Written questions by Morello.

What the average per-patient spend is per hospital (a) in England and (b) within the top quarter of most efficient hospitals.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

What estimate he has made of the potential financial impact of aligning funding to the average per-patient spend of the top quarter most efficient hospitals on rural hospitals.

The basis of the funding allocated to providers is set out in the National Payment Scheme, with further information available at the following link:https://www.england.nhs.uk/pay-syst/nhs-payment-scheme/This includes setting out the prices paid where funding varies with activity, and these prices are the same for all providers. They are based on average costs across National Health Service providers rather than top quarter performance. We have not directly assessed the impact of changing the payment scheme to set prices based on the top quarter of the most efficient providers. However, NHS England sends packs to all NHS providers quantifying productivity and efficiency opportunities based on metrics in the Model Health System dataset. This allows individual providers, including those in rural areas, to benchmark themselves against others, and measure the financial impact of improving performance.

What the difference is between per-patient spend in (a) each hospital, (b) the average per-patient spend of hospitals in the top quarter of efficiency and (c) the average per-patient spend of hospitals in the bottom quarter of efficiency.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

What comparative assessment he has made of the efficiency (a) rural and (b) urban hospitals; and how many hospitals in each of those categories are within the top quarter most efficient hospitals.

As part of the 2025/26 planning process, all National Health Service organisations were required to set efficiency and savings targets necessary to achieve a balanced financial position. These targets are publicly available in hospital board reports. The Department and NHS England do not assess hospital performance based solely on efficiency. Instead, the NHS Oversight Framework (NOF) measures NHS trust and foundation trust performance across a range of metrics. These reflect the delivery of NHS priorities, including performance against targets like reducing wait times for electives and accident and emergency, and improving ambulance response times.The NOF assigns trusts to four equal-sized performance categories called ‘segments’. NHS England has also recently published newly developed league tables to bring greater transparency to NHS performance at a provider level.

How and what proportion of major trauma hospitals operate 24-hour hospital helipads in England.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

Whether he will make an assessment of the potential merits of introducing legislative safeguards to protect existing hospital helipads from closure.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

What steps he is taking to help ensure that existing hospital helipads are protected from (a) planning and (b) operational restrictions.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

If he will make it his policy that all major trauma hospitals to have access to 24-hour helipad facilities.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

What the average per-patient spend is in (a) all hospitals and (b) the top quartile of efficient hospitals.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

Which hospitals are in the top quartile of most efficient hospitals.

The Department and NHS England do not measure efficiency by hospital. Instead, the NHS Oversight Framework measures National Health Service trust and foundation trust performance across a range of metrics. These reflect the delivery of NHS priorities, including performance against targets like reducing wait times for electives and accident and emergency, and improving ambulance response times.The framework assigns trusts to four equal-sized, or quartiled, performance categories referred to as segments. This year’s framework, however, emphasises the importance of maintaining financial control by limiting providers to no higher than segment 3 if they are not delivering a surplus or breakeven position.Segmentation under this year’s framework has now been published as part of newly developed league tables, designed to increase transparency and drive improvement. These tables are available at the following link:https://www.england.nhs.uk/publication/nhs-oversight-framework-nhs-trust-performance-league-tables-process-and-results/

Whether his Department has made an estimate of the potential impact of his proposed reforms to the Physician Associate role on the number of redundancies of Physician Associates.

The principle question of the Leng Review was to assess whether the roles of physician and anaesthesia associate, which we recommend should now be known as physician assistants and physician assistants in anaesthesia, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams. NHS England has written to National Health Service trusts, integrated care boards, and primary care networks reiterating their responsibilities to their staff as employers, including providing pastoral support where required. Importantly, it has also written directly to the staff most affected by the recommendations setting out where they can find support if required. Whilst decisions about recruitment are a matter for individual NHS employers at a local level, physician assistants, and physician assistants in anaesthesia, can play a vital role in the delivery of the shifts set out in the 10-Year Health Plan for England. Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.

What steps he plans to take to implement the recommendations of the Independent review of the physician associate and anaesthesia associate roles, published on 16 July 2025.

The Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. The Department, alongside NHS England, royal colleges, and other stakeholders including representatives of doctors, physician assistants, and physician assistants in anaesthesia, will develop a detailed implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course. The Government intends to commence consultation on a modernised legislative framework for the General Medical Council by the end of this year. These proposals will include the change in role titles. Subject to parliamentary time, our expectation is that these changes will be put before the Westminster and Scottish Parliaments during 2026.

Whether his Department plans to consult with stakeholders before implementing changes to the (a) role and (b) title of Physician Associates.

The Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. The Department, alongside NHS England, royal colleges, and other stakeholders including representatives of doctors, physician assistants, and physician assistants in anaesthesia, will develop a detailed implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course. The Government intends to commence consultation on a modernised legislative framework for the General Medical Council by the end of this year. These proposals will include the change in role titles. Subject to parliamentary time, our expectation is that these changes will be put before the Westminster and Scottish Parliaments during 2026.

Whether research has been (a) commissioned and (b) supported by his Department on the potential impact of exposure to Debendox during pregnancy.

The Department, through the National Institute for Health and Care Research, is not currently funding research into the potential impact of exposure to Debendox during pregnancy.

What assessment his Department has made of the potential impact of the introduction of car parking charges on (a) access to outdoor walking spaces and (b) public health.

Car parking charges for publicly-owned car parks are primarily a matter for local authorities. Local actions can encourage sustainable travel choices and reduce car dependency, potentially enhancing air quality and promoting active lifestyles, and local authorities are responsible for assessing the impacts of their policies.The Government recognises the importance of providing access to the outdoors for people’s health and wellbeing, and has committed to creating nine new national river walks and three new national forests in England, expanding access to the great outdoors.

What steps his Department is taking to improve early diagnosis and treatment options for people with secondary breast cancer in rural areas such as West Dorset.

Improving early diagnosis, access to treatments, and support across England are key priorities for the Government for all cancer types, including for those living with secondary breast cancer in West Dorset and rural constituencies.To ensure that people diagnosed with secondary breast cancer have timely access to new and innovative treatments, NHS England commissioned a National Audit of Metastatic Breast Cancer, which provides timely evidence for cancer service providers of where patterns of care in England may vary. The purpose of the audit was to identify information to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The National Health Service is now acting on those findings, including for patients in West Dorset.NHS England is responsible for funding allocations to integrated care boards (ICBs), including those in Dorset and rural constituencies. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. ICB’s are responsible for commissioning healthcare which best meets the needs of their local populations, including treatment and support for secondary breast cancer.To improve early diagnosis rates all over the country, including in West Dorset and rural areas, the Department and NHS England are improving public awareness of cancer signs and symptoms, streamlining referral routes, and increasing the availability of diagnostic capacity through the roll-out of more community diagnostic centres. The Department is also committed to improving waiting times for cancer treatment, so that people with cancer, including secondary breast cancer, can get access to the care they need more quickly. The NHS is now delivering an extra 40,000 operations, scans, and appointments each week, as the first step to ensuring early diagnosis and faster treatment.

Whether his Department has made an assessment of the potential impact of helipad accessibility on patient outcomes in air ambulance transfers.

No such discussions have been held. Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country.

If he will make an assessment of the potential merits of bringing forward legislative proposals to protect the use of the title Child Psychotherapist.

Titles can only be protected for statutorily regulated professions. The title of ’child psychotherapist’ is not currently protected in law in the United Kingdom and the Government has no plans to regulate child psychotherapists. No discussions have taken place with charities on protecting the title of ‘child psychotherapist’.

Whether he has had discussions with charities on the potential merits of protecting the title Child Psychotherapist.

Titles can only be protected for statutorily regulated professions. The title of ’child psychotherapist’ is not currently protected in law in the United Kingdom and the Government has no plans to regulate child psychotherapists. No discussions have taken place with charities on protecting the title of ‘child psychotherapist’.

What recent discussions he has had with NHS Trusts on improving access to helipads for emergency air ambulance services.

No such discussions have been held. Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country.