Written questions by Mierlo.

What comparative assessment he has made of levels of young people dying from sudden cardiac death in (a) England and (b) other European countries; and what steps he plans to take to reduce levels of sudden cardiac death in young people.

The treatment and prevention of cardiovascular disease is a priority for the Government. We want people to have the best chance of survival from cardiac arrest, and rapid intervention is central to improving outcomes. NHS England has published a national service specification for inherited cardiac conditions that covers patients who often present as young adults with a previously undiagnosed cardiac disease or from families requiring a follow up due to a death from this cause.  Further information on the national service specification for inherited cardiac conditions is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2017/11/cardiology-inherited-cardiac-conditions.pdfThe service specification describes the service model and guidance that should be followed to support the diagnosis and treatment of patients or family members. It also includes the requirement for specialised inherited cardiac conditions services to investigate suspected cases. NHS England is currently reviewing this service specification in line with the national service specification methods review process. NHS England is working with a broad range of stakeholders as part of this review, including National Health Service clinical experts, the Association of Inherited Cardiac Conditions, Cardiomyopathy UK, Heart Valve Voice, and the British Heart Foundation.The consensus at present is to focus on the rapid identification and care of people who are likely to be at risk of sudden cardiac death and automated external defibrillator use for people who suffer a cardiac arrest.

If he will have discussions with (a) Duchenne UK and (b) other patient advocacy groups on steps to increase access to the givinostat early access programme.

The Department has not had any discussions with ITF Pharma UK about the resources or guidance available to National Health Service trusts participating in the early access programme (EAP) for givinostat.Department officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicine schemes, such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/Under the EAP, givinostat is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the cost of administering it to patients. While there are no current plans to hold discussions with Duchenne UK on steps to increase access, ministers in the Department are keen to engage with a broad range of stakeholders. Participation in the programme is decided at an individual NHS trust level.

Whether he has had discussions with (a) NHS England and (b) ITF Pharma UK on the (i) resources and (ii) guidance available to NHS Trusts that participate in the early access programme for givinostat.

The Department has not had any discussions with ITF Pharma UK about the resources or guidance available to National Health Service trusts participating in the early access programme (EAP) for givinostat.Department officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicine schemes, such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/Under the EAP, givinostat is free to both patients taking part in it, and to the NHS, but NHS trusts must still cover the cost of administering it to patients. While there are no current plans to hold discussions with Duchenne UK on steps to increase access, ministers in the Department are keen to engage with a broad range of stakeholders. Participation in the programme is decided at an individual NHS trust level.

What steps his Department is taking to ensure all eligible NHS Trusts participate in the Early Access Programme for givinostat.

Under the Early Access Programme (EAP), givinostat is free to both patients taking part in it, and to the National Health Service, but NHS trusts must still cover the cost of administering it to patients. The Department and NHS England do not have any initiatives to encourage participation in compassionate use schemes such as the EAP for givinostat and participation is decided at an individual NHS trust level.NHS England has published guidance for integrated care systems (ICSs) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What recent assessment he has made of the adequacy of the provision of ambulance services by South Central Ambulance Service in Henley and Thame constituency.

No specific assessment has been made for the Henley and Thame area, however we recognise that ambulance response times have been below the high standards that patients should expect in recent years. The latest National Health Service data for January shows that ambulance response times performance for the South Central Ambulance NHS Trust, which provides services to the Henley and Thame, are not meeting the NHS Constitution standards.The Government is committed to returning the NHS to these standards. The NHS 2025/26 priorities and operational planning guidance included improving ambulance response times as one of four national priorities to improve patient outcomes. An urgent and emergency care improvement plan to further support improvements in services will be published shortly.

Whether he plans to retain the 66.7% national dementia diagnosis rate target for the 2025-26 financial year.

The Government and NHS England remain committed to recovering the dementia diagnosis rate to the national ambition of 66.7% The new approach to planning guidance will improve the operating model, giving local leaders the freedom and autonomy they need to provide the best services to their local community, including for those with dementia. Planning guidance is not a catalogue of everything the National Health Service does, and the absence of a target does not mean it has been deprioritised. Lord Darzi’s independent review showed that a timely diagnosis is vital to ensure that a person with dementia can access the advice, information, care and support that can help them to live well and remain independent for as long as possible. The review also highlighted that there were too many targets set for the NHS which made it hard for local systems to prioritise their actions or be held properly accountable.We are therefore reducing the number of national priorities from 32 last year to 18 this year. This will allow local NHS leaders to make the best choices to meet the needs of their local population.

If he will take steps to (a) increase diagnostic capacity at memory clinics, (b) prepare primary care, (c) increase numbers of specialists capable of prescribing new medicines, (d) adopt new diagnostic technology including blood biomarkers, (e) ensure adequate CT scanning capacity and (f) raise awareness among patients of new medications for Alzheimer's Disease.

The Government is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding Community Diagnostic Centres (CDCs), and better use of technology. With 170 CDCs due to be up and running by the end of March 2025, CDCs can take on more of the growing diagnostic demand within elective care. We will also deliver additional CDC capacity in 2025/26 by expanding a number of existing CDCs and building up to five new ones.Alongside Alzheimer’s Research UK, the Alzheimer’s Society, Gates Ventures, and the People’s Postcode Lottery, the National Institute for Health Research is funding the Blood Biomarker Challenge, which seeks to produce the clinical and economic data that could make the case for the use of a blood test in the NHS to support the diagnosis of dementia.New disease modifying drugs for Alzheimer’s disease are in development. NHS England is working closely with system partners to ensure that arrangements are in place to support the adoption of any new licensed and National Institute for Health and Care Excellence-recommended treatments as soon as possible.

Pursuant to the Answer of 22 January 2025 to Question 24596 on Caesarean Sections, what steps he is taking with NHS England to ensure that women are not unnecessarily discouraged from having elective caesarean sections.

NHS England’s three-year delivery plan for maternity and neonatal services recognises the importance of listening to women and families. It aims to ensure that women have clear choices, supported by unbiased information and evidence-based guidelines, and that all women are offered personalised care and support plans.Personalised care and support plans take account of physical health, mental health, social complexities, and choices. Personalised care includes open, honest, and ongoing dialogue between a woman, her midwife, and other clinicians, to understand the care she wants.If a woman would prefer a caesarean for non-medical reasons, they can ask their midwife or doctor, who will explain the overall benefits and risks of a caesarean to the woman and their baby compared with a vaginal birth. If, after discussing all the risks and hearing about all the support on offer, a woman feels that a vaginal birth is not an acceptable option, they should be offered a planned caesarean.

What assessment he has made of adequacy of the diagnostic capacity of memory clinics in Oxfordshire.

Cutting waiting lists, including for diagnostic tests, is a key priority for the Government. We are committed to transforming diagnostic services, and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding Community Diagnostic Centres (CDCs), and better use of technology.With 170 CDCs due to be up and running by the end of March 2025, CDCs can take on more of the growing diagnostic demand within elective care. We will also deliver additional CDC capacity in 2025/26 by expanding a number of existing CDCs and building up to five new ones.In Oxfordshire, we are currently working with the local population, including patients, carers, Age UK, and clinicians in primary care, mental health services, and acute hospital services, to develop a new strategy, Living Well with Dementia, to be implemented from April 2025. Within this work we are seeking to increase the rate of diagnosis by streamlining the referral processes into diagnostic and memory clinics, as well as the alignment with the other services that might be needed.

If he will make an assessment of the potential merits of expediting a NICE appraisal for Givinostat.

The National Institute for Health and Care Excellence (NICE) works with companies on timelines for its evaluations of new medicines, and aims, wherever possible, to issue guidance close to the point of licensing to support rapid access for National Health Service patients to clinically and cost-effective medicines. The NICE’s timeline for its evaluation of givinostat was rescheduled at the request of the company, to facilitate a suitably comprehensive and robust submission. The NICE’s Appraisal Committee is due to meet to consider its recommendations on givinostat in May 2025.

What steps the Government if taking to reach an agreement to end collective action by GPs.

The Government has accepted and implemented the independent pay review body recommendation of a 6% uplift in general practitioner (GP) pay, and has committed to hiring an extra 1,000 GPs.We have announced a proposed £889 million uplift for GPs in 2025/26 and set out the proposed areas of reform. This is the largest uplift to GP funding since the beginning of the five-year framework and means that we are reversing the recent trend with a rising share of total National Health Service resources going to GPs.The Department and NHS England started consultation with the General Practitioners Committee in England, of the British Medical Association, on the 2025/26 GP Contract on 19 December 2024, and will consider all proposed policy changes. An announcement will be made before April 2025.

If he will have discussions with (a) Eisai Co., Ltd and Biogen Inc. and (b) Eli Lilly and Company on the production of disease-modifying treatments for Alzheimer's disease in the UK.

The Government deeply values its relationships with life science companies and is committed to getting treatments to National Health Service patients through our 10 Year Plan for the NHS. This will include a plan for procurement, giving a clearer route to getting products into the NHS, coupled with reformed incentive structures to drive innovation and faster regulatory approval for new technology and medicines. The Government engages regularly with companies on the production of disease-modifying treatments for Alzheimer's disease in the United Kingdom, such as those developed by Eisai, Biogen, and Eli Lilly, and where appropriate, ministers may be involved in this engagement.

When he plans to respond to the letter of 6 November 2024 from the Hon. Member for Henley and Thame on a constituent's concern over confectionary VAT added to his product designed to be a healthier option.

We have received the Hon. Member’s correspondence of 6 November 2024, and responded on 23 January 2025, with the reference PO-1545237.

What criteria he plans to use to evaluate the respiratory syncytial virus immunisation method to protect infants in the June 2025 review.

The respiratory syncytial virus (RSV) antenatal maternal vaccination programme for infant protection began in England on 1 September 2024. The first uptake data will be published on 30 January 2025.The UK Health Security Agency (UKHSA) undertakes evaluations of national immunisation programmes, and will be evaluating the impact and effectiveness of the RSV maternal vaccination programme for infant protection once sufficient data is available. Immunisation programme effectiveness against hospital admissions is typically assessed using the test-negative case-control method.To raise awareness of the potential vaccination benefits and increase awareness of the programmes amongst health professionals, parents, carers, and the wider public, the UKHSA provides a comprehensive suite of public facing resources and assets. This includes information leaflets in multiple languages and accessible formats, like easy read, British Sign Language, and braille. The UKHSA also provides comprehensive clinical guidance, including e-learning programmes and training for healthcare professionals.

What the uptake rate was of the RSV vaccine by pregnant people in each of the last three years; and if he will make an assessment of the potential implications for his policies of trends in the uptake rate of the RSV vaccine by pregnant people in that time.

The respiratory syncytial virus (RSV) antenatal maternal vaccination programme for infant protection began in England on 1 September 2024. The first uptake data will be published on 30 January 2025.The UK Health Security Agency (UKHSA) undertakes evaluations of national immunisation programmes, and will be evaluating the impact and effectiveness of the RSV maternal vaccination programme for infant protection once sufficient data is available. Immunisation programme effectiveness against hospital admissions is typically assessed using the test-negative case-control method.To raise awareness of the potential vaccination benefits and increase awareness of the programmes amongst health professionals, parents, carers, and the wider public, the UKHSA provides a comprehensive suite of public facing resources and assets. This includes information leaflets in multiple languages and accessible formats, like easy read, British Sign Language, and braille. The UKHSA also provides comprehensive clinical guidance, including e-learning programmes and training for healthcare professionals.

What steps he is taking to help increase the uptake rate of the RSV vaccine during pregnancy.

The maternal respiratory syncytial virus (RSV) vaccination programme launched on 1 September 2024, and is being delivered by general practices and commissioned maternity services. NHS England has been working with systems, stakeholders, and partners to increase awareness and uptake of the RSV vaccine amongst pregnant women.A system letter setting out the role of providers in advising pregnant women of their eligibility for vaccination was sent from the Chief Midwifery Officer for England, the National Clinical Director for Maternity, and the Chief Delivery Officer and National Director for Vaccination and Screening in August 2024.NHS England has held webinars for health professionals on vaccination in pregnancy and with the midwifery and nursing teams delivering the RSV vaccine, to provide information on eligibility, outreach, and how to administer the vaccine before the programme started. Resources and information have been shared with maternity leads since the programme began, to increase awareness of the vaccine and ensure more women are booking their vaccination for when they become eligible at 28 weeks. Commissioned maternity services are also encouraged to have vaccination discussions with pregnant women early in pregnancy.A range of communication materials have been produced by NHS England and the UK Health Security Agency, who are working with stakeholders, including parenting clubs, to disseminate information on vaccination in pregnancy through their channels.RSV vaccination event data from all commissioned providers is made available to NHS England regional commissioning teams and their partner integrated care boards in a timely way. NHS operational vaccination data is being monitored closely at a local and national level, and is being used to drive further development of the programme.

Pursuant to the Answer of 24 October to Question 9576 on Methylphenidate: Shortages, if he will make an assessment of the adequacy of the supply of methylphenidate for ADHD since October 2024.

The Department continues to work hard with industry and NHS England to help resolve the supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved. All strengths of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution, and guanfacine prolonged-release tablets are now available.However, whilst the supply of methylphenidate prolonged-release tablets has improved since October 2024, issues persist. We are continuing to work to resolve these remaining issues by engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. The Department is also working with new suppliers of methylphenidate prolonged-release tablets to improve supply and resiliency for the UK market.We are supporting an ADHD taskforce that NHS England has established to examine ADHD service provision. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to help provide a joined-up approach in response to concerns around rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.

If he will make an assessment of the adequacy of access to (a) ultrasound and (b) other scans during pregnancy in Henley and Thame constituency.

Antenatal care can start as soon as a woman knows she is pregnant. This can be done by contacting a midwife or general practitioner, or by referring herself direct to a maternity service. There will be two ultrasound scans at 11 to 14 weeks and at 18 to 21 weeks, followed by any further scans recommended by the relevant healthcare professionals.Further details can be found on the NHS.UK website, at the following link:https://www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-appointments/The Government is continuing to work with NHS England as it delivers its three-year maternity and neonatal plan to ensure that women receive timely care.

What steps he is taking to ensure that pregnant women are informed of their rights to an elective C-section.

NHS England’s three-year delivery plan for maternity and neonatal services recognises the importance of listening to women and families. It aims to ensure that women have clear choices, supported by unbiased information and evidence-based guidelines, and that all women are offered personalised care and support plans.Personalised care and support plans take account of their physical health, mental health, social complexities, and choices. Personalised care includes an open and honest ongoing dialogue between a woman, her midwife, and other clinicians, to understand the care that is wanted.NHS England’s website includes information about asking for a caesarean.

If he will make an assessment of the adequacy of (a) the funding provided through and (b) other aspects of general practitioner core contracts.

We have announced a proposed £889 million uplift for general practices (GPs) in 2025/26, and set out the proposed areas of contract reform which will help us to deliver on our commitments. This is the largest uplift to GP funding in years, reversing the recent trend, with a rising share of total National Health Service resources going to GPs.GPs receive funding through a range of income streams in return for providing services specified in the GP Contract. Global sum, which is the funding allocated for providing core services, makes up 50 to 60% of practice income. The global sum allocation formula, also known as the Carr-Hill formula, is designed to ensure that resources are directed to practices based on an estimate of their patient workload and unavoidable practice costs.  The rest of the income is made of the Quality and Outcomes Framework, premises payments, directed enhanced services, and additional services, for instance vaccine and immunisation services.Practices are able to provide additional services by opting in, and will receive payment for these services separately to global sum payments. As commissioners of primary care, integrated care boards are responsible for commissioning additional services locally, which are not agreed nationally and can vary in scope and funding to fit local needs.