has made on the New Hospital Programme Review in relation to the Royal Berkshire Hospital.

The Royal Berkshire Hospital is in scope of the review into the New Hospital Programme. My Rt Hon. Friend, the Secretary of State for Health and Social Care will set out further details of the outcome, which will include a new and realistic delivery schedule for the programme, at the earliest opportunity.

Whether (a) children and (b) young people under 25 with cancer will be distinctly recognised in the National Cancer Plan.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has been clear in his view that there should be a national cancer plan, and we are now in discussions about what form it should take, including how we will account for children and young people. We will develop and publish the 10-Year Health Plan before publishing a new national cancer plan, and will provide updates in due course.We recognise that cancer in children and young people is different to cancer in adults, and should be treated as such, particularly in regard to treatment, diagnosis, and wider support. We are committed to carefully considering this as part of our work.In spring 2024, a series of stakeholder workshops, carried out in preparation for the Children and Young People Cancer Taskforce, identified several key areas where we know further work is required to improve the care and treatment of children and young people with cancer. These include data, early detection and diagnosis, and access to clinical trials. The work carried out to date on the taskforce was incredibly valuable, and remains important to the Department's work. We are committed to progressing work in this area and we will set out more details on next steps for the taskforce in due course.Young Lives vs Cancer is a valued stakeholder with a unique perspective on this issue. We will continue to engage with them, as well as other children and young people cancer charity stakeholders as we progress this work.

Whether his Department has made an assessment of the potential merits of recovering costs from insurance providers when patients with private health insurance seek NHS-funded treatment which would be covered under their health insurance policy.

The Department has made no assessment on recovering National Health Service costs from private health insurance providers, when patients with private health insurance seek NHS-funded treatment which would be covered under their health insurance policy. However, the Injury Cost Recovery scheme enables trusts to recover the cost of NHS treatment from insurers, where personal injury compensation is paid, for example after a road traffic accident. £180 million was recovered by trusts in 2023/24, for reinvestment in NHS patient services.

If he will take steps to improve access to gluten-free staple foods for patients with coeliac disease by (a) improving the availability of those foods on prescription and (b) providing financial support to assist patients on obligatory gluten-free diets.

The national prescribing position in England remains that gluten free bread and mixes can be provided to all coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions based on the individual preferences of their patients, while also being mindful of which product best suits the patient’s dietary needs.I recognise the pressures people are facing with the rising cost of living. Our extensive arrangements to help people afford NHS prescription charges means that almost 89% of prescription items in England are already provided free of charge. For those who are not exempt from charges, pre-payment certificates can be used to cap costs at just over £2 a week for regular prescriptions.

What data his Department holds on the number of men who live in areas without (a) universally accessible and (b) fully NHS funded vasectomy services.

The Department does not hold data on the number of men who live in areas without universally accessible and fully National Health Service funded vasectomy services.NHS vasectomy services in England are commissioned locally by integrated care boards. In most parts of the country, vasectomy is available free of charge from the NHS.

What steps his Department is taking to support the national prostate cancer screening programme.

There is currently no national prostate cancer screening programme. This is because it is not recommended by the UK National Screening Committees (UK NSC) due to the inaccuracy of the current best test, called the Prostate Specific Antigen (PSA). A PSA-based screening programme could harm some men, as many would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments which can also have harmful side effects, for instance sexual dysfunction and incontinence.The UK NSC is carrying out an evidence review for prostate cancer screening, which includes different potential ways of screening the whole population from 40 years of age onwards, and targeted screening programmes aimed at groups of men identified as being at higher-than-average risk, such as those with a family history, carriers of the BRCA2 gene mutation, and based on ethnicity.

What steps he is taking to improve early diagnosis for prostate cancer.

Prostate cancer patients are waiting too long for a diagnosis and treatment. We will improve cancer survival rates and hit all National Health Service cancer waiting time targets so no patient waits longer than they should.We will find the best way to screen for prostate cancer. The Department is investing £16 million towards the Prostate Cancer UK-led TRANSFORM screening trial seeking to find ways to catch prostate cancer in men as early as possible.Furthermore, we will support the NHS to transform diagnostic services by providing approximately £1.5 billion of capital funding in 2025/26 for new surgical hubs and diagnostic scanners, to build capacity for over 30,000 more procedures and 1.25 million diagnostic tests. £70 million will be invested on new radiotherapy machines, to improve cancer treatment.

What plans his Department has to encourage earlier diagnosis of bowel cancer in the Berkshire, Oxfordshire, Buckinghamshire Integrated Care Board region.

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.Lord Darzi’s independent investigation into the NHS highlighted that there is more to be done to increase the speed at which patients are diagnosed with and treated for cancer. His report will inform our 10-year plan to reform the NHS, which will include further details on how we will improve cancer diagnosis, treatment, and outcomes.The NHS will maximise the pace of roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.We are committed to getting the NHS diagnosing cancer earlier and treating it faster, so that more patients survive this horrible set of diseases. This includes bowel cancer patients in Berkshire, Oxfordshire, and Buckinghamshire.