Written questions by Rand.

How much funding is being allocated to upgrade legacy IT systems in a) the NHS b) individual integrated care boards and c) local authorities responsible for delivering adult social care services.

NHS England invests approximately £1 billion per year centrally to operate, support, and upgrade nationally managed technology systems, including the NHS App and core data services.In addition, over the current Spending Review period, NHS England plans to invest approximately £2 billion with care provider organisations through the Frontline Productivity Programme, supporting the use of technology to improve productivity and make better use of existing digital infrastructure. This includes targeted investment where providers choose to converge on common platforms to support local system working and the priorities of the 10‑Year Health Plan.Funding allocations for technology investment by individual integrated care boards and local systems will be determined by NHS England regions and systems in due course, in line with local priorities and national guidance.We have no funding allocated specifically to local authorities to update their legacy social care systems, and responsibility for procuring and updating their own systems lies with them.

How many registered social care provider applications were rejected by the CQC due to issues with policies and procedures (a) in England, (b) by region, and (c) by local authority in each of the last five years.

Care providers entering and exiting is a normal part of a functioning market, and local authorities should have appropriate contingency plans in place depending on the services being provided. Under the Care Act 2014, local authorities also have a temporary duty to ensure continuity of care in the event of business failure. This means that people continue to receive the care and support they need if their adult social care provider is no longer able to carry on delivering services.New providers registering with the Care Quality Commission (CQC) for the first time may have their application rejected if they send an application which is incomplete, for instance one that is missing documents or missing information within required documents. The CQC does not hold data at the level requested but can confirm that over the past five years, 22,629 incomplete applications across all sectors have been rejected. The following table shows a breakdown for the past five years of rejected incomplete applications across all sectors:Financial yearVolume20213,66320223,83520234,69720242,97620257,458Grand Total22,629 New providers registering with the CQC for the first time may have their application refused. In these cases, a complete application is reviewed by the CQC’s registration team who refuse the application if they are not satisfied the registering provider is able to meet the requirements as per the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. The CQC does not hold data at the level requested but can confirm that over the past five years, 1,385 applications across all sectors have been refused. The following table shows the breakdown for the past 5 years of refused applications across all sectors:Financial yearVolume20211412022236202328120243072025421Grand Total1,385 Providers already registered with the CQC may apply to vary their conditions of registration, and in some cases this may lead to a refusal or rejection by the CQC. Over the past five years, 85,822 applications to vary a registration by an adult social care provider have been received by the CQC. The following table shows the breakdown for the past five years of applications to vary a condition by an adult social care provider:Financial yearVolume202112,039202214,550202317,720202421,511202520,002Grand Total85,822 Over the past five years, 23,454 applications to vary a registration have been rejected, because the information submitted was incomplete. The following table shows a breakdown of these rejections for the past five years:Financial yearVolume20212,21220222,89920234,56320248,27620255,504Grand Total23,454 Over the past five years, 405 applications to vary a registration have been refused outright. The following table shows a breakdown of these rejections for the past five years:Financial yearVolume20214320224120237920241132025129Grand Total405

What steps he is taking to rollout of Jess’s Rule across the NHS; and if he will set out how technology is being used to make sure problems in care are being spotted and acted upon immediately.

Jess’s Rule was published in September 2024 and rolled out across England as formal clinical guidance, developed with the Royal College of General Practitioners and NHS England. It supports and strengthens general practitioners’ clinical judgement when a patient returns three or more times with worsening symptoms or without a substantiated diagnosis.Through the Frontline Digitisation programme, NHS England has provided £2 billion to National Health Service trusts to ensure trusts meet a core level of digitisation and have electronic patient records (EPRs) in place. EPR systems allow clinicians access to critical, real-time health related information, which supports the frontline to better treat and support patients. Following Cambridge University Hospitals' deployment of its EPR, automatic EPR alerts in 2018/19 saved at least 64 lives due to sepsis alerts improving the time it took to administer antibiotics. We will not be updating Jess’s Rule to mandate the use of technology systems, as any supporting tools are for local services to decide, in line with existing governance arrangements. We will continue to keep Jess’s Rule under review, including the case for any future updates to national guidance.

If guidance is being updated to mandate the use of technology systems to support the delivery of Jess’s Rule across the NHS.

Jess’s Rule was published in September 2024 and rolled out across England as formal clinical guidance, developed with the Royal College of General Practitioners and NHS England. It supports and strengthens general practitioners’ clinical judgement when a patient returns three or more times with worsening symptoms or without a substantiated diagnosis.Through the Frontline Digitisation programme, NHS England has provided £2 billion to National Health Service trusts to ensure trusts meet a core level of digitisation and have electronic patient records (EPRs) in place. EPR systems allow clinicians access to critical, real-time health related information, which supports the frontline to better treat and support patients. Following Cambridge University Hospitals' deployment of its EPR, automatic EPR alerts in 2018/19 saved at least 64 lives due to sepsis alerts improving the time it took to administer antibiotics. We will not be updating Jess’s Rule to mandate the use of technology systems, as any supporting tools are for local services to decide, in line with existing governance arrangements. We will continue to keep Jess’s Rule under review, including the case for any future updates to national guidance.

What steps his Department is taking to regulate non-surgical aesthetic procedures.

On 7 August 2025, the Government announced its plans to introduce measures to improve the safety of the cosmetics sector. This included prioritising the introduction of legal restrictions which will ensure that the highest risk cosmetic procedures are brought into Care Quality Commission regulation and can only be performed by specified regulated healthcare professionals.In addition, the Government also committed to legislating to introduce a licensing scheme in England for lower risk procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed. To protect children and young people, the Government is also committed to mandating age restrictions for cosmetic procedures.The proposals will be taken forward through secondary legislation and therefore will be subject to the parliamentary process before the legal restrictions, or licensing regulations, can be introduced. We are now working with stakeholders to develop detailed plans and intend to consult on proposals for restrictions around the performance of the highest risk procedures in the spring.

What steps he is taking to bring down NHS ADHD assessment waiting lists.

The Government has recognised that, nationally, demand for assessments for attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, recognising the need for early intervention and support.My Rt. Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. The purpose of the review is to provide advice and recommendations to the government on evidence on trends in mental health conditions, ADHD and autism in the population over the last decade, including how these changes have affected demand for NHS mental health, ADHD and autism services, including assessment. The independent review will inform our approach to enabling people with ADHD to have the right support in place to enable them to live well in their communities.It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to ADHD assessment in line with relevant National Institute for Health and Care Excellence guidelines.Through the Medium Term Planning Framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for ADHD services over the next three years, focusing on improving quality and productivity.NHS England also published management information on ADHD waits at a national level on 29 May 2025 as part of its ADHD data improvement plan, and has also issued technical guidance on 3 June 2025 for those who submit ADHD data, to improve recording of ADHD data, with a view to improving the quality of ADHD waits data.

What estimate he has made of the number of new or redeveloped primary care facilities required following Lord Darzi’s independent investigation into the NHS.

The primary care estate is in mixed ownership between general practices (GPs), property companies, and integrated care boards (ICBs), and can be funded through a variety of routes. The Care Quality Commission regulates sites that provide National Health Services, including primary care facilities, with further information on their data available at the following link:https://www.cqc.org.uk/about-us/transparency/using-cqc-dataPrior to 2016, new surgery premises were delivered either by GPs or by third parties. NHS England does not keep a register of the projects funded through these routes.In the period 2016 to 2025, the upgrades programme delivered 90 new GP or primary care schemes, alongside several refurbishments and extensions of existing sites, at a cost of £996 million. For 2024 to 2025, the NHS Property Services and Community Health Partnership was given £15 million to adapt the existing estate, so that it could be used more intensively.As a first step in response to the Darzi Report, in 2025/26 £102 million has been allocated for modernisation and improved utilisation in primary care. Capital budgets for 2026/27 onwards will be considered through Phase 2 of the Spending Review process and the launch of the 10-Year Health Plan in Spring 2025. This will give the necessary strategic direction and funding certainty as we shift to a Neighbourhood Health Service and treating patients closer to home. The following table shows the schemes, capital investment, and new facilities delivered from 2016 to 2025:SchemePeriodNational capital investmentNew facilities deliveredGP or third-party developerBefore 2016N/AN/APrimary care estates and IT2016 to 2020£800 million50Local authority joint schemes2019 to 2025N/A30Sustainability and transformation plan upgrades programme2020 to 2025£196 million10

How many new NHS primary care facilities have been built using central Government funding in each year since 2010.

The primary care estate is in mixed ownership between general practices (GPs), property companies, and integrated care boards (ICBs), and can be funded through a variety of routes. The Care Quality Commission regulates sites that provide National Health Services, including primary care facilities, with further information on their data available at the following link:https://www.cqc.org.uk/about-us/transparency/using-cqc-dataPrior to 2016, new surgery premises were delivered either by GPs or by third parties. NHS England does not keep a register of the projects funded through these routes.In the period 2016 to 2025, the upgrades programme delivered 90 new GP or primary care schemes, alongside several refurbishments and extensions of existing sites, at a cost of £996 million. For 2024 to 2025, the NHS Property Services and Community Health Partnership was given £15 million to adapt the existing estate, so that it could be used more intensively.As a first step in response to the Darzi Report, in 2025/26 £102 million has been allocated for modernisation and improved utilisation in primary care. Capital budgets for 2026/27 onwards will be considered through Phase 2 of the Spending Review process and the launch of the 10-Year Health Plan in Spring 2025. This will give the necessary strategic direction and funding certainty as we shift to a Neighbourhood Health Service and treating patients closer to home. The following table shows the schemes, capital investment, and new facilities delivered from 2016 to 2025:SchemePeriodNational capital investmentNew facilities deliveredGP or third-party developerBefore 2016N/AN/APrimary care estates and IT2016 to 2020£800 million50Local authority joint schemes2019 to 2025N/A30Sustainability and transformation plan upgrades programme2020 to 2025£196 million10

How much capital funding has been allocated by Government for the development of new NHS primary care facilities in each year since 2010.

The primary care estate is in mixed ownership between general practices (GPs), property companies, and integrated care boards (ICBs), and can be funded through a variety of routes. The Care Quality Commission regulates sites that provide National Health Services, including primary care facilities, with further information on their data available at the following link:https://www.cqc.org.uk/about-us/transparency/using-cqc-dataPrior to 2016, new surgery premises were delivered either by GPs or by third parties. NHS England does not keep a register of the projects funded through these routes.In the period 2016 to 2025, the upgrades programme delivered 90 new GP or primary care schemes, alongside several refurbishments and extensions of existing sites, at a cost of £996 million. For 2024 to 2025, the NHS Property Services and Community Health Partnership was given £15 million to adapt the existing estate, so that it could be used more intensively.As a first step in response to the Darzi Report, in 2025/26 £102 million has been allocated for modernisation and improved utilisation in primary care. Capital budgets for 2026/27 onwards will be considered through Phase 2 of the Spending Review process and the launch of the 10-Year Health Plan in Spring 2025. This will give the necessary strategic direction and funding certainty as we shift to a Neighbourhood Health Service and treating patients closer to home. The following table shows the schemes, capital investment, and new facilities delivered from 2016 to 2025:SchemePeriodNational capital investmentNew facilities deliveredGP or third-party developerBefore 2016N/AN/APrimary care estates and IT2016 to 2020£800 million50Local authority joint schemes2019 to 2025N/A30Sustainability and transformation plan upgrades programme2020 to 2025£196 million10

How many NHS GP surgeries have closed in each year since 2010; and how many new NHS GP surgeries have been built in each of those years.

The Department does not hold this information centrally.

How many clinical nurse specialists are currently working in the NHS.

The Department does not hold the information requested.

How many psycho-oncologists are currently working in the NHS.

The Department does not hold the information requested.

What steps his Department is taking to improve the dietary health of young children from financially deprived backgrounds.

The Government is committed to creating the healthiest generation of children ever, as set out in our Child Health Action Plan. The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or can be put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old.The NHS Business Services Authority (NHS BSA) delivers the scheme on behalf of the Department. The NHS BSA is committed to increasing uptake of the Healthy Start scheme to ensure as many children as possible have a healthy start in life.The NHS BSA promotes the Healthy Start scheme through its digital channels and has created free tools to help stakeholders promote the scheme locally. The NHS BSA has also reached out to stakeholders to see how it can support them in promoting the scheme.

What steps his Department is taking to improve the take up of the Healthy Start Scheme.

The Government is committed to creating the healthiest generation of children ever, as set out in our Child Health Action Plan. The Healthy Start scheme was introduced in 2006 to encourage a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. It can be used to buy, or can be put towards the cost of, fruit, vegetables, pulses, milk, and infant formula. Healthy Start beneficiaries have access to free Healthy Start Vitamins for pregnant women and children aged under four years old.The NHS Business Services Authority (NHS BSA) delivers the scheme on behalf of the Department. The NHS BSA is committed to increasing uptake of the Healthy Start scheme to ensure as many children as possible have a healthy start in life.The NHS BSA promotes the Healthy Start scheme through its digital channels and has created free tools to help stakeholders promote the scheme locally. The NHS BSA has also reached out to stakeholders to see how it can support them in promoting the scheme.

If his Department will take steps to obtain contact data for those who are eligible for but not accessing the Healthy Start scheme .

The NHS Business Services Authority (NHS BSA) runs the Healthy Start scheme on behalf of the Department. The Department of Health and Social Care is working closely with the NHS BSA and the Department for Work and Pensions, to enable the NHS BSA to receive the personal data for those potentially eligible citizens from the Department for Work and Pensions, as soon as possible. The NHS BSA will use this data to reach out to those eligible, who are not currently in receipt of Healthy Start, to encourage them to apply for the Healthy Start scheme.