Written questions by MacCleary.

What recent estimate his Department has made of the number of people diagnosed with temporomandibular disorder linked to orthodontic malpractice.

Information is not held centrally on the number of people with temporomandibular disorder linked to orthodontic treatment.More widely, 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 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.

If he will have discussions with Cabinet colleagues on how to support individuals who develop temporomandibular disorder as a result of orthodontic treatment.

Information is not held centrally on the number of people with temporomandibular disorder linked to orthodontic treatment.More widely, 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 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.

What steps he is taking to make (a) dental mouth guards and (b) other dental orthotics services available for free on the NHS for people who are on Pension Credit.

Dental mouth guards are available for free to any patient who is in receipt of Pension Credit, Guarantee Credit, or anyone else who is exempt from dental patient charges, where they have a specific dental need for one. There are currently no plans to change the dental patient charge exemption criteria.National Health Service orthodontic treatment is free for people under 18 years old with a clear health need for treatment. Orthodontic treatment is not usually available on the NHS for adults. More information is available at the following link:https://www.nhs.uk/conditions/orthodontics/

What assessment his Department has made of the adequacy of the availability of Enhertu in (a) Scotland and (b) Europe compared to (c) England and (d) Wales.

Health is a devolved matter and decisions on the availability of medicines in Scotland and Wales are a matter for their own administrations. Other European countries operate very different health systems and direct comparisons of medicine availability are very difficult.Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE) following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently and on the basis of the available evidence.The NICE has recommended Enhertu (trastuzumab deruxtecan) in advanced breast cancer for treating HER2-positive unresectable or metastatic breast cancer after one or more anti-HER 2 treatments, and for treating HER2-positive unresectable or metastatic breast cancer after two or more anti-HER2 therapies. Enhertu is now routinely funded for eligible patients in England in line with the NICE’s recommendations.The NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that the NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer, and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca and Daiichi Sankyo, in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite the NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. The NICE’s guidance, published in July 2024, will therefore remain unchanged. Although the deadline for a rapid review has now passed, the NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.

What steps his Department is taking to reduce waiting times for endometriosis treatment in Sussex, including (a) specialist consultations and (b) surgery.

At the end of December 2024, the gynaecology waiting list, which includes those waiting for endometriosis treatment, for Sussex Integrated Care Board stood at 18,454, with 54.3% of patient pathways waiting less than 18 weeks.As set out in the Plan for Change, we have committed to return to the NHS constitutional standard that 92% of patients, including those waiting for endometriosis treatment, wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. We have already supported this with additional investment in the Autumn Budget 2024, which has enabled us to deliver an additional two million appointments, seven months ahead of schedule.There are a range of efforts underway, nationally and in Sussex, to reduce the time patients are waiting for gynaecological care. The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts we will undertake to return to the 18-week standard, and ensure patients have the best possible experience while they wait. This includes increasing the relative funding available to support gynaecology procedures, including for certain endometriosis pathways, with the largest waiting lists and reviewing support options from the independent sector.Sussex has launched Women’s Health Hubs in five locations, namely Hastings, Eastbourne, Brighton and Hove, Worthing, and Horsham. The core specification in the hub model includes menstrual problems, assessment, and treatment, including but not limited to, care for heavy, painful, or irregular menstrual bleeding, and care for conditions such as endometriosis and polycystic ovary syndrome. The establishment of these five hubs aims to improve access for local women to advice, support and treatment.

When his Department plans to remove the requirement for female same-sex couples to self-fund initial IVF treatments; and what steps he has taken to ensure equal access to fertility services across the NHS.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues on joint advice from the Department and NHS England about the offer around NHS-funded fertility services, including the issues for female same sex couples. Funding decisions for health services in England are made by integrated care boards and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England. NICE is currently reviewing these guidelines.

What steps his Department is taking to increase access to NHS dentistry for (a) pensioners and (b) people who are unable to afford private treatment.

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 recruit new dentists to areas that need them most. Sussex Integrated Care Board, which includes Lewes constituency, is expected to deliver 26,546 additional urgent dental appointments.The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England.Free NHS dental care is available to people who meet the following criteria: aged under 18 years old, or under 19 years old and in full-time education; pregnant or have had a baby in the previous 12 months; being treated in an NHS hospital and the treatment is carried out by the hospital dentist, with patients possibly having to pay for any dentures or bridges; or receiving low-income benefits, or under 20 years old and a dependant of someone receiving low-income benefits.Support is also available through the NHS Low Income Scheme for those patients who are not eligible for exemption or full remission of dental patient charges. More information is available at the following link:https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/

What steps his Department is taking to improve access to public defibrillators outside of business hours in (a) rural, (b) suburban and (c) other areas.

The Government is committed to improving access to automated external defibrillators (AEDs) in public spaces, and reducing inequalities in access to these life saving devices. We have made a further £500,000 available from August 2024 to fulfil existing applications to the Department’s Community AED Fund. The criteria specified for the original grant continues to apply and will go to applications for AEDs in areas of England where there is the greatest need, including in areas of high footfall, hot spots for cardiac arrest, and areas that already have low access to AEDs. A further requirement of the fund was that AEDs be publicly accessible 24 hours a day, where practical.

What steps his Department is taking to ensure (a) transparency and (b) public trust in the collection and sharing of NHS patient data.

Strong public trust is critical for the collection and sharing of National Health Service patient data, and transparency is key to building that trust and retaining public confidence.NHS England publishes a range of documentation to maintain transparency about how data is used. These include:- directions made by my Rt Hon. Friend, the Secretary of State for Health and Social Care, to NHS England to establish information systems;- Data Protection Impact Assessments and other documentation, which provide information on how the information will be used in particular programmes; and- data use registers that include details of external data sharing agreements and are published monthly. All NHS Research Network Secure Data Environments also maintain a data use register that includes details of data access agreements.Statutory roles and functions have also been established to provide confidence and assurance that data is used lawfully and for the benefit of patients. The Confidentiality Advisory Group of the Health Research Authority (HRA), provides independent, expert advice to the HRA, and to my Rt Hon. Friend, the Secretary of State for Health and Social Care, on the use of confidential patient information, and their minutes and a register of the applications and decisions made are published. The National Data Guardian (NDG) provides advice to help ensure that people’s confidential information is kept safe and used properly. The eight Caldicott rules established by the previous NDG set out key principles for the use of confidential information, including that individuals are informed about how their data is used. Caldicott guardians in every NHS organisation work to ensure these principles are upheld. The NDG publishes an annual report on their work and objectives.To further build trust, we are delivering a national programme of large-scale public engagement on data which will reach over 6,000 people across England, representative of our diverse communities. This provides the opportunity for us to meaningfully involve the public in decisions and changes to how their health data is used, and complements smaller-scale activities carried out by data programmes throughout the NHS.

If he will take steps to update guidance on how funds are allocated to GP surgeries in places with high demand such as Seaford, East Essex.

There are currently no plans to update how funding is allocated to general practice (GP) surgeries. GP practices receive funding through a range of income streams in return for providing services specified in the GP contract. ‘Global sum’, which is the funding allocated for providing core services, makes up between 50 and 60% of practice income. The rest of the income is made of Quality and Outcomes Framework, premises payments, directed enhanced service and additional services, for example vaccine and immunisation. The global sum allocation formula, also known as the Carr-Hill formula, is designed to ensure that resources are directed to practices based on an estimate of their patient workload and unavoidable practice costs. The formula considers GP-registered patient list size, adjusted and weighted to reflect differences in the age and sex composition of the practice’s registered patient list, together with a range of factors that take into account the additional pressures generated by differential rates of patient turnover, morbidity, mortality and the impact of geographical location. Under this formula, practices whose registered patients have greater healthcare needs are paid more per patient than practices whose registered patients have fewer healthcare needs. The global sum figure for 2024/25 is set at £112.50 per patient as set out in the General Medical Services Statement of Financial Entitlements 2024.

If he will make an assessment of the potential impact of not allowing carers to be vaccinated for Covid-19 on people requiring care.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI). The primary aim of the national COVID-19 vaccination programme remains the prevention of severe illness, namely hospitalisations and deaths, arising from COVID-19.In its advice for the autumn 2024 vaccination campaign, the JCVI advised that COVID-19 vaccine should be offered to: adults aged 65 years old and over; residents in a care home for older adults; and persons aged six months to 64 years old in a clinical risk group, as defined in tables 3 and 4 of the COVID-19 chapter of the UK Health Security Agency Green Book, for which more information is available at the following link:https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a The JCVI noted that in the current era of high population immunity to COVID-19 and with all cases due to highly transmissible Omicron sub-variants, any protection offered by the vaccine against transmission of infection from one person to another is expected to be extremely limited. On this basis the JCVI did not advise offering vaccination to unpaid carers. The Government accepted JCVI advice for autumn 2024, which is available at the following link:https://www.gov.uk/government/publications/covid-19-autumn-2024-vaccination-programme-jcvi-advice-8-april-2024/jcvi-statement-on-the-covid-19-vaccination-programme-for-autumn-2024-8-april-2024On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme covering vaccination in 2025 and spring 2026, which is available at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026The Government has accepted JCVI advice on eligibility for the spring 2025 COVID-19 vaccination programme. The Government is considering the advice for autumn 2025 and spring 2026 carefully and will respond in due course.

What steps his Department is taking to ensure that retired NHS staff affected by the McCloud Judgement receive their full pension entitlements for the remedy period between 1 April 2015 and 31 March 2022; and whether his Department will publish a timeline for implementing the second phase of the McCloud Remedy.

The NHS Business Services Authority (NHSBSA) is implementing the McCloud remedy for impacted members of the NHS Pension Scheme. Remedy implementation is a complex and large-scale undertaking. The core element of the remedy will provide members with a choice of benefits at retirement for the period the discrimination identified by the McCloud judgment was effective. Approximately 350,000 retired members will be offered this choice retrospectively.The Department expects that the majority of impacted retired members will not receive their choice until after April 2025. Whilst the majority of impacted retired members are likely to already be in receipt of their most beneficial set of benefits, the Department is working with the NHSBSA to accelerate the provision of this choice, prioritising members for whom there would be a significant and immediate financial impact. The NHSBSA will communicate revised timelines with members once these are confirmed.

What steps his Department is taking to improve support for families affected by baby loss including (a) access to counselling services, (b) support for siblings and (c) training for healthcare professionals in providing compassionate care.

NHS England’s Three Year Delivery Plan for Maternity and Neonatal services sets out how the National Health Service will make care safer, more personalised, and equitable. The plan includes a commitment to provide compassionate and high-quality care for bereaved families.To deliver on this commitment, NHS England has made additional funding available to ensure all trusts can offer a seven day a week bereavement service. NHS England has also invested in Maternal Mental Health Services to provide care for women with moderate to complex or severe mental health difficulties, and published the Core Competency Framework for providers, to address known variation in multi-professional training and competency assessment, including for bereavement care.Additionally, the National Bereavement Care Pathway (NBCP) aims to reduce the variation in the quality of bereavement care provided by the NHS to ensure that parents receive quality and consistent care after pregnancy or baby loss. The pathway acts as a set of standards and guidance that trusts should follow when a patient has suffered a pregnancy or baby loss, with the aim of ensuring that all bereaved parents are offered equal, high quality, individualised, safe, and sensitive care. Since June 2024, all NHS England trusts had signed up to the NBCP.To support NHS staff to handle a range of difficult situations, NHS England has also launched an e-learning module, Handling difficult situations – Caring for yourself and others with compassion, for NHS staff in frontline, patient facing roles. This e-learning module, which is available for free, aims to help upskill colleagues in how to handle difficult situations with compassion, using appropriate communication techniques and active listening skills.

What steps his Department is taking to (a) prevent heart disease and stroke, (b) prioritise timely NHS heart care and (c) accelerate research into future treatments and cures.

We are committed to ensuring that fewer lives are lost to the biggest killers, such as heart disease, which includes cardiovascular diseases (CVD), and stroke.The NHS Health Check, England’s flagship CVD prevention programme, engages over 1.3 million people each year and prevents approximately 500 heart attacks or strokes. To improve access and engagement to this life saving check, we are developing a digital NHS Health Check, a service which people can use at home to understand and act on their CVD risk, providing people with a more flexible, accessible, and convenient service. We are also piloting a new programme to deliver more than 130,000 lifesaving heart health checks in workplaces across the country.The NHS Long Term Plan (NHS LTP) is committed to improving the care and outcomes for people with CVD through enhanced diagnostic support in the community, better personalised planning, and increased access to disease-specific rehabilitation. NHS England’s stroke priorities include rapid diagnosis and increased access to time-dependent acute stroke care, as well as facilitating ambulance service use of pre-hospital telemedicine, and supporting access to the use of artificial intelligence decision support tools for brain imaging.

How many vacancies were advertised in the NHS in each year since 2010.

The Department does not hold the information requested. NHS England publishes a compendium of NHS Vacancy Statistics each quarter. Whilst none of the data published is the exact number of vacancies advertised in the National Health Service, the information does currently provide three measures of the level of vacancies in the NHS. Detailed information on the definition of collected data and the available timeseries, along with the measure’s strengths and weaknesses, is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-surveyThe earliest data within this collection is from 2016, and no data is held prior to this period. Due to the complex nature of how NHS vacancy data is defined and collected, all data sources should be treated with a degree of caution.

How many EU-born staff were working in the NHS in each year since 2010.

The Department does not collect data on where staff working in the National Health Service were born. However, NHS England publishes quarterly data on the number of staff split by nationality in NHS trusts and other core organisations in England. The following table shows the number of staff working in the NHS in England with nationalities from the European Union, each September from 2010 until June 2024, the most recent data point available:DateHeadcount of staffSeptember 201030,032September 201132,259September 201234,418September 201338,334September 201445,066September 201552,808September 201659,796September 201761,974September 201863,484September 201965,741September 202068,919September 202170,056September 202271,174September 202374,969June 202477,289All staff within NHS trusts and commissioning bodies provide a self-reported nationality which is recorded on the Electronic Staff Record system. This may reflect an individual’s cultural heritage rather than their country of birth, with some individuals choosing not to specify it.