Written questions by Stafford.

What estimate his Department has made of the number of procedures deliverable per £1 million of Departmental spend via (a) NHS internal delivery, (b) outsourcing and (c) insourcing.

The National Health Service’s national cost collection gives a national average unit cost of £751 across all planned procedures within outpatients, day cases, and elective inpatient settings in 2023/24. This is the equivalent to 1,331 procedures per £1 million. Further information on the NHS’s national cost collection is available at the following link:https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/Prices for individual procedures are set out in the NHS Payment Scheme. How the procedures are delivered is a local decision, to reflect local population need and to allow for the greatest opportunity to deliver value for money in local budgets. The Department does not hold a national estimate by procedure of care delivered through insourcing or outsourcing. However, NHS guidance for both insourcing and outsourcing makes clear the expectation that services are contracted at or below the unit prices set out in the NHS Payment Scheme.

How revenues from the sale of NHS Property Services assets are re-allocated.

Where integrated care boards (ICBs) declare NHS Property Service (NHSPS) owned assets surplus to their future clinical requirements, the NHSPS markets these properties for sale with the net proceeds, after the cost of sale, being reinvested into operational healthcare facilities. All sales follow the process set out in Managing Public Money, to maximise value for the taxpayer.All net proceeds from the sale of surplus NHSPS assets are split equally between local and national capital investment projects, with half of the proceeds being invested in local priority capital investment schemes agreed with the local ICB, and the remainder being reinvested in NHSPS owned properties, to ensure that all NHSPS properties continue to meet statutory requirements. Running cost and rental savings associated with the rationalisation of the estate and the disposal of surplus sites accrue to the National Health Service. NHSPS is a not-for-profit company wholly owned by My Rt Hon. Friend, the Secretary of State for Health and Social Care.

What progress has been made on research into a breath test to enable early detection of Pancreatic Cancer.

The PANACEA study will recruit 8,000 patients across 40 sites by September 2026 to evaluate breath test performance and is expected to complete in March 2027. This is one strand of the Office for Life Sciences’ Cancer Healthcare Goals Programme, which supports the development of technologies that enable earlier, more effective cancer diagnosis and improved treatment. The Department invests over £1.6 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR spent £133 million on cancer research in 2023/24.

With reference to the Stroke Association's report entitled Unlocking Potential: A Bold Vision for Stroke Care in England, what steps his Department is taking to (a) reduce disability and death from stroke, (b) improve access to stroke care in the community and (c) help tackle social inequalities in stroke outcomes.

The Stroke Association’s report, Unlocking Potential: A Bold Vision for Stroke Care in England, provides comprehensive plan to improve stroke care in England over the next decade highlighting several key areas for improvement, including prevention, digital innovation, and community support. These areas align with the Department's commitment to the 10-Year Health Plan’s three transformative shifts in healthcare: moving more care from hospitals into homes, prioritising prevention over treatment, and advancing from analogue to digital solutions. These strategic shifts are the building blocks to our health mission, namely reducing time spent in poor health, tackling health inequalities and reducing the lives lost from the biggest killers, which includes stroke.NHS England is prioritising implementation of the National Service Model for an Integrated Community Stroke Service (ICSS model) with delivery of specialist stroke rehabilitation at home and in care homes, as well as improving life after stroke support and six-month follow-up reviews by working closely with the voluntary sector. The ICSS model is vital to support physical, cognitive and psychological recovery, return to work and quality of life. More information on the model is available at the following link:https://www.england.nhs.uk/publication/national-service-model-for-an-integrated-community-stroke-service/The ICSS model includes provision of tailored and patient centred reablement care, through joint working between the National Health Service and social care. Provision of peer support and reviews every six months, information, and longer-term support in the community is also achieved through integrated and collaborative working with the voluntary sector.The National Stroke Quality Improvement in Rehabilitation (SQuIRe) programme is driving implementation of the integrated community stroke services model in England. NHS England funds SQuIRe posts in each NHS region to work with integrated care boards (ICBs) to improve provision of community-based stroke rehabilitation, promote recovery from stroke and improve patient outcomes. ICBs also receive a separate funding allocation to support prevention services which include stroke rehabilitation.

What steps he is taking to improve early diagnosis of pancreatic cancer.

The Government is committed to improving care pathways for all those with cancer, including pancreatic cancer. This threshold is key to improving outcomes and survival rates, including for people diagnosed with pancreatic cancer.Pancreatic cancer is difficult to diagnose due to its unspecific symptoms. The National Health Service is implementing non-specific symptom pathways for patients who present with vague and non-site-specific symptoms which do not clearly align to a tumour type. This includes symptoms of pancreatic cancer.NHS England is providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer. NHS England is additionally creating pathways to support faster referral routes for people with non-specific symptoms and is increasing direct access for general practitioners to diagnostic tests. We have submitted an expression of interest to be a part of the upcoming national case finding pilot, which aims to improve earlier diagnosis of pancreatic cancers.

What steps his Department is taking to improve cross communication between NHS organisations.

The Government is committed to harnessing technology and modernising the health system by shifting from analogue to digital, including through streamlined data sharing to improve communication across National Health Service organisations.Regulations have been introduced in Parliament to establish the process for preparing and publishing information standards which will be mandatory for public and private health and adult social care providers. Information standards allow for interoperability between systems, and for information to be shared easily between the systems in different organisations, to improve outcomes for patients.We have also announced the development of a single patient record which will give professionals in different services access to patient information they need to make the best-informed decisions when delivering care and treatment.

Whether he plans to include measures to support palliative and end of life care in the 10 Year Health Plan.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and families receive the care they need when and where they need it, including those who need palliative and end of life care.As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners, including the hospice sector.

Whether the Comprehensive Spending Review will contain measures to (a) improve and (b) reform the current funding allocations for palliative and end of life care services.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift. In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.As part of the Spring Statement, Government announced a £3.25 billion Transformation Fund to drive efficiencies across government and save money later in the Parliament, and set out how this would be allocated over the Spending Review process.The Spending Review is underway, and details will be announced on 11 June 2025.

What discussions he has had with the Chancellor of the Exchequer on the Transformation Fund announced in the Spring Statement 2025; and whether he has made an assessment of the potential merits of using some of this money for the palliative and end of life care sector.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift. In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.As part of the Spring Statement, Government announced a £3.25 billion Transformation Fund to drive efficiencies across government and save money later in the Parliament, and set out how this would be allocated over the Spending Review process.The Spending Review is underway, and details will be announced on 11 June 2025.

What discussions he has had with Cabinet colleagues on providing long term, sustainable funding for transforming palliative and end of life care services.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has regular discussions with my Rt. Hon. Friend, the Chancellor of the Exchequer and colleagues across the Cabinet on a whole host of issues across our brief, including palliative and end of life care services.However, as part of the work to develop the 10-Year Health Plan, we will be carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners.We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift.Additionally, in February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.

What steps he is taking to provide clarity on levels of funding for (a) children’s and (b) adult hospices.

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.We are, however, at a national level, also supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England to ensure they have the best physical environment for care. The Government has released the first £25 million tranche of the £100 million capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be allocated in the coming weeks for use in 2025/26.Additionally, we are providing £26 million revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. NHS England has now communicated the details of the 2025/26 funding allocation and dissemination to individual hospices.In February 2025, I met with key palliative and end of life care and hospice stakeholders, and long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

What discussions his Department has had with Integrated Care Boards and hospital trusts to prevent falls inside hospitals.

We are informed by NHS England that there have been no recent discussions or directives to hospitals or integrated care boards on the prevention of falls inside hospitals, although we are aware of wider work to support fall prevention, including NHS England’s public health initiative, Harnessing the benefits of physical activity, and the ongoing National Audit of Inpatient Falls that NHS England commissions via the Healthcare Quality Improvement Partnership. Further information on Harnessing the benefits of physical activity and the National Audit of Inpatient Falls is available, respectively, at the following two links:https://www.england.nhs.uk/ourwork/public-health/harnessing-the-benefits-of-physical-activity/https://www.rcp.ac.uk/improving-care/national-clinical-audits/falls-and-fragility-fracture-audit-programme-fffap/national-audit-of-inpatient-falls-naif/

Whether he plans to take steps with the Secretary of State for Education to promote (a) CPR training and (b) defibrillator use in schools.

There are no plans to take steps with my Rt Hon. Friend, Secretary of State for Education to promote cardiopulmonary resuscitation (CPR) training and defibrillator use in schools. The Department for Education published guidance in January 2025 on the provision and use of automated external defibrillators in schools, as well as training in CPR. This guidance is available at the following link:https://assets.publishing.service.gov.uk/media/67936b102de28ea2d392f35b/Automated_External_Defibrillators__AEDs__guidance_for_schools.pdfThe Department for Education, working with NHS Supply Chain, has negotiated an arrangement for schools to purchase defibrillators at a reduced cost. As part of its work to help people survive an out-of-hospital cardiac arrest, the British Heart Foundation is offering CPR training packs free to all secondary schools in the United Kingdom.

Whether his Department has made an assessment of the potential merits of classifying severe chronic anorexia as a disability rather than solely a mental health condition.

The Department has made no such assessment. Under the Equality Act 2010, a disability is defined as a physical or mental impairment that has a substantial and long-term adverse effect on an individual’s ability to do normal day to day activities.The Equality Act 2010’s guidance on matters to be taken into account in determining questions relating to the definition of disability, refers to a range of impairments from which a disability can arise, including eating disorders. Further information is available at the following link:https://www.gov.uk/government/publications/equality-act-guidance/disability-equality-act-2010-guidance-on-matters-to-be-taken-into-account-in-determining-questions-relating-to-the-definition-of-disability-htmlWe recognise the devastating impact an eating disorder can have on someone’s life, and that the earlier treatment is provided, the greater the chance of recovery. NHS England is continuing to expand community-based eating disorder service capacity, including crisis care and intensive home treatment. By improving care in the community, the National Health Service can improve outcomes and recovery, reduce rates of relapse, prevent eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce lengths of stay in urgent and emergency care.

What steps he is taking to decrease waiting times for (a) urgent and (b) routine cardiology appointments in Surrey and Hampshire.

Too many people have been left in limbo waiting for National Health Service appointments. The Government has committed to returning to the constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment. Performance is currently at 58.9% for cardiology services in the Surrey Heartlands Integrated Care Board (ICB), and 59.3% for cardiology services in the Hampshire and Isle of Wight ICB. As a first step, we have already delivered on our pledge of an additional two million operations, scans, and appointments across elective services, nationally, between July and November 2024, compared to the same period in 2023, seven months ahead of schedule.Cardiology has been identified as one of five national priority specialties which will undergo clinically driven pathway transformation in the Elective Reform Plan, published in January 2025. Planned reforms to cardiology care will include increasing specialist input earlier in care pathways, in turn reducing the number of unnecessary diagnostics undertaken, by developing standard pathways for common outpatient presentations, such as palpitations, and increasing timely access to cardiac diagnostic tests.In addition to national efforts, the Department and NHS England are supporting a range of local actions in the South East region to reduce the time patients spend waiting for specialist cardiology care, both for urgent and routine appointments. For example, delays for echocardiography (ECG) are a key challenge in the Hampshire and Isle of Wight ICB. Local action is focussed on improving ECG access by standardising pathways, to remove unwarranted variation for patients, and rolling out wider direct access to diagnostic tests through community diagnostic centre provision, rather than in hospitals. We are also supporting local general practices and trusts, through their ICBs, to increase volumes of Advice and Guidance for cardiology, which significantly reduces the time patients spend waiting for care.

What the total cost to the public purse was of prescribing Ozempic to NHS patients without a diagnosis of diabetes, heart disease or kidney disease in 2024-25.

Information is not collected on the clinical condition a medicine is prescribed for. Ozempic is only licenced for the treatment of type 2 diabetes and guidance is clear that medications licensed to treat type 2 diabetes should not be prescribed for weight loss. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council and Pharmaceutical Society of Northern Ireland have issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines.

What steps his Department is taking to support people on low incomes to access ADHD treatment that is not available through the NHS.

As set out in the NHS Constitution, access to services in the National Health Service is based on clinical need, not an individual’s ability to pay. It is the responsibility of integrated care boards (ICBs) in England to make available appropriate provision to meet the health and care needs of their local population, including attention deficit hyperactivity disorder (ADHD) services, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the NHS, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer.In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also conducted detailed work to understand the provider and commissioning landscape, capturing examples from ICBs who are trialling innovative ways of delivering ADHD services. NHS England is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.

Whether local authorities in Farnham and Bordon have access to a dedicated key worker for families affected by Sudden Unexplained Death in Childhood; and whether there is a formal referral process to SUDC UK for additional support.

We recognise the devastating impact of sudden unexplained death in childhood (SUDC) on affected families and communities, and the importance of raising awareness of SUDC amongst relevant professionals, communities and parents.Information on SUDC is available at the following link, which also signposts to SUDC.UK:https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sids/Additional information for parents on SUDC is available in the form of the booklet "When a Child Dies".Health visitors in particular play a key role in supporting child health, wellbeing, and parenting confidence. We are committed to strengthening health visiting services, ensuring we have the staff needed so parents and families receive appropriate care from the right professional.Overall, local authorities determine what public health services they fund, to ensure these are tailored to their local needs. The Department of Health and Social Care does not hold the health workforce data for individual local authorities or the training they receive.In schools, the Department for Education is funding mental health and wellbeing support for school and college leaders. This includes professional supervision and counselling for those who need it. Support continues to be available and can be accessed by visiting the Education Support website, which is available at the following link:https://www.educationsupport.org.uk/

Whether health professionals in Farnham and Bordon constituency are currently receiving training on Sudden Unexplained Death in Childhood.

We recognise the devastating impact of sudden unexplained death in childhood (SUDC) on affected families and communities, and the importance of raising awareness of SUDC amongst relevant professionals, communities and parents.Information on SUDC is available at the following link, which also signposts to SUDC.UK:https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sids/Additional information for parents on SUDC is available in the form of the booklet "When a Child Dies".Health visitors in particular play a key role in supporting child health, wellbeing, and parenting confidence. We are committed to strengthening health visiting services, ensuring we have the staff needed so parents and families receive appropriate care from the right professional.Overall, local authorities determine what public health services they fund, to ensure these are tailored to their local needs. The Department of Health and Social Care does not hold the health workforce data for individual local authorities or the training they receive.In schools, the Department for Education is funding mental health and wellbeing support for school and college leaders. This includes professional supervision and counselling for those who need it. Support continues to be available and can be accessed by visiting the Education Support website, which is available at the following link:https://www.educationsupport.org.uk/

What steps he plans to take to (a) raise awareness of Sudden Unexplained Death in Childhood within schools and local communities and (b) provide educational materials for parents and professionals on this subject.

We recognise the devastating impact of sudden unexplained death in childhood (SUDC) on affected families and communities, and the importance of raising awareness of SUDC amongst relevant professionals, communities and parents.Information on SUDC is available at the following link, which also signposts to SUDC.UK:https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sids/Additional information for parents on SUDC is available in the form of the booklet "When a Child Dies".Health visitors in particular play a key role in supporting child health, wellbeing, and parenting confidence. We are committed to strengthening health visiting services, ensuring we have the staff needed so parents and families receive appropriate care from the right professional.Overall, local authorities determine what public health services they fund, to ensure these are tailored to their local needs. The Department of Health and Social Care does not hold the health workforce data for individual local authorities or the training they receive.In schools, the Department for Education is funding mental health and wellbeing support for school and college leaders. This includes professional supervision and counselling for those who need it. Support continues to be available and can be accessed by visiting the Education Support website, which is available at the following link:https://www.educationsupport.org.uk/