Written questions by Morello.

What discussions his Department has had with pharmaceutical manufacturers on resolving supply chain issues with pancreatic enzyme replacement therapy medications; and what his planned timetable is for the restoration of normal supply levels.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

What assessment his Department has made of the potential impact of shortages of pancreatic enzyme replacement therapy medications on patients.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

If he will take steps to ensure a continuous supply of pancreatic enzyme replacement therapy medications.

The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production to mitigate the supply issue. Through this work we have managed to secure additional volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to consider these unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest update on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.We expect normal supply to resume in 2026 but will remain focused on pushing manufacturers to shorten this timeline. The Department also has frequent conversations with representatives from the impacted patient groups so that they are informed on the supply situation and the mitigation actions being taken.

What assessment his Department has made of the average cost to student midwives of (a) unpaid clinical placement hours and (b) student loan debt; and whether he has made a recent assessment of the potential merits of providing additional financial support to student midwives.

No such assessment has been made. Students undertaking pre-registration midwifery courses can access support from Student Finance England (SFE). This includes payment for tuition fees, a partially means-tested loan for living costs and, where applicable, other grants, such as for childcare.The Government has announced that the maximum loans and grants for living and other costs from SFE will increase by forecast inflation, by 3.1% for the 2025/26 academic year, based on the RPIX inflation index.In addition to support provided by SFE, eligible midwifery students receive a non-repayable grant of £5,000 per year via the NHS Learning Support Fund. Further financial support is also available for childcare, dual accommodation costs, and travel.Funding arrangements are reviewed annually ahead of the start of each academic year.

If he will make an assessment of the level of availability of funding for newly qualified midwives at Dorset County Hospital NHS Foundation Trust.

Decisions on the level of funding available for hiring newly qualified midwives is a matter for individual National Health Service trusts. Trusts manage their recruitment at a local level to ensure they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.While we have no plans to make a specific assessment of Dorset County Hospital NHS Foundation Trust, we are committed to recruiting the staff the NHS needs across all parts of the country to get patients seen on time. In summer 2025, we will publish a refreshed Long Term 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.

What steps his Department is taking to ensure that newly qualified midwives in Dorset can secure employment at local NHS trusts upon completing their training.

Decisions about the employment of newly qualified midwives is a matter for individual National Health Service trusts, including in Dorset. Trusts manage their recruitment at a local level to ensure they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.In summer 2025, we will publish a refreshed Long Term 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.

What recent estimate his Department has made of the number of NHS dentists accepting new patients in West Dorset constituency.

As of 4 February 2025, in the West Dorset constituency, there were 15 National Health Service dentist practices, with two showing as ‘accepting new child patients when availability allows’ and two showing as ‘accepting new adult patients when availability allows’.This data is sourced from the Find a Dentist website and is matched to constituencies based on the postcode data shown on the website, which is available at the following link:https://www.nhs.uk/service-search/find-a-dentist

What recent steps his Department has taken to reduce waiting times for an endometriosis diagnosis.

The Government is committed to prioritising women’s health and improving the diagnosis times for gynaecological conditions, including endometriosis.We have taken urgent action to tackle gynaecology waiting lists through the Elective Reform Plan. In gynaecology, the plan supports innovative models offering patients care closer to home, and piloting gynaecology pathways in community diagnostic centres.Endometriosis is also included in the core curriculum for general practitioners, and for obstetricians and gynaecologists. The General Medical Council is introducing the Medical Licensing Assessment for most incoming doctors, including all medical students graduating from academic year 2024/25 and onwards. Within this assessment are several topics relating to women’s health, including endometriosis. This will encourage a better understanding of endometriosis among doctors as they start their careers in the United Kingdom.Clinical guidelines support healthcare professionals to diagnose and treat conditions. In November 2024 the National Institute for Health and Care Excellence published updated recommendations on the diagnosis, management and treatment of endometriosis, which are available at the following link:https://www.nice.org.uk/guidance/ng73

What steps he is taking to increase the number of children attending NHS dental services 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 areas that need them most. The most common reason children aged five to nine are admitted to hospital is for tooth decay. We will work with local authorities and the NHS to introduce supervised tooth brushing for children aged between three and five years old in the most deprived communities. These programmes are proven to reduce tooth decay and to boost good practices at home.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. For West Dorset constituency, this is Dorset ICB.

What steps his Department is taking to increase the number of NHS orthodontist appointments available in West Dorset constituency.

The responsibility for commissioning specialised orthodontic services is delegated to the integrated care boards (ICBs) across England. For the West Dorset constituency, this is the NHS Dorset ICB. In order to support the ICBs in the execution of their duties, NHS England has published a number of documents, including a clinical policy to support the commissioning of orthodontic activity, which is available at the following link: https://www.england.nhs.uk/publication/clinical-standards-for-dental-specialties-orthodontics/ More widely, 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.

What assessment his Department has made of the availability of speech and language therapy services in rural areas.

It is the responsibility of integrated care boards to make available appropriate provision to meet the health and care needs of their local population, including speech and language therapy services in rural areas.

What steps he is taking to improve adult attendance at NHS dental services 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. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, 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. For the West Dorset constituency, this is the NHS Dorset ICB.

What assessment his Department has made of the causes of reductions in the percentage of adults attending NHS dental appointments 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. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, 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. For the West Dorset constituency, this is the NHS Dorset ICB.

Whether his Department plans to review the system of financial penalties imposed on NHS trusts for health and safety breaches.

Enforcement is one of the core components of the operating model that the Care Quality Commission (CQC) uses to achieve its purpose and perform its role, to improve health and adult social care services and protect the health, safety and welfare of people who use them. The CQC monitors and assesses service providers against the fundamental standards of quality and safety. Failure to comply with the standards and make improvements, could result in enforcement action by the CQC.The current system of penalties imposed on National Health Service trusts for health and safety breaches is defined by law. The Department has not made any assessments of other models and, therefore, has no plans to review this.

What assessment his Department has made of potential alternative models to financial penalties for NHS trusts that (a) do not diminish frontline patient care and (b) improve affected local services.

Enforcement is one of the core components of the operating model that the Care Quality Commission (CQC) uses to achieve its purpose and perform its role, to improve health and adult social care services and protect the health, safety and welfare of people who use them. The CQC monitors and assesses service providers against the fundamental standards of quality and safety. Failure to comply with the standards and make improvements, could result in enforcement action by the CQC.The current system of penalties imposed on National Health Service trusts for health and safety breaches is defined by law. The Department has not made any assessments of other models and, therefore, has no plans to review this.

Pursuant to the Answer of 4 February 2025 to Question 26669 on Dental Services: Rural Areas and to the pursuant to the Answer of 4 February 2025 to Question 26670 on Dental Services: Rural Areas, what guidance his Department provides to Integrated Care Boards on the commissioning of dental vans.

Since 1 April 2023, the responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England.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/

What steps his Department is taking to provide additional funding to ICBs.

At the Autumn Budget, the Government announced a £22.6 billion increase in day-to-day health spending and a £3.1 billion increase in the capital budget over 2024/25 and 2025/26. The recently published recurrent integrated care board core allocations will grow by 4.1% in 2025/26, compared to 2024/25. These growths exclude funding allocations that are made after convergence, including additional elective funding and transfers in from the Service Development Fund, which are treated separately.

If he will make an assessment of the adequacy of the level of support provided by the NHS to people with ADHD after they have left full-time education.

There is, at present, no single, established dataset that can be used to monitor waiting times for the assessment and diagnosis of attention deficit hyperactivity disorder (ADHD) nationally or for individual organisations or geographies in England. Although the data requested is not held centrally, it may be held locally by individual National Health Service trusts or commissioners.It is the responsibility of the integrated care boards in England to make appropriate provision to meet the health and care needs of their local population, including ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England has established to look at ADHD service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the NHS, education, and justice, to better understand the challenges affecting people with ADHD, including timely access to services and support.Alongside the work of the taskforce, NHS England will continue to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services to ensure best practice is captured and shared across the system.

What steps his Department is taking to ensure that people over 65 can access free health checks every five years.

The NHS Health Check programme, England’s cardiovascular disease (CVD) prevention programme, aims to prevent CVD in people aged 40 to 74 years old, and is offered every five years. During 2023/24, over 1.4 million people received an NHS Health Check, and through behavioural and clinical interventions, the programme prevents approximately 500 heart attacks and strokes a year.To improve access and engagement with the NHS Health Check, we are developing a new digital service which will complement the existing face to face programme and enable people to undertake the NHS Health Check in the comfort of their own home.The Department is developing policy proposals and advice to ministers on options to improve the uptake and impact of the NHS Health Check programme. The work will consider the recommendations of the recent National Audit Office’s report, Progress on CVD Prevention.

What assessment his Department has made of support for people with ADHD outside the school environment.

There is, at present, no single, established dataset that can be used to monitor waiting times for the assessment and diagnosis of attention deficit hyperactivity disorder (ADHD) nationally or for individual organisations or geographies in England. Although the data requested is not held centrally, it may be held locally by individual National Health Service trusts or commissioners.It is the responsibility of the integrated care boards in England to make appropriate provision to meet the health and care needs of their local population, including ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England has established to look at ADHD service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the NHS, education, and justice, to better understand the challenges affecting people with ADHD, including timely access to services and support.Alongside the work of the taskforce, NHS England will continue to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services to ensure best practice is captured and shared across the system.