Written questions by Lavery.

What assessment he has made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care.

The monitoring of National Health Service patient correspondence, including appointment letters, is the responsibility of individual NHS providers. Data is not held centrally on the reasons why an appointment is registered as a ‘did not attend’. This includes whether appointments have been missed specifically because a letter has not been received by the patient. Data is also not held on the number of patient samples sent via Royal Mail that have been rendered unusable due to late arrival at laboratories in each of the last five years. Therefore, no estimate has been made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months, nor of the cost of repeat appointments, sample kits, and additional clinical activity caused by postal delays. No assessment has been made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post. No assessment has been made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care. No guidance has been issued to NHS trusts and general practices on the use of alternative communication methods in areas affected by Royal Mail delays.The Government’s focus on shifting from ‘analogue to digital’ will streamline information and communication processes, including by improving the NHS App. This will make it easier and quicker for patients to access information about their appointments, to cancel and reschedule appointments and to receive correspondence on NHS test results. 96% of acute trusts in England now allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. Usage has increased significantly, with the App now supporting approximately eight million patient–trust interactions per month, an increase of 82% compared to a year ago. It also saves staff time to focus on providing high quality, non-digital communication for those who want and need it.

What estimate he has made of the cost to the NHS of repeat appointments, replacement sample kits and additional clinical activity caused by postal delays.

The monitoring of National Health Service patient correspondence, including appointment letters, is the responsibility of individual NHS providers. Data is not held centrally on the reasons why an appointment is registered as a ‘did not attend’. This includes whether appointments have been missed specifically because a letter has not been received by the patient. Data is also not held on the number of patient samples sent via Royal Mail that have been rendered unusable due to late arrival at laboratories in each of the last five years. Therefore, no estimate has been made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months, nor of the cost of repeat appointments, sample kits, and additional clinical activity caused by postal delays. No assessment has been made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post. No assessment has been made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care. No guidance has been issued to NHS trusts and general practices on the use of alternative communication methods in areas affected by Royal Mail delays.The Government’s focus on shifting from ‘analogue to digital’ will streamline information and communication processes, including by improving the NHS App. This will make it easier and quicker for patients to access information about their appointments, to cancel and reschedule appointments and to receive correspondence on NHS test results. 96% of acute trusts in England now allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. Usage has increased significantly, with the App now supporting approximately eight million patient–trust interactions per month, an increase of 82% compared to a year ago. It also saves staff time to focus on providing high quality, non-digital communication for those who want and need it.

How many patient samples sent via Royal Mail have been rendered unusable due to late arrival at laboratories in each of the last five years.

The monitoring of National Health Service patient correspondence, including appointment letters, is the responsibility of individual NHS providers. Data is not held centrally on the reasons why an appointment is registered as a ‘did not attend’. This includes whether appointments have been missed specifically because a letter has not been received by the patient. Data is also not held on the number of patient samples sent via Royal Mail that have been rendered unusable due to late arrival at laboratories in each of the last five years. Therefore, no estimate has been made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months, nor of the cost of repeat appointments, sample kits, and additional clinical activity caused by postal delays. No assessment has been made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post. No assessment has been made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care. No guidance has been issued to NHS trusts and general practices on the use of alternative communication methods in areas affected by Royal Mail delays.The Government’s focus on shifting from ‘analogue to digital’ will streamline information and communication processes, including by improving the NHS App. This will make it easier and quicker for patients to access information about their appointments, to cancel and reschedule appointments and to receive correspondence on NHS test results. 96% of acute trusts in England now allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. Usage has increased significantly, with the App now supporting approximately eight million patient–trust interactions per month, an increase of 82% compared to a year ago. It also saves staff time to focus on providing high quality, non-digital communication for those who want and need it.

What assessment he has made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post on the NHS.

The monitoring of National Health Service patient correspondence, including appointment letters, is the responsibility of individual NHS providers. Data is not held centrally on the reasons why an appointment is registered as a ‘did not attend’. This includes whether appointments have been missed specifically because a letter has not been received by the patient. Data is also not held on the number of patient samples sent via Royal Mail that have been rendered unusable due to late arrival at laboratories in each of the last five years. Therefore, no estimate has been made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months, nor of the cost of repeat appointments, sample kits, and additional clinical activity caused by postal delays. No assessment has been made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post. No assessment has been made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care. No guidance has been issued to NHS trusts and general practices on the use of alternative communication methods in areas affected by Royal Mail delays.The Government’s focus on shifting from ‘analogue to digital’ will streamline information and communication processes, including by improving the NHS App. This will make it easier and quicker for patients to access information about their appointments, to cancel and reschedule appointments and to receive correspondence on NHS test results. 96% of acute trusts in England now allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. Usage has increased significantly, with the App now supporting approximately eight million patient–trust interactions per month, an increase of 82% compared to a year ago. It also saves staff time to focus on providing high quality, non-digital communication for those who want and need it.

What estimate he has made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months.

The monitoring of National Health Service patient correspondence, including appointment letters, is the responsibility of individual NHS providers. Data is not held centrally on the reasons why an appointment is registered as a ‘did not attend’. This includes whether appointments have been missed specifically because a letter has not been received by the patient. Data is also not held on the number of patient samples sent via Royal Mail that have been rendered unusable due to late arrival at laboratories in each of the last five years. Therefore, no estimate has been made of the number of NHS appointments missed as a result of delays in the delivery of appointment letters by Royal Mail in the last 12 months, nor of the cost of repeat appointments, sample kits, and additional clinical activity caused by postal delays. No assessment has been made of the potential impact of routine cases becoming urgent as a result of appointment letters being delayed in the post. No assessment has been made of the potential impact of postal delays on the timely delivery of referral letters between primary and secondary care. No guidance has been issued to NHS trusts and general practices on the use of alternative communication methods in areas affected by Royal Mail delays.The Government’s focus on shifting from ‘analogue to digital’ will streamline information and communication processes, including by improving the NHS App. This will make it easier and quicker for patients to access information about their appointments, to cancel and reschedule appointments and to receive correspondence on NHS test results. 96% of acute trusts in England now allow patients to view appointment information via the NHS App if they wish, reducing reliance on physical letters. Usage has increased significantly, with the App now supporting approximately eight million patient–trust interactions per month, an increase of 82% compared to a year ago. It also saves staff time to focus on providing high quality, non-digital communication for those who want and need it.

What recent assessment he has made of the potential impact of postal delays on national screening programmes, including bowel, cervical and breast cancer screening.

Our National Health Service screening programmes reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage.Bowel cancer screening relies on the provision of faecal immunochemical test (FIT) home testing kits to those eligible people. The bowel cancer screening hubs have a contract in place which includes 48 hour tracked returns via Royal Mail. This allows participants to return completed FIT kits, which must then be tested within 14 days of completion. Adherence to the 48-hour return is monitored within the contract by NHS trusts. If a kit is returned after 14 days, it cannot be tested so a new kit is sent out to the participant.Multiple incidents of late returns by Royal Mail, some of up to a month, have been reported across England. However, there is no evidence from customer contact centre that enquiries and complaints on this issue have been increasing.Since June 2025, invitations have been digitised and we are using the NHS App and text messaging. The figures for January and February 2026 show that approximately 100,000, or 11%, of all invitations are sent via Royal Mail.Since October 2025, normal result correspondence has been digitised using NHS App. Figures for January and February 2026 show that approximately 207,000, 38%, of normal results are sent via Royal Mail.We will be digitising correspondence for results requiring referral for further assessment by the end of March 2026 using the NHS App. Currently, these results are sent out by first class business mail which is prioritised by Royal Mail, which will continue if it is not possible to send by the NHS App.Cervical screening sample takers, for example, general practice nurses, are flagging with patients that results may be sent to them via the NHS App and are encouraging them to switch on notifications on the app.Providers have reported delays in invitations for screening and assessment appointments being delivered. Where receipt has been very close to, or after the appointment date, another appointment has been made.Providers send out SMS text message reminders ahead of appointments, which should potentially reduce the impact of delayed post.Additionally, where providers are aware of local postal delays, they have been advised to telephone women ahead of appointment, particularly in the case of assessment appointments. Some services have also introduced digital invitation letters at a local level.

What research his Department has commissioned on the long‑term health effects, including reproductive health outcomes, of occupational exposure to hazardous medicinal products among nursing staff; and what estimate he has made of the costs to the NHS of sickness absence related to such exposure.

The Government has not commissioned any research on the reproductive health outcomes or long-term health effects of the occupational exposure of nursing staff to hazardous medicinal products. No assessment has been made of the cost to the National Health Service of sickness absence related to this. The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including the health of the NHS workforce. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

What estimate his Department has made of the number of nurses and other healthcare professionals currently exposed to hazardous medicinal products; and if he will publish an estimate of how many workers would be covered by a definition of hazardous medicinal products.

I refer the Hon. Member to the answer I gave to the Hon. Member for North Devon on 28 November 2025 to Question 92661.

If he will make and assessment of the potential merits of reviewing the Control of Substances Hazardous to Health Regulations 2002 to ensure that hazardous medicinal products with reprotoxic effects are controlled to the same standard as carcinogens and mutagens.

I refer the hon. Member to the answer I gave on 30 October 2025 to Question UIN 84440.

What steps he is taking to promote the use of engineering controls such as biological safety cabinets and closed‑system drug‑transfer devices during preparation and administration of hazardous medicinal products to better protect healthcare workers.

I refer the hon. Member to the answer I gave on 30 October 2025 to Question UIN 84144.

If he will require NHS employers to provide ongoing education, training and health surveillance for all staff who handle or may be exposed to hazardous medicinal products.

I refer the hon. Member to the answer I gave on 30 October 2025 to Question UIN 84444.

Whether his Department plans to develop or adopt a UK list of hazardous medicinal products and to require safety data sheets for finished medicines; and if he will take steps to work with the Health and Safety Executive to make such a list publicly available to NHS employers.

I refer the hon. Member to the answer I gave on 30 October 2025 to Question UIN 84436.

If he will publish a new national strategy for palliative and end-of-life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England.The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.Further information about the MSF is set out in the Written Ministerial Statement HCWS1087, which I gave on 24 November 2025.

What assessment he has made of the potential merits of renegotiating current private finance debt to reduce future payouts.

Private Finance Initiative (PFI) contracts are not held by the Department. Contracts are held between the local National Health Service trust and their respective private finance company. The contracts were let for a prescribed period of time, with the terms set at the outset and limited areas for renegotiation.The Department’s Private Finance Team together with the National Infrastructure and Service Transformation Authority provides expert support and advice to NHS trusts with PFI contracts on a case-by-case basis, considering all options available whilst maintaining contractual compliance. This includes, but is not limited to, improving the performance of existing contracts, assessing the costs of existing contracts and where efficiencies and savings can be realised, and managing hand back of the assets at the end of the contract term. The Department’s Private Finance team also continues to assess opportunities to refinance debt where possible and where it would be value for money.

What estimate he has made of the impact of (a) changes in patient need, (b) drug prices, (c) inflation and (d) changes in the level of private finance debt on the budget for the NHS in each of the next ten years.

I refer the Hon. Member to the answer I gave to the Hon. Member for Hayes and Harlington on 1 December 2025 to Question 93637.

If he will publish his Department’s business case on new private finance in the NHS.

The Department has no plans to publish the Neighbourhood Health Centre (NHC) Public Private Partnership (PPP) Feasibility Programme Business Case. Publication is not standard practice for business cases outside of the Government’s Major Projects Portfolio. This was a strategic outline business case, the purpose of which was to scope and identify the preferred way forward for a new potential PPP model in line with the HM Treasury five case model.The Department and the National Infrastructure and Service Transformation Authority (NISTA) will continue to work with the market to further develop the new PPP model for NHCs, with further engagement next year. The final design and development of this new PPP model for NHCs will be led by NISTA and will be co-designed by the Department.

What assessment he has made of the potential merits of funding neighbourhood health centres through alternative, non-private finance means.

At the Autumn Budget, we announced our commitment to deliver 250 Neighbourhood Health Centres (NHCs) through the NHS Neighbourhood Rebuild Programme. This will deliver NHCs through a mixture of refurbishments, to expand and improve sites over the next three years, and new-build sites opening in the medium term.The first 120 NHCs are due to be operational by 2030, delivered through public private partnerships (PPPs) and public capital. 50 NHCs will be completed through the repurposing of the existing estate with public sector funding, and 70 through new builds by 2030. 80% of the new builds will be PPPs, with a further 20% coming from public sector investment.The Spending Review has seen the Government provide £426 million over four years through the Utilisation and Modernisation Fund, upgrading general practice estates and supporting delivery of 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

Whether she has issued guidance to (a) schools and (b) educational establishments to make them aware of potential concerns with Colours Play Sand.

UK regulators are in touch with counterparts in Australia regarding reports of chemical concerns related to rainbow-coloured sand products. There is no evidence these products are available on the UK market. Our product safety regulations require businesses to only place safe consumer products on the market, including toys or products aimed at children. The Office for Product Safety and Standards (OPSS), in my Department, and Local Authority Trading Standards enforce the regulations, and have powers to remove products from sale and prevent imports where unsafe items are identified. The Government does not collect data on sales of individual products.

What steps he is taking to communicate concerns of potential harmful substances in Educational Colours Rainbow Sand.

UK regulators are in touch with counterparts in Australia regarding reports of chemical concerns related to rainbow-coloured sand products. There is no evidence these products are available on the UK market. Our product safety regulations require businesses to only place safe consumer products on the market, including toys or products aimed at children. The Office for Product Safety and Standards (OPSS), in my Department, and Local Authority Trading Standards enforce the regulations, and have powers to remove products from sale and prevent imports where unsafe items are identified. The Government does not collect data on sales of individual products.

What data he holds on how many packs of educational colours rainbow sand was sold before it was no longer available.

UK regulators are in touch with counterparts in Australia regarding reports of chemical concerns related to rainbow-coloured sand products. There is no evidence these products are available on the UK market. Our product safety regulations require businesses to only place safe consumer products on the market, including toys or products aimed at children. The Office for Product Safety and Standards (OPSS), in my Department, and Local Authority Trading Standards enforce the regulations, and have powers to remove products from sale and prevent imports where unsafe items are identified. The Government does not collect data on sales of individual products.