Written questions by McMurdock.

What steps he is taking to ensure that people living in Essex who are digitally excluded have full access to the healthcare services they need.

We are working to improve access to digital services, outcomes, and experiences for the widest range of people, based on their preferences. Digital health tools should be part of a wider offering that includes face-to-face support, with appropriate help for people who struggle to access digital services. NHS England has successfully run a number of programmes to support patients, carers, and health service staff with their digital skills. These include:- the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online;- the Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation, and means to access health information and services online; and- the NHS App ‘Spoken Word’ Pilot project, designed to test the efficacy of promoting National Health Service digital health products and services in languages other than English. NHS England has published a framework for NHS action on digital inclusion and is developing further resources to support practical actions. All programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion.

What steps he is taking to increase public awareness of chronic migraine disease.

The National Institute for Health and Care Excellence’s (NICE) guideline, Headaches: Diagnosis and management of headaches in young people and adults, updated in December 2021, sets out best practice for healthcare professionals in the care, treatment, and support of people who suffer from headaches, including migraine. It aims to improve the recognition and management of headaches and migraine.At the national level, there are a number of initiatives supporting service improvement and better care for patients with migraine, including the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Headache and Migraine Toolkit, and the Neurology Transformation Programme. The GIRFT Programme published a National Speciality Report, which makes several recommendations in relation to improving the recognition and diagnosis of migraine by general practitioners. Additionally, the RightCare Headache and Migraine Toolkit sets out key priorities for improving care for patients with migraine, which includes correct identification and diagnosis of headache disorders.The Royal College of General Practitioners has developed two e-learning modules about migraine and cluster headaches, which aim to raise awareness amongst primary care clinicians about the different types of migraine and their associated symptoms, and how to differentiate between them.Over the last four years, a new class of drugs, calcitonin gene-related peptide (CGRP) inhibitors, has been made available on the National Health Service for the prevention and treatment of episodic and chronic migraines. On 15 May 2024, Atogepant became the latest CGRP inhibitor for which the NICE has published guidance. The NICE recommended Atogepant for use as a preventive medication for the treatment of migraine on the NHS in England.

What steps his Department is taking to increase access to treatment for people with chronic migraine disease.

The National Institute for Health and Care Excellence’s (NICE) guideline, Headaches: Diagnosis and management of headaches in young people and adults, updated in December 2021, sets out best practice for healthcare professionals in the care, treatment, and support of people who suffer from headaches, including migraine. It aims to improve the recognition and management of headaches and migraine.At the national level, there are a number of initiatives supporting service improvement and better care for patients with migraine, including the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Headache and Migraine Toolkit, and the Neurology Transformation Programme. The GIRFT Programme published a National Speciality Report, which makes several recommendations in relation to improving the recognition and diagnosis of migraine by general practitioners. Additionally, the RightCare Headache and Migraine Toolkit sets out key priorities for improving care for patients with migraine, which includes correct identification and diagnosis of headache disorders.The Royal College of General Practitioners has developed two e-learning modules about migraine and cluster headaches, which aim to raise awareness amongst primary care clinicians about the different types of migraine and their associated symptoms, and how to differentiate between them.Over the last four years, a new class of drugs, calcitonin gene-related peptide (CGRP) inhibitors, has been made available on the National Health Service for the prevention and treatment of episodic and chronic migraines. On 15 May 2024, Atogepant became the latest CGRP inhibitor for which the NICE has published guidance. The NICE recommended Atogepant for use as a preventive medication for the treatment of migraine on the NHS in England.

What steps he is taking to increase research into (a) the causes of and (b) treatment options for chronic migraine disease.

The Department funds research through the National Institute for Health and Care Research (NIHR) into a range of conditions, including chronic migraine. The NIHR promotes participation in research through the Be Part of Research service, which features chronic migraine research studies seeking participants. Further information is available at the following link: https://bepartofresearch.nihr.ac.uk/ The NIHR also invites proposals for new research into the causes and treatment of conditions through its website, which is available at the following link: https://www.nihr.ac.uk/get-involved/suggest-a-research-topic

What recent assessment he has made of the adequacy of the quality of mental health services in (a) England and (b) Essex.

NHS England uses the Oversight Framework to assess the quality and safety of all mental health inpatient services in England, including services in Essex. Risks and issues are escalated nationally using the quality risk and escalation framework.National Health Service commissioners in England are responsible for ensuring that mental health services are safe, effective, sustainable and meet the needs of the population.In addition, the Care Quality Commission carries out monitoring and assessments of providers in England to ensure they are providing safe and quality care to people using their services. The Care Quality Commission has a duty under the Mental Health Act 1983 to monitor how services exercise their powers and discharge their duties when patients are detained in hospital or are subject to community treatment orders or guardianship.

What steps he is taking to improve communication around delays in appointment wait times for people seeking access to mental health support services.

Long waits for mental health services are being driven by increasing demand to a system in desperate need of change. The Government is already responding by delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres to bring together community, crisis and inpatient care. These operate 24 hours a day, seven days a week.NHS England Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity. We are also improving data quality so we can support providers to understand demand across their areas.As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, the Government will recruit an additional 8,500 staff across children and adult mental health services.

What recent assessment he has made of trends in the level of average wait times for people being referred for appointments for mental health support.

Long waits for mental health services are being driven by increasing demand to a system in desperate need of change. The Government is already responding by delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres to bring together community, crisis and inpatient care. These operate 24 hours a day, seven days a week.NHS England Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity. We are also improving data quality so we can support providers to understand demand across their areas.As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, the Government will recruit an additional 8,500 staff across children and adult mental health services.

Whether he plans to (a) support and (b) expand community-based physical activity programmes specifically designed for older people.

The Government and the National Health Service recognise that prevention will always be better and cheaper than a cure. Reducing physical inactivity in people of all ages, including in older people, is important in helping people live longer, healthier lives, and a key part of the Department’s shift from treatment to prevention.The Department supports the NHS, together with local authorities, to provide a range of community services to support older people, such as exercise on referral and social prescribing, aquatic/swimming classes, dance classes, and fall prevention training through strength and balance classes. The Government continues to encourage local authorities to invest in and prioritise leisure facilities and community-based services.In addition to the above, the NHS Better Health Campaign promotes ways for people of all ages to move more, and signposts to digital support like the NHS Active 10 walking app, an accessible way of building movement into everyday life.

What steps he is taking to ensure that NHS services are responsive to the (a) complex and (b) long-term needs of people living with chronic kidney disease.

NHS England has established a renal Clinical Reference Group to deliver change across the National Health Service, to accelerate improvements in the diagnosis of, and treatment for, people living with kidney disease.Increasing access to home therapies for kidney issues is a priority for NHS England, and this is reflected in its inclusion in the Renal Transformation toolkit, published in 2023. This recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.NHS England is improving access to home dialysis for children, supported by a robust network of nurses and clinicians who can move care from hospitals to homes. This approach is working, with rates of home dialysis ranging from 64% to 76% across the 10 NHS paediatric dialysis centres.

What steps he is taking to improve access to local NHS services for older people.

Integrated care boards (ICBs) are responsible for commissioning healthcare services that meet the needs of their local populations. When ICBs exercise their functions, they have a duty to reduce inequalities between persons with respect to their ability to access health services and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.Further, as part of the Government’s five long-term missions, we have launched a 10-Year Health Plan to reform the National Health Service and make it fit for the future.The 10-Year Health Plan will deliver the three big shifts our NHS needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving support for older people in all parts of the country.More care and support delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support patients closer to home.The 10-Year Health Plan will also set the vision for what good joined-up care looks like for people with a combination of health and care needs, such as older people.  It will set out how to support and enable health and social care services, and wider services, to work together better to provide that joined-up care.

What steps he is taking to improve (a) early diagnosis and (b) prevention strategies for chronic kidney disease in primary care settings.

NHS England’s Renal Service Transformation Programme (RSTP) highlighted the importance of prevention and of optimising screening, detection, and treatment. Regional NHS England Renal Networks are working in partnership with integrated care systems to deliver the RSTP’s aims, and to help develop effective strategies for their local populations.NHS England recognises the importance of kidney disease, not only in preventing the progression of kidney disease but also in reducing cardiovascular events. A customer relationship management steering group has been established which aims to focus on the prevention of these common condition that often co-exist.NHS England has expanded the scope of the work under the Prevention and Long-Term Condition Programme Board to include consideration of opportunities for improving the prevention of kidney disease.The NHS Health Check programme is a core component of England’s cardiovascular disease (CVD) prevention programme, which aims to prevent heart disease, stroke, diabetes, kidney disease, and some cases of dementia. The programme assesses for high blood pressure and high blood sugar, which are risk factors for the development of both chronic kidney disease and CVD. Where an individual’s NHS Health Check indicates high blood pressure or high blood sugar, it is for the general practitioner to consider the results, and then, if required, undertake further clinical investigation and treatment where appropriate.Diabetes is a leading cause of kidney disease. People at risk of developing type 2 diabetes can also be referred by their general practitioner into the Healthier You NHS Diabetes Prevention Programme. The programme is highly effective, cutting the risk of developing type 2 diabetes by 37% for people completing the programme, compared to those who do not attend.

What steps his Department is taking to increase awareness of preventable complications associated with diabetes.

In England, the National Institute for Health and Care Excellence (NICE) recommends that people with diabetes are offered eight annual care processes in primary care, those being measurement of HbA1c, lipids, creatinine, albuminuria, blood pressure and body mass index, ascertainment of smoking status, and examination of the feet, to assess modifiable risk factors and facilitate the early identification of diabetic complications.These annual diabetes reviews are associated with reduced emergency admissions, amputations, retinopathy, and mortality.

What steps his Department is taking to help tackle the causes of diabetes.

The Department is actively tackling the root causes of type 2 diabetes. We are restricting junk food advertising on television and online, limiting school children's access to fast food, and are taking steps to ensure the Soft Drinks Industry Levy remains effective and fit-for-purpose.Through programmes such as the Healthier You NHS Diabetes Prevention Programme we are supporting individuals aged 18 to 80 years old to reduce their risk of developing type 2 diabetes through behavioural changes. As of December 2024, over 2.3 million people have been offered support through the programme, and an independent evaluation showed a 37% relative reduction in diabetes risk in those who completed the programme.Additionally, the Department’s Better Health resources include free evidence-based apps, websites, and other digital tools, to support people to make and sustain changes to their health and reduce their risk of developing type 2 diabetes, including the NHS Weight Loss app, the Food Scanner App, Couch to 5K, and Active 10. Type 1 diabetes cannot be prevented, and the exact causes of it are unknown.

What steps his Department is taking to ensure that GP websites using third party contractors for online appointment booking forms uphold patient privacy and security in data sharing.

All organisations that have access to National Health Service patient data must use the Data Security and Protection Toolkit to provide assurance that they are practising good data security and that personal information is handled correctly. The toolkit is available at the following link:https://www.dsptoolkit.nhs.uk/Third party organisations that use an IT system to make general practitioner appointments for patients must use a system which has been assured by NHS England, for example, through the usage of a Supplier Conformance Assessment List and clinical testing of the system before it is given permission to move to live usage. These checks help us to assure that patient data is managed within General Data Protection Regulation and that systems meet NHS security standards.There are strong protections in law to ensure that health and care information is used in a safe, secure and legal way. The privacy and confidentiality of people’s health and care data is championed by the National Data Guardian who provides independent advice on the use of such data and holds the Caldicott Principles which provide a framework for the safe and respectful use of data. In addition, every health and care organisation is required to appoint a Caldicott Guardian from within their organisation to advise on the protection of people’s health and care data and ensure it is used properly.

What discussions he has had with representatives of healthcare professions on levels of unmet equipment needs for children with disabilities.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

If he will make an estimate of the number of disabled children who do not have the equipment they need.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

What steps she is taking to ensure families with disabled children have timely access to medical equipment.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

How many patients with valid NHS prescriptions for (a) molnupiravir and (b) similar antivirals were unable to obtain their medication within the recommended treatment window in the last 12 months.

The Department does not have information about the date of the onset of patient symptoms, which is the start of the five-day treatment window. The service level from the distributor in the last 12 months was 99.2% for molnupiravir and paxlovid, another COVID-19 antiviral, with the standard delivery being either the same day or the day after, in more remote locations.

If he will ensure that pharmacies can access high-cost, short shelf-life medications rapidly.

In the United Kingdom, community pharmacies are private businesses which provide National Health Services, and therefore, for the majority of medicines which they supply in accordance with a prescription, they have their own buying arrangements. Not all manufacturers supply to all wholesalers and not all pharmacies use the same wholesalers, so there may be some specific manufacturer’s products that a pharmacy may not easily be able to source.Professional guidance advises that where a pharmacy is unable to supply a medicine promptly, if they have established there is not a shortage, then they should talk to the patient to discuss the possible options available to them. These can include:offering to contact the patient’s prescriber to jointly consider whether another suitable brand or medicine is available; andchecking whether the medicine is available at another pharmacy.

If his Department will conduct a review into the (a) supply chain and (b) distribution of prescription medication to pharmacies in England.

Medicine supply chains are complex, global, and highly regulated and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues, and regulatory issues. We have drawn on up-to-date intelligence and data on the root causes of medicine supply issues, with manufacturing problems being the most dominant root cause.The resilience of UK supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and strengthen our resilience. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver solutions. We have plans underway to increase the awareness of our work. Given that there is a large amount of work already underway to ensure supply chain resilience, there are no current plans to conduct a new supply chain review.