Written questions by Morgan.

Whether he has issued guidance to hospital trusts on reducing waiting lists for elective care through demand management.

The Government has committed to returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment, a standard which has not been met consistently since September 2015. Our Elective Reform Plan, published in January 2025 and sent to all NHS trusts, details the necessary reform efforts and includes several actions to reduce unnecessary elective referrals. This includes stepping up volumes of Advice and Guidance (A&G) through the introduction of a new £20 payment for general practitioners, per A&G request, and rolling out clinical triage more consistently to ensure patients receive care in the correct setting, including in primary or community services where this is in the patient’s best interests.The NHS Get it Right First Time (GIRFT) programme also has detailed national guidance for NHS trusts to help reduce their elective waits, including specialty-level guides with specific advice on demand management. GIRFT is proactively supporting trusts to implement this.

What recent progress each NHS Trust providing maternity services has made on implementing each of the immediate and essential actions set out in the Final report of the Ockenden review, published on 30 March 2022.

All of the recommendations made by Donna Ockenden in her review into maternity services at the Shrewsbury and Telford Hospital Trust in 2022 were accepted, including the requests made to the Government, the health system more widely, and the trust. Following publication of the Ockenden review, NHS England wrote to all trusts and systems asking them to deliver the recommendations and report to their public boards.To support this delivery, the three-year delivery plan for maternity and neonatal services brought together the immediate and essential actions from the Ockenden review with those from other reports and guidance. The National Health Service’s operational planning guidance sets out the expectation that trusts should implement the key actions from the plan. In accordance with the NHS operating framework, it is for integrated care boards to oversee local progress with this. The technical guidance which accompanies the plan sets out how we are monitoring progress at a national level.The plan aims to grow the maternity workforce, develop a culture of safety, and ensure women receive safe, compassionate care across the country. NHS England is in the second year of delivery, and progress has been made across the four themes to improve outcomes and experiences for women and their babies.The Shrewsbury and Telford Hospital Trust has seen a significant improvement in overall midwifery staffing levels. The trust has enhanced its senior and specialist midwifery teams to provide additional leadership, expert advice, and support for women and families, as well as the clinical teams. The Shrewsbury and Telford Hospital Trust now has in place robust training programmes that equip the maternity workforce with up-to-date skills, training, and development, including in the management of emergency scenarios.

What assessment he has made of the potential merits of publishing year-round data on the number of patients treated in temporary care environments.

We continue to keep the data available and published to support improvements to urgent and emergency care services under review.NHS England has been working with trusts since 2024 to put in place new reporting arrangements related to the use of temporary escalation spaces, to drive improvement. Subject to a review of data quality, this information will be published later this year, and we will consider how this data could be published on a more regular basis.

What steps he is taking to reduce the use of temporary care environments in patient care.

The Government recognises that long waits in accident and emergency are unacceptable and lead to worse patient outcomes. Patients should expect and receive the highest standards of service, and we are determined to tackle the issue of corridor care.NHS England published guidance in September 2024 regarding the use of temporary escalation spaces, which is available at the following link:https://www.england.nhs.uk/long-read/principles-for-providing-safe-and-good-quality-care-in-temporary-escalation-spaces/In January, we published the National Health Service’s mandate and planning guidance for 2025/26, which set out the priorities and actions to be taken to reform and improve urgent and emergency care services. This includes increasing the proportion of patients admitted, discharged, and transferred from an emergency department within 12 hours across 2025/26 compared to 2024/25.We will shortly set out the further improvements and actions to be taken to support urgent and emergency care services this year.

If he will ensure that outdoor hospitality areas remain outside the scope of the Tobacco and Vapes Bill.

The Tobacco and Vapes Bill, which will put us on track towards a smoke-free UK, was introduced to Parliament on 5 November 2024. On 26 March 2025, MPs voted overwhelmingly in favour of advancing the Bill to the next Parliamentary stage and it has now entered the House of Lords.The Bill allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. However, we have been very clear that in England, we intend to consult on extending smoke-free places to outside schools, children’s playgrounds and hospitals but not outdoor hospitality settings or wider open spaces like beaches. Private outdoor spaces are out of scope of the powers in the Bill.We do not intend to extend these powers further than this at this time and recognise that now would not be the right time to consult on making outdoor hospitality settings smoke-free in England.

If he will ensure that the Tobacco and Vapes Bill does not lead to (a) restrictions and (b) bans on smoking in outside areas of hospitality businesses.

The Tobacco and Vapes Bill, which will put us on track towards a smoke-free UK, was introduced to Parliament on 5 November 2024. On 26 March 2025, MPs voted overwhelmingly in favour of advancing the Bill to the next Parliamentary stage and it has now entered the House of Lords.The Bill allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. However, we have been very clear that in England, we intend to consult on extending smoke-free places to outside schools, children’s playgrounds and hospitals but not outdoor hospitality settings or wider open spaces like beaches. Private outdoor spaces are out of scope of the powers in the Bill.We do not intend to extend these powers further than this at this time and recognise that now would not be the right time to consult on making outdoor hospitality settings smoke-free in England.

With reference to the Answer of 12 January 2022 to Question 102658, how much money NHS England clawed back from primary care NHS dental practices in England that had not met their contractual targets in each year since the 2020-21 financial year.

The NHS Business Services Authority publishes the details of each National Health Service dental contract with the associated contract delivery data annually. This information includes additional NHS dental payments and deductions each year since 2015. Deductions to this amount include where a dentist does not deliver the contracted amount of NHS dental care. Performance adjustments each year relate to the performance in the previous financial year, for example, performance adjustments in 2023/24 relate to contract performance in 2022/23.The publications are available at the following link: https://www.nhsbsa.nhs.uk/dental-data/nhs-payments-dentists

What discussions he has held on the 2025/26 NHS Payment Scheme with the (a) voluntary and (b) community sector.

The NHS Payment Scheme is a policy of NHS England. NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service-funded services, the consultation accepts responses from any interested parties and members of the general public.On publication, all providers and commissioners affected by the proposals were sent details of the consultation and were asked to respond.An email to highlight the consultation was also sent to over 4,300 people, including from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the payment system support, FutureNHS. A reminder was also sent out a week before the consultation closed.NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. During the consultation period, NHS England also met with ADHD UK to discuss the proposals.Of the responses that were received regarding the consultation, 16 were from representative bodies, including health charities and royal colleges.

With reference his Department's consultation entitled 2025/26 NHS Payment Scheme, published on 30 January 2025, what (a) meetings he has held with and (b) representations he has received from (i) health charities and (ii) Royal Colleges on NHS payment limits.

The NHS Payment Scheme is a policy of NHS England. NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service-funded services, the consultation accepts responses from any interested parties and members of the general public.On publication, all providers and commissioners affected by the proposals were sent details of the consultation and were asked to respond.An email to highlight the consultation was also sent to over 4,300 people, including from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the payment system support, FutureNHS. A reminder was also sent out a week before the consultation closed.NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. During the consultation period, NHS England also met with ADHD UK to discuss the proposals.Of the responses that were received regarding the consultation, 16 were from representative bodies, including health charities and royal colleges.

With reference to his oral statement of 13 March 2025 on NHS England Update, Official Report, column 1284, what plans his Department has to support hospital trusts under the NHS Oversight Framework after NHS England is abolished.

Ministers will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. Work has begun immediately to start bringing teams in NHS England and the Department together, and over the next two years, NHS England and the Department will combine to form a new joint centre.NHS England will continue to carry out its statutory duties until Parliamentary time allows for legislation to be brought forward to amend the Department’s responsibilities.The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job. We will empower staff to focus on delivering better care for patients, driving productivity up, and getting waiting times down.

With reference to his oral statement of 13 March 2025 on NHS England Update, Official Report, column 1284, what steps his Department plans to take to implement the mandate to NHS England, published on 30 January 2025, after NHS England is abolished.

Ministers will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to lead this transformation. NHS England will have to comply with their legislative functions until the transformation is complete, which includes delivery against their mandate objectives.The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job. This will streamline processes and empower staff to focus on delivering better care for patients, driving productivity up and getting waiting times down.

If he will make an assessment of the potential merits of taking legislative steps to ensure there is an allied health professional on the boards of NHS (a) integrated care boards and (b) hospital trusts.

Allied health professionals play an important role in diagnosing, treating, and caring for patients, often requiring specialised training and certification.There are no statutory limitations on allied health professionals being board members of integrated care boards, National Health Service trusts, or NHS foundation trusts. The Health and Care Act 2022 promotes integration and joint working across NHS providers and local authorities to provide the best health and care services for their local population. Currently, there are no plans to take legislative steps in this area.NHS England has published an NHS leadership competency framework for board members. The framework is for chairs, chief executives, and all board members in NHS systems and providers, as well as serving as a guide for the aspiring leaders of the future. It is designed to support the appointment of diverse, skilled, and proficient leaders.

Whether he is taking steps to use on-framework staffing agencies to reduce the number of unfilled nursing shifts.

Trusts manage their own procurement processes and must align with framework and procurement regulations, to uphold fairness and deliver value for money. Any breaches of framework rules, including price cap violations, are closely monitored by NHS England through the Temporary Staffing Efficiency Programme.NHS England will continue to review framework applications as they are submitted, and will continue to communicate outcomes to framework operators and providers, including any updates to the list of approved framework agreements. A list of approved framework agreements can be found on NHS England’s website, at the following link:https://www.england.nhs.uk/reducing-expenditure-on-nhs-agency-staff-rules-and-price-caps/agency-rules-list-of-approved-framework-agreements-for-all-staff/

What assessment he has made of the potential merits of banning the use of off-framework staffing agencies by the NHS.

The planning guidance for 2024/25 set out the expectation that trusts should end off-framework agency use. The National Health Service is now operating at the lowest levels of off-framework use on record.The planning guidance for 2025/26 sets out, for the first time, in its Revenue Finance and Contracting Guidance, the ambition of eliminating agency spend altogether, and the expectation that trusts should reduce their agency spend by a minimum of 30% in 2025/26.The merits of eliminating off-framework agencies would be to increase procurement compliance, value for money, safeguarding measures, workforce productivity, and to provide a ring fence of governance to improve patient safety. A list of approved framework agreements can be found on NHS England’s website, at the following link:https://www.england.nhs.uk/reducing-expenditure-on-nhs-agency-staff-rules-and-price-caps/agency-rules-list-of-approved-framework-agreements-for-all-staff/

If he will make an estimate of the average cost to the public purse of one band 5 nursing hour supplied by (a) On-framework staffing agencies and (b) Off-framework staffing agencies at the Shrewsbury and Telford Hospital NHS Trust in each year since 2019.

The Department does not hold the data requested.The Government is committed to reducing off-framework agency use, the cost of which is at a premium, above the agreed framework rates. Additionally, staff hired through off-framework agencies are not subject to the same pre-employment checks as those carried out by on-framework agencies. Off-framework use is actively monitored through NHS England’s governance mechanisms, with additional oversight applied to trusts with recurring non-compliance.The NHS Planning Guidance 2025/26 states that trusts should reduce their agency spend by a minimum of 30%, and the accompanying Revenue Finance and Contracting Guidance sets the ambition that agency spend should be eliminated in the coming years.

What the average cost to the public purse is of one band 5 nursing hour supplied by (a) On-framework staffing agencies and (b) Off-framework staffing agencies to the NHS in each year since 2019.

The Department does not hold the data requested.The Government is committed to reducing off-framework agency use, the cost of which is at a premium, above the agreed framework rates. Additionally, staff hired through off-framework agencies are not subject to the same pre-employment checks as those carried out by on-framework agencies. Off-framework use is actively monitored through NHS England’s governance mechanisms, with additional oversight applied to trusts with recurring non-compliance.The NHS Planning Guidance 2025/26 states that trusts should reduce their agency spend by a minimum of 30%, and the accompanying Revenue Finance and Contracting Guidance sets the ambition that agency spend should be eliminated in the coming years.

What steps he took to raise awareness of the consultation on the proposed 2025/26 NHS Payment Scheme.

NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service funded services, the consultation accepts responses from any interested parties and members of the general public.On publication, all providers and commissioners affected by the proposals were sent details of the consultation, and were asked to respond.As well as publishing the documents on NHS England’s website, the consultation was also publicly available on NHS England’s consultation hub, which is available at the following link:https://www.engage.england.nhs.uk/An email to highlight the consultation was also sent to over 4,300 people, including those from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the Payment System Support FutureNHS. A reminder was also sent out a week before the consultation closed.NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. Of the responses that were received regarding the consultation, 621 were from the general public, namely individuals who did not specify an organisation.

How many members of the public were consulted as part of the stakeholder engagement on changes to the NHS payment scheme.

NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service funded services, the consultation accepts responses from any interested parties and members of the general public.On publication, all providers and commissioners affected by the proposals were sent details of the consultation, and were asked to respond.As well as publishing the documents on NHS England’s website, the consultation was also publicly available on NHS England’s consultation hub, which is available at the following link:https://www.engage.england.nhs.uk/An email to highlight the consultation was also sent to over 4,300 people, including those from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the Payment System Support FutureNHS. A reminder was also sent out a week before the consultation closed.NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. Of the responses that were received regarding the consultation, 621 were from the general public, namely individuals who did not specify an organisation.

What steps action he is taking to help reduce waiting times for mental health treatment in (a) Shropshire and (b) England.

The latest NHS Talking Therapies data for England show that as of December 2024, 91.2% of people completing treatment waited less than six weeks for their first appointment, against a target of 75%. Additionally, 98.4% of people completing treatment waited less than 18 weeks, against a target of 95%.Waiting times data for NHS Talking Therapies are not held at constituency or county level but are available at integrated care board (ICB) level through the NHS Mental Health Dashboard, which is available at the following link: https://www.england.nhs.uk/publication/nhs-mental-health-dashboard/Despite the challenging fiscal environment, the Government has chosen to prioritise the funding to deliver expansions of NHS Talking Therapies and Individual Placement & Support schemes, demonstrating our commitment to addressing the root cause of mental health issues and providing support for people with severe mental illness to contribute to the economy by remaining in or returning to work.

What proportion of savings from cuts to NHS England and ICB running costs will be directed to (a) primary care, (b) secondary care and (c) social care.

Ministers will work with the new transformation team at the top of NHS England, led by James Mackey, to ensure that the expected hundreds of millions of pounds worth of savings made will be reinvested in frontline services to deliver better care for patients.