Written questions by Morello.

What steps his Department is taking to reduce waiting times for adult ADHD assessments in rural areas.

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 recent estimate his Department has made of the average waiting time for an ADHD assessment.

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 assessment his Department has made of the (a) levels of diagnosis and (b) difficulties of diagnosing ADHD in girls.

We recognise that girls may be underdiagnosed for attention deficit hyperactivity disorder (ADHD).It is the responsibility of the integrated care boards in England to make available the 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 (NICE) guidelines.NICE guidelines on ADHD, published and updated in September 2019, aim to improve the diagnosis of ADHD, recognising that ADHD may be under-diagnosed in women and girls, and improve the quality of care and support that people of all ages who are diagnosed with ADHD receive.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 National Health Service, 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.

If his Department will make an assessment of the potential merits of piloting mobile NHS dental clinics to help improve access to routine dental care in remote communities.

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 decision about whether to commission dental vans should be made locally by integrated care boards (ICBs). Local areas know the needs of their population best 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 increase the number of NHS dental buses in (a) West Dorset constituency and (b) other remote 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 decision about whether to commission dental vans should be made locally by integrated care boards (ICBs). Local areas know the needs of their population best 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 her Department is taking to encourage schools to implement supervised toothbrushing programs in West Dorset constituency.

We are committed to introducing a national supervised toothbrushing scheme in England. This will be targeted at three, four, and five year olds in the communities with the highest needs. Further information on the timing of the implementation of the national supervised toothbrushing programme will follow in due course.

What recent assessment his Department has made of the accessibility of urgent mental health support for people in rural areas; and what steps he is taking to help ensure equitable service provision compared to urban areas.

Integrated care boards are responsible for providing health and care services to meet the needs of their local populations. We plan to recruit an additional 8,500 mental health workers across child and adult mental health services in England, to reduce delays and provide faster treatment.Anyone in England who needs urgent mental health support can now speak to a trained National Health Service professional at any time through a new mental health option on NHS 111. Trained NHS staff will assess patients over the phone and guide callers with next steps such organising face-to-face community support or facilitating access to alternatives services, such as crisis cafés or safe havens, which provide a place for people to stay as an alternative to accident and emergency or hospital admission.As set out in the Autumn Budget 2024, we are also committing £26 million in capital investment to open new mental health crisis centres, reducing pressure on busy emergency mental health and accident and emergency services, and ensuring that people have the support they need when they need it.

What assessment his Department has made of the potential impact of introducing mandatory toothbrushing programs in primary schools on improving oral health outcomes for children.

Supervised toothbrushing is an evidenced based intervention that reduces the prevalence and severity of tooth decay. We are committed to introducing a national supervised toothbrushing scheme in England. This will be targeted at three, four, and five year olds most in need.

What steps his Department is taking to improve the (a) availability of mental health services and (b) recruitment and retention of mental health professionals in rural areas.

Waiting lists for those referred for mental health support are too high all across England, including in rural communities. People with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health and that people can be confident in accessing high quality mental health support when they need it. Nationally, we plan to recruit an additional 8,500 mental health workers across child and adult mental health services in England to reduce delays and provide faster treatment. We will also provide access to a specialist mental health professional in every school and roll out Young Futures hubs in every community. We are working to consider the options to deliver this expansion of the mental health workforce, including where they should be deployed to achieve maximum effect. NHS England is also working to improve retention within the mental health workforce through clearer career progression pathways.

Pursuant to the Answer of 16 January 2025 to Question 23243, if he will publish a breakdown of spending on brain cancer research in 2023-24, including UK Research and Innovation funding bodies.

Research is crucial in tackling cancer, which is why the Department of Health and Social Care invests over £1.5 billion per year in research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24. Cancer is a major area of NIHR spend, reflecting its high priority.In 2023/24, total NIHR spending on direct research awards on brain cancer was £2.1 million spent across 22 active studies with a total lifetime value of £11.8 million. In the same year our wider infrastructure investments, which enable the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research funded by ourselves, charities and industry partners, allowed an additional 1,107 people to participate in potentially life-changing brain cancer research in the National Health Service. Information about research projects funded through NIHR Research Programmes, including on brain cancer, is available at the following link:https://fundingawards.nihr.ac.uk/The NIHR works closely with other Government funders, including UK Research and Innovation (UKRI), funded by the Department for Science, Innovation and Technology, which conducts research through its nine research councils. UKRI figures for spending on brain cancer research in 2023/24 have yet to be finalised.

If he will provide a breakdown of spending on brain cancer research in 2023-24.

Research is crucial in tackling cancer, which is why the Department invests over £1.5 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24. Cancer is a major area of NIHR spend, reflecting its high priority.In the financial year 2023/24, total NIHR spending on direct research awards on brain cancer was £2.1 million spent across 22 active studies, with a total lifetime value of £11.8 million. In the same year, our wider infrastructure investments, which enable the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research funded by ourselves, charities, and industry partners, allowed an additional 1,107 people to participate in potentially life-changing brain cancer research in the National Health Service.In addition to direct research awards, NIHR infrastructure funding enables the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research supported by other funders. These investments allowed an additional 1,107 people to participate in potentially life-changing brain cancer research in in the NHS in the same period.

What steps his Department is taking to improve mental health support for social care workers.

Most social care workers are employed by private sector providers who set their pay and terms and conditions, including any occupational health or wellbeing support, independent of the central Government.We recognise the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth, and to improve the retention of the domestic workforce. We want it to be regarded as a profession, and for the people who work in care to be respected as professionals. We are introducing the first ever Fair Pay Agreement to the adult social care sector so that care professionals are recognised and rewarded for the important work that they do.

What steps he is taking to address (a) recruitment and (b) retention in adult social care in rural areas.

The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth, and improve the retention of the domestic workforce.We are introducing the first ever Fair Pay Agreement to the adult social care sector, so that care professionals are recognised and rewarded for the important work they do. Fair Pay Agreements will empower worker representatives, employers, and others to negotiate pay, and terms and conditions in a regulated and responsible manner.

What assessment his Department has made of the potential impact of the National Insurance contributions rise on the provision of fast-track care to patients applying for Continuing Healthcare funding.

The employer National Insurance contributions rise will be implemented in April 2025. The Department will set out further details on the allocation of funding for next year in due course.

What steps his Department is taking to address shortages in NHS dentists in rural areas; and what his timeline is for tackling such gaps.

We are aware of the challenges faced in accessing a dentist, particularly in more 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 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.Integrated care boards 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 7 November 2024, 629 Expressions of Interest have been received, 308 of which have been approved for participation in the Dental Recruitment Incentive Scheme. 64 posts have been advertised, with five dentists commenced in post.

What assessment he has made of the impact of recent NHS contract reforms on access to NHS dentistry in (a) West Dorset constituency and (b) other rural areas.

In July 2022, the first substantial changes to the National Health Service dental contract, since the 2006 Dental System Reforms, were made. These allowed the best performing practices to see more patients, specifically up to an extra 10% more activity, where commissioners have given agreement, and enabled commissioners to better manage consistently underperforming contracts. The changes provided increased remuneration for dentists treating patients with high needs and supported the use of increased skill mix in practices.We will further reform the NHS contract to rebuild dentistry in the long term and increase access to NHS dental care, with a shift to focus on prevention and the retention of NHS dentists.There are no perfect payment models and 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.

If his Department will make an assessment of the potential merits of bringing forward legislative proposals on requiring drugs manufacturers to include additional labelling on the front of boxes of medications containing a potentially addictive substance.

The legislative requirements for the labelling of medicines are set out in Schedules 24 and 25 of the Human Medicines Regulations 2012. The regulations are continually under review and updated as and when a need is identified. It should be noted that the current legislative framework already provides for the presentation of ‘any special warning applicable to the product’ on the outer carton of a medicine, which would enable product-specific safety information to be presented on the pack if considered necessary.

If he will make an assessment of the potential merits of providing additional incentives for NHS dentists to operate in (a) rural and (b) remote areas.

We are aware of the challenges faced in accessing a dentist, particularly in more 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 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.Integrated care boards 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 7 November 2024, 629 Expressions of Interest have been received, 308 of which have been approved for participation in the Dental Recruitment Incentive Scheme. 64 posts have been advertised, with five dentists commenced in post.

If he will take steps to ensure that guidance to primary care clinicians on screening for prostate cancer includes reference to the potential impact of the BRCA2 gene variation on risk levels.

The Prostate Cancer Risk Management Programme provides guidance for general practitioners on how to counsel men who have no symptoms but wish to have a Prostate Specific Antigen (PSA) test for prostate cancer. It highlights the potential benefits and harms of PSA testing so that men including those at higher risk, such as men with a family history, can make an informed decision about whether to have the test.The UK National Screening Committee is carrying out an evidence review of prostate cancer screening which includes looking at the evidence for targeted screening of specific high-risk groups, such as men over 50, Black men and those with a family history, such as carriers of the BRCA2 mutation. This will determine whether a PSA test-based screening programme for high-risk groups could provide more good than harm.

What steps his Department is taking to increase the number of autism support services for adults in West Dorset constituency.

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 support services for autistic people, in line with National Institute for Health and Care Excellence’s (NICE) guidelines. The NICE guideline, Autism spectrum disorder in adults: diagnosis and management, aims to improve access and engagement with interventions and services, and the experience of care, for autistic adults.On 5 April 2023, NHS England published a national framework and operational guidance to improve outcomes in all-age autism assessment pathways. This guidance will help ICBs and the National Health Service to improve outcomes for children, young people, and adults referred to an autism assessment service. The guidance sets out what support should be available before an assessment, and what support should follow a recent diagnosis of autism, based on the available evidence. This includes setting out specific considerations for developing post-diagnostic support.The Dorset ICB advises that it has conducted an all-age review of services for people with neurodevelopmental conditions, including autism, and is currently working through the outcomes of that review, including in relation to assessment, diagnosis, and pre- and post-diagnostic support. In the meantime, the ICB has identified additional funding to increase capacity for additional appointments for those that have waited the longest. The ICB has also recently launched an online neurodiversity hub.