Written questions by MacCleary.

What steps is his department taking to raise awareness of the warning signs of sudden arrhythmic death syndrome.

Under the UK Rare Diseases Framework, the Government is working to improve awareness of rare diseases among healthcare professionals, including rare conditions that lead to sudden arrhythmic death syndrome (SADS).NHS England has a published the national service specification Cardiology: Inherited Cardiac Conditions (All Ages), which is available at the following link:https://www.england.nhs.uk/publication/cardiology-inherited-cardiac-conditions-all-ages/This outlines the service model and mandatory guidelines for commissioned providers in England to support the diagnosis and treatment of patients or families affected by inherited cardiac conditions or sudden cardiac death. NHS England is currently reviewing this service specification and is working with stakeholders as part of this review including NHS clinical experts and the British Inherited Cardiovascular Conditions Society. The NHS England Genomics Education Programme has also developed a range of educational resources for healthcare professionals.This includes a Knowledge Hub page on sudden arrhythmic death syndrome, including information on presentation, diagnosis, management, and links for clinicians to further resources. Further information is available at the following link:https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/sudden-arrhythmic-death-syndrome/

What steps he is taking to ensure his department’s contribution to the Fair Pay Agreement in adult social care will be passed on to independent adult social care employers.

We are introducing the first ever Fair Pay Agreement in 2028, backed by £500 million of funding to improve pay and conditions for the adult social care workforce.This £500 million of funding will be given to local authorities to support providers to improve pay, and terms and conditions through the Fair Pay Agreement. It represents the most significant investment in improving pay and conditions for adult social care staff to date.Negotiations between employee and employer representatives, including those from all types of providers, such as independent providers, will shape how this funding will be used to enhance pay, terms and conditions. The Government is committed to supporting commissioners to enable the successful delivery of the Fair Pay Agreement and we are exploring options for engagement to best inform our understanding of this.We also recognise that, in preparation for the first Fair Pay Agreement, commissioners and providers, will need time, support and guidance. We are committed to publishing guidance to support these groups, and our consultation seeks views from all providers, including independent providers, to ensure their perspectives are fully considered.

Whether his Department has made a recent assessment on the potential merits of allowing the use of prescribed medical cannabis within NHS buildings.

National Health Service trusts have a duty of care to both staff and patients, as outlined in the NHS constitution, to ensure a safe working and care environment. This will include local policies concerning the use and administration of a patient’s own medicines.The law was amended in 2018 to permit specialist doctors to prescribe unlicensed cannabis-based products for medicinal use. While smoking these medicines is banned, vaping and other forms of administration are not prohibited. Regardless of the form of administration, it is always advisable for patients to declare any medicines prescribed, whether on the NHS or privately, and discuss them with their clinical team upon admission.

When members of the NHS Pensions Scheme will receive McCloud remedies.

The Department recognises the importance of providing NHS Pension Scheme members certainty about when they will receive their McCloud Remediable Service Statements.An independent review of the NHS Business Service Authority’s (NHSBSA) revised plans for the delivery of the McCloud remedy for NHS Pension Scheme members is underway. This will provide an additional level of scrutiny and assurance of the NHSBSA’s delivery plan and the timetable for the remaining statements.I expect to be able to update the House on the review’s progress and the remedy delivery timetable before Christmas recess.In the meantime, the NHSBSA continues to provide Remediable Service Statements to affected members, prioritising those who may be experiencing immediate financial hardship due to the discrimination highlighted by the McCloud judgment. Additionally, members who meet specific criteria can request to receive a prioritised Remediable Service Statement. Further information is available at the following link:https://faq.nhsbsa.nhs.uk/knowledgebase/article/KA-29429/en-usThe Government is committed to ensuring that affected members are not subject to financial disadvantage due to these delays. Pension arrears arising from the McCloud remedy are paid with 8% interest, and a compensation scheme is available for members who have experienced other direct financial losses.

What steps is his Department taking to support people (a) injured or (b) bereaved by AstraZeneca COVID-19 vaccinations, including those with vaccine-induced thrombocytopenia and thrombosis.

In the very rare event where someone may have suffered a severe adverse reaction to a vaccine, care and treatment will be best managed by local National Health Service specialist services, augmented as appropriate by national specialist advice. Individuals will be treated and managed through existing healthcare services, with treatment dependent on the individual’s clinical needs.Individuals can also apply to the Vaccine Damage Payment Scheme (VDPS) which provides a one-off, tax-free payment of £120,000 to claimants who have been found, on the balance of probabilities, to have been severely disabled as a result of vaccinations against certain diseases listed in the Vaccine Damage Payments Act 1979.Outside of the VDPS, other Government support remains available for those with a disability or long-term health condition, including Statutory Sick Pay, Universal Credit, Employment and Support Allowance, Attendance Allowance, and Personal Independence Payments. Further information is available at the following link:https://www.gov.uk/browse/benefits/disability

Whether his Department has made an assessment of the potential duplication of (a) regulatory and (b) inspection activity in adult social care between the (i) Care Quality Commission and (ii) local authority adult social care services.

There is no direct duplication between how the Care Quality Commission (CQC) assesses individual registered providers and how local authorities oversee providers within their areas. Both bodies are involved in evaluating quality and safety, but they do so under different legislative frameworks and for distinct purposes.The CQC’s remit is to assess registered providers against the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The CQC monitors, inspects, and regulates services to make sure they meet fundamental standards of quality and safety. Local authorities are responsible for ensuring registered adult social care providers deliver care that meets people’s needs and the duties as set out in the Care Act 2014. Their oversight thus tends to focus on quality, safeguarding, and contract compliance. The CQC works with local authorities to share information and intelligence and are working on ways to strengthen these links.Similarly, there is no direct duplication between how the CQC assesses individual registered providers and how the CQC assesses local authorities. CQC provider regulation assesses against the Health and Social Care Act 2008, whereas local authority assessments assess against the Care Act 2014. Both pieces of legislation require different methodology, however they can be used to inform each other.The commission into adult social care is independent of the Government, and Baroness Casey has the autonomy to define her own engagement plans, including with ministers, based on what she believes is most appropriate for the commission’s work.

Whether he has had discussions with the Casey Commission on the potential duplication of (a)regulatory and (b) inspection activity in adult social care.

There is no direct duplication between how the Care Quality Commission (CQC) assesses individual registered providers and how local authorities oversee providers within their areas. Both bodies are involved in evaluating quality and safety, but they do so under different legislative frameworks and for distinct purposes.The CQC’s remit is to assess registered providers against the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The CQC monitors, inspects, and regulates services to make sure they meet fundamental standards of quality and safety. Local authorities are responsible for ensuring registered adult social care providers deliver care that meets people’s needs and the duties as set out in the Care Act 2014. Their oversight thus tends to focus on quality, safeguarding, and contract compliance. The CQC works with local authorities to share information and intelligence and are working on ways to strengthen these links.Similarly, there is no direct duplication between how the CQC assesses individual registered providers and how the CQC assesses local authorities. CQC provider regulation assesses against the Health and Social Care Act 2008, whereas local authority assessments assess against the Care Act 2014. Both pieces of legislation require different methodology, however they can be used to inform each other.The commission into adult social care is independent of the Government, and Baroness Casey has the autonomy to define her own engagement plans, including with ministers, based on what she believes is most appropriate for the commission’s work.

What steps his Department plans to take to help reduce the impact of chronic respiratory conditions on the NHS in winter 2025-26.

NHS England, working with the Department, the UK Health Security Agency, and other partners, is taking action to reduce the impact of respiratory conditions on the National Health Service this winter. This includes robust, consistent infection prevention and control measures, and a campaign to encourage eligible people to get their winter vaccinations. Further information on the actions being taken to reduce the demand on acute services during winter is available at the following link: https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/

What criteria his Department uses to determine which conditions should receive a modern service framework; and whether respiratory health meets these criteria.

Everyone in the National Health Service is responsible for delivering high-quality care. As announced in the 10-Year Health Plan, as well as an overall quality strategy, the National Quality Board will oversee the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in the quality of care and productivity.Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia. The Government will consider other long-term conditions with significant health and economic impacts for future waves of modern service frameworks.

What steps his Department plans to take to help (a) increase capacity and (b) tackle inequalities in accessing a respiratory diagnosis.

The Government is committed to increasing the capacity of respiratory services and is improving access to these services through new community diagnostic centres (CDCs).All standard and large CDCs are required to offer diagnostic respiratory tests such as spirometry and full lung function tests as part of their core testing offer.The 2025/26 capital guidance confirmed that £1.65 billion of capital funding is being allocated to support National Health Service performance across secondary and emergency care across 2025/26 more broadly. This includes funding to enable the completion of 2024/25 CDC schemes, as well as to expand existing and build new CDCs.

What assessment he has made of the potential merits of classifying stage 4 breast cancer as very severe in relation to access to life-saving drugs.

The Department understands the impact that cancer has on those living with it and their families, and the urgent need for new treatment options.The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for developing the methods and processes it uses to evaluate whether new medicines should be recommended for routine National Health Service funding.Whilst no such assessment has been made, in developing recommendations on whether medicines represent a clinically and cost-effective use of NHS resources, NICE is able to apply a weighting that recognises the additional value that society places on treatments for severe conditions. The weighting that is applied is calculated for each appraisal based on information on the expected shortfall in life expectancy and quality of life of people with the condition, considering existing treatment options. NICE has concluded for several appraisals of medicines for late-stage breast cancer that a weighting should be applied based on the severity of the condition and has recommended all but one of the new medicines for the treatment of breast cancer, including advanced breast cancer, that it has evaluated since 2018. These treatments are now available for the treatment of NHS patients.NICE’s methods that are used for determining whether an appraisal qualifies for a weighting under the severity modifier have been developed through extensive engagement with stakeholders and through public consultation.

What steps his Department is taking to support people with Niemann-Pick disease type B.

The Government is committed to improving the lives of those living with rare diseases, such as Niemann-Pick disease type B. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community. These include: helping patients get a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better coordination of care; and improving access to specialist care, treatments, and drugs. We published the annual England Rare Diseases Action Plan in February 2025, where we report on the steps we have taken to advance these priorities.

What assessment he has made of the adequacy of NHS surgery waiting time information published on the NHS My Care Portal in the context of reports that these timeframes differ from those provided by NHS hospital trusts.

Patients in England can choose the hospital for their first outpatient appointments via the NHS e-Referral Service and the NHS App, allowing them to view and choose from available appointments across different hospitals within the same region.The National Health Service is a large, decentralized system, and individual NHS hospital trusts are responsible for managing their own patient portals, resulting in different systems and features. Each trust may set its own policies and internal delays before results are displayed in the portal, rather than linking them directly to the patient. A delay in displaying results is a common practice for sensitive test results linked to conditions such as cancer, to give doctors an opportunity to review them with the patient first.The NHS ensures adequate data for My Planned Care by employing a multi-faceted approach, including centralised data collection and curation, implementing shared records for better data integration across systems, establishing robust data quality checks and reporting, adhering to strict information governance and security standards, and actively working to link diverse data sources. These processes support the provision of timely and accurate information on the My Planned Care website to help patients and healthcare professionals.The NHS continues to invest heavily in the NHS App and in the past two years we have been implementing digital integration between acute hospitals and the NHS App, meaning that patients can now view their clinical pathway and appointments via the NHS App. We continue to work with hospital trusts to maximise the opportunities available to update patients via the NHS App, which is a key part of the 10-year plan to reform the NHS.The NHS App has now been adopted by 88% of acute trusts, up nearly 20% since July 2024, which enables patients to view and manage their hospital appointments.Analysis shows that hospitals that make the changes to plug their systems and processes into the NHS App key app features have improved elective care waiting times.

If he will make an assessment of the accuracy of the classification of stage 4 breast cancer as moderate in severity.

Neither the Department for Health and Social Care nor the National Institute for Health and Care Excellence (NICE) have classified stage 4 breast cancer as moderate in severity.In developing guidance on whether new medicines can be recommended for routine use in the treatment of NHS patients, NICE is able to apply a weighting that recognises the additional value that society places on treatments for severe conditions. The weighting that is applied is calculated for each appraisal based on information on the expected shortfall in life expectancy and quality of life of people with the condition, taking into account existing treatment options. NICE has concluded for several appraisals of medicines for late-stage breast cancer that a weighting should be applied based on the severity of the condition.

What steps his Department is taking to ensure equitable access to Xonvea for women with hyperemesis gravidarum.

The Department recognises that hyperemesis gravidarum is a debilitating condition that can have a devastating impact on women and their families.Decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers are accountable for their prescribing decisions.Prescribers must always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed and that they take account of appropriate national guidance on clinical effectiveness, as well as the local commissioning decisions of their respective integrated care boards.The National Institute for Health and Care Excellence’s guideline on antenatal care includes guidance on the advantages and disadvantages of different pharmacological treatments, including Xonvea, for nausea and vomiting in pregnancy to support shared decision making.

If he will make an assessment of the potential merits of issuing national prescribing guidance to Integrated Care Boards to ensure the availability of Xonvea.

The Department recognises that hyperemesis gravidarum is a debilitating condition that can have a devastating impact on women and their families.Decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers are accountable for their prescribing decisions.Prescribers must always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed and that they take account of appropriate national guidance on clinical effectiveness, as well as the local commissioning decisions of their respective integrated care boards.The National Institute for Health and Care Excellence’s guideline on antenatal care includes guidance on the advantages and disadvantages of different pharmacological treatments, including Xonvea, for nausea and vomiting in pregnancy to support shared decision making.

What assessment he has made of the adequacy of the availability of (a) child psychologists and (b) other qualified specialists to assess severely disabled children for (i) ADHD and (ii) other neurodevelopmental conditions where (A) a lack of assessment prevents access to appropriate medication and support and (B) in other circumstances.

The Government has recognised that, nationally, demand for assessments for autism and attention deficit hyperactivity disorder (ADHD) 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, recognising the need for early intervention and support, without the need for diagnosis.It is the responsibility of integrated care boards (ICBs) to make appropriate provision to meet the health and care needs of their local population, including access to ADHD and autism assessments and support, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established an ADHD taskforce which is bringing together those with lived experience with experts from the NHS, education, charity and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim report was published on 20 June, with the final report expected to be published later in the year and we will carefully consider its recommendations.The Government is supporting inclusive environments for children with special educational needs and disabilities (SEND) through the ‘Partnerships for Inclusion of Neurodiversity in Schools’ programme and earlier intervention through the ‘Early Language Support for Every Child’ programme. In addition, through local commissioning, the Government will ensure that Neighbourhood Health Services work in partnership with family hubs, schools, nurseries and colleges to offer timely and joined-up support to children, young people and their families.

What assessment he has made of the adequacy of the availability of (a) child psychologists and (b) other qualified specialists to assess severely disabled children for (i) ADHD and (ii) other neurodevelopmental conditions in (A) cases where a lack of assessment prevents access to appropriate (1) medication and (2) other support and (B) other cases.

It is the responsibility of integrated care boards to make appropriate provision to meet the health and care needs of their local population, including access to attention deficit hyperactivity disorder (ADHD) and autism assessments and support, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established an ADHD taskforce which is bringing together those with lived experience with experts from the National Health Service, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim report was published on 20 June, with the final report expected to be published later in the year, and we will carefully consider its recommendations.The 10-Year Health Plan, published on 3 July 2025, sets out the core principle of early intervention and support, without the need for diagnosis, including specifically for children and young people with special educational needs and disabilities (SEND). In the autumn, the Government will bring forward a schools white paper, which will detail the Government’s approach to SEND reform, ensuring joined-up support for children and young people, including education and healthcare providers working together with other local services to plan and deliver evidence-based early interventions for children.The 10-Year Health Plan also sets out plans for new neighbourhood health services to work in partnership with family hubs, schools, nurseries, and colleges to offer timely support to children, young people, and their families, including those with SEND.

Whether his Department plans to prioritise UK medical school graduates for foundation year one posts.

The Government is committed to developing homegrown talent and to giving opportunities to more people across the country to join our National Health Service.At the same time, we will always welcome internationally educated staff, who remain an important part of the workforce, and who have been since the inception of the NHS. We have published a Code of Practice for International Recruitment, ensuring stringent ethical standards when recruiting health and social care staff from overseas.NHS England will keep the selection process for foundation training under review to make sure it works well for applicants.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.

Whether his Department plans to increase funding for the UK Foundation Programme office.

The UK Foundation Programme Office (UKFPO) manages the national application process for the UK Foundation Programme. The UKFPO is funded by, and is accountable to, the four United Kingdom statutory education bodies, including NHS England for England. We are committed to ensuring that the number of medical foundation training places meets the demands of the National Health Service in the future, and this will be supported by appropriate funding.