Written questions by Brown-Fuller.

What assessment his Department has made of the cost of (a) implementation for GP practices and (b) operation of the online appointment booking system introduced for GP practices in October 2025.

General practices (GPs) have been required to offer and promote an online consultation tool to their registered patients since 2021.The change introduced in October 2025 regarding online access will mean explicitly requiring that all modes of contacting the practice are available at least during core hours, from 08:00 to 18:30. This means parity for walk-in, phone, and online access. This requirement builds on policies that have been in place for several years to encourage the shift to modern GPs. Practices that consistently use online access have reported improvements in services for both patients and staff, support timely access to care, and enhance productivity for patients.The National Health Service provided extensive support to practices in the lead up to the introduction of these requirements and continues to do so. This includes reaching out to any practices that are struggling to help them to prepare, including providing guidance, webinars, case studies, and bringing in GP practitioners and practice staff who are experts in service redesign and improvement in GPs.NHS England has provided a total of £71 million in funding for practices to procure high-quality online consultation, messaging, and appointment booking tools. An additional £88 million over 2023/24 and 2024/25 was provided for transition cover and transformation support for practices to implement these new systems. We are also investing an additional £1.1 billion in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26, this is the biggest cash increase in over a decade. The percentage of patients who said that it was easy to contact their GP increased from 61% in August 2024, to 74% in October 2025 according to the Office for National Statistics Health Insight Survey.

What steps he is taking to help ensure that patients who are digitally excluded can retain (a) telephone and (b) in-person routes to book GP appointments.

We know that some patients may struggle or prefer not to use digital options. We are committed to ensuring that patients who are digitally excluded can retain telephone and in-person routes to book general practice (GP) appointments, by mandating that GPs must maintain these traditional access methods, alongside digital options. The move to digital-first access is designed to free up phone lines for those who want and need them, not replace them.

What steps he is taking to (a) increase the number of specialist training posts for UK doctors and (b) remove barriers to practice for UK-trained doctors returning from overseas.

The 10-Year Health Plan, published on 3 July, set out that over the next three years, we will create 1,000 new specialty training posts with a focus on specialties where there is the greatest need. The plan also sets out that we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training. We will set out next steps in due course.All medical practitioners wishing to practise in the UK must be registered with the General Medical Council (GMC) and must hold a licence to practise. The GMC is statutorily independent of the Government and sets the standards that must be met by domestic and international applicants wishing to be added to its register. This ensures that registrants are safe to practise and that patients receive a high standard of care. Information on the process for joining the GMC’s register and tailored support for international applicants can be found on its website.In 2023, the Department worked with the GMC to amend its legislation, including an updated standard for specialist registration, which has enabled improvements to expedite the process for specialist registration.

What steps he is taking to increase the capacity of NHS dental services in Chichester constituency.

The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Chichester constituency, this is the NHS Sussex ICB.We have asked ICBs to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. ICBs have been making extra appointments available from 1 April 2025. The NHS Sussex ICB is expected to deliver 26,546 additional urgent dental appointments as part of the scheme.ICBs are recruiting posts through the Golden Hello scheme. This recruitment incentive will see dentists receiving payments of £20,000 to work in those areas that need them most for three years.We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability. The Government is committed to achieving fundamental contract reform before the end of this Parliament.We recently held a full public consultation on a package of changes to improve access to, and the quality of, NHS dentistry, which will deliver better care for the diverse oral health needs of people across England. The consultation closed on 19 August. The Government is considering the outcomes of the consultation and will publish a response in due course.

Whether he has made an assessment of the potential merits of allowing appropriately skilled professionals using a competency-based framework to undertake Initial Health Assessments.

Local authorities are responsible for making sure a health assessment of physical, emotional and mental health needs is carried out for every child they look after, regardless of where that child lives. Integrated care boards (ICBs) commission a health provider to undertake initial health assessments (IHAs). The service specification for this service is aligned to the current Children Act 1989 regulations. The regulations for health assessments are set out in the Care Planning, Placement and Case Review (England) Regulations 2010, the Children Act 1989 guidance and regulations colume 2: care planning, placement and case review and supported within the statutory guidance Promoting the health and wellbeing of looked-after children. Regulation 7(3) of the Care Planning, Placement and Case Review (England) Regulations 2010 states that IHAs are required to be undertaken within twenty days of a child coming into the care of the local authority. The current regulations for the Children Act 1989 state that the IHA should be undertaken by a registered medical practitioner. This is different to a review health assessment, which may be carried out by a registered medical practitioner, or by a registered nurse or registered midwife, under the supervision of a registered medical practitioner, as stated in regulation 7(3). No assessment has been made on the potential merits of allowing additional appropriately skilled professionals using a competency-based framework to undertake IHAs. If IHAs are not happening on time, ICBs are the first line of statutory safeguarding assurance, which includes identifying early warning signs and responding to risks at local levels. NHS England, through ICBs, also undertake annual checks on how safeguarding, and other statutory commitments, are working in practice and across the system. NHS England is working with ICBs to improve the timeliness of IHAs and review health assessments.

Pursuant to the Answer of 17 June 2025 to Question 59607 on Infant Foods, when he plans to respond to the recommendations of the Competition and Markets Authority's report entitled Infant formula and follow-on formula market study, published on 14 February 2025.

The Government remains committed to giving every child the best start in life. Whilst breastfeeding has significant health benefits, we recognise that for those families that cannot or choose not to breastfeed, it is vital that they have access to infant formula that is affordable and high quality. Infant formula regulations ensure that all infant formula is suitable for meeting the nutritional needs of babies, regardless of the price or brand.The Government welcomes the Competition and Markets Authority’s market study into the United Kingdom’s infant formula and follow-on formula market. We have been working closely with the devolved administrations to consider its recommendations. We will respond in due course.

What steps he is taking to (a) increase NHS winter capacity in Chichester constituency for the 2025-26 winter period and (b) enhance public awareness of winter illness prevention.

The National Health Service is already preparing for winter this year with the development and better testing of winter plans. This includes the surge capacity and escalation plans in place across all NHS and urgent care services including Chichester.The UK Health Security Agency publishes the Adverse Weather and Health Plan for England, which sets out a framework for action to protect the population from harm to their health from adverse weather including excess cold.On 20 October 2025, the Department will launch a multimedia campaign encouraging flu vaccination among people with long-term health conditions. This follows September 2025 campaigns promoting vaccination for pregnant women and children of pre-school and school age.

What steps he is taking to reduce delays in NHS ophthalmology services.

We have committed to ensuring that 92% of all patients, across specialties, wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. As a first step, we have delivered a reduction in the waiting list by over 206,000, having now delivered 5.2 million additional appointments, compared to the previous year. This is more than double our pledge of 2 million extra appointments.In ophthalmology, the current national waiting list stands at 593,646 pathways, with 69.8% of those having waited 18 weeks or less. This marks a 16,630 reduction in the ophthalmology waiting list, and a 3.7 percentage point improvement in patients waiting 18 weeks or less than in June 2024. In June 2024, the ophthalmology waiting list stood at 610,276 pathways, with 66.1% of patients waiting 18 weeks or less.Ophthalmology is the largest outpatient speciality, with over 9.7 million outpatient attendances across 2024/25. Reforms to outpatient care outlined in our Elective Reform Plan, published in January 2025, are already reducing delays in National Health Service ophthalmology services. We are reducing missed appointments through enhanced two-way communication between hospitals and patients. We are using AI prediction to reduce missed appointments and increasing the use of remote monitoring and patient-initiated follow up where appropriate, to offer patients more flexibility over their care.We will improve the IT connectivity between primary and secondary eye care services, to improve the referral and triage of patients and enable a more integrated approach to delivering eye care. The 10-Year Health Plan will also support more eye care services being delivered in the community, to help create capacity in secondary care by shifting care away from hospitals.

Whether his Department plans to review the NHS Car Parking Guidance.

The Department currently has no plans to review National Health Service car parking guidance. Free hospital car parking is available to groups that are most in-need, including disabled people, frequent outpatient attenders, the parents of sick children staying overnight, and staff working night shifts.

What steps he is taking to provide clearer support pathways for women experiencing surgical menopause.

The Government recognises that women suffering from symptoms of menopause have been failed for far too long, and we acknowledge the impact it has on women’s lives, relationships, and participation in the workplace.Surgical menopause can have significant consequences both in the short and long term. Menopausal symptoms can be particularly severe due to the sudden loss of ovarian function in both pre/post-menopausal women. Experiences vary, but this can be very debilitating.Women should be counselled prior to surgery about what to expect and offered hormone replacement therapy if appropriate and desirable in managing symptoms. They should have a full discussion about implications of removal of ovaries and treatment options.We have supported the system to improve access to more specialised and multidisciplinary teams in the community through the introduction of women’s health hubs. The hubs provide better communication and integrated care for women with a range of different needs, including menopause symptoms.NHS England has supported a range of tools and interventions that will help to upskill more general practitioners in menopause care and will improve access to treatments that can be helpful, including a Menopause Optimal Pathway Toolkit (OPT). The OPT is an online resource that was developed in collaboration with partners including the British Menopause Society, the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners, and the Royal College of Physicians. It is designed to be used in real-time, alongside the consultation, to guide health professionals through a menopause consultation. The information within the OPT is intended to be comprehensive, including National Institute for Health and Care Excellence guidelines, easy-to-use and locate, and should provide up-to-date information.

Whether he has made an assessment of the potential benefits of creating NHS-approved meal planning kits.

The Department for Health and Social Care and the Department for Environment, Food and Rural Affairs, alongside other Government departments, are funding research on recipe boxes through the SALIENT food systems trials. The trial is partnering with a commercial recipe box company to understand whether recipe box subscriptions can lead to healthier dietary quality, are feasible and acceptable across the population, and can improve users’ capabilities to prepare food that they value. Further information is available at the following link:https://www.salientfoodtrials.uk/Government dietary advice is encapsulated in the UK national food guide, the Eatwell Guide, which shows how to construct a healthy balanced diet and guides food and drink choices. The guide is aimed at the general population and can be used flexibly regardless of budget or personal dietary requirements. The Department promotes the guide’s principles through platforms such as the NHS.UK website and social marketing campaigns, including Healthier Families and Better Health. Further information about the respective campaigns is available at the following links:https://www.nhs.uk/healthier-families/https://www.nhs.uk/better-health/The Healthier Families website also contains a selection of healthy recipes for those who are looking for further support in planning healthier meals.

What steps he is taking to (a) improve access to migraine (i) diagnoses and (ii) treatment, (b) increase the availability of long-term specialist care for migraine patients and (c) raise awareness of migraine amongst primary care clinicians.

The National Institute for Health and Care Excellence (NICE) guideline, Headaches in over 12s: diagnosis and management, 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.NICE updated its guideline in June 2025. Updates included a change to the strength of recommendations on treatments for migraine prevention to better reflect the balance between their benefits and harms, and incorporation of relevant technology appraisal guidance for treating and preventing migraine with or without aura.At the national level, there are several initiatives supporting service improvement and better care for patients with migraine, including the Getting It Right First Time (GIRFT) Programme for Neurology and the RightCare Headache and Migraine Toolkit. The GIRFT programme published a National Speciality Report, which makes several recommendations in relation to improving recognition and diagnosis of migraine by general practitioners. Additionally, the RightCare 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.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 recommended by NICE for use as a preventive medication for the treatment of migraine.A key priority for the Government is to cut waiting lists, including for patients with migraine. We have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by March 2029, including in neurology services. We have reduced the elective waiting list by over 206,000 since July 2024. Between July 2024 and June 2025, we have delivered 5.2 million additional appointments, many of which will have been for patients with migraine.

Whether he plans to (a) review and (b) update NHS Continuing Healthcare.

I have asked my officials to work with partners including NHS England to review how National Health Service Continuing Healthcare (CHC) is being implemented and explore how this could be improved.The Department continues to work with our partners to deliver CHC policy effectively and to ensure that people who are eligible receive it in a timely manner. Integrated care boards, who are responsible for the implementation of CHC with oversight from NHS England, must continue to have regard to our statutory guidance, the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. This is available at the following link:https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

How many applications for hormone replacement therapy implant licenses were received by the Medicines and Healthcare products Regulatory Agency in the last six months; and what steps he is taking to help ensure an ongoing supply of hormone replacement therapy implant products.

The Medicines and Healthcare Products Regulatory Agency (MHRA) is an executive agency of the Department and regulates medicine, medical devices, and blood components for transfusion in the United Kingdom, with responsibility for ensuring that medicines meet appropriate standards of safety, quality, and efficacy.The MHRA has not received any licence applications in the last six months for a new hormone replacement therapy (HRT) implant product. The MHRA has been working closely with the current importers of the product and is also looking to encourage other applications for a licenced medicinal product. The importer Smartway has assured that there are over 13 months of product in the UK based on the currently available stocks and usage rates.Oestrogen and testosterone HRT implants are not licenced in the UK. The Department is working closely with the MHRA to ensure safe access to these products. The Department has also reached out to specialist importers who can source unlicensed medicines in order to find alternative sources of both HRT implants for UK patients. The Department will continue to work closely with the MHRA and the National Health Service to ensure suitable alternatives are available for patients.

What steps he is taking to expand access to weight loss medications through the NHS.

Until recently, the newest obesity medicines liraglutide, under various brand names, semaglutide, under the brand name Wegovy, and tirzepatide, under the brand name Mounjaro, have only been available via the National Health Service through specialist weight management services which are mainly hospital-based. From 23 June, tirzepatide has started to become available in primary care, meaning it can be prescribed by general practitioners, or other competent prescribers. NHS England’s phased rollout within primary care will prioritise those with the greatest clinical need. Approximately 220,000 people are expected to benefit in the first three years of implementation. As part of the rollout plans, the NHS will look at different service models, including digital and community options. New approaches might enable access to be expanded more quickly. Progress will be reviewed in three years, and the roll out will be sped up if possible. In addition, the 10-Year Health Plan sets out our ambition to build on these plans by testing innovative models of delivering weight loss services and treatments to patients. On 12 August we announced an £85 million competition to fund the design and delivery of new community and primary care weight management pathways to support access to interventions such as weight loss medications. We expect tens of thousands of patients to directly benefit from increased access to interventions, such as GLP-1s. This will generate new evidence to inform the future commissioning and rollout of tirzepatide.

What steps he is taking to (a) help ensure that patients with Complex Regional Pain Syndrome have access to ongoing specialist care following diagnosis and (b) allocate funding for research into (i) Complex Regional Pain Syndrome and (ii) other persistent pain conditions.

The Government is committed to improving the lives of those living with rare diseases through the UK Rare Diseases Framework.Much of the routine care that people with chronic pain, such as some people with Complex Regional Pain Syndrome (CRPS), receive will be provided by local primary, community and a secondary care service commissioned via local integrated care boards (ICBs). The commissioning of these services is a local matter. In some cases, patients may receive care at Specialist Pain Centres. Details on commissioning of those services are available at the following link: https://www.england.nhs.uk/publication/adult-highly-specialist-pain-management-services/.The fourth priority of the Framework is improved access to specialist care, treatment and drugs. In February 2025, the England Rare Diseases Action Plan 2025 was published, including progress made under this priority:- Meeting to discuss the effectiveness of early access pathways for rare disease therapies;- Launching a review of the National Institute for Health and Care Excellence highly specialised technology programme for evaluating rare disease treatments; and- Introducing two new actions on reforming clinical trial regulations; and developing an operational framework for individualised therapies in the National Health Service.Pioneering research is an underpinning theme of the Framework. The Department for Health and Social Care funds and supports research into rare diseases such as CRPS through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including rare diseases. The usual practice of the NIHR and other research funders is not to ring-fence funds for expenditure on particular topics.The 2025 England Rare Disease Action Plan includes information on research for rare diseases through significant investments to support rare disease research. This includes the Rare Disease Research UK Platform (RDR UK), a £14 million investment over 5 years from the Medical Research Council (MRC) and NIHR, announced in 2023, which is now established and positioned well within the rare disease research landscape. In December 2024, the MRC launched the first 2 MRC Centres of Research Excellence (CoRE), both studying gene therapies, and each worth up to £50 million over 14 years.

What the provision is for manual lymphatic drainage on the NHS for patients following breast cancer treatment; and whether such treatment is routinely available.

Manual lymphatic drainage following breast cancer treatment-related lymphoedema is available through the National Health Service via referral from the healthcare team to a lymphoedema specialist or physiotherapist. Decisions regarding patient treatments are typically made by clinicians, considering all aspects of a patient's health and circumstances when recommending treatment options.

What steps his Department is taking to help improve (a) rates of early diagnosis, (b) access to treatment and (c) specialist care for people with rare diseases.

The Government is committed to improving the lives of those living with rare diseases. The UK Rare Diseases Framework sets out four priorities collaboratively developed with the rare disease community. These include helping patients get a final diagnosis faster, increasing awareness of rare diseases among healthcare professionals, better coordination of care and improving access to specialist care, treatments, and drugs. We published the annual England Rare Diseases Action Plan in February, where we report on the steps we have taken to advance these priorities in the preceding year. The Government will be working with the devolved nations this year to review what comes next following the expiry of the UK Rare Diseases Framework in 2026.

What steps he is taking to support (a) people injured by vaccination and (b) families affected by vaccine-related deaths.

In the very rare event where someone may have suffered a severe adverse reaction to a vaccine, care and treatment will be best met and managed by local National Health Service specialist services, augmented as appropriate by national specialist advice. Individuals will be treated and managed through existing healthcare services, with treatment dependent on the individual’s clinical needs.Individuals can also apply to the Vaccine Damage Payment Scheme (VDPS) which provides a one-off, tax-free payment of £120,000 to claimants who have been found, on the balance of probabilities, to have been severely disabled as a result of vaccinations against certain diseases listed in the Vaccine Damage Payments Act 1979.Outside of the VDPS, other government support remains available for those with a disability or long-term health condition, including Statutory Sick Pay, Universal Credit, Employment and Support Allowance, Attendance Allowance, and Personal Independence Payments. Further information is available at the following link:https://www.gov.uk/browse/benefits/disability

Whether he plans to review the (a) scope, (b) eligibility, (c) criteria and (d) compensation level of the Vaccine Damage Payment Scheme.

I would like to reiterate my profound sympathies to all those individuals who have experienced harm following vaccination, and to their families.Ministers continue to consider options for reforming the Vaccine Damage Payment Scheme (VDPS).In parallel, the Department continues to work with the NHS Business Services Authority, the administrators of the VDPS, to take further steps to improve the scheme, including through processing claims at a faster rate.