Written questions by Morgan.

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.

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 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 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 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.

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 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.

Communities and Local Government, when she plans to respond to Question 24712, tabled on 17 January 2025.

I refer the hon. Member to the answer I gave to Question UIN 24712 on 12 February.

Food and Rural Affairs, what steps he is taking to support community farms.

We welcome community farms in England as they give local communities a chance to get involved in the countryside. Community farms, like any other farm, may be eligible for a variety of grants. Depending on the setup of the community farm, projects may be eligible for the Environmental Land Management (ELM) schemes such as the Sustainable Farming Incentive. Our ELM schemes provide fairer support to smaller farms, and farmers and land managers can choose the scheme or schemes that work best for their business. To work out what’s available, you can visit the ‘funding for farmers, growers and land managers’ landing page on GOV.UK.

Food and Rural Affairs, when he plans to respond to Question 24518 on Farming Recovery Fund, tabled on 16 January 2025 by the hon. Member for North Shropshire.

A response to Question 24518 is being prepared and will be provided as soon as possible. I apologise for the delay in responding to the hon. Member.

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.

What steps she is taking to tackle illegal drug (a) use and (b) dealing in market towns.

The Government recognises the considerable impact of drug use and dealing on individuals, families and communities across the country, and tackling this is a vital part of our missions to deliver safer streets and improve health outcomes.That is why we are taking a collaborative, cross-government approach to drugs at a national level. We are dedicated to driving down drug-related harms through prevention and treatment, while acting quickly to stop the criminals peddling these harmful substances.Local drugs partnerships across England provide a whole-system, multi-agency response from police, probation, public health, the NHS and other local partners.

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.

If she will take steps to introduce a national strategy to deal with the prevalence of illegal drug (a) use and (b) dealing.

The Government recognises the considerable impact of drug use and dealing on individuals, families and communities across the country, and tackling this is a vital part of our missions to deliver safer streets and improve health outcomes.That is why we are taking a collaborative, cross-government approach to drugs at a national level. We are dedicated to driving down drug-related harms through prevention and treatment, while acting quickly to stop the criminals peddling these harmful substances.Local drugs partnerships across England provide a whole-system, multi-agency response from police, probation, public health, the NHS and other local partners.