Written questions by Naish.

What steps his Department is taking to reduce elective care waiting times, including for joint replacement surgery.

I refer the Hon. Member to the answer I gave on 19 November 2025 to Question 89685.

What recent progress he has made in meeting the 18-week referral-to-treatment standard.

The Government is committed to returning, by March 2029, to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment (RTT). NHS England’s Operational Planning Guidance for 2025/26 set a target that 65% of patients wait no longer than 18 weeks by March 2026, with every trust expected to deliver a minimum 5% improvement on current performance over that period. To achieve this interim March 2026 target, we expect the size of the total waiting list to reduce. We have already made significant progress on this. As of October 2025, the waiting list had reduced by over 225,000 since the Government came into office, and performance against the RTT standard has improved by 2.9%, reaching 61.8%. This has been supported by the delivery of 5.2 million additional appointments between July 2024 and June 2025 compared to the previous year, more than double the Government’s pledge of two million. This marks a vital First Step towards delivering the constitutional standard.

What steps his Department is taking to increase help access to weight loss injections for people with long-term health conditions.

I refer the hon. Member to the answer I gave on 19 November 2025 to Question 89687.

When he plans to announce the next phase of the Modern Service Frameworks.

Early priorities for Modern Service Frameworks will include cardiovascular disease, sepsis, severe mental illness and the first ever service framework for frailty and dementia. As advised by the National Quality Board, the Government will consider other conditions for future phases of MSFs and has recently announced an MSF on palliative and end-of-life care.

What steps he is taking to help reduce elective care waiting times (a) in general and (b) for joint replacement surgery.

The Government is committed to putting patients first and tackling waiting lists as part of our Health Mission. We exceeded our pledge to deliver an extra two million appointments, tests, and operations in our first year of Government, delivering 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on our commitment to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029.The Department is taking a range of steps to reduce waiting times for surgery, including joint replacement surgery. There are currently 123 surgical hubs operational across England, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures. Surgical hubs have been shown to deliver approximately 20% increased productivity in the hubs compared to trusts without a dedicated elective hub on site.The Getting it Right First time (GIRFT) programme published detailed guidance for hip and knee replacements in July 2023 and has been supporting trusts through a multidisciplinary team made up of anaesthetic, surgical, and allied health professional colleagues. Additionally, GIRFT is leading a community musculoskeletal programme, supporting improvements in the early stages of the pathway, to ensure that only those patients who require surgery are referred into secondary care, and that their condition is optimised for surgery as far as possible at the point of referral. Further information on the GIRFT programme is available at the following link:https://gettingitrightfirsttime.co.uk/

What steps he is taking to increase access to weight loss injections for long-term conditions.

Weight loss injections are currently recommended for use on the National Health Service for the treatment of obesity and/or type 2 diabetes. To be routinely used in the NHS in England, a medicine normally needs a marketing authorisation from the Medicines and Healthcare Products Regulatory Agency (MHRA) that shows it is safe and efficacious, and then a positive National Institute for Health and Care Excellence (NICE) appraisal to show if it is a clinically and cost-effective use of NHS resources. NICE is currently developing guidance on the use of semaglutide for the prevention of cardiovascular disease and, subject to licensing, liver fibrosis, without cirrhosis, caused by metabolic dysfunction-associated steatohepatitis.Most recently, NICE recommended semaglutide, brand name Wegovy, and tirzepatide, brand name Mounjaro, as treatments for obesity, in adults with a high body mass index and at least one weight-related comorbidity such as type 2 diabetes, hypertension, and/or cardiovascular disease.Until recently, these medicines were only available in specialist weight management services. From 23 June tirzepatide started to become available in primary care. This will help to increase access. Access is being prioritised for those with the highest clinical need first. The NHS will look at different service models including digital and community options and the roll out will be sped up if possible. As set out in the Government’s new 10-Year Health Plan, we are committed to expanding access to these medicines and will work closely with industry and local systems to test new models of care and identify innovative ways to do this.

Whether he has made an assessment of the potential merits of removing the use of body mass index thresholds to determine eligibility for joint replacement surgery.

The Department has made no specific assessment of the potential merits of removing the use of body mass index (BMI) thresholds to determine eligibility for joint replacement surgery. It is the responsibility of individual integrated care boards to determine policies for their local area.As with all surgery, BMI would be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.As part of the NHS Elective Reform Plan there is a commitment to expand access to the NHS Digital Weight Management Programme for patients waiting for hip and knee surgery.

What progress he has made on meeting the 18-week treatment targets in the Elective Reform Plan.

Tackling waiting lists is a key part of our Health Mission. We have exceeded our pledge to deliver an extra two million operations, scans, and appointments, having delivered 5.2 million additional appointments between July 2024 and June 2025. This marks a vital first step to delivering on the commitment that 92% of patients will wait no longer than 18 weeks from referral to consultant-led treatment, in line with the National Health Service constitutional standard, by March 2029.The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the constitutional standard. Planning Guidance for 2025/26 sets a target that 65% of patients wait no longer than 18 weeks by March 2026, with every trust expected to deliver a minimum 5% improvement on current performance over that period.Since April, when the Elective Reform Plan came in to effect, the percentage of patient pathways that involved waits of less than 18 weeks for treatment has improved by 2%, rising from 59.8% to 61.8% as of the end of September. This is the best performance since June 2022. The referral-to-treatment waiting list decreased to 7.39 million in September 2025, a reduction of 231,854 since the start of July 2024. But we know there is still much more to do, and we will continue to support NHS trusts to deliver our targets through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.

What steps his Department is taking to (a) research the causes of ankyloglossia and (b) improve early diagnosis of that condition.

The Department funds health and care research through the National Institute for Health and Care Research (NIHR). The NIHR funds clinical, public health, and social care research and works in partnership with the National Health Service, universities, local government, other research funders, patients, and the public. The NIHR welcomes proposals for research into a range of conditions, including ankyloglossia, at the following link: https://www.nihr.ac.uk/get-involved/suggest-a-research-topic

Whether his Department has made an assessment of the potential merits of publishing a national strategy for (a) palliative and (b) end of life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

What assessment he has made of the potential merits of increasing funding for the specialist (a) care, (b) advice and (c) assessment provided by hospices.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

What steps he is taking to ensure that hospice contracts reflect the (a) cost of the services they provide and (b) needs of their local populations.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

Whether his Department has allocated funding for the Government response to the Hughes Report.

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

With reference to the Prime Minister's oral contribution in response to the question from the Hon. Member for Rushcliffe of 5 February 2025, Official report, column 751, what progress he has made on addressing the Patient Safety Commissioner’s report on sodium valproate and pelvic mesh; and what steps he will need to take before implementation of the report's recommendations can commence.

The Government is carefully considering the work by the Patient Safety Commissioner and her report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different Government departments. The Government will provide a further update to the Patient Safety Commissioner’s report.

What discussions he has had with NHS trusts on accountability measures for contracted NHS transport providers in instances where they repeatedly fail to meet required standards.

No such discussions have been held.Local integrated care boards (ICBs) hold responsibility for the implementation of patient transport services at a local level, including monitoring and improving performance against targets. ICBs are best placed to work and consult with their local stakeholders, health and care organisations and local authorities to decide how to best meet and deliver for the needs of their local population.

If he will launch a public consultation before introducing legislation to abolish the statutory functions of local Healthwatch.

Although there are no plans to carry out a direct public consultation on the abolition of local Healthwatch arrangements. Dr Dash’s report on patient safety across the health and care landscape was published in July 2025 and made nine recommendations which the Government have accepted in full. Dr Dash’s findings and recommendations have also fed into the 10-Year Health Plan which itself was devised on the basis of the widest ever public consultation on the future of the National Health Service.Dr Dash’s review recommends bringing together the work of local Healthwatch organisations with the engagement functions of integrated care boards and providers to ensure patient and wider community input into the planning and design of services.These changes will improve quality, including safety, by making it clear where responsibility and accountability sit at all levels of the system. The changes will make it easier for staff, patients and service users to feed directly into the system to improve quality of care. We believe after these changes that patients and users will have a stronger voice and one that is more easily heard inside the system.

Whether his Department has decided on the future availability of the Complex Cancer Late Effects Rehabilitation Service provided by Royal United Hospitals Bath NHS Foundation Trust.

The responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate National Health Service commissioning body. NHS England commissions the Royal United Hospitals Bath NHS Foundation Trust’s Complex Cancer Late Effects Rehabilitation Service. NHS England has no immediate plans to decommission the rehabilitation service.

Whether his Department has contingency plans in place to extend eligibility for coronavirus vaccinations if infection rates rise in winter 2025-26.

The aim of the COVID-19 vaccination programme is to prevent serious disease, hospitalisation and/or mortality arising from COVID-19. Population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity.COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant. With rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged, the focus of the independent expert Joint Committee on Vaccination and Immunisation (JCVI) advice programme has moved towards targeted vaccination of the oldest adults and individuals who are immunosuppressed. These are the two groups who continue to be at higher risk of serious disease, including mortality.On 13 November 2024, the JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government decided, in line with this advice, that a COVID-19 vaccine should be offered in autumn 2025 to the following groups:adults aged 75 years and over;residents in a care home for older adults; andindividuals aged six months and over who are immunosuppressed, as defined in the immunosuppression sections of tables three or four in the COVID-19 chapter of the UK Health Security Agency Green Book.While the JCVI keeps the available data under regular review, there are no plans to offer vaccination through the national programme outside these JCVI-advised groups for autumn 2025. All those individuals who are eligible are encouraged to take up the offer of vaccination.The JCVI has advised that the emergence of a new COVID-19 variant of concern which escaped from current widespread immunity, and therefore results in serious disease, in a wider range of individuals, is unlikely. However, if this scenario did emerge, the JCVI does not consider it likely that current vaccines would be effective. This means that expanding groups eligible for vaccination is unlikely to be clinically useful when compared with developing a new variant vaccine matched to the variant of concern. In this scenario, which the JCVI believes to be unlikely, new advice would be required on which groups were at risk of serious disease and should therefore be eligible for vaccination.

What steps his Department plans to take to monitor coronavirus levels in winter 2025-26.

The UK Health Security Agency (UKHSA) continues to monitor COVID-19 through a variety of indicators and surveillance systems. Positive and negative laboratory tests, primarily taken in secondary health care settings, are reported through laboratory surveillance systems, and a sample of these positive tests are sequenced to monitor COVID-19 variants.In primary care, the Royal College of General Practitioners’ surveillance centre reports on the testing of those attending sentinel general practices with respiratory symptoms. In addition, selected National Health Service trusts report on the number of COVID-19 admissions, and all NHS trusts report on intensive care unit and high-dependency unit COVID-19 cases. Local health protection teams will report on outbreaks of respiratory viruses, including COVID-19, in settings such as care homes, schools, and places of detention.These data are analysed and published by the UKHSA in weekly official statistics in the National Influenza and COVID-19 Surveillance Report, which summarises information from the disease surveillance systems that are used to monitor seasonal influenza, COVID-19, and other seasonal respiratory illnesses. Further information is available at the following link:https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season

What eligibility criteria his Department plans to use for covid vaccination eligibility in winter 2025-26.

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 serious illness (hospitalisations and deaths) arising from COVID-19. Population immunity to COVID-19 has been increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. COVID-19 is now a relatively mild disease for most people, though it can still be unpleasant, with rates of hospitalisation and death from COVID-19 having reduced significantly since COVID-19 first emerged.The focus of the JCVI advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality. These are the oldest adults and individuals who are immunosuppressed.On 13 November 2024, JCVI published advice on who should be offered vaccination in autumn 2025. On 26 June 2025, the Government accepted the JCVI’s advice that in autumn 2025, a COVID-19 vaccination should be offered to the following groups:adults aged 75 years and over;residents in care homes for older adults;individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).The Government has no plans to change eligibility for autumn 2025. It has accepted the JCVI advice for this campaign in full. As for all vaccines, the JCVI keeps the evidence under regular review.