Written questions by Jones.

What assessment his Department has made of the potential implications for his policies of the proportion of bowel cancers diagnosed at each stage in the last five years.

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.

If he will make an assessment of the potential merits of providing (a) free and (b) reduced-price sanitary products for women with PCOS and similar conditions.

There are no current plans to carry out an assessment of the potential merits of providing free or reduced-price sanitary products for women with polycystic ovary syndrome (PCOS) and other gynaecological conditions. The Government is committed to prioritising women’s health and improving the diagnosis, treatment, and ongoing care for gynaecological conditions, including PCOS.Since 2019, the National Health Service has offered period products to every hospital patient who needs them. In January 2020, the Department for Education launched a scheme which makes free period products available for state-funded primary schools, secondary schools, and colleges in England. Since 1 January 2021, a zero rate of VAT has applied to all period products.

What steps his Department is taking to ensure that there are sufficient breast cancer clinical nurse specialists.

We are committed to training the staff we need, including clinical nurse specialists, to ensure patients are cared for by the right professional, when and where they need it.We will ensure that the number of medical specialty training places, including those involved in diagnosing and treating cancer, meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.The Government has set out plans to publish a ten-year plan to reform the National Health Service. The plan will be informed by Lord Darzi’s report and will include further details on how we will improve cancer diagnosis, treatment, and outcomes, including for breast cancer.

If he will make it his policy to test people diagnosed with triple negative breast cancer for the BRCA gene mutation.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service, and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory (NGTD), which includes tests for over 7,000 rare diseases and over 200 cancer clinical indications, including both whole genome sequencing (WGS) and non-WGS testing. The NGTD is updated regularly and sets out the eligibility criteria for patients to access testing.Genomic testing for inherited breast cancer is covered in the NGTD under clinical indications R208 and R444, and includes testing for a range of patients with triple negative breast cancer.

If he will make it his policy to ensure that people with triple negative breast cancer have access to a clinical nurse specialist at the point of diagnosis.

We are committed to training the staff we need, including clinical nurse specialists, to ensure patients are cared for by the right professional, when and where they need it.We will ensure that the number of medical specialty training places, including those involved in diagnosing and treating cancer, meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.The Government has set out plans to publish a ten-year plan to reform the National Health Service. The plan will be informed by Lord Darzi’s report and will include further details on how we will improve cancer diagnosis, treatment, and outcomes, including for breast cancer.

If he will make it his policy to ensure that people diagnosed with (a) triple negative breast cancer and (b) the BRCA gene mutation are offered genetic counselling.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs. Individuals should discuss with their healthcare professional whether genomic testing is appropriate for them. Following review, the healthcare professional will then make a decision whether to refer the individual either directly or via an NHS Clinical Genomics Service (CGS), or other relevant clinical speciality for genomic testing. The 17 NHS CGSs, commissioned by NHS England, deliver a comprehensive clinical genomic and counselling service that directs the diagnosis, risk assessment, and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a rare genetic or genomic condition.

If he will make an assessment of the potential merits of providing additional funding to hospices in Wokingham.

The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and hospices will have a big role to play in that shift.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people, and their families, at end of life.The amount of funding charitable hospices receive varies by integrated care board (ICB) area, and will, in part, be dependent on the breadth and range of the palliative and end of life care provision within their ICB footprint.  To support ICBs in this duty, NHS England has published statutory guidance and service specifications, which are available, respectively, at the following two links:https://www.england.nhs.uk/publication/palliative-and-end-of-life-care-statutory-guidance-for-integrated-care-boards-icbs/https://www.england.nhs.uk/publication/service-specifications-for-palliative-and-end-of-life-care-children-and-young-people-cyp/

If he will make an assessment of the potential merits of reforming the funding model for charitable hospices as part of his 10-year plan for health and care.

We have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future, by driving three shifts in the way health care is delivered, specifically: moving healthcare from hospital to the community; from analogue to digital; and from sickness to prevention. We will carefully consider policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders, including those in the hospice sector, as we develop the plan.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services.  The amount of funding charitable hospices receive varies by integrated care board (ICB) area, and will, in part, be dependent on the breadth of palliative and end of life care provision within each ICB catchment area.I recently met with NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care in England.  We will consider next steps on palliative and end of life care, including hospice funding, in the coming months.

Whether his Department has made a recent assessment of the impact of hospice funding on people's experience of death and dying in Wokingham.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and hospices will have a big role to play in that shift.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. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, as well as their loved ones.No assessment has been made of the impact of hospice funding on people’s experiences of death and dying. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth and range of palliative and end of life care provision within their ICB footprint.

What discussions he has had with Berkshire Healthcare NHS Foundation Trust on improving access to ADHD medication in Wokingham.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information is not collected on a local level.The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.We are continuing to work to resolve supply issues where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We anticipate intermittent regional supply disruptions to continue, and we expect supply to improve in the UK from October 2024.In parallel, the Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinion for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.To aid ADHD service providers and prescribers further we have widely disseminated our communications, and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients.

If he will make an assessment of the potential merits of establishing a a long-term cancer strategy.

Lord Darzi’s report has set out the scale of the challenges we face in fixing the National Health Service, and the need to improve cancer waiting time performance and cancer survival. In particular, he has highlighted the need to improve the number of patients starting their treatment within 62 days of referral and to increase the number of patients diagnosed at an earlier stage.Improving 62-day performance and early diagnosis are already key priorities for NHS England. Lord Darzi’s report will inform our ten-year plan to reform the NHS, which includes further details on how we will improve cancer diagnosis, treatment, and outcomes. The Government will set out any further priorities on cancer and health in due course.

What steps he is taking to tackle the redevelopment of the Royal Berkshire Hospital.

We are reviewing the New Hospital Programme (NHP) in order to put it on a sustainable footing, which will include a realistic timetable for delivery and clarity on the funding required. As set out in the Terms of Reference for the review, the new hospital scheme for the Royal Berkshire Hospital is in the scope of the review. The review will feed into the spending review process, where decisions will be taken in the round, and the Government will confirm the outcome as part of that process. Further information on the Terms of Reference is available at the following link:https://www.gov.uk/government/publications/new-hospital-programme-review-terms-of-referenceWhile the review is taking place, we are continuing to support all schemes within the NHP. Up to the end of the 2023/24, the Royal Berkshire NHS Foundation Trust has been provided with over £20 million in funding to progress their new hospital scheme.

Whether funding is available to help with building repairs for Grade II listed hospitals.

Currently, there are no national programmes providing funding specifically to Grade II listed hospitals and the Department does not keep records of which hospitals or buildings on hospital sites fit this criterion.It is the legal responsibility of National Health Service organisations to maintain their estates and they are expected to use existing capital budgets and assets to maximum effect, prioritising and delivering locally to maintain and repair NHS buildings, including Grade II listed buildings, as and when appropriate.In support of this, we are providing £4.2 billion for this financial year to upgrade, maintain, provide equipment to, and modernise NHS buildings in accordance with regional priorities.

If he will make it his policy to change the the entitlement to Nursery Milk Scheme from ending at age five to the end of the academic year.

The Nursery Milk Scheme allows early years childcare settings, such as childminders and nurseries, to reclaim the cost of providing one-third of a pint of milk to children under five years old, who attend their childcare setting for at least two hours per day. Schools are also allowed to claim under this scheme in respect of pupils under the age of five years old. There are no current plans to extend the Nursery Milk Scheme to the end of the academic year.From the age of five years old onwards, pupils eligible for benefits-based free school meals are eligible for free school milk. In addition, the school milk subsidy scheme subsidises the cost of milk and certain milk products for children in primary and secondary schools, including those over five years old. This means that participating schools can sell the products in schools at a lower price. More information on this scheme is available at the following link:https://www.gov.uk/guidance/school-milk-subsidy-scheme#:~:text=The%20school%20milk%20subsidy%20scheme,eligible%20milk%20products%20or%20yoghurts

What steps he is taking to ensure that funding for the Nursery Milk Scheme reflects the retail cost of milk.

The Nursery Milk Scheme allows early years childcare settings registered with the Office for Standards in Education, Children's Services and Skills to reclaim the cost of providing one-third of a pint of milk to children in their care, who are under the age of five years old and who attend the childcare setting for at least two hours per day. The scheme’s legislation allows childcare settings to reclaim the cost of the funds they have spent on milk, and the amount they can claim is not tied to a specific retail price of milk.