Written questions by Maguire.

What information his Department holds on the percentage of GPs that have downloaded firearms marker software.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensingTo support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

What assessment his Department has made of the potential impact of the tightening of eligibility criteria for NHS Continuing Healthcare by Integrated Care Boards on disabled people's ability to (a) access and (b) remain in employment.

The Department is responsible for Continuing Healthcare (CHC) policy and legislation. We have provided statutory guidance, setting out clear processes for CHC, which all integrated care boards (ICBs) must have regard to. CHC is funded by ICBs, and it is for individual ICBs to make assessments and decisions in a consistent manner in line with their statutory duties and guidance. This guidance has not changed and ICBs are expected to maintain CHC delivery in line with their statutory duties. NHS England holds ICBs accountable and engages with them to ensure that they discharge their functions. This includes monitoring eligibility rates and undertaking detailed work to compare ICBs with similar demographics, including further investigation of outliers for drivers of variation.

Whether his Department has made an estimate of the proportion of firearm holders with a firearms marker on their patient records.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensingTo support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

What steps his Department is taking to increase the accessibility of band five nursing roles available to newly qualified nurses with (a) less than two years' experience, (b) between two and four years' experience and (c) over four years' experience.

Decisions about recruitment are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.NHS England is working with employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What mechanisms are in place to ensure (a) local community and (b) patient engagement in the (i) design and (ii) delivery of new NHS hospital infrastructure.

Hospital 2.0 is the New Hospital Programme’s (NHP) approach to standardising the design for future hospitals and has been designed and developed with people with lived and learnt experiences throughout the stages of the design process, from strategic outline business cases, early plans to commissioning, and full operationalisation. Stakeholders include National Health Service staff, NHS trusts, royal colleges, patients, and the public, as well as the supply chain. Over 1,300 clinicians, over 400 patients and lived experience partners, and 57 architects and designers have worked alongside subject matter experts to feed into the design process. This is to ensure that new hospitals will meet current and future healthcare needs, and that patients and staff are at the heart of its designs. The NHP works collaboratively with NHS England and trusts to ensure that the design of each hospital is right-sized for local circumstances and tailored to the needs of the local community. The NHP is currently embarking on another cycle of formal engagement workshops with key national stakeholders to showcase the current progress of Hospital 2.0 designs, with a workshop focussed on the patient and public perspectives. Outside the NHP, the majority of investment in new hospital infrastructure relates to works on part of a site or to renovation and maintenance, and so is subject to local design considerations. When healthcare services are relocated to a new site a formal process of consultation is followed. At a local level, integrated care boards are responsible for strategic infrastructure planning, managing the budget, and allocating funding according to local priorities in their area. Local systems have also developed infrastructure strategies to create a long-term plan for future estate requirements and investment for each local area and its needs.

What steps his Department is taking to ensure that there is sufficient project delivery capacity within (a) the NHS and (b) supply chains to implement the New Hospital Programme.

Earlier this year, the New Hospital Programme (NHP) appointed a Health Delivery Partnership as its principal Programme Delivery Partner, which is working closely with the NHP to provide the expert technical skills needed to develop the infrastructure and programme delivery capability to support successful delivery.The NHP remains committed to strengthening its internal capacity, supported by a Knowledge and Skills Transfer Strategy aimed at embedding the self-sustaining knowledge and skills required to increase its in-house resource.Since 2021, the NHP has undertaken extensive market engagement with industry to build industry interest, assess current capacity, and understand key investment drivers. The NHP launched procurement for its bespoke Hospital 2.0 Alliance Framework, designed to establish a long-term, sustainable, and collaborative supply chain partnership and contracting model that will secure market appetite and investment.The NHP is currently engaging with industry on the Hospital 2.0 integrated system, particularly the technical requirements, specification, and designs. Three key industry sectors identified to focus on include: designers and architects; main works contactors; and mechanical, electrical, and plumbing contractors.

Whether his Department has made an assessment of the potential impact of NICE’s rejection of trastuzumab deruxtecan for use in secondary breast cancer treatment on patient outcomes.

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 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 have 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. 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.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible NHS patients.

What assessment his Department has made of the potential impact of NICE’s severity modifier on access to new treatments for incurable secondary breast cancer.

The National Institute for Health and Care Excellence (NICE) is responsible for the methods and processes that it uses in the development of its recommendations. The severity modifier was introduced in January 2022 as part of a number of changes intended to make NICE’s methods fairer, faster, and more consistent.NICE carried out a review of the implementation of the severity modifier in September 2024 and found that it is operating as intended. This showed that the proportion of positive cancer recommendations is higher, at 84.8%, than with the end-of-life modifier it replaced, at 75%, and the proportion of positive recommendations for advanced cancer treatments is also higher, at 81.1% compared to 69%.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews.

What assessment he has made of the level of employment opportunities for newly qualified nurses in Surrey.

Decisions on the employment of newly qualified nurses are a matter for individual National Health Service trusts, which manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.As set out in the 10-Year Health Plan, we are working closely with NHS England, employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What steps he is taking to ensure newly qualified nurses have pathways to gain clinical experience.

NHS England is working with employers, universities, and regional nursing leads to ensure that support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.It is important that as part of their first roles, newly registered nurses are supported to embed their skills and integrate into their new team and place of work. Nursing preceptorships provide structured support for newly qualified nurses to do this as they transition into professional roles. The NHS England National Preceptorship Framework sets out that all newly qualified nurses should receive preceptorship in their first-year post-registration.

What assessment he has made of the adequacy of suicide prevention training provided to ambulance staff.

Looking after the mental health of hard-working NHS staff is essential, and particularly so for ambulance staff as responders to emergency incidents. Ambulance Trusts and the Association of Ambulance Chief Executives have worked closely with NHS England to ensure there is a good range of health and wellbeing support available for staff. This includes an ambulance sector specific suicide prevention pathway to provide immediate support 24/7 for staff experiencing suicidal ideation. At a national level, ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction.We have also announced in the 10-Year Health Plan that we will roll out Staff Treatment Hubs to provide a high-quality occupational health service for all NHS staff, including support for mental health issues and back conditions, with both being significant causes of long-term sickness absence.

Whether his Department has made an assessment of the merits of (a) incentivising GPs nearing retirement to remain in the profession and (b) incentivising retired GPs to return to practice.

We will publish a 10 Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible and more fulfilled.The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.From now on, we will ensure that staff will be better treated, have better training, more fulfilling roles, and hope for the future, so they can achieve more.

What estimate his Department has made of the number of GPs expected to retire by 2030; and whether the NHS Long Term Workforce Plan accounts for shortages in (a) the South East and (b) other regions.

No estimate has been made of the number of general practitioners (GPs) expected to retire by 2030. A GP's decision to retire can be influenced by many factors. Therefore, we do not have the data to make forecasts.In May 2025, there were 691 more full time equivalent (FTE) GPs than in May 2024. Workforce shortages are greater in some, particularly deprived, areas.In August 2024, we announced an £82 million in-year funding boost to allow recently qualified GPs to be hired through the Additional Roles Reimbursement Scheme, and have so far recruited over 1,900 GPs, exceeding our target of 1,000.Through a 3% real terms growth in funding for the NHS over three years, we will train thousands more GPs and deliver millions more appointments.We will publish a 10-Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible and more fulfilled.The 10-Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.

What the target HPV vaccination rate for Epsom and Ewell constituency was in (a) 2023-24 and (b) 2024-25; what the actual vaccination rate was in those periods; and whether his Department plans to reach the World Health Organization vaccination target rate.

Human papillomavirus (HPV) vaccine coverage is presented for England at national, National Health Service commissioning region, and local authority levels. Data is not gathered at constituency level. Vaccine coverage data for the routine school-aged HPV immunisation programme in England, including for the 2023 to 2024 academic year, is available at the following link:https://www.gov.uk/government/collections/vaccine-uptake#hpv-vaccine-uptakePlease refer to the supporting tables for local level uptake data.Given the global public health burden of cervical cancer caused by HPV, the World Health Assembly adopted the Global strategy to accelerate the elimination of cervical cancer as a public health problem, with a target of 90% of girls being fully vaccinated with the HPV vaccine by 15 years old. This target focuses on the coverage of girls only. Further information on the strategy to accelerate the elimination of cervical cancer is available at the following link:https://www.who.int/publications/i/item/9789240014107In March 2025, NHS England published the Cervical cancer elimination plan by 2040 – for England, which outlines how the NHS will improve uptake and coverage across HPV vaccination and cervical screening. Further information on the Cervical cancer elimination plan by 2040 – for England is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/

What steps his Department is taking to help reduce delays in adult social care assessments for hospital discharge.

The Urgent and Emergency Care plan for 2025/26, published by NHS England, has set a priority that hospitals should tackle the delays in patients waiting to be discharged. The plan asks systems to set local performance targets by discharge pathway and eliminate internal discharge delays of more than 48 hours in all settings.For 2025/26, £9 billion is available through the Better Care Fund to provide services, including those which help reduce delayed discharges. All health and wellbeing boards are required to set goals to reduce discharge delays, which will be used to monitor performance and drive accountability throughout 2025/26.

What the current NHS dentist vacancy rate is in Surrey; and what steps he is taking to ensure equitable dental care access in Epsom and Ewell constituency.

In 2024, there was a 20% vacancy rate for NHS dentists in the Surrey Heartlands Integrated Care Board (ICB), which includes the Epsom and Ewell constituency. We do not hold data at constituency level. More data is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/dental-workforce/The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to ICBs across England. For the Epsom and Ewell constituency, this is Surrey Heartlands ICB.We will deliver 700,000 extra urgent dental appointments per year, and ICBs have been making extra appointments available from 1 April 2025. Surrey Heartlands ICB is expected to deliver 6,585 additional urgent dental appointments as part of the scheme.The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament.

What steps he is taking to help GPs who are unable to find employment despite workforce shortages.

The Government has invested £82 million in the Additional Roles Reimbursement Scheme (ARRS), which has enabled the recruitment of more than 1,900 recently qualified general practitioners (GPs) in England since October. This will increase the number of available appointments, secure the future supply of GPs, and alleviate the pressure on those currently working in the system.Under recently announced changes to the GP Contract in 2025/26, the ARRS will become more flexible to allow primary care networks to respond better to local workforce needs. The two ARRS pots have been combined to create a single pot for reimbursement of patient-facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.On 27 February, the Government and the British Medical Association agreed to the changes to the GP Contract to fix the front door of the National Health Service, and to bring back the family doctor. We are investing an additional £889 million in GPs for 2025/26, bringing total spending on the GP Contract to £13.2 billion. This is the largest uplift to GP funding since the beginning of the five-year framework, and means we are reversing recent trends by allocating a rising share of NHS resources to GPs.

What assessment his Department has made of the adequacy of core funding for general practice.

We have invested an additional £889 million in general practice (GP) to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.The changes to the contract will improve services for patients and make progress towards the Government’s Health Mission, supporting the three key shifts the Government wants to achieve, from analogue to digital, from sickness to prevention, and from hospital to community care.GP providers are valued independent contractors. Every year we consult with the sector both about what services they provide, and the money providers are entitled to in return under their contract. Operating costs for these providers are taken into account as a part of this process.

Pursuant to the Answer of 4 April 2024 to Question 19410 on General Practitioners: Labour Turnover, what estimate he has made of the number of GPs on ICB funded training schemes which are equivalent to the (a) General Practice Fellowship and (b) Supporting Mentors schemes.

Data on integrated care board (ICB) funded training schemes, their equivalent to the General Practice Fellowship scheme and the Supporting Mentors scheme, or the numbers of staff benefitting from these schemes is not held centrally.While NHS England provides funding, through ICB allocations and the Primary Care Transformation Fund, to develop general practice services and teams, ICBs have the autonomy and flexibility to make decisions that serve the best interests of local people and communities.

What assessment his Department has made of the potential impact of Integrated Care Board funding levels on GP recruitment and retention in Epsom and Ewell constituency.

We are investing an additional £889 million in GPs for 2025/26, bringing total spending on the GP Contract to £13.2 billion. This is the largest uplift to GP funding since the beginning of the five-year framework, and means we are reversing recent trends by allocating a rising share of National Health Service resources to GPs.Under recently announced changes to the GP Contract in 2025/26, the Additional Roles Reimbursement Scheme (ARRS) will become more flexible to allow primary care networks to respond better to local workforce needs. The two ARRS pots have been combined to create a single pot for the reimbursement of patient-facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.In the Epsom and Ewell constituency, as of 31 May 2025, there were 67.8 full time equivalent doctors in GPs, and since October 2024, 1,900 GPs have been recruited via the ARRS nationally.