Written questions by Cartlidge.

What assessment he has made of the adequacy of the accessibility of autism assessments in South Suffolk.

The Government has recognised that, nationally, the demand for assessments for autism has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, including early intervention and support, without the need for diagnosis.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including the provision of autism services, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the NHS to deliver improved outcomes for people referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and following a recent diagnosis of autism. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.The Government is also supporting inclusive environments and earlier intervention for children through the Early Language Support for Every Child and the Partnerships for Inclusion of Neurodiversity in Schools programmes.

What discussions he has had with the Nursing and Midwifery Council on the potential impact of the use of nurse as a title for staff who are not qualified nurses on patient safety.

The Government recognises that the protection in law of certain professional titles is important for public safety. Protecting a title provides assurance to the public that the person using that title is competent and safe to practise. Although ‘registered nurse’ is a protected title, ‘nurse’ is currently not a protected title. The Government is aware of the concerns which this generates.On the 12 May we announced our intention to amend the criminal offence of ‘misuse of professional titles’ so that the title of ‘nurse’ is protected, as part of the Government’s professional regulation reform programme.The term ‘nurse’ is used across multiple professions, for example, ‘dental nurse’, ‘veterinary nurse’ and ‘nursery nurse’. It is not our intention to prevent the legitimate use of the title ‘nurse’ within these instances. The legislation will therefore include exemptions to allow other professionals to use the title legitimately, without the risk of prosecution.The Government will continue to work with key stakeholders, including the Nursing and Midwifery Council, on developing the protection of title offence.

With reference to the NHS Long Term Workforce Plan, updated on 22 April 2024, what plans he has to prioritise measures to (a) make workers feel valued and (b) encourage workers to remain working in the NHS.

The Government is committed to making the National Health Service the best place to work, to ensure the retention of our hardworking and dedicated staff. We will publish a refreshed workforce plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.NHS England is leading work nationally through its retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

What assessment he has made of the effectiveness of the NHS Agenda for Change Pay Scale for reflecting trends in the level of workloads faced by medical professionals in the NHS.

The management of staff workloads is a matter for local employing organisations, and is not considered to be a national pay, terms, and conditions issue.The Agenda for Change pay scale, and the national terms and conditions of service, are used to support the employment of non-medical staff in the National Health Service. The NHS Staff Council has overall responsibility for the maintenance of the pay scales and the conditions of service.The Job Evaluation Scheme underpins the Agenda for Change system of pay and supports the principle of equal pay for work of equal value. Pay bands are assigned based on the requirements of the role, such as skills and knowledge.

What steps his Department is taking to improve services for people living with Parkinson’s disease in South Suffolk constituency.

At the national level, there are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time Programme for Neurology and the RightCare Progressive Neurological Conditions Toolkit. These initiatives will help to improve services for people living with Parkinson’s disease in South Suffolk.NHS England has also established a Neurology Transformation Programme, a multi-year, clinically led programme, which has developed a new model of integrated care to support integrated care boards (ICBs) to deliver the right service, at the right time, for all neurology patients, including those with Parkinson’s. This focuses on providing access equitably across the country, with care as close to home as possible and early intervention to prevent illness and deterioration in patients with long-term neurological conditions. A toolkit is being developed to support ICBs to understand and implement this new model, which will include components on delivering acute neurology services, improving health equity in neurology, and improving community neurology services.NHS England commissions the specialised elements of Parkinson’s care that patients may receive from 27 specialised neurology centres across England. Within specialised centres, neurological multidisciplinary teams ensure that patients can access a range of health professionals and specialised treatment and support, according to their needs. NHS England is updating the Neurosciences specialised neurology (adults) service specification, which will: set out clear deliverables for specialised centres; provide a clearer model of care incorporating up-to-date guidance and best practice; and set out new quality outcomes focusing on improving patient outcomes and experience. We are expecting the revised specification and standards to be published later in 2025.

What steps he is taking to ensure that people with Parkinson’s disease have access to their medication on time.

National Institute for Health and Care Excellence (NICE) guidance on Parkinson’s disease in adults highlights the importance of patients getting Parkinson’s medicines on time, to prevent harmful effects. NICE guidance states that people with Parkinson’s disease who are admitted to hospital or care homes should be given their medicines at the appropriate times, which, in some cases, may mean allowing self-medication.Whilst hospital providers are responsible for ensuring that patients within hospital settings, including those with Parkinson’s disease, receive their appropriate medication on time, there are tools to support both patients and staff to achieve this. Electronic prescribing systems, currently in use in 85% of hospitals in England, enable in-depth monitoring and reporting on missed or delayed dosing of medications.Parkinson’s UK has produced resources, as part of their Get It on Time campaign, which support people with Parkinson's with medicine management in preparation for a hospital stay. These resources can also support hospital and care home staff to make sure that patients and residents get their medication on time, every time.NHS England has also published guidance, developed in partnership with charities, including Parkinson’s UK, to help local National Health Service staff take practical steps to improve the care for patients with progressive neurological conditions in hospitals. The Right Care Toolkit for progressive neurological conditions provides advice on medicine optimisation, highlighting the importance of the timely administration of specific drugs for Parkinson’s, such as Levodopa, in both acute and community health settings.

What recent assessment he has made of the adequacy of the availability of epilepsy drugs.

The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, most issues have been resolved.We are currently aware of an ongoing supply issue with all strengths of topiramate tablets from one manufacturer. This supply issue is expected to resolve by the end of August 2025. Alternative suppliers have sufficient supply to support patients. We have issued management guidance to the National Health Service.We are also aware of a shortage of phenobarbital 15 milligram tablets and phenobarbital 15 milligram/5 millilitre elixir from two different manufacturers. Resupply dates are yet to be confirmed for phenobarbital 15 milligram tablets, and the elixir issue is expected to resolve by late June 2025. Management guidance has been issued to the NHS for both formulations. In both cases, alternative suppliers are in stock with sufficient supply to support patients.

If he will make an assessment of the potential impact of barriers to regular access to prescribed medication on people with epilepsy.

There are a range of anti-seizure medications that have been recommended by the National Institute for Health and Care Excellence (NICE) as effective in the treatment of epilepsy. NICE guidance outlines that clinicians should develop an individualised anti-seizure medication treatment strategy with their patient, accounting for safety considerations, and should regularly monitor and review their patient’s medications. Medicine supply chains are complex, global and highly regulated and there are several reasons why supply can be disrupted, many of which are not specific to the United Kingdom and are outside of Government control. These include manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues and regulatory issues. While we cannot always prevent supply issues from occurring, we have a range of well-established processes and tools to manage them when they arise and mitigate risks to patients. The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, most issues have been resolved. We are currently aware of an ongoing supply issue with all strengths of topiramate tablets from one manufacturer. This supply issue is expected to resolve by the end of August 2025. Alternative suppliers have sufficient supply to support patients. We have issued management guidance to the National Health Service.We are also aware of a shortage of phenobarbital 15 milligram tablets and phenobarbital 15 milligram/5 millilitre elixir from two different manufacturers. Resupply dates are yet to be confirmed for phenobarbital 15 milligram tablets, and the elixir issue is expected to resolve by late June 2025. Management guidance has been issued to the NHS for both formulations. In both cases, alternative suppliers are in stock with sufficient supply to support patients.

What steps his Department is taking to provide long-term support for people living with epilepsy.

At the national level, there are a number of initiatives supporting service improvement and better care for patients with epilepsy in England.NHS England, in collaboration with stakeholders and patient groups, has developed a National Bundle of Care for children and young people with epilepsy. This bundle outlines key standards for epilepsy services, with the goal of ensuring consistent, high-quality care across all English regions.The NHS Right Care programme has provided a toolkit designed to help healthcare professionals understand priorities in epilepsy care and identify areas for improvement. The programme emphasises the importance of patient-centred care and support coordination of care between different healthcare professionals. The program also promotes the use of epilepsy specialist nurses and the importance of mental health support for individuals with epilepsy.The Getting It Right First Time (GIRFT) neurology programme aims to improve epilepsy services by addressing inequities in access, standardising care pathways, and promoting workforce development. By analysing and sharing data, GIRFT identifies areas for improvement and helps hospitals implement evidence-based practices, ultimately leading to better patient outcomes.NHS England has also established a Neurology Transformation Programme, a multi-year, clinically led programme, which has developed a new model of integrated care to support integrated care boards to deliver the right service, at the right time, for all neurology patients, including those with epilepsy. Specifically, the programme aims to optimise patient pathways, integrate care across different settings, and improve the overall experience of people with epilepsy.The National Institute for Health and Care Excellence (NICE) guideline on epilepsy provides evidence-based guidance for the diagnosis and management of epilepsy in both adults and children and young people. Whilst this guidance is advisory and is intended to support and intended to best practice, adherence will ensure that that patients receive the most appropriate and effective treatment. NICE provides tools to help healthcare professionals and service commissioners effectively implement and adopt the recommendations within NICE guidance.The Government has recently established the Neuro Forum, a United Kingdom-wide Government-led forum focusing on services and support for people affected by neurological conditions. The Forum brings together the Department, NHS England, devolved governments and health services, and Neurological Alliances across the UK to address gaps in treatment and care, and to drive improvements in neurological health across the four UK countries.

What assessment he has made of the potential impact of removing targets in the NHS Operational Planning Guidance for local health systems in England on dementia diagnosis times.

The Darzi Investigation found that there were too many targets set for the National Health Service, which made it hard for local systems to prioritise their actions or to be held properly accountable.This is why we have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the NHS around by doing things differently. These are the first steps on our journey for the long-term reform of the NHS.NHS Planning Guidance is not an exhaustive list of everything the NHS does, and the absence of a target does not mean it is not an area of focus.We remain committed to increasing dementia diagnosis rates and agree that timely diagnosis is vital to ensure people with dementia can access the treatment and support they need.

What plans his Department has to improve outcomes for dementia patients in South Suffolk.

The Government is committed to improving dementia care and is empowering local leaders with the autonomy they need to provide the best services to their local community, including for those with dementia.That is why we have published the D100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for busy system leaders and help create communities and services where the best possible care and support is available to those with dementia. The D100: Pathway Assessment Tool launched in April, with further information available at the following link:https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-toolThe 10-Year Health Plan will address the challenges diagnosed by Lord Darzi, and will set the vision for what good joined-up care looks like for people with a combination of complex health and care needs, including people living with dementia. It will set out how we support and enable health and social care services to work together better to provide joined-up care.Through our extensive public engagement as part of the 10-Year Health Plan, including a roundtable on dementia, healthy aging, and digital exclusion that I hosted, we will continue to listen to patients’ priorities and will keep focused on what matters most to the public.

What steps he is taking to avoid potential late diagnosis of ADHD for patients in South Suffolk.

It is the responsibility of the integrated care boards (ICBs) in England to make available appropriate provision to meet the health and care needs of their local population, including assessments for attention deficit hyperactivity disorder (ADHD), in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the National Health Service, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the final report expected in the summer of 2025.In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services, and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.

What assessment he has made of the potential impact of restricting the patient’s Right To Choose service on people with ADHD in South Suffolk.

The Government is committed to patients, including those with attention deficit hyperactivity disorder in South Suffolk, having the right to choose their provider when referred to consultant-led treatment, or to a mental health professional, for their first appointment as an outpatient. A patient’s right to choose is set out in legislation, and no changes are being made to this legal right. Further information on the choices available for patients can be found on the NHS Choice framework, which is available at the following link:https://www.gov.uk/government/publications/the-nhs-choice-framework

Whether his Department plans to offer early diagnosis to people suspected of suffering from osteoporosis.

On 6 January 2025, NHS England published the new Elective Reform Plan, which sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament. Further information on the Elective Reform Plan is available at the following link:https://www.england.nhs.uk/publication/reforming-elective-care-for-patients/Part of the plan sets out funding to boost bone density scanning capacity, to support improvements in early diagnosis and bone health conditions such as osteoporosis. This will provide an estimated 29,000 extra scans per year.As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) Musculoskeletal (MSK) Community Delivery Programme. With a £3.5 million funding boost, GIRFT teams will deploy their proven Further Faster model to work with integrated care board leaders to further reduce MSK community waiting times, including for those with osteoporosis, and improve data, metrics, and referral pathways to wider support services.

If he will make an assessment of the potential impact of the increase in employer's National Insurance contributions on social care providers in South Suffolk constituency.

We have taken necessary decisions to provide stability to the country’s finances. The Government considered the cost pressures facing adult social care at an England level as part of the wider consideration of local government spending within the Spending Review process.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26. Overall, core local government spending power is increasing by 6% in cash terms.Suffolk County Council will receive a 5.7% cash terms increase in its core spending power for 2025/26, compared to 2024/25.

What recent assessment he has made of the effectiveness of the radiotherapy late effects service.

No specific assessment has been made by the Department. The National Health Service keeps under review the range of services it offers patients and the Government understands that many trusts are using the radiotherapy late effects service as part of the care pathway for their cancer patients.