Written questions by Whately.

If he will take steps to increase the financial support available to care workers who are seeking to gain new qualifications.

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.

Whether his Department is taking steps to develop new qualifications 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.

If he will take steps to (a) recognise and (b) reward care workers who take on nursing responsibilities.

Care workers deserve to be recognised and supported for the vital work they do. We want social care to be regarded as a profession, and for the people who work in care to be respected as professionals. That is why, as part of our health mission, we will task regulators with assessing the role social care workers can play in supporting health treatment and monitoring.We are continuing to develop a national career structure for the adult social care workforce, which will recognise the work care workers undertake, including more advanced and complex care, for instance delegated healthcare interventions. We will also publish updated guiding principles on effective delegation of healthcare interventions to care workers, including the benefits for care workers, the registered nursing workforce, and people who access care.

What steps he is taking to help extend access to virtual wards to (a) avoid admission to hospital and (b) speed up discharge.

We are continuing to expand services to treat patients outside of hospitals when they have urgent needs, helping to prevent avoidable hospital admissions and speed up discharges. This includes using virtual wards which have benefited more than 240,000 people across the country so far. The expansion of these innovative services is allowing people to get the specialist care they need safely, and in the comfort of familiar surroundings.A new virtual wards operational framework by NHS England sets out the further action being taken to improve access to virtual wards. The framework is available at the following link:https://www.england.nhs.uk/publication/virtual-wards-operational-framework/

What steps he is taking to help ensure ambulances are not delayed outside hospitals waiting to hand over patients.

The Government has committed to supporting the National Health Service to improve performance and achieve the standards set out in the NHS Constitution, including ambulance response times.As a first step, my Rt Hon. Friend, the Secretary of State for Health and Social Care appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September 2024 and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.Ahead of this winter, NHS England has set out the priorities for the NHS to maintain and improve patient safety and experience, including actions to support patient flow and ensure ambulances are released in a timely way. NHS England’s winter letter is available at the following link:https://www.england.nhs.uk/long-read/winter-and-h2-priorities/

If he will take steps to increase transparency to the public accessing of data on palliative care commissioned by local ICBs.

We want a society where every person receives high-quality, compassionate care from diagnosis through to end of life. Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications, which are respectively available at the following two links:https://www.england.nhs.uk/publication/palliative-and-end-of-life-care-statutory-guidance-for-integrated-care-boards-icbs/https://www.england.nhs.uk/publication/service-specifications-for-palliative-and-end-of-life-care-children-and-young-people-cyp/There is data available from National Health Service bodies to support local quality monitoring, most notably local palliative and end-of-life care profiles, through the data service Fingertips, and other guidance, analyses, and bulletins issued by the National End of Life Care Intelligence Network of the Office for Health Improvement and Disparities, within the Department. Further information on local palliative and end-of-life care profiles through the Fingertips data service is available at the following link:https://fingertips.phe.org.uk/end-of-life#page/4/gid/1938133060/pat/159/par/K02000001/ati/15/are/E92000001/iid/92489/age/162/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/car-ao-1_car-do-0_tre-do-1Additionally, the Care Quality Commission publishes ratings for the quality of end-of-life care in hospitals and hospices, and has carried out national reviews. Where people die in acute, community, or mental health hospitals, the National Audit of Care at the End of Life monitors standards related to the quality of the end-of-life care provided.Furthermore, NHS England has developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities and ensure that funding is distributed fairly, based on prevalence. Access to the platform is available to anyone with an NHS.net email account.I recently met with NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care.  We will consider next steps on palliative and end of life care in the coming months.

Whether he plans to allow Integrated Care Boards to enter into sub-leases for large non-owned GP leased premises (a) via exception and (b) by amending the rules.

Under the GP Contract, premises liabilities are the responsibility of the Contractor. Overall contractual payments reflect this arrangement, with the National Health Service also reimbursing direct premises costs including rent, business rates, water, and clinical waste.There are 8,842 practice premises across England; of these, 51% are leased premises. Integrated care boards (ICBs) are not a formal party to the leases on these properties.ICBs can hold leases for general practice (GP) or clinical premises, following the transition from clinical commissioning groups which were unable to hold such leases. However, this would require capitalisation of the lease under the International Financial Accounting Standard IFRS16, and limited NHS capital budgets would have to be diverted to offset this commitment, in addition to the payment of rents against the properties.This would provide, in effect, a double payment of costs against the asset and would commit substantial capital funds to the exercise. Currently, Primary Care Estates capital allocation to integrated care systems would not be sufficient to offset such a capital liability and so an ICB would be required to look to other system partners to provide a capital allocation, thus limiting the ability of the system to invest in primary care estate, address secondary, community care and mental health critical and address the usual infrastructure maintenance requirements.As a result, in general ICBs entering into sub-leases for large non-owned GP leased premises would not provide the best use of public funds.

Whether he plans to free up more GP appointments.

We know that patients are finding it harder than ever to see a general practitioner (GP), and we are committed to fixing this crisis in GPs.Our plan to do so will require both investment and reform. Firstly, we will increase the proportion of funding for GPs in primary care, starting with a commitment to recruit over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme. This will increase the number of GP appointments delivered, secure the future pipeline of GPs, and will take pressure off those currently working in the system.Additionally, we will train thousands more GPs across the country, beginning with the training places set out in the NHS Long Term Workforce Plan, which will be key in increasing GP capacity.

Whether he plans to allow GP practices to expand in areas with planned population increases.

We understand that there is pressure on primary care estates and service provision in areas of high population growth. The Government is committed to delivering a National Health Service that is fit for the future, and this means better utilising and expanding primary care infrastructure across the NHS estate. That is why we have set out our intention to fix the front door to the NHS and bring healthcare closer to home, and the local community.At a local level, the relevant integrated care board is responsible for commissioning, planning, securing, and monitoring general practice (GP) services within their health systems, through delegated responsibility from NHS England. The NHS has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area. It should take account of population growth and demographic changes.At a national level, we continue to work closely with the Ministry of Housing, Communities and Local Government to ensure all new and existing developments have an adequate level of healthcare infrastructure for the community.

What steps he is taking to increase the number of NHS dental appointments.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.

What steps he plans to take to ensure there is adequate healthcare provision for (a) existing and (b) new populations in (i) towns and (ii) rural areas.

The Department supports statutory integrated care systems (ICSs) in delivering National Health Services across England. ICSs are partnerships of organisations which come together to plan and deliver joined up health and care services, to improve the lives of the people who live and work in their area. This includes considering adequate healthcare provision for populations in towns and rural areas, and working collaboratively to plan for population change.The organisations within an ICS include the NHS, local government, social care providers, charities, and other organisations working together to provide more joined up care for people, and to improve the outcomes for their populations.