Written questions by Whately.

With reference to Budget 2025, what assessment he has of the potential impact of the proposed changes to the salary sacrifice policy for employee pension contributions on the number of hours worked by NHS employees.

The proposed Salary Sacrifice policy’s changes to employer contributions will not have an impact on National Health Service employees' working hours. HM Treasury's Managing Public Money guidelines prevent public funds from being used to offset National Insurance liabilities. As a result, NHS Pension Scheme contributions cannot be paid through salary sacrifice arrangements.

With reference to the Department for Health and Social Care's press release entitled Crack teams get patients off waiting lists at twice the speed, published on 16 March 2025, what estimate he has made of the associated impact on the reduction in waiting lists on employment.

No formal estimate has been made of the associated impact of the reduction in waiting lists on employment. The Further Faster 20 (FF20) programme continues to support trusts within the cohort to reduce their waiting lists, helping people to return to work. An evaluation across all FF20 schemes will be undertaken and made available later this year. However, we are clear that cutting waiting lists ensures that patients get the treatment they need quicker, supporting them to stay in or return to work wherever possible.

Pursuant to the Answer of 28 February 2025 to Question 31062 on Death Certificates, what the median time taken was to register a death at the most localised level for which data is available.

The Office for National Statistics (ONS) publishes weekly data showing the median time to register a death by certification type in England and Wales. The latest data, for deaths registered in the week ending 21 February 2025, shows that the median time to register all deaths was nine days, and the median time to register deaths certified by a doctor was eight days. The ONS is planning to extend this data to include the median time taken to register a death by region, and expect this to be available in Spring 2025.

Whether he plans to review the (a) capacity and (b) efficiency of the medical examiner system in the new death certification process.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year, and the average is expected to decrease again as more data becomes available for January and February 2025. The Department does not hold data on what was the longest period between a death and its registration since September 2024. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from. The core purposes of the death certification reforms are to introduce scrutiny of the cause of death, to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

What the (a) average and (b) longest recorded wait time is for the issuance of death certificates since September 2024.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year, and the average is expected to decrease again as more data becomes available for January and February 2025. The Department does not hold data on what was the longest period between a death and its registration since September 2024. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from. The core purposes of the death certification reforms are to introduce scrutiny of the cause of death, to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

What steps he is taking to reduce backlogs in the death certification process in the South East.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year, and the average is expected to decrease again as more data becomes available for January and February 2025. The Department does not hold data on what was the longest period between a death and its registration since September 2024. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from. The core purposes of the death certification reforms are to introduce scrutiny of the cause of death, to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

What steps he is taking to ensure that the new death certification process does not cause further distress for grieving families.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the Christmas weeks, but this was expected given increases are observed during this period every year, and the average is expected to decrease again as more data becomes available for January and February 2025. The Department does not hold data on what was the longest period between a death and its registration since September 2024. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from. The core purposes of the death certification reforms are to introduce scrutiny of the cause of death, to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

How many hospital visits the Minister for Health (Secondary Care) has made in the last six months; and which hospitals she visited.

Since 14 July 2024, I have engaged in a total of nine visits, of which the following five were hospitals:Red Kite View;Southmead Hospital;Leeds General Infirmary;Newham Hospital; andMusgrove Park Hospital.

If she will make an assessment of recent trends in the level the social care capacity available to support discharges from hospitals in the last 12 months.

Comparing December 2024 to December 2023, there was a 5% decrease in the average number of patients in hospital with delayed discharge at the end of each day. In December 2024, for patients with a length of stay of at least 14 days, an average of 33% of the delays were attributed to reasons relating to the capacity for onward care and support, due to issues with adult social care services, National Health Services, or housing. This proportion has come down from 37% in June 2024, when this figure was first published.

How many meetings the Minister for Health (Secondary Care) has attended on (a) A&E performance and (b) flow through the emergency care system.

I have attended regular winter preparedness meetings since 26 September 2024. Urgent and emergency care performance is a standing agenda item within these meetings.In addition, I have meetings most days to discuss the reform and improvement of the health and care system, with performance and patient flow a regular matter in such discussions.

How many meetings he has attended to discuss winter preparedness.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has chaired eight meetings on winter preparedness since 2 December 2024.

What plans he has to ensure Urgent Treatment Centres remain open.

No such assessment has been made. Integrated care boards are responsible for the commissioning of local services, including urgent treatment centres and their operational hours.

What plans he has to safeguard primary care services.

Work is already underway to ensure the safeguarding of primary care services. Neighbourhood Health Centres will be trialled to bring together a range of services, ensuring healthcare is provided closer to home. This is part of our broader ambition to move towards a Neighbourhood Health Service, with more care delivered in local communities to spot problems earlier.The 10-Year Health Plan has been launched to reform the National Health Service and make it fit for the future. The plan will set out a bold agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, from analogue to digital, and from sickness to prevention.The Government is providing the biggest investment into general practice for years, an additional £889 million on top of the existing budget. We will make sure the future of general practice is sustainable by training thousands more general practitioners, guaranteeing a face-to-face appointment for all those who want one, and delivering a modern booking system.We are committed to expanding the role of community pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.We plan to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. 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. NHS England is working to develop a long-term infrastructure strategy including anticipated primary care investment needed to meet demand over the next 10 years and beyond, as well as a detailed look at the quality of the estate.

What plans he has to support ICBs that are considering cuts to primary care services.

Integrated care boards (ICBs) have a delegated responsibility for planning and commissioning healthcare services to meet the reasonable needs of the people for whom they are responsible. ICBs should evaluate the needs of the populations for which they are responsible and plan service provision as required.NHS England will continue to develop national policy and guidance to support ICBs to discharge their primary care commissioning functions effectively, supporting primary care providers and Primary Care Networks to deliver high quality services for patients. The Government is providing the biggest investment into general practice (GP) for years, an additional £889 million on top of the existing budget.In the event of any GP closure, it is the responsibility of these local commissioners to ensure that patients are able to register with and attend another GP, so that their health needs continue to be met. When a practice does close, patients are informed of the closure and advised to register at another local practice of their choice within their area. Commissioners must put in place appropriate measures to ensure that the affected patients have access to GP services.

With reference to his Department’s Get Britain Working White Paper published on 26 November 2024, whether the 140,000 places for Individual Placement and Support for severe mental illness are in addition to the those announced in the Autumn Statement 2023.

The Government inherited a £22 billion blackhole in the nation’s finances which has required tough choices around spending priorities. Despite this bleak financial backdrop, we were determined to identify the funding required to support local Individual Placement Support schemes. The White Paper confirms the Government’s commitment to expand the number of places on these schemes, to help thousands more people with severe mental illness find and stay in employment.

With reference to the White Paper entitled Get Britain Working, published November 2024, whether the 384,000 additional Talking Therapies places in Priority 1 were previously (a) announced and (b) funded in the Autumn Statement 2023.

The Government inherited a £22 billion blackhole in the nation’s finances which has required necessary choices around spending priorities. Despite this backdrop, we were determined to identify the funding required to support NHS Talking Therapies.The White Paper confirms the Government’s commitment to expand access to NHS Talking Therapies for adults in England with common mental health conditions.

What steps he is taking to ensure adequate healthcare provision in areas with high (a) housing targets and (b) population growth.

The Government is committed to delivering a National Health Service that is fit for the future, and this means we require world class NHS infrastructure across the entire NHS estate. Beyond hospitals, we know we need the right infrastructure in the right place to deliver on our commitment of creating a Neighbourhood Health Service and ensuring that patients receive the care they deserve.We recognise the challenges facing local areas of rapid housing and population growth, including the challenges such growth can place on health care infrastructure. Whilst the Government has big ambitions to further boost house building, we recognise it must be sensitive to local need.The Department of Health and Social Care is working closely with the Ministry of Housing, Communities, and Local Government to determine how the local authority and developer contributions from new housing developments can support the vision for health services and infrastructure locally.The relevant integrated care board is responsible for deciding how the NHS budget for its area is spent, and allocates funding according to local priorities. Any further support for NHS organisations will be set out at the Autumn Spending Review.

Whether he has had recent discussions with the Secretary of State for Work and Pensions on improving the support available for people seeking a fit note.

As part of our Get Britain Working plan, more disabled people and those with health conditions will be supported to enter and stay in work, by devolving more power to local areas so they can shape a joined-up work, health, and skills offer that suits the needs of the people they serve.We launched a Call for Evidence to seek views on how the current fit note process works and the support required to facilitate meaningful work and health conversations to help people start, stay, and succeed in work. It closed on 8 July 2024, and we received approximately 1,900 responses that are now being reviewed.

What recent discussions he has had with the Secretary of State for Work and Pensions on improving the support for people who are signed off sick to help them return to work.

The Department for Work and Pensions and the Department for Health and Social Care are committed to supporting disabled people and people with long-term health conditions, and have a range of support available so individuals can stay in work and get back into work, including those that join up employment and health systems.Some measures include joining up health and employment support around the individual through Employment Advisors in NHS Talking Therapies and Individual Placement and Support in Primary Care, as well as support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants.We also support the role employers play in increasing employment opportunities and supporting disabled people and people with health conditions to be part of the workforce, including through increasing access to Occupational Health, a digital information service for employers, and the Disability Confident scheme. This information service is available at the following link:https://www.support-with-employee-health-and-disability.dwp.gov.uk/support-with-employee-health-and-disabilityAs part of our Get Britain Working plan, more disabled people and those with health conditions will be supported to enter and stay in work, by devolving more power to local areas so they can shape a joined-up work, health, and skills offer that suits the needs of the people they serve.

What steps he is taking to help develop a career path for care workers.

We are committed to supporting a professional, well-supported social care workforce. On 6 September 2024, the Department launched the Adult Social Care Learning and Development Support Scheme, which allows eligible employers to claim for funding for certain training courses and qualifications on behalf of eligible care staff. Over 150 courses and qualifications are eligible for funding from this scheme, including the new Level 2 Adult Social Care Certificate qualification. We will continue to work with the adult social care sector and representative organisations to monitor the impact of the funding under the Adult Social Care Learning and Development Support Scheme.Furthermore, we are working with care workers and employers to develop the next part of the Care Workforce Pathway, the new national career structure for adult social care, which we will publish in due course.