Written questions by Morgan.

Whether NHS England has provided guidance to integrated care boards on sequencing cost reduction to avoid operational disruption.

NHS England provided guidance to integrated care boards (ICBs), National Health Service trusts, and NHS foundation trusts in a letter on 1 April 2025, where ICBs were tasked with developing plans setting out how they will manage their resources to deliver across their priorities. 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/NHS England has also 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.These ICB reforms are not about reductions to front line services. We are clarifying the role of ICBs to focus on strategic commissioning and reduce duplication. ICBs have submitted their plans to deliver these changes, and NHS England is currently reviewing these plans, including implementation.

Whether his Department has approved a national redundancy scheme for the 50% integrated care board cost reduction target; and whether he has allocated funds allocated to meet exit costs.

There are significant workforce implications following the Prime Minister’s announcement of the integration of the Department and NHS England, and the associated reduction in size, as well as the subsequent announcement of integrated care board and National Health Service trusts corporate cost reductions. 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 in frontline services to cut waiting times through the Government’s Plan for Change. Through the 2025 Spending Review, we are working with NHS England and HM Treasury on how the costs of restructuring will be met. Those discussions have not yet concluded. NHS England expects to launch a national scheme shortly.

If he will publish the template issued by NHS England to Integrated Care Boards for completing their cost reduction plans by 31 May 2025.

NHS England has asked 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 with the expectation of achieving a reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts in a letter 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/NHS England has circulated the document, Model Integrated Care Board – Blueprint v1.0, to all ICBs to assist them in shaping their plans. The document identifies the functional changes that ICBs will have to manage and indicates the responsibilities they may look to grow, adapt, or review for transfer, including the functions and activities that might be safely transferred to other parts of the system over time, such as national bodies, regional teams, or providers.NHS England’s transformation team will continue to work with ICBs to develop their plans, including how the key functions will be delivered within the revised running cost allocations, ensuring a focus on delivering NHS statutory functions in line with the legislation.

Whether NHS England has set formal (a) criteria and (b) guidance on the key functions Integrated Care Boards will be expected to provide under the proposed cost envelope.

NHS England has asked 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 with the expectation of achieving a reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts in a letter 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/NHS England has circulated the document, Model Integrated Care Board – Blueprint v1.0, to all ICBs to assist them in shaping their plans. The document identifies the functional changes that ICBs will have to manage and indicates the responsibilities they may look to grow, adapt, or review for transfer, including the functions and activities that might be safely transferred to other parts of the system over time, such as national bodies, regional teams, or providers.NHS England’s transformation team will continue to work with ICBs to develop their plans, including how the key functions will be delivered within the revised running cost allocations, ensuring a focus on delivering NHS statutory functions in line with the legislation.

If he will list (a) all functions identified for (i) transfer and (ii) decommissioning in the NHS England Model Integrated Care Board Blueprint and (b) the designated receiving organisations for each function.

NHS England has asked 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 with the expectation of achieving a reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts in a letter 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/NHS England has circulated the document, Model Integrated Care Board – Blueprint v1.0, to all ICBs to assist them in shaping their plans. The document identifies the functional changes that ICBs will have to manage and indicates the responsibilities they may look to grow, adapt, or review for transfer, including the functions and activities that might be safely transferred to other parts of the system over time, such as national bodies, regional teams, or providers.NHS England’s transformation team will continue to work with ICBs to develop their plans, including how the key functions will be delivered within the revised running cost allocations, ensuring a focus on delivering NHS statutory functions in line with the legislation.

On what statutory basis NHS England has required Integrated Care Boards to reduce their running cost allowances by 50% by Quarter 3 of the 2025-26 financial year.

The National Health Service Act 2006, as amended by The Health and Care Act 2022, grants NHS England powers to establish integrated care boards (ICBs) as statutory bodies for commissioning the majority of health and care services in England. The National Health Service Act 2006 also grants NHS England powers to ensure that expenditure incurred by ICBs does not exceed the aggregated sum allocated to them in a financial year.

What plans he has to bring forward legislative proposals to to transfer (a) statutory duties and (b) functions from Integrated Care Boards to other bodies.

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 the health and care structure.To deliver on this commitment, NHS England rapidly convened a group of ICB leaders, including clinical representatives, in order to start developing the blueprint. The work was split into three areas: defining a vision and the future functions of ICBs; mapping functions and duties across the system; and managing a safe transition.We recognise that not all function transferrals can be done this year, particularly those rooted in ICB statutory duties. For the areas which will be reviewed for transfer, we recognise that further work and engagement is required, and we acknowledgment that, even with this flexibility, transferring functions requires careful consideration of interdependencies with other functions and the readiness of partner organisations to receive the function.The Department is working with NHS England and the ICBs to develop these plans to ensure the timely implementation of the changes, whilst expecting ICBs to continue to deliver on their statutory responsibilities.

Whether he plans to personally meet with cross-party representatives to discuss social care reform.

Building a cross-party consensus is fundamental to the national conversation that the Prime Minister has tasked Baroness Louise Casey of Blackstock to facilitate.The commission is independent and Baroness Casey has the full support of my Rt. Hon. friend, the Secretary of State for Health and Social Care, in taking this work forward and deciding how best to engage other political parties and in building cross-party consensus.

What estimate his Department has made of the potential savings to the public purse from reduced usage of on-framework staffing agencies.

We have answered this question referencing the Planning Guidance for 2024/25, where NHSE England stated that trusts should end the use of off-framework agencies.The 2025/26 NHS priorities and operational planning guidance aims to improve procurement, contract management, and work to accept operating models that meet commercial standards.Use of off-framework agencies, which tends to be more expensive, is at record lows, contributing to a forecast cost reduction of £1.4 billion from 2024/25 (approximately 38% reduction) - NHS England » Financial performance update.Off-framework use is actively monitored through NHS England governance mechanisms, with additional oversight applied to Trusts with recurring non-compliance.

What assessment he has made of the potential impact of the planned 30 per cent reduction in agency spend outlined in the NHS Planning Guidance 2025-26 on nurse fill rates.

As outlined in the NHS Planning Guidance 2025/26, all trusts are required to reduce agency spend by at least 30%, with an additional focus on achieving a 10% reduction in spend on bank staff. This aims to transition away from a reliance on costly temporary staff and to promote investment in permanent roles.While this specific assessment has not been made, fill rates on temporary staff, including nurses, are monitored monthly. It is essential that patient safety considerations continue to be the most important priority.Spend on agency increased significantly in 2021/22 to £2.96 billion and to £3.46 billion in 2022/2023. However, spend appears to have peaked as 2023/24 spend was £3 billion and it has decreased further in 2024/25.My Rt. Hon. Friend, the Secretary of State for Health and Social Care, and Jim Mackey, Chief Executive of NHS England, wrote to trusts and integrated care boards in early June 2025 to reinforce the message in the Planning Guidance and set the ambition to eliminate agency spend in this parliament as part of optimising costs and productivity. The expectation is that staff will move to bank and substantive roles.

What steps he is taking to ensure that the full budget available to community pharmacies in 2025-26 is spent on the sector.

For 2025/26, funding for the core community pharmacy contractual framework has been increased to £3.073 billion. This represents the largest uplift in funding of any part of the National Health Service, at over 19% across 2024/25 and 2025/26. This increased funding envelope is fully guaranteed for the sector.The funding allocated to Pharmacy First in 2025/26 reflects the growth of the service to date, with up to £215 million available to be earned by contractors in 2025/26. It is expected that changes to the remuneration arrangements, continued work on improving referral systems, and promotions to increase public awareness and knowledge around accessing community pharmacy services will ensure levels of activity that will see this funding fully utilised.

When he plans to set out a timeline for negotiations with community pharmacies for the 2026-27 Contractual Framework.

There is currently no set timeline for commencing consultations on the future community pharmacy contractual framework beyond 2025/26. Departmental budgets beyond 2025/26 will be set through Phase 2 of the Spending Review, which will conclude in June.A mandate for the consultation will then be sought when internal departmental budgets have been set.

What steps his Department is taking to help prevent the mishandling of patient information by social care providers.

Responsibility for delivering shared care records sits with local integrated care boards (ICBs).The health and care organisations which participate in the Devon and Cornwall Care Record are joint controllers for the shared care record system and are responsible for determining who is authorised to access medical records in the system, the process for authorising users, how those users access records and the purposes for which the records can be accessed.Every ICB which shares records is required to look after an individual’s information in accordance with the Information Governance Framework for shared care records published by NHS England, to ensure that only authorised users access relevant information, and that access is governed by appropriate access controls. The framework is available at the following link:https://transform.england.nhs.uk/information-governance/guidance/summary-of-information-governance-framework-shared-care-records/information-governance-framework-for-integrated-health-and-care-shared-care-records/There are safeguards in place to keep information confidential. All care organisations accessing information via the Devon and Cornwall Care Record must be compliant with the Data Security and Protection Toolkit and sign a data sharing agreement. To access, a user needs an account which must be requested by an authorised sponsor in their organisation. Each time a shared record is accessed in the Devon and Cornwall Care Record, it is recorded in an audit trail.The registered managers of any care home are responsible legally for the safe management of information and ensuring all staff receive training and must agree to the terms and conditions of use, of which they are reminded on the login page.

Whether he has had discussions with Baroness Casey on engaging with political parties (a) individually or (b) collectively in relation to the Independent commission into adult social care.

The commission has now formally begun. Given the commission is independent, it is only right for Baroness Casey to independently build public and cross-party consensus. This includes choosing how and when the voices of political parties are best brought into the conversation.Baroness Casey has the autonomy to convene cross-party talks over the course of her work as she sees fit, with political parties invited as participants.

With reference to his oral contribution of 19 May 2025, on what date his Department plans to hold the first meeting of cross-party talks on social care.

The Government has clearly set out the importance of reaching cross-party consensus on adult social care. Building cross-party consensus is fundamental to the national conversation, and the Prime Minister has tasked Baroness Casey, as Chair of the Independent Commission into adult social care, to facilitate this.Given the commission is independent, it is only right for Baroness Casey to independently build public and cross-party consensus on how best to meet the current and future needs of the population.Baroness Casey has the autonomy to convene cross-party talks over the course of her work as she sees fit, with political parties invited as participants.

With reference to the Prime Minister's oral contribution of 14 May 2025, Official Report, column 336, whether he plans to provide additional funding to local authorities for social care to enable care providers to increase wages.

To enable local authorities to deliver key services such as adult social care, the Government has made available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The Government is also introducing the first ever Fair Pay Agreement to the adult social care sector, so that care professionals are recognised and rewarded for the important work that they do. As we work towards a Fair Pay Agreement, the Government will engage all those who draw upon care, as well as those that work to provide care and support. We will also consult local authorities, unions, and others from across the sector.Decisions on local authority funding for future years will be made as part of the 2025 multi-year Spending Review and local government finance settlement processes.

What steps his Department is taking to (a) address high turnover and (b) improve management practices in the care sector.

The Government recognises that the adult social care sector faces significant workforce challenges and recognises the scale of the reforms needed to make the adult social care sector attractive, to support sustainable workforce growth, and to improve the retention of the domestic workforce. That is why we are introducing the first ever Fair Pay Agreement to the adult social care sector, so that care professionals are recognised and rewarded for the important work that they do.We are supporting the professionalisation of the adult social care workforce, through expanding the Care Workforce Pathway, including registered manager and deputy manager roles. The pathway will set out how people can develop across a long-term career in adult social care with support and training, attracting people to join and remain in the sector We are also continuing to fund the Learning Development Support Scheme to help people build their skills and careers in care. The scheme is backed by up to £12 million this financial year, and includes qualifications to enhance the quality of care more broadly, as well as opportunities to develop leadership and management skills.

Whether his Department undertook a risk assessment before making full medical records available to social care providers through the Devon and Cornwall Care Record.

Responsibility for delivering shared care records sits with local integrated care boards (ICBs).The health and care organisations which participate in the Devon and Cornwall Care Record are joint controllers for the shared care record system and are responsible for determining who is authorised to access medical records in the system, the process for authorising users, how those users access records and the purposes for which the records can be accessed.Every ICB which shares records is required to look after an individual’s information in accordance with the Information Governance Framework for shared care records published by NHS England, to ensure that only authorised users access relevant information, and that access is governed by appropriate access controls. The framework is available at the following link:https://transform.england.nhs.uk/information-governance/guidance/summary-of-information-governance-framework-shared-care-records/information-governance-framework-for-integrated-health-and-care-shared-care-records/There are safeguards in place to keep information confidential. All care organisations accessing information via the Devon and Cornwall Care Record must be compliant with the Data Security and Protection Toolkit and sign a data sharing agreement. To access, a user needs an account which must be requested by an authorised sponsor in their organisation. Each time a shared record is accessed in the Devon and Cornwall Care Record, it is recorded in an audit trail.The registered managers of any care home are responsible legally for the safe management of information and ensuring all staff receive training and must agree to the terms and conditions of use, of which they are reminded on the login page.

Which Community Diagnostic Centres patients could attend after being referred for a scan as of 30 April 2025; and what the addresses are of these locations.

The local community diagnostic centre (CDC) for patients in Shropshire is the Shrewsbury, Telford and Wrekin CDC. The CDC is located at Hollinswood House in Telford, TF3 3BD. Patients requiring tests will also be referred to other settings as appropriate, including local hospital sites. A list of all operational CDCs is published and available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/cdc-management-information/The Department and NHS England do not directly inform local providers or general practices (GPs) when CDCs open for referrals in the nearby area, but it is the expectation that each CDC and their host National Health Service trust does local engagement, including with local providers and GPs.

Whether his Department informs all (a) GPs and (b) care providers when a new Community Diagnostic Centre opens for referrals in the nearby area.

The local community diagnostic centre (CDC) for patients in Shropshire is the Shrewsbury, Telford and Wrekin CDC. The CDC is located at Hollinswood House in Telford, TF3 3BD. Patients requiring tests will also be referred to other settings as appropriate, including local hospital sites. A list of all operational CDCs is published and available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/cdc-management-information/The Department and NHS England do not directly inform local providers or general practices (GPs) when CDCs open for referrals in the nearby area, but it is the expectation that each CDC and their host National Health Service trust does local engagement, including with local providers and GPs.