Written questions by Grant.

Which recommendations of the Government’s British Sign Language Advisory Board he will implement to ensure the NHS is accessible to deaf and blind people.

Under the Equality Act 2010, health and care organisations have a legal duty to make changes in their approach and provision to ensure that services are as accessible to disabled people as they are for everybody else.All National Health Service organisations and publicly funded social care providers are expected to meet the Accessible Information Standard, which details the recommended approach to supporting the information and communication support needs of people with a disability, impairment or sensory loss, including Deaf and blind people.We welcome the British Sign Language Advisory Board’s report, Locked out: Exclusion of deaf and deafblind BSL users from health and social care in the UK. We will carefully consider its recommendations, including how, in the context of our work on the 10-Year Health Plan and reform of adult social care, we can improve the experiences of Deaf and blind people when accessing health and care services.

What steps his Department is taking to (a) support the development of treatments for Huntington's disease and (b) improve the ability of the NHS to deliver new gene therapies for people living with rare diseases.

We recognise the significant challenges faced by those living with rare diseases such as Huntington’s Disease. The Department supports research into Huntington’s disease through the National Institute for Health and Care Research (NIHR). NIHR infrastructure supports pioneering research into Huntington's, including the positive preliminary results for a novel gene therapy reported this year. NHS England will assess the service delivery impact of any specific gene therapy for Huntingdon's disease within three years of its expected licensing decision by the Medicines and Healthcare products Regulatory Agency. The National Institute for Health and Care Excellence (NICE) will make recommendations for the National Health Service on new medicines based on clinical and cost effectiveness. NHS England is required to fund medicines recommended by NICE, within three months of the publication of final guidance. The NHS has a dedicated team to support the adoption of advanced therapy medicinal products (ATMPs) that are recommended by NICE. NHS England works with a variety of internal and external stakeholders to ensure timely patient access to ATMPs that are on NICE’s technology appraisal and highly specialised technology workplan.

What steps he is taking to ensure that additional NHS funding leads to pay rises for (a) nurses and (b) other frontline staff.

The Department has remitted the independent pay review bodies (PRBs) to begin their work on pay recommendations for 2026/27 for nurses and other frontline National Health Service staff. The Government will carefully consider the PRB recommendations, which is the usual process to determine pay uplifts for NHS workers. As part of this process, the PRBs consider the evidence submitted, including a range of factors such as the economic context and the available funding.We hugely appreciate the work of the many talented staff across the NHS, which is why on 22 May 2025, we accepted the headline pay recommendations for 2025/26 made by the PRBs giving them a much deserved, above-inflation, pay rise.

What steps he is taking to improve care for people with Huntington's disease.

The revised NHS England Specialised Neurology Services (adults) Specification 2025 outlines a comprehensive model of care, detailing the requirements for specialised neurology services but also outlining the expectations of a system wide approach. It articulates how patients should move into and out of specialised neurology services, including patients with Huntington’s disease, incorporating end to end pathways within an Integrated Neurology System. The NHSE Specialised Commissioning Neurology Transformation Team (NTP) have also produced a number of guidance documents to support the implementation of the revised service specification. This includes developing a neurology transformation toolkit, which outlines the impact of care coordination and case management functions in supporting more equitable and efficient care for people with long-term neurological diseases, including Huntington’s disease.

What steps he is taking to protect patients with cystic fibrosis in the context of a shortage of Creon gastro-resistant capsules.

The Department is in regular discussions with the supplier of Creon on the latest stock availability and the actions that are being taken to mitigate the supply issue that is affecting the whole of the United Kingdom. Through these discussions we have managed to secure additional volumes of Creon for 2025 for the UK. We are continuing to work with all suppliers of pancreatic enzyme replacement therapy (PERT) to understand what more can be done to add further resilience to the market. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.In the longer term, the Department has had interest from non-UK suppliers of PERT wishing to bring their products to the UK and, along with colleagues in the Medicine and Healthcare products Regulatory Agency (MHRA), we are working with these potential suppliers, and if authorised, these products could further diversify and strengthen the market.The Department has issued management advice to healthcare professionals which directs clinicians to unlicensed imports when licensed stock is unavailable, and which includes actions for integrated care boards to put in place local mitigation plans to ensure that patients are not left without PERT. The Department, in collaboration with NHS England, has created a public facing page to include the latest update on PERT availability and easily accessible prescribing advice for clinicians.

What steps he is taking to improve the accessibility of face-to-face GP appointments (a) in general and (b) for people less digitally literate.

General practitioners (GPs) must provide face to face appointments alongside remote consultations. Online services must always be provided in addition to, rather than as a replacement for, in-person consultations.The GP contract also makes clear that patients have a right to request a face-to-face appointment and practices must make every effort to meet their preference, unless there are good clinical reasons to the contrary.We know that some patients can struggle to access digital services. To help address this, digital tools used in primary care settings must meet required minimum standards of functionality set by NHS England, ensuring a consistent quality of service for patients. All organisations providing services in the National Health Service, including primary care providers, must follow the Accessible Information Standard.

What steps his Department plans to take to accelerate provision of (a) therapy services, (b) wheelchairs, (c) orthotics, (d) prosthetics and (e) other equipment for children and young people.

Integrated care boards (ICBs) are responsible for the provision and commissioning of most children’s therapy services and equipment services in the National Health Service. Augmentative and Alternative Communication (AAC) for children and young people are specialised services, and are commissioned by NHS England.NHS England is working to reduce regional variation in the quality and provision of NHS wheelchairs, and to support ICBs to reduce delays in people receiving timely intervention and wheelchair equipment. This includes co-producing a wheelchair quality framework with key stakeholders and people with lived experience. It is due to be published by the end of 2024/25 and will set out quality standards and statutory requirements for ICBs, such as offering personal wheelchair budgets.NHS England will shortly publish a revised service specification, Amputee Rehabilitation and Prosthetics Services for People of All Ages with Limb Loss and Limb Difference. The revised specification ensures greater emphasis on children and young people being seen with an age-appropriate setting, with greater collaboration between the young person’s acute and rehabilitation teams.In relation to AAC services, NHS England is reviewing the current service specification, and it is anticipated that the revised service specification will be published in spring 2025.

If he will issue guidance clarifying the (a) roles and (b) responsibilities of (i) local services and (ii) the third sector in the provision of specialist equipment for disabled children.

Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population. NHS England Specialised Commissioning commissions complex disability equipment services, including communication aids, environmental controls, and prosthetics.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningThe Children and Families Act 2014 requires that education, health, and social care services must work together to meet the needs of children and young people with special educational needs and disabilities (SEND). In May 2023, NHS England issued statutory guidance setting out the requirement for ICBs to have an Executive Lead for SEND, who will lead on supporting the Chief Executive and the board in ensuring the ICB performs its functions effectively, in the interests of children and young people with SEND.Local authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers is available at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfFurther guidance on the roles and responsibilities of different organisations in meeting the needs of children with SEND can be found in the SEND Code of Practice, which is available at the following link:https://www.gov.uk/government/publications/send-code-of-practice-0-to-25

If he will make an assessment of the adequacy of legal protections against the (a) abuse and (b) neglect of older people.

Any form of elder abuse or neglect is unacceptable.Local authorities have a statutory duty to investigate safeguarding concerns under the Care Act 2014. The statutory guidance of the Care Act 2014 makes it clear that local authorities must ensure that the services they commission are safe, effective, and of high quality. Since April 2023, the Care Quality Commission (CQC) has had a duty to assess local authorities’ delivery of their duties under Part 1 of the Care Act 2014.

What steps his Department is taking to help improve (a) prevention, (b) diagnosis and (c) support for people affected by foetal alcohol spectrum disorder.

The Department has taken a number of steps to help prevent foetal alcohol spectrum disorder (FASD). The UK Chief Medical Officers’ low risk drinking guidelines, published in 2016, provide clear advice to women not to drink alcohol if they are planning for a pregnancy or are pregnant, and are available at the following link:https://assets.publishing.service.gov.uk/media/5a80b7ed40f0b623026951db/UK_CMOs__report.pdfThe National Health Service website offers advice on the use of alcohol during pregnancy and sources of support, which includes speaking to a general practitioner, midwife, or local treatment service, or contacting the Government’s Talk to Frank website. Further information on the NHS website’s advice on the use of alcohol during pregnancy and sources of support, and the Government’s Talk to Frank website is available, respectively, at the following two links:https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregnant/www.talktofrank.com/contact-frankThe Department asked the National Institute for Health and Care Excellence to produce a Quality Standard in England (QS204) for FASD to help the health and care system improve both diagnosis and support for people affected by FASD. The quality standard also covers support during pregnancy to improve awareness and prevent the disorder. It was published in March 2022, and is available at the following link:https://www.nice.org.uk/guidance/qs204The Department will soon be publishing the first ever United Kingdom clinical guidelines on alcohol treatment. The aim of the guidelines is to promote and support good practice and improve quality of service provision, resulting in better outcomes for people experiencing harmful drinking and alcohol dependence. The guidelines will set out how maternity, alcohol treatment, and other healthcare professionals should support women to reduce or stop their alcohol use as quickly and safely as possible, to reduce the ongoing exposure of the foetus to alcohol and the risk and severity of future disability.

What discussions he has had with (a) SeeAbility and (b) other charities that deliver public sector contracts on the potential impact of increases in levels of employers' national insurance contributions on those charities.

To repair the public finances and help raise the revenue required to increase funding for public services, the Government has taken the difficult decision to increase employer National Insurance. On the impact on charities in particular, our tax regime for charities, including exemption from paying business rates, is among the most generous of anywhere in the world, with tax reliefs for charities and their donors worth just over £6 billion for the tax year to April 2024.

Whether he has made an assessment of the potential impact of an increase in employers national insurance contributions on charity and not for profit providers of adult social care; and if he will publish this information.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process. This assessment took into account a wide range of factors, including changes to employer National Insurance contributions, and the National Living Wage increases.In response to the range of pressures facing local authorities, the Government is providing a real-terms uplift to core local government spending power of approximately 3.2%, which includes £1.3 billion of new grant funding in 2025/26.

What assessment he has made of the adequacy of women’s health provision.

The Women's Health Strategy call for evidence in 2021 received nearly 100,000 responses from individuals, and over 400 written submissions from expert groups and researchers. It identified a range of issues including women not feeling listened to by healthcare professionals, damaging taboos and stigmas in women’s health that can prevent women from seeking help and that can reinforce beliefs that debilitating symptoms are normal, healthcare services not considering women’s needs by default, and under-representation of women in research.We are considering how to take forward the Women’s Health Strategy for England. The Government is committed to prioritising women’s health as we reform the National Health Service, and we will put women’s equality at the heart of our missions.

What steps he has taken to assess the impact on the health outcomes of people with dementia of the (a) average length of time people with dementia stay in hospital relative to people over 65 without dementia and (b) availability of specialist dementia nurses to meet the needs of people with dementia during hospital stays.

NHS England does not hold this information centrally. However, the provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.Employers determine the number of specialist nurses needed to provide care for the population. However, there is no specific regulatory requirement for post registration education, and people can choose to upskill to meet their own educational requirements.Student nurses do receive broad preparation, so they are able to support adults needing care, including those with dementia. The Advanced Clinical Practice programme supports the progression of clinicians, enabling them to take on more specialist roles.