Written questions by Morgan.

If he will update guidance to allow 30mph speed limit repeater signs on roads with street lighting.

The Department has no plans to update legislation to allow 30mph speed limit repeater signs on roads with street lighting. Repeater signing is not used on street lit roads subject to a 30mph speed limit because the lamp columns act as the repeaters. Guidance is provided in rule 124 of the Highway Code. This has been law for over 70 years and all drivers are required to learn this in order to pass their driving test.

If he will set a target date for the implementation of a nationwide prostate cancer screening programme for men with a BRCA variant.

My Rt Hon. Friend, the Secretary of State for Health and Social Care will consider the final recommendation of the UK National Screening Committee (UK NSC) on screening for prostate cancer when it is received. He will make a decision on implementation, including any timeline, at that point.It is anticipated that the final recommendation will be provided in early 2026 after the conclusion of a 12 week consultation which opened on 28 November 2025. This seeks views on an evidence review and a draft recommendation to:offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from 45 years old to 61 years old;not recommend population screening;not recommend targeted screening of black men;not recommend targeted screening of men with family history; andcollaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history as soon as the trial data becomes available, and to await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of benefit and harm of screening.

What recent assessment his Department has made of the potential impact of the Joint Committee on Vaccination and Immunisation’s recommendation to narrow eligibility for the COVID-19 vaccination programme in 2025–26 on public health and the economy.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of serious illness, resulting in hospitalisations and deaths, arising from COVID-19.The JCVI has advised that population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed. The Government has accepted the JCVI’s advice for autumn 2025 and in line with this, a COVID-19 vaccination is being offered to the following groups:- adults aged 75 years old and over;- residents in care homes for older adults; and- individuals aged six months and over who are immunosuppressed.Under their standard cost-effectiveness approach, the JCVI considers a vaccination programme cost effective if the health benefits are greater than the opportunity costs. The Department does not ask the JCVI to complete an assessment of the wider economic benefits of a vaccination programme.As for all vaccines, the JCVI keeps the evidence under regular review.

If he will publish the full modelling and cost-effectiveness analyses underpinning the JCVI’s advice on COVID-19 vaccination eligibility for winter 2025–26, including the assumptions used on transmission, hospitalisation, mortality, and productivity losses.

The Joint Committee on Vaccination and Immunisation’s (JCVI) advice on COVID-19 vaccination in 2025 and spring 2026 was published on 13 November 2024. The JCVI met in September and October 2024 to formulate this advice, carefully considering the evidence on risk of illness, hospitalisation, or death as a consequence of infection, vaccine effectiveness and safety, and modelling and cost-effectiveness analysis. The minutes of these meetings, including a summary of the evidence considered, were made publicly available on the GOV.UK website in November 2024, and are available at the following link:https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisationThe cost-effectiveness analysis of COVID-19 vaccination in 2025 and spring 2026 was carried out by the University of Warwick. This was published in the peer-reviewed academic journal ‘Vaccine’ in April 2025 by Keeling et al, including with a detailed description of the methodology and assumptions used, and is available at the following link:https://www.sciencedirect.com/science/article/pii/S0264410X25002452As per the JCVI Code of Practice, productivity losses were not included in this cost-effectiveness analysis.

What data he holds on NHS spending on external consultants for (a) compliance and (b) the recovery of Value Added Tax.

My Rt Hon. Friend, the Secretary of State for Health and Social Care does not hold detailed data which can identify consultancy spending for compliance and the recovery of Value Added Tax.

What assessment she has made of the adequacy of legislation regarding VAT and the NHS following the First-tier Tribunal's ruling in the case of Isle of Wight NHS Trust v HMRC [2025] UKFTT 1114 (TC).

The government is carefully considering the impact of the Isle of Wight decision on the VAT treatment of the supply of temporary medical staff. HMRC will publish updated guidance in due course.

What steps he is taking to improve (a) monitoring of the medicine supply chain and (b) verification of medicines.

The resilience of the United Kingdom’s supply chains is a key priority, and the Department and NHS England are committed to helping to build long term supply chain resilience for medicines. We are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and strengthen our resilience. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency and other colleagues across the supply chain as we progress work to co-design and deliver solutions. However, medicine shortages are a complex and global issue and everyone in the supply chain has a role to play in addressing them, as any action will require a collaborative approach.We proactively monitor of supply and demand where there are particular concerns or threats to supply and as part of the management of live issues.Potential disruption can also be identified early through targeted monitoring around specific events or risks. For example, growing demand and challenges in forecasting disease rates during winter, combined with broader strains on healthcare, can put extra pressure on already stressed supply chains. For the past two winters, the Department and NHS England set up a winter monitoring group to proactively monitor, analyse, and assess demand trends for a specified subset of medicines most likely to be needed. These medicines were identified by analysing historical demand data, together with known supply constraints and clinical criticality.While manufacturers are not mandated to put verification barcodes on products, they are able to do so. This can help identify medicines accurately, automate storage and retrieval, verify expiry dates and batch numbers, and ensure the right product reaches the right patient, including automated dispensing or specific checks of the products due to be administered on hospital wards.

What steps his Department is taking to leverage emerging technologies to combat falsified medicines and improve patient safety.

No assessment of the impact of the disapplication of the EU Falsified Medicines Directive (EU FMD) on the United Kingdom’s medicine supply chain has been made by the Department. However, the Medicines and Healthcare products Regulatory Agency (MHRA) is not aware of any falsified medicines reaching patients through the legal supply chain in at least the last five years.The MHRA leads work to combat falsified medicines and protect patient safety, including through the application of the Human Medicines Regulations 2012 to online and retail sales. The MHRA uses several different approaches to support its work to combat falsified medicines entering the UK supply chain, including by leveraging emerging technology, for instance:Its FakeMeds campaign guides the public on how to buy medicines online from safe and legitimate sources;suspected side effects or falsified medicines can be reported through the MHRA’s Yellow Card scheme;it is exploring the use of artificial intelligence to proactively identify illicit internet domains for enforcement action;it is working with Ofcom to use the new preventative powers provided by the Online Safety Act for regulating online platforms;it is developing an online service enabling users to check whether a website has been classified as ‘Not Recommended’; andit is developing a new web-based reporting tool to allow users to report suspicious online sellers directly to its Criminal Enforcement Unit.Any additional initiatives to use emerging technologies, such as smartphone verification scanning, would require careful consideration of the evidence of the reduction of the risk to patients, as well as investment needed for infrastructure, and further regulatory changes for manufacturers and wholesalers. There are provisions in the Medicines and Medical Devices Act 2021 providing powers to enable the introduction of a similar system to the EU FMD with ‘safety features’ and verification in the UK. However, the powers allow us to go beyond the EU FMD and use derived data from any system for other health related purposes. For example, to support the recall of medicines, to support patient care, research, policy development, medicine supply, preventing diversion, supporting patient access to medicines, and countering fraud in primary care. However, regulations would be needed to set out the detail of any scheme, which would require consultation. Consideration is being given as to whether to consult on options for a potential UK system.

What assessment he has made of the efficacy of smartphone-enabled barcode scanning in the verification of medicines.

No assessment of the impact of the disapplication of the EU Falsified Medicines Directive (EU FMD) on the United Kingdom’s medicine supply chain has been made by the Department. However, the Medicines and Healthcare products Regulatory Agency (MHRA) is not aware of any falsified medicines reaching patients through the legal supply chain in at least the last five years.The MHRA leads work to combat falsified medicines and protect patient safety, including through the application of the Human Medicines Regulations 2012 to online and retail sales. The MHRA uses several different approaches to support its work to combat falsified medicines entering the UK supply chain, including by leveraging emerging technology, for instance:Its FakeMeds campaign guides the public on how to buy medicines online from safe and legitimate sources;suspected side effects or falsified medicines can be reported through the MHRA’s Yellow Card scheme;it is exploring the use of artificial intelligence to proactively identify illicit internet domains for enforcement action;it is working with Ofcom to use the new preventative powers provided by the Online Safety Act for regulating online platforms;it is developing an online service enabling users to check whether a website has been classified as ‘Not Recommended’; andit is developing a new web-based reporting tool to allow users to report suspicious online sellers directly to its Criminal Enforcement Unit.Any additional initiatives to use emerging technologies, such as smartphone verification scanning, would require careful consideration of the evidence of the reduction of the risk to patients, as well as investment needed for infrastructure, and further regulatory changes for manufacturers and wholesalers. There are provisions in the Medicines and Medical Devices Act 2021 providing powers to enable the introduction of a similar system to the EU FMD with ‘safety features’ and verification in the UK. However, the powers allow us to go beyond the EU FMD and use derived data from any system for other health related purposes. For example, to support the recall of medicines, to support patient care, research, policy development, medicine supply, preventing diversion, supporting patient access to medicines, and countering fraud in primary care. However, regulations would be needed to set out the detail of any scheme, which would require consultation. Consideration is being given as to whether to consult on options for a potential UK system.

What assessment he has made of the impact of the disapplication of the EU Falsified Medicines Directive on the UK’s medicine supply chain.

No assessment of the impact of the disapplication of the EU Falsified Medicines Directive (EU FMD) on the United Kingdom’s medicine supply chain has been made by the Department. However, the Medicines and Healthcare products Regulatory Agency (MHRA) is not aware of any falsified medicines reaching patients through the legal supply chain in at least the last five years.The MHRA leads work to combat falsified medicines and protect patient safety, including through the application of the Human Medicines Regulations 2012 to online and retail sales. The MHRA uses several different approaches to support its work to combat falsified medicines entering the UK supply chain, including by leveraging emerging technology, for instance:Its FakeMeds campaign guides the public on how to buy medicines online from safe and legitimate sources;suspected side effects or falsified medicines can be reported through the MHRA’s Yellow Card scheme;it is exploring the use of artificial intelligence to proactively identify illicit internet domains for enforcement action;it is working with Ofcom to use the new preventative powers provided by the Online Safety Act for regulating online platforms;it is developing an online service enabling users to check whether a website has been classified as ‘Not Recommended’; andit is developing a new web-based reporting tool to allow users to report suspicious online sellers directly to its Criminal Enforcement Unit.Any additional initiatives to use emerging technologies, such as smartphone verification scanning, would require careful consideration of the evidence of the reduction of the risk to patients, as well as investment needed for infrastructure, and further regulatory changes for manufacturers and wholesalers. There are provisions in the Medicines and Medical Devices Act 2021 providing powers to enable the introduction of a similar system to the EU FMD with ‘safety features’ and verification in the UK. However, the powers allow us to go beyond the EU FMD and use derived data from any system for other health related purposes. For example, to support the recall of medicines, to support patient care, research, policy development, medicine supply, preventing diversion, supporting patient access to medicines, and countering fraud in primary care. However, regulations would be needed to set out the detail of any scheme, which would require consultation. Consideration is being given as to whether to consult on options for a potential UK system.

What assessment his Department has made of the efficacy of hospitals delivering specialist multi-disciplinary teams for patients experiencing homelessness.

The Department published guidance in 2024 called Discharging people at risk of or experiencing homelessness to support the care transfer hub, which is available at the following link:https://www.gov.uk/government/publications/discharging-people-at-risk-of-or-experiencing-homelessness/discharging-people-at-risk-of-or-experiencing-homelessnessThis guidance recognises the necessity for multi-disciplinary teams. It recommends that dedicated housing options officers are embedded within the care transfer hub and advises hospitals treating over 200 homeless patients a year to offer access to a specialist multi-disciplinary homeless discharge team.Some areas of the country have introduced High Intensity Use Services to proactively meet the needs of the most frequent attenders of the local accident and emergency, a significant portion of whom are experiencing homelessness. These services include multi-disciplinary teams that are helping to address health inequalities faced by this cohort while alleviating pressure on urgent and emergency care pathway,

Communities and Local Government, what steps his Department is taking with the Department of Health and Social Care to reduce the number of people discharged from NHS care into homelessness.

In January 2024, the Ministry of Housing, Communities and Local Government and the Department of Health and Social Care published Discharging people at risk of or experiencing homelessness, guidance to help staff plan safe discharges and prevent homelessness after NHS care. We will look closely at the issue of people being discharged from NHS care into homelessness in our cross-government Homelessness Strategy.

If he will work with patients and charities in the development of a successor to the UK Rare Diseases Framework.

Patient voice is an underpinning theme of the UK Rare Diseases Framework, and we are committed to ensuring that the patient voice is a key driver of the action plans published under this framework. The UK Rare Diseases Framework was published following the National Conversation on Rare Diseases, which received nearly 6,300 responses. This helped identify the four priorities of the framework in tackling rare diseases: helping patients get a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better coordination of care; and improving access to specialist care, treatment, and drugs.The Government remains committed to improving the lives of those living with rare conditions, and will be publishing the next England Rare Diseases Action Plan for rare disease day in 2026, as in previous years. We recognise that despite the progress that has been made, there remains considerable unmet need for people living with rare conditions. Ministers from all four nations have agreed to extend the UK Rare Diseases Framework by one year, recognising the continued relevance of its four priorities. We will continue to engage with the rare diseases community to help shape the next steps.

If he will publish a timeline for refreshing the UK Rare Diseases Framework.

Patient voice is an underpinning theme of the UK Rare Diseases Framework, and we are committed to ensuring that the patient voice is a key driver of the action plans published under this framework. The UK Rare Diseases Framework was published following the National Conversation on Rare Diseases, which received nearly 6,300 responses. This helped identify the four priorities of the framework in tackling rare diseases: helping patients get a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better coordination of care; and improving access to specialist care, treatment, and drugs.The Government remains committed to improving the lives of those living with rare conditions, and will be publishing the next England Rare Diseases Action Plan for rare disease day in 2026, as in previous years. We recognise that despite the progress that has been made, there remains considerable unmet need for people living with rare conditions. Ministers from all four nations have agreed to extend the UK Rare Diseases Framework by one year, recognising the continued relevance of its four priorities. We will continue to engage with the rare diseases community to help shape the next steps.

What steps he is taking to address regional variation in access to rare disease care.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. England’s 2025 Rare Diseases Action Plan was published in February and reports on actions to address health inequalities for people with rare conditions.Within the National Health Service specialised commissioning portfolio, there are over 80 highly specialised services (HSS) including for rare diseases. Every three to four years, the geographical spread of patients accessing NHS England commissioned highly specialised services is reviewed, most recently in 2024. The analysis looks for variations in the spread of patients accessing the service that may warrant further investigation. Where the analysis found unexpected variation, providers have been asked to develop action plans to address these inequities. Providers who have been successful in reducing variation have also been asked to share this good practice.

What steps he is taking to improve helipad access at hospitals in the Midlands Air Ambulance region.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport on helipad accessibility for air ambulances across the country including the Midlands.

Media and Sport, pursuant to the Answer of 3 November 2025 to Question 87461 on Arts: West Midlands, what steps she is taking to include policies relating to local authorities outside of mayoral strategic authorities within the Creative Industries Sector Plan.

There are creative industries clusters and micro clusters in every part of the UK and they are equally crucial to growth. We are keen to ensure that there are no cultural not-spots in the country and that everyone has an equal chance to pursue a career in the creative industries whether they live in a major metropolitan area or not. The CI Sector Plan includes a universal offer to drive growth in the creative industries in any place in the UK, outlining new measures to break down barriers such as access to finance, supply of skills, and new support to kickstart innovation.

How many (a) Single Living Accommodation units and (b) Service Family Accommodation homes in (i) north Shropshire and (ii) Shropshire have recorded (A) Legionella, (B) unsafe water temperatures, (C) failed water hygiene checks and (D) all of the above in each year since 2015.

The tables below give the number of reports of (A) Legionella in Single Living Accommodation (SLA) across Shropshire and North Shropshire, as at 18 November 2025. Data prior to 1 April 2018 is not held. Shropshire YearLegionella201812019102020202021582022334202350520244412025333 North Shropshire YearLegionella201812019020204202132022231202331920242152025183 For SLA, information on the number of reports of (B) unsafe water temperatures and (C) failed hygiene checks can only be provided at disproportionate cost. For Service Family Accommodation, no (A) Legionella incidents, (B) unsafe water temperatures, or (C) failed water hygiene checks have occurred in Shropshire or North Shropshire since April 2022. Data prior to April 2022 is not held. Data prior to April 2022 is not held as the Future Defence Infrastructure Services (FDIS) contract started in 2022, hence why data starts from April 2022.

How many Single Living Accommodation units in (a) north Shropshire and (b) Shropshire were (i) flats, (ii) dormitories, (iii) container-type accommodation and (iv) other types of accommodation in each year since 2015.

The tables below provide a breakdown of Single Living Accommodation (SLA) in (a) North Shropshire and (b) Shropshire: Information prior to 1 January 2023 is not held. (a) North Shropshire: Year(i) Flats(ii) Dormitory*(iii) Container Type**(iv) Other*** 20230320506202403205102025 (up until 18 Nov)0320509 (b) Shropshire: Year(i) Flats(ii) Dormitory* (iii) Container Type**(iv) Other***202301,87402,148202401,874882,2632025 (up until 18 Nov)01,842882,148 * A dormitory is a room with multiple occupancy.** Bedspaces identified as ‘Container-Type’ are modular temporary accommodation units.*** Bedspaces identified under ‘Other’ are those with individual bedrooms.

How many Single Living Accommodation units in (a) north Shropshire and (b) Shropshire have been assessed as being in condition grade (i) A, (ii) B, (iii) C, (iv) D and (v) deemed uninhabitable in each year since 2015.

This information is not held in the format requested. For Single Living Accommodation, the condition grade is determined by categories, as detailed in the tables below: (a) North Shropshire: YearAs NewServiceableMinor RepairsMajor RepairsReplacement required, unsafe to useNo Condition Score201801140012019011400120200114001202101140022022091002202302800220240280012025 (up until 18 Nov)038000 (b) Shropshire:YearAs NewServiceableMinor RepairsMajor RepairsReplacement Replacement required, unsafe to useNo Condition Score20182808001420192808001420202808001420212808001620222785004202305810032024855830022025(up until 18 Nov)85682001