Written questions by Morgan.

What assessment he has made of the effectiveness of the Quality and Outcomes Framework guidance in ensuring appropriate management of patients with diabetes.

The Quality and Outcomes Framework (QOF) 2024/25 includes indicators for the effective control and management of diabetes. Performance improvements associated with the indicators in the QOF are seen in improvements in the care and management of diabetes.Annual diabetes reviews are associated with reduced emergency admissions, amputations, retinopathy, and mortality. Following a significant decrease in routine care delivery associated with the pandemic, the proportion of people with type 1 diabetes receiving all eight care processes had recovered back to 43.3% in 2023/24, and 62.3% for type 2 diabetes. This is comparted to 27% and 37% for 2020/21, respectively.The National Diabetes Audit core data for 2023/24 shows a steady trend of improvement in foot surveillance. The audit shows that the percentage of people with type 1 diabetes who received general practice foot checks in England reached 68.9%, versus 67.2% in 2022/23. The proportion of people with type 2 diabetes who received foot check examinations in 2023/24 was 81.3%, up from 78.8% in 2022/23. The foot check is financially incentivised via the QOF, and this is an important lever for maintaining high quality foot care.

What steps he is taking to help increase rates of diabetic foot screening in (a) North Shropshire constituency and (b) England.

The NHS Shropshire, Telford and Wrekin Primary Care team continues to work with practices and primary care networks (PCNs) to improve the access to low-risk diabetic foot screening, as well as with its providers to ensure timely access to medium- and high-risk foot screening. The integrated care system is in the process of transforming its diabetes care pathway to ensure high quality, consistent care, closer to home for those with, or at risk of, diabetes across Shropshire, Telford, and Wrekin, which includes access to diabetic foot screening.Whilst levels of diabetic foot screening across six of our nine PCNs are above the average levels for England, at 51.2% to 64.5% against an average for England of 46.9%, the integrated care board recognises that this is not universally the case, particularly in North Shropshire, where two of the three PCNs achieving below the average for England are situated, at 18.2% to 37.6%. These statistics are available in the National Diabetes Audit 2024/25 Quarterly Report April 2024 to December 2024.

How many NHS trusts have informed his Department that they plan to reduce the number of staff employed for non-corporate functions.

The Department has made no specific estimate of the change in contracted National Health Service staff, bank and agency staff, corporate functions staff, or those in other functions in NHS trusts in England over the 2025/26 financial year, beyond the position outlined in the 2025/26 NHS Priorities and Operational Planning Guidance. This guidance set out that integrated care boards and NHS trusts must:- reduce agency expenditure, as far as possible, as part of optimising costs and productivity. As a minimum, all systems are expected to deliver a 30% reduction based on current spending, with further reductions over this Parliament;- reduce bank use, with all systems expected to deliver a minimum 10% reduction. Bank rates should be optimised as far as possible; and- conduct a robust review of establishment growth and reduce spend on support functions to April 2022 levels. The Department and NHS England will continue to work with systems to develop plans that are affordable within the allocations set, exhausting all opportunities to improve productivity and tackle waste, and take decisions on how to prioritise resources to best meet the health needs of their local population.The Department does not hold information on the number of NHS trusts who may be planning to reduce the number of staff employed in non-corporate functions.

What estimate his Department has made of the potential change in the number of (a) contracted staff and (b) bank and agency staff in the NHS in 2025-26.

The Department has made no specific estimate of the change in contracted National Health Service staff, bank and agency staff, corporate functions staff, or those in other functions in NHS trusts in England over the 2025/26 financial year, beyond the position outlined in the 2025/26 NHS Priorities and Operational Planning Guidance. This guidance set out that integrated care boards and NHS trusts must:- reduce agency expenditure, as far as possible, as part of optimising costs and productivity. As a minimum, all systems are expected to deliver a 30% reduction based on current spending, with further reductions over this Parliament;- reduce bank use, with all systems expected to deliver a minimum 10% reduction. Bank rates should be optimised as far as possible; and- conduct a robust review of establishment growth and reduce spend on support functions to April 2022 levels. The Department and NHS England will continue to work with systems to develop plans that are affordable within the allocations set, exhausting all opportunities to improve productivity and tackle waste, and take decisions on how to prioritise resources to best meet the health needs of their local population.The Department does not hold information on the number of NHS trusts who may be planning to reduce the number of staff employed in non-corporate functions.

What estimate his Department has made of the potential change in the number of staff employed in (a) corporate and (b) other functions in the NHS in 2025-26.

The Department has made no specific estimate of the change in contracted National Health Service staff, bank and agency staff, corporate functions staff, or those in other functions in NHS trusts in England over the 2025/26 financial year, beyond the position outlined in the 2025/26 NHS Priorities and Operational Planning Guidance. This guidance set out that integrated care boards and NHS trusts must:- reduce agency expenditure, as far as possible, as part of optimising costs and productivity. As a minimum, all systems are expected to deliver a 30% reduction based on current spending, with further reductions over this Parliament;- reduce bank use, with all systems expected to deliver a minimum 10% reduction. Bank rates should be optimised as far as possible; and- conduct a robust review of establishment growth and reduce spend on support functions to April 2022 levels. The Department and NHS England will continue to work with systems to develop plans that are affordable within the allocations set, exhausting all opportunities to improve productivity and tackle waste, and take decisions on how to prioritise resources to best meet the health needs of their local population.The Department does not hold information on the number of NHS trusts who may be planning to reduce the number of staff employed in non-corporate functions.

What estimate his Department has made of the cost of redundancies in the NHS in 2025-26.

The Prime Minister has announced the integration of the Department and NHS England and the associated reduction in size, and NHS England has also set out separate ambitions of reducing integrated care board running costs as well as National Health Service trusts’ corporate costs. These reforms will deliver a more efficient, leaner centre, and will also free up capacity and help deliver significant savings of hundreds of millions of pounds a year, which will be reinvested into frontline services, to cut waiting times through the Government’s Plan for Change.Clearly these reforms will have workforce implications, and we are working closely with NHS England and HM Treasury to deliver these, however we do not yet have a robust estimate of costs for 2025/26. Discussions have been with NHS England at a national level, and not with individual integrated care boards or trusts.

How many (a) integrated care boards and (b) NHS trusts have contacted his Department to discuss the potential cost of redundancies since 1 January 2025.

The Prime Minister has announced the integration of the Department and NHS England and the associated reduction in size, and NHS England has also set out separate ambitions of reducing integrated care board running costs as well as National Health Service trusts’ corporate costs. These reforms will deliver a more efficient, leaner centre, and will also free up capacity and help deliver significant savings of hundreds of millions of pounds a year, which will be reinvested into frontline services, to cut waiting times through the Government’s Plan for Change.Clearly these reforms will have workforce implications, and we are working closely with NHS England and HM Treasury to deliver these, however we do not yet have a robust estimate of costs for 2025/26. Discussions have been with NHS England at a national level, and not with individual integrated care boards or trusts.

What proportion of the reduction in NHS waiting lists that took place between July and December 2024 was due to people (a) receiving the procedure they were on the waiting list for and (b) being removed from the waiting list because it was determined they no longer required the treatment.

Data is not held in the format requested.

When he plans to hold the first round of cross party talks on social care.

We are committed to building a national, cross-party consensus to create a fair and affordable adult social care system for all. This is why we have asked Baroness Casey of Blackstock to lead an independent commission into adult social care as part of our critical first steps towards building a National Care Service.As the commission is independent, Baroness Casey and her team are taking forward the arrangement of discussions with political parties.

For what reason cross-party talks on social care have not yet taken place.

We are committed to building a national, cross-party consensus to create a fair and affordable adult social care system for all. This is why we have asked Baroness Casey of Blackstock to lead an independent commission into adult social care as part of our critical first steps towards building a National Care Service.As the commission is independent, Baroness Casey and her team are taking forward the arrangement of discussions with political parties.

How many people came off an NHS waiting list without receiving treatment since September 2024; and what new (a) care pathways and (b) triaging policies his Department has introduced since July 2024.

A breakdown of the reasons for coming off the waiting list is not available in the aggregate monthly official statistics.There are a number of reasons why a patient may come off an NHS waiting list without receiving treatment including: the patient or their clinician initiating active monitoring; a decision being reached that no treatment is needed or no further contact required; the patient declining treatment; and the patient dying before treatment, including deaths unrelated to the condition the referral was made.The Elective Reform Plan, published in January 2025, set out key commitments to reform elective care, return to the constitutional standard of 92% of patients receiving treatment within 18 weeks, and build a sustainable National Health Service. This includes the commitment to transforming pathways, including: delivering at least 10 straight-to-test pathways by March 2026; opening CDCs 12 hours a day, seven days a week; ensuring all patients with long term conditions, who are on appropriate pathways, are offered Patient Initiated Follow-Up by March 2026; and undertaking pathway reform in five challenged specialties.The Plan also set a focus on increased delivery of Advice & Guidance and effective triage, with a new incentivised model for pre-referral Advice & Guidance going live in April 2025; and a commitment to develop an implementation toolkit for triage services by March 2026.

Whether his Department has made a recent estimate of the number of people that will have palliative care needs in the next 10 years.

Currently, approximately 600,000 people die per year in the United Kingdom. It is estimated that up to 90% of deaths could benefit from palliative and end of life care.The Office for National Statistics has projected that, by 2040, approximately 800,000 people a year will die in the UK. Also, current trends point to a growing proportion of people dying from chronic disease, particularly cancer and dementia. Taking these considerations together, it has been estimated that the number of people needing palliative and end of life care could increase by 42% by 2040.We have committed to develop a 10-Year Plan to deliver a National Health Service fit for the future, by driving three shifts in the way health care is delivered, from hospital to community, from treatment to prevention, and from analogue to digital. We will carefully be 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 stakeholders as we develop the plan.

What steps he is taking to repurpose spending on hospital care and emergency admissions for people at the end of life into improving community 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 community palliative and end of life care services will have a big role to play in that shift.Funding provision for hospital care and community care services is subject to the forthcoming Spending Review.

What steps she is taking through the 10 Year Health Plan to address (a) quality of care, (b) inadequate access and (c) rising demand in palliative and end of life care.

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.

Pursuant to the Answer of 26 March 2025 to Question 38394 on Integrated Care Boards: Operating Costs, whether his Department has conducted an impact assessment on the decision to reduce ICB running costs.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure to achieve a 50% cost reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, with ICBs being tasked to develop plans by the end of May setting out how they will manage their resources to deliver across their priorities.NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. Further information is available at the following link:https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/In his letter to ICBs, Sir Jim Mackey committed to greater transparency and moving back to a fair shares allocation policy over time.The Department has not conducted an impact assessment of the NHS decision to reduce ICB running costs.

Pursuant to the Answer of 9 April 2025 to Question 43516: Maternity Services and with reference to the Final report of the Ockenden Review, published on 30 March 2022, what assessment he has made of the effectiveness of the three year delivery plan for maternity and neonatal care in implementing the findings of the Ockenden review.

NHS England’s Three-Year Delivery Plan for Maternity and Neonatal Services, from 2023 to 2026, pulled together the majority of existing commitments, including the Ockenden recommendations, into a single package. The technical guidance outlines how progress towards the objectives of the plan is being tracked at a national level.The vast majority of recommendations in the second Ockenden report were aimed at trusts. Following this, NHS England wrote to all National Health Service trusts asking them to consider and act upon the report’s findings, and asked trust boards to have oversight of the progress. Integrated care boards are responsible for overseeing local progress.

Pursuant to the Answer of 26 March 2025 to Question 38394 on Integrated Care Boards: Operating Costs, what proportion of running costs integrated care boards are being asked to reduce; and what guidance he has issued on which services should be reduced.

Integrated care boards (ICBs) have been asked to make 50% cuts to running costs. Further detail on the future of ICBs was provided in a letter issued to all ICBs and National Health Service trusts and foundation trusts on 1 April 2025. This letter is available at the following link:https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/The letter details that in order to meet the expectations, ICBs should look carefully at functions where there is duplication.

Pursuant to the Answer of 9 April 2025 to Question 43516: Maternity Services, if he will update the three year delivery plan for maternity and neonatal care to include specific numerical targets.

NHS England’s three year delivery plan for maternity and neonatal services, ending in March 2026, will not be updated to include specific numerical targets. The focus remains on delivering actions to drive the necessary improvements on the ground to ensure that all women, babies and families receive the high-quality care that they deserve. This includes both the actions set out in the current plan, as well as the further actions needed to tackle the key issues in maternity and neonatal services. It is essential that any targets set are evidence-based and women and baby-centred.

Pursuant to the Answer of 9 April 2025 to Question 43516: Maternity Services, whether he has set a deadline for (a) outcome and (b) progress measures in the three year delivery plan for maternity and neonatal care.

NHS England’s three year delivery plan for maternity and neonatal care services was published on 31 March 2023 and implementation of the objectives is due to run for three years until March 2026. Progress is monitored through the plan’s technical guidance, which sets out how progress will be tracked at a national level against the four key themes of the plan.Due to the complexity of maternity and neonatal care and the need for robust validation, some of the outcome data is significantly lagged and will not be fully available within the lifetime of the plan. Much of this data is published by external organisations beyond NHS England.Although the delivery plan spans three years, its objectives are intended to enable services to deliver improvements in care that will lead to sustained, long-term improvements in outcomes and experiences for women, babies, and families.

Pursuant to the Answer of 9 April 2025 to Question 43516: Maternity Services, and with reference to the Final report of the Ockenden Review, published on 30 March 2022, which (a) Trusts and (b) systems have implemented (i) immediate and (ii) essential actions.

It is for integrated care boards to oversee local progress in implementing the immediate and essential actions from the Ockenden Review.