Written questions by Morgan.

What steps he is taking to (a) reduce potential disparities between waiting times for mental health services and physical health services and (b) ensure mental health is given equal priority to physical health.

We recognise that people with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health. This includes recruiting 8,500 more mental health workers, introducing access to specialist mental health professionals in every school, rolling out Young Futures hubs in every community, and modernising the Mental Health Act.

With reference to the press notice entitled Dental patients to benefit from 700,000 extra urgent appointments, published on 21 February 2025, if he will list the number of additional urgent dental appointments that will be made available in each Integrated Care Board area.

We will deliver 700,000 extra urgent dental appointments per year, and have already requested that integrated care boards (ICBs) start making extra appointments available from April 2025. NHS England issued a letter to the ICBs to start the rollout of the 700,000 urgent dental appointments. The letter provides specific targets for each ICB and the number of additional appointments they are expected to deliver, with further information available at the following link: https://www.england.nhs.uk/long-read/arrangements-for-nhs-urgent-primary-dental-care-during-2025-26-and-confirmation-of-the-closure-of-the-new-patient-premium-scheme/#annex-a-distribution-of-700k-additional-appointments

What steps his Department is taking to (a) improve the quality of administrative tasks within the NHS and (b) reduce the number of people receiving an invitation to an appointment after the date it is supposed to have taken place.

The Government is putting patients first, making sure they are seen as quickly as possible and have the best possible experience, which includes receiving timely communication and experiencing high quality administration.The Elective Reform Plan, published in January 2025 as part of the Government’s Plan for Change, sets out the reform we will deliver to reduce waiting times and improve experience of care. This will be patient-led and co-developed with people that use the National Health Service. We will work with patients, carers, and their representatives to target the things that matter most and will publish minimum standards patients should expect to experience.We are reforming the digital landscape to improve productivity, communication, and offer greater convenience for NHS service users, including changing the NHS App to make it easier and more helpful for patients to access information about their appointments. By the end of March 2025, 85% of acute trusts will allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. We will also provide high quality, non-digital options for those who want and need them.The Government is also reducing the burden of administrative tasks in the NHS. On Friday 4 October 2024, the Government and NHS England launched a Red Tape Challenge to address bureaucracy between primary and secondary care and give our health professionals back time to do what they do best. The challenge is being led by NHS England leaders, Medical Director for Primary Care, Dr Claire Fuller, and Medical Director for Secondary Care and Quality, Stella Vig.

With reference to the press release entitled Dental patients to benefit from 700,000 extra urgent appointments, published on 21 February 2025, if he will instruct NHS England to make further changes to the commissioning of NHS dentistry in 2025.

To rebuild dentistry in the long term, we will reform the dental contract, with a shift to focus on prevention and the retention of National Health Service dentists.There are no perfect payment models and careful consideration needs to be given to any potential changes to the complex dental system so that we deliver genuine improvements for patients and the profession.We are continuing to work with the British Dental Association and other representatives of the dental sector to deliver our shared ambition to improve access to treatments for NHS dental patients. At the same time, we will not wait to make improvements to the current system, where they can increase access and incentivise the workforce to deliver more NHS care.

With reference to the press release entitled Dental patients to benefit from 700,000 extra urgent appointments, published on 21 February 2025, what methodology his Department used for determining the geographical distribution of the proposed additional urgent dental appointments.

We will deliver 700,000 extra urgent dental appointments per year, and have asked that integrated care boards (ICBs) start making extra appointments available from April 2025. Appointments will be available across the country. Patients will be able to access these additional appointments either through NHS 111, or via helplines set up by their ICB, where these arrangements are in place. NHS England issued a letter to the ICBs to start the rollout of the 700,000 urgent dental appointments. The letter provides the methodology used to determine the allocation of the 700,000 appointments across the ICBs in Annex A, considering factors including unmet need, population size, and projected contract delivery at an ICB level for 2024/25. The letter and annex are available at the following link: https://www.england.nhs.uk/long-read/arrangements-for-nhs-urgent-primary-dental-care-during-2025-26-and-confirmation-of-the-closure-of-the-new-patient-premium-scheme/#annex-a-distribution-of-700k-additional-appointments

What steps he is taking to increase (a) the number of people seeing an NHS dentist and (b) access to NHS dentistry beyond the 700,000 additional urgent dental appointments.

We are determined to rebuild National Health Service dentistry, but it will take time and there are no quick fixes. We will deliver 700,000 extra urgent dental appointments per year, with integrated care boards (ICBs) asked to start making extra appointments available from April 2025. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.ICBs have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.The most common reason children aged between five and nine years old are admitted to hospital is for tooth decay. We will work with local authorities and the NHS to introduce supervised tooth brushing for children aged between three and five years old in the most deprived communities. These programmes are proven to reduce tooth decay and to boost good practices at home.

What progress his Department has made on carrying out an independent economic analysis of pharmacy funding.

NHS England commissioned Frontier Economics to undertake an independent economic analysis of National Health Service pharmacy funding in 2024. This work is nearing completion and will be published at the earliest opportunity.

What steps he is taking to improve access to Pancreatic Enzyme Replacement Therapy in Shropshire.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within local areas is not held centrally.The Department is continuing to engage with all suppliers of pancreatic enzyme replacement therapy (PERT) to boost production and mitigate the supply issue. Suppliers have managed to secure additional pharmaceutical ingredients resulting in expected increased volumes of PERT for 2025. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the gap in the market. In December 2024, the Department issued further management advice to healthcare professionals. This directs clinicians to prescribe unlicensed imports when licensed stock is unavailable, and includes actions for integrated care boards to ensure that local mitigation plans are put in place and implemented. The Department, in collaboration with NHS England, has created a webpage to include the latest updates on PERT availability and easily accessible advice on the prescribing and ordering of alternative PERT products.

What estimate he had made of the number of GP appointments performed by each of the Spine Directory Service roles in 2024.

In 2024, across the general practices (GPs) and primary care networks in England, over 165.8 million appointments were delivered by GPs, 77.3 million were delivered by nurses, 95 million were delivered by other direct patient care staff, and 40.1 million were delivered by professionals of an unknown spine directory service role. There has been a 9.6% increase in appointments delivered in GPs within the last year. In December 2024, 29.2 million appointments were delivered, an increase of 2.5 million appointments compared to December 2023, when 26.7 million were delivered.

With reference to the 2025-26 NHS Payment scheme consultation notice, whether there will be a deterioration in waiting times as a result of payment limits for elective services; and whether there will be (a) a nationally set floor for level of activity of each elective service in each ICB and (b) a minimum level of provision for ADHD and ASD assessments.

As set out in the Elective Reform Plan, integrated care boards (ICBs) will be allocated funding needed to deliver improvements to the 18-week referral-to-treatment performance standard for consultant-led care. The 2025-26 NHS Payment Scheme consultation proposes that, as a minimum, commissioners need to ensure that the planned level of activity would deliver their target referral to treatment time improvement for consultant-led treatments, considering affordability.The consultation also proposes that commissioners have the option of breaking down the planned level of activity into specific limits set at service, specialty or procedure level. These could consider where additional activity is required and where waiting times are already within the 18-week standard. However, there would be no requirement to break the limit down in this way.The introduction of a payment limit is being proposed to increase commissioners’ ability to manage their finite resources prioritising the specific health needs of their populations. In planning local service provision, including for attention deficit hyperactivity disorder and autism spectrum disorder assessments, ICBs should consider how local funding can be deployed to best meet the needs of their local population.

What discussions he is having with the Secretary of State for Housing, Communities and Local Government on improving the coordination of (a) the Local Government Finance Settlement and (b) Public Health Grant allocations.

Following the upcoming Spending Review, we will aim to issue multi-year public health allocations to local authorities from 2026/27, to support local planning.The Department of Health and Social Care will continue to work with the Ministry of Housing, Communities and Local Government to improve coordination of allocations.

If he will take steps to ensure that future announcements on provisional local government finance settlements and public health grants to local authorities are published within a week of each other.

Following the upcoming Spending Review, we will aim to issue multi-year public health allocations to local authorities from 2026/27, to support local planning.The Department of Health and Social Care will continue to work with the Ministry of Housing, Communities and Local Government to improve coordination of allocations.

When the 2025-26 Public Health Grant allocations will be published.

The Government published the 2025/26 Public Health Grant allocations to local authorities on 7 February 2025. These are available at the following link:https://www.gov.uk/government/publications/public-health-grants-to-local-authorities-2025-to-2026

What assessment he has made of the prevalence in the use of off-framework agency staff by NHS providers; and if he will make an assessment of the potential impact of using these staff on NHS finances.

The National Health Service is now operating at the lowest levels of off-framework on record, since a peak in month four of 2022/23, with the highest compliance on capped rates since the introduction of the Agency Rules in 2016.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 2025/26 NHS priorities and operational planning guidance aims to improve procurement, contract management, and work to accept operating models that meet commercial standards. The NHS Planning Guidance 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.

How many nursing shifts went unfilled at acute NHS trusts in each month since January 2020.

The Department does not hold the information requested. The Government is committed to ensuring that the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.In summer 2025, we will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.

Pursuant to the Answer of 3 February 2025 to Question 26911 on Dental Services: Contracts, how many NHS dental providers have had to return their contracts in each month since January 2020.

The following table shows the total number of general dental practice contracts that were terminated by contractors each financial quarter since the first financial quarter of 2020, to September 2021:QuarterNumber of contractor terminationsApril to June 20201July to September 20201October to December 20207January to March 20210April to June 202111July to September 202118 The data collection period changed from quarterly to monthly from October 2021. Therefore, the following table shows the total number of general dental practice contracts that were terminated by contractors in each month from October 2021 to December 2024:MonthNumber of contractor terminationsOctober 20219November 20216December 20216January 20223February 20225March 202222April 202210May 20222June 20227July 20227August 20226September 202210October 20223November 20228December 20220January 20235February 20236March 202320April 20237May 20234June 202328July 20234August 20239September 202317October 20239November 20237December 20239January 202415February 20242March 202412April 20244May 20247June 20247July 20246August 20245September 20245October 20244November 20243December 20241Notes:the data for November and December 2022 has been combined, as there were eight contract terminations between the 1 November and the 31 December; anddata for December 2024 is incomplete and only includes contracts terminated between 1 and 28 December.

Whether public health monies under section 7A of the National Health Service Act 2006 will be ringfenced in 2025.

Currently, there is no ring-fence funding for public health functions delegated by my Rt Hon. Friend, the Secretary of State for Health and Social Care to NHS England, known as section 7A services. Funding for section 7A services is allocated as part of NHS England’s Mandate funding total.

What the annual (a) budget and (b) spend was for public health monies under section 7A of the National Health Service Act 2006 in each year since 2022.

Funding for public health functions delegated by my Rt Hon. Friend, the Secretary of State for Health and Social Care to NHS England, known as section 7A services, is allocated as part of NHS England’s mandate funding total. The following table shows the allocation for section 7A services set by NHS England, and the spend for the financial years 2022/23 and 2023/24, as well as the allocation set for 2024/25:Total NHS England section 7A funding2022/232023/242024/25Allocation£1,804,000£1,675,100£1,650,900Expenditure including COVID-19 vaccinations£1,768,200£1,639,200 Source: NHS England’s validated but unpublished data on section 7A expenditure.Notes:for 2024/25, the allocation figure includes assumptions for demand-led spending on COVID-19 vaccinations so this figure may change; andactual expenditure for 2024/25 will be available after the publication of the 2024/25 NHS England annual report and accounts.

When he plans to announce the unit of dental activity rate for 2025-26; and from what date dentists will receive payments at that rate.

From 1 April 2024, the Department raised the minimum Unit of Dental Activity (UDA) rate to £28 to support practices with historically low UDA rates. Minimum UDA rates are not uplifted annually by the Department, however overall contract values are uplifted annually following the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration. Integrated care boards have the flexibility to influence the UDA rate locally, which may help to support local interventions, and there are differential UDA rates across England. Differential UDA rates allow providers to use differing pay rates to reflect local market rates.

When NHS dentists will receive payment for the 2024-25 unit of dental activity rate increase.

The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has uplifted National Health Service primary care dentistry contract values by 4.64%, net of pay and expenses elements.We have also increased payments for training practices for the first time in more than a decade. The Government implemented the overall uplift to contract values on 29 January. Uplifted payments will be made in March, backdated to 1 April 2024.