Written questions by Morgan.

What criteria were used to determine which providers were included in the Neighbourhood Health Framework.

The Neighbourhood Health Framework is designed to provide clarity and consistency to integrated care boards (ICBs), local authorities, and their partners, in developing and scaling neighbourhood health.The framework outlines the national minimum aims and objectives of neighbourhood health services. It is important that reforms are locally led, as ICBs and local authorities are best placed to design services that make sense for their local populations. Local systems can choose to go further than the minimum aims set out in the framework.General practice, primary care, pharmacies, mental health providers, community health services, social care services, local authorities, and civil society partners are included, to deliver the ambition to shift care from hospital to communities, improve access, and provide proactive, holistic care for people with complex needs.This is not an exhaustive list of all possible providers of neighbourhood health services but illustrates the types of providers with whom we are actively working.No specific criteria were used to determine which providers were included in the framework. The framework does not prevent other providers from being part of neighbourhood health services.

What assessment he has made of the potential impact of the level of volatility in the prices of petrol and diesel on the budgets of hospital trusts and ambulance trusts.

We will be carefully monitoring the impact of the current volatility in fuel prices on the National Health Service, with a view to managing it as part of usual in-year financial management of risk. The impact on fuel prices will be felt by all organisations who rely on fuel for transport, including the indirect potential impact on the cost of deliveries, and direct costs on the NHS fleet which consists of over 20,000 vehicles travelling over 460 million miles every year. The impact is likely to vary, for example as part of the NHS Net Zero travel and transport strategy, a number of ambulance trusts are trialling zero-emission response vehicles.

What assessment he has made of the potential impact of hospital handover delays on the budgets of ambulance trusts.

No specific assessment has been made. The Medium-Term Planning Framework, published in October 2025, recognises handover delays as a system wide responsibility and effective collaboration between ambulance services, acute trusts, integrated care boards, and others is required to reduce ambulance handover times toward the 15-minute standard. NHS England continues to monitor average hospital handover times, sharing data with regions to support focussed discussions and identify improvement actions with those trusts not achieving handovers within 45 minutes.

Whether NHS England has engaged formally with the General Medical Council about the interaction between mandatory pre-referral Advice and Guidance requirements and the professional duty of GPs under General Medical Council guidance to refer patients to specialist care when it is in their best interests to do so; and whether a joint risk assessment or patient safety review has been carried out to ensure GPs are not placed in conflict between their contractual and professional obligations.

In early 2026, we concluded the consultation on the changes to the GP Contract for 2026/27. As part of this process, we expanded the consultation to engage with a wider set of primary care stakeholders, these were the British Medical Association’s General Practitioner’s Committee England, the Royal College of General Practitioners, National Voices, the Institute of General Practice Management, Healthwatch England, the NHS Confederation, and the National Association of Primary Care. The Department has not engaged formally with the General Medical Council (GMC) regarding the interaction between the 2026/27 contractual changes and the professional duties set out in GMC guidance. No formal joint risk assessment or joint patient safety review has been undertaken. However, the Department and NHS England considered the potential risks, benefits, and wider impact of the policy changes as part of standard policy-development processes. The 2026/27 GP Contract embeds the current Advice and Guidance (A&G) enhanced service funding into core practice funding. The contract does not mandate the use of A&G in all circumstances. Instead, practices are expected to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways. This reflects longstanding planned‑care referral practice and does not alter existing legal or professional accountability frameworks for general practitioners (GPs). GPs, and other primary care referrers, remain professionally accountable for making appropriate clinical decisions, including referring patients to specialist care when it is in the patient’s best interests. The use of A&G does not override those responsibilities or place GPs in conflict between contractual and professional obligations. NHS England continues to support clinicians through guidance, pathway design, and local governance arrangements to ensure A&G is used safely, proportionately, and in a way that preserves clear clinical accountability.

What arrangements NHS England has made to ensure that patients retain the statutory right to choose a provider where a mandatory Single Point of Access triage process operates; and what guidance has been issued to Integrated Care Boards on preserving patient choice rights within mandatory Single Point of Access pathways from 1 April 2026.

The policy intention for Advice and Guidance (A&G) and the Elective Single Point of Access (SPoA) model is fully compatible with NHS England’s Patient Choice Guidance, published December 2023. Patients must continue to be offered a choice of provider at the appropriate point in the pathway, and local pathways should be designed to ensure that choice rights operate in practice.The purpose of A&G is to support decision‑making, reduce unnecessary referrals, and deliver more care closer to home. SPoA acts as a single ‘front door’ to support clinical triage to the most appropriate service or outcome, meaning timelier, more joined-up care for patients, without altering patients’ statutory right to choice.NHS England has published system guidance The Elective Single Point of Access: Technical Guidance for 2026/27, which specifies that patients must continue to be offered choice of provider and team at the appropriate point in the pathway when they can make an informed choice. An elective SPoA diagram showing touchpoints of choice is included in the technical guidance annex.

What the referral to treatment clock start date is where a GP resubmits a referral following a Single Point of Access triage outcome with which they disagree; and what guidance NHS England has issued to Integrated Care Boards on the referral to treatment clock start date in these circumstances ahead of mandatory Single Point of Access triage processes taking effect from 1 April 2026.

We're setting the Advice and Guidance (A&G) clock start so it's the same as outpatient referrals, ensuring no patient will have to wait longer for an appointment as a result of A&G As set out in the Medium Term Planning Framework, the National Health Service will move toward delivering care through a ‘Single Point of Access’ (SPoA) for all appropriate requests and referrals, excluding for urgent suspected cancer. Under the new SPoA model, if a patient needs treatment, their Referral to Treatment (RTT) clock start date will be calculated from the date the Advice and Guidance (A&G) request or referral was received by the SPoA. This is instead of the current process for A&G, where the clock start date is the date that the request or referral is converted to a treatment pathway. This will ensure that patients' waiting times are accurately reflected. In February 2026, NHS England issued The Elective Single Point of Access: Technical Guidance for 2026/27 to integrated care boards. This provides guidance on RTT rules and quality assurance arrangements, and advice on establishing leadership and governance structures that ensure SPoA outcomes are assessed regularly. The SPoA will be supported by improvements to the NHS e-Referral Service, which will enable NHS England to collect data on triage outcomes.SPoA is designed to promote clinical collaboration between primary care referrers and secondary care clinicians, including by facilitating two-way communication and shared decision making. General practitioners (GPs) can re-submit a referral following a SPoA triage outcome if they have concerns about the clinical decision. Escalation routes for concerns about triage decisions will continue to operate through locally agreed referral pathways and communication processes for GPs and patients, supported by improvements to the NHS e-Referral Service. Where patients have concerns regarding outcomes, local Patient Advice and Liaison Service teams can provide advice and support.

What quality assurance arrangements NHS England has put in place for mandatory Single Point of Access triage decisions from 1 April 2026; what monitoring will be conducted of triage outcomes by specialty and provider; and how GPs and patients will be able to escalate concerns about triage decisions that they consider clinically inappropriate.

We're setting the Advice and Guidance (A&G) clock start so it's the same as outpatient referrals, ensuring no patient will have to wait longer for an appointment as a result of A&G As set out in the Medium Term Planning Framework, the National Health Service will move toward delivering care through a ‘Single Point of Access’ (SPoA) for all appropriate requests and referrals, excluding for urgent suspected cancer. Under the new SPoA model, if a patient needs treatment, their Referral to Treatment (RTT) clock start date will be calculated from the date the Advice and Guidance (A&G) request or referral was received by the SPoA. This is instead of the current process for A&G, where the clock start date is the date that the request or referral is converted to a treatment pathway. This will ensure that patients' waiting times are accurately reflected. In February 2026, NHS England issued The Elective Single Point of Access: Technical Guidance for 2026/27 to integrated care boards. This provides guidance on RTT rules and quality assurance arrangements, and advice on establishing leadership and governance structures that ensure SPoA outcomes are assessed regularly. The SPoA will be supported by improvements to the NHS e-Referral Service, which will enable NHS England to collect data on triage outcomes.SPoA is designed to promote clinical collaboration between primary care referrers and secondary care clinicians, including by facilitating two-way communication and shared decision making. General practitioners (GPs) can re-submit a referral following a SPoA triage outcome if they have concerns about the clinical decision. Escalation routes for concerns about triage decisions will continue to operate through locally agreed referral pathways and communication processes for GPs and patients, supported by improvements to the NHS e-Referral Service. Where patients have concerns regarding outcomes, local Patient Advice and Liaison Service teams can provide advice and support.

What assessment his Department has made of the potential impact of mandatory pre-referral Advice and Guidance requirements from 1 April 2026 on workload transferred to GP practices, including the workload arising from acting on specialist advice responses, requesting and reviewing diagnostic investigations recommended by specialists, and managing patients while awaiting responses; and whether additional funding has been allocated to reflect that workload transfer.

Advice and Guidance (A&G) is designed to support quicker, clearer clinical decision making, by enabling general practitioners (GPs) and specialists to discuss and agree on the most appropriate next steps for a patient. The 2026/27 GP Contract does not mandate the use of A&G in all circumstances. Instead, practices are expected to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways. In 2025/26 we introduced a £20 payment for GPs for each A&G request, allocating up to a total of £80 million of new funding, which has supported significant increases in A&G. For 2026/27, this funding is being incorporated into the GP Contract to provide a consistent, streamlined approach that recognises the vital role of GPs in delivering A&G. Embedding A&G in the GP Contract recognises it as routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways. We are investing £485 million in GPs in 2026/27, bringing the total spend on the GP Contract to over £13.8 billion. This builds on last year’s £1.1 billion of investment. This uplift represents a 3.6% cash increase, or 1.4% real terms increase, and includes an assumed pay increase of 2.5%. As with previous years, we have asked the independent pay review body for Doctors' and Dentists' Remuneration, for a pay recommendation for 2026/27 for the Government to consider.

How many days were taken by NHS England staff as sick leave in total in each month since January 2024; and what the average number was.

NHS England publishes monthly information on the sickness absence of staff employed by NHS bodies, including NHS England. This is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-sickness-absence-rates

How many days were taken by NHS England staff as sick leave in total in each of the last ten years; and what the average number was.

NHS England publishes monthly information on the sickness absence of staff employed by NHS bodies, including NHS England. This is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-sickness-absence-ratesAnnual (financial year) summaries are included within the publication up to 2021/22. Subsequent years’ sickness absence days taken and the associated sickness absence rates can be constructed by aggregating the monthly published data.

If he will make an assessment of the adequacy of the consistency of the mandatory Single Point of Access triage process with NHS England's Jess's Rule guidance; and what safeguards are in place to ensure that a mandatory Single Point of Access triage process does not return to primary care a patient whom a GP has referred in accordance with that guidance.

The Single Point of Access (SPoA) triage process is consistent with Jess’s Rule.Jess’s Rule is an NHS England patient safety initiative for primary care. It is designed for general practitioners (GPs) and supports them to reconsider a patient’s presentation and/or diagnosis where the patient has attended a GP three or more times and symptoms have escalated, or the diagnosis is uncertain.Jess’s Rule can be used to support a GP’s decision on an appropriate referral within the SPoA model. SPoA will provide a more efficient approach to triaging patients, with all appropriate requests and referrals, excluding urgent suspect cancer, flowing through a single ‘front door’. SPoA supports clinical triage to the most appropriate service or outcome, meaning timelier, more joined-up care for patients. Patients will still have a choice about where they receive care.Safeguards within the SPoA model include senior clinical oversight of triage decisions and the ability for primary care clinicians to re‑escalate concerns where symptoms persist, worsen, or remain unexplained. These arrangements aim to ensure patients who require specialist assessment are not inappropriately managed in the community, and that shared clinical judgement remains central to decision‑making.

What steps she is taking to ensure adherence to the FCA’s Consumer Duty requirement for firms to avoid causing foreseeable harm.

The Financial Conduct Authority's (FCA’s) Consumer Duty requires firms to act in good faith, prevent foreseeable harm, and act in the best interests of consumers. All FCA-authorised firms are required to comply with the Consumer Duty.The FCA has extensive powers to enforce regulations and to impose penalties for breaches of regulation. This includes powers to investigate potential breaches, issue fines and ultimately to withdraw authorisation in the case of serious breaches. The FCA is operationally independent and the Treasury has no role in ensuring firms meet their responsibilities under the Consumer Duty. The Treasury continues to work closely with the FCA to hold it to account for delivering against its statutory objectives, including its objective to secure an appropriate degree of consumer protection in relation to the activities it regulates.

What steps her Department is taking to provide guidance to bus manufacturers on the legislative requirements on size and location of wheelchair space, in the context of the consultation on the Public Service Vehicles Access Regulations.

The Government is committed to improving passenger transport services, so they are more inclusive and enable disabled people to travel safely, confidently and with dignity. As part of our broader mission to break down barriers to opportunity, we recognise that more needs to be done to ensure transport is accessible to all. Our Bus Services Act 2025 includes a comprehensive package of measures to improve the accessibility and inclusivity of local transport. This includes requiring local authorities to regularly review the accessibility of their bus networks through the development and publishing of a Bus Network Accessibility Plan. We are also providing nearly £700 million a year to local transport authorities through the Local Authority Bus Grant over the next three years to maintain and improve local bus services. These allocations include capital funding for most areas, which can be used to improve the accessibility of transport infrastructure. The Public Service Vehicles Accessibility Regulations 2000 (PSVAR) set accessibility minimum standards for physical features on board buses and coaches designed to carry over twenty-two passengers and used on local or scheduled services. These include requirements for the size and location of the wheelchair space. In 2023 the Department undertook a Call for Evidence to understand the efficacy of PSVAR, and we continue to engage regularly with stakeholders, including local authorities, on the impact of the Regulations and how they can support accessible journeys sustainably. We will announce any next steps on PSVAR in the coming weeks. In March 2025, we launched the UK Bus Manufacturing Expert Panel. Over 12 months, this panel brought together industry experts and local leaders to support UK bus manufacturing, develop a pipeline of future bus orders to give better planning certainty to the sector, and to prioritise passenger-centric bus design. The last meeting of the Panel took place on 18 March, during which we secured agreement from Mayors on a set of commitments, including on adopting standards and driving continuous improvement on accessible and inclusive zero emission bus design.

What steps her Department is taking to increase wheelchair accessibility on buses.

The Government is committed to improving passenger transport services, so they are more inclusive and enable disabled people to travel safely, confidently and with dignity. As part of our broader mission to break down barriers to opportunity, we recognise that more needs to be done to ensure transport is accessible to all. Our Bus Services Act 2025 includes a comprehensive package of measures to improve the accessibility and inclusivity of local transport. This includes requiring local authorities to regularly review the accessibility of their bus networks through the development and publishing of a Bus Network Accessibility Plan. We are also providing nearly £700 million a year to local transport authorities through the Local Authority Bus Grant over the next three years to maintain and improve local bus services. These allocations include capital funding for most areas, which can be used to improve the accessibility of transport infrastructure. The Public Service Vehicles Accessibility Regulations 2000 (PSVAR) set accessibility minimum standards for physical features on board buses and coaches designed to carry over twenty-two passengers and used on local or scheduled services. These include requirements for the size and location of the wheelchair space. In 2023 the Department undertook a Call for Evidence to understand the efficacy of PSVAR, and we continue to engage regularly with stakeholders, including local authorities, on the impact of the Regulations and how they can support accessible journeys sustainably. We will announce any next steps on PSVAR in the coming weeks. In March 2025, we launched the UK Bus Manufacturing Expert Panel. Over 12 months, this panel brought together industry experts and local leaders to support UK bus manufacturing, develop a pipeline of future bus orders to give better planning certainty to the sector, and to prioritise passenger-centric bus design. The last meeting of the Panel took place on 18 March, during which we secured agreement from Mayors on a set of commitments, including on adopting standards and driving continuous improvement on accessible and inclusive zero emission bus design.

What steps she is taking to ensure that policyholders with protected characteristics are not discriminated against by insurance companies.

Insurers make commercial decisions about pricing and the terms of cover they offer based on their assessment of the relevant risks. However, the government is determined that insurers treat customers fairly and insurers must comply with relevant legislation, including the Equality Act 2010. The Act generally prohibits discrimination based on certain personal characteristics, though the law accepts that some exceptions apply for insurance. The Financial Conduct Authority’s (FCA) rules also require insurers to treat customers fairly. The FCA requires firms to ensure their products offer fair value (i.e. if the price a consumer pays for a product or service is reasonable compared to the overall benefits they can expect to receive). The FCA has robust powers to monitor firms and, where necessary, to take action against firms that do not comply with its rules. The Government also seeks to ensure that people are able to access the financial products they need. That is why I published a Financial Inclusion Strategy in November which includes interventions to increase household financial resilience through insurance and help people find the right insurance product for their needs.

When she plans to publish a response to her Department's consultation on Public Service Vehicles Access Regulations, which closed on 4 September 2023.

The Government is committed to improving passenger transport services, so they are more inclusive and enable disabled people to travel safely, confidently and with dignity. As part of our broader mission to break down barriers to opportunity, we recognise that more needs to be done to ensure transport is accessible to all. Our Bus Services Act 2025 includes a comprehensive package of measures to improve the accessibility and inclusivity of local transport. This includes requiring local authorities to regularly review the accessibility of their bus networks through the development and publishing of a Bus Network Accessibility Plan. We are also providing nearly £700 million a year to local transport authorities through the Local Authority Bus Grant over the next three years to maintain and improve local bus services. These allocations include capital funding for most areas, which can be used to improve the accessibility of transport infrastructure. The Public Service Vehicles Accessibility Regulations 2000 (PSVAR) set accessibility minimum standards for physical features on board buses and coaches designed to carry over twenty-two passengers and used on local or scheduled services. These include requirements for the size and location of the wheelchair space. In 2023 the Department undertook a Call for Evidence to understand the efficacy of PSVAR, and we continue to engage regularly with stakeholders, including local authorities, on the impact of the Regulations and how they can support accessible journeys sustainably. We will announce any next steps on PSVAR in the coming weeks. In March 2025, we launched the UK Bus Manufacturing Expert Panel. Over 12 months, this panel brought together industry experts and local leaders to support UK bus manufacturing, develop a pipeline of future bus orders to give better planning certainty to the sector, and to prioritise passenger-centric bus design. The last meeting of the Panel took place on 18 March, during which we secured agreement from Mayors on a set of commitments, including on adopting standards and driving continuous improvement on accessible and inclusive zero emission bus design.

What assessment her Department has made of the potential impact of valid Covid-19 business interruption claims becoming time-barred in March 2026 on the insurance sector.

The Financial Conduct Authority (FCA), as the independent regulator for financial services, sets the conduct standards required of insurance firms. This includes rules requiring insurers to handle claims fairly and promptly. The Supreme Court published its final judgment in the FCA’s Business Interruption Insurance test case in 2021. At the time of the judgment, the FCA set out its expectation that insurers should communicate to all impacted policyholders what the judgment meant for their claim and should move quickly to resolve claims as determined by the judgment. The FCA court case did not cover all potential issues with business interruption policies. The FCA has been clear that, in the event of further court rulings, insurers will need to consider carefully how the rulings impact claims they have already decided. The FCA considered the issue of new ‘stop the clock’ guidance as part of its response to Stewarts LLP on 23 January. The FCA was clear that insurers must look at claims that have already been made in light of any new legal rulings to see if any action must be taken. Where no claim has been submitted, it is not clear why an insurer would not be able to rely on relevant time limits set out in the insurance policy, subject to the particular circumstances of each claim and compliance with the FCA’s broader rules. The FCA is continuing to supervise firms to ensure they are meeting their expectations and has robust powers to take action where necessary.

What steps her Department is taking to ensure that SMEs not party to (a) NFU Mutual and (b) Bath Racecourse litigation are not permanently deprived of the right to an indemnity due to the expiration of limitation periods.

The Financial Conduct Authority (FCA), as the independent regulator for financial services, sets the conduct standards required of insurance firms. This includes rules requiring insurers to handle claims fairly and promptly. The Supreme Court published its final judgment in the FCA’s Business Interruption Insurance test case in 2021. At the time of the judgment, the FCA set out its expectation that insurers should communicate to all impacted policyholders what the judgment meant for their claim and should move quickly to resolve claims as determined by the judgment. The FCA court case did not cover all potential issues with business interruption policies. The FCA has been clear that, in the event of further court rulings, insurers will need to consider carefully how the rulings impact claims they have already decided. The FCA considered the issue of new ‘stop the clock’ guidance as part of its response to Stewarts LLP on 23 January. The FCA was clear that insurers must look at claims that have already been made in light of any new legal rulings to see if any action must be taken. Where no claim has been submitted, it is not clear why an insurer would not be able to rely on relevant time limits set out in the insurance policy, subject to the particular circumstances of each claim and compliance with the FCA’s broader rules. The FCA is continuing to supervise firms to ensure they are meeting their expectations and has robust powers to take action where necessary.

What steps her Department is taking to improve rail connectivity in North Shropshire.

Services in North Shropshire are provided by Transport for Wales (TfW) in accordance with its Train Service Requirement which is agreed with the Department with respect to services at stations in England. The Department keeps the performance and connectivity of the rail network under continual review including through regular engagement with TfW. There are no active proposals to increase services on this route.

What discussions she has had with the FCA on stop the clock guidance and related litigation.

The Financial Conduct Authority (FCA), as the independent regulator for financial services, sets the conduct standards required of insurance firms. This includes rules requiring insurers to handle claims fairly and promptly. The Supreme Court published its final judgment in the FCA’s Business Interruption Insurance test case in 2021. At the time of the judgment, the FCA set out its expectation that insurers should communicate to all impacted policyholders what the judgment meant for their claim and should move quickly to resolve claims as determined by the judgment. The FCA court case did not cover all potential issues with business interruption policies. The FCA has been clear that, in the event of further court rulings, insurers will need to consider carefully how the rulings impact claims they have already decided. The FCA considered the issue of new ‘stop the clock’ guidance as part of its response to Stewarts LLP on 23 January. The FCA was clear that insurers must look at claims that have already been made in light of any new legal rulings to see if any action must be taken. Where no claim has been submitted, it is not clear why an insurer would not be able to rely on relevant time limits set out in the insurance policy, subject to the particular circumstances of each claim and compliance with the FCA’s broader rules. The FCA is continuing to supervise firms to ensure they are meeting their expectations and has robust powers to take action where necessary.