Written questions by Morello.

What steps his Department is taking to increase the availability of autism support services for adults in rural areas.

Integrated care systems (ICSs) are responsible for the planning and delivery of health and care services in their local area, including meeting the needs of autistic people in rural communities. Local priorities are set out in the Integrated Care Strategy, which must be informed by local assessments of need. The Department published updated statutory guidance on integrated care strategies in February 2024.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 integrated care boards, including those in rural areas, 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.The importance of supporting rural communities has been recognised by the Chief Medical Officer in his reports, which also recognise the role played by ICSs in understanding local needs and arranging services to meet these needs.

What assessment his Department has made of the potential merits of providing funding for research into the early detection of sepsis.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health and care, including sepsis diagnosis. 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.In the last five years, the NIHR has invested over £9.2 million into 10 research projects to improve the diagnosis of sepsis. In addition, the NIHR Research Delivery Network, which helps patients, the public, and health and care organisations to participate in high quality research, has supported 19 studies on sepsis diagnosis.The NIHR’s investment into sepsis diagnosis includes research into the application of novel point-of-care diagnostic tests for sepsis, predicting those most at-risk of developing sepsis, and evaluating the accuracy of pre-existing measures to identify patients with suspected sepsis.For example, the NIHR funded the Prehospital early warning scores for adults with suspected sepsis (PHEWS) study, which aimed to determine the impact and accuracy of early warning scores to identify sepsis requiring urgent treatment. In 2024, the PHEWS study found that the National Early Warning score, a standardized early warning system based on simple measurements used to identify acutely ill patients, including those with sepsis, was as good as or better than all the other scores to prioritize people with suspected sepsis, and avoided missing patients with sepsis. This finding supports the early diagnosis of sepsis in patients, therefore reducing treatment delay, and consequentially deaths caused by sepsis.The UK Health Security Agency is conducting ongoing work to explore the development of two diagnostic tests to bridge gaps in early detection and disease confirmation, and inform detection and ongoing management.

What steps his Department is taking to ensure that support for minimal to intensive assistance are tailored to each adult with autism.

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 support services for autistic people, in line with National Institute for Health and Care Excellence (NICE) guidelines.The NICE quality standard for autism sets out that the needs of autistic people are varied, with some people needing complex levels of support from a range of professionals, and some people not wanting or needing any ongoing support. In line with this, the quality standard recommends that autistic people should have a personalised plan that is developed and implemented in a partnership between them, and their family and carers, if appropriate, and the autism team.On 5 April 2023, NHS England published a national framework and operational guidance to deliver improved outcomes in all-age autism assessment pathways. 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 for adults diagnosed as autistic.In addition, under the Care Act 2014, it is the responsibility of local authorities to assess individuals’ care and support needs, including where it appears that an autistic adult may have care and support needs, and, where eligible, for meeting those needs.

What steps his Department is taking to improve access to primary healthcare services in (a) West Dorset constituency and (b) other rural constituencies.

We acknowledge the urgent challenge of ensuring that rural areas, including West Dorset, have the resources to continue serving their patients. To address this, we will increase capacity in general practices (GPs) and ensure that rural areas have the necessary workforce to provide integrated, patient-centred services.We are committed to training thousands more GPs across the country, including in rural areas. We have also committed to recruiting over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme, which will increase the number of appointments delivered in GPs. This will increase capacity, secure the future pipeline of GPs, and alleviate the pressure on those currently working in the system.We are tackling the challenges that people in rural areas face when accessing National Health Service dental care. Work is underway to deliver our rescue plan to provide 700,000 more urgent dental appointments, and to recruit new dentists to the areas that need them most. The Golden Hello scheme will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most, for three years.  To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a focus on prevention and the retention of NHS dentists.Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether their population is adequately served, and they must keep these assessments under review. These assessments inform integrated care boards when reviewing applications for NHS pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there is no pharmacy, GPs are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.

What steps his Department is taking to help support for people during their transition from child to adult autism services.

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 services for autistic people, in line with National Institute for Health and Care Excellence (NICE) guidelines.NICE guidelines, specifically Autism spectrum disorder in under 19s: recognition, referral and diagnosis, and Autism spectrum disorder in under 19s: support and management, provide guidance on the transition to adult services, including that local autism teams should make arrangements for a smooth transition to adult services.On 5 April 2023, NHS England published a national framework and operational guidance for autism assessment services. This guidance will help the National Health Service improve autism assessment services, and improve the experience for people referred to an autism assessment service. This includes guidance to local areas on how to manage referrals and transitions between child and adult assessment services.The Care Act 2014 places a duty on local authorities to conduct a transitions assessment for young people, adult carers, and young carers that are likely to have needs for care and support, or support as a carer, after they turn 18 years old.

What steps the Department is taking to support hospice funding to ensure (a) sustainability and (b) quality care in regions with limited alternatives.

Most hospices are charitable, independent organisations which receive some statutory funding for providing services within the National Health Service. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.Palliative care services are included in the list of services that ICBs, including the Dorset ICB, which covers the West Dorset constituency, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England has also developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those their local population, thereby enabling ICBs to put plans in place to address and track the improvement of health inequalities.I have met NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. We, alongside key partners NHS England, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face.We will consider next steps on palliative and end of life care, including funding, in the coming months.

What steps he plans to take to tackle primary healthcare staffing shortages in rural areas with limited local resources.

We acknowledge the urgent challenge of ensuring that rural areas, including West Dorset, have the resources to continue serving their patients. To address this, we will increase capacity in general practices (GPs) and ensure that rural areas have the necessary workforce to provide integrated, patient-centred services.We are committed to training thousands more GPs across the country, including in rural areas. We have also committed to recruiting over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme, which will increase the number of appointments delivered in GPs. This will increase capacity, secure the future pipeline of GPs, and alleviate the pressure on those currently working in the system.We are tackling the challenges that people in rural areas face when accessing National Health Service dental care. Work is underway to deliver our rescue plan to provide 700,000 more urgent dental appointments, and to recruit new dentists to the areas that need them most. The Golden Hello scheme will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most, for three years.  To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a focus on prevention and the retention of NHS dentists.Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether their population is adequately served, and they must keep these assessments under review. These assessments inform integrated care boards when reviewing applications for NHS pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there is no pharmacy, GPs are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.

Whether he has plans to provide additional support to ensure primary healthcare remains accessible in isolated regions.

We acknowledge the urgent challenge of ensuring that rural areas, including West Dorset, have the resources to continue serving their patients. To address this, we will increase capacity in general practices (GPs) and ensure that rural areas have the necessary workforce to provide integrated, patient-centred services.We are committed to training thousands more GPs across the country, including in rural areas. We have also committed to recruiting over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme, which will increase the number of appointments delivered in GPs. This will increase capacity, secure the future pipeline of GPs, and alleviate the pressure on those currently working in the system.We are tackling the challenges that people in rural areas face when accessing National Health Service dental care. Work is underway to deliver our rescue plan to provide 700,000 more urgent dental appointments, and to recruit new dentists to the areas that need them most. The Golden Hello scheme will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most, for three years.  To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a focus on prevention and the retention of NHS dentists.Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether their population is adequately served, and they must keep these assessments under review. These assessments inform integrated care boards when reviewing applications for NHS pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there is no pharmacy, GPs are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.

What steps his Department is taking to provide additional funding for hospices in (a) West Dorset constituency and (b) other rural areas.

Most hospices are charitable, independent organisations which receive some statutory funding for providing services within the National Health Service. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.Palliative care services are included in the list of services that ICBs, including the Dorset ICB, which covers the West Dorset constituency, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England has also developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those their local population, thereby enabling ICBs to put plans in place to address and track the improvement of health inequalities.I have met NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. We, alongside key partners NHS England, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face.We will consider next steps on palliative and end of life care, including funding, in the coming months.

If he will undertake a review of the funding model for hospices serving (a) rural and (b) other isolated communities.

Most hospices are charitable, independent organisations which receive some statutory funding for providing services within the National Health Service. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.Palliative care services are included in the list of services that ICBs, including the Dorset ICB, which covers the West Dorset constituency, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England has also developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those their local population, thereby enabling ICBs to put plans in place to address and track the improvement of health inequalities.I have met NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. We, alongside key partners NHS England, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face.We will consider next steps on palliative and end of life care, including funding, in the coming months.

What steps his Department plans to take to ensure that people in (a) West Dorset constituency and (b) other rural areas receive equitable access to social care support.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014. Local authorities have a further duty to shape their care markets and commission a diverse range of care and support services that enable people to access quality care.The majority of grant funding for adult social care is distributed to local authorities using the Adult Social Care Relative Needs Formula. This is designed to account for factors that affect the differences in the need for, and cost of, adult social care services that are outside of local authorities’ control, including population, income and wealth, informal care support, wages and prices, and population sparsity.We recognise that there are challenges in adult social care. Lord Darzi’s report indicated a growing gap between requests and those receiving publicly funded care, and some people are waiting too long to get the care they need. Long-term reform is needed in adult social care, and we will work with the sector to create a sustainable care system across all constituencies that supports people to live independent and dignified lives.In the short term, the Government is providing at least £600 million of new grant funding for social care in 2025/26, as part of the broader estimated real-terms uplift to core local government spending power of approximately 3.2%. We will set out further details at the Local Government Finance Settlement.In addition, the Care Quality Commission (CQC) local authority assessments consider the performance of the delivery of Care Act 2014 duties. If the CQC identifies that a local authority has failed or is failing its functions to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene. The CQC has published twelve local authority ratings and reports.

What steps he plans to take to improve access to social care in underserved regions where the amount of care providers is lower per capita.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014. Local authorities have a further duty to shape their care markets and commission a diverse range of care and support services that enable people to access quality care.The majority of grant funding for adult social care is distributed to local authorities using the Adult Social Care Relative Needs Formula. This is designed to account for factors that affect the differences in the need for, and cost of, adult social care services that are outside of local authorities’ control, including population, income and wealth, informal care support, wages and prices, and population sparsity.We recognise that there are challenges in adult social care. Lord Darzi’s report indicated a growing gap between requests and those receiving publicly funded care, and some people are waiting too long to get the care they need. Long-term reform is needed in adult social care, and we will work with the sector to create a sustainable care system across all constituencies that supports people to live independent and dignified lives.In the short term, the Government is providing at least £600 million of new grant funding for social care in 2025/26, as part of the broader estimated real-terms uplift to core local government spending power of approximately 3.2%. We will set out further details at the Local Government Finance Settlement.In addition, the Care Quality Commission (CQC) local authority assessments consider the performance of the delivery of Care Act 2014 duties. If the CQC identifies that a local authority has failed or is failing its functions to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene. The CQC has published twelve local authority ratings and reports.

What steps he plans to take through social care reforms to help (a) reduce waiting times for and (b) increase access to care services in rural areas.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014. Local authorities have a further duty to shape their care markets and commission a diverse range of care and support services that enable people to access quality care.The majority of grant funding for adult social care is distributed to local authorities using the Adult Social Care Relative Needs Formula. This is designed to account for factors that affect the differences in the need for, and cost of, adult social care services that are outside of local authorities’ control, including population, income and wealth, informal care support, wages and prices, and population sparsity.We recognise that there are challenges in adult social care. Lord Darzi’s report indicated a growing gap between requests and those receiving publicly funded care, and some people are waiting too long to get the care they need. Long-term reform is needed in adult social care, and we will work with the sector to create a sustainable care system across all constituencies that supports people to live independent and dignified lives.In the short term, the Government is providing at least £600 million of new grant funding for social care in 2025/26, as part of the broader estimated real-terms uplift to core local government spending power of approximately 3.2%. We will set out further details at the Local Government Finance Settlement.In addition, the Care Quality Commission (CQC) local authority assessments consider the performance of the delivery of Care Act 2014 duties. If the CQC identifies that a local authority has failed or is failing its functions to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene. The CQC has published twelve local authority ratings and reports.

What steps he plans to take to support community pharmacies in West Dorset

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists, as we shift care from the hospital to the community.Integrated care boards (ICBs) are responsible for understanding the health needs of their areas, and commissioning services to meet those needs. Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether their population, such as the constituency of West Dorset, are adequately served, and they must keep these assessments under review. These assessments inform ICBs when reviewing applications for National Health Service pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there is no pharmacy, general practices are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.Now that the Budget for Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements. We are unable to say more until these have been concluded.

What steps his Department is taking to help improve the sustainability of pharmacies in rural communities that lack alternative healthcare access.

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists, as we shift care from the hospital to the community.Integrated care boards (ICBs) are responsible for understanding the health needs of their areas, and commissioning services to meet those needs. Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether their population, such as the constituency of West Dorset, are adequately served, and they must keep these assessments under review. These assessments inform ICBs when reviewing applications for National Health Service pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there is no pharmacy, general practices are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.Now that the Budget for Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements. We are unable to say more until these have been concluded.

What steps his Department is taking to incentivise private sector investment into research for (a) brain tumours and (b) other rare diseases.

The Department is committed to implementing recommendations from Lord O'Shaughnessy’s independent review of commercial clinical trials, maximising our potential to be a world leader, and developing a more competitive, efficient, and accessible clinical research system.The Department aims to ensure that all patients, including those with brain tumours and rare diseases, have access to cutting-edge clinical research and innovative, lifesaving treatments.The Government funds research through The Department of Health and Social Care funded National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), sponsored by the Department for Science, Innovation and Technology. The NIHR and the MRC are jointly funding the Rare Diseases Research Platform UK, a £14 million initiative made up of eleven research centres based at universities, which work collaboratively with industry and charities to accelerate understanding, diagnosis, and therapy of rare diseases.Additionally, Genomics England, a company owned by The Department, partners with the world’s leading pharmaceutical companies and biotechnology firms through their Discovery Forum to accelerate new treatment development.

If he will make a comparative assessment of funding allocated to (a) brain tumours and (b) other cancers in the last five years; and if he will take steps to increase funding available for brain tumours.

The Department spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer the largest area of spend at over £121.8 million in 2022/23 reflecting its high priority. The Department does not currently have plans to make a comparative assessment of funding allocated to brain and other cancers in the last five yearsThe NIHR has taken steps on opportunities for brain cancer research funding. In September 2024, the NIHR announced new research funding opportunities for brain cancer research spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients and a new funding call to generate high quality evidence in brain tumour care, support and rehabilitation.We will get the National Health Service diagnosing cancer, including brain tumours, earlier and treating it faster so more patients survive, and we will improve patients’ experience across the system. To do this, we will address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging and other tests that are needed to reduce cancer waits.

If he will make an assessment of the potential merits of increasing the amount of funding provided to community pharmacies for delivering primary healthcare services.

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.Now that the budget for Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements for 2024/25. We are unable to say more until these have been concluded.

What steps his Department is taking to increase the availability of GP appointments in West Dorset constituency.

We know that patients are finding it harder than ever to see a general practitioner (GP), we know that this applies to the constituents of West Dorset, and we are committed to fixing the crisis in GPs. West Dorset sits within the NHS Dorset Integrated Care Board, where the number of appointments delivered in August 2024 was 396,000. In August 2023, 409,000 appointments were delivered. This is a decrease of 3.2%.Our plan will require both investment and reform. Firstly, we will increase the proportion of funding for GPs, starting with a commitment to recruit over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme. This will increase the number of appointments delivered in GPs, secure the future pipeline of GPs, and take pressure off those currently working in the system.Additionally, we will deliver a modern booking system to end the 8:00am scramble for GP appointments and will bring back the family doctor by incentivising GPs to see the same patient.

What steps his Department is taking to support community pharmacies in providing primary healthcare consultations.

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.Now that the budget for Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements for 2024/25. We are unable to say more until these have been concluded.