Written questions by Morello.

What guidance his Department has issued to integrated care boards on maintaining access to dental services in underserved communities.

Integrated care boards (ICBs) are responsible for commissioning primary care dentistry and receive an annual allocation of funding to secure services to meet the needs of their population.NHS England supports ICBs with their local commissioning responsibilities for primary dental services with the provision of nationally agreed policies and procedures. NHS England has also published guidance to support commissioners to take advantage of the opportunities offered to commission further and additional services through flexible commissioning, which enables the responsible commissioner to tailor services to meet local population oral health needs. Further information is available at the following link:https://www.england.nhs.uk/long-read/opportunities-for-flexible-commissioning-in-primary-care-dentistry-a-framework-for-commissioners/We are aware of the challenges faced in accessing a dentist, particularly in rural and coastal areas. The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.ICBs have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. As of 10 April 2025, in England, there are 53 dentists in post with a further 44 dentists who have been recruited but are yet to start in post. Another 256 posts are currently advertised.

What assessment he has made of the potential contribution of overseas recruitment in helping to tackle NHS dental workforce shortages.

National Health Service dentistry has always valued the vital contribution made by internationally trained staff in delivering high quality dental care. At the same time, we are committed to growing homegrown talent and giving opportunities to more people across the country to join the NHS. The Government plans to expand access to NHS dental care by recruiting new dentists to the areas that need them, and with a rescue plan to provide 700,000 more urgent dental appointments.We have launched a 10-Year Health Plan as part of the Government’s five long-term missions, a central part of which will be our workforce. We will publish a refreshed workforce plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.We have welcomed the additional sittings of both parts of the Overseas Registration Exam that the General Dental Council (GDC) has put in place. The GDC is working to put new ORE provider contracts in place in 2025 which will increase the flexibility and availability of the exam, further expanding capacity.To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What assessment he has made of the potential impact of dental school capacity on long-term access to NHS dentistry.

We are determined to rebuild National Health Service dentistry, but it will take time and there are no quick fixes. Strengthening the workforce is key to our ambitions.To achieve these aims, we will work with partners such as the General Dental Council to explore the creation of new dental schools as necessary in currently under-served parts of the country, as well as with the Office for Students, which has statutory responsibility for allocating Government funded dental school places.We have also launched a 10-Year Health Plan as part of Government’s five long-term missions, a central part of which will be our workforce. We will publish a refreshed workforce plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

What assessment he has made of the effectiveness of short-term models to ensure dental access in (a) rural and (b) coastal areas with no current NHS dental practices.

We are aware of the challenges faced in accessing a dentist, particularly in rural and coastal areas. The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England.The additional 700,000 urgent dental appointments will be available across the country, with specific expectations for each region. These targets are more heavily weighted towards those areas where they are needed the most.ICBs have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.

If she will take steps to introduce dental buses to treat (a) low-income, (b) elderly and (c) disabled patients in West Dorset constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most.The decision about whether to commission dental vans should be made locally by integrated care boards (ICBs). ICBs know the needs of their local areas and are best placed to make decisions about whether or how mobile dental vans can contribute to meeting the dental care needs of their population. For the West Dorset constituency, this is the NHS Dorset ICB.

What steps his Department is taking to support local commissioning bodies during dental contract reforms.

Integrated care boards (ICBs) are responsible for commissioning primary care services, including NHS dentistry, to meet the needs of the local populations and to determine the priorities for investment.NHS planning guidance for 2025/26 confirms that dental budgets are ringfenced, and that improving access to urgent dental appointments is a key national priority. Careful consideration needs to be given to any potential changes to the complex dental system so that we deliver genuine improvements for patients and the profession, and so that ICBs are supported to commission services in line with system changes. NHS England supports ICBs with their local commissioning responsibilities for primary dental services with the provision of nationally agreed policies and procedures. NHS England has also published guidance to support commissioners to take advantage of the opportunities offered to commission further and additional services through flexible commissioning, which enables the responsible commissioner to tailor services to meet local population oral health needs. Further information can be found at the following link:https://www.england.nhs.uk/long-read/opportunities-for-flexible-commissioning-in-primary-care-dentistry-a-framework-for-commissioners/We are continuing to meet representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients

Pursuant to the Answer of 29 of April 2025 to Question 46588 on Abiraterone, what discussions she has had with NICE on its engagement with health authorities on the (a) appraisal and (b) use of abiraterone acetate for high-risk non-metastatic prostate cancer.

The Department has had no such discussions. Abiraterone does not have a marketing authorisation for use in the treatment of high-risk, non-metastatic prostate cancer and has not been evaluated for that indication by the National Institute for Health and Care Excellence (NICE). The NICE makes recommendations for the National Health Service in England on the vast majority of new and significant licence indications, but does not evaluate medicines that are used outside their marketing authorisations or “off-label”.NHS England considered abiraterone as an off-label treatment for the treatment of hormone sensitive, non-metastatic prostate cancer through its clinical policy development process in 2024/25. Through this process NHS England confirmed that there was sufficient supporting evidence to support the routine commissioning of abiraterone in this indication, but it has not been possible to identify the necessary recurrent funding to support the commissioning of abiraterone for this purpose, or any other treatments within the prioritisation round. Should the funding position change and a further prioritisation round take place, abiraterone for the treatment of hormone sensitive, non-metastatic prostate cancer will be reconsidered.

Whether his Department plans to make an assessment of the adequacy of (a) the allocation of resident funds and (b) other aspects of the regulatory framework governing financial accountability in retirement homes.

The Care Quality Commission has regulatory powers to compel providers to be financially viable when delivering regulated activities and to protect service users from financial misappropriation.In addition, the Local Government and Social Care Ombudsman is the independent complaints lead for adult social care and investigates complaints from those receiving social care, including on financial issues.Whilst there are no immediate plans to make an assessment of resident funds, the independent commission chaired by Baroness Louise Casey will have the scope to consider all aspects of adult social care, including financial matters, and will make recommendations on impactful reform as part of the first steps towards delivering a National Care Service.

Whether he has had recent discussions with the Secretary of State for the Home Department on funding for fire and rescue services assisting ambulance services with emergency entry to properties.

There have been no recent discussions about such funding.

Whether his Department has made an assessment of the potential merits of implementing mandatory reporting requirements for retirement homes on staff departures and replacements.

The Department does not currently mandate reporting requirements for retirement homes on staff departures and replacements.The Care Act 2014 sets out local authorities’ legal duties when assessing people’s care and support needs. For workforce capacity, there is a duty to ensure that sufficient services are available for meeting the care and support needs of adults and their carers in the area.Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 states that providers registered with the Care Quality Commission (CQC) must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. The CQC can take regulatory action if providers registered with them are in breach of any parts of this regulation, including if providers have an insufficient number of suitably qualified, skilled, and experienced persons deployed.The Department continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool, and intelligence from key sector partners.

What steps the NHS is taking to help improve the (a) early detection and (b) treatment of chronic obstructive pulmonary disease.

Respiratory disease, including chronic obstructive pulmonary disease (COPD), is a clinical priority, and the National Health Service is investing in the provision of more and better rehabilitation services for respiratory patients. This has the objective of improving outcomes for people with COPD through early diagnosis, including via spirometry tests, and through increased access to treatments.The NHS RightCare COPD pathway has been rolled out nationally and defines the optimal service for people with COPD. Furthermore, the National Respiratory Audit Programme aims to improve quality of care, services, and clinical outcomes for patients with asthma and COPD, by collecting and providing data on a range of indicators and pulmonary rehabilitation activity.A national programme of work is underway to support systems with improving access to pulmonary rehabilitation for the eligible population, increase the capacity of provision to reduce waiting lists, and improve the quality and consistency of rehabilitation programmes through accreditation. Pulmonary rehabilitation is effective for people with COPD, improving exercise capacity or increasing the quality of life in 90% of the patients who complete a programme.

What steps his Department is taking to support retirement homes in maintaining continuity of care during staffing changes.

Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 states that providers registered with the Care Quality Commission (CQC), including residential care homes, must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. The CQC can take regulatory action if providers registered with them are in breach of any parts of this regulation, including if providers have an insufficient number of suitably qualified, skilled, and experienced persons deployed.

How much funding his Department has provided for research on the long-term effects of covid-19 on lung health.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR and the Medical Research Council (MRC), which is part of UK Research and Innovation, remain committed to funding high-quality research to understand the causes, consequences, and treatment for the long-term effects of COVID-19. The NIHR committed £15.06 million to the following three research projects related to the long-term effects of COVID-19 on lung health, between financial years 2020/21 and 2024/25:Characterisation, determinants, mechanisms and consequences of the long-term effects of COVID-19: providing the evidence base for health care services;HypErpolarised Xenon Magnetic Resonance PuLmonary Imaging in PAtIeNts with Long-COVID (EXPLAIN); andHElping Alleviate the Longer-term consequences of COVID-19 (HEAL-COVID): A national platform trial.Between 2019/20 and 2023/24, Government research funders invested several hundred million pounds to understand SARS-COV-2 and the COVID-19 illness. As COVID-19 is a predominantly respiratory condition, much of this research is relevant to understanding the long-term effects of COVID-19 on lung health. On long COVID specifically, through the NIHR and the MRC, we have invested over £57 million on research studies. The funded projects aim to improve our understanding of the diagnosis and underlying mechanisms of the disease and the effectiveness of both pharmacological and non-pharmacological therapies and interventions, as well as to evaluate the effectiveness of clinical care.Funding is available and we welcome funding applications for research into any aspect of human health and care, including on long COVID and lung health. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

What assessment his Department has made of the potential impact of research on the long-term effects of covid-19 on his Department's public health strategies.

In October 2024, the Department hosted a roundtable on long COVID research with the Chief Scientific Officer, Professor Lucy Chappell, discussing the relevance of the research to other post-viral syndromes and strategies to stimulate further research in the scientific community.The Department regularly reviews evidence on the health and economic impact of diseases and conditions. Where appropriate, this evidence is used to produce impact assessments which inform the development of new policies to address the needs of the population.The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR and the Medical Research Council (MRC), which is part of UK Research and Innovation, remain committed to funding high-quality research to understand the causes, consequences, and treatment for long COVID.Between 2019/20 and 2023/24, through the NIHR and the MRC, we have invested over £57 million on research into long COVID, with almost £40 million of this through two specific research calls on long COVID. The funded projects aim to improve our understanding of the diagnosis and underlying mechanisms of the disease and the effectiveness of both pharmacological and non-pharmacological therapies and interventions, as well as to evaluate the effectiveness of clinical care.

Whether he has had recent discussions with the Secretary of State for Education on the potential merits of introducing dental apprenticeships as a pathway to becoming a qualified dentist.

Ministers regularly meet with Cabinet colleagues to discuss a range of issues.Dental apprenticeships are available for roles such as dental nurses and technicians but are not available to become a qualified dentist. These apprenticeships provide skills and experience, combining work-based training with a degree.We are determined to rebuild National Health Service dentistry, but it will take time and there are no quick fixes. Strengthening the workforce is key to our ambitions. A core part of the 10-Year Health Plan will be our workforce and how we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

If he will make an assessment of the potential impact of introducing dental apprenticeships on shortages of dental professionals in each region.

Ministers regularly meet with Cabinet colleagues to discuss a range of issues.Dental apprenticeships are available for roles such as dental nurses and technicians but are not available to become a qualified dentist. These apprenticeships provide skills and experience, combining work-based training with a degree.We are determined to rebuild National Health Service dentistry, but it will take time and there are no quick fixes. Strengthening the workforce is key to our ambitions. A core part of the 10-Year Health Plan will be our workforce and how we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

What steps his Department is taking to support Integrated Care Boards to provide earwax removal services.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.Guidance for general practitioners (GPs) on ear wax removal is provided by the National Institute for Health and Care Excellence (NICE). Manual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

What steps his Department is taking to help support the NHS Dorset Integrated Care Board to provide adequate earwax removal services.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.Guidance for general practitioners (GPs) on ear wax removal is provided by the National Institute for Health and Care Excellence (NICE). Manual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

What steps he is taking to ensure that funds allocated for resident care in retirement homes are used for the purpose intended.

To enable local authorities to deliver key services such as adult social care, the Government has made available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant. Local authorities are best placed to understand and plan for the needs of their population.To ensure local authorities are fulfilling their duties for care users, including care home residents, under Part 1 of the Care Act 2014, the Care Quality Commission (CQC) assess local authorities' delivery of their adult social care duties. If the CQC identifies that a local authority has failed or is failing to discharge its duties under the Care Act 2014 to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene.

What assessment his Department has made of the potential impact of staff turnover on the quality of care in retirement homes.

The Department continues to monitor adult social care (ASC) workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool which collates data from all ASC providers regulated by the Care Quality Commission and intelligence from key sector partners.With high rates of turnover and recruitment challenges, the ASC sector faces significant workforce challenges. In April 2025, we expanded the Care Workforce Pathway, the first ever universal career structure for the ASC workforce in England, and we are introducing the first ever Fair Pay Agreement to the ASC sector so that care professionals are recognised and rewarded for the important work that they do. This will help to address the recruitment and retention crisis in the sector; in turn supporting the delivery of high-quality care. We have also launched an independent commission into social care as part of first steps towards a National Care Service.