Written questions by Morgan.

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/

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.

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.

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 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.

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.

What proportion of savings from changes to (a) NHS England and (b) Integrated care boards running costs will go the consolidated fund.

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 of savings made will be reinvested in frontline services to deliver better care for patients.

Whether he plans to ask ICBs to reduce running costs by half.

As part of the necessary changes to support the National Health Service to recover, NHS England has indicated that integrated care boards (ICBs) should reduce running costs. The Government is supportive of NHS England taking the action needed to get the NHS back on its feet.The reduction in ICB running costs is a necessary step to ensure that more funding is directed toward frontline health services, where it is needed most. These changes will streamline commissioning and administrative costs so we can prioritise patient care and improve health outcomes. This decision reflects our commitment to delivering the best possible services while using resources responsibly.

What steps he is taking to help ensure that elective service changes to the NHS Payment Scheme comply with legislation on the NHS Right to Choose.

Patients will continue to have the right to choose their provider as set out in legislation. The proposed NHS Payment Scheme does not and cannot change this.The Government is committed to patients having the right to choose their provider when referred to consultant-led treatment, or to a mental health professional, for their first appointment as an outpatient. Further information on the choices available for patients can be found on the NHS Choice framework, which is available at the following link:https://www.gov.uk/government/publications/the-nhs-choice-framework

What assessment he has made of the potential impact of elective services changes in the NHS payment scheme on (a) patients and (b) people with (i) ADHD and (ii) other disabilities.

As required by law, NHS England has assessed the impact of the proposed NHS Payment Scheme. This is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/01/25-26-NHSPS-Consultation-notice-C-impact-assessment.pdfThis impact assessment includes consideration of the impact on patient choice, as well as an assessment of the impact on patients, in line with NHS England’s public sector equality duty.Attention deficit hyperactivity disorder (ADHD) patients will continue to benefit from the Right to Choose their provider at the point of referral. None of the proposed changes to the NHS Payment Scheme included in the consultation would change this.Local integrated care boards (ICBs) are responsible for planning service provision in their local area, including for ADHD assessments. In planning local services, ICBs should take account of waiting lists. It is important that local National Health Service systems live within their means and manage their finite resources, prioritising the specific health needs of their local population.NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the NHS, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer.The consultation on the proposed NHS Payment Scheme closed on 28 February 2025. The outcome of the consultation will be published shortly once all responses received have been fully considered and any decisions made about the final Payment Scheme.

What assessment he has made of the potential impact of proposed changes to (a) elective and (b) activity-based payments on (i) access to (A) (1) ADHD and (2) other medication and (B) other treatments and (ii) the timeframe in which NHS England patients who opt to use Right to Choose will receive their treatment.

As required by law, NHS England has assessed the impact of the proposed NHS Payment Scheme. This is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/01/25-26-NHSPS-Consultation-notice-C-impact-assessment.pdfThis impact assessment includes consideration of the impact on patient choice, as well as an assessment of the impact on patients, in line with NHS England’s public sector equality duty.Attention deficit hyperactivity disorder (ADHD) patients will continue to benefit from the Right to Choose their provider at the point of referral. None of the proposed changes to the NHS Payment Scheme included in the consultation would change this.Local integrated care boards (ICBs) are responsible for planning service provision in their local area, including for ADHD assessments. In planning local services, ICBs should take account of waiting lists. It is important that local National Health Service systems live within their means and manage their finite resources, prioritising the specific health needs of their local population.NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the NHS, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer.The consultation on the proposed NHS Payment Scheme closed on 28 February 2025. The outcome of the consultation will be published shortly once all responses received have been fully considered and any decisions made about the final Payment Scheme.

What information his Department holds on the amount of money clawed back by NHS England 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 associated contract delivery data, annually. This information includes additional NHS dental payments and deductions each year since 2015. NHS England contracts with dentists to deliver NHS dental services, with the amount of NHS dental care to deliver and financial value specified in each contract. Deductions to this amount include where a dentist does not deliver the contracted amount of NHS dental care. These publications are available at the following link:https://www.nhsbsa.nhs.uk/dental-data/nhs-payments-dentists

If he will make an estimate of the number of pharmacies that have been registered in each integrated care board area for each year since financial year 2021-22.

NHS England maintains the lists of National Health Service pharmacies in each Health and Wellbeing Board area. As high volumes of changes take place each month, the consolidated pharmaceutical list is produced and validated on a quarterly basis. Since the second quarter of 2022/23, the consolidated lists are published on the NHS Business Services Authority (NHSBSA) Open data portal, which is available at the following link:https://opendata.nhsbsa.net/dataset/consolidated-pharmaceutical-listThe following table shows the number of community pharmacies included in the fourth quarter consolidated pharmaceutical list for each integrated care board (ICB) between 2021/22 and 2023/24: ICB31 March 202231 March 202331 March 202431 December 2024Bath and North East Somerset, Swindon and Wiltshire ICB146148138138Bedfordshire, Luton and Milton Keynes ICB158159151149Birmingham and Solihull ICB317312304301Black Country ICB280275267263Bristol, North Somerset and South Gloucestershire ICB167167156156Buckinghamshire, Oxfordshire and Berkshire West ICB264265249248Cambridgeshire and Peterborough ICB149151141140Cheshire and Merseyside ICB585578542540Cornwall and the Isles of Scilly ICB98999490Coventry and Warwickshire ICB196194184181Derby and Derbyshire ICB209206198197Devon ICB224225204203Dorset ICB144143138135Frimley ICB137137130129Gloucestershire ICB110110105105Greater Manchester ICB656653631626Hampshire and the Isle of Wight ICB305300284283Herefordshire and Worcestershire ICB122121118116Hertfordshire and West Essex ICB286286269266Humber and North Yorkshire ICB324323300297Kent and Medway ICB325323308305Lancashire and South Cumbria ICB395390368367Leicester, Leicestershire and Rutland ICB228227222222Lincolnshire ICB117115112114Mid and South Essex ICB217214199198Norfolk and Waveney ICB182181171169North Central London ICB299295290290North East and North Cumbria ICB651648614613North East London ICB380382371368North West London ICB502500477475Northamptonshire ICB127126125125Nottingham and Nottinghamshire ICB227226221216Shropshire and Telford and Wrekin ICB83838279Somerset ICB1011009191South East London ICB336338326323South West London ICB292293278272South Yorkshire ICB310312305304Staffordshire and Stoke on Trent ICB240238233232Suffolk and North East Essex ICB170171162162Surrey Heartlands ICB176175162160Sussex ICB310311291290West Yorkshire ICB545543514505Source: NHSBSANote: The consolidated pharmaceutical list for the fourth quarter of 2024/25 will be published once the validation process is completed, so the third quarter data of 2024/25 has been provided instead.

What information his Department holds on the number of hours pharmacies were open in (a) 2015 and (b) 2024.

The Department does not hold opening hours data for pharmacies in 2015. Data for opening hours from 2022 is available at the following link:https://opendata.nhsbsa.net/dataset/consolidated-pharmaceutical-list

If he will take steps to ensure there will be no deterioration in access to the Pharmacy First scheme in the next financial year.

The Government recognises that pharmacies are an integral part of the fabric of our communities, as an easily accessible front door to the National Health Service, staffed by highly trained and skilled healthcare professionals.The Government is committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes embedding the Pharmacy First service.We are working at pace with Community Pharmacy England to ensure that the funding we have available is used to support community pharmacy in the best way possible, to support them in dispensing medicines to patients and in offering a range of clinical services, including Pharmacy First.We will announce the outcome of the consultation in the normal manner, by letter to contractors, when the consultation has concluded.

What steps he is taking to expand access to the Pharmacy First scheme.

The Government recognises that pharmacies are an integral part of the fabric of our communities, as an easily accessible front door to the National Health Service, staffed by highly trained and skilled healthcare professionals.The Government is committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes embedding the Pharmacy First service.We are working at pace with Community Pharmacy England to ensure that the funding we have available is used to support community pharmacy in the best way possible, to support them in dispensing medicines to patients and in offering a range of clinical services, including Pharmacy First.We will announce the outcome of the consultation in the normal manner, by letter to contractors, when the consultation has concluded.

What steps he is taking to prevent pharmacy closures.

The Government recognises that pharmacies are an integral part of the fabric of our communities, as an easily accessible front door to the National Health Service, staffed by highly trained and skilled healthcare professionals.The Government is committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes embedding the Pharmacy First service.We are working at pace with Community Pharmacy England to ensure that the funding we have available is used to support community pharmacy in the best way possible, to support them in dispensing medicines to patients and in offering a range of clinical services, including Pharmacy First.We will announce the outcome of the consultation in the normal manner, by letter to contractors, when the consultation has concluded.

What discussions he has had with the Chancellor of the Exchequer on the potential impact of increased National Insurance contributions on pharmacies.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, and this enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26.The employer National Insurance rise will be implemented from April 2025. The Government will provide support for departments for additional employer National Insurance contribution costs for public sector employers only, and the level of funding will be confirmed at Main Estimates shortly.