Written questions by Kirkham.

What guidance his Department provides to ensure that GPs approach (a) shared care and (b) collaboration with gender identity specialists in the same way as other specialists.

The Department has not issued guidance relating to shared care agreements. The General Medical Council’s guidance states that general practitioners (GPs) should collaborate with a Gender Dysphoria Clinic (GDC) to provide effective and timely treatment for patients, including prescribing medicines on the recommendation of an experienced gender specialist, and that it is reasonable for a GP to expect the GDC to provide timely support and advice where necessary.The Royal College of General Practitioners’ position statement on the role of the GP in transgender healthcare sets out that GPs should “liaise and work with Gender Identity Clinics in the same way as with any other specialist. This includes consideration of prescribing under a shared care agreement”.

What steps he is taking to ensure that amateur athletes have access to an effective screening programme for cardiac conditions.

The UK National Screening Committee (UK NSC) last reviewed screening for sudden cardiac death (SCD) in people under the age of 39 years old in 2019, and concluded that screening should not be offered. Further information is available at the following link:https://view-health-screening-recommendations.service.gov.uk/sudden-cardiac-death/Research showed that the current tests are not accurate enough to use in young people without symptoms, and that treatments and interventions to prevent SCD were not based on good scientific evidence.To stop SCDs in young people, the current consensus is to focus on rapid identification and care of people who are likely to be at risk of SCD, due to a family link or because they have had symptoms, and to train people to carry out cardiopulmonary resuscitation and to use defibrillators.NHS England has published guidance for inherited cardiac conditions which requires services to investigate patients with a previously undiagnosed cardiac disease, suggestive symptoms, or those from families with sudden unexplained deaths. Where a genetic variation is identified, cascade testing is offered to relatives based on risk.We are aware that the UK NSC has received a submission via its annual call process to consider SCD screening in young people aged 14 to 35 years old engaging in sport. The UK NSC is currently reviewing all annual call proposals. Further information on the annual call process is available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal

What steps he is taking to ensure that all healthcare professionals have adequate training and awareness of endometriosis.

The Government is committed to prioritising women’s health and improving the diagnosis, treatment and ongoing care for gynaecological conditions including endometriosis. Several measures are in place to raise awareness of endometriosis among clinicians and support diagnosis and care.National Institute for Health and Care Excellence (NICE) guidelines support healthcare professionals to diagnose and treat conditions. In November 2024, NICE published updated recommendations on the diagnosis, management and treatment of endometriosis. This is available at the following link:https://www.nice.org.uk/guidance/ng73Endometriosis is included in the core curriculum for general practitioners, and for obstetricians and gynaecologists. The General Medical Council is introducing the Medical Licensing Assessment for most incoming doctors, including all medical students graduating from academic year 2024/25 and onwards. Within this assessment are several topics relating to women’s health, including endometriosis. This will encourage a better understanding of endometriosis among doctors as they start their careers in the United Kingdom.We will continue to keep opportunities for training and further awareness raising about endometriosis under review.

What steps he is taking to increase the proportion of patients (a) transferred, (b) admitted and (c) discharged within four hours at the Emergency Department in Royal Cornwall Hospitals NHS Trust.

The Government has committed to supporting the National Health Service to improve performance, including at the Royal Cornwall Hospitals NHS Trust (RCHT), and achieving the standards set out in the NHS Constitution, which includes that 95% of patients attending accident and emergency are admitted, transferred, or discharged within four hours.We are also committed to improving accident and emergency waiting times for patients waiting over 12 hours to be admitted, transferred, or discharged through increasing bed capacity and improving hospital discharge, both nationally and at the RCHT.The Government appointed the Professor Lord Darzi to lead an independent investigation of NHS performance. The investigation’s findings were published on 12 September 2024 and will feed into the Government’s work on a 10-year plan to radically reform the NHS and build a health service that is fit for the future.

What steps he is taking to reduce the hours lost to handover delays by South Western Ambulance Service Foundation Trust.

Ambulance services experiencing long delays when handing over patients to hospitals is a priority for the National Health Service to address, because it holds up ambulances that could be responding to further 999 calls.The South Western Ambulance Service NHS Foundation Trust and the Royal Cornwall Hospital are working on improving ambulance handover times by supporting patients flow through the health and care system.To support longer term urgent and emergency care performance, my Rt Hon. Friend, the Secretary of State for Health and Social Care, appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.

What steps he is taking to reduce the proportion of attendees who waited 12 hours or more from their time of arrival to be (a) transferred, (b) admitted and (c) discharged from Royal Cornwall Hospitals NHS Trust Emergency Department.

The Government has committed to supporting the National Health Service to improve performance, including at the Royal Cornwall Hospitals NHS Trust (RCHT), and achieving the standards set out in the NHS Constitution, which includes that 95% of patients attending accident and emergency are admitted, transferred, or discharged within four hours.We are also committed to improving accident and emergency waiting times for patients waiting over 12 hours to be admitted, transferred, or discharged through increasing bed capacity and improving hospital discharge, both nationally and at the RCHT.The Government appointed the Professor Lord Darzi to lead an independent investigation of NHS performance. The investigation’s findings were published on 12 September 2024 and will feed into the Government’s work on a 10-year plan to radically reform the NHS and build a health service that is fit for the future.

What steps he is taking to reduce ambulance hand over times at the Royal Cornwall Hospital.

Ambulance services experiencing long delays when handing over patients to hospitals is a priority for the National Health Service to address, because it holds up ambulances that could be responding to further 999 calls.The South Western Ambulance Service NHS Foundation Trust and the Royal Cornwall Hospital are working on improving ambulance handover times by supporting patients flow through the health and care system.To support longer term urgent and emergency care performance, my Rt Hon. Friend, the Secretary of State for Health and Social Care, appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.

What steps he is taking to improve ambulance response times in Cornwall.

The Government has committed to supporting the National Health Service to improve performance and achieve the standards set out in the NHS Constitution, including for ambulance response times.As a first step, my Rt. Hon. Friend, the Secretary of State for Health and Social Care appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.Ahead of this winter, NHS England has set out the priorities for the NHS to maintain and improve patient safety and experience, including actions to support patient flow and ensure ambulances are released in a timely way. NHS England’s winter letter, sent to all integrated care boards including those in Cornwall, is available at the following link:https://www.england.nhs.uk/long-read/winter-and-h2-priorities

If he will make an assessment of the potential merits of increasing the NHS Bursary living allowance to match the Student Finance England maintenance loan.

The NHS Bursary funding arrangements are reviewed annually ahead of the start of each academic year.We have applied an uplift of 2% to all NHS Bursary maintenance grants and allowances for the academic year 2024/25. This is the first time the maintenance grant has been uplifted since 2015.

If he will make an assessment of the potential merits of allowing medical students in all years of the course to access the Learning Support Fund.

Funding arrangements for students are reviewed annually ahead of the start of each academic year.

If he will make an assessment of the potential merits of making retrospective payments to student nurses that were incorrectly labelled as being ineligible for the £5,000 annual training grant via the NHS Learning Support Fund since 2019.

There are no such plans.The NHS Learning Support Fund (LSF) is an annual scheme operated under rules that are published by the Department for each academic year. Eligibility for the LSF under these rules reflects eligibility for student loans set by the Department for Education.The NHS LSF scheme is administered by the NHS Business Services Authority (NHSBSA) on behalf of the Department. It includes provisions for students to ask the NHSBSA for a review of their decisions, and to contact the Department to appeal NHSBSA decisions.

If he will make an assessment of the potential merits of making retrospective payments to student nurses who were not eligible for the £5,000 annual training grant through the NHS Learning Support Fund since 2019.

The Department has no plans to make retrospective payments to student nurses who were not eligible for the £5,000 annual training grant through the NHS Learning Support Fund since 2019.

Whether his Department issues guidance to integrated care boards on agreeing bespoke contractual arrangements with dental practices for NHS dental provision.

Since 1 April 2023, responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. Dental contracts are underpinned by the nationally defined General Dental Service (GDS) contract, or a Personal Dental Service (PDS) Agreements and NHS England supports ICBs with their local commissioning responsibilities for primary dental services with the provision of nationally agreed policies and procedures. NHS England has also published guidance to support commissioners to take advantage of the opportunities offered to commission further and additional services through flexible commissioning, which enables the responsible commissioner to tailor services to meet local population oral health needs. Further information is available at the following link:https://www.england.nhs.uk/long-read/opportunities-for-flexible-commissioning-in-primary-care-dentistry-a-framework-for-commissioners/

What steps his Department is taking to encourage people from lower-income backgrounds to study medicine, in the context of the availability of financial support for maintenance available in the fifth and sixth years of a medicine degree.

From year five of their undergraduate course, medical students can access the NHS Bursary. This is non-repayable and comprises payment for tuition fees, income-assessed help towards living costs, and where eligible, further allowances, such as for dependents and childcare and for those living with a disability. A further grant may also be available to medical students who are struggling financially, depending on their current financial circumstances.Students eligible for the NHS Bursary can also apply for a reduced rate loan for living costs from Student Finance England. The Government is committed to supporting people from all backgrounds to study medicine and these funding arrangements are reviewed annually.