Written questions by Stafford.

What discussions he has had with stakeholders on his Department's modelling of workforce numbers in the 10 Year Workforce Plan.

The Government will publish the 10 Year Workforce Plan in spring 2026. This plan will set out action to create a National Health Service workforce which is able to deliver the transformed service set out in the 10-Year Health Plan. It is important we do this in a robust and joined up way. We are therefore engaging extensively with partners to ensure this plan delivers for staff and patients.That engagement began well before the call for evidence was closed. In early November, ministers hosted an event with nearly one hundred representatives of partner organisations to hear views from across the health system.Engagement is now continuing while we analyse the submissions to our call for evidence, including a roundtable with medical royal colleges on 14 January, which I chaired.We have committed to publishing regular workforce planning. This will start with the 10-Year Workforce Plan, which will include updated workforce modelling and its underlying assumptions when published in spring 2026. The updated workforce modelling will be subject to independent scrutiny by our appointed external scrutiny panel.

Whether his Department plans to introduce a modern service framework for kidney disease; and what steps he is taking to support early diagnosis and prevention.

As announced in the 10-Year Health Plan, as well as an overall quality strategy, the National Quality Board is overseeing the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in quality of care and productivity.Early priorities include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia. The Government will consider other long-term conditions with significant health and economic impacts for future waves of modern service frameworks.NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease. In 2023, NHS England published a renal services transformation toolkit to support earlier identification of chronic kidney disease and strengthen management across the whole patient pathway.

Whether he has made an assessment of the potential merits of extending business rates reimbursements to community pharmacies.

In the 2025 Autumn Budget, the Government took the hard choices to protect the National Health Service in England and to continue to prioritise reducing waiting times. We have also stepped in to cap bills and help businesses, as part of a £4.3 billion support package.This year, we have also increased funding to community pharmacies to almost £3.1 billion, the largest uplift in funding for any part of the NHS across 2024/25 and 2025/26.The Department will consult Community Pharmacy England on any proposed changes to reimbursement and remuneration of pharmacy contractors for 2026/27 shortly.

What assessment they have made of the potential impact of abolishing local Healthwatch organisations on constituents’ ability to raise concerns about health and social care services.

The abolition of Healthwatch England and the transfer of its functions and the changes to Local Healthwatch will require primary legislation. The timing of this is subject to the will of Parliament and will happen when parliamentary time allows. A full Impact Assessment, including an Equality Impact Assessment, will be produced and published on the Government website when legislation is introduced in Parliament.We are proposing to place responsibility for the health function of local Healthwatch (LHW) with integrated care boards (ICBs). ICBs will ensure the functions are incorporated in provider organisations alongside existing patient engagement work such as Patient Participation Groups. Local authorities will be responsible for the social care LHW functions.

What progress his Department has made on developing independently verified, modelled projections of the numbers of NHS staff needed to meet future population demand in the 10-Year Workforce Plan.

The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. It will include modelling of the potential size and shape of the future workforce and population projections.That updated workforce modelling and its underlying assumptions will be set out in and alongside the plan, when published in spring 2026. It will be supported by external independent scrutiny.

Whether his Department has made an assessment of the potential merits of increasing the accessibility of Enhertu as a treatment for breast cancer.

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE) following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently and on the basis of the available evidence.NICE has recommended Enhertu (trastuzumab deruxtecan) in advanced breast cancer for treating HER2-positive unresectable or metastatic breast cancer after one or more anti-HER 2 treatments and for treating HER2-positive unresectable or metastatic breast cancer after two or more anti-HER2 therapies. Enhertu is now funded for eligible patients in England in line with NICE’s recommendations.NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca, and Daiichi Sankyo in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance published in July 2024 will therefore remain unchanged. Although the deadline for a rapid review has now passed, NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.

What steps her Department is taking to increase specialist capacity for complex and rare connective tissue disorders.

We recognise the significant challenges faced by those living with complex and rare connective tissue disorders such as Ehlers-Danlos Syndrome (EDS). Optimal management of these conditions is across services beginning with primary care, including various services and pathways within primary and intermediate care, which allows for appropriate identification of those patients who have the rarer and more complex manifestations and appropriate resources for them. Integrated care boards have a statutory responsibility to commission services which meet the needs of their local population, including for those with complex and rare connective tissue disorders.A primary goal of the Complex EDS Service, which is commissioned by NHS England, is to educate referring doctors about the diagnosis, investigation, and management of patients with complex and atypical forms of EDS. While the service focuses on rare types and accepts referrals from secondary and tertiary care, its development of guidelines and educational initiatives also benefits general practitioners who are on the front line of patient care.Under the UK Rare Diseases Framework, the government is working to improve coordination of care across all rare conditions including rare connective tissue disorders.

Given the existing co-location of many health services with leisure centres, what assessment his Department has made of the benefits of including these facilities in neighbourhood health schemes.

Neighbourhood health sits at the heart of the Government’s 10-Year Health Plan. Our ambition is to build a service that: delivers more personalised care closer to where people live; empowers individuals to lead healthier, more independent lives; and offers genuine choice in how to access support. Further information on the 10-Year Health Plan is available at the following link:https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-futureWe are engaging with local government sector representatives, as well as the voluntary, community, and social enterprise sector, to understand how neighbourhood health plans and centres can make best use of the full range of existing local assets, as well as create opportunities to co-locate and join up a broad range of health-impacting services. This includes those that are local authority commissioned and owned as well as those that are National Health Service commissioned and owned.We will be publishing further guidance to support local areas to develop Neighbourhood Health Plans in due course. This will set out how the NHS, local authorities, and partners should work together under the leadership of Health and Wellbeing Boards to develop and implement plans.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While the focus on personalised, coordinated care will be consistent, that will mean the service will look different in rural communities, coastal towns, and/or deprived inner cities.

What steps his Department is taking to include a) gyms, b) swimming pools, and c) leisure centres in the Men’s Health Strategy and 10 Year Plan.

Both the Men’s Health Strategy and the 10-Year Health Plan commit to cross sector action to reduce physical inactivity. Addressing physical inactivity and getting people moving more is important for improving health outcomes, reducing demand on the National Health Service, and supporting economic growth. The Government recognises the important role that gyms, swimming pools, and leisure centres play in providing affordable and accessible opportunities for people to increase their physical activity levels.

What steps his Department is taking to include a) gyms, b) swimming pools, and c) leisure centres in the neighbourhood health schemes.

Neighbourhood health sits at the heart of the Government’s 10-Year Health Plan. Our ambition is to build a service that: delivers more personalised care closer to where people live; empowers individuals to lead healthier, more independent lives; and offers genuine choice in how to access support. Further information on the 10-Year Health Plan is available at the following link:https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-futureWe are engaging with local government sector representatives, as well as the voluntary, community, and social enterprise sector, to understand how neighbourhood health plans and centres can make best use of the full range of existing local assets, as well as create opportunities to co-locate and join up a broad range of health-impacting services. This includes those that are local authority commissioned and owned as well as those that are National Health Service commissioned and owned.We will be publishing further guidance to support local areas to develop Neighbourhood Health Plans in due course. This will set out how the NHS, local authorities, and partners should work together under the leadership of Health and Wellbeing Boards to develop and implement plans.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations. While the focus on personalised, coordinated care will be consistent, that will mean the service will look different in rural communities, coastal towns, and/or deprived inner cities.

What steps her Department is taking to reduce the time taken for (a) referrals and (b) assessments for Ehlers-Danlos syndrome.

The Department recognises that Ehlers-Danlos syndromes (EDS) are complex, multi-systemic conditions that can be challenging to diagnose. While no formal assessment of average diagnosis times has been made, the Department is aware that many patients experience significant delays for a confirmed diagnosis. These delays are primarily due to low awareness among clinicians, the absence of a single diagnostic test for hypermobile EDS, and the need for multidisciplinary input.For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service. In addition to investigating and diagnosing complex and rare EDS types, the national diagnostic service supports general practitioners (GPs) and specialists in secondary and tertiary care by issuing detailed reports with management recommendations, developing guidelines and pathways of care, and offering clinician-to-clinician advice. It helps GPs by clarifying referral pathways and guiding ongoing care, while supporting hospital specialists through access to genetic testing, multidisciplinary input, and best practice guidance. This collaboration ensures accurate diagnosis, reduces unnecessary investigations, and promotes coordinated care across all levels of the health system, helping to avoid inappropriate referrals and ensuring that patients are able to access the correct specialist care efficiently.We also recognise that GPs can find it challenging to diagnose EDS because these conditions share symptoms with many other disorders. The EDS GP Toolkit, developed by the Royal College of General Practitioners in partnership with Ehlers-Danlos Support UK, helps GPs in managing EDS by improving recognition, diagnosis, and management of these multi-system disorders. The toolkit aims to reduce delays in diagnosis and helps to prevent long-term disability through appropriate early management.The Department is engaging with patient organisations to identify further opportunities to streamline referral processes and ensure equitable access to assessment and care.

What plans her Department has to improve training and clinical awareness of Ehlers–Danlos syndrome among GPs and primary care clinicians to support earlier recognition and referral.

The Department recognises that Ehlers-Danlos syndromes (EDS) are complex, multi-systemic conditions that can be challenging to diagnose. While no formal assessment of average diagnosis times has been made, the Department is aware that many patients experience significant delays for a confirmed diagnosis. These delays are primarily due to low awareness among clinicians, the absence of a single diagnostic test for hypermobile EDS, and the need for multidisciplinary input.For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service. In addition to investigating and diagnosing complex and rare EDS types, the national diagnostic service supports general practitioners (GPs) and specialists in secondary and tertiary care by issuing detailed reports with management recommendations, developing guidelines and pathways of care, and offering clinician-to-clinician advice. It helps GPs by clarifying referral pathways and guiding ongoing care, while supporting hospital specialists through access to genetic testing, multidisciplinary input, and best practice guidance. This collaboration ensures accurate diagnosis, reduces unnecessary investigations, and promotes coordinated care across all levels of the health system, helping to avoid inappropriate referrals and ensuring that patients are able to access the correct specialist care efficiently.We also recognise that GPs can find it challenging to diagnose EDS because these conditions share symptoms with many other disorders. The EDS GP Toolkit, developed by the Royal College of General Practitioners in partnership with Ehlers-Danlos Support UK, helps GPs in managing EDS by improving recognition, diagnosis, and management of these multi-system disorders. The toolkit aims to reduce delays in diagnosis and helps to prevent long-term disability through appropriate early management.The Department is engaging with patient organisations to identify further opportunities to streamline referral processes and ensure equitable access to assessment and care.

What recent assessment she has made of the adequacy of NHS waiting times for the diagnosis of Ehlers–Danlos syndrome.

The Department recognises that Ehlers-Danlos syndromes (EDS) are complex, multi-systemic conditions that can be challenging to diagnose. While no formal assessment of average diagnosis times has been made, the Department is aware that many patients experience significant delays for a confirmed diagnosis. These delays are primarily due to low awareness among clinicians, the absence of a single diagnostic test for hypermobile EDS, and the need for multidisciplinary input.For rarer genetically confirmed types of EDS, NHS England commissions a national diagnostic service. In addition to investigating and diagnosing complex and rare EDS types, the national diagnostic service supports general practitioners (GPs) and specialists in secondary and tertiary care by issuing detailed reports with management recommendations, developing guidelines and pathways of care, and offering clinician-to-clinician advice. It helps GPs by clarifying referral pathways and guiding ongoing care, while supporting hospital specialists through access to genetic testing, multidisciplinary input, and best practice guidance. This collaboration ensures accurate diagnosis, reduces unnecessary investigations, and promotes coordinated care across all levels of the health system, helping to avoid inappropriate referrals and ensuring that patients are able to access the correct specialist care efficiently.We also recognise that GPs can find it challenging to diagnose EDS because these conditions share symptoms with many other disorders. The EDS GP Toolkit, developed by the Royal College of General Practitioners in partnership with Ehlers-Danlos Support UK, helps GPs in managing EDS by improving recognition, diagnosis, and management of these multi-system disorders. The toolkit aims to reduce delays in diagnosis and helps to prevent long-term disability through appropriate early management.The Department is engaging with patient organisations to identify further opportunities to streamline referral processes and ensure equitable access to assessment and care.

How many NHS trusts in England provide specialist clinics for Ehlers–Danlos syndrome.

Integrated care boards (ICBs) have a statutory responsibility to commission services which meet the needs of their local population, including for those with Ehlers-Danlos syndrome (EDS). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop services and care pathways that meet patients’ needs.More widely, through the 10-Year Health Plan, we are introducing Neighbourhood Health Centres, and deploying multidisciplinary teams to provide holistic support to people with EDS. Patients will benefit from enhanced NHS App functionality, including the My Medicines and My Health sections, and will be able to self-refer to specialist services where appropriate.Additionally, the 10-Year Health Plan’s commitments on artificial intelligence will give clinicians advanced tools for faster diagnosis, predictive analytics, and personalised care planning. For people with long-term conditions like EDS, this means earlier interventions, better monitoring of complex needs, and more time for clinicians to focus on patient-centred care rather than administrative tasks. The plan also commits to 95% of people with complex needs having a personalised care plan by 2027.

What steps his Department is taking to ensure continuity and improvement of national cancer awareness campaigns following the abolition of NHS England, including plans to raise awareness of the symptoms of gynaecological cancers and support earlier diagnosis of ovarian cancer.

Early diagnosis of cancer remains a key priority for the Government. The Government will continue to work to ensure that the public is aware of cancer symptoms, especially for cancers such as ovarian cancer, which are harder to detect in the early stages.We will work to ensure a smooth transition during the merger of NHS England and the Department, so that the public continues to have access to high-quality cancer care.

What discussions the Government has had with representatives of the United States on the pricing of medicines for the NHS in the last six months.

The pharmaceutical sector and the innovative medicines it produces are critical to our national interest, helping people to access life changing treatments, reducing pressure on the health service over the longer-term, and ensuring we have a National Health Service that is fit for the future.Thanks to the strength of our relationship with the United States, we have secured the first and only deal with them that delivers 0% tariffs on pharmaceutical products, the lowest rate offered to any country. This deal secures the United Kingdom’s access to and supply of medicines for tens of thousands of patients while safeguarding our supply chain and ensuring groundbreaking new treatments will reach the NHS front line quicker. It also delivers mitigations on the US’ ‘Most Favoured Nation’ policy and preferential terms for UK MedTech exports, helping expand access innovative treatments for patients and driving crucial investment in the UK.

What assessment his Department has made of the current strategic approach to ME/CFS research; and whether his Department plans to develop a coordinated national research strategy for the condition.

We have outlined our strategy to support myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), research in the ME/CFS Final Delivery Plan published in July. These steps include a research showcase event, a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical interventions, and the announcement of new funded studies in health and care services, and research infrastructure and capacity-building.We are determined to accelerate progress in the treatment and management of ME/CFS and will continue working with the ME/CFS community to identify and address barriers to research, with the ambition of supporting more research and capacity-building programmes.The Department funds research 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 ME/CFS. Research funding is available, and applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

What assessment his Department has made of the adequacy of the availability of ADHD medication.

The Department has made substantial progress in improving the availability of medicines for attention deficit hyperactivity disorder (ADHD), working closely with industry and key stakeholders to resolve previous supply challenges. Through intensive work with industry, NHS England and the Medicines and Healthcare products Regulatory Agency have resolved most of the previous shortages. All strengths of lisdexamfetamine, atomoxetine, both the capsules and the oral solution, guanfacine prolonged-release tablets, and methylphenidate prolonged-release tablets are now available.There is a current supply issue with methylphenidate 30 milligram prolonged-release capsules, brand name Equasym XL, which is out of stock until late December. The Department has issued guidance to healthcare professionals with advice on how to manage patients until this shortage resolves.We continue to work closely with suppliers to resolve the few remaining challenges and to strengthen resilience in the supply chain. This includes securing additional stocks, expediting deliveries, and expanding the United Kingdom supplier base to support future demand. In collaboration with NHS England’s ADHD taskforce and national data improvement plan, we are developing growth forecasts to improve demand planning and ensure a sustainable supply of ADHD medicines.To support prescribers and dispensers, the Department maintains and regularly updates a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, at the following link:www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd

What steps he is taking to help reduce waiting times for ADHD medication.

It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder (ADHD) assessment and treatment, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England established an ADHD taskforce which brought together those with lived experience with experts from the National Health Service, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing timely and equitable access to services and support. We are pleased that the taskforce's final report was published in November 2025, and we are carefully considering its recommendations.For the first time, NHS England published management information on ADHD waits at a national level on 29 May 2025 as part of its ADHD data improvement plan; it will soon release technical guidance to ICBs to improve recording of ADHD data, with a view to improving the quality of ADHD waits data. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.My rt. Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. This independent review will inform our approach to enabling people with ADHD and autistic people to have the right support to enable them to live well in their communities.

What assessment his Department has made of the potential impact of the early flu season on corridor care, hospital capacity and patient outcomes.

We continue to monitor the impact of flu and the performance of hospitals over the winter months.The Department is continuing to take key steps to ensure the health service is prepared for the colder months. This includes taking actions to try and reduce demand pressure on accident and emergency, increasing vaccination rates, and offering health checks to the most vulnerable, as well as stress-testing integrated care boards and trust winter plans to ensure that they are able to meet demand and ensure patient flow.Flu is a recurring pressure that the National Health Service faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.