Written questions by Brown-Fuller.

Whether the Government has considered writing to every pension-age person to inform them they can phone or go in-person to book a GP appointment following the introduction of the online booking system on 1 October 2025.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

Whether his Department has assessed the impact of the online GP booking system introduced on 1 October 2025 on (a) patient access to GPs and (b) appointment waiting times.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

Whether he has made an assessment of the potential impact of the online GP booking system introduced on 1 October 2025 on the digitally excluded.

The contractual change made on 1 October 2025 required general practices to keep their existing online systems open during core hours, allowing patients to contact the practice online between 8am and 6.30pm. Telephone and in-person routes continue to operate as before. As non-digital routes remain available, a separate assessment of the impact on digitally excluded patients was not required.It is not a standard practice to write to citizens where services remain unchanged.National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged not to discriminate. Although digital first services are encouraged for those who choose to use them, a non‑digital solution must be available for patients who cannot or do not wish to engage digitally. The GP contract is clear that telephone and face to face access must remain in place, and online tools can only be provided in addition to not instead of other routes.These requirements apply across all NHS services. We recognise that not all patients can or want to use online services. To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. We have also committed to work with digital transformation teams in integrated care boards (ICBs) and with groups at risk of digital exclusion to ensure digital solutions are inclusive.Based on the data currently available, the time between booking and attending a GP appointment has remained stable following the introduction of the 1 October 2025 contractual requirement for online consultation systems to operate throughout core hours.Data for October to December 2024 and the corresponding period in 2025 show only marginal variation. 37.9% to 46% of appointments were booked on the same day in 2024 compared with 38.7% to 46% in 2025, and 74.9% to 82.7% were seen within two weeks in 2024 compared with 75% to 82.8% in 2025. This is consistent with the fact that many practices were already operating their systems in this way prior to the contractual change. Access to general practice has continued to improve. In December 2025, 88.8% of appointments not usually booked in advance were seen within 14 days, the highest proportion in 2025. Nationally, patient satisfaction with GP access has also improved, rising from 61% in July 2024 to 75.2% in December 2025.

What steps his Department is taking to provide consistent funding for fertility treatment across all NHS Trusts.

Access to NHS-funded fertility services varies across England, which is unacceptable.Revised National Institute for Health and Care Excellence (NICE) fertility guidelines are due this Spring.Funding decisions for health services in England are made by Integrated Care Boards (ICBs), based on their population’s clinical needs. We expect ICBs to commission fertility services consistent with these new guidelines, ensuring equal access to treatment across England.

What steps he is taking to improve access to specialist care, treatment and medication for a) children and b) people with phenylketonuria.

The Government is committed to improving the lives of those living with rare diseases, such as phenylketonuria, through the UK Rare Diseases Framework. A priority of the framework is improved access to specialist care, treatment, and drugs. In February last year the England 2025 Rare Diseases Action Plan was published, including progress made under this priority, namely: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;introducing two new actions on reforming clinical trial regulations; anddeveloping an operational framework for individualised therapies in the National Health Service.Information about symptoms, medicines, tests and treatments, is provided on the NHS England webpage on phenylketonuria, at the following link:https://www.gov.uk/government/publications/pku-suspected-description-in-brief/phenylketonuria-pku-detailed-informationThe treatment sapropterin is eligible for people with phenylketonuria. Clinical trials suggest that approximately four in 10 people may benefit from sapropterin, improving their quality of life significantly and reducing restrictions on the food they can eat.

What steps he is taking to increase the availability of medication options for bronchiectasis.

The National Institute for Health and Care Excellence (NICE) published guidance in 2019 on antimicrobial prescribing for managing and preventing acute exacerbations of bronchiectasis, sometimes called non-cystic fibrosis. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng117NICE guidelines are based on a thorough assessment of the available evidence and should be taken fully into account by healthcare professionals in the care and treatment of individual patients.NICE makes recommendations for the National Health Service on whether all new licensed medicines should be routinely funded by the NHS based on an assessment of the available evidence. NICE has selected brensocatib for treating non-cystic fibrosis bronchiectasis in people 12 years old and over as a topic for guidance development, and currently expects final guidance to be published by July 2026, subject to it being granted a marketing authorisation by the Medicines and Healthcare products Regulatory Agency. The progress of this appraisal can be followed on NICE’s website, at the following link:https://www.nice.org.uk/guidance/indevelopment/gid-ta11564

What steps his Department is taking to improve the collection of data on triple-negative breast cancer.

Data on triple negative breast cancer for England is collected through the National Disease Registration Service (NDRS). An NDRS Quality Assurance Team is in place to identify, investigate, and monitor data quality issues, with over 130 Quality Assurance reports being run each month as well as quarterly reports to assess the completeness of key data.To drive up the completeness of the data, progesterone receptor status, human epidermal growth factor receptor in situ hybridization status, and oestrogen receptor status are assessed as part of the Cancer Outcomes and Services Data set, which supports national registration.

What steps he is taking to reduce the time taken for occupational therapy a) assessments and b) reassessments.

Integrated care boards are responsible for the commissioning Occupational Therapy services that meet the needs of their local populations. This includes overseeing waiting lists for access to Occupational Therapy services, improve outcomes and deliver best value from the health budget.

What assessment his Department has made of the adequacy of levels of public understanding of winter illness (a) transmission and (b) prevention; and if he will consider a public information campaign on infection prevention, in addition to vaccination programmes.

The UK Health Security Agency (UKHSA) Public Perceptions Tracker provides insight into public attitudes and behaviours in relation to priority public health issues. It is a quarterly online survey, with a sample of approximately 1,000 participants per wave. The sample is representative of the following groups in England: gender identity; age; region; and social grade; interlocked with ethnicity.In addition to vaccine campaigns, the UKHSA runs annual no-cost public information campaigns each winter, focused on promoting infection prevention behaviours. The campaign includes social media content, downloadable digital assets, and stakeholder engagement.The UKHSA produces 'Virus Watch' which includes 60-second expert videos, explanatory infographics, and data summaries. This aims to help people understand which viruses are circulating and take the right actions to protect their health and prevent spread.

What steps he is taking to (a) help reduce delays in continuing healthcare reviews for previously unassessed periods of care and (b) reduce the associated administration.

The Department and NHS England published guidance in 2023 for assessing requests for Previously Unassessed Periods of Care (PUPoC). This guidance sets out how integrated care boards (ICBs) should approach and address PUPoC assessment requests. The guidance is available at the following link:https://www.gov.uk/government/publications/continuing-healthcare-previously-unassessed-periods-of-care/dealing-with-requests-for-assessments-of-previously-unassessed-periods-of-care-from-1-april-2012The guidance states that ICBs should set their own reasonable and proportionate timeframes for responding to requests. It provides best practice examples for how ICBs should complete PUPoC requests, based on the timeframe for the unassessed period of care and the completion of the required application and consent forms. NHS England publishes quarterly statistics relating to the activity of NHS Continuing Healthcare and National Health Service-funded Nursing Care which includes PUPoC data, reporting on the number of cases agreed eligible, both total and per 50,000. This is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/

What assessment he has made of access to specialist endometriosis services for young people aged 17 and under.

We know that girls and women deserve better, which is why we are renewing the Women’s Health Strategy, to assess the progress that has been made so far and to continue progressing delivery while empowering women with information about heavy menstrual bleeding and reproductive health conditions.All hospitals providing specialised care and treatment for endometriosis for patients aged 17 and under must have a paediatric gynaecologist as part of their multi-disciplinary team, who will be a part of the treatment planning and decision-making process. The individual’s parents or a person with parental responsibility must also be involved where applicable. If this is not available, these patients must be referred to a paediatric and adolescent gynaecology service.

What assessment he has made of the adequacy of criteria for (a) parental and (b) professional involvement in decision-making for young people who lack the capacity to make the appropriate decisions to keep themselves safe after they turn 18.

People over the age of 18 years old come under the Mental Capacity Act (MCA) 2005, which has the statutory principle that an individual must be assumed to have capacity unless it is established otherwise. All practicable steps must be taken to help any individual above 18 years old to make a decision by themselves, and if unsuccessful, then all decisions made on their behalf must be in their best interests.On 18 October 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care announced the intention to launch a public consultation on the Liberty Protection Safeguards (LPS) in the first half of 2026. The consultation will cover a revised Code of Practice and will incorporate changes in case law, legislation, and good practice in application of the MCA.The LPS, as introduced by the Mental Capacity (Amendment) Act 2019, aims to deliver greater involvement of families and professionals in providing care to vulnerable people in circumstances that amount to a deprivation of liberty.

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 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.