Written questions by Maguire.

What steps his Department is taking to ensure that primary care services are adequately resourced in Surrey.

Every year we consult with each primary care profession about what services they will provide, and the funding providers are entitled to in return under their contracts.Integrated care boards (ICBs) are responsible for commissioning primary care services within their regions. This includes ensuring service providers are able to meet the reasonable needs of their patient population. Where necessary, ICBs can commission local enhanced services which can vary in scope and funding, to fit the needs of the patient population.

What assessment he has made of the adequacy of funding for the new hospital in Sutton, in the context of rising construction and building costs.

We have now put the New Hospital Programme on a sustainable footing, with a timeline that can be met, and a budget that is consistent with the fiscal rules under which the Government is operating. We are backing this plan with investment, which will increase to up to £15 billion over each consecutive five-year wave, averaging approximately £3 billion a year from 2030. The exact profile of funding will be confirmed in rolling five-year waves at regular Spending Reviews, as with all Government capital budgets in future. The cost estimates for schemes include the significant cost of inflation in recent years and use a construction specific index to inflate future costs.The final funding amount for the Specialist and Emergency Care Hospital in Sutton will be subject to the review and approval of a Full Business Case nearer to construction starting between 2032 and 2034, as is standard for large infrastructure projects.

When his Department plans to announce the (a) personnel requirements and (b) organisational design for (i) Op Courage and (ii) Op Restore.

Op RESTORE and Op COURAGE are established bespoke National Health Service commissioned services for veterans. There are currently no plans for announcements to be made about personnel requirements and organisational design for Op COURAGE and Op RESTORE.The new joint centre will take forward the Government’s ambitious reform agenda as set out in the Health Mission and Plan for Change, with more details to come when the 10-Year Health Plan is published.

Whether his Department has made an assessment of the potential impact of community care staffing levels on hospital bed occupancy levels in Surrey.

No specific assessment has been made. Integrated care board are responsible for commissioning services to meet the needs of their local communities, including in Surrey, as they are best placed to take those decisions.The Government is committed to building a health service fit for the future. We will shortly publish a 10-Year Health Plan which will set out the radical reforms needed to make the National Health Service fit for the future. This will include a focus on shifting care from the hospital to the community, to bring care closer to where people live.

What the average delay is between patient (a) referral and (b) diagnostic testing in Epsom and St Helier University Hospitals NHS Trust; and what steps he is taking to reduce diagnostic waiting times.

There is no complete measure for the average wait time for a patient between a referral and receiving a diagnostic test for all diagnostic tests.The Diagnostic Waiting Times and Activity monthly collection, known as DM01, measures the current waiting times of patients still waiting for 15 key diagnostic tests or procedures at the end of each month. As of the end of March 2025, of those that were on the waiting list for a key diagnostic test at the Epsom and St Helier University Hospitals NHS Trust, the median average length of time patients had been waiting was 2.5 weeks, compared to 2.7 weeks nationally. Details on this collection are available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/Cutting waiting lists, including for diagnostic tests, is a key priority for the Government. Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres, and better use of technology.

What assessment he has made of the potential impact of using private partnerships to build NHS hospitals on public finances.

There has been no formal assessment on the potential impact of using private partnerships to build National Health Service hospitals. Current HM Treasury policy is that private finance cannot be used. As part of the NHS capital strategy, we are considering how best to address capital funding issues in the NHS estate, and all investments will be subject to value for money and strategic assessments.

How many referrals there have been to (a) Operation Courage and (b) Operation Restore in each year since 2016; and how many of those referrals were reviewed by multi-disciplinary teams within 8 weeks.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

What the allocated budget was for (a) Operation Courage and (b) Operation Restore in each financial year between 2020-21 and 2024-25; and how much funding has been allocated to each programme in the 2025-26 financial year.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

Who Operation (a) Courage and (b) Restore will be (i) managed and (ii) funded by after the abolition of NHS England.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

What steps his Department is taking to improve NHS staff (a) working conditions and (b) wellbeing.

The Government inherited a broken National Health Service with an overworked and demoralised workforce.We hugely value all NHS staff and are committed to improving working conditions, so we can keep staff healthy, motivated, and retain valuable skills. That is why one of our first actions was to give NHS staff an above inflation pay rise.Local employers across the NHS have in place arrangements for supporting staff, including occupational health provision, employee support programmes, and a focus on healthy working environments. At a national level, NHS England has made available additional emotional and psychological health and wellbeing support. They have also set out a roadmap for the NHS and partner organisations to work together to develop and invest in occupational health and wellbeing services for NHS staff.

What are the retention rates for NHS staff for each year since 2020.

NHS England publishes quarterly information on the turnover of National Health Service staff within their NHS Workforce Statistics publication, with further information available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statisticsThis covers the rate of staff joining and leaving active service in English NHS trusts and other core organisations over annual periods. Rates include staff going on, or returning from, periods of unpaid leave, such as career and maternity breaks, and will also include staff remaining in their professions but undertaking roles in other sectors such as primary care, social care, or independent provision. This data is available at national and regional levels, as well as for individual staffing groups. The latest release, which covers the year to December 2024, can be found at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/december-2024The Government is committed to making the NHS the best place to work, to ensure we retain more of our skilled and dedicated staff. NHS England is leading work nationally through its retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

How much of the Claimant’s legal costs paid by the NHS in all clinical negligence claims under £25,000 in 2023-24 were expert fees.

NHS Resolution (NHSR) manages clinical negligence and other claims against the national Health Service in England. The following table shows the total legal costs paid for claimants due to clinical negligence claims closed in the financial year 2023/24, where damages were paid up to £25,000:Damages trancheClaimant legal costs paid by NHSR£1 to £1,500£2,422,432£1,501 to £25,000£94,364,395Total£96,786,827Claims closed in 2023/24 will often have been settled in previous years, as costs can take some time to finalise after an agreement on damages. NHSR does not record a breakdown of claimant legal costs between profit costs and disbursements in its claims management system. It also does not record a breakdown for expert fees.

What data is held by NHS Resolution on the breakdown of Claimant costs in clinical negligence claims under £25,000.

NHS Resolution (NHSR) manages clinical negligence and other claims against the national Health Service in England. The following table shows the total legal costs paid for claimants due to clinical negligence claims closed in the financial year 2023/24, where damages were paid up to £25,000:Damages trancheClaimant legal costs paid by NHSR£1 to £1,500£2,422,432£1,501 to £25,000£94,364,395Total£96,786,827Claims closed in 2023/24 will often have been settled in previous years, as costs can take some time to finalise after an agreement on damages. NHSR does not record a breakdown of claimant legal costs between profit costs and disbursements in its claims management system. It also does not record a breakdown for expert fees.

What assessment he has made of the potential impact of introducing fixed recoverable costs in lower-value clinical negligence cases on patients’ access to legal expertise.

Currently, the Government is considering the way forward on a wide range of matters relating to clinical negligence reform, and we will announce our position in due course.

How much of the Claimant’s costs paid by the NHS in all clinical negligence claims under £25,000 in 2023-24 were (a) legal costs, (b) disbursements and (c) VAT.

NHS Resolution (NHSR) manages clinical negligence and other claims against the national Health Service in England. The following table shows the total legal costs paid for claimants due to clinical negligence claims closed in the financial year 2023/24, where damages were paid up to £25,000:Damages trancheClaimant legal costs paid by NHSR£1 to £1,500£2,422,432£1,501 to £25,000£94,364,395Total£96,786,827Claims closed in 2023/24 will often have been settled in previous years, as costs can take some time to finalise after an agreement on damages. NHSR does not record a breakdown of claimant legal costs between profit costs and disbursements in its claims management system. It also does not record a breakdown for expert fees.

With reference to the publication entitled Working together in 2025/26 to lay the foundations for reform, published on 1 April 2025, if he will extend the time in which ICBs have to respond to the Model ICB once it is published.

Integrated care boards (ICBs) have a critical role to play as strategic commissioners, improving population health, reducing inequalities, and ensuring access to high quality care. NHS England has circulated a draft of The Model ICB - blueprint document to all ICBs, to assist them in shaping their future plans, including which functions they should focus on, as indicated in Sir James Mackey’s letter to the National Health Service trusts, foundation trusts, and ICBs, which is available at the following link:https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/#:~:text=When%20we%20met%20on%2013,the%20last%20few%20tricky%20weeks.We expect ICBs to adhere to the timelines set out by NHS England on 1 April 2025, to ensure that ICBs are acting as lead strategic commissioners of health and care services and to ensure that cost savings are directed to frontline NHS health and care services.

If he will make an assessment of the adequacy of his Department's implementation of the recommendations on stronger clinical leadership and management roles outlined in the paper entitled High Quality Care For All: NHS Next Stage Review Final Report, published in June 2008.

There are no current plans to assess implementation of the 2008 High Quality Care for All report.The Government recognises the importance of ensuring that the National Health Service has strong and effective leadership in place. As Lord Darzi stated in his recent independent report on the NHS in 2024, “the NHS has many strong and capable leaders”, although we know there is more work to do to strengthen NHS leadership. That is why there is a significant programme of work underway to improve NHS management and leadership, including our commitment to establish an NHS College of Executive and Clinical Leadership and to introduce professional standards for, and regulation of, NHS managers. This builds on a wider programme of work being led by NHS England to develop standards, a code of practice, and a curriculum for NHS managers and leaders.

What steps he is taking improve training pathways for medical professionals.

In February this year, NHS England launched an extensive engagement and listening exercise to help shape the future of postgraduate medical training. The review will hear about best practice, listen to concerns, including issues around training pathways and the capacity, quality, and inclusivity of training, and will explore ideas and thoughts about how postgraduate medical training could evolve for the future. An engagement exercise will run through to June this year, with findings reported in the summer.To reform the National Health Service and make it fit for the future, we have launched a 10-Year Health Plan as part of the Government’s five long-term missions. Ensuring we have the right people, in the right places, with the right skills will be central to this vision. We will publish a refreshed workforce plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.

If he will make an estimate of the number of qualified medical professionals unable to progress in their training pathways in the most recent period for which figures are available.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. It is not possible, from the data held, to consistently and accurately identify unique applicants, as many applicants will apply to more than one specialty training pathway We will ensure that the number of medical specialty training places meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.Post graduate medical training consists of several different phases of training courses, depending on the speciality choices a doctor makes. After graduating, doctors will typically do a two year foundation programme, followed by speciality training. Speciality training can be a single “run through” programme or can be core training followed by competitive entry into higher speciality training. Further information is available at the following link:https://www.healthcareers.nhs.uk/explore-roles/doctors/training-doctorIn 2024, there were 59,698 total applications across all medical specialty training pathways in the United Kingdom, for the 12,743 speciality training posts that were available. This data covers all round one and round two specialty training pathway programmes. The Department does not hold information on the number of individual, or unique, applicants that this comprises of in order to make and estimate on the specific progression of medical professionals. The timing of progression, from foundation years training to medical specialty training, will depend on a wide variety of factors, including personal preferences for future specialty training programmes, development of current strengths and skills, personal factors influencing the timing of progression, and the NHS’s demand for specialty training roles.Once medical professionals have entered a training pathway, progress outcomes within that pathway are collected and reported by the General Medical Council in its Annual Review of Competency Progression reports. This information is available at the following link:https://edt.gmc-uk.org/progression-reports/arcp

What steps his Department is is taking to help tackle delays in the transfer of care.

It is a priority for the Department to tackle delays in the transfer of care, and to ensure that people receive the care that they need.On 30 January 2025, the Government published a revised policy framework for the £9 billion Better Care Fund. The new BCF Policy Framework for the 2025-2026 financial year supports local areas to use pooled funding in way that delivers greater impact for those receiving integrated health and social care.Under the new framework, local authorities and National Health Service integrated care boards are accountable for providing timely and joined-up support for people with more complex health and care needs, and for achieving more timely and effective discharge from acute, community, and mental health hospital settings.