Written questions by Paffey.

What steps his Department is taking to ensure families are not penalised under the 5 day legal requirement to register a death when facing delays caused by (a) lack of appointments and (b) administrative bottlenecks.

Awaiting answer.

Whether his Department plans to review guidance to Integrated Care Boards on access to NHS-funded frozen embryo transfers for patients with remaining embryos from previous NHS-funded IVF cycles seeking to have a further child.

Awaiting answer.

What assessment he has made of the potential impact on children and families of local pauses to neurodevelopmental assessments under the NHS Right to Choose pathway; and what steps his Department is taking to ensure that interim support is available to families whose referrals have been affected.

The Government has recognised that, nationally, demand for assessments for neurodevelopmental conditions such as autism and attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future and it recognises the need for early intervention and support.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 access to neurodevelopmental assessments. 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 autism and ADHD services over the next three years, focusing on improving quality and productivity.Patients’ right to choose is set out in legislation. Patients being referred to a mental health professional, including for neurodevelopmental assessments, have the right to be treated by any clinically appropriate provider who holds a contract for the provision of NHS services. ICBs are responsible for ensuring that their processes comply with the legal right to choose. This includes any qualifying contract requirements and clinical appropriateness or eligibility criteria. ICBs also have a duty to publicise and promote choice and can provide local referral guidance to support referrers and ensure that referrals into any NHS funded service are appropriate. There has been no change to the existing legal right patients have to choose the provider and team who will provide their elective care in certain cases. These rights extend to any provider in England who holds a contract with an ICB, or NHS England, for the service/s the patient requires, as per the NHS Choice Framework. This includes independent sector providers who deliver NHS funded care. Neurodivergent services are already in scope of this legislation.

What assessment he has made of the potential impact of extending statutory regulation by the Health and Care Professions Council to clinical technologists and sonographers on (a) workforce recruitment and retention, (b) diagnostic capacity and (c) patient safety within NHS services.

The Government is clear that the professions protected in law must be the right ones and that the level of regulatory oversight must be proportionate to the risks to the public.There are no current plans to extend statutory regulation by the Health and Care Professions Council to clinical technologists or sonographers.

What steps he is taking to ensure that patients with the rare genetic form of Motor Neurone Disease within Hampshire have timely access to Tofersen; and what assessment he has made of regional disparities that prevent this being available across the NHS.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases and evaluates whether they can be considered a clinically and cost-effective use of NHS resources. NICE is working with the company to confirm timelines for this evaluation. If NICE is able to recommend tofersen in draft guidance, NHS England is committed to exploring an interim funding agreement with Biogen to use the Innovative Medicines Fund to expedite NHS commissioning of the treatment as soon as a positive recommendation is made by NICE.No assessment has been made of the extent of regional inequities in the provision of early access programmes for innovative treatments and people living with SOD1 motor neurone disease. Participation in company-led early access schemes is decided at an individual NHS trust level, and under these programmes, the cost of the drug is free to both the patients taking part in it, and to the NHS, although NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP. NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes, providing advice on potential financial, resourcing, and clinical risks. ICSs should use the guidance to help determine whether to implement any free of charge scheme including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What assessment his Department has made of the feasibility of introducing a national risk-stratified screening programme for prostate cancer.

The UK National Screening Committee (UK NSC), which advises ministers on all screening matters, commissioned an evidence review modelling the clinical effectiveness and cost of several approaches to prostate cancer screening. This included different potential ways of screening the whole population and targeted screening aimed at groups of people identified as being at higher-than-average risk, such as black men, men with the BRCA gene mutation, and/or men with a family history of cancer.The modelling and evidence review reports are now complete, and the UK NSC plans to open a three-month public consultation towards the end of the year. After this, the UK NSC will make a recommendation on screening for prostate cancer. Ministers will then be asked to consider whether to accept the recommendation.

Whether he has made an assessment of the potential merits of extending eligibility for the Autumn 2025 COVID-19 vaccination to individuals under the age of 75 who, while not classified as immunosuppressed, have (a) COPD, (b) limited mobility and (c) other chronic health conditions that may increase their vulnerability to serious illness.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed. The Government has accepted the JCVI’s advice for autumn 2025 and in line with the advice, a COVID-19 vaccination is being offered to the following groups:- adults aged 75 years old and over;- residents in care homes for older adults; and- individuals aged six months and over who are immunosuppressed.As for all vaccines, the JCVI keeps the evidence under regular review.

What assessment he has made of the adequacy of the cost effectiveness of the XYLA-provided NHS diabetes prevention programme.

The NHS Diabetes Prevention Programme (NHS DPP) has been commissioned since 2016, and as of the end of September 2025, there have been over two million referrals into the programme and over 980,000 programme starts.An independent evaluation of the NHS DPP published in 2024 demonstrated that the programme is cost effective and estimated a cost saving of £71.4 million based on the number of participants to March 2020.The evaluation states that the NHS DPP is highly effective and continues to deliver positive outcomes, and that individuals who attended have a 46% lower risk of developing type 2 diabetes than those who do not attend.

Pursuant to the Answer of 24 October 2025 to Question 82861 on Prescriptions: Fees and Charges, what assessment he has made of the potential merits of (a) amending the process for applying for a maternity exemption certificate and (b) extending the backdating period for successful applications.

A healthcare professional, such as a midwife, practice nurse, health visitor or general practitioner, can complete the maternity exemption (MATEX) application as soon as they have confirmed the pregnancy, birth, or stillbirth. This confirms the individual is eligible for a MATEX certificate and acts as a mechanism of transferring evidence of eligibility from the patient’s individual health records to national systems and systems used by community pharmacies.The National Health Service (Charges for Drugs and Appliances) Regulations 2015 allow for a MATEX certificate to be backdated one month before the date on which the application is received by the NHS Business Services Authority, the organisation which processes applications. The one-month backdating of certificates is a longstanding provision to allow for the administration time taken to receive, process and post a paper MATEX certificate to the patient, and also applies to digital certificates. The regulations do not allow a MATEX certificate to be backdated further and there are no current plans to amend this.

If his Department will make an assessment of the potential merits of prioritising care-experienced children for (a) mental health, (b) neurodiversity and (c) other NHS appointments.

Although the Department is not convening a formal assessment, we believe that for care-experienced children and young people who are struggling with their mental health, fast access to early, high-quality support is critical. That is why the 10-Year Health Plan sets out how we will work with schools and colleges to better identify and meet children's mental health needs by expanding mental health support teams in schools and colleges in England, to reach full national coverage by 2029. This will build on the work that has already begun, including providing mental health support for almost one million more young people in schools this year and investing an extra £688 million in Government funding to transform mental health services, hire more staff, and deliver more early interventions.

What assessment he has made of the adequacy of the eligibility criteria for the shingles vaccine, and what steps his Department is taking to ensure that the criteria are clearly communicated to (a) patients and (b) general practices.

From September 2023, the routine shingles vaccination programme changed from the Zostavax vaccine to the two-dose Shingrix vaccine, to better protect individuals from the effects of shingles, provide better clinical outcomes, and reduce pressures on the health system. The programme was also expanded, and as a result, almost one million more people became eligible for the shingles vaccination.The expansion is being rolled out in phases to maximise cost-effectiveness and population benefit, ensure consistent messaging to maximise coverage, and take account of National Health Service capacity, all while being consistent with the approach taken by all four nations in the United Kingdom. During the first phase, which commenced in September 2023, those who reach the ages of 65 or 70 years old will be called in for vaccination on or after their 65th or 70th birthday. During the second phase, from September 2028, individuals will be called in for vaccination on or after their 60th or 65th birthday. From 1 September 2033 onwards, vaccination will be routinely offered to those turning 60 years of age on or after their 60th birthday.Separately, in November 2024, the Joint Committee on Vaccination and Immunisation provided advice on eligibility for the shingles vaccination programme for adults aged 80 years old and over. The Department is considering this advice as it sets the policy on who should be offered shingles vaccinations.In addition, as of September 2025, all severely immunosuppressed individuals aged 18 years old and over are now eligible for the shingles vaccine in order to protect those who are most at risk of serious illness and complications from shingles.The UK Health Security Agency (UKHSA) ensures commissioners, providers, and relevant healthcare professionals have access to the necessary resources to communicate accurate information on eligibility for all national vaccination programmes. For example, comprehensive guidance on shingles vaccination is provided for healthcare professionals on GOV.UK website, at the following link: https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals/shingles-immunisation-programme-information-for-healthcare-practitioners Additionally, to strengthen awareness of the programme amongst health professionals and the wider public, the UKHSA provides a comprehensive suite of public facing resources and assets. This includes information leaflets on shingles vaccination in multiple languages and accessible formats, for instance easy read, British Sign Language, and braille, with further information available at the following link: https://find-public-health-resources.service.gov.uk/filter?diseases=Shingles&diseases=Varicella&vaccinations=Shingles+vaccine This is a relatively newly expanded programme, and anyone unsure if they are eligible for the shingles vaccination should check online, on the NHS.UK website, or should speak to their general practice.

Pursuant to the Answer of 9 January to Question 22115 on Prescriptions: Fees and Charges, how many people with a maternity exemption certificate that received a penalty charge notice in 2024 were (a) eligible for an exemption certificate but did not hold an exemption at the time they were issued with a penalty charge notice and (b) awarded an exemption certificate after receiving a penalty charge notice.

In 2024, the NHS Business Services Authority (NHS BSA) issued 48,063 penalty charge notices (PCNs) to people that claimed a maternity exemption on their prescription form, but where no exemption was found/matched as part of the NHS BSA process. Of the 48,063 PCNs, 23,710 were eased. An easement is applied when someone has a condition/circumstance that would allow for free prescriptions but does not have an exemption in place. The process allows for the person to subsequently arrange their exemption, and for the penalty charges to be eased.The NHS BSA is unable to identify the number of people who were eligible for the maternity exemption (matex) but who had not applied for it when claiming the exemption. It is not possible to state that all 23,710 PCNs were eased due a matex certificate being awarded, as easements could also be for exceptional circumstances, or for other exemptions being applicable.

What discussions his Department has had with the Medicines and Healthcare products Regulatory Agency on the potential impact (a) emerging diagnostic technologies and (b) breath testing on (i) detection and (ii) survival rates for people for pancreatic cancer.

The Department has not had discussions with the Medicines and Healthcare products Regulatory Agency on this topic, however we remain committed to improving survival rates for people with all cancers including pancreatic cancer.The National Cancer Plan for England will include further details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates.

What steps he is taking to increase the number of specialists able to carry out (a) ADHD and (b) autism assessments.

The Government is committed to publishing a 10 Year Workforce Plan to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan.The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.Autism and attention deficit hyperactivity disorder (ADHD) assessments are carried out by multiple professional groups and often form only a part of their roles. NHS England has recently launched an England-wide survey of the learning disability and autism workforce, which will also capture staff undertaking ADHD assessments, and the data is expected to be reported in 2026.In addition to this, NHS England provides autism training for psychiatrists to develop enhanced skills and confidence in diagnosis. It is also piloting a neurodevelopment credential for doctors to develop specialist neurodevelopmental skills.

What assessment he has made of the potential impact of Penalty Charge Notices issued for maternity exemption certificates that could not be validated but who were eligible for the exemption on pregnant women and new mothers.

The maternity exemption, known as matex, and penalty charge notices (PCNs) are administered by the NHS Business Services Authority (NHS BSA) on behalf of the Department. The NHS BSA has adopted a policy of waiving the penalty charge for the matex, if a patient’s midwife or other clinician is able to submit a completed application for an exemption certificate within 60 days of receipt of the PCN. The matex certificate issued during this 60-day grace period can only be backdated one month from the date of application which means that the patient is still liable for any prescription charges that should have been paid before a valid matex certificate was put in place.

What data his Dpartment holds on the average waiting times for (a) ADHD and (b) autism diagnosis for (i) primary school age and (ii) secondary school age children.

The information is not held centrally in the format requested, but some data on waiting times for attention deficit hyperactivity disorder (ADHD) and autism assessments for children aged 0-17 is available on the NHS England website at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-adhd/august-2025https://digital.nhs.uk/data-and-information/publications/statistical/autism-statistics/july-2024-to-june-2025

Whether he has made an assessment of the potential (a) merits of introducing a preventative screening programme for (i) kidney and (ii) chest conditions and (b) impact of such a programme on (A) early detection, (B) patient outcomes and (C) long-term cost savings to the NHS.

The UK National Screening Committee (UK NSC) reviewed the evidence to screen for kidney disease (glomerulonephritis) in 2011 and recommended against screening becausethere is no evidence that screening would be effective at improving outcomes for those with a positive resultthere is a lack of effective treatments for those who receive a positive resultprogrammes in other countries have not been found to be clinically or cost effective However, the National Health Service Health Check assesses for high blood pressure and high blood sugar which are risk factors for the development of both chronic kidney disease (CKD) and cardiovascular disease (CVD). Where an individual’s NHS Health Check indicates high blood pressure or high blood sugar, it is for their general practitioner to consider the results, and then, if required, undertake further clinical investigation and treatment where appropriate.The 10-Year Health Plan outlines our intention to publish a Modern Service Framework for CVD, which will identify the best evidenced interventions, set clear quality standards, drive innovation in CVD prevention and management, and reduce unwarranted variation.The UK NSC’s recommendation to screen for lung cancer was accepted in 2023 and a national programme is in the process of being rolled out.

If he will take steps to ensure that increases in the National Living Wage are matched by sustainable funding for local authority social care budgets.

The Spending Review 2025 allows for an increase of over £4 billion of funding available for adult social care in 2028/29 compared to 2025/26.The Government took the cost pressures facing adult social care, including increases to the National Living Wage, into account as part of the wider consideration of local government spending within the 2024 Autumn Budget process.

What assessment he has made of (a) the potential merits of adding fluoride to drinking water and (b) the potential impact of this on oral health for children.

Water fluoridation is an evidence based, effective public health intervention for improving the oral health of children and adults. The 2022 Health Monitoring Report showed that five-year-olds were less likely to experience dental caries, and less likely to experience caries of high severity, in areas with a fluoridation scheme. Further information is available at the following link:https://www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for-england-2022The 10-Year Health Plan sets out our plans to expand water fluoridation in the north east of England by 2030, and that we will assess further rollout in areas where oral health outcomes are worst.

What proportion of eligible families were in receipt of Healthy Start in Southampton Itchen constituency on 9 June 2025.

The NHS Business Services Authority (NHSBSA) operates the Healthy Start scheme on behalf of the Department. Monthly figures for the number of people on the digital Healthy Start scheme are published on the NHS Healthy Start website, which is available at the following link:https://www.healthystart.nhs.uk/healthcare-professionals/The NHSBSA does not hold data on the number of families receiving Healthy Start and does not currently hold data on the number of people eligible for Healthy Start. The NHSBSA does not hold data on local constituencies. The table below shows the number of people on the digital scheme in the relevant local authorities as of 23 May 2025:Local authorityNumber of people on the digital schemeBlackpool1,434City of Bristol2,778County of Herefordshire736Southampton1,677Worthing348Brighton and Hove1,041East Suffolk1,129