Written questions by McMurdock.

What steps he is taking to help reduce the number of patients waiting over 12 hours to be admitted to, or discharged from, Basildon Hospital’s Accident and Emergency Department.

The Government recognises that urgent and emergency care performance has fallen short in recent years. We are committed to restoring accident and emergency waiting times to the National Health Service constitutional standard.Our Urgent and Emergency Care Plan for 2025/26 sets out clear actions to deliver improvements and make services better. The plan commits to reducing the number of patients waiting over 12 hours for admission or discharge to less than 10% of the time. This is supported by almost £450 million of capital investment for Same Day Emergency Care, Mental Health Crisis Assessment Centres, and new ambulances, avoiding unnecessary admissions to hospital and supporting the faster diagnosis, treatment, and discharge for patients.The NHS Medium-Term Planning Framework sets out a further trajectory to improve urgent and emergency care performance year-on-year toward the constitutional standard, reducing long waits and improving patient experience. The plan focuses on practical steps such as expanding urgent treatment centres, improving patient flow, and reducing 12-hour waits, to make emergency departments safer and more efficient.NHS England provides regional oversight to support local delivery of services and improvement. The Mid and South Essex NHS Foundation Trust’s One Team Improvement Plan has a focus on improving urgent and emergency care outcomes. The programme group looking at quality and patient safety has been focusing on reviewing processes and the fundamentals of care in wards and in the trust’s emergency departments. The trust has also introduced additional consultant cover during the weekends to increase the number of people discharged at the weekend. This helps to keep the emergency department safe as it allows for the movement of people who need to be admitted into the right beds.

What steps he is taking to ensure the adequacy of primary care estates to support workforce expansion.

It is the responsibility of the integrated care boards to ensure that the National Health Service estate is fit for purpose, in order to meet the needs of the local population.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 and will be delivered through public private partnerships and public capital.The Government is providing £426 million over four years through the Utilisation and Modernisation Fund, upgrading general practice (GP) estate and supporting delivery of 40 to 50 NHCs this Parliament through refurbishment of existing buildings.In Spring we will publish the 10 Year Workforce Plan, which will set out the high-level vision for how we can prepare our workforce to deliver the three shifts set out in the 10-Year Health Plan.The Government has committed to training thousands more GPs, which will support the delivery of the left shift and focus more resources in the community. Our work on this has already started, with the number of available GP training places increasing by an additional 250 places to 4,250 for 2025/26 and again to 4,500 for 2026/27.

What proportion of GP trainees qualified as GPs in each of the last three years.

General practice (GP) speciality training has maintained a low rate of attrition over the last three years of approximately 1.3% to 1.5%, and the average length of time to complete GP training has remained at 3.8 years.A proportion of trainees achieving a Certificate of Completion of Training is difficult to provide as programme length can vary due to individual circumstances, such as changes in working hours, maternity/paternity leave, sick leave, and out of programme activities.

What assessment he has made of the potential impact of A&E waiting times on post-discharge outcomes for older patients.

No assessment has been made of the impacts of accident and emergency waiting times on post-discharge outcomes. There have been studies on the impact of waiting times on clinical outcomes in general, which inform the targets the National Health Service sets for accident and emergency waiting times.

Whether he plans to publish data on cases where patients deteriorate or die in Accident and Emergency waiting rooms before being seen by a doctor.

This data is not available in the format requested and there is no plan to publish this. Patients are reviewed at the front door and are seen by a clinical member of staff and streamed to the right service for them. If there is an incident around care processes, this is logged.The National Health Service and the Department have taken significant steps forward to improve patient safety, including by implementing significant programmes under the NHS Patient Safety Strategy from 2019.We are also introducing new clinical operational standards for the first 72 hours of care, setting clear expectations for timely reviews and specialist input, including guidance on monitoring patients with frailty. This supports the early identification of deterioration and helps ensure patients waiting in accident and emergency departments are appropriately monitored.

What assessment he has made of trends in the level of regional variations in the quality of GP specialty training.

Post-graduate medicine general practice specialty trainees consistently report high levels of satisfaction with their overall educational experience, according to the results of the National Education and Training Survey (NETS), 2022 to 2024.Alongside NETS reporting broadly consistent overall educational experience satisfaction rates across regions, this speciality programme has a low attrition rate nationally.

What assessment he has made of the potential impact of capacity of NHS primary care premises in Thurrock on the recruitment of GPs.

No assessment has been made by the Department of the potential impact of National Health Service primary care premises in Thurrock on the recruitment of general practice (GP) doctors. It is the responsibility of the NHS Mid and South Essex Integrated Care Board (ICB) to ensure that the NHS estate in Thurrock is fit for purpose, in order to meet the needs of the local population. GP contractors are responsible for securing, managing, and maintaining suitable premises. The ICB has set up a new joint estates group with Thurrock Council to identify where void space can be used to enhance access to primary, community, and social care facilities.The ICB has a range of schemes to improve recruitment and retention of GPs, including GP partnership courses, portfolio development scheme, and fellowships for newly qualified GPs. Thurrock has seen an increase in the number of GPs with at least 82 full time equivalent GPs now working in Thurrock, the highest number recorded since March 2016.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 and will be delivered through public private partnerships and public capital. We are also providing £426 million over four years through the Utilisation and Modernisation Fund, upgrading GP estates, and supporting delivery of 40 to 50 NHCs this Parliament through refurbishment of existing buildings.

What proportion of outpatient activity was delivered outside hospital settings in Essex in the most recent period for which data is available.

The Department does not centrally hold data on outpatient activity delivered outside hospital settings in Essex.Approximately 80% of the waiting list is made up of people waiting for outpatient appointments. Modernisation of this important stage of planned care is a top priority for the Government. We have committed, in our Elective Reform Plan and 10-Year Health Plan, to modernise elective pathways to ensure that they are better for patients and more productive. This radical plan will end outpatient care as we know it by 2035.Face-to-face hospital appointments will become the exception, as two thirds of outpatient appointments will be replaced by digital advice, direct input from specialists, and patient-initiated follow ups as we introduce a new digital front door to the National Health Service via the NHS App by 2035, which is more responsive to patients’ needs. Patients will still have a choice in where they get their care.We will deliver this vision with a new model for planned care that is digital by default and local where possible, providing rapid access to patient-centred services.

What proportion of clinical negligence claims in each of the last three years were attributable to a) staffing levels, b) triage issues and c) delays in treatment.

NHS Resolution is the body that manages clinical negligence and other claims against the National Health Service in England. They are unable to provide a full response to the questions in the format requested without commissioning work to review files manually, which would incur disproportionate cost. NHS Resolution has published a thematic review titled Learning from Emergency Medicine compensation claims - NHS Resolution, which may be helpful.

How many negligence claims arising from accident and emergency care cited delays in a) triage and b) admission as a contributing factor.

NHS Resolution is the body that manages clinical negligence and other claims against the National Health Service in England. They are unable to provide a full response to the questions in the format requested without commissioning work to review files manually, which would incur disproportionate cost. NHS Resolution has published a thematic review titled Learning from Emergency Medicine compensation claims - NHS Resolution, which may be helpful.

What the total monetary value was of NHS costs submitted under the European Health Insurance Card scheme that were not recovered in each of the last three financial years.

Under our agreements with the European Union, European Free Trade Association countries and Switzerland, we make claims to European countries for National Health Service costs incurred by temporary visitors from those countries. Claims are made in arrears and take up to four years before they are fully settled.The following table shows the position of European Health Insurance Card and Provisional Replacement Certificate claims for the last three financial years as of 31 March 2025:Financial yearTotal value of claims submitted by UK (£000s)Claims withdrawn by UK (£000s)Claims paid to the UK (£000s)Outstanding claims (£000s)2022/2310,2004029,1746242023/2412,0542336,5705,2512024/2512,0411986311,159Grand Total34,29565416,60617,035 These figures come from extracts from the NHS Business Services Authority’s claims processing database used by the Department for accounting purposes. Claims listed as withdrawn or paid have been settled whereas those listed as outstanding are still being agreed. We expect most outstanding claims to be settled in the United Kingdom’s favour.This data excludes countries where NHS costs for temporary visitors are reimbursed based on a formula agreement which calculates costs from the number of visitors from that country to the UK. Further information is available at the following link:https://www.gov.uk/government/publications/healthcare-eea-and-switzerland-arrangements-act-2019-annual-report-april-2021-to-march-2022/annual-report-on-payments-made-under-the-healthcare-eea-and-switzerland-arrangements-act-2019-april-2021-to-march-2022#financial-reimbursement-arrangements-of-current-agreements-listed-under-heeasa

With reference to the Medicines and Healthcare products Regulatory Agency’s press release entitled MHRA seizes illegal medicines worth almost £45m in 2025 – disrupting major criminal networks, published on 26 January 2026, what guidance his Department issues to GPs and other healthcare professionals when patients indicate they have obtained illegally traded medicines.

The General Medical Council (GMC) is independent of the Government, is directly accountable to Parliament, and is responsible for operational matters concerning the discharge of their statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government.The GMC’s Good medical practice states that doctors must follow “Good practice in proposing, prescribing, providing and managing medicines and devices” which notes that when prescribing, doctors must consider whether the information they have is reliable enough to enable them to provide safe care, including a consideration of whether the patient is obtaining medication from other sources.In addition, the GMC’s Confidentiality: good practice in handling patient information content sets out doctors’ responsibilities regarding disclosure of patient information in the public interest. This guidance sets out the circumstances in which a medical professional may disclose a patient’s personal information without breaching duties of confidentiality, including when disclosure is required by law.

With reference to the Medicines and Healthcare products Regulatory Agency’s press release entitled MHRA seizes illegal medicines worth almost £45m in 2025 – disrupting major criminal networks, published on 26 January 2026, what recent steps his Department have taken to raise public awareness of the health risks associated with consuming illegally traded medicines.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicines for human use, medical devices, and blood products for transfusion in the United Kingdom. This includes applying the legal controls on the retail sale, supply, and advertising of medicines which are set out in the Human Medicines Regulations 2012.Sourcing medicines from unregulated suppliers significantly increases the risk of getting a product which is either falsified or not authorised for use. Products purchased in this way will not meet the MHRA’s strict quality and safety standards and could expose patients to incorrect dosages or dangerous ingredients.The MHRA is continually developing new and innovative ways to combat the illegal trade in medicines and to raise public awareness. These measures include:- publication of a #Fakemeds campaign which explains how to access medicines through safe and legitimate online sources, with further information available at the following link: https://fakemeds.campaign.gov.uk/;- public guidance on how to safely access and use GLP-1 medications, available at the following link: https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know.- implementation of a web-based reporting scheme allowing users to report suspicious online sellers to the MHRA;- rollout of an online service which will allow users to check if a website has been deemed ‘Not Recommended’ by the MHRA; and- extensive work with media outlets to raise awareness of the dangers of illegal medicines.The MHRA, and its Criminal Enforcement Unit, works hard to prevent, detect, and investigate illegal activity involving medicines and medical devices and takes enforcement action where necessary. It works closely with other health regulators, customs authorities, law enforcement agencies, and private sector partners, including e-commerce and the internet industry to identify, remove and block online content promoting the illegal sale of medicines and medical devices.

What steps he is taking to help ensure that patients waiting in Accident and Emergency are adequately monitored.

The safety of patients waiting in accident and emergency is of the highest priority, and we have set out various measures in national guidance. There is a national target that patients receive an initial assessment within 15 minutes of arrival in accident and emergency. This assessment considers patient acuity, ensuring those that are most unwell and at greatest risk are identified and prioritised. Patients should be then observed at clinically appropriate intervals to identify any deterioration, with specific arrangements determined through local clinical decision making and governance.The National Health Service and the Department have taken significant steps forward to improve patient safety, including by implementing significant programmes under the NHS Patient Safety Strategy, published in 2019.We are also introducing new clinical operational standards for the first 72 hours of care. These are largely focused on the period after patients leave emergency departments, setting clear expectations for timely reviews and specialist input, but also provide guidance on early assessment and monitoring of older people for frailty and delirium.

What assessment he has made of the effectiveness of measures for identifying the deterioration of patients' health in Accident and Emergency waiting rooms.

The safety of patients waiting in accident and emergency is of the highest priority, and we have set out various measures in national guidance. There is a national target that patients receive an initial assessment within 15 minutes of arrival in accident and emergency. This assessment considers patient acuity, ensuring those that are most unwell and at greatest risk are identified and prioritised. Patients should be then observed at clinically appropriate intervals to identify any deterioration, with specific arrangements determined through local clinical decision making and governance.The National Health Service and the Department have taken significant steps forward to improve patient safety, including by implementing significant programmes under the NHS Patient Safety Strategy, published in 2019.We are also introducing new clinical operational standards for the first 72 hours of care. These are largely focused on the period after patients leave emergency departments, setting clear expectations for timely reviews and specialist input, but also provide guidance on early assessment and monitoring of older people for frailty and delirium.

What steps is he taking to help tackle the causes of negligence claims received by the NHS.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the 10-Year Health Plan for England, David Lock KC is providing expert policy advice on the rising costs of clinical negligence and how we can improve patients’ experience of claims. The review is ongoing, following initial advice to ministers and the recent National Audit Office report.Over recent years, the NHS and the Department have taken significant steps forward to address the rising costs of clinical negligence and to improve patient safety, including by implementing significant programmes under the NHS Patient Safety Strategy, published 2019. The strategy is now achieving its aim of saving an extra 1,000 lives per year and £100 million in care costs per year.In addition, the Government is committed to restoring urgent and emergency care waiting times to the standards set out in the NHS Constitution by the end of this Parliament, as laid out in out 10-Year Health Plan. The NHS Medium-Term Planning Framework sets out a clear trajectory to improve urgent and emergency care performance year-on-year, reducing long waits and improving patient experience.

What steps he is taking to reduce risk of negligence in Accident and Emergency waiting rooms.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on NHS finances.As announced in the 10-Year Health Plan for England, David Lock KC is providing expert policy advice on the rising costs of clinical negligence and how we can improve patients’ experience of claims. The review is ongoing, following initial advice to ministers and the recent National Audit Office report.Over recent years, the NHS and the Department have taken significant steps forward to address the rising costs of clinical negligence and to improve patient safety, including by implementing significant programmes under the NHS Patient Safety Strategy, published 2019. The strategy is now achieving its aim of saving an extra 1,000 lives per year and £100 million in care costs per year.In addition, the Government is committed to restoring urgent and emergency care waiting times to the standards set out in the NHS Constitution by the end of this Parliament, as laid out in out 10-Year Health Plan. The NHS Medium-Term Planning Framework sets out a clear trajectory to improve urgent and emergency care performance year-on-year, reducing long waits and improving patient experience.

What assessment he has made of the potential impact of clinical negligence claims on NHS finances.

The rising costs of clinical negligence claims against the National Health Service in England are of great concern to the Government. Costs have more than doubled in the last 10 years and are forecast to continue rising, putting further pressure on National Health Service finances.Although forecasts remain uncertain, it is likely that the costs of clinical negligence will continue to grow substantially. The Government Actuary’s Department forecasts that annual payments for compensation and legal costs will increase from £3 billion in 2024/25 to £4.1 billion by 2029/30.As announced in the 10-Year Health Plan for England, David Lock KC is providing expert policy advice on the rising costs of clinical negligence and how we can improve patients’ experience of claims. The review is ongoing, following initial advice to ministers and the recent National Audit Office report.We welcome the report by the National Audit Office. The results of David Lock’s work will inform future policy making in this area. No decisions on policy have been taken at this point, and the Government will provide an update on the work done and next steps in due course.

What plans he has to expand clinical capacity at Basildon Hospital.

In June 2026, Basildon Hospital will open a new Acute Kidney Care Ward, providing an additional 24 beds on the site and increasing capacity for people presenting to the emergency department with kidney problems, speeding up access to urgent care.Following this, the current renal ward will be refurbished to support more medical care beds for winter and to provide space to move patients out of older wards so that improvements can be made as part of the trust’s prioritised capital programme.In addition, two newly upgraded orthopaedic operating theatres opened at Basildon Hospital in November 2025 following essential maintenance works to improve the advanced air handling system. Since the start of November, staff working in theatres six or seven in the main theatre department have already completed hundreds of operations and procedures, including shoulder replacements, foot reconstructions, and knee replacements.To help reduce its waiting lists, the trust is running additional capacity theatre slots, as well as outsourcing patients to other hospitals to receive their treatment and reduce waiting times. The trust is also insourcing within the hospital providers for extra outpatient capacity.

What plans he has to expand orthopaedic theatre capacity at Basildon Hospital.

In June 2026, Basildon Hospital will open a new Acute Kidney Care Ward, providing an additional 24 beds on the site and increasing capacity for people presenting to the emergency department with kidney problems, speeding up access to urgent care.Following this, the current renal ward will be refurbished to support more medical care beds for winter and to provide space to move patients out of older wards so that improvements can be made as part of the trust’s prioritised capital programme.In addition, two newly upgraded orthopaedic operating theatres opened at Basildon Hospital in November 2025 following essential maintenance works to improve the advanced air handling system. Since the start of November, staff working in theatres six or seven in the main theatre department have already completed hundreds of operations and procedures, including shoulder replacements, foot reconstructions, and knee replacements.To help reduce its waiting lists, the trust is running additional capacity theatre slots, as well as outsourcing patients to other hospitals to receive their treatment and reduce waiting times. The trust is also insourcing within the hospital providers for extra outpatient capacity.